Drano for the Heart (February 28, 2004) 

OKLAHOMA CITY (Ivanhoe Newswire)

Researchers say a new therapy that was created after observing the population of a small town in Italy may actually reverse heart disease in some patients.

Fourteen years ago, Bob Garrison had a heart attack -- an event that led to several angioplasties and eventually to Muhammad Yasin, M.D., an interventional cardiologist at Southwest Cardiologist Associates in Oklahoma City.

“Bob was known to have coronary artery disease. He came in with what we call unstable angina or acute coronary syndrome, where he was ready to have a heart attack,” Dr. Yasin tells Ivanhoe.

He asked Garrison to participate in a clinical trial to reduce the plaque in his heart. Garrison said yes. “They injected a solution in my arm, and I sat for about an hour," he says. "Then you left for a couple of hours, and then I came back, and they did some other things.”

To reduce years of plaque that had built up in Garrison's heart, Dr. Yasin injected him with a lab-produced version of HDL, or good cholesterol. “In the long-run, there is a reduction in the plaque size," says Dr. Yasin. "In the short-run, I think we decrease inflammation in the artery wall.”

Those injections of HDL have the potential to reverse years of heart disease. “This is the first time we have proved that this medication, or any medication, can cause significant reduction in the plaque size,” Dr. Yasin says.

Garrison says he feels great and is grateful he avoided what he feared could have happened. “I'm sure I would continue to have angioplasty or maybe finally open-heart surgery.” Now, he's doing all he can to protect his health and his heart.

Garrison received five weekly infusions of HDL. Dr. Yasin says that the 4-percent reduction in the plaque on Garrison's artery wall would have taken years using standard drugs.

If you would like more information, please contact:
Kathy Stillwell
Research Coordinator
Southwest Cardiology Associates, Inc.
(405) 644-5120

HRT Risks Could Have Been Found Earlier (February 28, 2004) 

(Ivanhoe Newswire)

Countless women were needlessly exposed to the risks of hormone replacement therapy because existing evidence was not used effectively argue researchers in the latest issue of the British Medical Journal.

In 2002, the Women’s Health Initiative stopped an eight-year trial on hormone replacement therapy because it uncovered that the long-term risks of taking estrogen plus progestin outweighed the benefits. That trial showed that menopausal women were at an increased risk for coronary heart disease, breast cancer and strokes. Years before those findings were published, the authors of the BMJ article analyzed 23 small trials of HRT and found that the therapy was not as protective against cardiovascular events and menopausal symptoms as the observational data had shown. Pharmaceutical companies trying to obtain licenses conducted many of these early trials, and the data was not publicly available.

When the authors published these findings in 1997, they say they were “ridiculed.” In response to their findings, one opposing expert asserted, “I shall continue to tell my patients that hormone replacement therapy is likely to help prevent coronary heart disease.” The authors’ critics claimed that their choice of trials was selective, the quality of the trials was inadequate and the follow up was too short.

The authors sought unpublished randomized licensing data. They were eventually able to obtain access through the High Court in Finland. They say access to such data would have been impossible in the United States.

The authors say the recording of rare adverse events found during clinical efficacy trials is currently haphazard and unreliable. They say a systematic synthesis of trials with reliable recording of adverse events would enable earlier detection of unexpected effects. They are urging regulators to require drug manufacturers to record adverse effects -- whether or not they are thought to be contextually relevant -- and to make the results public. They say in this particular case, if earlier results had been more readily available, the risks of HRT would have been revealed much earlier. They conclude: “How long will it take us to learn? How many women were needlessly exposed to an increased risk of cardiovascular disease?”

SOURCE: British Medical Journal, 2004;328:518-520

Accidental Addiction (February 28, 2004) 

WEST PALM BEACH, Fla. (Ivanhoe Newswire)

Eighty-three percent of older adults take prescription medications, half of which have addictive properties. As the body ages, it processes drugs and alcohol differently, and the potential for problems grows. Here's more on how elderly individuals become accidental addicts.

At 80 years old, Mae loves to have fun playing golf and bridge. But as a young woman, her fun usually involved alcohol. “It relaxed me," she says. "It made me a better dancer.” At the time, Mae says her drinking was under control. With age, casual drinking became addiction.

Carol Colleran works with senior addicts as director of Hanley-Hazelden Center's Center of Recovery for Older Adults, in West Palm Beach, Fla. She says few people are aware that alcohol and medications affect older people differently. The liver, kidneys and stomach all work slower, so drugs and alcohol are in the body longer. Also, with age, the water content in the body decreases, so drugs are more potent.

“It sums up, less does more. It’s a potential for disaster,” Colleran says. In fact, she says medications safe for young adults can be toxic in people over 65, including some tranquilizers, antidepressants, blood thinners, and arthritis drugs. “Because it was originally prescribed to them by the doctor," Colleran says, "They believe that it’s OK, no matter how long they’ve been taking it.”

But Colleran says there is good news. “Treatment works for older adults. It works well,” she says.

Treatment worked for Mae. “You talk about serenity. I believe I have it,” she says, and she is thankful for every day that she does.

Colleran points out that retirement communities may also make the problem worse, since many of the social activities revolve around drinking. Some signs that your loved one may have a problem include losing interest in activities, letting their hygiene go, and unexplained bruises. If you suspect a problem, Colleran suggests you first speak with a doctor who is familiar with alcohol abuse in the elderly.

If you would like more information, please contact:
Carol Colleran, Director
Center of Recovery for Older Adults/Hanley-Hazelden Center
(800) 444-7008
ccolleran@hazelden.org
http://www.agingandaddiction.net

Sexual Abuse Linked to Smoking in Women (February 27, 2004) 

(Ivanhoe Newswire)

A new study shows women who were sexually abused as children are nearly four-times more likely to be current smokers than women who didn't report sexual abuse. They were also two-times more likely to have started smoking before age 14.

The overall rate of cigarette smoking has been declining over past decades. However, smoking in adolescent and adult women has been increasing over recent years. Now researchers say the increase in smoking for girls and women may be due to mental anguish by sexual abuse.

Colmar De Von Figueroa-Moseley, Ph.D., director of the Mayo Clinic's Office of Diversity in Clinical Research, led the investigation, which is published in the February 2004 issue of the journal Addictive Behaviors. The study was performed at California State University, San Bernardino.

For the study, Figueroa-Moseley and colleagues reviewed anonymous written surveys of 296 women. The women ranged in age from 18 to 74 years, and were racially, economically and socially diverse. Researchers defined childhood sexual abuse as sexual fondling, attempted rape, or rape before age 17.

In all analyses of the study, researchers found childhood sexual abuse was a better predictor of smoking than social variables of income, age and ethnicity. The direct relationship between past sexual abuse and smoking in adult women was so great that researchers didn't consider the amount of abuse an important variable. They say the women most likely picked up smoking as a coping mechanism in response to the trauma of experiencing childhood sexual abuse.

This research is limited due to its small number of participants in an uncontrolled environment. "But the findings do support a compelling argument that sexual abuse is a strong -- yet little understood -- predictor of smoking," says Figueroa-Moseley. He says these results promote further studies of this correlation and the use of this information to create a smoking
prevention program.


SOURCE: Addictive Behaviors, February 2004; 29:245-251

Combination Treatment Better for Rheumatoid Arthritis (February 27, 2004) 

(Ivanhoe Newswire)

Two drugs are better than one in the treatment of rheumatoid arthritis. New research shows a combination therapy of two commonly prescribed drugs for rheumatoid arthritis improves patients’ symptoms and increases the chance for remission.

Rheumatoid arthritis affects around 1 percent of people worldwide. The drugs etanercept and methotrexate are commonly used to treat patients with rheumatoid arthritis. But there is little information on whether using both of these drugs could be more effective. Researchers from Karolinska Institute in Sweden conducted a study comparing a single drug treatment vs. a combination treatment in patients with rheumatoid arthritis.

For the study, 686 patients with rheumatoid arthritis were randomly assigned to receive etanercept, methotrexate or a combination of both treatments. The patients were evaluated for their response to the treatment after six months and one year.

Researchers report the patients given the combination treatment had better symptom relief than the patients receiving either individual therapy. They also found after one year, remission occurred in 35 percent of the patients on the combination therapy compared with 16 percent of the patients given etanercept alone and 13 percent taking methotrexate only. The combination therapy was also found to be more effective in the improvement of joint erosion.

Study authors conclude the combination therapy appears to be more effective for some patients with rheumatoid arthritis. They also say this is the first demonstration that erosion in patients with rheumatoid arthritis can improve over time. They say this shows that repair of joints destroyed by the disease may be a biological and clinical possibility.

In an accompanying commentary, Armin Schnabel, from Germany, says studies suggest treatment for rheumatoid arthritis needs to be started during a critical time early in the disease. He feels the next generation of trials needs to target patients recently diagnosed with the disease verses patients who have had it for years. He says drug combinations may have different
benefits for early onset patients.

SOURCE: The Lancet, 2004;363:675-681 670-671

Childhood Weight Gain and Risk of Diabetes (February 27, 2004) 

(Ivanhoe Newswire)

The prevalence of type 2 diabetes is increasing rapidly in developing countries such as India. Medical investigators say the increase is particularly seen in people who have low birth weights and subsequently become obese as adults. Researchers in India conducted a new study to try to pinpoint and understand the connection between low birth weight, future obesity, and the risk for type 2 diabetes.

Researchers say the epidemic of type 2 diabetes in developing countries has been attributed to what is called nutritional transition. Nutritional transition is the increased availability of food, reduced physical activity, and increases in obesity. But type 2 diabetes may originate from what happens during fetal development or childhood weight gain. Previous studies have shown high rates of diabetes in people who were born small but became overweight adults. To study this trend, researchers evaluated the glucose tolerance and plasma insulin concentrations in 1,492 men and women between 26 and 32 years old. Researchers had the records for all the participants that included birth weight and weight every three to six months throughout infancy, during childhood, and into adolescence.

The study reports 10.8 percent of the participants suffered from impaired glucose tolerance, and 4.4 percent were diagnosed with diabetes. Study authors noted these participants typically had a low body mass index up to 2 years of age, followed by an increase in weight gain. However, despite the increase in weight gain, none of the participants were obese at age 12. Researchers conclude there is an association between impaired glucose tolerance and diabetes in young adulthood for children born with a low birth weight. They also say if a low birth weight child crosses into higher categories of weight after age 2, they are at an increased risk for the disease.

In an accompanying perspective, William H. Dietz, M.D., Ph.D., says, “Overweight in childhood can no longer be considered a benign condition or one related only to appearance.” He says 60 percent of overweight children have at least one risk factor for cardiovascular disease. He says the current research raises several important issues, yet it is still unclear if delaying weight gain or changing the timing of it would reverse the negative health impacts. He believes complications from being overweight vary with different ethnic groups and further research on strategies specific to each ethnic group is needed.

