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Subject: HICN611 Medical News Part 2/4
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HICNet Medical Newsletter Page 13
Volume 6, Number 11 April 25, 1993
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Food & Drug Administration News
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FDA Approves Depo Provera, injectable contraceptive
P92-31 Food and Drug Administration
FOR IMMEDIATE RELEASE Susan Cruzan - (301) 443-3285
The Food and Drug Administration today announced the approval of Depo Provera,
an injectable contraceptive drug.
The drug, which contains a synthetic hormone similar to the natural hormone
progesterone, protects women from pregnancy for three months per injection.
The hormone is injected into the muscle of the arm or buttock where it is
released into the bloodstream to prevent pregnancy. It is more than 99 percent
effective.
"This drug presents another long-term, effective option for women to prevent
pregnancy," said FDA Commissioner David A. Kessler, M.D. "As an injectable,
given once every three months, Depo Provera eliminates problems related to
missing a daily dose."
Depo Provera is available in 150 mg. single dose vials from doctors and
clinics and must be given on a regular basis to maintain contraceptive
protection. If a patient decides to become pregnant, she discontinues the
injections.
As with any such products, FDA advises patients to discuss the benefits and
risks of Depo Provera with their doctor or other health care professional
before making a decision to use it.
Depo Provera's effectiveness as a contraceptive was established in extensive
studies by the manufacturer, the World Health Organization and health agencies
in other countries. U.S. clinical trials, begun in 1963, also found Depo
Provera effective as an injectable contraceptive.
The most common side effects are menstrual irregularities and weight gain. In
addition, some patients may experience headache, nervousness, abdominal pain,
dizziness, weakness or fatigue. The drug should not be used in women who have
acute liver disease, unexplained vaginal bleeding, breast cancer or blood
clots in the legs, lungs or eyes.
The labeling advises doctors to rule out pregnancy before prescribing the
drug, due to concerns about low birth weight in babies exposed to the drug.
HICNet Medical Newsletter Page 14
Volume 6, Number 11 April 25, 1993
Recent data have also demonstrated that long-term use may contribute to
osteoporosis. The manufacturer will conduct additional research to study this
potential effect.
Depo Provera was Developed in the 1960s and has been approved for
contraception in many other countries. The UpJohn Company of Kalamazoo, Mich.,
which will market the drug under the name, Depo Provera Contraceptive
Injection, first submitted it for approval in the United States in the 1970s.
At that time, animal studies raised questions about its potential to cause
breast cancer. Worldwide studies have since found the overall risk of cancer,
including breast cancer in humans, to be minimal if any.
HICNet Medical Newsletter Page 15
Volume 6, Number 11 April 25, 1993
New Rules Speed Approval of Drugs for Life-Threatening Illnesses
P92-37 Food and Drug Administration
Monica Revelle - (301) 443-4177
The Food and Drug Administration today announced that it will soon publish new
rules to shed the approval of drugs for patients with serious or life-
threatening illnesses, such as AIDS, cancer and Alzheimer's disease.
"These final rules will help patients who are suffering the most serious
illnesses to get access to new drugs months or even years earlier than would
otherwise be possible," said HHS Secretary Louis W. Sullivan, M.D. "The effort
to accelerate FDA review for these drugs has been a long-term commitment and
indeed a hallmark of this administration."
These rules establish procedures for the Food and Drug Administration to
approve a drug based on "surrogate endpoints" or markers. They apply when the
drug provides a meaningful benefit over currently available therapies. Such
endpoints would include laboratory tests or physical signs that do not in
themselves constitute a clinical effect but that are judged by qualified
scientists to be likely to correspond to real benefits to the patient.
Use of surrogate endpoints for measurement of drug efficacy permits approval
earlier than if traditional endpoints -- such as relief of disease symptoms or
prevention of disability and death from the disease -- are used.
The new rules provide for therapies to be approved as soon as safety and
effectiveness, based on surrogate endpoints, can be reasonably established.
The drug's sponsor will be required to agree to continue or conduct
postmarketing human studies to confirm that the drug's effect on the surrogate
endpoint is an indicator of its clinical effectiveness.
One new drug -- zalcitabine (also called ddC) -- was approved June 19, using a
model of this process, for treating the human immunodeficiency virus, HIV, the
cause of AIDS.
Accelerated approval can also be used, if necessary, when FDA determines that
a drug, judged to be effective for the treatment of a disease, can be used
safely only under a restricted distribution plan.
