| General Medicine/Family Medical
U.S. rolls back AIDS drug prevention trial in Botswana
HIV infections by taking a daily pill because too few people are being infected.
There are also problems keeping track of people enrolled in the trial, so it will be adjusted to show instead how well people can stick to the routine, the team at the U.S. Centers for Disease Control and Prevention said.
The trial of 1,200 people was trying to see if people could prevent infection with the AIDS virus if they took a daily pill that combined two HIV drugs. It was using Gilead Sciences Inc's Truvada, a combination of two drugs called tenofovir and emtricitabine.
They did not release the data on how many people in the trial became infected. The researchers also said that there appeared to be no safety concerns with the treatment so far.
The study, called TDF2, is one of several globally looking at the new approach, called pre-exposure prophylaxis, or PrEP. The idea is that a daily low dose of the drugs, which interfere with the ability of the virus to replicate, could also lower the risk of infection.
United States pledges $2.7 billion for Kenya HIV battle
NAIROBI (Reuters) - The United States committed $2.7 billion on Wednesday to help fight HIV infection in Kenya where more than a million people are living with the disease.
The pledge is part of the largest U.S. foreign aid program devoted to a single disease -- the President's Emergency Plan for AIDS Relief -- and has been lauded as a bright spot of former President George W. Bush's tenure.
The money, which is to be dispersed over the next five years, represents a 112 percent increase in funding for the program in Kenya, east Africa's largest economy. It is seen by the United States as an enhancement of a successful program.
"Kenya is now the biggest recipient of this program in the world, more than South Africa," U.S. Ambassador Michael Ranneberger told reporters in Nairobi.
AIDS prevention gel fails in African trials
LONDON (Reuters) - U.S. drug company Endo Pharmaceuticals' gel designed to prevent infection with the AIDS virus was ineffective in trials in Africa, Britain's Medical Research Council (MRC) said on Monday.
The large international trial of vaginal microbicide Pro 2000 in more than 9,000 women in four African countries found no evidence that it reduces the risk of HIV infection.
The result is a setback for the specialty drugmaker, whose shares were hit earlier in the month when U.S. health regulators declined to approve its Aveed drug for low testosterone.
To date, no such gel, known as a microbicide, has been shown to prevent HIV infection and this trial "showed conclusively that Pro 2000 gel was of no added benefit," the council said in a statement.
"This result is disheartening, particularly in light of the results of a smaller trial sponsored by the U.S. National Institutes of Health which suggested that Pro 2000 could reduce the risk of HIV infection by 30 per cent," the council's Sheena McCormack, who led the trial, said in a statement.
WHO: Increased funds show results in malaria battle
LONDON (Reuters) - Increased funding is starting to pay off in the battle against malaria but prevention and treatment must be increased to try to halt the killer disease, the World Health Organization said on Tuesday.
The WHO's World Malaria Report 2009 found "significant progress" in the delivery of mosquito nets and malaria drugs, thanks largely to an increase in funds to $1.7 billion in 2009 from $0.3 billion in 2003. But it said $5 billion more was needed every year to get maximum global impact worldwide.
"The tremendous increase in funding for malaria control is resulting in the rapid scale up of today's control tools," WHO director-general Margaret Chan said in a statement.
"This, in turn, is having a profound effect on health -- especially the health of children in sub-Saharan Africa. In a nutshell, development aid for health is working."
FACTBOX: Key findings of WHO's 2009 malaria report
The report summarizes information received from 108 malaria endemic countries and from other relevant sources.
New vaccine to be critical in wiping out polio: WHO
GENEVA (Reuters) - A new vaccine against polio, being used for the first time on children in Afghanistan this week, will be critical in the drive to eradicate the crippling virus, the World Health Organization said on Tuesday
The bivalent oral polio vaccine, known as bOPV, is made by Europe's biggest drugmaker GlaxoSmithKline, the first of five manufacturers to be licensed, it said.
Some 2.8 million children under the age of five are being inoculated in a three-day campaign which began on Tuesday in the southern and eastern regions of Afghanistan, according to the United Nations health agency.
Because the new vaccine is effective against both types of polio still in circulation, the WHO said: "This will vastly simplify the logistics of vaccination in the conflict-affected parts of this country."
The WHO expects the oral vaccine to be "a critical new tool" in the global eradication initiative and intends to use it on tens of millions of children in India and Nigeria by late January, spokesman Rod Curtis said.
Experts uncover genes that may be linked to leprosy
HONG KONG (Reuters) - Genes may explain why some people are more susceptible than others to leprosy, an extensive study in China published in the New England Journal of Medicine appears to have found.
