News in brief - Dec. 19, 2005

Bird flu fears lead to rise in related spam e-mail - Sinusitis guidelines recommend against quick antibiotic prescribing - Alzheimer's disease and insulin - Stress and healing in marriage

Bird flu fears lead to rise in related spam e-mail

More than 1 million spam e-mail attacks related to avian influenza were blocked during November by anti-junk e-mail service SpamStopsHere, according to a statement issued by the company that administers it, Greenview Data, in Ann Arbor, Mich. This development is believed to be directly linked to the increasing amount of worry about the disease.

"We expect that as media coverage and public concern increases, the bird flu spam problem will get much worse before it gets better," said Mark Adam, SpamStopsHere's technical support director.

The e-mails generally fall into two categories. One includes virus-infected attachments that are purported to contain treatment and prevention information but actually could cause computers to crash or relay spam to others. The second category includes e-mails linking to Web sites claiming to sell antiviral medications.

Public health agencies and medical societies, including the AMA, have urged against stockpiling these drugs.

"The risk of receiving counterfeit, spoiled or even toxic medication is extremely high," said SpamStopsHere CEO Ted Green. "Tamiflu, along with all other prescription drugs, should only be prescribed by licensed physicians and purchased from trusted and reputable sources."

Sinusitis guidelines recommend against quick antibiotic prescribing

Unless symptoms are severe, antibiotics should not be prescribed for sinusitis unless the condition continues for at least 10 days. Radiographs and CT scans also are unnecessary, and a diagnosis should be made based on a history and physical exam of the patient, according to a practice parameter published this month in the Journal of Allergy and Clinical Immunology.

The paper was developed by the American Academy of Allergy, Asthma and Immunology; the American College of Allergy, Asthma and Immunology; and the Joint Council of Allergy, Asthma and Immunology.

"This practice parameter is intended to improve on the diagnosis and management of patients," said Raymond G. Slavin, MD, lead author and chair of the Sinusitis Update Workgroup. "This will result in reduced health care costs and a better quality of life for patients with sinusitis."

The parameter also urges that if the cause is determined to be bacterial, penicillin should not be used because of increasing resistance to that drug. Patients should be referred to a specialist if the condition becomes chronic, and surgery should be considered only after medical therapies have been unsuccessful.

Alzheimer's disease and insulin

Insulin and its receptors drop significantly in the brain during the early stages of Alzheimer's disease, and levels decline progressively as the disease becomes more severe, according to a study in the November Journal of Alzheimer's Disease.

The new findings, the first to look at insulin levels early in the course of the disease, provide further evidence that Alzheimer's is a new type of diabetes, said the researchers from Rhode Island Hospital and Brown Medical School. They had published work earlier this year that focused on the late stages of Alzheimer's.

"Insulin disappears early and dramatically in Alzheimer's disease. And many of the unexplained features of Alzheimer's, such as cell death and tangles in the brain, appear to be linked to abnormalities in insulin signaling," said senior author Suzanne M. de la Monte, MD, MPH, a neuropathologist at Rhode Island Hospital and a professor of pathology at Brown Medical School.

"This demonstrates that the disease is most likely a neuroendocrine disorder or another type of diabetes," she said. "In the most advanced stage of Alzheimer's, insulin receptors were nearly 80% lower than in a normal brain."

Stress and healing in marriage

The stress a typical married couple feels during an ordinary half-hour argument is enough to slow their bodies' ability to heal from wounds by at least one day, according to a study in the December Archives of General Psychiatry.

If the couple's relationship is routinely hostile, the delay in healing can be even longer, said the researchers, Jan-Kiecolt-Glaser, PhD, a professor of psychiatry and psychology at Ohio State University and Ronald Glaser, PhD, professor of molecular virology, immunology and medical genetics, also at Ohio State.

They have been studying how stress can affect human immunity for three decades. "We have enough data now from all of our past studies to basically suggest that hospitals need to modify existing practices in ways that will reduce stress prior to surgery," Dr. Ronald Glaser said.

Meanwhile, a separate study in the November Health Psychology showed that stress can raise a person's LDL cholesterol levels. Researchers from University College in London, England, studied the changes in cholesterol levels of 199 healthy men and women over a three years.

They found that individuals with larger stress responses were three times more likely to also have higher levels of LDL cholesterol.