HEAL
TA
Boning up on
buying fish
recent rtlcle bout the
y of e ting fi h in Consumer
Report , the public w w rned
bout poilage d to poor handling
in the marketplace, and con
taminants due to polluted w ters.
� ult, the article criticized
by the fi hing industry and everal
govemm nt officials primarily be
cause it' conclusions were based
on only 113 ample from a few fi h
markets.
However, the rticle by Con
sumer Reports didn't advi e the
public to stop eating fish. To the
contrary, most health authoritie
maintain that fish is an important
part of any healthy diet. Neverthe
less, Consumer Reports was right to
advise people to "bone up" on fish
before you buy, serve, and eat it.
Fish and shellfish are among the
most pereishable of all foods. Even
when properly refregirated, they
don't last nearly as long as chicken
or beef. Also, even fish from the
purest waters requires careful han
dling to prevent early spoilage.
Complicating matters further is
the growing worldwide pollution of
lakes, rivers, and even our oceans
with raw sewage, industrial waste,
and heavy metals such as mercury
and lead. While it's true -tnat the
U.S. government has many
programs that attempt to insure the
freshness of the fish we eat, funds
are limited and consumer groups
have long complained that a lot
more should be done.
HEALTH
D orr-A report on chool-
b ed dru prevention throughout the
country how th t comprehe ive
multi-ye r pro r ms, uch the
. chi n Model for Comprehensive
School Health Education, reduce
cig rette, lcohol nd drug u e
among tee gers.
Compiled by the Addiction Re-
e rchlnstitute (ARI) t Wayn State
University, the report urveyed 11
current research on drug prevention
progr m in chools, including
Michigan' "Growing Healthy" and
Michigan Model programs.
The report how that these
programs re effective, particularly
the Michigan Model, which has come
under fire recently from ome parent
roup nd ta legislators for being
too perm' ive.
Dr. Eugene Sch ner, director of
I nd one of th report' uthors,
id th t the report upholds what ex
p rts in sub tance abuse prevention
have aid 11 along bout ineffective
programs. ..�
"'K OWL DG 0 LY'
P OG M, which only offer in
formation about drugs, do little to
prevent ubstance abuse, and may
even encourage it," he aid.
"Programs that are focused too
narrowly, or last only a semester or
les , al 0 are ineffective.
THE LARGEST and most com
prehensive work of its kind to date,
the study focuses on three com
ponents of eye movement and looks
at a cross-section of individuals at
various stages of the dise�e.
The study, one of several taking
place as part of the School of
Medicine's AIDS Clinical Trial
Group, has shown that eye movement
abnormalities exist at all stages of
AIDS disease-from the
asymptomatic phase when no signs
of illness are apparent to the stage
when symptoms are most severe.
"We're looking for tests that will
be sensitive to signs of change in
brain function . that seem to coincide
with the course of disease," says
David Clifford, M.D., associate
professor of neurology and director
of the study.
"With such information, we can
begin treatment earlier and measure
its effectiveness before people begin
having serious problems."
EYE MOV'EMENT TESTS can
detect even mild neurological dys
fun-ction because numerous well
defined areas of brain function are
involved in moving the eyes.
Clifford and his colleagues
studied fixation, the ability to fix a
gaze; smooth pursuit, the ability to
track a target in space; and saccadic
performance, the abili ty to rapidly
. shift gaze. Results of Clifford's
study appear in the August issue of
the journal Annals of Neurology.
"Neuropsychometric tes ts, such as
follow-the-number puzzles and peg
board exercises, are tools used to
detect brain damage caused by my
before other disease symptoms ap
pear, but they are not good indicators
for early progression of the disease in
the brain, " Qifford notes.
"Numerous areas of brain func
tion are involved in eye movement so
the tests are better suited to assessing
extent of disease. "
"To be ucce ful, program
hould b offered ov r a long period
of time and provide a balance of in
formation, attitudinal dir ction, nd
coping and refusal kill ."
Leonard Smith, pre ident of Th
Skillman Foundation which funded
th res arch, said that the report up
port a recent Rand Corporation
study on drug abus in th Detroit
area.
