Study links teens' body image to suicide

CHICAGO, Illinois (AP) -- Suicidal impulses and attempts are much more common in teenagers who think they are too fat or too thin, regardless of how much they actually weigh, a study found.

Using actual body size based on teens' reports of their height and weight, the researchers found that overall, overweight or underweight teens were only slightly more likely than normal-weight teens to have suicidal tendencies.

But teens who perceived themselves at either weight extreme -- very fat or really skinny -- were more than twice as likely as normal-weight teens to attempt or think about suicide.

The study was based on a nationally representative 2001 survey involving 13,601 students in ninth through 12th grade. The findings appear in the June issue of Archives of Pediatrics & Adolescent Medicine, published Monday.

About 19 percent said they had considered suicide in the previous year and about 9 percent said they had attempted it.

About 65 percent of students were in the normal-weight range, but only about 54 percent perceived themselves as "about the right weight." Some thought they weighed too much; others thought they were too thin.

"Suicide ideation was more likely even among students whose perceptions of body size deviated only slightly from 'about the right weight,"' said lead author Danice Eaton, a researcher at the Centers for Disease Control and Prevention.

Because nearly half of the students perceived themselves as too thin or too heavy, "these results suggest that a sizable proportion of students may be at increased risk" for suicide, the researchers said.

Perceptions of being very overweight were linked with an increased risk for suicide attempts among whites. But black and Hispanic students who saw themselves as being very overweight were no more likely to say they had attempted suicide than blacks and Hispanics who thought they were about the right weight.

The link between perceptions of being very underweight and an increased risk for suicide attempts existed for whites, blacks and Hispanics alike.

The study did not determine which came first -- perceptions of extreme weight or suicidal tendencies. But the results suggest that extreme weight perceptions might be a suicide warning sign, the researchers said.

In an accompanying editorial, Dr. Alain Joffe of Johns Hopkins University said widespread media images of perfect bodies might help shape adolescent perceptions of normal.

But he said it is also possible that adolescents who are already concerned with body image pay more attention to media images.

Peru's 'miracle baby' doing well

LIMA, Peru (AP) -- Doctors on Thursday gave the world its first peek at 13-month-old Milagros Cerron since surgery to separate her fused legs in the second such successful operation on record to correct "mermaid syndrome."

Grasping a pink and green plastic toy dog, the bright-eyed baby was alert and tranquil while Dr. Luis Rubio flexed her toes and spoke to her softly.

Rubio on Thursday defended the unprecedented media coverage of Milagros' case after criticism from the regional dean of Peru's medical board that graphically televising her surgery live on Peru's Tuesday night news broadcasts violated medical ethics.

At the end of the 4 1/2 hour operation, Rubio held up the girl's legs in a V-shape for the cameras, displaying the line of stitches extending up from her heels to her inner thighs, and declared the surgery "a true success."

"This is an exceptional case. I don't know if we are going to see another one and the world has a right to be informed," Rubio told The Associated Press on Thursday.

He said that like many poor people in Peru's Andes, Milagros' parents -- young, humble and devoutly religious people -- at first saw her deformity as a punishment from God and had to be convinced that a medical solution existed.

Other babies born with congenital defects are often abandoned to die, Rubio said.

"Those are the beliefs in our Andean communities," he said. "In our Andes, Peruvians who do not have medical information do not know where they can turn to resolve a problem.

"If we do not educate ourselves, inform ourselves through the normal education systems, the press and communications media, we will not advance. What we cannot do is stay with our arms crossed and we are not going to be resigned to our poverty nor our misinformation."

Milagros -- whose name means "miracles" in Spanish -- was born with her legs fused together from her thighs to her ankles inside a seamless sack of skin and fat.

Rubio said Thursday, 28 hours after the operation, that her condition was satisfactory with full blood flow in each of her legs.

"The blood is reaching the tips of her toes with good pressure, constant temperature," he said, adding that the stitches would be removed in 10 days.

Rubio said his medical team hopes Milagros will be able to walk within two years, but cautioned that she will need years of corrective surgery to repair her sexual, digestive and other internal organs.

Among other problems, she has a deformed left kidney and a very small right one located very low in her body and her urinary tract, anus and genitals end in the same opening.

He said Tiffany Yorks, a 16-year-old American girl with the same condition, was the only other known case of surgical correction of the congenital defect, which occurs in one out of every 70,000 births and is almost always fatal within several days.

He said there is a third person living somewhere in Asia with the deformity, also known as "sirenomelia," but that details about the person's identity and circumstances were sketchy.

Milagros' mother, Sara Arauco, 20, said Thursday that her "heart is filled with joy" after her daughter's successful operation.

"I feel really good, seeing her smiling, seeing her playing quietly. She doesn't seem to feel any pain," she said. "I prayed to God that everything would turn out all right and that his blessing would be passed to the hands of the doctors. I have had a lot of faith."

Study: Calcium, Vitamin D may reduce PMS

BOSTON, Massachusetts (AP) -- Women searching for ways to ward off the anxiety and irritability caused by premenstrual syndrome may be able to find answers as nearby as their local supermarket.

A study published Monday finds that a diet rich in calcium and Vitamin D -- available in milk, cheese, yogurt and fortified orange juice -- appears to help women reduce the risk of PMS symptoms.

The findings support earlier research indicating calcium seems to help women cope with PMS. But the new study also suggests that when calcium is combined with enough vitamin D, it may help prevent PMS altogether.

"It seems that women who eat more foods high in calcium and vitamin D have less risk of experiencing PMS," said the study's lead author, Dr. Elizabeth Bertone-Johnson of the University of Massachusetts. "It's very exciting, and could end up being good news for many women out there."

She said, however, that the research is too preliminary to recommend diet changes for women in general and that more thorough studies are needed.

Researchers say women who ate four servings or more a day of a dairy product, including milk, were less likely to develop feelings of anxiety, loneliness, irritability, tearfulness and tension that characterize PMS.

Estimates are that 8 percent to 20 percent of women may have premenstrual syndrome.

