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Autopsy Survey Detects Many Cancers : AIDS Virus Seen to Mutate Within Patient : The AIDS virus can mutate into separate strains in a patient's semen and blood, suggesting the infection may be craftier and harder to treat than previously thought. The findings challenge the widely held belief that an individual can harbor only one strain of the AIDS virus. The researchers urged the development of drugs that attack blood- and semen-based viruses separately. : The research, to be published in Thursday's issue of the journal AIDS, involved 11 HIV-infected men in North Carolina and Switzerland. Some of those who were treated before the study had AIDS strains that had mutated and developed resistance to antiviral drugs. In most of the volunteers with these resistant viruses, their sperm and blood were found to contain different viral strains.

October 19, 1998

At a time when autopsies are on the decline, a 10-year study of the procedure at one hospital revealed a significant number of cancers that had not been found during the patients' lives, researchers reported in Tuesday's Journal of the American Medical Assn.

Dr. Elizabeth C. Burton and her colleagues at Louisiana State University Medical Center found that 100 patients autopsied there had developed 111 undiagnosed or misdiagnosed cancers. Worse was the finding that cancer was the immediate cause of death for 57 of the 100 patients.

The researchers noted that the medical center serves a mainly indigent population, so malignancies might have been masked by other, more acute problems when the patients were treated. According to the study, autopsy rates have fallen from an estimated 50% in the 1960s to an average of 10% today in teaching hospitals. In community-based hospitals, the rate is as low as 5%, they said.

Milk Allergy Suspected in Child Constipation

Children with chronic constipation may be allergic to cow's milk and may get relief by switching to soy milk, according to a study in Thursday's New England Journal of Medicine. Italian researchers looked at 65 children younger than 6 who were taken to gastrointestinal experts for chronic constipation. All were drinking cow's milk or milk-based infant formula, or eating other dairy products.

The children were fed soy milk for two weeks, then switched to cow's milk for two weeks, or vice versa. Two-thirds of the children improved while drinking soy milk and became constipated when they drank cow's milk. The study included only children for whom there was no other clear cause of constipation.

Brain Stimulus Shows Promise for Parkinson's

Electrical stimulation of the brain can greatly improve the ability of Parkinson's patients to perform everyday tasks, French researchers have found. In many people with advanced Parkinson's, a progressive disease of the nervous system, the standard drug, levodopa, helps only some of the time. Patients alternate between periods of severe disease--when they suffer from tremors, rigid limbs and inability to move--and periods of relief.

The researchers reported in Thursday's New England Journal of Medicine that electrical stimulation to a part of the brain called the subthalamic nucleus produced a 60% improvement in patients' motor skills and ability to perform daily tasks when the medication was not working. The study involved 24 patients.

Report Calls for Routine Prenatal HIV Testing

Prenatal testing for HIV, the virus that causes AIDS, should become routine in the United States because too many children are still being born infected with the virus, according to a new report from the Institute of Medicine in Washington, D.C. Although chemotherapy with AZT sharply reduces transmission of the drug from mother to child, many women do not receive the therapy because they do not know they are HIV-positive. The AZT discovery caused births of HIV-infected babies to plummet 43% between 1992 and 1996, when 1,600 infected babies were born. The government doesn't have more recent figures but says at least 432 babies were diagnosed with full-blown AIDS last year.

Snoring on the Rise in Men, Study Finds

Snoring is on the increase among men, but the prevalence drops after they reach 50 to 60 years old, according to a study of 2,668 Swedish males reported in the October issue of Chest. Researchers from Uppsala University found that the prevalence of snoring among men increased from 15% in 1984 to 20.4% in 1994, with the most important predictors of snoring being smoking and significant weight gain. Among older men, only weight gain was an important predictor of smoking.

Old-Age Illness Linked to Midlife Heart Health

People with a low risk of heart disease in middle age need far less hospital care for any reason when they get old, a study found. The greater the number of heart-disease risk factors in middle age, the higher the Medicare spending on hospital services an average of 23 years later, researchers at Northwestern University Medical School in Chicago reported in Thursday's New England Journal of Medicine.

The risk factors for heart disease are high blood pressure, high cholesterol, smoking, a previous heart attack, diabetes or an abnormal heartbeat.

The study also found that women at low risk for heart disease in middle age cost Medicare less than half as much as women with at least one risk factor. Men with no risk factors cost Medicare one-third less than men with at least one risk factor.

Side Effects Hinder Use of Anti-Fracture Drug

The drug alendronate (Fosamax) has proven very effective at reducing hip and other fractures in women, but many women have quit using it because of gastrointestinal side effects, according to new studies from researchers at Kaiser Permanente in Oakland. Nearly one in three women taking the drug complained of such problems, according to a study in the October Journal of Managed Care Pharmacy. Of that group, 46% discontinued taking the drug within 10 months, citing the gastrointestinal problems as the cause. The researchers also found that 56% of the 812 women they studied did not comply with dosing guidelines for the drug, potentially reducing or eliminating its positive effects on bone density.

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--Compiled by THOMAS H. MAUGH II

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