SOURCE: New England Journal of Medicine, 2004;350:865-875 855-857

Major Complication of Sickle Cell Disease Found (February 26, 2004) 

(Ivanhoe Newswire)

A new study pinpoints a major complication in adults with sickle cell disease that can often lead to death. The research shows nearly one-third of adults with sickle cell disease develop high blood pressure in their lungs and that the condition increases their risk of death.

Sickle cell disease is a genetic disease that occurs predominantly in people of African descent. Patients suffer from severe attacks of pain from blood vessels being blocked by red blood cells that become rigid and form a sickle shape when de-oxygenated.

High blood pressure in the lungs is known as pulmonary hypertension. Experts say it has nothing to do with blood pressure measured by a cuff on your arm. Instead, pulmonary hypertension occurs when the blood vessels that supply the lungs narrow and their walls thicken, so they can’t carry as much blood. The pressure builds up and the heart has to work harder trying to force the blood through. Eventually the heart can’t keep up and patients become tired, dizzy and short of breath.

For this research project, investigators followed 195 sickle cell disease patients for two years. Each patient underwent a Doppler echocardiography, which is a test that uses waves to see the heart. Study authors say 32 of the patients suffered from pulmonary hypertension.

During the study period, researchers say 20 percent of the patients with pulmonary hypertension died and all but two of the patients without the condition survived. Researchers say even patients with mild arterial pressure in the lungs had a high rate of fatality.

Study authors say the Doppler echocardiography is a reasonably priced, non-invasive test that should be offered to adults with sickle cell disease. They say once the patients are identified as having pulmonary hypertension, there are several interventional therapies that could help. They also point out that there is a high rate of sudden death in sickle cell patients and that may be explained by pulmonary hypertension. Researchers say this study gives doctors an opportunity to address a major cause of disability and death in the adult sickle cell disease population and move forward with clinical trials to investigate therapies.

SOURCE: New England Journal of Medicine, 2004;350:886-895

Weight Gain Leads to Breast Cancer (February 26, 2004) 

(Ivanhoe Newswire)

A new study shows weight gain after age 18 can be a significant predictor of breast cancer risk for postmenopausal women who are not taking hormone replacement therapy.

In 1992, researchers from the American Cancer Society sampled nearly 62,000 women, ages 50 to 74, by asking them about their weight at age 18 and their current weight. Since then, the women have been periodically asked to provide updates on their weight, in addition to any diagnosis of cancer.

The research shows women who gained 20 to 30 pounds since age 18 were 40-percent more likely to develop breast cancer than those who had not gained more than five pounds. Women who gained more than 70 pounds doubled their risk.

This supports the theory that more body fat yields higher estrogenic levels, increasing the risk of breast cancer in women. Women with less body fat are reported to have lower estrogenic levels and lower risks of breast cancer.

Heather Spencer Feigleson, Ph.D., lead author of the study, says even modest weight gain should motivate women to take precautionary measures. "Avoiding weight gain is one of the few ways we know of to reduce the risk of breast cancer among postmenopausal women," she concludes.

SOURCE: Cancer Epidemiology Biomarkers and Prevention, 2004;13:224-234

Prophylactic Mastectomies Reduce Cancer Risk (February 25, 2004) 

(Ivanhoe Newswire)

Women who carry one or both of the genes associated with breast cancer can reduce their chances of getting disease by 90 percent if they have both breasts removed before the disease takes hold.

That’s the key finding from a new study conducted by researchers at the University of Pennsylvania, which is set to be published in the March 15 edition of the Journal of Clinical Oncology.

Doctors know women with the BRCA1 or BRCA2 genes are at significantly increased risk for breast and ovarian cancer. Some women with the genes have elected to have prophylactic mastectomies to reduce their cancer risk, but evidence that this truly keeps them from getting the disease (because some breast tissue is always left behind) has been lacking.

In this study, researchers followed 483 women with one or both of the mutations. One hundred and five of the women chose to undergo a double mastectomy in an attempt to prevent the disease from occurring. The other 378 chose not to have the surgery and were closely monitored instead.

Only two of the women who had the surgery, or 1.9 percent, developed breast cancer over six years, compared to 184, or 48.7 percent, of those who chose not to have the surgery. Women who also had their ovaries removed were the least likely to develop breast cancer.

Study author Timothy R. Rebbeck, Ph.D., from the University of Pennsylvania, notes more study needs to be done to refine estimates of risk for women in specific situations. He notes, “The decision to undergo genetic testing or have prophylactic breast surgery is a highly personal one that should be discussed with a clinician trained in counseling patients about the risks and benefits of each preventive option.”

SOURCE: Journal of Clinical Oncology, Published online Feb. 23, 2004

Hormone Replacement and Respiratory Disease (February 24, 2004) 

(Ivanhoe Newswire)

Taking hormones after menopause could put a woman at increased risk of developing asthma, report researchers who studied data from the long running Nurses Health Study (NHS). However, hormone replacement doesn’t appear to affect chronic obstructive pulmonary disease (COPD) risk.

The incidence of both asthma and COPD are rising in the developed world. About 5 percent to 8 percent of Americans have asthma, and deaths due to COPD have risen more than 40 percent since 1982. Since the prevalence of asthma tends to change over time, with boys more likely to have the disease before puberty and girls more likely to have it after puberty, researchers speculated hormone replacement after menopause might put women at higher risk. COPD, which is mainly caused by smoking, has traditionally hit men harder than women, but the increasing tendency of women to smoke has recently led to more and more women being diagnosed with the disease. Now, women are dying from COPD in greater numbers than men, suggesting gender might also play a role in this disease.

An analysis of the NHS data shows asthma risk did increase with hormone replacement after menopause. Women who used estrogen alone or estrogen plus progestin had more than twice the risk of developing asthma for the first time as women who never took hormone replacement therapy. No such risk was noted for COPD, however. Women were no more likely to be diagnosed with a new case of COPD if they took hormones or not.

SOURCE: Archives of Internal Medicine, 2004;164:379-386

Little-Known Asthma Inducer (February 23, 2004) 

(Ivanhoe Newswire)

A new study shows one out of five people with asthma are sensitive to aspirin. However, researchers say many of these people are unaware they are at risk for aspirin-induced asthma.

Aspirin-induced asthma is a severe reaction to aspirin or other painkillers that is characterized by the onset of asthma 30 minutes to three hours after taking the medications. British researchers analyzed more than 20 studies on asthma and found more than 20 percent of adults and about 5 percent of children suffer from the condition.

Researchers say most of these patients were also sensitive to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and diclofenac. However, only 7 percent of patients were sensitive to acetaminophen. Thus, researchers estimate only about 2 percent of asthmatic patients are likely to be sensitive to both acetaminophen and aspirin.

Researchers say aspirin-induced asthma is more prevalent than previously thought. They say more needs to be done to alert patients with asthma about potential negative reactions to drugs, like aspirin. Authors conclude: “Since aspirin and NSAIDs are often self-prescribed, patients diagnosed with asthma should be alerted to the possibility of aspirin-induced asthma by their health care professional. Our data justify the need to include simple, standardized warnings on packs of aspirin and NSAIDs, alerting asthmatic patients to the potential risks.”

SOURCE: British Medical Journal, 2004;328:434-437

Hungry? Your Food may Taste Stronger (February 23, 2004) 

(Ivanhoe Newswire)

A new study shows hunger may be associated with an increased ability to taste.

Researchers from the University of Malawi in Zomba studied 16 men who agreed to skip breakfast. The men had not eaten since 6:30 p.m. the previous evening. Participants were asked to consume sugary, salty or bitter solutions and describe the flavor they tasted. The participants did not swallow the drinks, but instead spit them out after tasting them. One hour after lunch, the men took the test again.

Researchers say when the participants were hungry, they were more sensitive to the sugar and salt in the drinks. However, they say hunger did not influence the participants’ ability to recognize bitter tastes. Researchers say, instinctively, sweet and salty tastes indicate edible substances, while a bitter taste may indicate a substance that should not be consumed. They say this may be why participants were more sensitive to the sugary and salty solutions.

Yuriy P. Zverev, author of the study, says hunger could increase a person’s ability to taste by increasing the sensitivity of the taste receptors in the tongue or by simply changing the way a person perceives the same taste. He concludes: “The present study demonstrated that short term caloric deprivation decreases recognition thresholds for sweet and salty stimuli but it did not affect the taste sensitivity to a bitter substance. This fact might reflect different biological roles of sweet, salty and bitter substances.”

SOURCE: BMC Neuroscience, Published online Feb. 23, 2004

Liver Cancer: Who’s at Risk? (February 23, 2004) 

BALTIMORE (Ivanhoe Newswire)

Are you at risk of liver cancer? A new study shows early detection of liver cancer and a specific type of treatment are critical for survival.

Worldwide, 1.5 million people die of liver cancer each year. Many more are at risk but don’t know it.

“Hepatitis C, B, and hemochromatosis. These are the major risk factors, and cirrhosis for many reasons, could predispose someone to liver cancer,” says Paul Thuluvath, M.D., a hepatologist at Johns Hopkins Medical Institutions in Baltimore.

Dr. Thuluvath worries not enough people know they are at risk. He says, “Unless they’re educated, they’re not going to go to their physician and say, ‘Time for me to have a screening test.’”

He says a screening every six months to 12 months could save their lives because if liver cancer is detected early, it is curable. He goes further to suggest people at high risk of liver cancer get on the transplant waiting list even before cancer has a chance to develop.

Pat Baker doesn’t have cancer, but she does have cirrhosis, a condition that causes up to 80 percent of all liver cancers. She’s already on the transplant list. “It’s not real easy when you think of somebody has to die to even give you one," she says. "That’s the hard part.”

Until then, medication keeps Baker alive. She says, “I take seven pills in the morning, and I take four at night.” And by being on the transplant list, she knows she’s on the right track.

Liver transplant survival rates have steadily improved over the years. From 1987 to 1991, only about 25 percent of transplant recipients survived. From 1997 to 2001, more than 60 percent of those who received a transplant survived.

If you would like more information, please contact:
John M. Lazarou
Senior Media Relations Representative
Johns Hopkins Medical Institutions
(410) 502-8902

Wheat Intolerance may Lead to Schizophrenia (February 23, 2004) 

(Ivanhoe Newswire)

A history of gluten intolerance, a hereditary disease that affects thousands of Americans, appears to be a risk factor for schizophrenia, according to a new study.

Danish researchers identified nearly 8,000 people over age 15 who were admitted to a Danish psychiatric unit with a diagnosis of schizophrenia. They examined known risk factors such as socioeconomic class, urban residence, and family history of schizophrenia, as well as untested risk factors such as ulcerative colitis and Crohn’s disease. Based on prior scientific literature, the researchers also included celiac disease -- a chronic hereditary intestinal disorder that is characterized by an inability to absorb gluten, a protein found in wheat, rye, barley and oats.

For this study, only celiac disease occurring before onset of schizophrenia was considered. Most people, however, live with celiac disease for years without getting sick. The tendency for it is inherited from parents, and usually something like severe stress, physical injury, infection, childbirth, or surgery “trigger” the disease. It usually affects Caucasians of Northern European descent.