The study compared the diets and supplement use over 10 years of 1,057 women, ages 27-44, who were diagnosed with PMS to 1,968 women who didn't have PMS. All the women were part of the large, long-running Nurses Health Study and answered food questionnaires and other health surveys in 1991, 1995 and 1999.

Bertone-Johnson said researchers were able to control for other factors that might affect PMS.

The study, which appears in Monday's Archives of Internal Medicine, was supported by a grant from GlaxoSmithKline, the manufacturer of calcium supplements, as well as grants from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. A co-author, Adrianne Bendich, is an employee of GlaxoSmithKline, but the scientists said the company had no control over the study design or analysis.

Death toll climbs from Ebola-like fever

LUANDA. Angola (Reuters) -- The World Health Organization (WHO) said on Monday that Angola's Marburg fever outbreak was not over as the death toll from the disease climbed.

"We've seen new cases in new municipalities that don't have obvious links to earlier cases of Marburg. We are very concerned about the situation," WHO spokesperson Aphaluck Bhatiasevi told Reuters by phone from northern Uige province, the epicenter of the outbreak.

"We are trying to do as much tracing as possible. But some of the cases we have seen in the last 10 days don't have a clear link to previous cases," she said. "The outbreak is not over."

The death toll in the worst-recorded outbreak from the rare hemorrhagic fever has risen during the past 10 days to 292 -- out of the 336 known cases -- from 277, officials said.

Overcoming cultural barriers remains the biggest obstacle in the battle to contain the Ebola-like disease, Deputy Health Minister Jose Van Dunem said.

"We're working hard on social mobilization in communities in Uige, trying to motivate a change of behavior," Van Dunem told Reuters.

"We have some cultural problems. People think if they don't bathe the dead body then they are not properly putting them to rest," he said in an interview.

The fever is spread by bodily fluids like blood, saliva, tears and sweat. There is no cure.

Experts say protection is essential when dealing with corpses. Bodily fluid secretions increase after death, meaning the corpses of Marburg victims are highly contagious.

Some six traditional healers were among the dead, Van Dunem said. But others had started changing their behavior to protect themselves.

"We are reaching the people in the communities more than before. But it is very challenging because they have a strong culture," he said.

Van Dunem said two Marburg patients being cared for in the isolation unit in Uige hospital could be among the few people known to have survived the disease.

"We've had the two cases there for a week and we're hopeful they're not going to die," he said.

A total of 123 people died in a Marburg epidemic in the neighboring Democratic Republic of Congo in 1998-2000.

Plan to train kids about eating healthy

WASHINGTON (AP) -- Choose food portions no larger than your fist. Eat "go foods" -- like lowfat milk, oatmeal and veggies -- every day and save chips and other "whoa foods" for special occasions.

This advice is part of a new government campaign to use kid-friendly nutrition tips to prevent preteens from getting fat.

Simple training did get 8- to 10-year-olds to eat healthier for three years, concludes the biggest study ever to track the impact of childhood nutrition education. But there's more work to do: Snacks, desserts and pizza still made up an astonishing one-third of those youngsters' diets.

Nevertheless, "kids can learn to take small, positive, healthy steps," said Dr. Elizabeth Nabel, chief of the National Heart, Lung and Blood Institute, which sponsored the research and on Wednesday begins the "We Can!" program to spread the results. "It suggests that kids who learn to eat healthy during their adolescence will continue to eat healthy."

One key: Don't forbid the foods that children find yummy, but teach balance. For example, eating a healthy breakfast is important for staying fit. Unsweetened whole-grain cereal, like oatmeal, is a go-food choice. Prefer waffles or pancakes? Those are "slow foods," perhaps for the weekend. Croissants, doughnuts or sweetened breakfast cereals are "whoa foods," maybe for a holiday or vacation treat.

Getting grade-school children in the habit of drinking lowfat milk instead of whole milk, eating an apple a day, or choosing carrot sticks or raisins as an after-school snack makes them more likely to continue those habits when they're old enough to choose foods on their own, said Northwestern University dietitian Linda Van Horn, who led the new study.

But children must have access to tasty, healthy choices, stressed Van Horn: If only hot dogs are served at the baseball game, that's what they'll eat. Noses turn up when the only vegetable choice at the school lunch program is mushy beans.

Already, the nation has 9 million children ages 6 to 16 who are overweight, according to federal health officials. Overweight children usually grow into overweight adults, at increased risk of heart disease, diabetes, asthma and other disorders -- not to mention the childhood turmoil of being teased and left out of sports and other fun activities.

The new study tracked 595 children, half of whom had received, with their parents, special education on how to make healthier food choices. Three years later, kids who had attended the nutrition classes were eating more "go" foods than their peers in every food group except fruit, Van Horn reports in the June issue of the journal Pediatrics. They also ate fewer "whoa" foods, with one exception: pizza. And for desserts, they were more likely to pick lower-fat options like frozen yogurt.

Still, neither group ate enough fruits or vegetables, and the high amount of daily snacking and pizza was stunning, said Van Horn.

The $2.6 million "We Can!" campaign aims to extend those food lessons -- along with encouraging more physical activity -- to all 8- to 13-year-olds.

It's a two-pronged program. First, more than 35 communities so far have signed up to offer youth and parent education materials, or to offer hands-on activities such as summer camps that teach nutrition and afterschool programs that promise healthy snacks.

Second, a government Web site aimed at parents -- http://wecan.nhlbi.nih.gov -- provides education on ways to fight obesity, including such tips as:

Make it easier to get healthy snacks and harder to get unhealthy ones. Don't keep chips in the house, but keep a bowl of fruit within reach on the kitchen counter. Choose a checkout line without the candy display.

Limit TV or video games to two hours or less a day. Don't just sit and watch -- challenge your children to a jumping-jack contest during commercials.

Go on an after-dinner family walk or bike ride; make outdoor play, or visits to gyms or recreation centers, routine.

