Reducing Sodium Intake Does not Raise Cholesterol (September 29, 2003) 

(Ivanhoe Newswire)

Previous studies have shown extreme reductions in sodium may raise blood cholesterol levels -- putting a person at risk for heart attack or stroke. However, researchers now say reducing sodium has no effect on cholesterol.

In the largest study of its kind, researchers from the Johns Hopkins University School of Medicine in Baltimore examined data from the DASH-Sodium trial, which took place between 1997 and 1999. They particularly focused on 390 participants who provided complete cholesterol test results during the study period.

Participants were divided into two groups. One group followed the DASH diet, which allows for fruits, vegetables, low-fat dairy products, and reduced amounts of fats. The second group followed a diet lower in fruits, vegetables, low-fat dairy products, and reduced amounts of fats. Every 30 days, the participants’ sodium intake was altered. They received 3,450 milligrams, 2,300 milligrams, or 1,150 milligrams of sodium while following their assigned diets.

Results of the study show reducing sodium intake does not raise a person’s cholesterol. Lawrence J. Appel, M.D., from the Johns Hopkins University School of Medicine, says, “Basically, we found that there was no change in total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, or triglycerides with any of these amounts of sodium.”

SOURCE: The American Heart Association’s 57th Annual High Blood Pressure Conference in Washington, D.C., Sept. 25, 2003

Ginseng Associated with Pregnancy Risks (September 26, 2003) 

(Ivanhoe Newswire)

Women who are pregnant should avoid taking the herbal supplement ginseng, report researchers publishing in this month’s Human Reproduction.

Their study of developing embryos in rats links one of the active ingredients in the supplement to increased risk of organ malformation in early pregnancy.

Ginseng is a popular herbal supplement thought to have anti-cancer properties and to boost stamina, improve physical and mental abilities, and help people cope with stress. Previous studies suggest it is regularly used by pregnant women, particularly in Asian countries. One study there, for example, found up to 10 percent of women had taken the supplement while pregnant. Another recent survey found about 9 percent of pregnant women were taking herbal supplements, including ginseng.

The current study out of Hong Kong measured fetal growth in rats that were and were not given an active ingredient in ginseng called ginsenoside. Results showed those who received more than 30 micrograms scored significantly lower on a standard test to assess organ development. The scores went down as the dose of the ginsenoside increased.

Study author, Dr. Louis Chan, says, “Our study has demonstrated that ginsenoside exerts a direct teratogenic effect on rat embryos: that is to say it is capable of causing malformations in rat embryos.” The authors call for more research to assess the possible effects of ginseng on human pregnancies, but conclude these findings suggest, “Use of ginseng during first trimester of pregnancy should be with caution.”

SOURCE: Human Reproduction, 2003;18:2166-2168

Preventing Osteoporosis (September 26, 2003) 

SEATTLE (Ivanhoe Newswire)

It costs pennies per pill, and it’s proven to reduce heart disease and stroke. Now research shows a blood pressure medication taken by about 10 million Americans also has another benefit.

Virginia Neumaier takes thiazide to lower her blood pressure. This little pink tablet has long been used as a diuretic and now, may also prevent osteoporosis. “It’s very reassuring to think I was doing a double-good thing,” Neumaier tells Ivanhoe.

The findings come from a study of more than 300 older adults. “Women who took 25 milligrams of thiazide each day for three years ended up having bone density that was about 1-percent better than women who took placebo for the three years,” investigator Andrea Z. LaCroix, Ph.D., of Group Health Cooperative in Seattle, tells Ivanhoe.

Over time, that increase adds up. LaCroix says other studies show long-term use can reduce the risk of hip fractures by 30 percent. That’s especially important for postmenopausal women like Neumaier. She took estrogen to prevent osteoporosis, until a study showed it increases the risk for breast cancer and heart attacks.

LaCroix says, “Without that medicine in our armamentarium, it’s nice to know there are other medicines that can preserve bone density.”

The other advantage is the cost. A three-month supply costs less than $5. Since thiazide is not a big money maker, LaCroix says drug companies don’t study or promote it -- part of the reason many doctors and patients don’t know about the added benefit.

People who take thiazide are encouraged to eat foods high in potassium, since the medicine can lower levels of the mineral. Side effects can also include dizziness and leg cramping. The vast majority of patients tolerate thiazide well.

If you would like more information, please contact:

Andrea Z. LaCroix, Ph.D.
Center for Health Studies
Group Health Cooperative
1730 Minor Ave., Suite 1600

New Glaucoma Device (September 26, 2003) 

WINTER PARK, Fla. (Ivanhoe Newswire)

Glaucoma is one of the leading causes of blindness in the United States. It happens when the optic nerve in the back of the eye gets damaged -- usually from elevated pressure inside the eye. Eye drops or surgery can reduce the pressure. Now, a new device is reducing surgery time and error.

