Air Quality Improving in Many U.S. Cities: Report

HealthDay – 4 hrs ago WEDNESDAY, April 25 (HealthDay News) -- Air quality in America's most polluted cities has improved significantly over the past decade, according to a new report from the American Lung Association.

Even Los Angeles, famous for its morning smog, is the cleanest it's been in 13 years, the association noted. Santa Fe, N.M. leads the pack, having been ranked as the cleanest city in the nation.

Despite progress in reducing the level of smog and soot in the air, the "State of the Air" report warned that unhealthy levels of air pollution still persist around the country.

"'State of the Air' shows that we're making real and steady progress in cutting dangerous pollution from the air we breathe," Charles Connor, president and CEO of the American Lung Association, said in an association news release. "We owe this to the ongoing protection of the Clean Air Act. But despite these improvements, America's air quality standards are woefully outdated, and unhealthy levels of air pollution still exist across the nation, putting the health of millions of Americans at stake."

In rating the air quality in cities and counties around the country, the lung association takes into account the color-coded Air Quality Index developed by the U.S. Environmental Protection Agency (EPA), which alerts the public about unhealthy air conditions. The report, released Wednesday, also used data collected by the EPA from 2008 to 2010 on ozone and particle pollution.

The report found drastic improvements in 18 of the 25 cities most polluted by ozone. Nine out of the top 10 cities most polluted by ozone were in California. Topping the list was Los Angeles, although it showed the lowest smog levels since the report was first published back in 2000.

Particle pollution also dropped significantly in 17 of the 25 most polluted cities, including Los Angeles, Pittsburgh and Cincinnati. This mix of microscopic bits of ash, soot, diesel exhaust, chemicals, metals and aerosols can lead to early death, heart attacks and strokes.

Four cities -- Pittsburgh, San Diego, Philadelphia and Visalia, Calif. -- dropped to their lowest levels of short-term particle pollution on record, the report noted. Birmingham, Ala., Detroit and York, Pa., dropped off the list of the 25 most polluted cities entirely -- a first for all three.

The lung association cautioned that much work remains to be done to improve air quality in the United States. Forty percent of Americans, or 127 million people, live in areas where air pollution poses a threat to their health. These people are at greater risk for wheezing and coughing, asthma attacks, heart attacks, and premature death, the report noted.

Infants, children, seniors and anyone with lung diseases, heart disease or diabetes are most vulnerable to the harmful effects of air pollution. Those with low incomes or jobs that require them to work outside are also at greater risk.

The report revealed that 38.5 percent of Americans live in counties that received an "F" for air quality because of unhealthy levels of ozone air pollution, which can cause chronic health problems. Meanwhile, almost 50 million people in the United States live in counties with unhealthy surges in particle pollution levels. Year-round particle pollution threatens another 6 million Americans.

The standards set under the Clean Air Act are a driving force behind the improvement in air quality in the United States, according to the lung association. The legislation aims to clean up major sources of air pollution such as coal-fired power plants and diesel engines to reduce the amount of ozone and particle pollution in the air. The EPA estimated that cutting air pollution through this measure would prevent at least 230,000 deaths and save $2 trillion annually by 2020.

The report warned, however, that the positive trend in U.S. air quality will not continue if opponents of the Clean Air Act gain the upper hand on Capitol Hill.

"We still need to fulfill the promise of clean, healthy air for everyone, and that can only become a reality through the full implementation of the Clean Air Act. The American Lung Association strongly opposes any efforts to weaken, delay, or undermine the protective standards the law provides," said Connor. "The American Lung Association has been leading the fight for clean air for decades, and we are as determined as ever to give every American the clean air they deserve to breathe every day."

More information

The U.S. Centers for Disease Control and Prevention has more on air pollution.

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Experimental Drug Eases Autistic Behaviors in Mice

HealthDay – 4 hrs ago WEDNESDAY, April 25 (HealthDay News) -- An experimental drug reduced two signature characteristics of autism -- repetitive behavior and abnormal social interactions -- in laboratory mice, new research finds.

The drug, GRN-529, targets glutamate, a major neurotransmitter found throughout the brain that's involved with activating neurons, or brain cells. Researchers believe the compound works through a specific glutamate receptor (mGluR5) and decreases glutamate activity.

Researchers bred mice to have the hallmarks of autism -- including unusual social interactions, impaired communication and repetitive self-grooming -- and injected them with GRN-529.

Almost immediately, the mice showed fewer repetitive behaviors and more normal social interactions, although their communication was still not typical.

"These findings offer encouragement that research focused on developing medicines for core symptoms of autism are gaining momentum," said study co-author Robert Ring, vice president for translational research for Autism Speaks, an autism research and advocacy organization.