Many children live in communities where traffic, distance or crime make outdoor play or getting to a park or gym impossible. The National Institutes of Health is bringing together researchers Wednesday to debate how much a child's environment increases the risk for obesity, and how to help.

Association offers advice on buying insurance

A national association of state insurance regulators is helping to arm service members and their families with information for making wise decisions about insurance needs, and to make it easier to file complaints against agents and companies.

Buying the right kind of insurance is challenging enough under the best of circumstances, but military life brings additional uncertainties and circumstances, according to officials with the National Association of Insurance Commissioners.

The “Insurance Issues for Military Personnel” section on the association’s Web site helps troops assess their needs for different types of insurance.

Their new online brochure “Life Insurance for Military Personnel,” lists questions to consider when thinking about shopping for life insurance and offers information about consumer rights, along with a list of phone numbers for insurance regulators in every U.S. state and territory. It also links to the Pentagon’s list of actions taken by installation commanders against life insurance companies.

The brochure lists “red flags” such as:

• Non-military or former military personnel acting as investment or financial advisors in a group or classroom setting.

• Agents selling without a valid license from a state insurance department.

• Agents selling on base without authorization.

For decades, concerns have been raised about some companies taking advantage of troops by selling them expensive life insurance products they don’t need.

Some state regulators have taken actions, such as Georgia Insurance Commissioner John Oxendine, who in January ordered American Amicable Life Insurance Company of Texas to refund $1.3 million in life insurance premiums to soldiers who were solicited and sold term life insurance policies while they were in a training brigade at Fort Benning, Ga., in 2002.

NAIC developed the resources for military families in conjunction with state insurance departments, the Pentagon, the Department of Labor, and the Better Business Bureau.

Bill aims to create national health insurance market

House Speaker Dennis Hastert endorsed legislation to allow individuals to buy health insurance from any state, regardless of where they live.

The legislation would lower the cost of health insurance by allowing individuals to get around their state's coverage mandates and pick a less-comprehensive plan, says Rep. John Shadegg, R-Ariz., the bill's sponsor.

These mandates add thousands of dollars to the cost of health insurance in some states, bill supporters say.

"Where you live should not determine whether or not you can afford a health insurance policy," says Angela Hunter, federal affairs director for the Council for Affordable Health Insurance.

Shadegg says his bill would "create a national market for health insurance." This additional competition would keep a lid on premiums, he says.

Under the legislation, any insurer that meets the regulatory requirements of its home state could sell in any state.

Senate sponsor Jim DeMint, R-S.C., says the bill is a "great start" toward the day when every individual will have their own "personal, portable and permanent" health insurance. Most people now are covered by employer-based plans.

Hastert, whose support boosts the bill's chances, calls the legislation "one of the more innovative ideas" for the health insurance market.

Online auctioneer eBay agrees. The legislation would allow consumers to go online and find more choices for health insurance just like eBay gives consumers more choices for a whole host of products, company officials say.

The legislation also would help the 400,000 Americans who make a living selling on eBay, says Brian Bieron, the company's senior director of federal government affairs. These individuals now have a tough time finding affordable insurance.

"That is a problem that has to be solved," Bieron says.

Two small business organizations, the National Federation of Independent Business and the Small Business & Entrepreneurship Council, also have endorsed the legislation. So has Golden Rule Insurance Co., which specializes in the individual market.

Fat People, Smokers Should Pay More For Health Insurance

LAVAL, QUE - A majority of Canadian employees surveyed believe people who engage in unhealthy habits should pay more for their healthcare coverage.

In an Ipsos-Reid poll of 1,500 employees with supplementary health programs, 54 per cent said the cost of employee health benefit plans should be higher for employees who smoke, don't exercise or are seriously overweight. The survey was commissioned by Sanofi-Aventis, the world's third-largest pharmaceutical company.

Around 70 per cent of the respondents said that employees who do not smoke should pay less for coverage.

About 63 per cent agreed the government should promote healthy living by providing tax credits or deductions for personal gym memberships or recreational fees.

Almost 70 per cent said they'd be willing to pay a small fee – such as $5 – for some publicly funded services, if the money were invested in services such as home or community care, palliative care or costly drugs.

The survey suggests services people would be willing to pay for include a visit to the emergency room, to the doctor's office, or for a day in the hospital.

First Graders' Behavior Problems Linked to Caffeinated Cola

ATLANTA, May 23-Children who are inattentive, restless, and having difficulty sleeping may be reacting to the caffeinated cola drinks in the school vending machine or the home refrigerator.

First-graders have more behavior problems on the days that they are exposed to caffeinated colas than on the days that they have caffeine-free drinks, according to Chicago investigators who reported today to the American Psychiatric Association meeting here.

The findings may provide a simple answer to some instances of children's hyperactivity, according to principal investigator Alan R. Hirsch, M.D., director of the Smell and Taste Treatment and Research Foundation and an assistant professor of both neurology and psychiatry at Rush Medical College.

"Exposure to caffeinated cola drinks impaired children's learning ability by causing restlessness, hyperactivity, and inattention," he said. "On the days that the children were drinking caffeinated drinks, their Connors scores increased an average of 5.5 points compared to the days that they were only drinking caffeine-free drinks." Dr. Hirsch is the director of the Smell and Taste. The Connors test is a standard screen for attention deficit hyperactivity disorder (ADHD).

Twenty first-grade children, 10 boys and 10 girls, participated in the study. In three-hour time segments that occurred sequentially over a two-week study period, the students consumed up to 12 ounces of either a caffeinated cola drink or a caffeine-free cola drink. The children were given 10 dimes with which they could "buy" repeat servings of their designated drink for the study session after an initial serving of two ounces. At the end of each session, the children's teacher, who did not know the purpose of the study or the type of soda each child consumed, assessed each child's behavior with a modified Connors test.

On the study days, the children consumed an average of 7.55 ounces of caffeine-free cola and 9.45 ounces of caffeinated cola (p = 0.03). On the days without caffeine, the children had an average modified Connors score of 1.55. On the days they drank caffeinated cola, the children had an average score of 7.00 (p = 0.002). Among the individual students, 60% had elevated Connors scores on the caffeine days, while 15% had higher scores on the caffeine-free days (p = 0.008). The remaining 25% had consumed the maximum servings of both types of drinks and were not included in the analysis.

