WEDNESDAY, Aug. 6 (HealthDay News) -- You say tomato, I say tomahto.

Which is all well and good as long as we're talking about fruits and vegetables -- but not so good if the nurse says "fentanyl" and the hospital pharmacist hears "sufentanil," as happened to one patient preparing for an endoscopy.

The patient, given an opioid about 10 times more potent than the one prescribed, ended up in cardiopulmonary resuscitation.

The problem of sound-alike/look-alike drug names and its close cousin -- plain old mispronunciation -- abounds. The dilemma would almost be comical, except that people can die.

"[Mispronunciation] is more than a challenge, it's also a danger," said Robert Stanberry, assistant professor of pharmacy practice at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy.

"If you pronounce it wrong, you may end up with the wrong drug," added Marilyn Storch, coordinator for all patient safety projects and the health care quality and information department at U.S. Pharmacopeia (USP), the official "standards-setting" authority for medications, dietary supplements and other health-care products sold in the United States.

And more words -- and syllables -- are entering the drug world all the time.

"As drugs proliferate, they start to sound alike, like Celexa and Celebrex," said Dr. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "It's just going to get worse with increases in the number of drugs and in the number of unfamiliar names."

Also, bear in mind that for countless physicians, many medications that they were trained to pronounce and prescribe when they were in medical school are no longer used, Kennedy added.

The Celexa/Celebrex combination is a classic example, but there are others. Losec, for heartburn, was confused so often with Lasix, a diuretic, that the name was changed to Prilosec. But now that gets confused with Prozac, according to a USP report.

And the Alzheimer's drug Reminyl was changed to Razadyne after mix-ups involving Amaryl, which lowers blood sugar. The mix-ups reportedly resulted in two deaths.

And what about names that are just too long? The generic name for Flurizan, an investigational Alzheimer's drug, is tarenflurbil. "It's almost too many syllables to pronounce," Kennedy said. Does anyone know how to pronounce bapineuzumab, another investigational drug for Alzheimer's?

The report issued earlier this year by USP on the relationship between drug names and medication errors reviewed more than 26,000 records. It found almost 1,500 different drugs implicated in medication errors as a result of names that looked or sounded alike. The drugs in question added up to 3,170 pairs, double the number of pairs found in a 2004 report. According to the document, 1.4 percent of the errors resulted in patient harm, including seven that may have played a part in patient death.

To be fair, there have been initiatives aiming to fix the problem, such as a pronunciation guide from the United States Adopted Names Council, and the "good naming practices" effort from the drug industry trade group PhRMA (Pharmaceutical Research and Manufacturers of America), not to mention the Unique Ingredient Identifier system being developed by USP and the U.S. Food and Drug Administration, as well as efforts to bar code all drugs.

Since 2002, the USP Nomenclature Expert Committee has been reviewing drug-name pronunciations to ensure consistency. The council actually changed the entry in the dictionary for ibuprofen to reflect a suggested pronunciation.

But what happens when globalism comes into play?

"As far as pronunciation of words, my experience is that it's pretty much all over the place," Stanberry said. Americans and the British pronounce "barbiturate" differently and both are right.

"Even if you were pronouncing something correctly, if you had a really deep Southern drawl, it's not going to sound the same. Or if you come in with an English accent or a French accent or a Texas accent, you may be pronouncing it correctly, but it's not going to sound the same," Storch said.

And sometimes, no one seems to know the correct pronunciation.

Stanberry recalls being at a conference last year and listening to a speaker repeatedly mispronounce a drug name -- or so he believed. "I thought, 'This guy's just mispronouncing this terribly, and he's the speaker.' But he actually studied under the guy who discovered the drug."

Then again, the speaker was British. Stanberry is American.

More information

The Merck Manuals   has a guide to drug-name pronunciations.

WEDNESDAY, Aug. 6 (HealthDay News) -- Researchers have zeroed in on more than 300 human genes that appear to impact West Nile virus infection of human cells.

Finding ways to interfere with how these genes work may provide ways to treat or even prevent infection.