"The Rand tudy howed that
these prevention program were
helpful in reducing tobacco and il
legal drug use among adolescents,"
Smith aid. "The Rand study al 0
recommended that prevention
programs like the e should be in-
mlqh
. Eye Function decline as AIDS
Worsen
Clifford and colleague Gary
Paige, M.D., Ph.D., now at the
University of Rochester, examined a
cross-section of 72 subjects, 47 of
whom tested positive for mv infec- . THE TIME SUBJECTS nee ded
tion. They included 17 with to make the shifts also significantly
asymptomatic HIYinfection; 16with varied. Controls required 339 mil
AIDS Related Complex (ARC), in- liseconds while the AIDS dementia
eluding weight loss, fever and diar- patients required 410 milliseconds.
rhea; eight with advanced AIDS; and To further complicate the task, in
six with AIDS dementia and severe stead of an asterisk, the letter Lor R
neurologic problems. Twenty-five was designed as the target, and sub
controls were not infected. jects [lad to press a key under the left
During the 20-minute test, sub- of right index finger corresponding to
jects completed four different tasks the letter presented.
by watching a target displayed on a In the control group, 96 percent
computer monitor. Using an Eye had correct finger responses com
Tra� infrared monito� sy�tem, th� I pa,r�<1 to 78 percent of AJDS <;1eme,n-
�nzonltd eyts �tio� record d. tia subiects . go." ...
.1 .m bn8� � 1 (,lc. u ot J. "'Y ,
111 lXatlon tnal, suojec ere, also declined in both groues to 80
asked tQ . .. larset,,ji � I perC'eX In ltiev�ontrb1"'grouP and 21
seconds. While the control group percent in the AIDS dementia group,
maintained a near perfect steady .
gaz� fixationsta�lity s��ficantly ���������������������������������������
decreased in HIY-infected subjects F 0 0 T '. PRO B L EMS?
with advanced disease.
Eye movement in the control and
asymptomatic groups shifted less
than one degree on ei her side of the
target, while those with AIDS and
AIDS dementia shifted form one-to
two times further from the target.
THOSE WITH AIDS dementia
made nearly six times the number of
rapid shifts in eye movements (sac
cades) interrupting fixation as those
in the control group.
For the tracking task subjects
watched a target move back and forth
across the monitor at different
speeds, while investigators measured
the eye's range of motion against the
target's range of motion, and the
position of the eye in relation to the
target.
They found that as the target's
speed increased, the AIDS and AIDS
dementia subjects fell behind, then
jumped ahead of the target, whereas
controls followed the target very ac-
curately. .
Movement Control Rapidly
Dlmlnlshe
To measure saccadic eye move
ments, subjects watched a dot jump
across the monitor. In this task, Clif
ford measured latency-the time dif
ference between when the dot moved
and when the eyes moved-and the
number of movements it took to gel
the eye from one point to the next.
"We wanted to know how soon
they would tum their eyes after the
position of the dot changed," Clifford
says. "We found that a predictable
targeting of the eyes wasn't possible:
even in asymptomatic persons. The
unpredIctability of the control move
ment started early, in the
asymptomatic tages of the disease."
In this test, the controls moved to
within four degres of the target on
their initial saccade while HIY -in
fected subjects averaged 10 percent
off target. The numb r of eye move
ments required to reach the target
varied from 1.7 in the control group
to 2.9 in the AIDS dementia group.
A more difficult anti-saccade trial
required SUbjects to look at a target
for one econd, then tum the eyes to
.
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WEEKENDS • EVENINGS. EMERGENCIES. HOUSE CALLS
We've put together the toughest test in the book
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c::;?
the opposite side and look at an
asterisk briefly presented. Among
the controls, 91 percent correctly
shifted their gaze compared to 37 per
cent of AIDS dementia ubjects.
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,
tegrated into all chool di tric '
regular and trat glc pl "
H 0-
TUDY, Drug Abu e Problem,
Program ,and Policy Recomm nd -
tions for Metropoli n Detroit,
ria ed earlier thi ye r nd covers
broad range of drug-related i u ,
including chool-b ed progr MS,
community b ed efforts, drug tre t
ment and law enforcement. The
Rand Study al 0 wa funded by the
Foundation.
The ARI report noted, however,
that there till are many are for im
provement in chool prevention
programs.
al
"Loc n men m t be
conducted to develop more p
propri te po e th problem
th n th eo ered by'off-the- hel •
prog ," Schoener ide 'P rent
and community involvement 0 i
vi ta 1. "
Th ARI report provide the fol-
lowin w rning: "If me ge
received in home nd the com
munitycontradict tho learned in the
cl room, t program i certain to
b Ie uc fuI."
Copie of th ARI report and the
Rand Corporation report re avail
able from th Skillm n Found tion,
333 We t Fort Street, Suite 1350,
Detroit, Michig n, 48226, (313) 961-
8850.
