CHECKUP STUDY: AMERICANS GET ONLY HALF OF THE CARE THEY NEED.

Byline: - Staff and Wire Services

Most Americans receive only about half the health care considered optimal for their conditions, according to a new study in the June 26 issue of the New England Journal of Medicine.

That rate holds for prevention measures, treatment of chronic problems such as high cholesterol and blood pressure - and even immediate conditions like headaches and hip fractures.

``On average, adults fail to receive about half of recommended care,'' says Dr. Eve Kerr, a research scientist at the VA Ann Arbor Healthcare System in Michigan and a co-author of the study.

A research team, led by Dr. Elizabeth McGlynn of the RAND research group, interviewed and reviewed the medical records of 6,712 men and women in 12 major cities, including Boston, Miami, Indianapolis, Seattle, Newark, N.J., and Little Rock, Ark. The volunteers, whose average age was 45, were asked about their history with any of 30 acute or chronic ailments - from broken hips to congestive heart failure and alcoholism - as well as their experience with a range of common preventive steps such as screening for HIV and colorectal cancer.

For each condition, the researchers came up with a roster of recommended treatments, based on guidelines from medical societies, the government and other best-practice groups. The tally ultimately included 439 measures of quality care.

Some conditions were much more likely to receive appropriate care than others. Men and women with cataracts, for example, got nearly 80 percent of the recommended treatment, while those with an alcohol addiction got only 10.5 percent. Breast cancer fared second best, at about 76 percent, followed by prenatal care. Hip fractures and an abnormal heart beat came in last.

On average, people got about 55 percent of the care they should have received. The nature of their condition - acute or chronic - or whether the treatment was simply a precaution didn't significantly affect that rate. Nor did whether they had insurance or what kind.

ALZHEIMER'S DEVELOPMENT: The buildup of toxic proteins in the brains of Alzheimer's patients is accompanied by changes in several genes linked to memory and learning, according to a new study in the latest issue of the Journal of Neuroscience.

The study, which looked at both mice and humans, found that brain cell genes known to regulate memory and learning were significantly suppressed in the presence of plaques composed of a renegade protein called beta-amyloid. Many Alzheimer's researchers believe these plaques cause the dementia and other mental decline that mark the condition.

Dave Morgan, an Alzheimer's expert at the University of South Florida in Tampa, and the leader of the study, says the work could open a new frontier in the search for therapies to fight the disease.

So far, scientists have come at Alzheimer's from three directions: drugs that block the buildup of protein deposits, ``plaque-busting'' drugs that break up the protein clusters and allow the brain to clear them away and vaccines that encourage the immune system to destroy the plaques.

The fourth way, Morgan says, would be to use the latest information and subsequent research to design drugs that could reverse the effects of beta- amyloid on brain genes.

HIV REMEDIES: Half of Americans infected with HIV have used alternative remedies along with or in place of conventional antiretroviral drugs, according to a study by UCLA and RAND researchers.

Alternative therapies may ease the side effects from the antiretroviral drugs. But in some cases, they can interfere with the medication's effectiveness or cause harmful results. The research team surveyed patients about a number of alternative therapies, including megavitamin doses, homeopathy, and herbs such as St. John's Wort.

About 26 percent of the patients did not tell their doctors they were using alternative therapies. The study results underscore the need for doctors to ask their patients about their use of alternative medicines, researchers said.

BONE DRUG FOR CANCER? Drugs used to treat osteoporosis appear to decrease bone destruction in children suffering from neuroblastoma, a common form of cancer. Neuroblastoma often spreads to the bone, which causes significant pain. Researchers at Childrens Hospital Los Angeles discovered that cells called osteoclasts degraded the bone and allowed the cancer cells to invade. When mice received Ibandronate, a medicine used to counter osteoporosis, the bone destruction was slowed.