After adjusting for non-caffeine related factors, such as the number of ounces consumed and the amount of sugar in the drinks, the scores were still higher on the caffeine days (p = 0.015).

"Children ages six to 11 years old conservatively drink an average of seven to eight ounces of carbonated soda per day," said Dr. Hirsch. As the findings show, "this can have a substantial impact on children's behavior in school."

"These findings are consistent with prior researchers' results," said David W. Fassler, M.D., in a comment seeking an independent perspective. "Although the sample size is small, the authors demonstrated that behavior difficulties can be caused by caffeinated beverages." Dr. Fassler is a clinical professor at the University of Vermont in Burlington, and a member of the American Psychiatric Association's board of trustees.

"The study shows why it is so important to completely evaluate young children who are having behavioral and emotional problems, and to review the child's dietary habits, including caffeinated beverages, as part of the evaluation," Dr. Fassler said. Although questions about caffeine consumption are typically part of the screen for anxiety disorders, pediatric insomnia, and ADHD, the findings are a reminder not to neglect this part of the evaluation.

Health Watch: Battling Mesothelioma

Ben Swann-KFOX Morning News Anchor/Reporter

Mesothelioma is a rare, but devastating cancer diagnosed in approximately 3,000 people each year in the U.S., mostly in men. Researchers now have encouraging news that a combination of surgery and radiation treatment is extending some patient's lives.

Countless U.S. workers were exposed to asbestos before it was banned in the early 1980s. Two years ago, when his doctors suspected he developed Mesothelioma as a result of being exposed to asbestos, John Ross and his wife Dorothy weren't given many treatment options.

Dorothy Ross-Wife of Cancer Patient: "So few people know about Mesothelioma, really. And it's a deadly disease. It is deadly."

That's when Mr. Ross enrolled in a clinical trial at M. D. Anderson Cancer Center in Houston treating Mesothelioma patients with a combination of surgery followed by intensity modulated radiation therapy or IMRT.

Dr. Craig Stevens-M. D. Anderson Cancer Center: "What we've done here at M. D. Anderson has actually been to develop some treatments that would probably work quite well in early stage disease."

Mesothelioma develops in the lining between the lungs and the chest wall. It can invade the lungs, abdomen and lining of the heart. Surgeons remove the affected lung and nearby tissue and implant titanium clips along the chest wall to mark where tumors were found. The clips are used to create computer-generated images and give doctors more exact targets for radiation therapy. Using IMRT, targeted doses of radiation are delivered only to the areas where the disease is found, sparing nearby organs, such as the lung and heart. In the clinical trial, Dr. Stevens says IMRT following surgery has greatly reduced the number of recurrences.

Dr. Craig Stevens-M. D. Anderson Cancer Center: "This is in contrast with historical series that used surgery alone that has as high as 80% recurrence right in the area where the tumor was originally."

Dr. Stevens reports a 55% three-year survival rate. Typically patients diagnosed with Mesothelioma are only given months to live. Dr. Stevens and his colleagues are continuing their research by now giving patients chemotherapy before surgery to prevent the disease from spreading to other organs.

Now that treatment options are lengthening and improving quality of life for people with Mesothelioma, researchers urge those with previous asbestos exposure to talk with their doctor about screening options.

Koreans Say They Cloned Embryos for Stem Cells

Scientists in South Korea reported making nearly a dozen cloned human embryos that are genetic twins of patients with various medical problems and have isolated from those embryos batches of stem cells with the potential to replace failing tissues in those patients.

The experiments mark a significant advance in therapeutic cloning, the fast-paced but controversial field that aims to make customized heart tissues for heart attack patients, nerves for patients with spinal cord injuries and a host of other laboratory-grown spare parts genetically tailored to the patients who need them.

The single previous claim that stem cells had been derived from a cloned human embryo, reported last year by the same team at Seoul National University's College of Veterinary Medicine, left some scientists doubting the results. Moreover, the process appeared to be hopelessly inefficient, requiring almost 250 human eggs extracted from female donors to get just one cloned embryo with its precious cache of stem cells.

In the new experiments, described in yesterday's online version of the journal Science, the team needed only 17 eggs on average to make each batch of stem cells, which have the capacity to develop into any type of tissue. That means just a single egg-retrieval procedure of the sort used routinely in fertility clinics is now adequate to produce a colony of personalized cells with the potential to treat a wide spectrum of diseases.

If therapeutic cloning can indeed be achieved with the same efficiency as such a widely accepted medical procedure, it would deeply undercut one of the major ethics arguments against it: that it would require egg donations by countless women -- at some risk -- to make enough embryos and stem cells to be medically useful.

"I think this paper will have enormous impact on the political discussion," said Rudolf Jaenisch, a stem cell researcher at the Whitehead Institute for Biomedical Research in Cambridge, Mass.

The report comes at a delicate time in the escalating U.S. battle over funding of embryonic stem cell research. Within the next week, a closely divided House is expected to vote on legislation that would, for the first time, loosen the restrictions that President Bush imposed on federal funding for the field in 2001.

That legislation would not allow funding of cloning research like that done in South Korea -- a kind of research the House has twice voted to ban and which the Senate has deadlocked over for years. Rather, it would facilitate the less contentious use of frozen embryos about to be discarded by fertility clinics.

Unknown at this point is whether the Korean advance will bolster the bill's opponents -- who have painted the legislation as a step down a slippery slope that could lead to cloned babies -- or strengthen the bill's supporters by making the pending bill look relatively modest by comparison and by heightening concerns that the United States is falling behind in one of the hottest arenas of biomedical research.

Several countries, including South Korea, Singapore and Britain, not only support research on unused fertility clinic embryos but also have given their blessings to research on cloned human embryos and promulgated ethics rules for such work.

