Menopause

In 2005-2006, about one in 16 babies (6.1%) born in Canadian hospitals
was underweight, weighing less than 2,500 grams (or 5.5 pounds), according to new analysis from the Canadian Institute for Health Information (CIHI). This represents a steady increase
in the rate of low birth weight babies over the past five years, up from 5.7% of hospital births
in 2001-2002. The low birth weight rate had been declining between 1997 and 1999.

“Some babies weighing less than five-and-a-half pounds at birth may have difficulties ahead,” said Caroline Heick, CIHI’s Director of Acute and Ambulatory Care Information Services. “For example, they may face long periods of hospitalization and have an increased risk of lifelong complications. Though the increase seems to mirror U.S. trends, it is very important to continue to monitor these rates in Canada and try to determine why, after years of progress in prenatal care, the number of babies born underweight appears to be rising again.”

CIHI’s new analysis, Giving Birth in Canada: Regional Trends From 2001-2002 to 2005-2006, provides the most up-to-date information on the birthing process in Canada, and shows notable variations in the rates of low birth weight babies across Canada. For example, among the provinces, Prince Edward Island and Manitoba reported the lowest low birth weight rate (5.0% and 5.4% respectively) in 2005-2006, while Alberta and Ontario reported the highest average provincial rates (6.9% and 6.4% respectively). Rates were even higher at the health region level within the provinces, with some regions in Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, and Alberta reporting low birth weight rates of over 7%.

One in four babies delivered by Caesarean section

The number of women giving birth by Caesarean section in Canada steadily increased over
the past five years, climbing from 23% in 2001-2002 to 26% in 2005-2006. This is lower than the rate in the United States and Australia in 2004 (29%), though higher than the rate in England in 2005-2006 (24%). The World Health Organisation (WHO) recommends no more than 15% of all births should involve a Caesarean section.

CIHI’s analysis found that women who had a previous Caesarean-section delivery have an 82% chance of having a repeat Caesarean section, up from 73% in 2001-2002. Women who had a Caesarean section in 2005-2006 were older than women having a vaginal delivery (30.4 years versus 28.7 years).

“Over the past five years, we’ve seen an increase in Caesarean-section rates for birth mothers in all age groups across Canada,” says Heick. “However, we do see wide variation in these rates between provinces. Some literature suggests that changes in obstetrical practice and a low tolerance for fetal risk may be contributing factors.”

At the provincial level, Caesarean-section rates ranged from lows of 21% in Saskatchewan and Manitoba to highs of 30% in Newfoundland and Labrador and British Columbia. Regionally, lows ranged from 18% in Interlake (Manitoba) and 19% in Prince Albert (Saskatchewan) to highs of 34% in the Central Health Region (Newfoundland and Labrador) and 37% in South Vancouver Island (B.C.).

Use of epidurals increasing; assisted deliveries decreasing

Epidural use also increased between 2001-2002 and 2005-2006 in most regions. More
than half (54%) of all women who gave birth vaginally in 2005-2006 were given an epidural, up from 45% of all vaginal births four years earlier. The rate of epidural use varied greatly among regions, as well as among provinces and territories. In 2005-2006, provincial rates ranged from 25% in P.E.I. and 28% in B.C. to 56% in Ontario and 68% in Quebec. Rates in
the territories were generally much lower, at 9.0% in Nunavut, 15% in the Northwest Territories and 32% in the Yukon Territory. Regionally, rates ranged from 9.0% in the Central Health Region (Newfoundland and Labrador) and 10% in North Vancouver Island (B.C.) to 79% in LanaudiГЁre (Quebec) and 78% in Capitale nationale (Quebec).