The study found mutations of seven genes which appear to increase a person's susceptibility to leprosy, which is in sharp contrast to what experts have believed for a long time - that the disease is not congenital, or inherited.
"All along, people thought it was caused (only) by an infectious agent but our study found it is influenced by genetics. If a parent has the disease, it is highly likely that the child will develop the disease," one of the researchers Zhang Furen at the Shandong Provincial Institute of Dermatology and Venereology in northeast China said by telephone.
"What is interesting is that between couples, if one has the disease, the other remains uninfected for decades ... so how can this (strictly) be an infectious disease? Maybe this disease has to do with inheritability."
"What we found was that apart from the infectious agent, there is an internal reason, we found seven (susceptibility) genes ... it may have a lot to do with genetics (inherited susceptibility)," Zhang told Reuters.
Tailored treatment may be best for diabetics
CHICAGO (Reuters) - For many years, diabetes experts assumed that the closer they could get a diabetic patient's blood sugar level to what is considered normal, the better.
But recent studies now suggest that a more tailored treatment approach, taking into account age and other health problems, may be a better way to go to control heart disease.
"How sick a patient is matters and how long they've had diabetes matters," said Dr. Elbert Huang, a clinical and health care policy researcher at the University of Chicago.
"Those are new ideas that no one really ever suspected," Huang said in a telephone interview.
Aggressive treatment strategies that use drugs, diet and exercise to dramatically reduce blood sugar levels have been shown to reduce the risks of diabetic complications such as blindness and kidney disease.
But recent studies looking at whether intensive treatment helps prevent the most deadly complications of diabetes -- heart attacks and strokes -- have been mixed.
A federally sponsored trial called ACCORD was stopped in February 2008 because there were 20 percent more deaths among diabetics with heart problems who got intensive treatment compared to those who were treated more conservatively.
Heart disease to cost U.S $503 billion in 2010: group
WASHINGTON (Reuters) - Cardiovascular disease and stroke will cost the United States an estimated $503.2 billion in 2010, an increase of nearly 6 percent, and many cases could have been prevented, the American Heart Association said on Thursday.
The figure includes both health care costs and lost productivity due to death and disease, according to an update published online in the journal Circulation.
The heart association says obesity and other risk factors, like too little exercise and poor diet, are fueling the expected increase in health care costs associated with heart disease and stroke.
"Current statistical data show Americans to be on average overweight, physically inactive and eating a diet that is too high in calories, sodium, fat and sugar," said Dr. Donald Lloyd-Jones, head of the American Heart Association Statistics Committee.
Patients urged to weigh CT scan risks and benefits
CHICAGO (Reuters) - Patients should not let recent studies showing that exposure to radiation from a CT scan may raise their cancer risk scare them away from getting this type of X-ray when it is needed, radiology specialists said on Tuesday.
A CT scan, also known as computed tomography, gives doctors a view inside the body, often eliminating the need for exploratory surgery. But CT scans involve a much higher radiation dose than conventional X-rays. A chest CT scan exposes the patient to more than 100 times the radiation dose of a typical chest X-ray.
Radiology specialists emphasized that an individual's risk of developing cancer as a result of radiation exposure from a single CT scan is very low, especially when compared to the risk to them from a disease that a CT scan may help identify.
One superbug infection costs hospital $60,000: study
WASHINGTON (Reuters) - A single patient infected with the increasingly common "superbug" known as MRSA can cost a hospital $60,000, U.S. researchers reported Tuesday.
Their study of seven hospitals and health facilities shows that taking action, even expensive action, to fight infections can save money, the researchers at Duke University in North Carolina said.
The study, published in the Public Library of Science journal PLoS ONE, addresses methicillin-resistant Staphylococcus aureus or MRSA infections associated with surgery.
"Our estimates of the financial burden of surgical site infections due to MRSA are unique," Deverick Anderson of Duke University Medical Center and colleagues wrote.
Medical therapy has benefits in neck artery disease
NEW YORK (Reuters Health) - For people found to have a symptomless buildup of plaque in their neck arteries, intensive medical therapy, not surgery, should be tried first, researchers conclude based on a study they conducted.
For these patients, intensive medical therapy, including aggressive control of blood pressure and cholesterol levels, appears to reduce rates of stroke, heart attack, death and need for surgery. It also curbs the risk of tiny blood clots in the brain arteries that can lead to stroke.
