News in brief - Jan. 20, 2003

Placebo effect evaluated - Gun injuries pose financial burden - Cocaine on the brain - Cancer screenings increase - Menthol cigarette byproducts last longer in the blood stream - Fighting bioterrorism in North Carolina - Teen drug use down

Placebo effect evaluated

The placebo effect may reduce cancer-related pain and increase a patient's appetite, but it won't have any impact on the tumor, according to a study published in the Journal of the National Cancer Institute this month.

Some beneficial effects have long been seen in the placebo arms of clinical trials. Researchers at Princess Margaret Hospital in Toronto reviewed the results of 47 cancer trials to determine exactly what those benefits might be.

In some studies just over a quarter of patients who received placebo reported a reduction in pain. Studies analyzed also found 7% to 17% of patients in the control arm gained weight. But placebos had almost no impact on tumor size, with less than 3% of patients reporting improvement in that area.

Gun injuries pose financial burden

Nearly a third of patients with gun-related injuries do not have health insurance, and firearm injuries are among the leading causes of hospital stays for the uninsured, according to a study in the January American Journal of Preventive Medicine. Hospitalizations due to firearm-related injuries also tend to be longer than for other medical conditions.

Researchers at the Agency for Healthcare Research and Quality analyzed hospital discharge summaries and abstracts from 1997 to illustrate the cost of caring for gun-related injuries, particularly for urban teaching hospitals.

Also, another study published in the Annals of Emergency Medicine this month found that nearly a third of all unintentional shootings are a result of bad handgun design.

Cocaine on the brain

New research strongly suggests that cocaine harms or even kills the brain cells that trigger the "high" that cocaine users feel.

The results are the latest from research involving postmortem brain tissue samples. The findings appeared in this month's American Journal of Psychiatry.

Cancer screenings increase

Use of cancer-screening tests has increased during the past 20 years, according to a review article published in the December 2002 Journal of the National Cancer Institute.

The increase was most marked for mammography, with only 17% of women older than 40 reporting in 1987 that they had had a mammogram in the past two years. By 1998, that number had risen to 67%.

Researchers at the National Cancer Institute analyzed 73 papers that used data from the National Health Interview Survey, a program organized by the National Center for Health Statistics and conducted by the U.S. Census Bureau.

The paper also looked at factors associated with higher rates of screening, finding that higher education and incomes were associated with an increase in the likelihood of being screened. Women with insurance coverage were more likely to have mammograms and Pap smears. Older women were less likely to be screened than younger women. Urbanites were more likely to be screened than those who live in rural areas. Black women had the highest rate of Pap smears. Hispanics were less likely than whites to be screened for colorectal cancer. People who exercised, ate right and didn't smoke were also more likely to take advantage of cancer screening.

Menthol cigarette byproducts last longer in the blood stream

Cotinine, a byproduct of nicotine, lasts longer in the bodily fluids of women who smoke menthol cigarettes than other kinds of tobacco products, according to a study published in Nicotine & Tobacco Research this month.

Researchers at Ohio State University analyzed long-time smokers over a one-week period to uncover factors that could influence the amount of time cigarette byproducts last in the body.

The chemical also lasted longer if women were lean and were not long-time imbibers of alcohol.

Researchers suggest that this study may explain why African-American smokers -- who are more likely to smoke menthols -- have higher levels of cotinine than their Caucasian counterparts, despite usually smoking fewer cigarettes.

Cotinine levels in Caucasian and African-American smokers of menthol cigarettes were similar.

Fighting bioterrorism in North Carolina

The North Carolina Statewide Program for Infection Control and Epidemiology, or SPICE, has developed wall charts with information to help physicians and others recognize victims of possible bioterrorist or chemical attacks.

SPICE developed its bioterrorist wall chart last year and, because of its popularity, introduced a similar chart on chemical terrorism this year.

"Recognition of exposed persons will fall on primary care physicians, emergency room physicians, EMTs and infection-control professionals," said Karen K. Hoffmann, RN, associate director of the University of North Carolina School of Medicine-based SPICE program.

The program is supplying charts free to North Carolina hospitals. Others may purchase copies or download a smaller version of the charts from the Web (www.unc.edu/depts/spice).

Teen drug use down

Results from the federal Monitoring the Future Survey of eighth, 10th and 12th grade students in U.S. schools shows a decrease in the use of marijuana, cigarettes, alcohol and some club drugs from 2001 to 2002, according to the Dept. of Health and Human Services.

The proportion of eighth and 10th graders reporting the use of any illicit drug in the prior 12 months declined significantly from 2001 to 2002, according to the survey. The decrease among eighth graders continued a decline in illicit drug use that began in 1997, but this is the first significant decline among 10th graders since 1998.

In addition to finding an overall decline in drug use, the survey also found the use of Ecstasy showed statistically significant declines for the first time after rising rapidly in recent years.