The researchers say this study shows a history of celiac disease is a risk factor for schizophrenia. They say an important question to consider is the degree to which removal of gluten from the diet will alleviate symptoms in the small proportion of people with schizophrenia who screen positively for celiac disease but do not show its classical symptoms.

Celiac disease has already been shown to cause other long-term health problems such as anemia and osteoporosis. Since gluten damages the intestines, the damage also keeps the body from absorbing nutrients, like vitamins, calcium, protein and fat from food.

SOURCE: British Medical Journal, 2004;328:438-439

When Lung Cancer Spreads (February 23, 2004) 

(Ivanhoe Newswire)

A new study shows people diagnosed with the less frequent form of lung cancer stand a significant chance of having the disease travel to the brain.

Around 165,000 cases of lung cancer are diagnosed in the United States annually, and of these, 20 percent to 25 percent are classified as small cell lung carcinoma (SCLC). Prognosis for these patients is poor, and the disease frequently travels to the brain and central nervous system. The probability of developing brain cancer, for example, ranges up to 80 percent. Whether or not these brain metastases directly impact mortality from the disease, however, has been unclear.

Researchers publishing in this month’s Cancer studied around 430 patients with SCLC. All underwent neurological exams on a regular basis throughout their treatment for the disease to check for problems in the brain. Results showed about 18 percent of the patients already had evidence of brain cancer at the time they were diagnosed with lung cancer, although about a third were not having any symptoms related to the brain disease.

By two years later, more than half of all the patients had developed brain metastases. Patients with brain metastases had poorer survival rates than those without the distant cancer. About half of the deaths among those who developed brain cancer were directly attributed to the brain cancer.

SOURCE: Cancer, 2004;100:801-806

Little-Known Asthma Inducer (February 23, 2004) 

(Ivanhoe Newswire)

A new study shows one out of five people with asthma are sensitive to aspirin. However, researchers say many of these people are unaware they are at risk for aspirin-induced asthma.

Aspirin-induced asthma is a severe reaction to aspirin or other painkillers that is characterized by the onset of asthma 30 minutes to three hours after taking the medications. British researchers analyzed more than 20 studies on asthma and found more than 20 percent of adults and about 5 percent of children suffer from the condition.

Researchers say most of these patients were also sensitive to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and diclofenac. However, only 7 percent of patients were sensitive to acetaminophen. Thus, researchers estimate only about 2 percent of asthmatic patients are likely to be sensitive to both acetaminophen and aspirin.

Researchers say aspirin-induced asthma is more prevalent than previously thought. They say more needs to be done to alert patients with asthma about potential negative reactions to drugs, like aspirin. Authors conclude: “Since aspirin and NSAIDs are often self-prescribed, patients diagnosed with asthma should be alerted to the possibility of aspirin-induced asthma by their health care professional. Our data justify the need to include simple, standardized warnings on packs of aspirin and NSAIDs, alerting asthmatic patients to the potential risks.”

SOURCE: British Medical Journal, 2004;328:434-437

Is the low-carb backlash beginning? (February 23, 2004) 

SCOTTSDALE, Arizona (Reuters)

U.S. foodmakers are scrambling to satisfy consumer clamorings for low-carbohydrate products but also see a move toward more balanced eating that could spell doom for the strictest low-carb diets, like Atkins.

At an industry conference last week in Scottsdale, Arizona, companies including Kellogg Co. and Hershey Foods Corp. touted products such as low-carb cereals and chocolate bars catering to the millions of Americans following diets that eschew carbohydrates like bread, sugar and pasta in favor of high-protein foods and those made with sugar alternatives.

But even as they push these new products, companies which have been hurt by the backlash against carbohydrates expect consumers will soon back off the more extreme low-carb diets due to growing concerns about their intake of artery-clogging fat and cholesterol.

Recent studies have put the number of Americans following low-carb diets at anywhere from 10 million to 24 million.

"Everything in moderation is ultimately where all these things lead to," said Douglas Conant, chief executive of Campbell Soup Co. "These diets become fad-like and take on lives of their own ... and typically they are not sustainable."

The Atkins diet, which tells followers they may eat liberal amounts of bacon, eggs, cream and other high-fat products, is widely considered to be the most extreme low-carb diet.

Controversy surrounding the Atkins diet intensified after reports alleging that the diet's creator Dr. Robert Atkins, had a heart condition and overweight at the time of death.

But Dr. Stuart Trager, chairman of the Atkins Physicians' Council, said Atkins' heart condition was not related to his diet. In addition, the doctor weighed 195 pounds only a week before his death, Trager said, calling the suggestion that Atkins was obese a "misrepresentation."

Still, food executives said the negative reports have started to raise some concerns.

"You are beginning to see a bit of the wheels coming off the cart right now already on this whole Atkins diet," Irwin Simon, chief executive of organic foods maker Hain Celestial Group Inc., said in an interview. "No carbs, high fat -- there are going to be some big challenges."

Simon added that he follows his own low-carb -- but also low-fat -- diet, staying away from red meat as well as bread and pasta.

Reports raise eyebrows. The negative reports about Atkins, which prompted a flurry of headlines across the globe labeling him "Dr. Fatkins," come on top of numerous public attacks by low-fat diet gurus such as Dr. Dean Ornish and nutrition advocacy groups.

Late last year, the vegetarian group Physician's Committee for Responsible Medicine created buzz by saying the Atkins diet could lead to heart disease and may have contributed to the death of one teen-age dieter.

"You're beginning to see some publications and some articles about taking these diets to an extreme," Kellogg Chairman and CEO Carlos Gutierrez told reporters at the conference. "All these small events, whether it's somebody on the news or whether it's a magazine article, they chip away at the diet."

Kellogg is addressing concerns about the strictest low-carb diets in a new television commercial for its Morningstar Farms vegetarian burgers and patties, which the company says are naturally low in carbs. In the commercial, a voice questions whether low-carb diets are being taken too far, while a woman is overheard ordering veal chops, ribs, buffalo wings and a burger without the bun.

"It addresses that there is a lot of confusion out there," Gutierrez said of the ad. "What we're trying to say is that we know the whole thing seems a bit ridiculous. Here's something you can try."

Cereal-maker Kellogg is not the only company that is hoping to inject a dose of moderation into the low-carb craze.

Hershey CEO Richard Lenny, for one, said the candy company has teamed up with Dr. Barry Sears, an advocate of the popular Zone diet, to make a line of nutrition bars that Lenny said follow the principles of balanced nutrition.

"As most fads go, something converges back to the center, which is one of the reasons we have this alliance," Lenny said in an interview.

Another big food company, ketchup maker H.J. Heinz Co. , stressed that its new "Truth About Carbs" line of Smart Ones frozen entrees, which are being co-marketed with Weight Watchers International Inc., are aimed at dieters who are interested in balanced eating.

"It hits people who are interested in low carb, it hits people who are interested in caloric intake, and it hits people who just want to feel better about themselves," said Heinz CEO William Johnson.

"We present a balanced approach to this instead of a one-sided, overly aggressive approach to try to deal with a trend that may or may not last and may or may not change over time."

Vaccine for Kidney Cancer (February 20, 2004) 

(Ivanhoe Newswire)

German researchers have developed what appears to be an effective vaccine against recurrent kidney cancers.

The groundbreaking study, published in this week’s The Lancet, suggests new hope for people with the disease.

Kidney cancer accounts for about 3 percent of all cancers and causes about 12,000 deaths in the United States every year. The disease most often strikes those in their 50s and 60s. Standard treatment involves removal of all or part of the kidney. Unlike some other cancers, however, kidney cancer does not respond well to subsequent treatment with chemotherapy or radiotherapy. About half of all patients diagnosed with the disease will have a recurrence after the initial surgery.

Scientists from the University of Lubeck Medical School and elsewhere tested vaccines custom made using the individual tumors from kidney cancer patients. The study involved 558 patients scheduled for surgery for kidney cancer. About half the group received six vaccine injections at four-week intervals following surgery. The other half received no additional treatment.

The patients were then followed for five years. Among the 379 patients for whom follow up data were available, 77 percent of those who received the vaccinations were still alive without a recurrence of the disease. This compares to 68 percent of those who did not receive the injections.

In an accompanying commentary, fellow scientists call the study an “immunological breakthrough” and suggest “such a milestone can serve as a concrete step towards making adjuvant treatment of renal cancer a routine and effective intervention.”

SOURCE: The Lancet, 2004;363:594-599,583-584

Predicting Cervical Cancer Risk (February 20, 2004) 

(Ivanhoe Newswire)

Women who have abnormal Pap smears may want to be tested for the human papillomavirus (HPV), report researchers publishing in this month’s Journal of the National Cancer Institute.

They believe testing for the infection -- known to cause nearly all cases of cervical cancer -- more accurately predicts whether a woman is at risk for the cancer than having another Pap smear at a later date.

Right now, women who have abnormal Pap smears are often advised to have another Pap smear six to 12 months later to see if the abnormal cells found the first time around are still present. If the abnormalities are still present, doctors usually advise the woman to undergo a biopsy using a technique called colposcopy. However, some researchers suggest testing for HPV might save these women from undergoing the more invasive procedure, since cervical cancer is nearly always caused by the virus.

Belgium investigators decided to review the medical evidence for both strategies. They collected data from 15 studies, comparing the effectiveness of the two methods to identify and rule out a diagnosis of high-grade cervical intraepithelial neoplasia (CIN2), which occurs when abnormal cell growth with the potential to become cancerous develops on the surface of the cervix. Results showed the HPV test was better at both identifying and ruling out the precancerous condition. The newest version of the test was the most sensitive in identifying women with the condition, accurately picking up CIN2 in nearly 95 percent of the cases.

In an accompanying editorial, researchers from the National Cancer Institute note these results add to the knowledge doctors have about HPV testing, but suggest more study is needed to find optimal methods to identify cervical cancer risk.


SOURCE: Journal of the National Cancer Institute, 2004;96:280-293, 250-251

One Drug, Many Cancers -- Full-Length Doctor's Interview  (February 16, 2004) 

In this full-length doctor's interview, David Agus, M.D., explains how one drug may successfully treat everything from breast
to prostate cancer.

Ivanhoe Broadcast News Transcript with
David Agus, M.D., Medical Oncologist,
Cedars-Sinai Medical Center, Los Angeles, California,
TOPIC: One Drug, Many Cancers

How do typical cancer drugs work, and what makes Omnitarg different?

Dr. Agus: Typical cancer drugs kill cells that are dividing very rapidly. This drug is exciting because it turns off an on switch. It turns off one of the switches within the cancer cell to stop it from growing, so there are much less side effects because you’re targeting the cancer rather than targeting also the whole body.

What is it doing as far as how is it treating the cancer, the effectiveness of it?

Dr. Agus: The cancer cells are driven by a pathway called the HER-kinase pathway and this antibody, called 2C4, turns off this pathway. It stops the cells from growing so that when the patients receive it, many of them receive a benefit in that the tumor starts to shrink and their symptoms go away from the cancer.