These findings are "hugely important in the US," Dr. J. David Spence told Reuters Health, where roughly 70 percent of carotid (neck) artery surgery and stenting are being performed for symptomless plaque buildup. "Our study shows that 95 percent of that activity is inappropriate," Spence said.
Combo drug therapies best for helping smokers quit
NEW YORK (Reuters Health) - Nearly one in five smokers offered help in kicking the habit while visiting their doctor's office for a check-up will make a serious attempt to quit, a new study shows.
And in this "real world" setting, the most effective smoking cessation drug therapy was a combination of bupropion SR (a sustained-release form of Zyban) and nicotine lozenges, Dr. Stevens S. Smith of the University of Wisconsin School of Medicine and Public Health in Madison and colleagues found.
Implanted device has benefits in heart failure
NEW YORK (Reuters Health) - Implanted heart defibrillators may help elderly heart failure patients live longer, a study released today suggests.
Heart failure is a chronic condition in which the heart muscle is weakened and cannot pump blood efficiently enough to meet all the body's needs -- leading to symptoms like fatigue and breathlessness on exertion.
People older than age 65 account for more than 70 percent of heart failure cases, yet they are underrepresented in trials of implantable cardioverter defibrillators, or ICDs, and so the effectiveness of ICDS has not been clearly established for this group.
Dr. Gregg C. Fonarow, from UCLA Medical Center, Los Angeles, and his co-authors addressed this question by analyzing data from 4,685 elderly men and women with heart failure who participated in a heart failure treatment trial.
Hangover impairs judgment in young adults
NEW YORK (Reuters Health) - It's not enough to "sleep it off" after a night of drinking.
According to a study released today, the effects of intoxication last long after the booze is out of the blood, not only leaving a nasty hangover but also slowing reaction times and the ability to concentrate the next morning.
Rhode Island and Massachusetts researchers found that it didn't matter whether the liquor consumed was clear or dark; the level of brain impairment was the same the next morning.
"People will be impaired the morning after - after the alcohol leaves the system," Dr. Damaris Rohsenow of the Brown University Center for Alcohol and Addiction Studies in Providence, Rhode Island noted in a telephone interview with Reuters Health.
Milk thistle may limit liver damage from chemo
NEW YORK (Reuters Health) - An herb used since ancient times to treat liver ailments may help reduce the liver damage caused by some cancer drugs, a study published Monday suggests.
In a study of 50 children undergoing chemotherapy for acute lymphoblastic leukemia (ALL), researchers found that an herb called milk thistle appeared to reduce treatment-related liver inflammation.
H1N1/Seasonal Influenza
Infants' Swine Flu Vaccine Is Recalled as Less Potent
Nearly a million doses of swine flu vaccine for infants may have been slightly less potent than required but should work anyway, federal officials said Tuesday in announcing a recall of the shots.
Recent developments on swine flu with background, analysis, timelines and earlier events from NYTimes.com and Google.
The maker of the vaccine, Sanofi-Aventis, voluntarily recalled 800,000 doses of low-dose, thimerosal-free vaccine in prefilled syringes intended for infants ages 6 months to 35 months, the Centers for Disease Control and Prevention said.
Scientists discover natural flu-fighting proteins
CHICAGO (Reuters) - U.S. researchers have discovered antiviral proteins in cells that naturally fight off influenza infections, a finding that may lead to better ways to make vaccines and protect people against the flu.
They said a family of genes act as cell sentries that guard cells from an invading influenza virus, the team reported on Thursday in the journal Cell.
"This prevents the virus from even getting into the cell," said Stephen Elledge of Harvard Medical School and a Howard Hughes Investigator at Brigham & Women's Hospital.
"It is out there fighting the flu all of the time," Elledge said in a telephone interview.
Elledge and colleagues used a new research technique called RNA interference in which they systematically turned off individual genes and then exposed cells to the flu virus.
Assessment and Thanks as Flu Wave Ebbs in U.S.
WASHINGTON - "And, of course," added Kathleen Sebelius, after summing up the accomplishments of eight months of battling swine flu, "we've taught everyone how to sneeze."
With that, Ms. Sebelius, the health and human services secretary, bent her elbow across her face and sent a delicate imitation of a virus-loaded "kerchoo!" into the sleeve of her quilted Christmas-red jacket.
The nine federal officials leading the fight against the H1N1 flu gathered for a news conference here on Thursday to review the progress made since the virus was spotted in late April and to thank the hundreds of thousands of Americans - including doctors, vaccine plant workers and schoolteachers - who had labored in the effort.