"The new rules will help streamline the drug development and review process
without sacrificing goad science and rigorous FDA oversight," said FDA
commissioner David A. Kessler, M.D. "While drug approval will be accomplished
faster, these drugs and biological products must still meet safety and
effectiveness standards required by law."
HICNet Medical Newsletter Page 16
Volume 6, Number 11 April 25, 1993
The new procedures also allow for a streamlined withdrawal process if the
postmarketing studies do not verify the drug's clinical benefit, if there is
new evidence that the drug product is not shown to be safe and effective, or
if other specified circumstances arise that necessitate expeditious withdrawal
of the drug or biologic.
HICNet Medical Newsletter Page 17
Volume 6, Number 11 April 25, 1993
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Articles
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Research Shows Promise for Preventing or Slowing
Blindness due to Retinal Disease
National Retinitis Pigmentosa Foundation
Neutrophilic Factors Rescue Photoreceptor Cells in Animal Tests
Baltimore, MD - Researchers at the University of California San Francisco
and Regeneron Pharmaceuticals, Inc. [NASDAQ: REGN] have discovered that
certain naturally occurring substances known as neurotrophic factors can
prevent the degeneration of light-sensing cells in the retina of the eye. The
degeneration of these cells, known as photoreceptors, is a major cause of
visual impairment
This research, published to in the December issue of the Proceedings of
the National Academy of Science (PNAS), holds promise for people who may lose
their sight due to progressive retinal degeneration -- currently, no drug
treatment for retinal degeneration exists. It is estimated that 2.5 million
Americans have severe vision loss due to age-related macular degeneration and
100,000 Americans are affected by retinitis pigmentosus, a hereditary disease
that causes blindness. In addition, each year more than 15,000 people undergo
surgical procedures to repair retinal detachments and other retinal traumas.
The research was funded in part by the RP (Retinitis Pigmentosa)
Foundation Fighting Blindness, Regeneron Pharmaceuticals and the National Eye
Institute. It was conducted by Drs. Matthew M. LaVail, Kazuhiko Unoki, Douglas
Yasurnura, Michael T. Matthes and Roy H. Steinberg at UCSF, arld Dr. C;eorge
Yancoooulos, Regeneron's Vice President for Discovery. Regeneron holds an
exclusive license for this research from UCSF.
In the research described in the PNAS , a light-damage model was used to
assess the survival-promoting activity of a number of naturally occurring
substances. Experimental rats were exposed to constant light for one week.
Eyes that had not been treated with an effective factor lost most of their
photoreceptor cells -- the rods and cones of the retina -- after light
exposure. Brain Derived Neurotrophic Factor (BDNF) and Ciliary Neurotrophic
Factor (CNTF) were particularly effective in this model without causing
unwanted side effects; other factors such as Nerve Growth Factor (NGF) and
Insulin-like Growth Factor (IGF-1) were not effective in these experiments.
Discussing the research, Dr. Jesse M. Cedarbaum, Regeneron's Director of
Clinical Research, said, "BDNF's ability to rescue neurons in the retina that
have been damaged by light exposure may hold promise for the treatment of age-
related macular degeneration, one of the leading causes of vision impairment,
and for retinal detachment. Following detachment, permanent vision loss may
HICNet Medical Newsletter Page 18
Volume 6, Number 11 April 25, 1993
result frorn the death of detached retinal cells. It is possible that BDNF
could play a role in rescuing those cells once the retina has been reattached
surgically."
"Retinitis pigmentosa is a slowly progressing disease that causes the
retina to degenerate over a period of years or even decades. Vision decreases
to a small tunnel of sight and can result in total blindness. It is our hope
that research on growth factors will provide a means to slow the progression
and preserve useful vision throughout life," stated Jeanette S. Felix, Ph.D.,
Director of Science for the RP Foundation Fighting Blindness.
In addition to the work described , Regeneron is developing BDNF in
conjunction with Aingen Inc. [NASDAQ:AMGN] as a possible treatment for
peripheral neuropathies associated with diabetes and cancer chemotherapy,
motor neuron diseases, Parkinson's disease, and Alzheimer's disease. By
itself, Regeneron is testing CNTF in patients with arnyotrophic lateral
sclerosis (commonly known as Lou Gehrig's disease).
Regeneron Pharlnaceuticals, Inc., based in Tarrytown, New York, is a
leader in the discovery and development of biotechnology-based compounds for
the treatment of neurodegenerative diseases, peripheral neuropathies and nerve
injuries, which affect more than seven million Americans. Drs. LaVail and
Steinberg of UCSF are consultants to Regeneron.