What kind of results did you see from the early studies that you’ve done?

Dr. Agus: The early studies were presented publicly in May 2003 at the American Society of Clinical Oncology meetings, and they showed that a number of patients had significant benefit from the drug, their cancer shrank by more than 50 percent, and symptoms improved markedly. Since then, it’s been expanded to phase II clinical trials in ovarian cancer, breast cancer, lung cancer, and prostate cancer. Those studies are presently ongoing.

That’s a lot of cancers.

Dr. Agus: Yeah, four separate phase IIs around the world. It’s very exciting.

It’s treating four different cancers. How is that possible?

Dr. Agus: Well, what we’ve learned over the last several years is that many of the on-switches in most of the solid tumors are very similar, so for example, this HER-kinase access that this drug targets is present in most of the solid tumors, including lung cancer, ovarian cancer, breast cancer, prostate cancer and several others.

What is your hope for the use of Omnitarg in the future?

Dr. Agus: Certainly, the hope is that you can take patients with advanced cancer and give them a therapy with very few side effects that stops the growth of the disease. In cancer, we always start treating patients with more advanced disease, and the hope is we can move that up earlier and earlier rather than just patients with advanced disease.

What does this drug mean for the life expectancy when somebody is diagnosed with a cancer?

Dr. Agus: We don’t know the answer to that question yet. Those studies are ongoing, but certainly this brings a lot of hope. Any drug that with a minimal amount of side effects can stop cancer growth, certainly the hope is it can make patients live significantly longer. I can tell you now that many of the patients on the clinical trial seem to be doing better and feeling better from receiving the therapeutic.

Who are the people that you are treating?

Dr. Agus: Right now, we at Cedars-Sinai have three trials ongoing -- in ovarian cancer, in lung cancer, and in prostate cancer. I’m running the prostate cancer trial, and to date, it seems to be very exciting.

These are people with advanced cancers?

Dr. Agus: Right. These are people who have failed standard chemotherapy. There aren’t many other options to treat these patients.

That’s pretty exciting.

Dr. Agus: Yeah, it’s great.

You said you’d see results from phase I. Typically phase I is just safety and efficacy, right?

Dr. Agus: Right. Typically, phase I is just safety and dosage studies, and we did that. But as we got to the higher doses, we saw significant responses. We’ve had responses that have lasted over a year and a half in patients, again with minimal if any side effects.

What were your thoughts when you saw these results?

Dr. Agus: I’ve been working with this molecule together with Mark Slakowski from Genentech for about five years. We worked on it initially in the laboratory and then took it into patients. So, it’s very exciting to see validated in patients what you hoped to be true.

What’s the next step?

Dr. Agus: The next step is we complete the phase II studies in these four cancers, and those will be completed mid next year. Then based on those data, we’ll go to phase III studies, together with Genentech, with the hope of getting this drug on the market to treat cancer patients.

What’s been the response from patients?

Dr. Agus: Patients are very excited. Patients classically take chemotherapy and chemotherapy helps them, but there are a lot of side effects associated with chemotherapy. So, the nice thing about 2C4 is that many of the patients receiving the drug can actually go back to work and can continue on with their daily lives even though they’re being treated for cancer.

What does it mean for patients?

Dr. Agus: The hope of these molecular-targeted therapies is that we can stop the cancer from growing, so in a sense make it a chronic disease like diabetes is or hopefully like HIV is becoming. It’s not going to cure a cancer by any means, but hopefully it will stop it from growing.

Does that mean somebody could live with a cancer?

Dr. Agus: Yeah, so the hope is that when you have cancer, you receive this therapy for a year, year and a half, and then go to another therapy that blocks another on-switch within the cancer. So, the hope is it’s a chronic disease and you keep going every year or six months or 18 months to new therapies that are just chronic and just stop the cancer from growing.

Literally in the last several years, we’ve got a number of cancer drugs that are adding a lot of excitement, and this is one of the many. Certainly, the hope is that we’ll get many shots on goal, and with each of these shots on goal, there’s a chance for getting a significant benefit for patients. 2C4 is one of those shots that we’ve been working with here for several years that certainly have a lot of excitement about.

Hope for Chemo-Resistant Leukemia  (February 16, 2004) 

By Jackie Shaner, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire)

For patients with chemo-resistant leukemia, a new drug is showing promising results.

For the past decade, researchers at the National Cancer Institute have been experimenting with bacteria-based recombinant immunotoxins. An immunotoxin is bioengineered and consists of only the most essential and functional part of the antibodies that are commonly used to fight leukemia. One of those immunotoxins, BL-22, is showing encouraging results in a phase II study at the NCI.

Robert Kreitman, M.D., of the NCI in Bethesda, Md., tells Ivanhoe that in a phase I study, 19 of 31 patients with hairy cell leukemia had a complete remission of the disease after treatment. Another six people had partial responses. Dr. Kreitman says, even if patients did not have remissions, they usually had improvements in their blood count to a level that was nearly normal. He says this is significant because most hairy cell leukemia patients die from low blood counts. Doctors are excited by these results because hairy cell leukemia is particularly tough to treat -- most patients do not respond to currently available therapies.

Using those results, Dr. Kreitman says the goal of the phase II study is to determine the best dosage levels. He says, “We hope that that response rate [in phase II] will be higher since we’re treating with a good dose in all the patients.” In the first cycle, trial participants are given 40 micrograms/kilograms every other day for three doses. If patients need repeat cycles, they are given 30 micrograms/kilograms every other day for three doses.

“We’re very encouraged,” Dr. Kreitman says. “We’ve been able to follow patients for a long period of time and we’re very comfortable that many of them are able to have complete remissions a long time.” He also says the patients have experienced no significant side effects thus far.

The trial is still enrolling patients at the National Cancer Institute. For more information, call the project coordinator at (301) 402-5633.

SOURCE: Ivanhoe interview with Robert Kreitman, M.D.

Pros and Cons of Hormone Replacement Therapy  (February 16, 2004) 

(Ivanhoe Newswire)

Previous studies show conflicting results over whether hormone replacement therapy is safe and effective for postmenopausal women. Now, a new study published in this week's British Medical Journal examines the pros and cons of the controversial therapy.

Researchers from Leicester University studied women who used combined HRT therapy for five years. All the women studied were 50 years old. Some of the participants had menopausal symptoms, while others did not.

Results show women free of menopausal symptoms should not use HRT therapy because of the associated risk of breast cancer.
Authors write, "HRT for the primary prevention of chronic diseases in women free of menopausal symptoms is unjustified, with a net harm that increases with baseline risk of breast cancer."

However, researchers say their study shows HRT is beneficial in women with menopausal symptoms, with benefit decreasing with increasing risk of breast cancer.

Researchers say their results reinforce the UK Medicines and Healthcare Products Regulatory Agency's recommendations. They say overall benefits of HRT depend on the severity of symptoms and how those symptoms affect women’s quality of life.

Authors of the study conclude, "A decision analysis tailored to an individual woman would be more appropriate in clinical practice than a population based approach."

SOURCE: British Medical Journal, 2004;328:371-375

Depression Linked to Heart Disease  (February 16, 2004) 

(Ivanhoe Newswire)

New research shows older women with depression may have an increased risk of heart disease and death.

Researchers from the Albert Einstein College of Medicine in New York studied more than 93,600 older women who participated in the Women's Health Initiative Observational Study (WHI-OS). The WHI-OS is a long-term program designed to determine how biological and lifestyle factors influence the risk of heart disease, cancer, osteoporosis, and other health conditions. For this study, participants were evaluated for depression and cardiovascular disease and were followed for about four years.

Researchers found nearly 16 percent of women reported experiencing symptoms of depression. They say depression was significantly linked to cardiovascular disease risk. Women with depression were 12 percent more likely to have hypertension and 60 percent more likely to have a history of stroke. Women with depression were also 50 percent more likely to die from cardiovascular disease and about 30 percent more likely to die from another cause.

Authors of the study conclude, "A large proportion of older women report levels of depressive symptoms that are significantly related to increased risk of CVD [cardiovascular disease] death and all-cause mortality, even after controlling for established CVD risk factors. Whether early recognition and treatment of subclinical depression will lower CVD risk remains to be determined in clinical trials."

SOURCE: Archives of Internal Medicine, 2004;164:289-298

Chronic Cough Worse in Women  (February 16, 2004) 

(Ivanhoe Newswire)

New research shows chronic cough affects women more severely than men and greatly impacts their quality of life. The new study shows more women than men seek medical care for chronic cough because their quality of life is more compromised by physical and psychosocial issues.

Researchers from the University of Massachusetts Medical School in Worcester, Mass., analyzed data from 116 women and 56 men seeking medical attention for chronic cough and a control group of 31 men and women smokers who were observed to be coughing but did not complain of cough.

The study shows significantly more women than men in the chronic cough group reported physical and extreme physical complaints, such as headache, painful breathing, and nausea. Women with chronic cough who seek medical treatment were more likely than their male counterparts to suffer from urinary incontinence and consequent feelings of embarrassment. In addition, women reported more psychosocial issues, such as family members unable to tolerate chronic cough and upset feelings by the response of others. In the control group of smokers, women also complained of urinary incontinence significantly more than men.

Lead researcher Cynthia French, M.S., says, “Cough of any kind is not normal and is typically a sign that something is wrong with the patient. Chronic cough is most often caused by a postnasal drip syndrome from nose and sinus diseases, asthma, or gastroesophageal reflux disease.”

Paul Kvale, M.D., FCCP, president-elect of the American College of Chest Physicians, says cough is the most common complaint for which patients seek medical attention, which results in more than $1 billion annually in health care costs.

SOURCE: CHEST, 2004;125:482-488

Elderly Fear of Falling  (February 16, 2004) 

TAMPA, Fla. (Ivanhoe Newswire)

One-third to one-half of elderly people who have suffered a fall live with a fear that can drive them to stay in their home and withdraw from society. Falls are the leading cause of injury deaths for people over 65. But there are ways to face and overcome the fear of falling.

Not long ago, Albert A. Torino almost gave up his walks. After two falls in six months, his fear got the best of him. “I was afraid to walk because every time I went walking in the mall, I was afraid someone was going to cut me off and knock me over,” he says.

Determined to keep moving, this 85-year-old got help.

Torino works with physical therapist Stephanie Hart-Hughes. On machines specifically designed address the skills needed to avoid falling, Torino practices controlling his balance by shifting his weight. In another exercise, he stands on a foam cushion while reaching for items. He can even balance now, with his eyes closed.

“People rely on their eyes very much for their balance, so it’s very important for us to practice for you to be able to use other systems to help you with your balance,” Hughes says.

While awareness of falling is a good thing, Tatjana Bulat, M.D., an internist/geriatrician at Veterans Health Administration in Tampa, Fla., says too much fear can cause more problems. She says, “Because of the fear, they cut down their activities, which makes them weaker and then more prone to falling.”