Women's Health
Experimental drug kills breast cancer stem cells
CHICAGO (Reuters) - An experimental drug was effective at killing breast cancer stem cells -- a kind of master cancer cell that resists chemotherapy, U.S. researchers said on Friday.
Studies in animals and women with advanced breast cancer showed the experimental compound MK-0752, under development by Merck & Co Inc, was able to kill off cancer stem cells that linger in the breast after chemotherapy.
Researchers are still trying to understand the role cancer stem cells play in promoting different types of cancer, but many teams think they may explain why so many cancers come back even after treatment with powerful chemotherapy and radiation.
High-dose vitamin C may boost women's cataract risk
NEW YORK (Reuters Health) - Women who take high-dose vitamin C supplements may be increasing their risk of age-related cataracts, hint findings of a Swedish study.
Among nearly 24,600 adult women followed for more than 8 years, those who reported regular or occasional vitamin C supplementation of about 1000 milligrams per serving were about 25 percent more likely than those who did not take supplements to have age-related cataracts removed.
Women who took extra vitamin C for 10 years or longer; or in combination with being 65 years and older, or taking hormone replacement or corticosteroid medications had even greater risk, researchers found.
However, in the American Journal of Clinical Nutrition, Alicja Wolk, of the Karolinska Institutet in Stockholm, and colleagues caution that the apparent association between vitamin C and cataract risk does not involve vitamin C obtained from fruits and vegetables.
Antidepressants may have risks after menopause
NEW YORK (Reuters Health) - Older women who take an antidepressant seem to have a small but noteworthy increased risk of stroke and death compared to older women not on an antidepressant medication, a new study shows.
But given that depression itself is a well-established risk factor for early death, heart disease and other ills, the study's author told Reuters Health, women who need to take these medications shouldn't see the new findings as a reason to quit.
"Women should not stop taking the medications based on this one study," Dr. Jordan W. Smoller of Massachusetts General Hospital in Boston said in an interview. "What our study does is give patients and doctors a little bit more information about the risk-benefit calculation for older women."
Antidepressant use in the US has more than quintupled since the early 1990s, Smoller and his colleagues note in their report in the Archives of Internal Medicine.
Sexual problems common in women with breast cancer
SAN ANTONIO (Reuters Health) - About three-quarters of women with breast cancer report some degree of sexual problems, according to results released at the 32nd Annual San Antonio Breast Cancer Symposium (SABCS).
Surveys have found that anywhere from a quarter to two-thirds of healthy women experience sexual problems. Given that such problems are a known side effect of breast cancer treatments that block hormone activity, researchers wanted to know how often women with breast cancer experienced them.
Dr. Shari B. Goldfarb of Memorial Sloan-Kettering Cancer Center (MSKCC) in New York and colleagues anonymously surveyed more than 500 women with breast cancer of any stage in outpatient clinic waiting areas at MSKCC's Breast Cancer Center and at two community centers.
Men's Health
Sex equally satisfying with circumcised men: study
NEW YORK (Reuters Health) - Women find sex just as pleasurable with circumcised men as with men who are uncircumcised, a new study suggests.
Some experts have speculated that removal of the foreskin might make sex less pleasurable for women. But in the study, conducted in Uganda, the overwhelming majority of women indicated that sex was equally satisfying, if not more so, after their partners were circumcised.
The study, published in the latest issue of BJU International, did not examine the effect of circumcision on male sexual satisfaction. But one of the study's authors, Dr. Ronald H. Gray, told Reuters Health in an email, "We previously reported on this and found no effects on (male sexual) function or satisfaction."
The finding could help curb the spread of HIV/AIDS by allaying widespread concern that women find sex with circumcised men less satisfying. "The finding that circumcision does not adversely affect female satisfaction should increase acceptability of the procedure," said Gray, who is a professor of population and family planning at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
"Mad" honey sends virility-seeking men to the ER
NEW YORK (Reuters Health) - People hoping to boost their sex lives with the help of "mad" honey may find themselves in the emergency room instead, according to a new report.
The honey, produced from the nectar of a particular rhododendron species, has long been linked to food poisoning, with most of the documented cases seen in Turkey. In the country's Black Sea region, mad honey is used as an alternative medicine for gastrointestinal problems and, more often, as a sexual stimulant.
Reporting in the Annals of Emergency Medicine, Turkish researchers document 21 cases of mad-honey poisoning that passed through their ER over five years. Nearly all patients were middle-aged and older men -- a demographic that, according to local beekeepers, usually buys mad honey as a way to enhance sexual performance.
The problem with mad honey is its concentration of substances called grayanotoxins, some of which can cause low blood pressure, slowed heart rate, vomiting, dizziness and fainting.