"The point of the article was to determine what human genes are critical to or influence West Nile Virus infection," said Dr. Erol Fikrig, senior author of a paper in the current issue of Nature. "This indicates possible pathways for therapy."

The findings have significance not only for West Nile virus, but also for the whole family of flaviviruses, which include dengue, yellow fever, Japanese encephalitis, tick-borne encephalitis and others.

"They're interested in identifying the genetic factors that regulate susceptibility to infection with a certain class of viruses, and among those viruses are some which are of public health importance," said Philip Alcabes, an associate professor of public health at the School of Health Sciences at Hunter College, City University of New York. "In theory, if you could identify the genetic factors that make cells susceptible to infection, you could do something about that to make people less susceptible."

But what form that intervention will take is, at this point, far from clear, Alcabes warned.

Since it first appeared in North America in 1999, West Nile virus has made its way across the continent and has infected humans in virtually every contiguous state. The virus is normally passed from an infected mosquito to a bird then, from the bird, to other mosquitoes. The mosquitoes then pass the virus on to humans.

People infected with West Nile can experience a range of symptoms, from mild, flu-like aches and pains to life-threatening encephalitis (inflammation of the brain).

But the virus has a mere 10 proteins, suggesting that it uses cellular processes in the host to enable it to infect and replicate.

Using genome-wide screening, the authors of this paper identified 305 genes or proteins in human cells that affect West Nile virus infection.

Some 30 percent to 40 percent of these genes also affect infection with dengue virus. "There are some pathways that are important for both viruses," explained Fikrig, who is a professor of medicine and microbial pathogenesis at Yale University School of Medicine and an investigator with the Howard Hughes Medical Institute. "We're testing other viruses and are hopeful that some of these pathways will be important for the common family of viruses and, if so, will provide special targets for prevention."

Fikrig and his team are now trying to replicate and confirm their findings in mice. They are also testing existing compounds to see if they inhibit these pathways.

And they're hoping others will take up some of the slack.

As Fikrig pointed out, 300 genes "is more than anyone can handle on their own. I'm hopeful this will provide a road map for other people to ask these types of questions."

Another expert pointed out that the researchers have basically started to untangle how the virus uses the host's cellular processes to replicate.

"The finding has good potential to provide us with novel targets in humans that can be exploited to intervene in a wide array of viral infections," said Young Hong, assistant professor of molecular entomology at Tulane University School of Public Health and Tropical Medicine in New Orleans.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on West Nile.

WEDNESDAY, Aug. 6 (HealthDay News) -- Americans are drinking less alcohol, with middle-aged people consuming about one-third less than 50 years ago, researchers report.

Overall, Americans are drinking less beer, but more wine, while consumption of hard liquor has remained fairly constant. Also, more people say they don't drink, and those born later in the 20th century are more moderate drinkers than their parents.

"It looks like moderate drinking has been increasing, heavy drinking is down a little bit, and total alcohol consumption is down a little bit," said lead researcher Dr. R. Curtis Ellison, a professor of medicine and public health at Boston University School of Medicine.

"It is encouraging news that more people are drinking moderately, and the average intake is coming down rather than shooting up," he said.

For the study, Ellison's team collected data on 8,000 people who took part in the Framingham Heart Study. People in the initial arm of the study were born before 1900 up until 1959. Those from the initial enrollment group as well as their children were interviewed every four years from 1948 to 2003 about their alcohol consumption.

Ellison explained that the Framingham study consists primarily of white, middle-class individuals from the Massachusetts town of the same name. "It generally tends to reflect trends within the country among middle-class, white Americans," he said.

The researchers found that, overall, people are drinking less. "People drank about a third more back in the '50s and '60s than they did in the '70s up to 2004," Ellison said.

There's been a gradual decrease in the average amount of alcohol people drink. For instance, alcohol consumption among men has gone from about two-and-a-half drinks a day to one-and-a-half drinks a day, Ellison said.

"At the same time, there's been a decrease in beer and an increase in wine consumption among people. But the average intake has decreased," he said.

