Health & medicine in brief

Compiled from Times wires

© St. Petersburg Times, published April 22, 2001

Computers would predict diseases

Doctors have asked the questions for years. Has anybody in your family had breast cancer? Heart disease? Do you smoke? And what's your weight?

The answers are supposed to help them guess what might afflict patients in the future. But computer programs are being designed to turn a doctor's "say ah" into a data-crunching process that could give patients a more accurate forecast of what diseases they can expect to develop -- and how to treat them.

Called evidence-based predictive modeling, the process combines a patient's personal data -- including age, gender, race, family history, cholesterol -- with data collected from studies of specific diseases to determine a person's likelihood of developing those diseases.

Although not widely in use, the programs are aimed at health-care providers, self-insured employers and pharmaceutical companies looking for more efficient ways to manage and prevent illness.

These types of predictive technologies are not without critics. Some, for example, wonder whether drugmakers will use the reports to urge doctors to prescribe unnecessary preventive medications. Others worry that a patient's personal information could be used by insurers and employers looking to protect themselves from people who are health risks.

"Generating profiles of high-risk individuals, given the almost sieve-like nature of medical information, is almost an invitation to discrimination," says Ronald Green, director of the Ethics Institute at Dartmouth College in Hanover, N.H.

Vaccine could treat virus linked to lung cancer

CHICAGO -- Scientists gathered Friday for a two-day conference to explore the suspected causes and possible treatments for one of the deadliest of human cancers.

For years, doctors were certain that the lethal lung cancer was caused only by exposure to asbestos. In 1994, however, a researcher at the National Institutes of Health discovered genetic material from a monkey virus inside 60 percent of the cancers, called mesotheliomas, that he tested.

Millions of people might have been exposed to the virus, called SV40, through contaminated polio vaccine in the 1950s, and scientists believe the virus, asbestos and genetics can work together to cause the cancer.

Life expectancy for those who get the disease is nine to 15 months, and a cure was unimaginable just a few years ago.

But a vaccine is being developed for the virus, along with potential genetic therapies for those predisposed to the disease. The vaccine might be ready in about a year for tests on humans.

The first case of mesothelioma, which attacks the lungs' lining, was diagnosed in 1946, and few cases were reported until 1960. That number has climbed to 2,000 to 3,000 cases a year.

C-sections on the rise, journals report

C-sections are making a comeback, reversing the course set in the early 1990s, when public health officials campaigned to increase the rate of vaginal births after Caesareans.

C-sections cost more than vaginal deliveries, are thought to carry a higher risk of complications for the mother and require longer hospital stays.

But recent publications in medical journals have pointed out small risks in Caesareans. Those warnings come at a time when medical malpractice premiums are on the rise.

"It is simply not a secret that there are trial lawyers out there and having babies is a big issue," said Marc Volavka, executive director of the Pennsylvania Health Care Cost Containment Council, which issued the Caesarean section report Friday. "In the absence of counter-pressure from the purchaser community, certainly the pressure on doctors not to get sued is going to be there."

Dr. Bruce Flamm, research chairman at Kaiser Permanente Medical Center in Riverside, Calif., said there have always been people who feel too many C-sections are done, and others, not enough.

What's new in the debate, he said, is that more women are requesting them. A few first-time mothers are asking to schedule C-sections rather than attempt a vaginal delivery.

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