In Turkey, most mad-honey buyers know they are getting a "special honey," and discuss possible side effects with the beekeepers selling it, according to Dr. Ahmet Demircan, of Gazi University in Ankara, Turkey, the lead researcher on the new study.
Pediatric Health
Dirty air makes for wheezy kids: study
NEW YORK (Reuters Health) - Small particles from traffic and heating oil combustion may cause children younger than two to wheeze and cough, according to a new study.
High air pollution levels have previously been linked to asthma symptoms in children living in urban areas with heavy traffic, but this study is one of the first to investigate the types of particles that may be the most harmful, the researchers point out in the American Journal of Respiratory and Critical Care Medicine.
"This study shows that there are multiple components of air pollution that we should be looking at in terms of health effects," Dr. Rachel L. Miller, lead investigator of the study, said in a telephone interview with Reuters Health.
Premature birth tied to later behavioral problems
NEW YORK (Reuters Health) - Children who were born prematurely and at a very low weight may have an increased risk of certain behavior problems and symptoms of depression and anxiety, research suggests.
As the survival rates of very preterm newborns have improved in recent years, studies have uncovered some of the potential long-term challenges these infants will face -- including lower IQ and higher rates of behavioral problems compared with their peers born at term.
In the new study, researchers found that among 104 7- to 16-year-olds they assessed, the 49 who were born very prematurely had higher rates of hyperactivity and attention problems, as well as symptoms of depression and anxiety.
The higher risk was not explained by lower IQ scores, however. Nor was families' socioeconomic status an important factor in children's odds of behavioral or emotional issues.
Childhood brain power tied to adult heart health
NEW YORK (Reuters Health) - People who had greater intellectual ability as children may have fewer heart disease risk factors in middle-age, a new study suggests.
A number of studies have linked higher childhood IQ to better adulthood health and a longer life, but the reasons have not been entirely clear.
For example, early environment -- starting in the womb -- may affect both a child's intellectual ability and long-term disease risks. On the other hand, childhood ability also affects a person's chances of getting a good job or adopting a healthy lifestyle in adulthood.
These latest findings, published in the American Journal of Public Health, suggest that childhood intelligence indirectly affects long-term heart health -- mostly by influencing a person's education, job and health habits in adulthood.
Diabetic kids may focus too much on carb counting
NEW YORK (Reuters Health) - Keeping tabs on carbohydrates can help young people with type 1 diabetes control their blood sugar. But they should also be careful about putting too much emphasis on carb counting alone, researchers say.
Nutrition counseling for children and teens with type 1 diabetes often recommends carb counting. By calculating the grams of carbohydrates in a meal or snack, diabetics can more closely control blood sugar levels and adjust their doses of insulin appropriately.
People with type 1 diabetes do not produce insulin, a blood sugar-regulating hormone, and must take multiple doses of synthetic insulin each day.
But in the new study, published in the journal Diabetes Care, researchers found that parents and kids sometimes put too much emphasis on carb quantity at the expense of diet quality.
Sharing class won't affect twins' school success
NEW YORK (Reuters Health) - Twins who share a classroom will do just as well academically as twins placed in separate classes, new research shows
The findings, the study's authors say, show that blanket recommendations on whether to keep twins together in school or separate them are not a good idea. "Classroom placement of twins should be based on each family's needs individually, in consultation with teachers, parents, and the children themselves," Dr. Tinca Polderman of VU University in Amsterdam, The Netherlands and her colleagues conclude.
The question of whether or not twins should be taught together has long been a "dilemma," the researchers note, which is particularly important to address giving the continuing increase in multiple births.
mental problems often unaddressed: U.S. survey
EW YORK (Reuters Health) - About 13 percent of American children and young teens have at least one mental health disorder, yet only about half have been seen by a mental health professional.
That's according to a survey funded in part by the National Institute of Mental Health (NIMH) and released online today ahead of print in the journal Pediatrics.
"We need to get these kids the help they need and determine what the best type of intervention to help kids from suffering needlessly," NIMH researcher Dr. Kathleen R. Merikangas noted in a telephone interview with Reuters Health.
Aging
Videos may aid end-of-life care decisions
NEW YORK (Reuters Health) - Videos that depict different options for end-of-life care may help terminally ill cancer patients decide on what they want, a new study suggests.
Research shows that only a minority of cancer patients complete documents on advance care planning -- and that even when doctors and patients have discussions on end-of-life care, poor communication and patients' lack of medical knowledge remain significant obstacles.