Besides balance classes, Dr. Bulat recommends hip protectors for those with osteoporosis who are at risk of falling. She says they decrease a chance of breaking a hip by up to 80 percent when they are worn at the time of a fall.

For Torino, the balance exercises not only gave him the skills but also the confidence to get moving again. He says, “I think it’s the best thing I ever did.”

Many physical therapists work with patients one-on-one to help with balance problems. Sometimes, Medicare even covers the cost. If you are afraid of falling, have a history of falls, or feel your balance is impaired, talk to your doctor about finding a physical therapist -- especially if you’ve limited any of your activities.

If you would like more information, please contact:
Patricia A. Quigley, Ph.D.
Patient Safety Center
11605 North Nebraska Ave.
Tampa, FL 33612
(813) 558-3912
patricia.quigley@med.va.gov
http://www.patientsafetycenter.com

Islet Transplantation for Diabetes Examined  (February 13, 2004) 

(Ivanhoe Newswire)

In the latest issue of the New England Journal of Medicine, researcher R. Paul Robertson, M.D., examines the progress of islet transplantation as a treatment for diabetes and offers suggestions for improvement based on current research.

He writes, “The good news is that rates of successful islet transplantation are increasing, and each success is teaching us valuable lessons about improving beta-cell replacement in patients with diabetes.”

One of Dr. Robertson’s suggestions concerns the site of islet infusion. Though the liver, spleen, kidney capsule, testes, brain and other sites have been considered as potential locations for islet infusion, Dr. Robertson found the liver is by far the most commonly used site because of early successes. Due to several clinical complications shown using the liver, he suggests using the peritoneal cavity and omentum, both in the intestine area of the stomach. These sites have been used successfully in animal models and shown to be safe for humans.

Dr. Robertson concludes many other important problems must be solved before islet transplantation can become a conventional therapeutic option. These include huge losses of islets during the isolation and purification processes, adverse reactions to immunosuppressive drugs, and insufficient supply. “The demand for islet transplantation far exceeds the number of islets available,” Dr. Robertson writes. In addition, there is no research that has firm conclusions about who should receive this therapy.

SOURCE: New England Journal of Medicine, 2004;350:694

New Way to Predict Spread of Skin Cancer  (February 13, 2004) 

(Ivanhoe Newswire)

Researchers in England may have found a new way to predict whether skin cancers will spread to other organs. This may lead to earlier detection and resources being concentrated on those patients who are most in need of close follow-up.

Scientists from Bristol University and Frenchay University in England measured the density of lymph vessels surrounding a skin cancer and followed which patients went on to develop secondary cancers within eight years. Of the 21 patients with malignant melanoma, 13 later had their cancers spread and eight were still free of any form of clinically detectable distant cancer.

Results of the study show the lymphatic density around malignant melanomas was more than twice as great in patients who subsequently developed metastasis, cancers in other organs. In addition, lymphatic density around malignant melanomas was approximately four-times higher than the density around normal skin samples. It was also three-times higher than the density around basal cell carcinoma (the most common form of skin cancer in the United States) and Merkel cell carcinoma (a skin tumor thought to spread through a vascular route). The density inside the malignant melanoma tumor was eight-times higher than inside the basal cell carcinoma and Merkle cell carcinoma. However, it was not significantly lower than the density inside normal skin.

In England, skin cancers cause 16,000 deaths each year due to the spread of the disease to other parts of the body. Previously, the best way to predict whether melanoma was likely to spread was by measuring its thickness. It was believed the thicker a tumor was, the more likely it was to spread. However, many thin melanomas spread and only 40 percent of thick ones do.

SOURCE: British Journal of Cancer, 2004;90:693-700

Proteins in Blood Predict Preeclampsia (February 12, 2004) 

(Ivanhoe Newswire)

A new study shows increased levels of a certain protein in the blood may predict future development of preeclampsia. Preeclampsia is a multisystem disorder characterized by mild to severe high blood pressure in pregnant women. It affects 5 percent of pregnancies and the cause of the condition remains unclear.

During the study, 120 women with preeclampsia were matched with 120 healthy women. Researchers measured the angiogenic protein tyrosine kinase 1 (sFlt-1), which binds the placental growth factor (PIGF) and vascular endothelial growth factor, both of which play a role in the normal development and function of the placenta. Researchers of the study found during the last two months of pregnancy, the level of sFlt-1 in the healthy group increased while the level of PIGF decreased. These changes occurred earlier and were more pronounced in the women who later developed preeclampsia.

Results of the study show the PIGF levels were significantly lower in the women who went on to develop preeclampsia than in the healthy group beginning around 13 weeks of gestation, with the greatest difference between the groups occurring during the weeks before the onset of preeclampsia. The sFlt-1 level increased starting five weeks before the onset of the condition. Changes in sFlt-1 and PIGF levels were greater in women with an earlier onset of preeclampsia and in women whose preeclampsia was linked to a smaller than average infant for its gestational age.

In an accompanying commentary, researchers from Brigham and Women’s Hospital in Boston mention that not all women in the study with high sFlt-1 levels and low PIGF levels developed preeclampsia and the condition developed in some women with low sFlt-1 levels and high PIGF levels. However, they conclude, “Although more work is needed, the current report brings us one step closer.”

SOURCE: New England Journal of Medicine, 2004;350:672-683, 641

Hormones Predict Heart Problems  (February 12, 2004) 

(Ivanhoe Newswire)

Certain hormones in the body may yield a new method of predicting the risk of cardiovascular events and death in people with no symptoms. Researchers found excess risk was apparent at levels well below the current standards used to diagnose heart failure.

Investigators from the Framingham Heart Study in Massachusetts studied 3,346 people without heart failure. They tested the participants’ blood looking for specific substances and compared the findings to each person's risk of death from a first major cardiovascular event, heart failure, atrial fibrillation, stroke, coronary heart disease, or other causes. Specifically, they looked at the levels of natriuretic peptides, a group of hormones that regulate blood volume, arterial pressure, and cardiac and vascular function.

At the five-year follow-up, 119 participants had died and 79 had a first cardiovascular event. The study shows each incremental increase of the peptide level was associated with a 27-percent increased death risk, a 28-percent increase in the risk of a first cardiovascular event, a 77-percent increase in heart failure risk, a 66-percent increase in the risk of atrial fibrillation, and a 53-percent increase in the risk of stroke or transient ischemic attack. Peptide levels were not significantly associated with the risk of coronary heart disease events. Researchers found similar results for a related peptide.

In an accompanying article, researchers from Duke University conclude that B-type natriuretic peptide measurements may provide a very early warning signal for future cardiovascular disease in people without symptoms. However, this exam should be coupled with others for the most effective early detection.

SOURCE: New England Journal of Medicine, 2004;350:655-663, 718

Iron Linked to Diabetes  (February 11, 2004) 

(Ivanhoe Newswire)

New research shows high amounts of iron in the blood are associated with an increased risk of type 2 diabetes in women who have no known risk factors.

Researchers from the Harvard School of Public Health studied more than 32,800 middle-aged women who took part in the Nurses’ Health Study. The women provided blood samples between 1989 and 1990. Researchers evaluated patients’ iron levels in the blood to determine if a correlation between stored iron and type 2 diabetes exists. Participants did not have diabetes, cardiovascular disease or cancer when the study began.

Results show nearly 700 women developed diabetes after 10 years. Researchers compared the iron levels of these women to 716 women who did not develop diabetes. They say women with diabetes had higher intakes of iron than those who did not develop the disease. The average iron concentration was 109 nanograms/milliliter in patients with diabetes and 71.5 nanograms/milliliter in healthy patients. Women with diabetes were also heavier, more likely to have a family history of the disease, and less likely to exercise.

Authors of the study conclude, “This finding may have important implications for the prevention of type 2 diabetes because elevated ferritin concentration and lower concentration in the ratio of transferring receptors to ferritin in healthy populations may help to identify a high-risk population for type 2 diabetes who may benefit from further evaluation and interventions.”

SOURCE: Journal of the American Medical Association, 2004;291:711-717

Prescription Drugs Affect Unborn Babies  (February 10, 2004) 

(Ivanhoe Newswire)

Women who use a serotonin reuptake inhibitor (SSRI) to treat depression or other psychiatric problems during pregnancy may be putting their infants at risk for neurobehavioral problems, report investigators publishing in this month’s Pediatrics.

The lifetime risk for depression in women ranges from 10 percent to 25 percent, with the peak prevalence occurring during the childbearing years. Some reports suggest as many as 14 percent of pregnant women suffer from depression and up to 35 percent of women use antidepressants during pregnancy. Studies involving infants exposed to SSRIs in the womb have shown few ill effects, so most doctors believe these drugs can be safely prescribed for pregnant women. However, most of these studies have only compared major outcomes, such as physical growth and complications evident on the medical record.

Researchers from the University of North Carolina at Chapel Hill studied 17 full-term newborns whose mothers had taken an SSRI during pregnancy and 17 similar infants whose mothers had not taken one of the drugs, assessing them for more subtle neurobehavioral differences. They found infants exposed to SSRIs in the womb were more likely to have had a shorter gestational age, and were also more likely to suffer from a range of neurobehavioral problems, including nervousness, startles, and sleep disturbances. After adjusting the findings for gestational age, differences in nervousness and sleep disturbances remained significant.

Researchers conclude, “Results of the present study call into question the conclusion that SSRI use during pregnancy has little impact on the developing fetus and infant outcome.”

SOURCE: Pediatrics, 2004:113:368-375

Wrist Traction Device Relieves Carpal Tunnel Pain  (February 13, 2004) 

NEW YORK (Reuters Health)

A new device that temporarily places the wrist in "traction" holds promise as a treatment for the painful carpal tunnel syndrome, researchers report.
Carpal tunnel syndrome occurs when one of the nerves that pass through the wrist becomes compressed. Symptoms included numbness, weakness, tingling and pain in the fingers and hand.

There are several non-surgical treatments for carpal tunnel syndrome, including wrist splints and steroid injections. The new wrist traction device was studied in 30 people who had mild to moderate carpal tunnel syndrome, by a team led by Dr. Ronald M. Repice of the Delaware Valley Pain and Rehabilitation Center in Chester, Pennsylvania.

Repice is one of the developers of the device.

The device applies traction forces to relieve pressure on the median nerve by acting on the joints and soft tissues in the wrist, according to a report in January's issue of the American Journal of Pain Management.

During the first 4 weeks of the study, participants wore the device for 10 minutes twice a day. For the next 4 weeks, they wore it once a day. No other treatments for carpal tunnel syndrome were allowed during the study.

Most of the people in the study reported symptom relief within two weeks, Repice's team reports. One of the first symptoms to improve was waking up during the night, followed by a lessening of numbness and tingling.

At the end of the study, results of a test of nerve function that is used to diagnose carpal tunnel syndrome were normal in 50 percent of participants and near normal in another 33 percent.

The results suggest that the wrist traction "promises to be an appropriate, safe and effective conservative treatment of mild-to-moderate carpal tunnel syndrome," Repice and his colleagues conclude.