In contrast to Caesarean-section and epidural rates, overall assisted delivery rates decreased in most regions, from 16% of births in 2000-2001 to 14% of vaginal births in 2005-2006. As an assisted delivery technique, vacuum extraction was used approximately twice as frequently as forceps, with average rates in Canada of 9.8% and 3.7% respectively in 2005-2006. At the provincial level, the lowest overall assisted delivery rates were observed in P.E.I. (6.5%) and Manitoba (8.7%), while the highest were in Newfoundland and Labrador and Alberta (17%). Regionally, lows ranged from 4.5% in Region 6 (Bathurst area) of New Brunswick and 5.4% in the Central Health Region (Manitoba), to highs of 23% in the East Central and Calgary Health Regions in Alberta.

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

cihi

In a letter to leaders of the U.S. House of
Representatives Ways and Means, and Energy and Commerce committees, the
president of the American College of Physicians (ACP) expressed
support for the Children’s Health and Medicare Preotection (CHAMP) Act
of 2007 (H.T. 3162). Representing 124,000 internal medicine physicians
and medical student members, ACP is the largest medical specialty
society in the United States.

David C. Dale, MD, FACP, president of ACP, sent letters to
Representatives Charles Rangel, chair, and Fortney H. “Pete” Stark,
chair of the Health Subcommittee, Committee on Ways and Means. The
letter also was sent to Representatives John D. Dingell, chair, and
Frank Pallone, Jr., chair of the Health Subcommittee, Committee on
Energy and Commerce.

Dr. Dale pointed out that the CHAMP Act will strengthen and expand
access to care for children and seniors by:

— Providing funding to assure continued and expanded coverage for
millions of children from lower-income families through the State
Children’s Health Insurance Program (SCHIP).

— Protecting access to Medicare by funding positive physician
payment updates in 2008 and 2009 instead of allowing devastating cuts to
go into effect. The bill also seeks to improve physician spending
targets by eliminating drugs from the targets, ensuring the new coverage
decisions are incorporated, and supporting the value of primary and
preventive services. The College notes that further legislation will be
needed to avert payment cuts in 2010 and subsequent years and to develop
an effective method for future updates.

— Creating the building blocks for Medicare reforms to improve
quality. The College is particularly pleased that the bill will create
incentives for care coordination by a patient’s personal physician
through a large scale demonstration of the Patient-Centered Medical
Home. ACP also strongly supports provisions to fund research on the
comparative effectiveness of different treatments, to create a process
for identifying procedures that may be incorrectly valued, to improve
geographic equity in payments, and to provide physicians with
confidential data on their practice patterns.

— Helping to reduce smoking rates while provide funding for SCHIP
and Medicare by increasing federal taxes on tobacco products.

— Reducing costly and unfair overpayments to Medicare Advantage
plans and applying these savings to ensuring health care access to
children and seniors.

Dr. Dale completed the letters by commending each of the Congressmen
for their efforts and pledging that ACP will work for enactment of the
Children’s Health and Medicare Protection (CHAMP) Act of 2007 (H.R.
3162).

“It is critical for Congress to vote for health care for children and
seniors,” Dr. Dale concluded.

The American College of Physicians is the nation’s largest medical
specialty organization. Membership is composed of 124,000 internal
medicine physicians (internists) and medical students. Internists
provide the majority of health care to adults in America. Internists
are specialists in adult medicine and provide comprehensive care to
adult patients.

acponline

The Center for Medicare Advocacy, a non-profit, non-partisan organization that works to obtain fair access to Medicare and necessary health care for older people and people with disabilities, commends the House of Representatives for its leadership in protecting and expanding access to health care for Medicare beneficiaries and for children.

“For over 40 years Medicare has provided stable, uniform health care benefits for America’s elders and people with disabilities,” Executive Director Judith Stein states. “The Children’s Health and Medicare Protection Act of 2007 introduced in the House of Representatives will stop efforts to make Medicare a private program run by insurance companies who value profits more than people. This bill would protect the stability and effectiveness of Medicare by helping to preserve the Medicare trust fund and by ensuring that the premiums Medicare beneficiaries pay are not inflated by overpayments to private insurance companies.”

