European Stars and Stripes (Newspaper) - May 29, 1990, Darmstadt, Hesse                                To your health a file Elizabeth Taylor suffering from viral pneumonia. Pneumonia Early treatment is crucial by Shari Roan los Angeles times puppeteer Jim Henson s sudden death from pneumonia is a reminder that this usually benign disease which strikes about 3 million americans each year can be fatal. Generally pneumonia is Well understood by doctors and is easily treated with a variety of antibiotics said or. Bisher Akil an expert in infectious diseases and pulmonary Medicine at the University of Southern California. You get simple outpatient treatment with antibiotics and you get Over it Akil said. In healthy people it s not a problem unless you ignore it and let it  but pneumonia is fatal for an estimated 70,000 americans each year ranking As the sixth leading cause of death according to the american lung association. Most of the deaths occur among the elderly infants and people with illnesses such As cancer or diabetes All of whom have weak immune systems and May be unable to fight off infection. In other cases death can occur if treatment begins too late As was apparently the Case with Henson or because the particular Strain of pneumonia is difficult to identify As in the Case of actress Elizabeth Taylor s Brush with death from pneumonia last month experts said. Pneumonia is an infection of lung tissue and is classified according to its cause and its location in the lung Akil said. The disease is most commonly caused by bacteria such As the streptococcus bacteria that killed Henson. It is also caused by viral infections such As influenza. In rarer instances pneumonia is caused by fungi parasites chemical agents or allergic reactions to foreign particles that Lodge in the lung. Streptococcus a bacterium found in the Mouth is the leading cause of pneumonia and is fatal in about 5 percent of cases usually in people with weakened immune systems experts said. Henson apparently died the body s defences against pneumonia the first line of defense is the Epiglottis a Flap of tissue that covers the Trachea. It opens to allow breathing but closes to Block organisms in the Mouth and Throat from entering the lower respiratory tract. If reflexes Are slowed however it can remain open at the wrong time. If an organism slips past the Epiglottis it usually gets trapped in the mucus that Coats the Trachea and the bronchial tubes in the lung. Tiny hairy cells called cilia then sweep the unwanted mucus material toward the Mouth. To expel the bacteria Laden mucus the body triggers the diaphragm muscle to produce a cough. Cigarette smoking pollution and viral infections among other things can hinder this process. Infectious organisms that reach the Alveoli or air bladders deep in the lungs Are attacked by macrophages the scavenger cells of the immune system. The macrophages engulf the organisms and Are flushed from the lungs by the Lymphatic system. The immune system also dispatches White blood cells and antibodies to inactivate the organisms. Fat Chance of losing weight not from a Strain called group a streptococcus which officials at the centers for disease control in Atlanta said is increasing in frequency for reasons that Are unclear. Group a streptococcus is fatal in 20 percent to 30 percent of cases the cd reports. But the 53-year-old creator of the puppets apparently did not seek treatment in time to arrest his rapidly spreading infection said or. David m. Gelmont director of intensive care at new York Hospital where Henson died May 16. According to Gelmont Henson was examined by a physician in North Carolina May 12 after developing flu like symptoms but pneumonia was not diagnosed. Henson reportedly returned to new York May 14 and died less than 24 hours after being admitted to new York Hospital. When he entered the emergency room May 23 at 4 58 a.m., Henson was dying of massive infection and acute respiratory distress officials said. He received Large doses of antibiotics and was placed on a ventilator. Physicians estimated that the overwhelming infection had been progressing for at least three Days and said antibiotics were ineffective at that Point. The pneumonia was not detected by the doctor in North Carolina but by no Means did someone blow the diagnosis Gelmont said. He did not have the textbook symptoms of pneumonia. He did not have a fever or sputum. He did have a mild  symptoms of pneumonia can vary according to its Type. Four major symptoms common to streptococcus Are fever Chest pain cough and shortness of breath Akil said. Bacterial pneumonia is usually accompanied by a discharge of sputum sometimes blood tinged from the lungs viral pneumonia often produces a dry cough. Pneumonia commonly triggers a particular kind of chill a severe trembling of the body called a rigor said or. Ellie Goldstein chief of infectious disease at St. John s Hospital and health Center in Santa Monica calif., where Taylor is recovering. From the autopsy and from a physical examination it is apparent that Henson was a healthy Man Gelmont said. He was so healthy he did t have a regular  by the time Henson was admitted to the Hospital the infection in his lungs had already migrated throughout his body and had begun to cause failure of his kidneys heart and blood clotting ability. Pneumonia can be impossible to arrest after abscesses form in the lungs and then spread through