Since the device is portable and can be used at home, it should be more convenient for patients than treatments that must be performed in office visits, the authors note.

However, the study did not include a placebo group of people who received sham treatment. Placebo-controlled trials are considered the gold standard for testing the effectiveness of medical treatments.

American Journal of Pain Management, January 2004.

Metabolic Syndrome Linked to Stroke (February 9, 2004) 

(Ivanhoe Newswire)

Researchers presenting at the 29th Annual International Stroke Conference say having metabolic syndrome may double a patient’s risk of stroke.

Metabolic syndrome is a clustering of five cardiovascular risk factors, which include obesity, high fasting levels of blood sugar, high triglyceride levels, low levels of HDL (good cholesterol), and high blood pressure. Experts say patients have metabolic syndrome when they have at least three of the five risk factors. The syndrome also increases a person’s risk of developing type 2 diabetes.

Researchers studied more than 1,800 participants who did not have diabetes. Nearly 28 percent of the men in the study and nearly 22 percent of the women in the study were diagnosed as having metabolic syndrome without the presence of diabetes. When an additional 216 patients with diabetes were added to the study, more than 30 percent of men and nearly 25 percent of women had metabolic syndrome.

Results show men with metabolic syndrome have a 78-percent greater risk of stroke, and women with the condition have more than double the risk of stroke than those without metabolic syndrome. After 14 years, about 6 percent of men and 4 percent of women in the study had a stroke or transient ischemic attack. However, researchers say patients with diabetes had a significantly higher risk of stroke over 10 years than those with metabolic syndrome.

Researchers say, although metabolic syndrome is not as strong of a risk factor as diabetes, the condition occurs more often than diabetes and is a major consideration for stroke risk. Robert M. Najarian, from Boston University School of Medicine, says: “Metabolic syndrome looks like the precursor for a number of health problems. Because the prevalence of the syndrome is so high, we need to start thinking about how to prevent the condition.”


SOURCE: The American Stroke Association’s 29th International Conference in San Diego, Feb. 5-7,  2004

Prevent Post-Stroke Mental Impairment (February 9, 2004) 

(Ivanhoe Newswire)

Cholesterol-lowering drugs may reduce the risk of mental impairment after a stroke, according to a study presented at the American Stroke Association’s 29th International Stroke Conference in San Diego.

High cholesterol may increase the risk of a stroke, yet patients with a history of high cholesterol actually had a lower risk of cognitive impairment three to six months after stroke. However, doctors say this does not imply that cholesterol itself has a protective effect -- it is most likely attributed to the cholesterol treatment.

Forty-five percent of the patients involved in the study were being treated with  cholesterol-lowering drugs, also known as statins, before their stroke. David Nyenhuis, Ph.D., an associate professor of neurology and rehabilitation at the University of Illinois at Chicago Center for Stroke Research, says, “We believe that perhaps statins were exerting the protective effect.”

Patients often experience cognitive impairment or memory loss after a stroke. Cardiovascular risk factors, such as high blood pressure, diabetes and obesity, are thought to influence cognitive impairment after strokes. But one doctor involved in the study say medical literature has not documented these assumptions. Researchers at the UIC Center for Stroke Research have been searching for identifying markers for dementia after stroke, using brain scans with magnetic resonance imaging. They are also evaluating demographic factors and cardiovascular risk factors as other potential predictors.

The study focused on vascular cognitive impairment-no dementia (VCIND), a mild brain disorder caused by ischemic strokes -- caused by clots that disrupt blood flow to the brain. The researchers say the prevalence of VCIND is not known but vascular dementia -- the most severe form of stroke-related brain dysfunction -- may occur in up to one-third of stroke survivors.

After several analyses, researchers say two variables predicted risk of cognitive impairment -- the patient’s level of education (a well-known protective factor) and a history of high cholesterol.

SOURCE: The American Stroke Association’s 29th International Conference in San Diego, CA, Feb. 5-7, 2004

HRT Increases Recurrence of Breast Cancer (February 9, 2004) 

(Ivanhoe Newswire)

A new study assessing the use of hormone replacement therapy among breast cancer survivors has been stopped early because results indicate an unacceptably high rate of recurring or new cancers.

Swedish researchers embarked on the study in part because more women are surviving the disease and therefore subject to the same menopausal symptoms as other women. The study was expected to involve around 1,300 women over five years. After the initial 345 women in the study were followed for about two years, however, results showed 26 of those randomized to receive HRT experienced a new or recurring cancer, compared to just seven in a placebo group. The risk was deemed unacceptable, and the study was halted on December 17, 2003.

Noting some doctors prescribe HRT for their breast cancer patients with severe menopausal symptoms because observational studies have suggested no harm from the treatment, Harmon J. Eyre, M.D., chief medical officer of the American Cancer Society, comments, “This study will no doubt change that. It is large enough and clear enough to show that HRT appears to increase the chance of a new or recurring breast cancer. Because of that, offering HRT to women with a history of breast cancer would be unwise.”

In an accompanying commentary to the study, Rowan T. Chlebowski, from Harbor-UCLA Research and Education Institute in Torrance, Calif., and Nananda Col, from Brigham and Women’s Health Hospital in Boston, Mass., agree, noting, “Alternative safe and effective strategies for the difficult problem of menopausal symptoms in these women now need to be developed.”

SOURCE: The Lancet, 2004;363:453-455

Infections to Blame for Newborn Brain Injuries (February 9, 2004) 

(Ivanhoe Newswire)

New research shows brain injuries in newborns are most often caused by infections and are not related to a doctor’s delivery technique, as previously thought.

Researchers from Johns Hopkins University studied more than 150 premature babies who had “white matter” brain injuries. White matter helps the brain communicate messages and is generally injured between the arteries that supply blood to the brain. When white matter is injured, a newborn is more susceptible to cerebral palsy and other disorders. The injury is often marked by excess acid in the umbilical cord. Researchers compared the deliveries of babies whose white matter was damaged to those of healthy babies.

Results show acid levels in the umbilical cords were similar in both healthy babies and babies with brain injuries. Other factors such as maternal infections and the number of babies born by Caesarean section were also similar. Researchers say the only difference between the two groups is the brain-injured babies were more likely to have infections in the cerebrospinal fluid, blood, and windpipe. Ernest Graham, M.D., from Johns Hopkins, says, “Our study refutes the fact that white matter injuries are caused by delivery. The biggest association with these injuries in our study was clearly neonatal infections.”

Researchers say although infections can be treated after birth, it’s often difficult to determine where they originated. Dr. Graham says even if infections are treated, babies could still be at higher risk for permanent brain damage.

SOURCE: Society for Maternal-Fetal Medicine’s 24th Annual Meeting in New Orleans, Feb. 2-7, 2004

Mad Cow Linked to Blood Transfusions (February 6, 2004) 

(Ivanhoe Newswire)

The human disease believed to be caused by eating beef from cattle with mad cow disease may also be caused by blood transfusions from infected individuals, report researchers in this week’s issue of The Lancet.

In two studies, investigators outline the possibility that the variant form of Creutzfeldt-Jakob disease (vCJD), which has been linked to a prion protein found in cattle with bovine spongiform encephalopathy (BSE), can be transmitted through an intravenous route.

The first study analyzed records on CJD patients who had given blood at some point before developing the disease. Results showed 15 donors had given blood to 48 recipients, one of who developed vCJD six and a half years after receiving a transfusion from a donor who gave the blood years before developing the condition.

While the case could be a coincidence -- the patient could have gotten the disease from eating tainted beef rather than from the transfusion -- the authors note statistical analysis shows that is unlikely. They write, “The identification of a case of vCJD who received a blood transfusion from a donor who later died of vCJD raises the possibility that this infection was transfusion transmitted.”

The second study, conducted in monkeys, found the BSE prion is transmitted just as effectively through the intravenous route as the oral route, leading them to conclude, “In view of the high efficiency of transmission of the BSE agent to primates by the intravenous route, the latter should be regarded as a likely route of contamination for vCJD patients with a medical history involving a transfusion during the period at risk.”

SOURCE: The Lancet, 2004;363:417-421, 422-428

Anxious Mothers Delay Preemies’ Development (February 6, 2004) 

(Ivanhoe Newswire)

Researchers publishing in this month’s Pediatrics find mothers who are overly anxious about the welfare of their premature infants are more likely to have babies who show developmental delays at 1 year.

Investigators from Wake Forest University School of Medicine in Winston Salem, N.C., studied 116 premature births. All of the infants were born at 32 weeks gestation or less and required supplemental oxygen after birth. Mothers completed standard surveys to gauge their perception of child vulnerability at the time of their infants’ discharge from the hospital, and the infants were assessed for factors that could put them at increased risk for developmental delays at 1 year.

At the one-year follow up, infants were assessed for motor and mental development, and mothers completed a survey aimed at reassessing their perception of their children’s vulnerability.
Babies whose mothers scored high on the tests to measure perceptions of child vulnerability were more likely than others to have babies who scored lower on tests to measure psychomotor development but not on tests to measure mental development. The finding was still significant after researchers adjusted the results to take the number of medical factors that might have predicted high perceptions of child vulnerability into account. Mothers who had been most anxious about their babies at hospital discharge were most likely to have continued problems with perceptions of child vulnerability after one year.

The authors write, “Parents may tend to shelter children whom they see as vulnerable, providing fewer opportunities for them to gain independence in activities of daily living.” They call for programs to identify and assist mothers at risk.

SOURCE: Pediatrics, 2004;113:267-273

Predicting Pregnancy Complication (February 6, 2004) 

(Ivanhoe Newswire)

Findings from a new study suggest a simple blood test may help doctors identify women at risk for the potentially serious complication of pregnancy known as preeclampsia.

Preeclampsia usually occurs without warning when a woman develops dangerously high blood pressure during pregnancy. Many also begin to excrete protein in their urine. If the condition progresses to eclampsia, potentially life-threatening seizures can result. About 5 percent of pregnant women are affected by the condition. While doctors can treat the seizures and high blood pressure associated with the condition, only delivery of the baby can resolve the problem.

Researchers built on previous work indicating large amounts of a blood molecule called sFlt-1 is present in women with preeclampsia, and sFlt-1 can induce preeclampsia in pregnant rats. Using blood samples taken from women participating in another study, they compared blood levels of sFlt-1 and another blood molecule, PIGF, in 120 women who developed preeclampsia and 120 women who did not develop the condition. Early in their pregnancies, sFlt-1 levels were about the same in the two groups. However, levels began to rise in the women who eventually developed preeclampsia about five weeks before they showed signs of the condition. By the time they were diagnosed with preeclampsia, their blood levels were three-times higher than women who did not have the condition.

In terms of PIGF, the study found women destined to develop preeclampsia had lower levels than women who did not develop the condition, with the levels dropping between the 13th and 16th weeks of pregnancy. The researchers also found these women had lower levels of a growth factor called VEGF both shortly before developing preeclampsia and during preeclampsia, although they were unable to use this substance as a predictive factor.