The Bill promotes fiscal responsibility by reducing payments to private Medicare Advantage plans to keep them more in line with payments for people in the traditional Medicare program. It protects Medicare beneficiaries with low-incomes by improving programs that help pay Medicare Part B premiums and improving eligibility requirements for the Part D Low Income Subsidy. The bill increases access to health care providers by ensuring that doctors and rural health care providers are compensated adequately by Medicare.

“Like Medicare, The State Children’s Health Insurance Program – the SCHIP program – has been successful in increasing access to health care for a vulnerable population,” Ms. Stein continues. “We are pleased that the House of Representatives has taken action to protect and improve that program as well. Without excessive payments to private plans, there is plenty of funding to provide access to health care for all generations.”

The Center for Medicare Advocacy wholeheartedly supports The Children’s Health and Medicare Protection Act of 2007, H.R. 3162, introduced on July 24, 2007 by Rep. John D. Dingell (D-MI) and co-sponsored by Rep. Charles B. Rangel (D-NY), Rep. Pete Stark (D-CA), and Rep. Frank Pallone, Jr. (D-NJ).

medicareadvocacy

For infants with a common and potentially serious viral lower respiratory infection called bronchiolitis, a widely used steroid treatment is not effective. A new study co-authored by Dr. Joan Bregstein of the Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center found that steroid treatment did not prevent hospitalization or improve respiratory symptoms for bronchiolitis, the most common cause of infant hospitalization. Bronchiolitis symptoms frequently include fever, runny nose, coughing and wheezing.

The multicenter study, conducted by the Pediatric Emergency Care Applied Research Network (PECARN), is published in the July 26 New England Journal of Medicine.

“Our study shows that treating bronchiolitis with steroids doesn’t work. We hope this study will resolve some of the uncertainty for physicians and families, as we move forward in developing better means of preventing and treating the infection,” says Dr. Bregstein, site principal investigator and emergency medicine pediatrician at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and assistant clinical professor of pediatrics at Columbia University College of Physicians and Surgeons.

Current recommendations suggest that simple supportive care is the best available treatment for bronchiolitis. Researchers note that steroid-based medications still play an important role in other respiratory illnesses of childhood such as asthma and croup. They point out these medications are not the androgenic steroids sometimes abused by athletes, and that the side effects seen with long-term steroid use are not a risk in the short-course treatments used for croup and asthma attacks.

The study compared hospitalization rates for 600 children between the ages of 2 months and 12 months who visited emergency rooms with moderate-to-severe bronchiolitis. Patients were treated with either a dose of dexamethasone (a glucocorticoid form of steroid medication) or a placebo and evaluated after one hour, and again at four hours. The hospital admission rate for both groups was identical at nearly 40 percent. Both groups improved during treatment, but the placebo group did as well as the group treated with active medication. The three-year study was conducted in the emergency departments at 20 hospitals across the United States.

Most children recover from the illness in eight to 15 days. The majority of children hospitalized for bronchiolitis are under 6 months old. Although many children with bronchiolitis have mild infections, and most don’t need hospitalization, children born prematurely or who suffer from heart and lung disease are most at risk for complications.

The study received funding from the Health Resources and Services Administration (HRSA) Emergency Medical Services for Children (EMSC) program. The PECARN network is funded with cooperative agreements from HRSA as part of the EMSC program. The network includes 21 affiliated hospitals and their emergency departments and conducts multi-institutional research in the prevention and management of acute illnesses and injuries in children.

The study was led for PECARN by the University of Utah’s Department of Pediatrics and Primary Children’s Medical Center in Salt Lake City.

