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 RESEARCH TRIANGLE PARK, NC—The National Toxicology Program is considering an NCI request that it do toxicity studies of four herbal products and a substance found in vegetables: aloe vera, used in cosmetics and as a dietary supplement; ginseng, promoted to increase vigor; kava kava, sold as a mood elevator; milk thistle, believed by some to prevent cancer and protect the liver; and indole-3-carbinol, which occurs in cruciferous

Despite recent decreases in sexual risk behaviors among high school students nationwide, human immunodeficiency virus (HIV) infection was the seventh leading cause of death for persons ages 15 to 24 years in the United States during 1997. To determine whether the prevalence of HIV-related sexual risk behaviors among high school students also has decreased in certain urban areas heavily affected by the epidemic, the Centers for Disease Control (CDC) analyzed data from the Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997 in eight large-city school districts: Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Fort Lauderdale, Florida; Jersey City, New Jersey; Miami, Florida; Philadelphia, Pennsylvania; and San Diego, California. This report summarizes the results of this analysis, which indicate that, from 1991 to 1997, the percentage of high school students engaging in HIV-related sexual risk behaviors decreased in some US cities.

Each year, cigarette smoking causes an estimated 430,000 deaths in the United States. In addition, the health risks for smoking cigars, which include mouth, throat, and lung cancers, are well documented. This report summarizes the findings from the 1998 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of current cigarette and cigar smoking in the 50 states and the District of Columbia. The findings indicate that state-specific cigarette smoking prevalence among adults ³ 18 years old varied twofold and having ever smoked a cigar (ie, ever cigar smoking) varied nearly fourfold.

CLEVELAND-Primary care physicians and their patients should make advance care planning part of their routine office visits. This is the message of the Education of Physicians in End-of-Life Care (EPEC) program, developed by the American Medical Association in conjunction with the Robert Wood Johnson Foundation.

WASHINGTON—The federal government has created an internet source that allows access to more than 27 million pages of tobacco industry papers, one that allows full-text searches of these key documents for the first time. The website, http://www.cdc.gov/tobacco, has four parts: citations from 4 million tobacco industry documents; a database for the Minnesota Select Set, which holds about 350,000 pages of documents used by attorneys in the state’s successful suit against the tobacco companies; a similar database containing nearly 7,000 documents from the British American Tobacco Co.;

NEW YORK-Marrow hypoplasia was achieved within 28 days in 14 of 41 patients with refractory leukemia after a first cycle of a new nucleoside analog, troxacitabine, Francis J. Giles, MD, associate professor of medicine, M.D. Anderson Cancer Center, reported at the Chemotherapy Foundation Symposium XVII.

CLEVELAND-While the majority of Americans wish to die in the comfort of their homes, most are actually dying in institutions, often with pain and other symptoms poorly controlled.

CHICAGO-V. Craig Jordan, PhD, has been named Diana, Princess of Wales, Professor of Cancer Research at Northwestern University. Dr. Jordan, a native of the United Kingdom, is professor of cancer pharmacology at Northwestern University Medical School and director of the Lynn Sage Breast Cancer Research program affiliated with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

NEW YORK-A simplified version of the Brief Symptom Inventory (BSI) that can be completed by patients in less than 2 minutes is speeding screening and referral for psychosocial problems at Johns Hopkins University cancer clinics.

The interim results of an ongoing phase II trial of IntraDose (cisplatin [Platinol]/epinephrine) were presented at the 17th Annual Chemotherapy Foundation Symposium in New York City. Of 29 evaluable patients with liver cancer, 12 (41%) responded to treatment. Of the 12 responders, 6 achieved a complete response (100% reduction in viable tumor volume), while the other 6 showed a more than 50% reduction in viable tumor. To date, 10 of the 12 responders remain in remission, while the 2 other patients maintained remissions for 200+ days. Median survival time from the date of diagnosis for all patients has not yet been reached and is currently in excess of 15 months.

WASHINGTON-An Institute of Medicine (IOM) committee has urged instituting a comprehensive strategy to sharply reduce medical errors that result in needless death and injury. According to an IOM report, one study put the annual number of deaths in the United States from medical mistakes at 44,000 and a second study concluded the toll reached 98,000.

SAN FRANCISCO-The Cancer Survival Toolbox is a set of self-learning audiotapes available in English and Spanish, designed for persons with cancer to help them develop skills needed to manage their cancer experience.