Duane Alexander, M.D., director of the National Institute of Child Health and Human Development, comments, “This is the most promising lead yet in the pursuit of a life-threatening disorder that has defied all attempts to prevent or cure it. If we could predict the development of preeclampsia, we could offer treatment before it becomes a serious problem.”

SOURCE: New England Journal of Medicine, Published online Feb. 5, 2004

New Heart Guidelines for Women (February 5, 2004) 

(Ivanhoe Newswire)

The American Heart Association has released new guidelines for preventing heart disease and stroke in women.

Cardiovascular disease is the leading cause of death for men and women in the United States. It kills nearly 500,000 women each year. The new guidelines are based on results from all available research and take a woman’s individual health status into account.

According to the new recommendations, doctors should consider whether a woman has a low, intermediate or high risk of having a heart attack when considering treatment options. The AHA defines low risk as a less than 10 percent chance of having a heart attack in the next 10 years. Intermediate risk is a 10 percent to 20 percent chance. High risk is a greater than 20 percent chance.

Aspirin, ace-inhibitors, cholesterol-lowering drugs and beta-blockers are recommended for all high-risk women. However, aspirin is not recommended for low-risk women and is only recommended for intermediate risk women who have their blood pressure under control. For stroke prevention, the AHA recommends women with atrial fibrillation and those at intermediate or high risk for embolic stroke take the blood-thinner warfarin. Experts say if women cannot take warfarin, they should take aspirin.

The new guidelines still recommend certain lifestyle interventions such as quitting smoking, exercising, following a healthy diet, and maintaining a healthy weight for all women. Lifestyle and medical prevention measures are now divided into classes based on their importance.

Lori Mosca, M.D., Ph.D., from New York-Presbyterian Hospital and Columbia University Medical Center, says, “Overwhelming evidence suggests cardiovascular disease can be prevented in both women and men. These recommendations should help health care providers and the public avoid initial or recurrent heart attacks and strokes.”

For more information, log onto http://www.americanheart.org.

SOURCE: American Heart Association

Vitamins Don’t Prevent Second Stroke (February 4, 2004) 

(Ivanhoe Newswire)

A new study shows high-dose vitamins do not lower a person’s risk of having a second stroke.

Researchers from Wake Forest University School of Medicine studied more than 3,600 patients who already suffered a stroke. Half of the patients were given high doses of folic acid, vitamin B6 and vitamin B12, and the other half were given low doses of the same vitamins. Results show about 8 percent of patients in both groups had a second stroke within two years. Researchers say the statistics were nearly identical.

James F. Toole, M.D., from Wake Forest University Baptist Medical Center, says, “High-dose vitamin therapy had no effect on stroke prevention, coronary heart disease events or death in this study, which was disappointing.”

Researchers say previous studies have shown low levels of homocysteine -- an amino acid -- are associated with a decreased risk of stroke. Certain vitamins are known to lower homocysteine levels, which led researchers to believe that vitamins might lower the risk of stroke.

Despite the disappointing findings, researchers say reduction in total homocysteine levels was greater in the high-dose vitamin group, which could be significant for future studies. Authors conclude, “This trial showed that moderate reduction of total homocysteine level after ischemic stroke had no effect on vascular outcomes during the two years of follow-up. However, because of the consistent findings of an association of total homocysteine level with vascular risk, further exploration of the hypothesis is warranted and longer trials in different populations with elevated total homocysteine may be necessary.”

SOURCE: Journal of the American Medical Association, 2004;291:621-622

Antioxidants Lower Risk of Asthma (February 3, 2004) 

(Ivanhoe Newswire)

New research shows children who are exposed to increased doses of antioxidants have a lower risk of developing asthma.

Researchers from Cornell University studied data on more than 6,100 children between ages 4 and 16 to determine if increasing antioxidant consumption is associated with a lower prevalence of asthma in children. Researchers observed trends in children who were not exposed to second-hand smoke as well as those who were. The study included a comprehensive health exam, a questionnaire, and various lab evaluations.

Results of the study show an increase in beta-carotene intake was associated with a 10-percent reduction in asthma risk. Children who were exposed to second-hand smoke had a 40-percent decrease in asthma prevalence when they were given increased doses of beta-carotene. Researchers say higher doses of vitamin C showed similar results.

Children who took increased doses of selenium -- a trace mineral -- were 10-percent to 20-percent less likely to have asthma. Those who were exposed to second-hand smoke had a 50-percent decrease in asthma prevalence when they were given the higher doses of selenium.

However, researchers say vitamin E showed little or no help in decreasing asthma prevalence. They say selenium, which showed the most promise in lowering asthma risk, can be found in cereal grains, fish, meat and poultry.

SOURCE: American Journal of Respiratory and Critical Care Medicine, 2004;169:393-398

Cancer Increases Risk of Blood Clots (February 3, 2004) 

(Ivanhoe Newswire)

New research finds some cancer patients are at higher risk for a blood clot or venous thromboembolism (VTE). The study found specifically patients with colorectal cancer treated with chemotherapy are at an increased risk for VTE.

It is generally accepted that there is a risk of VTE in cancer patients, but the medical community does not know the true incidence of VTE in cancer patients. Researchers in the Netherlands conducted a study to evaluate the association of VTE and cancer patients treated with chemotherapy.

The study included 206 patients diagnosed with cancer who were treated with chemotherapy. The kind of cancer and chemotherapeutic treatment was noted, as was the date of treatment. Researchers also reviewed the records for other risk factors for VTE and deep venous thrombosis or pulmonary embolism.

Researchers report 15 of the patients had VTE during or within three months after receiving chemotherapy. The annual incidence of VTE in the patients was 10.9 percent. The study also found the incidence of VTE was notably high in the 39 patients treated with a combination of fluorouracil and leucovorin calcium to treat their colorectal cancer. They found 15 percent of these patients were affected.

Study authors conclude the annual incidence of VTE in patients treated with chemotherapy was high, specifically in patients with colorectal cancer treated with chemotherapy. They say further research is needed to evaluate the use of this treatment and the impact on the quality of life of these patients.

SOURCE: Archives of Internal Medicine, 2004;164:190-194

Eye Disease Blamed for Sleepiness (February 2, 2004) 

(Ivanhoe Newswire)

Researchers from St. Louis say people who have optic nerve damage are at increased risk for sleep disorder. The study, published in this month’s Ophthalmology, shows inner retinal and optic nerve disease could be behind pathological sleepiness in some individuals.

The study involved 25 people with visual impairment. The participants had their sleep-wakefulness cycles followed for 14 days, and their results were compared with those of 12 young subjects with normal sight. Researchers discovered those with optic nerve disease were 20-times more likely to have daytime sleepiness than those with normal sight. Additionally, the people with optic nerve damage were nine-times more likely to suffer sleepiness than even those were blind due to non-optic nerve disease.

Recent work has indicated that the retina contains non-visual photoreceptors that communicate with the area of the brain involved in circadian rhythms. Based on their findings, lead author of the study Russell Van Gelder, M.D., from Washington University, says, “Physicians and other health care professionals should be sensitive to the possibility of daytime sleepiness or insomnia, particularly in patients with severe optic nerve disease.”

Researchers add that these findings also suggest the need to try to maintain any remaining vision in people with optic nerve damage as it plays a crucial role in health and longevity.

SOURCE: Ophthalmology, 2004;111

Stiff Lower Lip (February 2, 2004) 

BEVERLY HILLS, Calif. (Ivanhoe Newswire)

Lips are one of the best facial indicators of a person’s true age. For years, women have tried injecting various substances into their lips to achieve a plump, youthful appearance. Now, a new technique is achieving great results, without any need for injections.

Salon owner Lisa Xavier is a former model, so when years of plastic surgery left her with hard “square-looking” lips, she took action. “As vain as that may seem, it’s just something I wanted to change,” she tells Ivanhoe.

Plastic surgeon Randal Haworth, M.D., says this feeling is not uncommon. “What happens is that everything drops. Just like the rest of the face and the breasts and other parts of the body, the lower lip drops. It’s no exception, so we start to see the lower teeth [when the mouth is] at rest,” he says.

Now, a new procedure brings the lip back up to a youthful position. Instead of injecting foreign substances like collagen, Dr. Haworth simply tightens the muscles inside the lip. He says, “What I did with Lisa was an internal tissue rearrangement by moving the inside skin of the lip upwards and outwards and also, in the process, tightening the muscle [that runs along the bottom of the lower lip].”

The procedure can be done with local anesthesia and takes only a few minutes. It left Xavier with lips she loves that are free of foreign substances. “They’re really full, which is really nice,” she says. “I don’t have something in my lip, which is great. I don’t have to worry when I’m 90 years old that this thing in my lip is going to cause some kind of problem.”

The lower lip lift costs about $1,500. So far, Dr. Haworth believes he is the only plastic surgeon performing the procedure.

If you would like more information, please contact:
Randal Haworth, M.D.
Plastic Surgeon
436 N Bedford Dr.
Suite 105
Beverly Hills, CA 90210
(310) 273-3000

Life After 50: Building Better Bones (February 2, 2004) 

ORLANDO, Fla. (Ivanhoe Newswire)

The average person loses 1 percent of bone mass each year after age 40. If you don’t think osteoporosis is a major health issue, consider this: Osteoporosis is responsible for more than 1.5 million fractures each year. Statistics show about 12 percent of people who fracture a hip die in the hospital, and about 25 percent die in the first year. Here are four steps you may not have heard about that could keep your bones from breaking down.

Carole Mason is among 44 million Americans with osteoporosis. “I have fallen a couple of times and broken my right arm twice trying to catch myself in the fall,” she says.

Geriatric physician Karen Prestwood, M.D., of University of Connecticut Health Center in Farmington, Conn., tells Ivanhoe: “Typically, you don’t have any symptoms, and that’s the problem. You don’t have any symptoms until you actually break a bone.”

Dr. Prestwood says there are ways for women to protect their bones. One way is to take low doses of estrogen. Specifically, one quarter of the usual dose. “This very low dose of estrogen actually increased bone density to a similar degree as higher doses, but it didn’t have the side effects of the higher doses,” she says.

A study on hormone replacement therapy last year showed dangers of taking estrogen and progestin together. That prompted many women to stop taking hormones at all. But Dr. Prestwood says estrogen alone is safe, especially in low doses.

Another way to protect bones is vibration exercise. As we get older and less active, our muscles vibrate less and less. That lack of vibration promotes bone loss. Clinton Rubin, Ph.D., a biomedical engineer at State University of New York at Stony Brook, designed a vibrating plate to mimic muscles. His study shows standing on it 20 minutes a day can prevent bone loss, which can be as severe as 3 percent a year.

Rubin is in the study development phase with three more sites, including Harvard. For now, you can get the same benefits as the vibrating plate by walking or running on hard pavement.

As for the future of the plate, Rubin has high hopes for the plate. He says: “There might be one at the ‘Stop and Shop,’ you know, while you’re waiting to check out your groceries, you’re being treated without drugs to help prevent bone disease. What could be better?”