Morgan Stanley Children’s Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top six children’s hospitals in the country, Morgan Stanley Children’s Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics — including the most complex neonatal and critical care, and all areas of pediatric subspecialties — in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation’s premier children’s hospitals, Morgan Stanley Children’s Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City’s only hospital dedicated solely to the care of children and the largest provider of children’s health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children’s Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide. For more information, visit nyp.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists and public health professionals at the College of Physicians and Surgeons, the College of Dental Medicine, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions.

cumclumbia.edu

The beginning of the school year is the perfect time to make sure your child has his or her most recent immunization, especially vaccinations that can help prevent meningitis and middle ear infections (otitis media).

Childhood vaccination can stem millions of illnesses and prevent thousands of deaths. While eight out of every ten children in the United States are fully vaccinated, checking your child’s health records is the perfect preparation for the back-to-school time period.

Your child’s academic success is linked to their ability to stay healthy and in school. Nearly 100 percent of American children will suffer from otitis media by the age of five, accounting for over 25 million visits to the doctor’s office each year.

This year, ask your otolaryngologist about what vaccines are appropriate for your child. Depending on your child’s health history, this may include:

The conjugated pneumococcal vaccine

–This shot-administered vaccine prevents diseases caused by seven of the most common types of pneumococcal bacteria. It is safe and effective; the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommended the vaccine for infants and toddlers under the age of five. It protects against serious forms of the disease up to 97 percent of the time, depending on the person. The vaccine’s side effects, which are usually minor and temporary, include some redness, swelling or tenderness from the injection, and a mild fever. Serious side effects, including allergic reactions, are quite rare.

Haemophilus influenzae (NTHi) and Moraxella catarrhalis vaccine

–These protect against two other common bacteria that cause ear and sinus infections, nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis. Recently, the National Institutes of Health has issued a license for the first clinical trials for a nontypeable Haemophilus influenzae (NTHi) vaccine. Vaccines to prevent viral infections like the flu that can eventually lead to ear infections should be considered for children with recurring ear infections. These vaccines are usually administered in the fall.

For more information on vaccines and other health issues affecting their children, parents can head to the American Academy of Otolaryngology-Head and Neck Surgery’s Kids ENT website at
entnet/kidsent/.

About the AAO-HNS

The American Academy of Otolaryngology – Head and Neck Surgery, one of the oldest medical associations in the nation, represents more than 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization’s mission: “Working for the Best Ear, Nose, and Throat Care.”

American Academy of Otolaryngology – Head and Neck Surgery

New research has suggested that people who spend more time in the sun as a child are less likely to develop multiple sclerosis (MS).

Scientists in California have released results of a study involving 70 pairs of identical twins in which one twin had MS while the other did not, which examined their history of sun exposure.

The twins were asked how much time they had spent outdoors on hot and cold days, how much time they had spent on getting a tan, going to the beach, and taking part in team sports. Sun exposure was gauged according to a sun exposure index (SI).

Scientists found a strong connection between a lack of sun exposure and development of MS and discovered that a twin spending more time in the sun as a child was up to 40 per cent less likely to be diagnosed with MS in later life.

Dr Laura Bell, research communications officer at the MS Society, said: “This interesting study highlights the role of sunlight in MS development and supports findings from previous similar studies.

“There are issues involved in accuracy of recall in studies based on self reporting from participants, however the authors do point out that their data was collected when sun exposure was not considered to be an important factor in MS development – meaning participants would be less likely to unintentionally bias their activities,” she said.

The causes of MS are unknown. However, research suggests that a combination of genetic and environmental factors play a role in its development.

If a twin has MS there is a one in three chance the other twin will have MS as its development is not due to genetic susceptibility alone.

It is thought exposure to sunlight could bring about protection against autoimmune disease such as MS by any number of several immunosuppressive mechanisms such as vitamin D production.

Laura added: “Further studies of the pathways by which sun exposure reduces MS risk would be beneficial in determining factors involved in MS development.”

Read more information about vitamins and minerals on the MS Society’s diet and nutrition pages.

mssociety

The Muscular Dystrophy Campaign is inviting nurseries across the UK to organise a Big Buggy Push. The series of fundraising walks, aimed at pre-school children and their carers, plays an important role in the charity’s wider Big Push Week from 15 to 22 September 2007 – a nationwide campaign to raise much needed funds for, and awareness of, the fight against muscle disease.