A few months ago, Janelle Kelly nearly lost her peripheral vision because of glaucoma -- an eye disorder that ophthalmologist Richard Cohn, M.D., calls a plumbing problem. “If the drain doesn’t work as well as the faucet, then the pressure inside the eye goes up, and that damages the optic nerve,” says Dr. Cohn, of Cohn Eye Center in Winter Park, Fla.

A tiny stainless steel shunt repairs the problem. Dr. Cohn says, "The purpose of this is to actually allow a little bit of fluid to escape from the eye in patients when their eye pressure is too high."

That's how most glaucoma surgeries work, but because the shunt is so small, it has benefits over the others, including less margin for error and less operating time. According to Dr. Cohn, the traditional glaucoma surgeries can take anywhere from 30 minutes to an hour and a half to do. The express glaucoma shunt is only a 10-minute procedure.

He also says the results are encouraging. "Studies have shown that patients who are using maybe two glaucoma medications, prior to surgery, might end up on just one or maybe no medications after surgery."

Out of the 30 patients he's implanted, Dr. Cohn says it's worked in 28 -- including Kelly. "I see fine. I can read," she says. I can whatever." She also says she can't even feel her implant. "I don't even know it's there." Which helps keep her mind -- and her eye -- on other things.

The implant costs about $800 and can be paid for by insurance. Potential side effects may include minimal bleeding, excessive healing or a small infection inside the eye. Dr. Cohn says these side effects are very rare. There may also be blurred vision for about a week or two after surgery.

If you would like more information, please contact:

Jim McGillis
Surgical Coordinator
Cohn Eye Center
1850 Greenwhich Avenue
Winter Park, FL 32789
(407) 647-7227 x106
http://www.cibavision.com

“Senior Moments” Linked to High Blood Pressure (September 26, 2003) 

(Ivanhoe Newswire)

Researchers say memory problems commonly associated with age -- or “senior moments” -- may be related to reduced blood flow to the brain resulting from high blood pressure.

Researchers from the University of Pennsylvania studied 59 volunteers, average age 60, with blood pressure below 140/90. Thirty-seven volunteers, average age 61, were recruited with either systolic pressure higher than 140 or diastolic pressure higher than 90. Those with high blood pressure had an average reading of 144/84. All participants went through various memory tests while a PET scan recorded responses in different brain regions.

The scans show blood flow was not fully available among those with high blood pressure as it was in those without high blood pressure. J. Richard Jennings, Ph.D., from the University of Pennsylvania, says the most notable differences were those seen in the posterior regions of the brain. He says when a person has high blood pressure, the brain protects itself by remodeling its blood vessels to compensate. That remodeling likely explains the blood flow differences that were observed in this study.

Jennings says, “The reduced blood supply reduces the brain’s ability to perform needed tasks, such as remembering an unfamiliar phone number.” He says one way to look at high blood pressure is to think of it as adding a few years to mental age.

SOURCE: 57th Annual Fall Conference and Scientific Sessions of the Council for high Blood Pressure Research in Washington, D.C., Sept. 23-26, 2003

 

Fruits and Vegetables Protect Against Stroke (September 26, 2003) 

(Ivanhoe Newswire)

A new study shows including fruits and yellow and green vegetables in your diet each day may protect you against stroke.

There are two major types of stroke. Hemorrhagic stroke happens when a blood vessel ruptures within the brain. Ischemic stroke -- also called cerebral infarction -- occurs when a blood clot blocks a blood vessel from bringing oxygen and nutrients to the brain. Previous studies have shown fruits and vegetables are beneficial at reducing stroke risk. These studies either included only one gender, one stroke type or looked at total strokes, not specific types. Researchers in Japan conducted a study to determine if eating fruits and vegetables specifically protected against the two major types of stroke.

Study authors say this study is important because the two main types of strokes are actually two different diseases with different risk factors. For the study, researchers analyzed information from nearly 15,000 men and more than 23,000 women. In 1980, the participants answered questions about how often they ate green-yellow vegetables and fruits. Death certificates were examined for all who had died during the follow-up period until 1998.