HICNet Medical Newsletter Page 19
Volume 6, Number 11 April 25, 1993
Affluent Diet Increases Risk Of Heart Disease
Research Resources Reporter
written by Mary Weideman
Nov/Dec 1992
National Institutes of Health
High-fat, high-calorie diets rapidly increase risk factors for coronary
heart disease in native populations of developing countries that have
traditionally consumed diets low in fat. These findings, according to
investigators at the Oregon Health Sciences University in Portland, have
serious implications for public health in both industrialized and developing
countries.
"This study demonstrates why we can develop coronary heart disease and
have higher blood cholesterol and triglyceride levels. It shows also the
importance of diet and particularly the potential of the diet to increase body
weight, thereby leading to a whole host of other health problems in developing
countries and affluent nations as well," explains principal investigator Dr.
William E. Connor, head of the section of clinical nutrition and lipid
metabolism at Oregon Health Sciences University.
Over the past 25 years Dr. Connor and his team have characterized the
food and nutrient intakes of the Tara humara Indians in Mexico, while
simultaneously documenting various aspects of Tarahumara lipid metabolism.
These native Mexicans number approximately 50,000 and reside in the Sierra
Madre Occidental Mountains in the state of Chihuahua. The Tarahumaras have
coupled an agrarian diet to endurance racing. Probably as a result, coronary
heart disease, which is so prevalent in Western industrialized nations, is
virtually non existent in their culture. Loosely translated, the name
Tarahumara means "fleet of foot," reflecting a tribal passion for betting on
"kickball" races, in which participants run distances of 100 miles or more
while kicking a machete-carved wooden ball.
The typical Tarahumara diet consists primarily of pinto beans, tortillas,
and pinole, a drink made of ground roasted corn mixed with cold water,
together with squash and gath ered fruits and vegetables. The Tara humaras
also eat small amounts of game, fish, and eggs. Their food contains
approximately 12 percent of total calories as fat of which the majority (69
percent) is of vegetable origin. Dietician Martha McMurry, a coinvestigator
in the study, describes their diet as simple and very rich in nutrients while
low in cholesterol and fat.
The Tarahumaras have average plasma cholesterol levels of 121 mg/ dL,
low-density lipoprotein (LDL)-cholesterol levels of 72 mg/dl, and high-density
lipoprotein (HDL)-cholesterol levels of 32 to 42 mg/dl. All of those values
are in the good, low-risk range, according to the researchers. Elevated
cholesterol and LDL-cholesterol levels are considered risk factors for heart
HICNet Medical Newsletter Page 20
Volume 6, Number 11 April 25, 1993
disease. HDL-cholesterol is considered beneficial. In previous studies the
Tarahumaras had been found to be at low risk for cardiac disease, although
able to respond to high-cholesterol diets with elevations in total and LDL-
cholesterol.
Clinical Research Center dietitian McMurry and coinvestigator Maria
Teresa Cerqueira established a metabolic unit in a Jesuit mission school
building near a community hospital in the small village of Sisoguichi. Food
was weighed, cooked, and fed to the study participants under the
investigators' direct supervision, ensuring that subjects ate only food
stipulated by the research protocol. Fasting blood was drawn twice weekly,
and plasma samples were frozen and shipped to Dr. Connors laboratory for
cholesterol, triglyceride, and lipoprotein analyses. Regular measurements
included participant body weight, height, and triceps skin fold thickness.
Thirteen Tarahumaras, five women and eight men, including one adolescent, were
fed their native diet for 1 week, followed by 5 weeks of an "affluent" diet.
"In this study we went up to a concentration of dietary fat that was 40
percent of total calories. This is the prototype of the holiday diet that
many Americans consume a diet high in fat, sugar, and cholesterol, low in
fiber," elaborates Dr. Conners. Such dietary characteristics are reflected in
the cholesterol-saturation index, or CSI, recently devised research dietitian
Sonja Conner working with Dr. Connor. "The CSI is a single number that
incorporates both the amount of cholesterol and the amount of saturated fat in
the diet. CSI indicates the diet's potential to elevate the cholesterol
level, particularly the LDL," Dr. Connor explains. The Tarahumaran diet
averages a very low CSI of 20; Dr. Connor's "affluent" diet used in the study
ranks a CSI of 149.