There are more than 60 cruel and devastating muscle wasting conditions that affect over 30,000 people in the UK, with some forms greatly reducing life expectancy. Duchenne muscular dystrophy is one of the more common forms of muscle disease, the first signs of which occur at nursery age.

The Muscular Dystrophy Campaign is the only national charity providing care and information for children and adults affected by the various types of muscle disease and also funds research to find effective treatments and cures. There have been recent research breakthroughs which bring real hope to families affected by these life-shattering conditions, but this is still just the beginning.

The charity is appealing to day nurseries to help find a cure and support families. Participating nurseries will be entered into a free draw for a magic show and receive free balloons, stickers, Big Push ‘kid’s tattoos’ and T-Shirts for top fundraisers along with fundraising advice and a certificate!

If you know of a nursery that might be interested in organising a sponsored pram and buggy push, or sponsored wobble, toddle and walk, please visit thebigpush.

muscular-dystrophy

In comparison to natural conception, the risks of complications during and post-pregnancy through ART (assisted reproduction techniques) are significantly higher. It is essential that long-term follow-up of children born through ART take place, says an article in this week’s edition of The Lancet .

Dr Alastair Sutcliffe, Institute of Child Health, University College London, UK and Dr Michael Ludwig, Endokrinologikum, Hamburg, Germany, examined data that had been published between 19080-2005 on IVF and intracytoplasmic sperm injection – they used 3,980 articles to compile their analysis. They concentrated mostly on ART single births, as multiple births have their own set of problems.

“In-vitro fertilisation has been done for nearly 30 years; in developed countries at least 1% of births are from ARTs. These children now represent a substantial portion of the population but little is known about their health,” the authors say.

The authors explain that several points should be taken into account when couples are counseled for fertility treatment. The main ART risk is that multiple births may occur. Nevertheless, there are a number of additional risks that come with ART.

Spontaneous abortions are 20-34% more probable among ART couples, compared to those who spontaneously conceived. There could be several reasons for this, among which is the age of the average ART couple – most of them are usually older. Other possible factors include endocrine disorders, organic abnormalities and the extent of ovarian stimulation.

A woman who becomes pregnant as a result of ART has a higher risk that the following occur, when compared to a woman who became pregnant naturally:

– Pre-eclampsia – 55% higher risk
– Still birth – 155% higher risk
– Low birthweight – 70-77%higher risk
– Very low birthweight – 170-200% higher risk
– Small baby for gestational age – 40-60% higher risk

The risk of cerebral palsy in children born to ART couples is also higher, mainly because of the elevated risk of premature birth.

“Some of the risks to children born after ART do not arise as a result of the techniques but from the background biology of the subfertile couple… many unknowns exist about the health of children conceived after ART as they grow, which remain to be fully addressed. Long term follow-up of children born after ART to reproductive age and beyond is necessary,” the authors concluded.

thelancet

The G8 countries, the most powerful economies of the industrial world, have donated $1.5 billion towards to eradication of disease among the poor children of the world. However, only 25% of this money will be spent on vaccine costs, the other 75% will go to profits. In order to save the highest number of lives possible the G8 should really have negotiated the lowest, sustainable non-profit price, according to a Comment in The Lancet this week.

According to Prof. Donald Light, Netherlands Institute for Advanced Study, the contract the G8 countries are using follows the same business model as that used by multinational pharmaceutical companies when selling in rich nations. In the current case, the G8 is planning to purchase a pneumococcal vaccine that is already discovered, and has already been developed for the markets of the developed world. In other words, it is in effect an extra contract – icing on the cake – that should be non-profit to help fight disease among the poorest kids in the world.

“This alternative strategy could be called the Advance Maximum Benefit Commitment (AMBC),” explains Prof. Light.