Researchers say 1,926 participants died of a stroke during the study. Forty-eight percent had cerebral infarction and 32 percent had hemorrhagic strokes. Twenty-one percent had other diseases that eventually resulted in a stroke. When analyzing the fruit and vegetable intake of the participants, study authors report those who ate green-yellow vegetables nearly every day reduced their risk of death from any stroke type by 26 percent compared with those who ate vegetables no more than once a week. Researchers also report eating fruit nearly every day reduced the risk of stroke death by 35 percent in men and 25 percent in women. Overall, frequent fruit and vegetable intake protected against death from both major types of stroke.

Researchers say they also took into consideration other factors including weight, smoking, alcohol consumption, education, consumption of animal products, and a history of hypertension, diabetes or heart attack. Even when adjusting for these factors, the lower stroke risk was still present in people who eat more fruits and vegetables.

SOURCE: To be published in an upcoming issue of the journal Stroke

Does Radiation Cause Lung Cancer? (September 26, 2003) 

(Ivanhoe Newswire)

Could the radiation a woman receives for breast cancer be putting her at higher risk for subsequent development of lung cancer?

Maybe, report researchers from Pittsburgh publishing in this month’s Cancer. Their study finds women who underwent simple mastectomy and radiotherapy for their cancer were more likely than those who had a radical mastectomy and no radiotherapy to later develop lung cancer. However, no difference in subsequent lung cancer rates were noted among a group of women who had breast conserving lumpectomies and radiotherapy when compared with women who had lumpectomies alone or mastectomies alone.

As more and more research suggests benefits for radiation after breast cancer surgery, an increasing number of women are being exposed to radiation that also affects the chest wall and lungs. Some studies have hinted such exposure could lead to greater risk of lung cancer, but little specific research exists to confirm those findings.

This study used data from women taking part in two large clinical trials. In the first, women who underwent radical mastectomies without radiation were compared to those who underwent simple mastectomies with radiation. In the second study, women who had mastectomies and no radiation were compared to those who had lumpectomies and no radiation and those who had lumpectomies plus radiation.

The researchers believe the higher doses and greater volumes of the lung exposed to radiation in the first study may have led to the higher incidence of lung cancer seen in the group of women who underwent radiation.

SOURCE: Cancer, 2003;98:1362-1368

Panic Attacks in Postmenopausal Women (September 24, 2003) 

(Ivanhoe Newswire)

Panic attacks may be common in postmenopausal women, and those attacks may be linked to stressful life events, medical illnesses, and functional impairment, according to a new study.

Researchers from Massachusetts General Hospital in Boston studied more than 3,300 postmenopausal women to determine the prevalence of panic attacks. Women between ages 50 and 79 years old were questioned about the number of panic attacks and migraines they suffered between 1997 and 2000.

In this study, a full-blown panic attack was defined as an attack of sudden fear, anxiety, or extreme discomfort during the past six months, which was accompanied by four or more panic symptoms. A limited-symptom attack was similar to a full-blown attack, except patients suffered fewer than four panic symptoms.

Results of the study show nearly 18 percent of the women surveyed suffered a form of a panic attack. Nearly 10 percent suffered a full-blown attack, and nearly 9 percent suffered a limited-symptom attack. Researchers also found full-blown panic attacks were more common in women with a history of migraines, emphysema, cardiovascular disease, chest pain and symptoms of depression. In addition, full-blown panic attacks were linked to stressful life events. Researchers say there was no association between panic attacks and hormone therapy.

Authors of the study conclude, “Panic attacks were associated with younger age, lower income, recent negative life events, a history of medical comorbidity, and depression, as well as self-reported limitations in social functioning.”

SOURCE: Archives of Internal Medicine, 2003;163:2041-2050

Acupuncture for Cancer (September 22, 2003) 

PITTSBURGH (Ivanhoe Newswire)

The American Cancer Society reports there will be more than 105,000 new cases of colon cancer and 42,000 new cases of rectal cancer diagnosed this year in the United States. When the cancers become advanced, they bring on a host of side effects that make quality of life poor. Now, doctors hope acupuncture will help them live better and with less stress.

Every Tuesday for 33 years, Eddie Thomas has played Bingo. “I have to set the board up," he says. "Then I put the quickies out.” The church bingo game keeps Thomas going -- despite the cancer in his colon that spread to his lungs.

Chemo keeps the nodules in Thomas' lungs under control, but it’s an alternative treatment that recently helped this gambling man cope with the cancer.

“Acupuncture? Wow! That’s exciting. It’s an exciting word to me,” Thomas tells Ivanhoe.

Clinical psychologist Ellen Redinbaugh, Ph.D., and colleagues at University of Pittsburgh Cancer Center are looking to tiny acupuncture needles as a way to improve the quality of life for cancer patients. More than that, they’re trying to understand why it works.

