Cholesterol tests aren't as accurate as many people believe, according to a recent issue of the Nutrition Action Healthletter, published by the Center for Science in the Public Interest, a Washington-based nonprofit citizens group.
A single test result could be as much as 15% higher or lower than a person's actual level, the group claims. Agreed Dr. Irving Ackerman, an internist and endocrinologist at Kaiser Permanente, Los Angeles: "Even in the best labs, there's a 10% variation. And cholesterol levels tend to be a little higher in winter than summer. It's not known why."
The best way to contend with such variation, experts say, is to have two or three readings. Ackerman recommends they be spaced a week apart if a physician is attempting to make a diagnosis; others suggest longer between-test intervals.
A pending bill (HR 4325) would tighten regulation of labs that process cholesterol tests, requiring ongoing proficiency testing and governmental oversight.
Late last year a federal panel recommended that Americans age 20 and older have their total cholesterol measured every five years and those with "borderline" results should have the test repeated. Levels of 240 milligrams per deciliter are considered high, 200 to 239 borderline and below 200 desirable.
Genital Warts Treatment
The Food and Drug Administration approved alpha-interferon Monday for the treatment of genital warts, a highly contagious viral disease that is spread sexually and afflicts an estimated 8 million people a year. But a local expert predicts alpha-interferon will prove mainly a last-resort treatment for patients resistant to traditional modes of therapy.
Marketed under the brand name Intron-A by Schering-Plough, Madison, N.J., the drug is already used to treat hairy cell leukemia. Physicians will pay $68 a vial, about enough for the recommended three-week treatment of a single wart, said company spokesman Ronald Asinari, noting that costs to patients will be higher.
In three studies of 192 patients, alpha-interferon--an immune hormore that is produced by the body in small amounts--completely cleared up warts in 42% of patients and resulted in a 75% to 99% reduction for 24% of the patients, said FDA spokesman Brad Stone. Remaining patients had no change or less than a 75% reduction, he added. The drug is injected directly into the wart.
"But," noted Dr. Richard Nalick, a gynecologic oncologist at Good Samaritan Hospital in Los Angeles, "they're talking about warts you can see with the naked eye. The majority (of warts) are invisible."
Nalick believes Intron-A will work best in patients who are immunosuppressed (because alpha-interferon boosts the immune system) and in those who have not responded to traditional therapies such as topical drugs, cauterization (burning to destroy visible warts) and laser surgery.