Experts caution, however, that although studies in animals can be useful, the results of animal studies often don't hold up in humans.

The study is in the April 25 issue of the journal Science Translational Medicine.

Autism is a neurodevelopmental disorder characterized by problems with social interaction, verbal and nonverbal communication, and restricted interests and behaviors. An estimated one in 88 U.S. children has autism, according to the U.S. Centers for Disease Control and Prevention.

Until recently, experts believed that the core symptoms of neurodevelopmental disorders such as autism and Fragile X syndrome, a genetic disorder that shares many of the same symptoms as autism, couldn't be treated well with medications, because the underlying abnormalities were "hardwired" into the brain during fetal development, according to background information in the study.

But now that dogma is being challenged, said study co-author Daniel Smith, a senior research scientist at Pfizer Worldwide Research and Development.

Studies have suggested that some genes involved with autism play a role in the formation of brain synapses throughout childhood, and even into adulthood. That has led researchers to hunt for compounds that could alter how those genes function.

In Fragile X, for example, research suggests that excessive glutamate signaling may underlie the condition, and clinical trials are already underway by Novartis, Seaside Therapeutics and Roche to test other compounds that inhibit glutamate activity, Ring said.

"Because Fragile X symptoms overlap with autism symptoms, we hypothesized this same mechanism might affect autism patients from populations other than Fragile X," Smith said.

In an accompanying journal editorial, Baltazar Gomez-Mancilla, executive director of translational medicine neuroscience at Novartis, wrote that GRN-529 reduced repetitive behavior and partially reversed lack of sociability in a mouse model of autism.

And yet this is only "early stage, preclinical research" that will help advance the understanding of molecular mechanisms involving the mGluR5 receptor and generate more avenues for research, Gomez-Mancilla said.

"It is too early to speculate as to whether or not autism spectrum disorders can be reversed by small molecules," Gomez-Mancilla said.

Gomez-Mancilla wrote that this trial and previous work onmGluR5 inhibitors support further clinical trials. If the trials show the drugs are effective, a major question would be whether children should receive the drugs when diagnosed or if adults would also benefit.

Dr. Jeremy Veenstra-VanderWeele, an assistant professor of psychiatry, pediatrics and pharmacology at Vanderbilt University in Nashville, Tenn., said other considerations exist. Mice don't have to learn much throughout their lifetimes to engage in normal mouse activities, whereas "humans need to learn a ton in order to function typically in a social setting," he said. "We don't know how well interventions that normalize social interest at a defined point in time will impact actual social function."

Still, he added, this line of research is very promising.

"There are now multiple clinical trials underway of mGluR5 antagonists inindividuals with Fragile X syndrome," Veenstra-VanderWeele said. "Many of us hope that these medications will help not only those who have autism spectrum disorder due to Fragile X syndrome but some people within the larger group of those with

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Leaded Gas Exposure Linked to Later Violence: Study

HealthDay – 4 hrs ago WEDNESDAY, April 25 (HealthDay News) -- Urban areas contaminated decades ago by airborne lead dust now face an increased incidence of aggravated assault, according to a new study.

The surge in violence is linked to exposure to the lead dust emitted from older vehicles that ran on leaded gasoline, according to the researchers, who say improper handling of lead-based paint could have played a role as well.

"Children are extremely sensitive to lead dust, and lead exposure has latent neuroanatomical effects that severely impact future societal behavior and welfare," said study co-author Howard Mielke, a research professor in the pharmacology department at the Tulane University School of Medicine, in a Tulane news release.

The researchers compared the amount of lead released from 1950 to 1985 in Atlanta, Chicago, Indianapolis, Minneapolis, New Orleans and San Diego.

Exposure to lead dust in the air surged during that time period because of the use of leaded gasoline, the study found. Two decades later, rates of aggravated assault in those cities increased as well. Exposure to lead dust had negative effects on children's behavior as adults, according to the researchers, who said the association held true even after they took other factors into consideration, such as household income and education.

The current rate of aggravated assault rose by almost one-half of a percentage point for every 1 percent increase in tonnages of environmental lead that was released more than two decades earlier, the study found.

"Up to 90 percent of the variation in aggravated assault across the cities is explained by the amount of lead dust released 22 years earlier," Mielke said in the release.

The study is published online, ahead of print publication in the August issue of the journal Environment International.

While the study found an association between lead contamination and future violence, it did not prove a cause-and-effect relationship.

More information

The U.S. Environmental Protection Agency provides more information on lead in dust.

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Poor Sleep Heightens 'Ringing Ear' Disease Symptoms: Study

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Many Who First Misuse Prescription Pills Get Them From Friends, Family: Report

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Heroin Addicts Have Higher Pain Sensitivity, Even During Treatment

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Donor Kidney Re-Used in Second Patient After Failing in First

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Low-Radiation CT Scans Effective at Spotting Appendicitis: Study

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Warnings on Cigarette Packs May Keep Ex-Smokers From Relapse

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Aromatherapy: More Than Just a Pleasant Scent?