"There are well known communication barriers in the patient-doctor relationship," Dr. Angelo E. Volandes, the senior researcher on the new study, told Reuters Health in an email.
Using video to supplement end-of-life discussions "helps surmount some of these barriers," said Volandes, of Harvard Medical School and Massachusetts General Hospital in Boston.
Appetite hormone leptin plays role in Alzheimer's
CHICAGO (Reuters) - People who have higher levels of an appetite-suppressing hormone produced by fat cells may be less likely to develop Alzheimer's disease or dementia than others, U.S. researchers said Tuesday.
They said people in a study who had the highest levels of leptin were far less likely to develop Alzheimer's disease or any sort of dementia than those in the study with the lowest levels of leptin.
People with higher leptin levels also had more brain volume at the end of the study, something that is lost in people with Alzheimer's, a mind-robbing form of dementia that affects more than 26 million people globally.
"What we found is that people with higher leptin levels at baseline had a lower risk of developing Alzheimer's disease and dementia," Dr. Wolfgang Lieb of Boston University, whose study appears in the Journal of the American Medical Association, said in a telephone interview.
Feeling old and blue? Green tea may help
NEW YORK (Reuters Health) - Elderly men and women who sip on several cups of green tea a day may be less likely to have the blues, hint findings of a study from Japan.
Dr. Kaijun Niu, at Tohoku University Graduate School of Biomedical Engineering in Sendai, and colleagues found men and women aged 70 and older who drank four or more, versus one or fewer, cups of green tea daily were 44 percent less likely to have symptoms of depression.
Several prior studies have linked green tea consumption to reduced levels of psychological distress. This led Niu and colleagues to look at associations between drinking green tea and symptoms of depression in 1,058 relatively healthy elderly individuals.
Mental Health
Treating depression helps with blood sugar control
NEW YORK (Reuters Health) - Treating depression may help people with diabetes get their blood sugar under control.
In a study of low-income minorities with poorly controlled diabetes, researchers found that antidepressant therapy was associated with improved long-term blood sugar control and reduced blood pressure.
Rates of depression in people with diabetes are double those in the general population, and even higher among minorities, who are more prone to worse blood sugar control, more diabetes complications, and more severe depression, the researchers point out. Yet few studies have focused on the effect of depression treatment among minorities with uncontrolled diabetes.
To investigate, Dr. Mayer B. Davidson and his colleagues at Charles Drew University in Los Angeles screened low-income patients attending a diabetes clinic for depression.
'Alarming' mental problems seen in SARS survivors
NEW YORK (Reuters Health) - Many survivors of the severe acute respiratory syndrome (SARS) pandemic of 2003 suffer from persistent mental health problems and chronic fatigue years later, new research from Hong Kong shows
What's more, these psychiatric problems seemed to become more common among survivors over time, say Dr. Marco Ho-Bun Lam and colleagues from The Chinese University of Hong Kong, who call the persistence of these problems "alarming."
A year after the disease outbreak, Lam and his team note in their report in the Archives of Internal Medicine, some survivors still had mental problems even though their physical symptoms had improved.
Nutrition/Diet/Healthy Recipes
Self-help on par with therapy for binge-eaters
NEW YORK (Reuters Health) - "Out of control" binge eaters who get help from a therapist do better in the short-term than people who use self-help techniques, new research shows.
But in the long-term, self-help and therapist-led or therapist-assisted approaches seem to have about the same effectiveness, Dr. Carol B. Peterson of the University of Minnesota in Minneapolis and her colleagues found.
Binge eaters often eat large amounts of food while feeling a loss of control over their eating. It is different from the binge-purge syndrome of bulimia because binge eaters do not purge afterward by vomiting or taking laxatives. Binge eating disorder is contributing to the rise in obesity.
Stir-Fried Shiitake Mushrooms, Tofu and Asparagus
1/2 pound fresh shiitake mushrooms
Salt to taste
1 pound asparagus, woody ends snapped off, cut on the diagonal in 2-inch lengths
2 tablespoons canola or peanut oil
3/4 pound tofu, cut in 1/2 x 3/4x 1/4 inch dominoes
Low-sodium soy sauce to taste
2 tablespoons finely minced garlic
2 tablespoons finely minced ginger
1 tablespoon dry or amontillado sherry
1/4 teaspoon sesame oil
1 teaspoon cornstarch
1. Stem the mushrooms, and quarter the caps. Place the stems in a saucepan, and add 2 1/2 cups water and salt to taste. Bring to a simmer over medium-high heat. Reduce the heat, cover and simmer 20 minutes. Strain, discard the mushroom stems and return the broth to the heat. Bring back to a boil. Add the asparagus, and blanch for one to two minutes, just until bright. It should still be crunchy. Transfer to a bowl of cold water, then drain. Retain the broth.