The new research was led by Woo Suk Hwang, a cow-cloning expert whose recent rise to international fame for his stem cell work has made him somewhat of a folk hero in Korea.

A cloned embryo is made from a single cell -- often a skin cell -- taken from the person or animal to be cloned, which is then fused to an egg from a donor. In the latest experiments, the team started with 185 eggs donated by 18 women. The women underwent a month-long series of hormone shots followed by the extraction of about a dozen ripened eggs from their ovaries. None of the women was paid.

Each egg had its own DNA removed and then was fused to a single skin cell taken from one of 11 patients. The patients, ages 2 to 56, had either a spinal cord injury, diabetes or an inborn disease of the immune system.

Of those 185 treated eggs, 31 grew into early embryos in laboratory dishes. The team was able to extract stem cells from 11 of them. Each of the resulting colonies of stem cells is a genetic and immunological match to the patient who supplied the original skin cell.

The overall efficiency was 11 self-perpetuating colonies -- or cell lines -- from 185 eggs, or about one cell line for every 17 eggs. But the procedure was even more efficient with eggs from the youngest donors. For eggs retrieved from women under age 30, one cell line was obtained for every 14 eggs.

In another major advance, the Koreans said they are cultivating the stem cell lines in dishes without any animal cells. Virtually all other human embryonic stem cell lines to date have been grown for at least a while on mouse cells, which secrete a cocktail of hormones that support the growth of finicky stem cells.

By growing the stem cells on a bed of human support cells instead of mouse cells, the team does not have to worry that animal viruses or other contaminants may prevent transplantation of the stem cells, or tissue grown from them, into patients -- the ultimate goal.

"We want to find a way to cure devastating diseases, and one of the big points of our research is patients [now] have immune-matched, cloned, embryonic stem cells," Hwang said in a telephone interview.

The team is now working to transform the cells into various kinds of tissues -- a process at which scientists are becoming increasingly adept -- but has no current plans to put them into patients, Hwang said.

Several experts said they were extremely impressed and predicted that the first therapeutic cloning treatment would come more quickly than they had imagined.

"They have increased the efficiency tenfold over what their paper was a year ago, and this is very important," said John Gearhart, a stem cell researcher at Johns Hopkins University. "It's kind of remarkable. It tells you how quickly things are moving."

Judy Norsigian of the Boston Women's Health Book Collective, who supports stem cell research but has warned against therapeutic cloning's potential to exploit egg donors, said she was relieved that the process would need fewer eggs but still had concerns because the ovarian stimulation used to mass-produce the eggs can lead to complications.

"Young women would still be providing eggs to treat men, children and older women. We need to make sure that those women aren't put at unnecessary risk," she said.

Others voiced greater concerns.

"You're placing the woman at risk to create an embryo that has a 100 percent risk of death, to attempt to treat patients who themselves will face significant risks," said Richard Doerflinger, deputy director of the Secretariat for Pro-Life Activities of the U.S. Conference of Catholic Bishops.

"To say something was initially impossible but is now possible is not enough," Doerflinger said. "We have to make moral decisions about whether we should do this."

Money can't buy happiness -- just ask geriatrician

ORLANDO, Florida -- Dr. David Reuben is the anti-Peter Pan.

Peter urged his followers to "never grow up." Reuben is in the business of helping people grow old.

He is a geriatrician, a physician who is specially trained to care for the elderly.

When the specialty was founded three decades ago, caring for elderly usually meant caring for patients who were over 65.

"But that has changed as aging has changed," says Reuben, who is president of the American Geriatrics Society, which just held its annual meeting in Orlando.

Today most people in their 60s are healthy, active and -- increasingly -- not yet retired individuals who receive their medical care from family physicians and other primary care doctors.

Typically Reuben's patients come to him when they are beginning to show signs of the diseases of aging --memory loss, dementia, and a mixed bag of chronic diseases that often worsen with age. These include heart disease, arthritis, chronic obstructive lung disease and diabetes.

In general, they are patients "on the other end of life," Reuben says.

As he talks about his work as chief of the division of geriatrics at the University of California at Los Angeles, Reuben often becomes caught up in the emotion of his patients' stories.

He laughs as he recalls stories from a woman who was involved in Hollywood glamour from the 1920s through the era of movie musicals in the 1940s and 1950s.

He is clearly torn up as he relates "awful" stories of patients who "died without dignity."

A compact, tanned 53, Reuben doesn't come across as a physician who spends much of his time in the company of 80- and 90-year-olds. But, as he says, "I love it. I've learned from every one of my patients."

One patient in particular, Freda Sandrich, taught him about a "polished death."

Now, he says, "my goal is to help every patient achieve a polished death -- a death that is dignified, where the patient is in control, a death that is orchestrated so as to be painless, dignified and respectful."

Freda Sandrich became Reuben's patient when she was 98. "She lived in an apartment in West Los Angeles," he says. "Since this is California -- where almost no one is a native -- I always ask new patients how long they have lived here.

"She told me she moved to Los Angeles from New Jersey -- in 1925. She came here to get married, and her husband was once a movie director, one of the very few who made the transition from silent films to talkies."

Teaching medical students

So, one of the joys of being Sandrich's doctor was "hearing all these wonderful stories about people like George and Ira Gershwin, Cole Porter, Irving Berlin Ginger Rogers, Fred Astaire," he says. "These were the people who were her friends."

When Sandrich came to him, she was still "sharp as a tack," with a "wonderful sense of humor and great dignity. She was beginning to have some disability, but she was very good at covering it up," Reuben says.

Every year, Reuben asked Sandrich to put in an appearance "when I was teaching medical students. I wanted them to find out what someone in their 90s was like," he says.

Sandrich faithfully made her medical school visits every year until she died at age 103.

My goal is to help every patient achieve a polished death -- a death that is dignified, where the patient is in control, a death that is orchestrated so as to be painless, dignified and respectful. -- Dr. David Reuben

Now medical students and residents are still enjoying her annual visits because "I made a movie about Freda Sandrich. We videotaped all of her annual visits, and it is very interesting for me to watch that movie because I can see the differences -- the decline -- from year to year," Reuben says.