As the current G8 contract stands, $5.00 to $7.50 will be shelled out for each dose. This, according to Prof. Light’s estimate, is about four times the average cost, including capital and overhead costs for enlarging production facilities. With the AMBC strategy, however, 1.2 billion more children could be helped. He wonders whether developing countries will stand by silently while the G8 pay four times the average sustainable costs of these vaccines.

thelancet

Children living with HIV/AIDS in developing countries need access to specialized antiretroviral drugs and other treatments, Annette Sohn, an assistant professor at the University of California-San Francisco’s pediatric infectious disease division, said on Wednesday at the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney, Australia, AFP/iafrica reports (Sands, AFP/iafrica, 7/25).

Delegates attending the conference, which ends on Wednesday, presented studies and discussed advances in HIV/AIDS prevention and treatment. The conference aims to improve understanding of HIV/AIDS, treatments for the disease and methods to prevent it from spreading worldwide (Kaiser Daily HIV/AIDS Report, 7/24).

According to Sohn, about 780,000 HIV-positive children worldwide need antiretroviral drugs but only 15% have access to them. Sohn urged pharmaceutical companies to focus on designing specialized antiretrovirals for children after a study — which was conducted by NIH’s National Institute of Allergy and Infectious Diseases and found that HIV-positive infants have a greater chance of survival if they are given immediate treatment — was presented at the conference on Wednesday (AFP/iafrica, 7/25).

The NIAID study began in 2005 and was conducted in Cape Town and Soweto, South Africa. It examined 337 infants ages six to 12 weeks and initially aimed to determine whether early antiretroviral drug therapy over a limited time period would postpone HIV progression, Reuters reports. The study found that 96% of infants given immediate drug treatment were alive two years after birth, compared with 84% of the children given treatment later (Perry, Reuters, 7/24). An independent safety and monitoring board in London last month said that the study’s results were so convincing that the study should be changed to allow all the infants to receive treatment and that the early results should be released (Foley, AP/South Florida Sun-Sentinel, 7/25).

Kevin De Cock, director of the HIV/AIDS Department at the World Health Organization, at the conference said the study is “obviously immensely important in its insight into pediatric treatment strategies,” adding, “But the data will need to be looked at more before we really say what the implications are for treatment policy.” Current WHO policy says that drugs should be administered only after children demonstrate signs of a weakening immune system. According to De Cock, “You can’t scale up therapy or provide appropriate treatment to people if they don’t know their HIV status.” He added, “There’s a need across the board to scale up HIV testing” (Foley, Associated Press 7/25).

Comments
“Children with HIV infection frequently show rapid disease progression within the first year of life due to their developing immune system and susceptibility to other serious infections,” NIH Director Elias Zerhouni said Wednesday when releasing the study at the conference. He added, “This is the first randomized clinical trial that shows that infants treated before three months of age will do better than infants who have their treatment delayed.”

Anthony Fauci, director of NIAID, said, “The results of this trial could have significant public health implications worldwide because these findings will cause experts to consider changes in standards of care in many parts of the world” (Reuters, 7/24).

Sohn on Wednesday said, “These findings have implications for guidelines on timing of antiretroviral therapy in early infancy and support the need for enhanced early diagnosis of infants and early effective transition into care.” She added, “Research presented at this and other conferences have increasingly proven that we are waiting too long to treat HIV-positive children” in developing countries. According to Sohn, “Better generic pediatric antiretrovirals that are both potent enough to achieve sustained clinical and virological improvement and have limited long-term metabolic side effects are urgently needed.”

Better diagnostic tools for health care workers working on pediatric HIV also are needed, Sohn added. “We are not identifying more HIV-positive women during pregnancy, and we lack the ability to diagnose their infants, so we don’t know they’re infected until they’re already very sick,” she said, adding, “By that time, it’s often too late to prevent opportunistic infections and maximize the treatment benefits of antiretroviral therapy” (AFP/iafrica, 7/25).