The experimental design of this study reflects the importance of
establishing baseline plasma lipid levels, typical of the native diet, before
exposing subjects to the experimental diet. The standard curve relating
dietary food intake to plasma cholesterol demonstrates a leveling off, or
plateau, for consumption of large amounts of fat. Changes in dietary fat
and/or cholesterol in this range have little effect on plasma levels. "You
must have the baseline diet almost free of the variables you are going to put
into the experimental diet. The Framingham study, for example, did not
discriminate on the basis of diet between individuals who got heart disease
because the diet was already high in fat. All subjects were already eating on
a plateau," Dr. Connor says.
After 5 weeks of consuming the "affluent" diet, the subjects' mean plasma
cholesterol levels had in creased by 31 percent, primarily in the LDL
fraction, which rose 39 percent. HDL-cholesterol increased by 31 per cent,
and LDL to HDL ratios changed therefore very little. Plasma triglyceride
levels increased by 18 percent, and subjects averaged an 8-pound gain in
weight. According to Dr. Connor, lipid changes occurred surprisingly soon,
yielding nearly the same results after 7 days of affluent diet as after 35
days.
HICNet Medical Newsletter Page 21
Volume 6, Number 11 April 25, 1993
The increase in HDL carries broad dietary implications for industrialized
nations. "We think HDL-cholesterol increased because we increased the amount
of dietary fat over the fat content used in the previous Tarahumara metabolic
study. In that study we saw no change in HDL levels after raising the dietary
cholesterol but keeping the fat relatively consistent with native consumption.
In the present study we increased fat intake to 40 percent of the total
calories. We reached the conclusion in the Tarahumara study that HDL reflects
the amount of dietary fat in general and not the amount of dietary
cholesterol. HDL must increase to help metabolize the fat, and it increased
quite a bit in this study," Dr. Connor explains.
Low HDL in the Tarahumarans is not typically an important predictor of
coronary heart disease because they do not normally consume large amounts of
fat or cholesterol. HDL remains an important predictor to Americans because
of their usual high fat intake.
Dr. Connor recommends a diet for Americans that contains less than 20
percent of total calories as fat, less than 100 mg of cholesterol, and a CSI
around 20, varying in accordance with caloric needs. Such a diet is low in
meat and dairy fat, high in fiber. Dr. Connor also comments on recent
suggestions that Americans adopt a "Mediterranean-style" diet. "The original
Mediterranean diet, in its pristine state, consisted of a very low intake of
fat and very few animal and dairy products. We are already eating a lot of
meat and dairy products. Simply to continue that pattern while switching to
olive oil is not going to help the situation."
The World Health Organization (WHO) is focusing much attention on the
emergence of diseases such as coronary heart disease in nations and societies
undergoing technological development. Dr. Connor says that coronary heart
disease starts with a given society's elite, who typically eat a different
diet than the average citizen. "If the pattern of afluence increases, the
entire population will have have a higher incidence of coronary heart disease,
which places a termendous health care burden on a society. WHO would like the
developing countries to prevent coronary heart disease, so they can
concentrate on other aspects of their economic development and on public
health measures to improve general well-being, rather than paying for
unnecessary, expensive medical technology," Dr. Connors says.
"The overall implication of this study is that humans can readily move
their plasma lipids and lipoprotein values into a high-risk range within a
very short time by an affluent, excessive diet. The present rate of coronary
heart disease in the United States is 30 percent less than it was 20 years
ago, so a lot has been accomplished. We are changing rapidly," he concludes.
HICNet Medical Newsletter Page 22
Volume 6, Number 11 April 25, 1993
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General Announcments
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Publications for Health Professionals Available from NCI (1/93)
Unless otherwise noted, the following materials are provided free of charge by
calling the NCI's Publication Ordering Service, 1-800-4-CANCER. Because
Federal Government publications are not subject to copyright restriction, you
are free to photocopy NCI material.
GENERAL INFORMATION
ANTICANCER DRUG INFORMATION SHEETS IN SPANISH/ENGLISH. Two-
sided fact sheets (in English and Spanish) provide
information about side effects of common drugs used to treat
cancer, their proper usage, and precautions for patients.
The fact sheets were prepared by the United States
Pharmacopeial Convention, Inc., for distribution by the
National Cancer Institute. Single sets only may be ordered.
CANCER RATES AND RISKS, 3RD EDITION (85-691). This book is
a compact guide to statistics, risk factors, and risks for
major cancer sites. It includes charts and graphs showing
incidence, mortality, and survival worldwide and in the
United States. It also contains a section on the costs of
cancer. 136 pages.