Reuben says his job satisfaction is fairly typical of geriatricians, a specialty that likes to promote itself as the one with the "highest job satisfaction."

That claim is backed up by a survey published in 2002 in the Archives of Internal Medicine in which "practicing geriatricians reported unusually high job satisfaction," even though they were, and remain still, the lowest paid of all specialties.

At the mention of income, Reuben shakes his head.

"We like the work we do, but for most geriatricians it is economically difficult," he says. "My situation is unique: I teach, I do research and I care for patients one day a week.

"If I had to make a living just by seeing patients, I don't think I could do it. I could do it mentally, but I don't think I could do it financially.

"It's a tragedy. These [geriatricians] are the people with the biggest hearts. They love their patients and they want to do the right thing -- but it costs them economically to do their jobs," he says.

That cost, Reuben says, is probably why so few doctors chose geriatrics as a specialty.

Last year fewer than 300 physicians entered geriatric training programs, which is especially disturbing, "because we only have about one geriatrician for every 5,000 elderly Americans."

When boomers grow old

That means a geriatrician gap of about 14,000 in 2005 and an anticipated gap of 36,000 by 2030 -- when the last of the baby boomers turns 65.

Those figures prompted the American Society of Geriatrics to issue a special report called "Caring for Older Americans: The Future of Geriatric Medicine."

As expected, the report makes a case for more money for geriatricians, but since, as Reuben says, "you can't just demand more money," the report also suggests ways to turn geriatricians into multi-tasking doctors who teach "geriatric approach" to all physicians that treat older patients.

The report also proposes that geriatricians enlist the aid of patients in a lobbying effort to change Medicare payment rules so that geriatricians will get a pay raise.

But Reuben doesn't expect immediate changes. Geriatrics, he says, has taught him patience.

Using foster kids in experiments scrutinized

WASHINGTON (AP) -- Standards for enlisting foster children in federal medical experiments vary widely among the states, and the Bush administration is examining how best to protect "the most vulnerable in our population," a top government health official says.

"Foster children are certainly vulnerable and failing to protect them will not be tolerated," Health and Human Services Deputy Assistant Secretary Donald Young said in testimony prepared for delivery Wednesday to a congressional panel investigating the use of foster children in federal research.

The House Ways and Means human resources subcommittee called the hearing to examine the practice after The Associated Press reported earlier this month that federally funded researchers had tested AIDS drugs on hundreds of foster children since the late 1980s, often without providing independent advocates to safeguard the children's interests.

Young said his agency began surveying states and found a wide variance in how and when permission is given to enlist foster children in research.

"Information gathered from several state foster care agencies suggests that authority to provide permission for other than standard medical treatment typically lies either with the judge supervising the foster care case, with a senior official within the foster care agency or with a guardian" appointed by the court, he explained.

"Some states continue to preclude the enrollment of foster children in experimental trials altogether, or will provide permission on behalf of the child only if the biological parents also give permission for the child's participation."

Nonetheless, the administration believes drug testing on children is "essential" to ensure the best medicines for children suffering from ailments like AIDS reach the marketplace and that current federal regulations, if followed, offer adequate protections, he said.

"We also recognize, however, the importance of continued vigilance to ensure the regulations are adhered to by investigators and the IRBs (institutional review boards) that oversee their activities," he testified.

Dr. Alan R. Fleischman, a top medical ethicist, told the panel he believed research on foster children can be conducted safely and ethically and that it would have been wrong to exclude foster kids outright from AIDS drug testing during the height of the U.S. AIDS crisis in the 1990s.

"The only way to provide the best treatment to any child with HIV at that time was through the clinical trials -- the drugs were just not available any other way," he told the panel in prepared testimony.

AP reported that researchers and the review boards that supervised their work often did not provide independent advocates for the foster children enlisted in AIDS drug trials, even in cases where they had signed agreements in New York and Illinois promising to do so in exchange for gaining access to the child wards.

Federal law also requires the appointment of such advocates in studies where there is a greater than minimal risk and the benefits to the patient aren't as certain as current treatments in the marketplace.

Marjorie A. Speers, executive director of the Association for the Accreditation of Human Research Protections Programs, told the panel in her prepared testimony that the use of foster wards presents "special ethical dilemmas" to the review boards that oversee federal studies.

The boards "must make specific determinations regarding the level of risk involved in a proposed study and whether there is a prospect of direct benefit to the individual subjects," she explained.

"These determinations are not easy to make because IRBs must interpret regulatory terms, such as 'minimal risk' or 'minor increase over minimal risk,' she added.

It is those concerns that led several states to decline enrolling foster children for medical experiments.

Roberta Harris, a top Wisconsin health official, told the panel that her state has declined to enroll foster children in medical experiments for several reasons, including a desire to protect the mostly poor, disadvantaged families in the system from "giving consent under duress."

"The types of research that have unfortunately occurred in our nation in the past also make it difficult for us to earn the trust and confidence of the families we are seeking to help," Harris' prepared testimony added.

Peanut allergy can be deadly

BALTIMORE, Maryland (CNN) -- Peanuts are as American as baseball -- Americans ate nearly 1.7 billion pounds of them last year, according to the Georgia Peanut Council.

But for those with peanut allergies, even 1/1,000 of a peanut can cause a severe reaction.

The chicken that 15-year-old Robert Bigelow Rubin chose at a bar mitzvah because he thought it was safe was prepared with peanut oil. His night ended in the emergency room.

"I couldn't breathe, and then I started wheezing, and then they called 911," he said.

Food allergic reactions cause an estimated 30,000 emergency room visits and kill 150 to 200 people a year.

Anaphylaxis, the massive allergic reaction triggered in some sufferers, can also be triggered by bee stings, latex rubber and even vigorous exercise.

According to the Food Allergy and Anaphylaxis Network (FAAN), 11.4 million Americans have food allergies.

Reactions can be triggered by even trace amounts of peanuts.