2. In a small bowl or measuring cup, stir together 1 tablespoon soy sauce, the sherry, sesame oil and 1/4 cup of the broth. In a separate bowl or measuring cup, stir together 1/2 cup of the broth and the cornstarch.
3. Heat a large, heavy skillet or wok over high heat. Add 1 tablespoon of the oil, and when the oil is hot but not smoking, add the tofu. Stir-fry until lightly colored, two to three minutes. Add soy sauce to taste, toss together for about 30 seconds, and transfer to a bowl or plate. Set aside.
4. Add mushrooms to the pan, and stir-fry three to four minutes, until just tender and moist. Add the remaining tablespoon of oil, and stir in the garlic, ginger and asparagus. Stir-fry for 30 seconds. Add the tofu and soy sauce mixture, and stir-fry for two to three minutes, until the asparagus is just tender and the mixture is fragrant. Stir the cornstarch mixture again, and add to the pan. Stir just until the tofu and vegetables are glazed, and serve immediately with rice or noodles.
Yield: Serves four.
Advance preparation: This is a last-minute stir-fry, but you can make the mushroom stem broth and blanch the asparagus several hours ahead. Everything can be prepped long before you begin to cook.
Puree of Mushroom Soup
1 1/2 pounds white or cremini mushrooms
1/2 ounce dried mushrooms, any kind
Salt to taste
2 tablespoons extra virgin olive oil, or 1 tablespoon olive oil and 1 tablespoon butter
1/2 cup finely chopped shallot or onion
3 or 4 garlic cloves, green shoots removed, minced
3 tablespoons dry sherry
2 teaspoons low-sodium soy sauce (optional)
A bouquet garni made with a bay leaf and few sprigs each parsley and thyme
2 medium potatoes (5 or 6 ounces total), preferably on the starchy side (such as Yukon gold), peeled and diced
Freshly ground pepper
1/2 teaspoon fresh lemon juice
Chopped flat-leaf parsley or slivered fresh sage leaves for garnish
1. Set aside 4 medium mushrooms for garnish. Stem the remaining mushrooms, and cut the caps into quarters. Set aside the caps, and combine the stems with the dried mushrooms in a large saucepan. Add 1 1/2 quarts water and bring to a simmer. Cover, reduce the heat and simmer 30 minutes. Set a strainer lined with cheesecloth, a coffee filter, or paper towels over a bowl, and drain the mushrooms. Squeeze the mushrooms over the strainer to extract all of the tasty liquid remaining in them. Season the broth to taste with salt. Discard the dried mushrooms and stems.
2. Heat the olive oil (or olive oil and butter) over medium heat in a large, heavy soup pot, and add the shallots or onions. Cook, stirring, until tender -- about three minutes for shallots, five for onions. Add the garlic, and stir together for about 30 seconds. Add the quartered mushrooms and a generous pinch of salt. Cook, stirring often, until the mushrooms are tender and have released a lot of juice, about 10 minutes. Add 2 tablespoons of the sherry and the soy sauce, and cook, stirring, for a few minutes. Add the mushroom broth, the bouquet garni and the potatoes. Bring to a simmer, cover and simmer 1 hour. Remove the bouquet garni, and discard.
3. Working in small batches and covering the top of your blender tightly with a kitchen towel, puree the soup. Alternatively, use a hand blender to puree the soup in the pot. (You'll get a smoother, more velvety texture if you use a blender.) Return to the pot, and heat through. Season to taste with salt and pepper. If you wish, stir in another tablespoon of sherry.
4. Trim the mushrooms you set aside, and slice paper-thin. Toss with the lemon juice. Serve the soup, and garnish each bowl with chopped parsley or slivered sage and sliced fresh mushrooms.
Yield: Serves four.
Advance preparation: You can make this a day ahead and reheat.
