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Too Many Needless Pap Smears?

July 30, 2001|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

As many as 11.6 million American women who have had hysterectomies continue to receive yearly Pap smears to test for cervical cancer--even though they no longer have a cervix, according to researchers from the Centers for Disease Control and Prevention. The tests cost the health care system as much as $505 million per year, money that could be better spent on testing women with an intact cervix who are not now receiving testing, said Dr. Mona Saraiya, a CDC researcher, writing in the August issue of the journal Obstetrics & Gynecology.

About 12.5 million U.S. women have undergone hysterectomies, but only about 10% of them were for cervical cancer or precancerous lesions. Continued Pap smears are essential for such women, Saraiya said. But most women undergo hysterectomies for noncancerous conditions and are at very low risk of developing cervical cancer. Pap tests are unnecessary for such women, she argued.

Stuttering Found to Have Biological Source

Imaging studies of the brain have provided further evidence that stuttering is a physiological problem, not a psychological one. Psychologists once thought that stuttering was the result of an emotional problem, but that viewpoint has been shifting toward a consensus that the disorder has a biological underpinning, just like most other mental problems. An estimated 3 million Americans stutter, 80% of them males.

Dr. Anne Foundas and colleagues at Tulane University in New Orleans used magnetic resonance imaging to study brains of 16 adults with stuttering that began in childhood and persisted into adulthood. They reported in the journal Neurology's August issue that the right and left temporal lobes of the stutterers' brains were larger than normal and that there were more irregularities in the shape of their brains than in those of subjects who spoke normally.

Myelin-Cell Transplants Tested in MS Patient

Researchers at the Yale University School of Medicine have for the first time transplanted myelin-forming cells into the central nervous system of a multiple sclerosis patient in an effort to repair damage from the disease. Myelin is the nerve covering that acts like the insulation on electrical wires to prevent short-circuiting. Myelin in the brain and spinal cord is produced by specialized cells called oligodendrocytes, which are attacked and destroyed in MS. But myelin in nerve cells on the body's periphery is produced by Schwann cells, which are not affected by the disease process.

Dr. Timothy Vollmer and his colleagues isolated Schwann cells from the sural nerve in the ankle of an adult MS patient, then injected the cells into an MS lesion in her brain. They will monitor her for at least six months to determine if the cells survive and if they can produce a new myelin sheath around the damaged nerve.

New Drug Effective in One Form of Leukemia

A specially engineered molecule containing a toxin produced by Pseudomonas bacteria is effective at treating hairy cell leukemia, according to preliminary studies conducted at the National Cancer Institute. Hairy cell leukemia constitutes about 2% of all leukemia cases. Its name comes from the distinctive hair-like filaments on the surface of the bone marrow cells in which the disease develops.

To make the new drug, called BL22, researchers at NCI stripped the Pseudomonas toxin of the segment that allows it to bind to healthy cells, then added an artificial segment that makes it bind to proteins known as CD22, which are abundant on leukemia cells. The molecule then delivers the toxin directly to the malignant cells, killing them.

Dr. Robert Kreitman and his colleagues reported in the July 26 New England Journal of Medicine that they administered BL22 to 16 patients who were resistant to conventional chemotherapy.

Although the trial was only a first-stage safety trial, 11 of the 16 patients had a complete remission after receiving the drug and two had a partial remission.

Vitamin E, Selenium in Prostate Cancer Study

The National Cancer Institute last week began a massive study of prostate cancer prevention that will eventually enroll 32,400 healthy men age 55 or older.

The Selenium and Vitamin E Cancer Prevention Trial, or SELECT, will test whether either of the supplements can prevent the disease, which is the most common form of cancer in men after skin cancer. This year, prostate cancer will be diagnosed in an estimated 198,100 U.S. men and more than 31,500 men are expected to die from it. Information about enrolling in the trial can be obtained online at http://cancer.gov/select or by calling (800) 4-CANCER.

Alcohol Buzz Curbed by Smoking, Study Says

If you are smoking cigarettes, you will have to drink more alcohol than usual to get high, according to researchers at Texas A&M University in College Station. The findings may help explain why people tend to drink more when they are smoking, said Dr. Wei-Jung A. Chen.

Chen and his colleagues reported in the July issue of the journal Alcoholism: Clinical and Experimental Research that nicotine lowers the amount of alcohol in the blood stream.

The cause is not yet known, but the researchers speculated that nicotine induces the alcohol to stay in the stomach longer than normal, so that more of it is broken down by digestive enzymes.

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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.

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