"There are true risks when ... enough peanut protein is really being disturbed. So if people are cracking open peanuts, especially in a confined space, a waiting area of a restaurant, you could have a very severe reaction because there's enough peanut airborne there," said Dr. Robert Wood of Johns Hopkins University.

At least five U.S. airlines have stopped serving peanuts: American, Delta Shuttle (not all of Delta Airlines), Northwest, United, and US Airways.

A study by FAAN and the Mt. Sinai School of Medicine in New York showed the number of children allergic to peanuts doubled between 1997 and 2002.

Jacqui Corba, 15, had her first reaction when she was 2, even though she wasn't eating peanuts herself.

"I was on an airplane flight with my mom, and she ate peanuts and gave me a kiss on my face, I blew up like all over and I was red."

She also had an anaphylactic reaction at school after a classmate opened a bag of peanuts near her.

Many schools now reserve separate tables where no peanut butter is allowed.

The medical community cannot fully explain the phenomenon. But there are theories.

Noticing that developing countries have almost no allergy led doctors to suspect that our society is too germ-free.

"As a country becomes more developed, allergy rises and rises. And the notion there is that in the more-developed countries, you may be getting less exposure to infections and germs and other things that may stimulate your immune system in a direction other than allergy," Wood said. "The more your immune system is kept busy by exposure to germs and infections early in life, the less time it can devote to things like allergy."

Anne Muñoz-Furlong, head of FAAN, says "Perhaps our homes are too clean -- we've done too much to take away the job of the immune system. We don't have parasites, a lot of the childhood diseases you vaccinate and don't have, so maybe for some people, the immune system is looking for something to do and decides, 'Aha, I don't like milk' or 'I don't like peanuts,'" and the body then attacks the food protein as if it were an enemy invader."

Another theory researchers are looking at is that children are exposed too early to peanuts.

Adding to the confusion is that in countries like Indonesia and Thailand, where peanuts are ubiquitous, there is virtually no peanut allergy, leaving the experts to concede they really don't know for sure why food allergies are on the rise.

Doctors can only prescribe avoidance

For now there is no cure. Doctors can only prescribe strict avoidance. But that's not easy as so many candies might contain traces of peanuts inside.

Brandon Katona, a 13-year-old allergy sufferer, explains "you never know where peanuts ... will show up in anything you eat or touch."

Epinephrine offers treatment for a reaction. Those with serious food allergies carry EpiPens -- epinephrine obtained by prescription that they can inject quickly to the thigh.

Without epinephrine, these reactions can lead to a sudden drop in blood pressure or even death and it can happen fast.

Wood lost three teenage patients who had anaphylactic reactions. One had eaten a baked good, another Chinese food, the third a piece of candy. None had epinephrine available.

"People shouldn't be dying of allergic reactions," he said. "Because if you get epinephrine in a timely way after reactions, we can be very reassuring to our patients that they are not going to have a fatal reaction ... and timely means within a few minutes."

But even experts inadvertently expose themselves.

Wood, who has had a lifelong allergy to peanuts, has rules about what he eats. And he doesn't accept baked goods from others.

But he made what he thought was a safe exception and accepted a homemade cookie from a colleague, another expert on food allergies, who assured him it was safe.

"You know quickly, typically, if you're having an allergic reaction -- you get an immediate sensation in your mouth that you've been exposed to something," Wood said. "So I knew it within seconds, literally."

His colleague had used the same spatula and maybe cookie sheets in making one batch of peanut butter cookies and a second batch of peanut-free cookies that he gave to Wood.

"But that amount of contamination just from a spatula when it comes to peanut allergy, is enough to cause severe reactions," he said.

It took five shots of epinephrine to stop Wood's reaction.

A few minutes isn't always enough

Michelle Risinger, 20, is allergic to peanuts and tree nuts like pistachios. She once ate a cookie in her dorm room she was told had white chocolate chunks, which really turned out to be macadamia nuts.

"Within seconds, my throat started closing. It was tingling. I started to get hot all over. And I went to my desk drawer, used my EpiPen, and I called 911."

Even though she injected herself, the reaction wasn't over.

"As the ambulance was pulling up, my throat started closing again, and by the time we got to the hospital, which was maybe a five minute ride, I was having severe respiratory trouble," she said.

She ended up spending the night in intensive care.

Risinger and a boyfriend had earlier found out about the severity of her allergy the hard way.

"I've had a reaction from kissing once ... he started kissing me, and my lips started tingling, and immediately I was like, 'we have to stop, and I need to take Benadryl.'"

To avoid what literally could be the kiss of death, Risinger gives her dates a choice: It's either peanuts and nuts, or her.

CNN senior medical correspondent Dr. Sanjay Gupta and senior producer Sharona Schwartz contributed to this report.

Consumer Reports rates diets

Weight Watchers, Slim-Fast top ratings

Meetings and shakes trump counting carbs when it comes to long-term weight loss, according to a recent analysis of diets by Consumer Reports magazine.

The publication, best known for rating cars and electronics, put Weight Watchers, with its support group meetings, and Slim-Fast, whose shakes let you opt out of cooking, at the top of the heap.

The ratings were based on pounds lost, nutrition, how easy the diet was to follow and dropout rates after six months and a year.

Though low-carb diets have dominated headlines, the highest marks went to Weight Watchers, which uses weekly meetings to reinforce its decidedly simple philosophy -- eat less and exercise more. After a year, its followers were far more likely to stick with the plan.

Weight Watchers did not, however, earn the strongest scores on weight loss, a distinction that went to second-ranked Slim-Fast, which replaces parts of two meals a day with shakes and bars.

Atkins, which has led the low-carb charge, got good scores for short-term weight loss, but landed at the bottom of the ratings because of poor marks on retention and nutrition.

The report, released in the magazine's June issue, said the Atkins diet calls for too much fat and saturated fat, too few fruits, too little fiber and "might have a negative effect on some dieters' health."