ROCKVILLE, Md—Evidence supporting the use of garlic in cancer prevention and the efficacy of preventive behavioral dietary interventions to reduce cancer risk will be assessed in studies ordered by the Agency for Health Care Policy and Research. The agency assigned the studies to two of its Evidence-based Practice Centers—the Research Triangle Institute and the University of North Carolina at Chapel Hill, and the University of Texas Health Sciences Center, San Antonio.

BETHESDA, Md-A new report from the California state government links secondhand smoke to a number of diseases, including lung and nasal-sinus cancers, heart disease, and sudden infant death syndrome (SIDS). The National Cancer Institute has taken the lead in distributing the 430-page document nationwide.

The Institute of Medicine (IOM) committee that released a report on medical errors in December recommended that physicians demonstrate “competence and knowledge of safety practices” through periodic reexamination and relicensing. The report, entitled “To Err is Human: Building a Safer Health System,” was written by a committee chaired by William Richardson, chief executive officer of the W. K. Kellogg Foundation. Most members of the 19-person committee were doctors.

BETHESDA, Md-G.D. Searle & Co. has won FDA approval for its COX-2 inhibitor Celebrex (celecoxib) as an oral adjunct to usual care (endoscopic surveillance and surgery) to reduce the number of adenomatous colorectal polyps in patients with familial adenomatous polyposis (FAP). The FDA initially approved Celebrex for treating osteoarthritis and rheumatoid arthritis in April 1998.

NEW ORLEANS-The use of highly active antiretroviral therapy (HAART) in HIV-infected individuals with lymphoma may make it possible for them to receive high-dose chemotherapy with autologous stem cell transplantation (ASCT), according to a study conducted at City of Hope National Medical Center, Los Angeles.

ATLANTA-Smoking rates among adults in the United States have dropped dramatically over the past 30 years, from 44% in 1965 to 25.5% in 1990, but now the rate seems to have leveled off, the Centers for Disease Control and Prevention (CDC) said in a report.

WASHINGTON-Americans across the political spectrum would prefer that Congress raise the federal excise tax on cigarettes rather than cut funding for existing programs or spend Social Security funds in order to meet federal budget needs, according to a new poll.

NEW YORK-On October 4, Sister Elizabeth Vermaelen, president of the Sisters of Charity of St. Vincent de Paul of New York, welcomed His Eminence John Cardinal O’Connor, New York Mayor Rudolph Giuliani, and more than 200 other guests to celebrate the grand opening and dedication of The Saint Vincents Comprehensive Cancer Center.

Off-Label Drug Promotion

The Senate’s only physician, Sen. Bill Frist (R-TN), told FDA Commissioner Jane Henney, MD, that when Congress rewrites the “off-label” drug marketing law, the new version should give physicians more credit for being sophisticated

TOWSON, Md-New breast biopsy techniques are making it more likely that one-stop procedures will become standard of care for small lesions. With this technique, lesions are sampled and removed for biopsy in a minimally invasive procedure, said Rachel Brem, MD, assistant professor of radiology and oncology at the Johns Hopkins Medical Institutions’ Breast Imaging Center.

WASHINGTON-National Cancer Institute director Richard D. Klausner, MD, was among the names immediately mentioned as Washington policy wonks and the biomedical community began speculating about who might replace Harold Varmus, MD, as director of the National Institutes of Health.

BUFFALO, NY-The 1990s have seen a new focus on cancer prevention, particularly chemoprevention. Researchers must use results of basic, clinical, and translational chemoprevention studies to design more effective trials to further this field, Scott M. Lippman, MD, said at the New Horizons in Cancer Prevention Symposium, hosted by Roswell Park Cancer Institute.

MADISON, Wis-In attempting to increase availability of opiates for pain, "we are really up against the war on drugs," David E. Joranson, MSSW, said, "because it is the same laws aimed at preventing illicit narcotic trafficking that also control medical availability of opioid analgesics, and some governments may be reluctant to relinquish that control."

MINNEAPOLIS-United-Healthcare, a subsidiary of UnitedHealth Group, has announced that it is further advancing its philosophies on consumer choice and physician autonomy through an initiative called Care Coordination. The new initiative makes obsolete certain programs associated with traditional managed care, such as preauthorization for inpatient hospital procedures.

A three-day interdisciplinary cancer conference will be held March 2 through 4, 2000, at the Best Western Gateway Grand in Gainesville, Florida. The seminar will emphasize the latest advances in radiation therapy techniques and results. It will include refresher courses by senior faculty, panel discussions, and new departmental research results. Visiting Professor will be Professeur Jean-Pierre Gerard, Service de Radiotherapie-Oncologie, Hôpitaux de Lyon, France. Other presentations will be made by clinicians from the Department of Radiation Oncology,University of Florida.