Citric Juice, Microbicide Studies
Roger Short, a reproductive biologist at the University of Melbourne, at the conference Tuesday presented a study that found vaginal douching with citrus juice has no effect on the spread of sexually transmitted infections, including HIV, Australia’s The Age reports (Leung, The Age, 7/24).

Short in 2002 told the Australian Broadcasting Corporation that a “few drops” of lemon or lime juice could protect women from HIV infection and unplanned pregnancies. He said he thought HIV, in addition to sperm, also might be affected by lemon juice because the virus is “extremely susceptible” to acidity. According to Short, laboratory tests, which did not include tests on humans or animals, indicated that the citrus juice killed HIV and sperm (Kaiser Daily HIV/AIDS Report, 10/11/02).

The recent study, conducted in collaboration with clinicians in the U.S. and Nigeria, examined the sexual health of almost 400 commercial sex workers in Jos, Nigeria. About one-fifth used lemon or lime juice to prevent STIs while the others did not. Tests for STIs — including HIV, syphilis and hepatitis B and C — found that there were no statistically significant differences in incidence between the groups, The Age reports. “Unfortunately, [lemon and lime juice] doesn’t appear to have worked” in preventing STIs, Short said (The Age, 7/24).

Also at the conference, Jeremy Paull, a researcher at the Australian pharmaceutical company Starpharma, presented data from recent trials of an experimental microbicide, called VivaGel, that has been found to prevent the sexual transmission of HIV and genital herpes, the AAP/Sydney Morning Herald reports.

According to Paull, recent trials on animals have shown the gel to be between 85% and 100% effective at preventing the transmission of HIV and genital herpes. He added that the active ingredient in the gel is dendrimer, which is a molecule that binds to both viruses and prevents them from infecting healthy cells. Safety trials of the gel are under way among humans, the AAP/Morning Herald reports. According to Paull, the gel will be used by men who apply it before sex with women. Initial data presented at the conference indicate that the gel is safe and well-tolerated by healthy men whether or not they are circumcised (AAP/Sydney Morning Herald, 7/25).

In related news, conference delegates also discussed the risks people living with HIV/AIDS face as their lives are extended by the use of antiretrovirals, Business Day/AllAfrica reports. Physicians speaking at the conference warned that while HIV-positive people are living longer, they face a higher risk of age-related illnesses, including cardiovascular disease, osteoporosis and dementia (Kahn, Business Day/AllAfrica, 7/24).


Kaisernetwork serves as the official webcaster of the IAS conference. Individuals can sign up for a free daily update e-mail and find more information about conference webcasts online.


Video of the session that examines pediatric HIV/AIDS treatment is available online.


PBS’ “The Charlie Rose Show” on Tuesday included a discussion about developments in HIV/AIDS research. Guests on the program included biochemist and Nobel Prize winner Paul Nurse; Seth Berkley, president and founder of the International AIDS Vaccine Initiative; Scott Hammer, a professor of medicine at Columbia University; Peter Kwong of the Vaccine Research Center at NIAID; and Judy Lieberman, director of the Division of AIDS at Harvard Medical School and senior investigator at the CBR Institute for Biomedical Research (Rose, “The Charlie Rose Show,” PBS, 7/24) Video of the segment will be available online later this week.

BMS Launches New Approach to Expanding HIV Treatment Model
Bristol-Myers Squibb at the conference on Monday announced a new approach to expanding its Secure the Future initiative in developing countries. The new approach will replicate the initiative’s HIV/AIDS treatment support programs in conjunction with governments, community groups and other funders. Secure the Future at the conference released a manual on establishing antiretroviral treatment programs that include community support to ensure that HIV-positive people receive assistance at home and in the community, as well as in clinics. The manual includes experiences from Botswana, Lesotho, Namibia, Swaziland and South Africa (BMS release, 7/23).

Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.