As for liquor, the average intake has remained pretty much the same, he added.

Despite the decline in alcohol consumption, the risk of alcohol dependence did not show a corresponding decrease, the study also found.

"We don't know why alcohol consumption has gone down," Ellison said. "The data are very clear that light to moderate drinking, without binge drinking, is generally good for health, whereas a larger amount of binge drinking is bad. It looks like, in this population, it's going in the right direction."

The study findings were published in the August issue of The American Journal of Medicine.

David L. Katz, director of the Yale University School of Medicine Prevention Research Center, noted that during "recent decades, the messages about alcohol have increasingly emphasized the potential to derive both pleasure and health benefits from wine, provided the dose is prudent. The trends in this study suggest those messages are having an impact, at least in Framingham, Massachusetts. Among those not vulnerable to alcohol abuse, intake patterns appear to be shifting in accord with expert recommendations."

More information

For more on alcohol abuse, visit the U.S. National Institute on Alcohol Abuse and Alcoholism.

FRIDAY, July 25 (HealthDay News) -- For many Americans, the meanings of various lab tests have long been the Bermuda Triangle of health care: poorly explained and often mysterious.

Enter a nonprofit Web site from the American Association for Clinical Chemistry (AACC) called Lab Tests Online. It offers patients easy access to detailed but consumer-friendly information on lab work and test results.

"Traditional lab medicine has been an invisible component of health care," observed George Linzer, executive producer of the Web site. "It's just like when you turn the light on: You really don't know all that's transpiring between that action and the light turning on in your room. Similarly, we go to our doctors, and they take our blood, and we get results back -- but often without much of an explanation from the physician or nurse or even the lab itself about what's just happened. We don't understand the process."

"But now we're in a culture where the consumer is really taking more responsibility for their care," added Linzer. "So, this Web site does just one thing: It focuses exclusively on providing up-to-date, evidence-based information on lab tests that's been vetted by representatives from just about every major lab organization in the country. No other Web site does that."

If numbers are any indication, the public education effort -- supported by 19 of the leading lab organizations in the United States and Canada -- has been a notable success. The site routinely experiences more than 1 million hits per month, and, by this fall, a total of 50 million visitors will be expected to have logged on for a free crash course on what a blood and fluid work-up really means.

On the home page, users can seek out information on the why, when and how of about 250 of the most common lab tests; scroll through lay-term language explanations of a range of conditions and diseases; and review outlines for general screening protocols and recommendations according to patient age. The site also offers the latest news regarding lab test innovations.

In addition to providing links to other mostly governmental and non-commercial sites, patients can also pose specific questions to a volunteer staff of lab scientists -- getting a response within 24 to 72 hours.

The site's popularity has led the AACC to establish other sites around the world. Currently, local versions are active in the United Kingdom, Australia, Spain, Germany, Italy, Hungary and Poland. Future sites are in development for Greece, the Czech Republic and Portugal.

"Our experience is that regardless of where people are and what medical system they encounter, they want more information than simply a doctor telling them 'We need to do such and such tests' or 'Your tests are normal,' " explained Dr. D. Robert Dufour, an emeritus professor of pathology at George Washington University Medical Center and the Web site's international liaison editor.

"And we get a lot of comments from users who say they're not getting enough time with their doctor to discuss the issue," he added. "So, they're anxious while waiting for their results and anxious when they get them. And this site helps to relieve some of that anxiety, by telling people what certain tests are used for, when they're ordered, factors that might affect interpretation, what results mean and, more importantly, what they don't mean."

Dufour noted that although the site is written for the lay public in mind, they've found that one-quarter to one-third of users are, in fact, health-care professionals.

"And we actually have a lot of doctors who are referring patients to the site," noted Linzer. "And as a consequence, we've gotten comments back from patients that now that they have this information, they are able to go and talk more intelligently to their doctors. So, we think, in the end, that this is a site that both patients and doctors have come to appreciate."

More information

For more about lab tests, visit the Lab Tests Online  .