the bloodstream to different organs in the body experts said. Despite All of the antibiotics and modern techniques we possess patients do die in hospitals because of rapidly spreading pneumonia when they Are not admitted until after the illness has reached the critical stage said or. David b. Skinner president of new York Hospital. Antibiotics Don t actually kill the bacteria causing pneumonia they allow the body to mount its own natural defences. Thus the seriousness of the illness varies according to the strength of an individual s defences. If the agent causing the pneumonia can be identified the particular Antibiotic that will be most effective is prescribed Akil said. If a cause is not immediately apparent doctors must try various drugs and perform Laboratory tests of lung sputum or lung tissue. With viral pneumonia which May not produce sputum from the lungs that can be used to identify the virus doctors sometimes remove a piece of lung tissue to make a diagnosis. The problem with viral pneumonia is that our ability to identify the virus is not Good Akil said. Most of the time the diagnosis is one of exclusion. But what happened with Elizabeth Taylor is that they had to go with open lung Biopsy because they could t find a reason. They had to take a big piece of lung tissue and look at  Taylor 58, was near death with viral pneumonia when doctors performed a lung Biopsy to identify which antibiotics would Best assist her. Anti viral drugs have been developed that Are effective in treating some viral pneumonia to a canc to lean Gene machine by Susan okie Washington Post Hen it comes to gaining weight who you Are matters More than How much you eat. Clothes May make the Man but it s genes that make the Waistline. One new study confirms what almost everyone has Long suspected people can eat identical meals and some will gain More weight than others. According to the study one person can put on up to three times As much weight As another. A second study shows that if you re fat you can t blame it All on your Mother for overfeeding you As a child. That study shows that sets of identical twins who were separated and raised in different families on widely different diets still grew up to weigh about the same. Together the studies published in the new England journal of Medicine contain the strongest evidence yet that the genes a person inherits Are the dominant Factor determining whether that person is fat lean or in Between. No one knows what the genes do in detail but they presumably set metabolic rates and Lay the body s strategy for handling extra calories. So striking were the findings that some researchers who conducted the studies said they were worried about sending too gloomy a message to overweight people. On the contrary said Albert j. Stunkard a psychiatrist at the University of Pennsylvania and author of one of the reports the conclusions should console those whose extra pounds have been blamed on Lack of will Power or on supposed hidden psychological needs. Diet and exercise will work to modify the genetic effect he said but people who Are overweight can now be told it s very largely due to your genes. You have a specific vulnerability. You re much More vulnerable than other  in one study researchers at Quebec s Laval University confined 12 pairs of male identical twins to a College dormitory for 100 Days. The volunteers were Between 19 and 27 years old and none had a history of being overweight. Each Man ate a diet that contained 1,000 extra calories a Day and exercise was forbidden. The subjects spent their time playing sedentary games Reading or watching television while researchers observed them constantly to make sure that everyone kept to the same Low level of physical activity. The members of each pair of identical twins gained Page 16 the stars and stripes tuesday May 29,1990 checking children for cholesterol by Sandra Blakeslee new York times Eart disease begins in childhood accelerates in adolescence and is firmly established in the arteries of 25 percent of White men by the age of 35, researchers have found. The research based on autopsies of children teen agers and Young adults who die in accidents is providing clues As to Why some fatty streaks in arteries become dangerously thick while others do not. While scientists have known since the 1950s that Many cases of heart disease begin in childhood the new research is offering the first Clear picture of the genetic and environmental mechanisms involved. Although White women and Blacks of both sexes do not seem to develop the same degree of dangerous not it you re overweight it s largely due to your genes but diet and exc Erise can modify the genetic effect. Similar amounts of weight in response to overfeeding but the difference among pairs was remarkable. After eating exactly the same number of excess calories one Man in the study gained Only 91/2 pounds while another gained almost 30. The Brothers of each of these men gained almost the same amounts. The variation among pairs was three times As great As the differences seen Between members of the same pair. The differences were ascribed to genes because they showed up Only in comparisons of men with different genes. Identical twins have identical genes. The researchers found even wider variations when they measured whether extra fat showed up on the men s middles or on their hips and thighs. Identical twins tended to gain weight