News in brief - March 3, 2003

Military reports on first wave of smallpox shots - Stroke test identifies symptoms - Ibuprofen could reduce cardiac benefits of aspirin

Military reports on first wave of smallpox shots

Several notable adverse reactions but no deaths have been recorded in the first wave of smallpox inoculations initiated by the Dept. of Defense in the mid-December 2002, according to statements released in February.

Six people developed "generalized vaccinia," a mild skin rash that can be one of the rare reactions to the shot. Two came down with encephalitis more than a week after being vaccinated. One person developed inflammation of the heart, possibly caused by an infection, and another developed redness in the eye, possibly caused by ocular vaccinia. The role of the smallpox vaccination has not been confirmed in those situations, although the Dept. of Defense Web site suggests that the timing is circumstantial evidence that suggests it may play a part.

All have since recovered.

As of the end of January, the Defense Dept. vaccinated more than 8,000 of its health workers and more than a 100,000 soldiers, essential civilians and contractors connected to military missions.

Three percent required sick leave for an average of a day and a half because of illness connected to the shot. There have been no incidents of inadvertently transferring the vaccinia virus to another.

"Our safety experience with smallpox vaccinations to date is consistent with what we expected overall," said William Winkenwerder Jr., MD, assistant secretary of defense for health affairs.

Stroke test identifies symptoms

A test that takes bystanders less than one minute to complete can accurately identify stroke victims and allow physicians time to speed the delivery of effective treatments, according to a study presented at the American Stroke Assn.'s 28th Internation al Stroke Conference.

The test involves asking the possible victim to try to smile, raise both arms and keep them up and speak a simple sentence coherently.

The study determined that bystanders could correctly administer the three-step test used by professionals and known as the Cincinnati Prehospital Stroke Scale.

"While treating stroke patients may require extensive training and expensive equipment, our study shows that untrained adults can successfully detect stroke symptoms," said Amy S. Hurwitz, a second-year medical student at the University of North Caroli na at Chapel Hill School of Medicine. Jane H. Brice, MD, assistant professor of emergency medicine at the school, designed the study.

Researchers recruited 100 nonpatient visitors to the hospital's emergency department to serve as bystanders and participants in the hospital's stroke support group to serve as victims. The bystanders in the study scored high when detecting arm weakness and slurred speech -- two key symptoms suggesting a patient may have had a stroke.

They were less successful detecting facial weakness, possibly because it is hard to assess a stranger's smile, said the researchers. But if the stroke patient was the bystander's spouse, it's likely the bystander could detect an abrupt change in the qu ality of the smile, they said.

Ibuprofen could reduce cardiac benefits of aspirin

A letter in the Feb. 14 issue of The Lancet suggests that the painkiller ibuprofen could diminish the well-known beneficial effects of aspirin on preventing cardiovascular disease.

Individuals studied by researchers from the University of Dundee in Scotland who were prescribed both aspirin and ibuprofen had about a doubling of risk of death from any cause and around a 75% increased risk of death from cardiovascular disease compar ed with those prescribed aspirin alone.

Researchers from the hospital's medical monitoring unit noted that, although their findings were not conclusive, they do support a developing hypothesis that ibuprofen may reduce the benefits of aspirin in people with cardiovascular disease.

They had studied 7,107 patients with cardiovascular disease who were discharged from the hospital and who were taking low-dose aspirin. Within that group they compared the death rate of those patients taking prescribed aspirin alone with those taking p rescribed aspirin and ibuprofen.