Fettuccine With Braised Mushrooms and Baby Broccoli
1/2 ounce (about 1/2 cup) dried porcini mushrooms
2 tablespoons extra virgin olive oil
1 small shallot, minced
1 pound mushrooms, cleaned, trimmed and sliced 1/2 inch thick
Salt to taste
2 garlic cloves, minced
1/4 cup dry white wine or red wine
1 teaspoon chopped fresh rosemary or fresh thyme leaves
1/2 pound baby broccoli, cut in 1-inch pieces
Freshly ground pepper
3/4 pound fettuccine or egg noodles
Freshly grated Parmesan for serving
1. Place the dried mushrooms in a Pyrex measuring cup and pour on 2 cups boiling water. Let soak 30 minutes while you prepare the other ingredients. Place a strainer over a bowl; line it with cheesecloth, a coffee filter or paper towels; and drain the mushrooms. Squeeze the mushrooms over the strainer to extract all the flavorful juices, and measure out 1 1/2 cups of the broth. Rinse the mushrooms, away from the bowl with the broth, until they are free of sand. Squeeze dry and set aside. If very large, chop coarsely.
2. Begin heating a large pot of water for the pasta. Heat the olive oil in a large, heavy nonstick skillet or saucepan over medium heat, and add the shallot. Cook, stirring for a few minutes, until tender, and add the fresh mushrooms and salt to taste. Cook, stirring often, until the mushrooms begin to soften and to sweat, about five minutes. Add the garlic, and continue to cook the mushrooms, stirring often, until they have softened a little more, about two minutes. Add the reconstituted dried mushrooms, the wine and rosemary (or thyme), and turn the heat to high. Cook, stirring often, until the wine evaporates and the pan is almost dry, five to 10 minutes. Stir in the mushroom broth. Bring to a simmer, and cook over medium heat, stirring often, until the mushrooms are thoroughly tender and fragrant and the surrounding broth is thick and gravy-like, about 20 minutes. Taste and adjust salt and pepper. Remove from the heat, and keep warm.
3. When the pasta water comes to a boil, salt generously and add the baby broccoli. Blanch for five minutes, until tender but still bright. With a slotted spoon or skimmer, transfer to the pan with the mushrooms.
4. Add the pasta to the boiling water. Cook al dente, until firm to the bite, following the directions on the package but checking a minute or two before the end of the designated cooking time. (Note that some egg noodles, such as Al Dente Pasta, take only three to four minutes). Add a ladleful of pasta cooking water to the mushrooms and baby broccoli, drain the pasta, and toss with the mushrooms and broccoli in a large pasta bowl or in the pan. Serve at once, passing Parmesan at the table.
Yield: Serves four to six.
Advance preparation: You can make this through step 3 several hours before you cook the pasta. Bring the pot of water back to a boil, and reheat the mushrooms and baby broccoli shortly before serving.
Stuffed Portabella Mushrooms With Swiss Chard
1 pound Swiss chard, stemmed and cleaned
Salt to taste
2 tablespoons extra virgin olive oil
2 garlic cloves, halved, green shoots removed
2 tablespoons pine nuts or finely chopped almonds
Freshly ground pepper
1/4 cup plus 2 tablespoons freshly grated Parmesan
12 medium-size portabella stuffing mushrooms, about 3/4 pound
1. Bring a large pot of water to a boil. Fill a bowl with ice water. When the water comes to a boil, salt generously and add the chard. Blanch two minutes until tender, and transfer to the ice water. Drain and squeeze out excess water. Chop fine, and set aside.
2. Set aside 1/2 garlic clove, and mince the rest. Heat 1 tablespoon of the olive oil in a large, heavy skillet, and add the pine nuts or almonds. Cook, stirring, until the nuts begin to color, and add the minced garlic. Cook, stirring, until the garlic is fragrant, 30 seconds to a minute. Add the chard and salt and pepper to taste. Stir together for a minute or two, and remove from the heat. Taste and adjust seasonings. Transfer to a bowl, add 1/4 cup of the Parmesan and stir together.
3. Preheat the oven to 350 degrees. Oil a baking sheet or baking dish that will accommodate all the mushrooms. Gently twist the stems off the mushrooms, if they are still there, and set aside for another purpose. Heat the remaining olive oil over medium heat in the skillet, and add the half clove of garlic that you set aside. Cook the garlic in the olive oil until it turns golden, then remove it from the oil and discard. Add the mushrooms to the oil, season with salt and pepper, and cook, shaking them in the pan, just until they begin to soften, no longer than three minutes. Using tongs, remove from the oil and place on a lightly oiled baking sheet or in a baking dish, rounded side down.
4. Fill the mushroom caps with the chard mixture, packing it in tight. Sprinkle the remaining Parmesan over the top. If any oil remains in the pan, drizzle it over the mushrooms. Place in the oven for 15 to 20 minutes, until the mushrooms are moist and tender.
Yield: One dozen stuffed mushrooms, serving four as a side dish.
Advance preparation: You can make the filling and fill the mushroom caps up to a day ahead. Cover tightly and refrigerate.
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