in identical places. The variation among the pairs with respect to fat distribution was six times greater than that within pairs Bouchard said. There was also wide variation in the proportion of weight gained As muscle rather than fat with those who added mostly fat tending to put on More pounds Overall. Bouchard said people who can eat extra calories without gaining much weight seem to convert some of the extra fuel into muscle mass and to Burn off much the rest As heat by adjusting the rates of chemical reactions in the body. I was astonished to see such a wide Range of response said Claude Bouchard a professor of exercise physiology and the study s principal author there Are clearly people at risk much More than others to gain fat " Stunkard s study on the twins raised apart is the first to tease apart the effect of heredity on adult weight from that of Early childhood diet because it is the first to study a Large number of identical twins who grew up in different families using a Sample drawn from a swedish National twin registry he and his co workers examined differences among 93 pairs of identical twins reared apart 154 pairs of identical twins reared together 218 pairs of fraternal twins reared apart and 208 pairs of fraternal twins reared together. The most striking finding was that pairs of adult identical twins who had been raised in different families were just As similar As pairs raised together the Early family rearing environment apparently had no Oll oct at All on adult weight Stunkard said that finding leads Stunkard to discount previous theories that the amount children eat Early in life helps determine whether they will be fat As adults environment does affect adult weight he said but it s not the Early family environment in which you were raised it s the environment in which you live As an adult. The study suggests that heredity is at least twice As important As environmental factors in determining weight differences among different people. It concluded that genetic differences accounted for 70 percent of the weight variation among men and 66 percent of the variation among women with environment contributing the rest Bouchard said a separate still unpublished study by the Laval researchers shows that people who Gam weight easily also have the hardest time losing it additional studies by the group show that such individuals Are aware of that tendency since they tend to eat less per Pound of their own body weight than people who stay lean. They use that strategy he said. By and Large they go hungry or they gain  coronary lesions by the age of 35 As White men do the researchers say Young Blacks tend to develop High blood pressure that damages both the heart and kidneys. Such damage is clearly seen in autopsies. The studies Are fueling a debate on whether Young children should be screened routinely for cholesterol Levels. Children As Young As 3 have fatty streaks in their arteries said or. Gerald Berenson a cardiologist who Heads an autopsy study at Louisiana state University in new Orleans. Berenson said he believed that diet was unquestionably a major risk Factor for heart disease in children and he had urged that All children be screened for cholesterol beginning in kindergarten. Evidence has been accumulating for 30 years that certain risk factors serum cholesterol Levels High blood pressure and smoking Are associated with heart disease in Middle age said or. Henry c. Mcgill jr., a pathologist at the Southwest foundation for biomedical research in san Antonio Texas who is participating in a second autopsy study. But proof that adult risk factors particularly High serum cholesterol influence the earliest stages of the disease process was lacking said Mcgill. And without proof he said paediatricians Are unwilling to change the diets of children. Some physicians believe that too Little fat can stunt a child s growth and harm Normal development of the brain and nervous system said or. Ronald Lauer a paediatric cardiologist at the University of Iowa who is heading an expert panel on childhood cholesterol for the National heart lung and blood Institute s National cholesterol education program. Thus cholesterol guidelines issued by the american Academy of paediatrics last year advised parents to test children for cholesterol Only if the family has a history of premature heart disease Launcr said. The autopsy studies provide the missing link Between risk factors and the Early development of heart disease in childhood Berenson and Mcgill agreed for the last 18 years Berenson has been following the lives and deaths of 12,000 children in the area of Bogalusa la., a racially mixed Semi Rural Community 70 Miles North of new Orleans the children who ranged in age from Newborn to 14 when the study began in 1972, have been Given medical examinations every few years he said. Their medical histories changes in height and weight and multiple blood pressure readings wore recorded along with periodic measures of so called Good cholesterol and bad cholesterol genetic variations in proteins involved in cholesterol transport diet studies Type a behaviour insulin Levels glucose tolerance and smoking habits. The children Are now in mid adolescence and Young adulthood Berenson said. Thus far 150 of them have died accidentally or violently and autopsies have been conducted to search for evidence of heart disease tuesday May 29,1990 the stars and stripes Page 17