By KLEILN CARLSON
The eyes have been called the
window to the oul, but researchers at
WaShington University School of
Medicine in St. Louis are turning to
these telling organs to learn more
about the progression of the AIDS'
virus in the brain.
By better understanding the
neurological effects of AIDS, scien
tists hope they can postpone some of
the more devastating symptoms of
the disease. Researchers have
learned that subtle changes in eye
movements of people with vartous
stages of AIDS may provide early
evidence of the course the disease
. takes in the brain.
While investigators have known
for s �eral yea th!l JQ; w-ai is a
ppmary ta get of the. V-infectiop
o � .. iIlWoI"'_ ftj • t_tive
reg ted n 1 �...o'IHhoI)I �ethods fcti nitonng InsicIioJs
milk, and many fcel that such an changes have not been applied.
important food ource should be. At Washington University, re-
Any fish may carry some bacteria searchers are involved in a unique
and viruses and fish from polluted
study of oculomotor function itt my
waters may carry large doses of
infected people that has yielded clues
them. on early neurologic manifestations of
Many varieties of fish common- mv infection.
Iy contain the larvae (early stage) of
tapeworms and roundworms. And,
while proper cooking will usually
kill all such parasites, if bacteria in
fish reach a high level it can be
unsafe to eat no matter how much
you cook it. But, cooking won't
eliminate mercury, lead, and in
d us trial pollutants such as
polychlorinated biphenyls; better
known as PCBs.
These chemicals were once
widely used in electrical insulation,
pesticides, plastics, inks and dy ,
as well as many other industrial
products, and have been showD: to
seep into the food chain in a variety
of ways. Banned in the U.S. since
1979, PCBs continue to persist in
the environment, and when they ac
cumulate in the body, they can
cause birth �efects.
In addition, PCBs are officially
classified as "probable
carcinogens' (cancer-causing).
o her dangerous industrial con
taminants may include chlordane,
diodn,and DDT.
A major report by the National
Academy of Sciences pointed out
that fish 8(C more likely to be con-
tanripated by chemicals than the
animals we e:it from the land be
cause fish not only feed on plants,
but also feed on other dead animals, �
which �a'y be diseased or decaying.
In addition, fish filter gallons of
potentially polluted water through
their bodies each day, unlike the
anjm.ls we eat raised on land.
However, the academy admitted
that, �P1e current state of knowledge
on e subjects most be regarded
as q Ie tenative," and went on to
concl cle that fish and shellfish, if
properly cooked, are safe and that
Americans should be eating them.
. So, given the conflicting mes
sases, even from our experts,
what's the best advice about eating
fish'? Eat fish in reasonable
amounts. Some have suggested no
more than three times a week. Vary
your choices.
Po rt Two Oontlnued Next WHkl
"When you have a task where you
have to think about the job, it make
the task even more difficul t, " Clifford
explains. "When we asked them to
look away from the target on the left,
their eyes should have looked to the
right, not at the target. Tho e with
AIDS glanced at the target then
moved their eyes the other way.
Even the asymptomatic subjects had
trouble and it got worse with the
severity of my infection.·
Although decline in oculomotor
function was not directly correlated
with clinical staging of disease, Clif
ford says it's clear that people who
develop AIDS dementia have eye
movement problems. He plans fur
ther tes ting to learn whether this early
decline in oculomotor function
p �t - ,,_ \tel p," . ., f A
dernentii ..... , ,I,;: i""1 .. brtn r "/ n
�/1Wl _. '.� weiv
t.;L B VES it will
be several years before researchers
DR. N.A. IGBOKWE
Thi
pace provid d 8 8 public
r
are able to pinpoint specific change
that occur during the asymptomatic
period of disease. To do that,
oculomotor function t ts need to be
employed in new drug therapies and
monitored.
"Not long ago, people died within
months of developing an AIDS
defining problem, but now people
typically live everal years," Clifford
ays. "We've at least quadrupled the
lifespan with therapies found in the
first decade of this disease.
Treatment can delay the com
plications of AIDS," he continues,
"We can modify lifestyles to prevent
infection and, with medications,
protect tho e already infected.
Prophlactic treatments for common
complications such as pneumocystic
pm; nJ4( hit- s like
NL bf�tdo � dlay the com-
p . . HI d rolong life" .J
Can your home pass it?
C.all us for more information on Hom
Ey
Saf ty.
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