HealthDay – 4 hrs ago WEDNESDAY, April 25 (HealthDay News) -- Aromatherapy is beginning to enter the medical mainstream, with groups as diverse as the American Cancer Society and the U.S. Department of Veterans Affairs touting the use of fragrance as a therapy that can complement traditional health care.

There's little evidence to suggest that aromatherapy can directly cure illness, but research has found it can help reduce a wide range of symptoms and side effects in some people.

"Many specific ailments can benefit from aromatherapy blends and treatments," said Monika Meulman, president of the Canadian Federation of Aromatherapists. "For example, insomnia, nausea, headaches and migraines, and aches and pains are often improved with aromatherapy -- just to name a few."

Aromatherapy involves the use of what are called essential oils, which are very potent distillations of the fragrant portions of plant life such as flowers, roots and bark, said Dr. Hal Blatman, medical director of the Blatman Pain Clinic in Cincinnati and a past president of the American Holistic Medical Association.

These oils are either applied topically to the body, through a cream or a soaking bath, for instance, or are inhaled after they've been diffused into the air in a room, Meulman explained.

Researchers believe that the oils trigger smell receptors in the nose, prompting the transmission of chemical messages along nerve pathways to the brain's limbic system, Blatman said. The limbic system is a part of the brain closely associated with moods and emotion.

"It's easy to see smells have an effect on the body," Blatman said. "Smells have deep emotional triggers in people."

Aromatherapists recommend using different oils for different effects. For example:

Lavender and rosemary oil are suggested for relieving muscle tension and anxiety.Peppermint and ginger oil may relieve nausea and help perk up a fatigued person.Eucalyptus oil is considered helpful in treating respiratory ailments -- something known by the legions of kids who've had Vicks VapoRub smoothed onto their chest.

The oils also can be layered on to get a combination of effects, Blatman said.

"There are all kinds of specific conditions and specific remedies," he said. "There are a number of reference books for how to use the oils."

The potential plusses of aromatherapy, however, come with possible drawbacks, too.

For instance, people who decide to pursue aromatherapy on their own need to be careful because the essential oils used are very strong, Meulman and Blatman said. The oils can cause an allergic reaction when touched or inhaled and can prompt an asthma attack in some people.

The quality of essential oils also can change over time.

"Often the oils sitting on the shelf in a health food store are no longer viable -- they break down with time -- and may no longer have active compounds in them," Meulman said. "Many essential oils are only effective for several months to a year. By the time they get to an end user, they have oxidized to the point of not being useful and, in some cases, may be harmful."

People also should be aware that the oils can have an internal effect even if applied to the skin.

"Some essential oils can accumulate in the liver," Meulman said. "For example, eucalyptus is broken down slowly by the body and tends to accumulate in the liver. If used daily in large amounts, within a few weeks a person can experience signs of toxicity due to this buildup."

For these reasons and others, Meulman and her association recommend that people interested in aromatherapy consult with a professional aromatherapist.

"For do-it-yourself use, one can use some oils for ambiance, room spray experiences and other such occasional uses," she said. "For daily aromatherapy use and self-treatment, professional aromatherapist guidance is strongly advised."

More information

The National Association for Holistic Aromatherapy has more on aromatherapy.

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Senate passes postal bill that would end Saturday mail

Reuters – 3 hrs ago (Reuters) - The Senate advanced legislation on Wednesday that would allow the U.S. Postal Service to end Saturday mail after two years as part of efforts to overhaul the mail agency and prevent it from shuttering thousands of facilities next month.

The Postal Service has been losing billions of dollars each year due to the rise of online communications and high labor and other costs. Both houses of Congress have been working for months on legislation to restructure the agency and offer some relief.

The Senate voted 62-37 to pass its bill, which would also let the mail agency use about $11 billion in surplus funds in a retirement account to offer early retirement incentives as a means to reduce its workforce.

But while the bill was sponsored by a bipartisan coalition of senators, it faces a difficult challenge in the Republican-led House of Representatives. Leaders have yet to schedule a full House vote on the leading bill, which differs significantly from the Senate version, even though a committee approved it in October.

"This bill will bring the change that the post office needs to stay alive and serve the people and businesses of our country," Independent Senator Joe Lieberman, one of the Senate bill's sponsors, said before the vote.

"Now we've got to challenge the House" to pass a bill, he told reporters afterward.

The Postal Service lost more than $3 billion last quarter, much of it due to a massive annual payment for future retiree health benefits. Postmaster General Patrick Donahoe has said the agency needs to cut operating costs by $20 billion by 2015, including ending Saturday mail delivery, taking over its health care plan and raising postage rates beyond inflation.

