Octuplets born 'screaming and kicking' in Calif.

BELLFLOWER, Calif. – A woman gave birth to eight babies in Southern California on Monday, the world's second live-born set of octuplets.

The mother, who was not identified, gave birth to six boys and two girls weighing between 1.8 pounds and 3.4 pounds, doctors at Kaiser Permanante Medical Center told The Associated Press.

"It's a surprise," Dr. Karen Maples said. "Eight newborns are in stable condition and they're doing quite well."

Kaiser spokeswoman Myra Suarez said she could not release any information about the mother, including her condition or whether she used fertility drugs. Such drugs make multiple births more likely.

"They are all doing the best they can," Suarez told the AP.

The first baby was born at 10:43 a.m.; the eighth one at 10:48 a.m.

"They were all screaming and kicking around very vigorously," Dr. Harold Henry told the TV station.

The first live-born octuplets were born in Houston in 1998, and one baby died about a week later. The surviving siblings — girls Ebuka, Gorom, Chidi, Chima and Echerem, and their brothers Ikem and Jioke — celebrated their 10th birthday in December.

Their parents, Nkem Chukwu and Iyke Louis Udobi, said they are astonished and grateful that their children have grown up to be healthy and active kids who are now in the fourth grade.

Chukwu said the new parents have much to look forward to.

"Just enjoy it. It's a blessing, truly a blessing," Chukwu said. "We'll keep praying for them."

The Bellflower medical center is about 17 miles southeast of Los Angeles.

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Associated Press writers Denise Petski and Alicia Chang in Los Angeles contributed to this report.

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How to help when smoking, alcohol complicate PTSD

WASHINGTON – Reaching for a cigarette to cope with a flashback is all too common among sufferers of post-traumatic stress disorder. The nicotine hit may feel good but scientists say its brain action probably makes their PTSD worse in the long run.
Here's the rub: At least half of PTSD sufferers smoke, and others wind up dependent on alcohol, anti-anxiety pills, sometimes even illegal drugs. Yet too few clinics treat both PTSD and addictions at the same time, despite evidence they should.
Now studies are recruiting PTSD patients — from New England drug-treatment centers to veterans clinics in North Carolina and Washington — to determine what combination care works.
"It's kind of a clinical myth that you can only do one at a time or should only do one at a time," says Duke University PTSD specialist Dr. Jean Beckham, a psychologist at the Durham, N.C., Veterans Affairs Medical Center. "Everybody's afraid to have their patients quit smoking because they're afraid they're going to get worse. There's not a lot of empirical data about that."
And her research on how to break the nicotine-and-PTSD cycle raises a provocative question for a tobacco-prone military: Are people at higher risk of developing PTSD if they smoke before they experience the violent event or episode?
Post-traumatic stress disorder — which can include flashbacks, debilitating anxiety, irritability and insomnia — is thought to affect nearly 8 million Americans at any given time. Anyone can develop it after a terrifying experience, from a mugging to a hurricane, a car crash to child abuse. But PTSD is getting renewed attention because so many veterans returning from combat in Iraq and Afghanistan seem vulnerable. A study last year by the RAND Corp. research organization estimated nearly 20 percent of them, or 300,000 people, have symptoms of PTSD or major depression.
What's less discussed is that patients often don't realize they might have PTSD and try to relieve symptoms by self-medicating with alcohol, tobacco and other substance use — worsening habits that existed before the trauma or starting anew.
Addiction itself is a mental health disorder that causes changes in some of the same brain areas disrupted by mood and anxiety disorders like PTSD, says a new report on the co-illnesses from the National Institute on Drug Abuse. That argues for simultaneous treatment. Indeed, up to 60 percent of people in addiction treatment are estimated to have PTSD — although they seldom acknowledge symptoms — and they're three times more likely than other patients to drop out.
A handful of studies suggest combo care helps. One example: VA researchers in Connecticut gave the alcoholism drugs naltrexone and disulfiram to PTSD patients, and watched not only their drinking ease but their PTSD symptoms improve, too.
Then there's nicotine. It temporarily enhances attention when it hits the brain — one reason that members of military tell the VA's Beckham they smoke. Although PTSD patients say a cigarette helps their mood when they're having symptoms, the extra attention may be reinforcing bad memories.
"If you think about your traumatic event and you smoke your cigarette, you can think about it even better," explains the VA's Beckham.
Yet the NIDA report found combination care rare, partly because of our specialty-driven health system.
Another big reason: "The majority of people with PTSD don't seek treatment," Dr. Mark McGovern of Dartmouth Medical School told a NIDA meeting this month that brought together military and civilian experts to jump-start research.
"People try to swallow it or take care of it on their own and it just kind of gets out of control," agrees Bryan Adams, 24, who is working with the Iraq and Afghanistan Veterans of America to raise PTSD awareness.
Adams, now a business major at Rutgers University, was awarded a Purple Heart after being shot when his Army patrol was ambushed in Iraq in 2004. Back home he handled restlessness and irritability with increasing alcohol use. Only when he got into college did a checkup lead to a PTSD diagnosis and therapy. He quit excessive drinking as the PTSD improved, despite no formal alcohol treatment.
The new studies may prompt more merging of care:
_In Durham, Beckham is giving PTSD-suffering smokers either a nicotine patch or a dummy patch to wear for three weeks before they quit smoking. The theory: Steady nicotine release will blunt a cigarette's usually reinforcing hit to the brain, possibly helping both withdrawal symptoms and the intensity of PTSD symptoms.
_In some New Hampshire and Vermont substance-abuse clinics, McGovern is randomly assigning patients to standard addiction-only care or cognitive behavioral therapy traditionally used for PTSD. A pilot study found the cognitive behavioral therapy improved both PTSD symptoms and substance use.
_In Seattle, researchers at the VA Puget Sound Health Care System have PTSD therapists conducting smoking cessation therapy in the same visit. In a pilot study, those patients were five times more likely to quit cigarettes than PTSD patients sent to separate smoking programs.
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EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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FDA reviews benefits of Plavix in certain patients