DIET, NUTRITION & CANCER PREVENTION: A GUIDE TO FOOD CHOICES
(87-2778). This booklet describes what is now known about
diet, nutrition, and cancer prevention. It provides
information about foods that contain components like fiber,
fat, and vitamins that may affect a person's risk of getting
certain cancers. It suggests ways to use that information
to select from a broad variety of foods--choosing more of
some foods and less of others. Includes recipes and sample
menus. 39 pages.
NATIONAL CANCER INSTITUTE FACT BOOK. This book presents
general information about the National Cancer Institute
including budget data, grants and contracts, and historical
information.
HICNet Medical Newsletter Page 23
Volume 6, Number 11 April 25, 1993
NATIONAL CANCER INSTITUTE GRANTS PROCESS (91-1222) (Revised
3/90). This booklet describes general NCI grant award
procedures; includes chapters on eligibility, preparation of
grant application, peer review, eligible costs, and post-
award activities. 62 pages.
PHYSICIAN TO PHYSICIAN: PERSPECTIVE ON CLINICAL TRIALS. This
15-minute videocassette discusses why and how to enter
patients on clinical trials. It was produced in
collaboration with the American College of Surgeons
Commission on Cancer.
STUDENTS WITH CANCER: A RESOURCE FOR THE EDUCATOR (91-2086).
(Revised 4/87) This booklet is designed for teachers who
have students with cancer in their classrooms or schools. It
includes an explanation of cancer, its treatment and
effects, and guidelines for the young person's re-entry to
school and for dealing with terminally ill students.
Bibliographies are included for both educators and young
people. 22 pages.
UNDERSTANDING THE IMMUNE SYSTEM (92-529). This booklet
describes the complex network of specialized cells and
organs that make up the human immune system. It explains how
the system works to fight off disease caused by invading
agents such as bacteria and viruses, and how it sometimes
malfunctions, resulting in a variety of diseases from
allergies, to arthritis, to cancer. It was developed by the
National Institute of Allergy and Infectious Diseases and
printed by the National Cancer Institute. This booklet
presents college level instruction in immunology. It is
appropriate for nursing or pharmacology students and for
persons receiving college training in other areas within the
health professions. 36 pages.
MATERIALS TO HELP STOP TOBACCO USE
CHEW OR SNUFF EDUCATOR PACKAGE (91-2976). Each package
contains:
Ten copies of CHEW OR SNUFF IS REAL BAD STUFF, a
brochure designed for seventh and eighth graders that
describes the health and social effects of using
HICNet Medical Newsletter Page 24
Volume 6, Number 11 April 25, 1993
smokeless tobacco products. When fully opened, the
brochure can be used as a poster.
One copy of CHEW OR SNUFF IS REAL BAD STUFF: A GUIDE
TO MAKE YOUNG PEOPLE AWARE OF THE DANGERS OF USING
SMOKELESS TOBACCO. This booklet is a lesson plan for
teachers. It contains facts about smokeless tobacco,
suggested classroom activities, and selected
educational resources.
HOW TO HELP YOUR PATIENTS STOP SMOKING: A NATIONAL CANCER
INSTITUTE MANUAL FOR PHYSICIANS (92-3064). This is a step-
by-step handbook for instituting smoking cessation
techniques in medical practices. The manual, with resource
lists and tear-out materials, is based on the results of NCI
clinical trials. 75 pages.
HOW TO HELP YOUR PATIENTS STOP USING TOBACCO: A NATIONAL
CANCER INSTITUTE MANUAL FOR THE ORAL HEALTH TEAM (91-3191).
This is a handbook for dentists, dental hygienists, and
dental assistants. It complements the physicians' manual
and includes additional information on smoking prevention
and on smokeless tobacco use. 58 pages.
PHARMACISTS HELPING SMOKERS QUIT KIT. A packet of materials
to help pharmacists encourage their smoking patients to
quit. Contains a pharmacist's guide and self-help materials
for 25 patients.
SCHOOL PROGRAMS TO PREVENT SMOKING: THE NATIONAL CANCER
INSTITUTE GUIDE TO STRATEGIES THAT SUCCEED (90-500). This
guide outlines eight essential elements of a successful
school-based smoking prevention program based on NCI
research. It includes a list of available curriculum
resources and selected references. 24 pages.