The agency also intends to close thousands of money-losing post offices and hundreds of mail processing facilities.

Postal officials agreed late last year to a moratorium on closings through mid-May to give Congress time to pass legislation. The Senate bill would place some restrictions on which facilities can be closed, requiring the Postal Service to consider factors such as Internet access before closing a post office.

The final version of the bill also forces the Postal Service to keep some post offices open until after November elections to protect by-mail voting and to maintain rural post offices that are more than 10 miles away from another location.

PRESSURE ON HOUSE

The bill's sponsors said after the vote on Wednesday they hope the approaching end of the closings moratorium puts pressure on the House to act on its bill.

The leading House bill, from Republican Representative Darrell Issa, takes a different approach to reform, creating oversight groups to close post offices and cut costs.

"I talked earlier today to Congressman Issa on the House side to encourage him to move the House version of postal reform, which is very different from our approach," Republican Senator Susan Collins told reporters.

Issa, who heads the House Oversight Committee, has criticized the Senate bill for returning the retirement-fund surplus and for restricting the post offices and processing facilities that can be closed.

"Instead of finding savings to help the Postal Service survive, the Senate postal bill has devolved into a special interest spending binge that would actually make things worse," he said in a statement on Wednesday.

Others, including rural-state lawmakers, took the opposite tack, criticizing the Senate for allowing the mail agency to close facilities.

Senator Joe Manchin, a Democrat, offered an amendment that would have extended for two years the moratorium on closings. His amendment failed to obtain the needed 60 votes on Wednesday, and he voted against the final bill.

"Without the inclusion of a two-year moratorium, I will not support the final passage of the Postal Reform bill," Manchin tweeted.

Postal unions had also criticized the bill, with some organizing rallies and asking Twitter followers to tell their senators to vote against the bill.

Fredric Rolando, president of the National Association of Letter Carriers, called the bill "flawed" in a statement on Wednesday and said the group would continue to fight for a postal overhaul that would eliminate the annual retiree health payment and not allow the agency to end thousands of jobs.

(Reporting by Emily Stephenson; editing by Todd Eastham)

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FDA advisers back HeartWare blood pump device

Reuters – 3 hrs ago WASHINGTON (Reuters) - HeartWare International Inc won a U.S. advisory panel's support on Wednesday for its most important product - a blood pump that helps people with severe heart failure.

A panel of outside experts to the Food and Drug Administration voted 9-2 to recommend approval of the mechanical heart-assist device, called the HeartWare ventricular assist device (HVAD). HeartWare shares were halted pending the panel outcome.

The FDA usually follows panel advice, although it is not required to and a final decision is expected later.

Panelists said the device helped save lives, although they expressed doubts about the company's conduct of clinical trials and about missing safety data.

"Overall, this is a novel device for a desperate population, and I hope it will be available soon," said panel member Dr. David Slotwiner, of the Long Island Jewish Medical Center.

Heart failure is a chronic condition with no cure, in which the heart is too weak to pump enough blood to meet the body's needs. In the most severe cases, people may need a heart transplant.

HeartWare's device helps people with failing hearts pump blood while awaiting a transplant. The device is already approved in Europe.

It is estimated that some 50,000 people around the world are candidates for heart transplant, but only some 5,000 patients per year get them.

But reviewers from the FDA said earlier this week they were concerned about device-related clotting rates and stroke. FDA reviewers and outside experts to the agency also said clinical trial results may have missing data, meaning they could over-estimate how well the device works.

"In terms of safety, these data have more holes in them than Swiss cheese," said panel member Dr. Gregory Dehmer, of Texas A&M University.

Panel members called for HeartWare to conduct further safety trials if the FDA approves its device.

If approved, the device will compete with Thoratec Corp's HeartMate II, which has been sold in the United States since 2008. It is currently the only blood pump available to people with heart failure awaiting a transplant.

Thoratec shares fell 1.5 percent in after-market trading.

Many investors have been betting HeartWare's device will eventually eclipse the HeartMate II since it is smaller and takes less time to implant. However, concerns about pump-associated thrombosis, or the formation of blood clots, as well as stroke issues, could hurt market share.

HeartWare said it changed the instructions for doctors using the device to reduce the risk of clots and there was no evidence strokes in clinical trials were linked to its device.

"Each device is going to have its relative strengths and our patients deserve these options," said Dr. Keith Aaronson, a paid consultant for HeartWare and professor of internal medicine at the University of Michigan. "And as a cardiologist treating patients with advanced heart failure, I feel strongly we need to have competition in this field."

(Editing by Gary Hill, Bernard Orr and Andre Grenon)

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