“I think we, in Western science, have some tools available to us that can help answer that question,” Redinbaugh tells Ivanhoe.

Using cotton, study participants’ saliva is tested for the stress hormone cortisol four times a day. Redinbaugh thinks she knows what they’ll see. She says. “Their cortisol levels will actually start to decline because their overall stress will decline.”

These days Thomas is feeling good. He says part of it may be the acupuncture and another part, his faith. Together, they’re a winning card.

Study participants receive acupuncture three times a week for four weeks. Each session lasts about 45 minutes and is done at the patient’s home. The current study is being performed only at the University of Pittsburgh, but a qualified acupuncture physician may be able to help relieve the symptoms, too.

If you would like more information, please contact:

Donna Creola, Project Coordinator
University of Pittsburgh Cancer Center
UPMC Cancer Pavilion
5150 Centre Ave., Room 447
Pittsburgh, PA 15232
(412) 623-5774

Seeing Spots (September 22, 2003) 

SARASOTA, Fla. (Ivanhoe Newswire)

When you look into a light, do you see dots, lines or cobwebs? You could have either floaters or flashes -- two common conditions that often affect people over age 40.

Carol Tokarczyk finds beauty in tending to her rose garden. “It’s just a hobby of mine," she tells Ivanhoe. "I like to play with my roses and watch them bloom. It gives you real satisfaction.“

But, Tokarczyk nearly lost that ability when she started having vision problems. “I saw lightning-like flashes along the side of my vision,” she tells Ivanhoe.

Tokarczyk was diagnosed with a detached retina -- a serious condition that can lead to blindness. Ophthalmologist Melvin Chen, M.D., of Sarasota Retina Institute, says her case is extreme. In most cases, seeing floaters or flashes is a natural part of the aging process.

“They describe it as either dots or spots or twigs, hairs, lines, veils or just a generalized haziness,” he says.

A floater is a small clump of gel that forms in the vitreous -- the jelly-like fluid that fills the inside of your eye. “As the light passes through the pupil into the back of the eye, it will cast a shadow on the retina, and that’s what a floater is,” Dr. Chen says. Flashes are caused by the vitreous gel tugging on the retina. “So, as the vitreous falls, it’ll pull on the retina a little bit and mechanically stimulates the retina, and that’s the light flash.”

Dr. Chen says most floaters settle below the line of vision and become less noticeable, while flashes eventually disappear. If you have either, consult your eye doctor.

After treatment, Tokarczyk's flashes disappeared. Once again, a thing of beauty is a joy forever in her rose garden.

Floaters and flashes are more common for people who are nearsighted, have undergone cataract surgery or who have suffered an eye injury. Isolated, bright flashes of light -- like lightning bolts -- could be more serious, suggesting a possible retinal tear. Dr. Chen says these should be evaluated as soon as possible. Also, if flashes or floaters are associated with loss of central or peripheral vision, it could suggest retinal detachment, and patients should see their doctor immediately.

If you would like more information, please contact:

Melvin Chen, M.D.
Sarasota Retina Institute
Fax: (941) 927-4450
srqretina@aol.com

Hormone Replacement Therapy -- What to do? (September 22, 2003) 

By Liz Rosenblum, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire)

Since the announcement from the Women’s Health Initiative that hormone replacement therapy is associated with an increased risk of heart disease and breast cancer, many postmenopausal women have been left unsure about whether or not to use the treatment. At this week’s annual meeting of the North American Menopause Society, JoAnn Pinkerton, M.D., from the University of Virginia, tried to ease some of the confusion and provided a look ahead to what the future holds.

In an interview with Ivanhoe, Dr. Pinkerton says the hardest group to treat right now is women around 50 years old who are first facing menopause. These women are likely to be suffering from symptoms such as hot flashes and night sweats and for them, the treatment “may be safe and reasonable, but they’re made to feel if they take HRT they are taking cyanide.” She says women have to consider their own individual risk, including their risk for breast cancer, heart disease and osteoporosis, and then consider how severe their symptoms are, how great a fear they have of the risks, and how willing they are to make lifestyle changes. From there, she says, women should re-evaluate their situation annually.

She says for those who choose not to use HRT, but who are suffering from symptoms of menopause, Dr. Pinkerton points out there are other options available. She says for milder symptoms there are over-the-counter options as well as alternative therapies. For people with moderate to severe symptoms, defined as more than seven hot flashes a day or three to four night sweats each night, low-dose antidepressants have been found to ease the symptoms in 30 percent to 60 percent of patients.

In the future, Dr. Pinkerton says other options will be available to help more women without the systemic side effects found with HRT. These treatment options include a gel that would be rubbed on the arms or abdomen, nasal estradiol, a patch, or a vaginal ring.