Colette Heimowitz, vice president of education and research at Atkins Nutritionals, criticized the study, saying it focused only on Atkins' weight-loss components, ignoring its more flexible weight maintenance stages.

The magazine's conclusions are based on a review of published clinical research on each diet, and a nutrient and calorie analysis of a week's worth of menus, including how closely they follow federal dietary guidelines.

Heimowitz took issue with the use of the federal guidelines as a way to evaluate the diets, saying those standards are intended for maintaining a healthy weight, not losing fat.

All of the diets reviewed are low enough in calories to produce results, but success relies on sticking to the plan, said Nancy Metcalf, a senior editor at Consumer Reports.

That accounts for the strong showing by Weight Watchers, which backs up a flexible, low-calorie, low-fat approach with weekly motivational meetings, Metcalf said.

"We are not necessarily the fastest kids in town, but we're livable and sustainable, and we feel that's very important," said Karen Miller-Kovach, chief scientist at Weight Watchers.

Slim-Fast, which sells its bars and beverages in grocery and drug stores, was praised for its ease and balanced nutrition. Its retention matched Weight Watchers' during the first six months, but then dropped considerably.

The high-protein "Zone" diet, from a book by Dr. Barry Sears, was the magazine's No. 3 program. Though its followers tended to drop out over time, the diet earned points for having considerably less fat than the Atkins approach.

The fourth-ranked ultra-low-fat, high-fiber vegetarian Ornish diet, from Dr. Dean Ornish, had the worst retention rate, though it had good long-term weight loss and was praised as a treatment for heart disease.

Thomas Wadden, a University of Pennsylvania weight loss expert, said the ratings seem sound, but noted the challenge of making comparisons when some diets involve structured meetings and others are do-it-yourself.

He added that the Atkins diet might have ranked better if weight loss was the only criterion. But Wadden said the magazine rightly considered the overall healthfulness of the diets' approaches.

Four other programs, Internet-based eDiets, Jenny Craig, South Beach and Volumetrics, were included in the review, but not ranked because not enough independent clinical studies had been done on them to allow comparison, the magazine said.

Landmark blood test fuels hope for mesothelioma cure

The world's first blood test for the lung cancer mesothelioma is being launched with the hope it will lead to a cure.

The 700 Australians diagnosed with the disease every year can now have a blood test that detects proteins released by the tumour.

Research team head, Professor Bruce Robinson, says there is no cure for the asbestos-related disease, but early detection and treatment could lead to a breakthrough.

Professor Robinson says the blood test will mean immediate diagnosis and says more money needs to be channelled into research.

He says it is exciting Australia's scientists and clinicians are world leaders in asbestos research, but he says it is also frustrating.

"I think it's kind of hard sometimes to get companies like James Hardie and even the government to realise that hey, there's a chance that we really might be successful in this disease," he said.

"When you think about it, they're all spending billions of dollars in compensation and yet here's a chance - well, I think they are thinking of putting some money into this kind of research, around the country, because for the first time there might be a cure, might save them some money."

Professor Robinson hopes early detection will lead to a breakthrough in finding a cure.

"I think that's one of our main hopes at the moment," he said.

"Sometimes it can take a very long time to diagnose this cancer but if you've got a blood test, it can help you diagnose it straight away, then the possibility exists that you could get in and treat earlier."

Professor Robinson expects the blood test to be available to the public within the next few weeks.

Man who 'inhaled asbestos' as a child dies

A 32-YEAR-OLD man thought to have developed cancer after inhaling asbestos dust from his stepfather’s work overalls when he was a toddler has died after a year-long battle with the disease.

Barry Welch, a father-of-three, is thought to be the youngest person in Britain to suffer from mesothelioma, a rare form of cancer linked to asbestos exposure.

His widow, Claire, said she was "devastated" by his death, which came earlier than doctors had predicted. She said she would carry on with a compensation claim her husband had been pursuing against the company his stepfather, Roger Bugby, had worked for.

"He was a loving, caring man who would do anything for anyone," said Mrs Welch, from Leicester. "He was everything to me. It seems so unfair."

Law firm Irwin Mitchell, which is pursuing a compensation claim for Mr Welch’s widow, said they were now seeking colleagues of his stepfather, who worked as a scaffolder at Kingsnorth power station in Kent during the 1970s.

When Mr Bugby came home from work at Kingsnorth, Mr Welch’s mother, Kate, would brush down his overalls at the family home in Chatham, Kent, each evening, to remove the dust.

Mr Welch, who was diagnosed with the disease in June last year, had been pursuing a claim on the grounds that exposure to the dust, which contained asbestos, as a child made him susceptible to the disease in later life. Children are more susceptible to the rare form of cancer than adults.

He said last year: "I haven’t really come to terms with the fact that I am going to die and leave behind my wife and three children because of this disease.

"It seems so unfair that my life will be cut short even though I never knowingly came into contact or worked with asbestos. I am an innocent victim."

Mrs Welch said her husband wanted to provide for her and his three daughters, Natasha, 11, Samantha, nine, and six-year-old Leticia, after his death.

She said that the speed of the disease had taken the family by surprise.

"He became ill last May," said Mrs Welch. "We thought it was an asthma attack. The doctors didn’t think it was cancer. In fact he asked them and they laughed it off because he was so young. It was in June that he was finally diagnosed.

"Baz kept grasping at other things, thinking it would be OK, but I was devastated. I listened to the doctors a bit closer than he did. There was nothing they could do."

A spokesman for the lobby group Clydeside Action on Asbestos said Mr Welch’s death was a "tragedy".

"It is very unusual for a child to be affected," he said. "Usually it is the wife of the workers. But sadly the disease is set to peak around 2015/2020."

Mesothelioma affects about 2,000 people in the UK each year and kills most victims within a year of diagnosis.

Martyn Hayward, of Irwin Mitchell, said that he would still be seeking compensation for Mr Welch’s family.

"We are still putting together the claim against Mr Bugby’s former scaffolding company," he said.

"We would like to hear from any of Mr Bugby’s colleagues from the time who might have helpful information."