WASHINGTON – Federal health officials are investigating whether the blood thinner Plavix — the world's second-best-selling drug and used by millions to reduce the risk of heart attack and stroke — may be less effective in some patients.

The Food and Drug Administration said Monday it is reviewing reports that certain heartburn medications can neutralize the benefits of Plavix. The agency said it is also investigating whether patients from certain genetic backgrounds also don't reap the drug's benefits.

In both cases, FDA said patients may have trouble metabolizing Plavix, reducing its ability to prevent deadly blood clots.

Plavix had global sales of $7.3 billion in 2007. The drug is marketed by Bristol-Myers Squibb Co. and Sanofi-Aventis SA and has been prescribed to more than 90 million patients around the world.

In November, researchers found that taking Plavix with popular prescription heartburn drugs like AstraZeneca PLC's Nexium significantly increased patients' chances of being hospitalized for a heart attack, stroke or chest pain. The researchers suggested that the heartburn drugs might interfere with a liver enzyme needed to metabolize Plavix.

However, some heart experts were skeptical of the findings. They noted that patients taking heartburn drugs may already have health problems that skew their risk for heart attack and other problems.

Doctors prescribe so-called proton pump inhibitor drugs to treat heartburn, in which painful stomach acids come back up the esophagus. Because Plavix, known generically as clopidogrel, can upset the stomach, it is often prescribed with the acid-blocking drugs, which include Wyeth's Protonix.

FDA said in a statement it is important to determine how the drugs interact because "decreases in the effectiveness of clopidogrel might be avoided, in part, by using other drugs ... that do not interfere with its metabolism."

FDA said there is no evidence that the "H2 blocker" family of heartburn drugs counteract Plavix. Those drugs include Johnson & Johnson's Pepcid, Boehringer Ingelheim's Zantac and GlaxoSmithKline's Tagamet HB.

Sanofi-Aventis and Bristol-Myers Squibb said they are conducting studies of whether genetic factors or heartburn drugs can interfere with Plavix.

"Individuals do not all respond to the same degree to a specific drug," said Sanofi spokeswoman Elizabeth Baxter. "Many studies are currently ongoing, including studies of clopidogrel, to explore what is responsible for this phenomenon."

The studies will take several months to complete, according to FDA, which said it would issue recommendations after reviewing them.

Until more information is available, the FDA says patients should continue taking Plavix. However, doctors should be cautious when prescribing the heartburn drugs to patients already taking Plavix.

In general, the FDA has begun notifying the public earlier about possible safety issues involving drugs. The policy change came after the agency was criticized for acting too slowly on information about medicines that were later removed from the market due to safety reasons.

Shares of Paris-based Sanofi-Aventis rose 23 cents Monday to $30.60 in midday trading. Shares of New York-based Bristol-Myers Squibb Co. dipped 1 cent to $22.38.

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