SELF-GUIDED STRATEGIES FOR SMOKING CESSATION: A PROGRAM
PLANNER'S GUIDE (91-3104). This booklet outlines key
characteristics of successful self-help materials and
programs based on NCI collaborative research. It lists
additional resources and references. 36 pages.
SMOKING POLICY: QUESTIONS AND ANSWERS. These ten fact sheets
HICNet Medical Newsletter Page 25
Volume 6, Number 11 April 25, 1993
provide basic information about the establishment of
worksite smoking policies. Topics range from the health
effects of environmental tobacco smoke to legal issues
concerning policy implementation.
STRATEGIES TO CONTROL TOBACCO USE IN THE UNITED STATES: A
BLUEPRINT FOR PUBLIC HEALTH ACTION IN THE 1990s (92-3316:
Smoking and Control Monograph No. 1). This volume provides
a summary of what has been learned from 40 years of a public
health effort against smoking, from the early trial-and-
error health information campaigns of the 1960s to the NCI's
science-based project, American Stop Smoking Intervention
Study for Cancer Prevention, which began in 1991. It offers
reasons why comprehensive smoking control strategies are now
needed to address the smoker's total environment and to
reduce smoking prevalence significantly over the next
decade.
MATERIALS FOR OUTREACH PROGRAMS
CANCER PREVENTION AND EARLY DETECTION: COMMUNITY OUTREACH
PROGRAMS FOR HEALTH PROFESSIONALS
Three kits are available for community program planners
and health professionals to set up local cancer
prevention and early detection education projects:
DO THE RIGHT THING. . . GET A NEW ATTITUDE ABOUT
CANCER COMMUNITY OUTREACH PROGRAM. This community
outreach kit targets Black American audiences. It
contains materials to help health professionals
conduct community education programs for black
audiences. The kit emphasizes the early detection of
breast cancer by mammography and of cervical cancer by
the Pap test. It also discusses smoking and
nutrition. The kit includes helpful program guidance,
facts, news articles, visuals, and brochures.
HAGALO HOY COMMUNITY OUTREACH PROGRAM. This community
outreach kit targets Hispanic audiences. It contains
bilingual and Spanish language materials to help
health professionals conduct community education
programs. The materials educate Hispanic audiences
about early detection of breast cancer by mammography
HICNet Medical Newsletter Page 26
Volume 6, Number 11 April 25, 1993
and of cervical cancer by Pap tests. The kit also
discusses smoking and related issues. The kit
includes helpful guidance, facts, news articles,
visuals and brochures.
ONCE A YEAR..FOR A LIFETIME COMMUNITY OUTREACH
MAMMOGRAPHY PROGRAM. This community outreach kit
targets all women age 40 or over. It supplies
community program planners and health professionals
with planning guidance, facts about mammography, news
articles, visuals and brochures.
MAKING HEALTH COMMUNICATION PROGRAMS WORK: A PLANNER'S GUIDE
(92-1493). This handbook presents key principles and steps
in developing and evaluating health communications programs
for the public, patients, and health professionals. It
expands upon and replaces "Pretesting in Health
Communications" and "Making PSAs Work." 131 pages.
SUPPORT MATERIAL FOR COMMUNITY OUTREACH PROGRAMS
The video and slide presentations listed below support the
mammography outreach programs.
ONCE A YEAR...FOR A LIFETIME VIDEOTAPE. This 5-minute
VHS videotape uses a dramatic format to highlight the
important facts about the early detection of breast
cancer by mammography.
UNA VEZ AL ANO...PARA TODA UNA VIDA VIDEOTAPE. This 27-
minute Spanish videotape informs Spanish-speaking women
of the need for medical screening, particularly
mammography. It explains commonly misunderstood facts
about breast cancer and early detection. The program, in
a dramatic format, features Edward James Olmos and
Cristina Saralegui.
ONCE A YEAR...FOR A LIFETIME SPEAKER'S KIT (SLIDE SHOW).
This kit includes 66 full-color slides and a number-
coded, ready-to-read script suitable for a mammography
presentation to a large group. It addresses the
misconceptions prevalent about mammography and urges
women age 40 and older to get regular mammograms so that
breast cancer can be detected as early as possible. Kit
HICNet Medical Newsletter Page 27
Volume 6, Number 11 April 25, 1993
includes a guide, poster, media announcement, news
feature, flyer, and pamphlets on mammography. This kit
is available directly by writing to: Modern, 5000 Park
Street North, St. Petersburg, FL 33709-9989.
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