A third way to help bones is thiazide, a blood pressure drug. Since 60 million Americans already take a blood pressure medication, it could have big impact. “The prospective epidemiologic studies that have been done show approximately a 30-percent reduction in hip fracture,” says epidemiologist Andrea LaCroix, Ph.D., of Group Health Cooperative in Seattle.

For people who already have severe osteoporosis, there’s parathyroid hormone, also called Forteo. Diane Biskobing, M.D., an endocrinologist at Medical College of Virginia and Virginia Commonwealth University in Richmond, says Forteo would be the only drug available that actually stimulates bone formation. Studies show it produces up to a 14-percent improvement in the spine’s bone density.

Mason has injected Forteo once a day since last April. “I still feel healthy,” she says. “I don’t feel limited at this point, so we’ll see.”

Just by taking a few preventative steps, baby boomers can keep their bones strong for the second half of their lives.

If you would like more information, please contact:
National Osteoporosis Foundation
http://www.nof.org

Life After 50: Best Diet for Your Brain (February 2, 2004) 

ORLANDO, Fla. (Ivanhoe Newswire)

Experts say the average person notices a loss of memory capacity at age 40. What most people don’t realize is that our brains start to lose that capacity as early as age 18. Now, simply adjusting your diet can preserve your memory.

Every eight seconds, someone in America turns 50.

“The problems with growing old and loss of memory and the body failing are something that you keep in the closet,” says baby boomer Sam Meiner. “It’s between you and yourself.”

Meiner just turned 52. He has a law degree and owns a successful barbecue chain in Orlando, Fla., but what he worries about most is memory loss. “It’s almost like a plexiglass bank teller screen in front of me. I can see the person. I know who they are, and I know their name, and I can’t, for the life of me. It’s just behind here. It’s gone,” he says.

That fading memory is common in Meiner’s generation, but experts say his diet could save it. Neuroscientist Mark P. Mattson, Ph.D., says cutting calories 30 percent a day protects the brain, resists disease, and even extends lives in animals. For a man eating 3,000 calories a day, that would mean cutting out at least 800 calories per day. “It can enhance learning and memory, particularly in older rats and mice, and it can stimulate the production of new nerve cells,” Mattson, of the National Institute on Aging in Baltimore, tells Ivanhoe.

Mattson says another way to preserve the brain is fasting every other day, but that doesn’t necessarily mean cutting calories. “In some of the mice we studied, they will gorge on the day that they have food, so they will make up for the lost food,” he says. “That is to say, they’ll eat twice as much food on the day they have food as they normally would.”

Studies show that cycle of fasting and gorging increases lifespan by 30 percent. Neuropsychiatrist Jeff Victoroff, M.D., of University of Southern California in Los Angeles, is doubtful humans can stick to such a restrictive diet, but he says simple steps can even push off Alzheimer’s. “The typical American diet is almost perfectly designed to wreck the brain,” he says.

But according to Dr. Victoroff, omega-3 fatty acids from tuna or salmon will help; so will high amounts of vitamin E. Choose wheat germ, bulgur wheat or granola instead of white bread. And, consider alcohol.

“People who drank moderately, that is one to two glasses of wine a day or hard liquor or beer, had a lower risk of Alzheimer’s disease, and that was a substantially lower risk,” Dr. Victoroff says. If red wine gives you headaches, he says a glass of white wine three times a week works too.

But will wine, fish and vitamin E do the trick? Dr. Victoroff concludes, “Those three changes, in and of themselves, would probably make a remarkable difference in the quality of life, in the longevity of Americans, and in their thinking abilities.”

Meiner has his own way of coping with his fears. He says: “In the morning, I go make a cup of coffee and put it in the microwave for 39 seconds, and I watch 39 seconds of my life sweep away. That microwave just lets me know that I better make sure that this day is a 10.”

Dr. Victoroff warns that alcohol in the limited quantities he suggests is safe for about 85 percent of the population. However, he says that about 15 percent of Americans will develop a problem with alcohol and should avoid it completely. Both doctors agree it’s valuable to consult with your doctor before any change in diet is made.

If you would like more information, please contact:
Mark Mattson, Ph.D.
National Institutes on Aging
mattsonm@grc.nia.nih.gov

Life After 50: Fountain of Youth? (February 2, 2004) 

ORLANDO, Fla. (Ivanhoe Newswire)

Every day, 25,000 Americans turn 50 or older. Ninety cents out of every dollar spent on health care is spent on degenerative diseases, or quite simply, aging diseases like cancer, heart disease and Alzheimer’s. Some say human growth hormone can keep older people healthier and feeling younger, while others say it’s a disaster waiting to happen.

Lawyer Bob Huskinson works out seven days a week and fills himself with two piles of vitamins every day. Twice a day, he also injects himself with human growth hormone. “I feel as good as a I did when I was in my 20s or 30s,” he says. At 68 years old, Huskinson says he’s come a long way from what he was like 10 years ago.

HGH is a natural hormone that the body slowly stops producing, about 14 percent less each decade. Low levels cause fatigue, depression, fading memory and poor sleep -- all signs of aging.

Ronald Klatz, D.O., an anti-aging specialist and founder of the American Academy of Anti-Aging Medicine in Chicago, says: “We have to do something about old age. We can’t let it just happen.” He says prescription HGH can preserve youth. “In relatively normal aging people, a significant portion of them perk up. More energy. More muscle. More bone. More life. What’s wrong with those things?”

Klatz uses HGH himself and says it’s improved his mood, energy and arthritic pain. Samuel Epstein, M.D., a former Harvard researcher who is now a cancer prevention physician at University of Illinois, Chicago, has a different opinion. “[HGH] is a very dangerous drug and should only be administered by a highly qualified endocrinologist for very specific purposes and with full and adequate warning to the patient of the risks,” he says.

HGH increases a substance in the body called IGF-1. “Elevated blood levels of IGF-1 are associated with major increased risks of breast, colon and prostate cancer,” Dr. Epstein says. In fact, one study shows women with high levels of IGF-1 had up to seven-times the risk of breast cancer. Another showed men with prostate cancer had significantly higher levels of IGF-1 than healthy men.

When asked what he would tell a friend taking HGH, Dr. Epstein says, “I would say, ‘Stop immediately,’ and recommend that he file a malpractice suit against the clinician who administered it.”

HGH is already FDA-approved for children destined to be shorter than 5’3”. Klatz says doses used in anti-aging are lower than what’s approved for kids. “One day in the not-too-distant future, I think it very well may be considered malpractice for a doctor to withhold human growth hormone from those people who are clinically deficient,” he says.

While some experts say it will never be safe, others are convinced of its benefits. Huskinson says he’s not waiting for agreement. He doesn’t have time.

Even supporters of human growth hormone agree that you should not be on the drug unless blood tests prove you are clinically deficient. An endocrinologist can administer this test for you and determine how normal -- or abnormal -- your levels are.

If you would like more information, please contact:
American Academy of Anti-Aging Medicine
http://www.worldhealth.net

Artificially Conceived Babies at Risk (February 1, 2004) 

(Ivanhoe Newswire)

Babies conceived through artificial methods face a much higher risk of complications and death during delivery than babies conceived naturally, according to new research.

The study shows the risks are different for single births compared to twins. In births involving a single baby, artificially conceived babies are twice as likely to be born prematurely, and their death rates are significantly higher than naturally conceived infants. For artificially conceived twins, there are higher counts of intensive care admissions, premature and Caesarean delivery rates, and lower live birth rates. However, mortality rates are about 40-percent lower for artificially conceived twins compared to twins conceived without medical help.

The researchers write that since the rate of premature delivery for artificially conceived single babies is twice that of naturally conceived infants, assisted reproduction is as much a predictor for preterm birth as history of preterm birth. They say the reasons are still unclear, but it appears that assisted twin pregnancies may actually start off with a relative advantage over single-birth pregnancies.

Frans Helmerhorst and colleagues write that whatever the explanation may be, babies born to women through artificial means are “significantly disadvantaged” compared with other newborns. They say women undergoing assisted reproduction should be informed of these increased risks.

They conclude that 25 years after the first baby was conceived by in vitro fertilization, the focus needs to now shift from achieving pregnancy to achieving a successful birth. Also, they say more work needs to be done to reduce the risks for babies conceived with medical help.

SOURCE: British Medical Journal, published online Jan. 23, 2004

Drug Reduces Fractures (February 1, 2004) 

(Ivanhoe Newswire)

A drug for women with osteoporosis appears to be effective in reducing the risk for a vertebral fracture, according to new research. The study reports the drug strontium ranelate can reduce the risk of breaking a bone in the vertebral column by 49 percent.

Vertebral fractures are a serious consequence of osteoporosis. Such a break can lead to acute and chronic back pain, spinal deformity and hip fracture. An early study found strontium ranelate reduces the risk of vertebral fractures and increases bone mineral density. This happens because the drug, taken orally, increases bone formation and decreases bone resorption. Researchers in France conducted a larger study to compare the drug to placebo in postmenopausal women with osteoporosis.

The study included 1,649 postmenopausal women with osteoporosis and who suffered at least one vertebral fracture. The women received either the drug strontium ranelate or a placebo daily for three years. Participants were also given calcium and vitamin D supplements. Vertebral radiographs were done each year and measurements of bone mineral density were performed every six months.

Researchers report new vertebral fractures occurred in fewer patients in the strontium ranelate group than in the placebo group. Specifically, patients on the drug had 49-percent reduced risk in the first year of treatment and a 41-percent reduction during the three-year study. Study authors also report at the end of the study the women on the drug had an increase in their bone mineral density including a 14.4 percent increase at the lumbar spine and 8.3 percent at the femoral neck.

Investigators conclude strontium ranelate given orally each day appears to reduce the risk of vertebral fractures rapidly, effectively and safely among postmenopausal women with osteoporosis.

SOURCE: New England Journal of Medicine, 2004;350:459-468

Statins Could Prevent Fractures (February 1, 2004) 

(Ivanhoe Newswire)

Statins are widely used to treat high cholesterol, but now new research finds the drugs may play a role in preventing fractures. However, researchers say further studies are needed to confirm this association.

For the current research, investigators from the University of California, San Francisco, analyzed data on statin use and fracture rates from four large studies involving older women. They also summarized the results of eight observational studies and two clinical trials. The statin use ranged from 1 percent of participants to more than 26 percent in the various studies.

Researchers then took into account age, body mass index and estrogen use and adjusted the data. They found a trend towards fewer hip fractures and nonspine fractures in the statin users in the four large studies. In the observational studies, the analysis indicated a 57-percent reduction in hip fracture and a 31-percent reduction in nonspine fractures among statin users. However, the analysis of the clinical trials did not indicate a protective effect with statin use for hip and nonspine fractures.

Study authors write, “These finding build on the recent reports that statins increase bone formation in rodents and suggest statins could be may be useful agents for osteoporosis.” However, researchers say clinical trials testing the association between statins and fracture reduction still need to be done.

SOURCE: Archives of Internal Medicine, 2004;164:146-152