News in brief - Dec. 5, 2005

HHS unveils updated computer tool for family health histories - Sedatives to treat insomnia in elderly may not be worth associated risks - Certain ovarian tumors might not show cancer, could create therapies - Women's association calls for higher recommended vitamin D intake - Smoking rate not declining rapidly enough to meet public health goals - Less may mean more when physicians advise parents on prevention

HHS unveils updated computer tool for family health histories

A new version of a computerized tool designed to help families gather their health information was unveiled Nov. 15 by U.S. Surgeon General Richard H. Carmona, MD, MPH.

Noting that a detailed family history can predict an individual's risk of cancer, diabetes and heart disease, Dr. Carmona said the new reporting tool, called My Family Health Portrait, can help provide better diagnostic information.

"Even with all the high-tech tests, medicines and procedures available in today's modern health care setting, family health history remains the cornerstone of our efforts to prevent disease and promote personal health," Dr. Carmona said.

The original computer tool, introduced last year, required downloading from the Health and Human Services Web site. The new version is online familyhistory.hhs.gov/.

Sedatives to treat insomnia in elderly may not be worth associated risks

The benefits of using sedating medication, such as over-the-counter antihistamines or prescription benzodiazepines, to treat insomnia may not be worth the risks in patients older than 60, according to a review of the data published last month in the British Medical Journal.

Researchers at the University of Toronto analyzed 24 studies that included a total of more than 2,400 older patients treated for at least five days with these drugs but who were without other psychological comorbidities. The authors found a statistically significant but small improvement in sleep patterns but also found a worrying increase in adverse events, such as dizziness, disorientation, cognitive impairment and falls, which may be clinically relevant for this age group.

"In people over 60, the benefits of these drugs may not justify the increased risk," the authors concluded. They suggested that behavioral therapies may be the way to go for insomnia in this age group.

Certain ovarian tumors might not show cancer, could create therapies

A new study suggests that ovarian tumors classified as serous borderline or low malignant potential, or LMP, are not early precursors in the development of aggressive ovarian cancer but may be part of an entirely different class of tumors.

Also, genes that were identified in the study as being expressed, or active, in these different classes of tumors could help identify targets for more specific diagnostics and therapies to treat the disease. The study appears in the Nov. 15 Cancer Research.

LMP is different than serous high-grade ovarian tumors, which are more aggressive, yet it shares similarities with serous low-grade ovarian tumors, said the researchers. Both serous high-grade and low-grade ovarian tumors are types of invasive ovarian cancer. Whether serous LMP ovarian tumors are types of invasive ovarian cancers has been controversial.

"Patients with serous low-grade or high-grade ovarian tumors currently receive the same treatment, which is surgery followed by chemotherapy," said Michael Birrer, MD, PhD, study leader and head of the Molecular Mechanism Section at the National Cancer Institute. "However, the finding that low-grade tumors are more similar to LMP tumors has significant therapeutic implications."

Women's association calls for higher recommended vitamin D intake

The American Medical Women's Assn. issued recommendations Nov. 17 calling for an increase in the recommended vitamin D intake for men and women to 800 IU to 1,000 IU daily. Current recommendations are 400 IU for men and women ages 51 to 70 and 600 IU for men and women older than 70.

A panel convened by the group also recommended that treatment for optimum bone health be individualized among patients to include a combination of exercise; healthy diet; vitamin D and calcium supplements, and, potentially, prescription medications.

"The recommendations we provided are designed as a guide for primary care physicians and specialists and are sufficient for most patients," said Kimberly Templeton, MD, associate professor of orthopedic surgery at Kansas University Medical Center. "However, some patients may need to obtain serum levels of vitamin D, as determined by their physicians, to ascertain vitamin D adequacy."

Smoking rate not declining rapidly enough to meet public health goals

The rate of cigarette smoking by adults went from 21.6% in 2003 to 20.9% in 2004, but public health officials say the numbers are not declining fast enough to meet the Healthy People 2010 goal of 12%, according to a report published last month in the Morbidity and Mortality Weekly Report.

According to an analysis of National Health Interview Survey data by the Centers for Disease Control and Prevention's Office on Smoking and Health, 81.3% of smokers light up every day, with the remainder smoking regularly but less often. Slightly more than 40% of those who were daily smokers had attempted to quit in the past year, and more than half of people in the United States who had ever been smokers have successfully given up the habit.

"More states need to fully implement comprehensive tobacco prevention and control programs if they are to achieve the Healthy People 2010 objective of reducing smoking prevalence to 12% or less," the authors wrote.

Less may mean more when physicians advise parents on prevention

When physicians focus on fewer health prevention topics when counseling parents of young children, the information is more likely to be remembered, according to a study in the November/December Ambulatory Pediatrics.

Researchers studied more than 800 parents from across the country who brought their children ages 2 to 11 in for a well-child visit. Physicians and parents were surveyed after the appointment about the number of subjects, including child safety topics, discussed. One month later, parents were interviewed about what they remembered. When physicians discussed more than nine topics in a single visit, the recall went down significantly. When the number dipped below four, the amount of information remembered went up.

"The bottom line is that more information is not always better," said Shari Barkin, MD, study leader and associate professor of pediatrics at Wake Forest University Baptist Medical Center in North Carolina.