SOURCE: Ivanhoe interview with Joann Pinkerton, M.D., University of Virginia, Sept. 18, 2003

Treatment for Syndrome X (September 22, 2003) 

(Ivanhoe Newswire)

Syndrome X is a disorder that many people are at risk for developing by the time they reach middle age. Syndrome X is why many people feel lousy and tired all the time, and it can put them at risk for health problems such as heart disease, diabetes, Alzheimer’s, cancer and other age-related diseases. Syndrome X refers specifically to the health problems that include insulin resistance, abnormal blood fats, overweight and high blood pressure. New research shows an effective solution for syndrome X is the combination of exercise and weight loss.

Researchers from Duke Medical Center conducted the study to determine if a six-month intervention could have an effect on coronary heart disease risk factors associated with syndrome X. The study included 53 men and women who were part of a larger clinical trial. The participants suffered from insulin resistance, abnormal blood fats and high blood pressure. They were randomly assigned to the exercise only group, exercise and structured weight-loss program group, or the group that was on the waiting list for treatment. Before and after treatment, the participants underwent a variety of tests including glucose tolerance, lipid levels and blood pressure measurements.

Researchers found the response to glucose in the body was significantly reduced in both the exercise only and exercise/weight-loss groups. They say participants who lost the most amount of weight showed the most improvements in abnormal insulin responses. Researchers also report the diastolic blood pressure level was significantly reduced in the exercise/weight-loss group, but not in the exercise only group. The lipid or fat profile was not significantly improved in either intervention group.

Study authors conclude the combination of exercise and weight loss is an effective treatment for hyperinsulinemia (failure of blood sugar control system) and lowering diastolic blood pressure in patients with syndrome X.

SOURCE: Archives of Internal Medicine, 2003;163:1889-1895

Dangerous Weight-loss Products (September 19, 2003) 

(Ivanhoe Newswire)

Taking herbal supplements for weight loss has become a popular trend, but a new study shows not all products are safe.

Researchers in Japan studied 12 patients who developed liver problems after taking Chaso and Onshido -- two popular herbal weight-loss products made in China and sold on the Internet. Researchers reviewed the patients’ records to evaluate their medical history and conducted a chemical analysis of the herbal products to determine what ingredients they contained.

Although both products were advertised as containing only botanicals, results of the study show the supplements contain N-nitroso-fenfluramine -- a drug taken off the market in the United States after being linked to heart problems. Researchers did not find any other potential causes for liver problems in the patients. One of the 12 patients died and another needed a liver transplant. The remaining 10 patients recovered after they stopped taking the supplements.

Researchers say people should not assume herbal weight loss aids are safe. Because the products can be purchased without a prescription, they are not subject to the same standards as drugs. Authors of the study say more needs to be done to educate the general public about the potential dangers of herbal supplements. They write, “We highlight the need for increased awareness among individuals, including medical professionals, of the potential toxicity risks of some herbal weight loss aids.”

SOURCE: Annals of Internal Medicine, 2003;139:488-492

Fiber for the Heart (September 19, 2003) 

(Ivanhoe Newswire)

Here’s another reason to include more fiber in your diet -- it may reduce your risk of coronary heart disease. A new study confirms the recommendation by the American Heart Association that eating more fiber, especially water-soluble fiber, is beneficial to your heart.

A number of studies have found a connection between dietary fiber intake and the reduction of heart disease. In the current study, researchers from Tulane University School of Public Health and Tropical Medicine focused on the relationship of total and soluble dietary fiber intake and the risk of coronary heart disease and cardiovascular disease.

The study included 9,776 adults who participated in another study. The participants did not have any diagnosed heart disease at the beginning of the research. Each person completed a form listing what he or she ate for 24 hours. The nutrient intakes were calculated using computer software. The participants were then followed for an average of 19 years to see who developed heart disease.

Researchers report 1,843 of the participants developed coronary heart disease and 3,762 of the participants developed cardiovascular disease. Researchers then compared the dietary fiber intake of all of the participants. They report those who consumed the lowest amount of fiber (about six grams) were at a greater risk of having a heart problem compared to those who ate the most fiber (about 21 grams). Specifically researchers report a 12-percent lower risk of coronary heart disease and an 11-percent lower risk of cardiovascular disease for people who eat more than 22 grams of fiber a day. Researchers also found those who consumed water-soluble fiber had a decreased risk of heart problems. Cereal grains and legumes are excellent sources of water-soluble fiber.

Clearly the consumption of dietary fiber is key in reducing the risk of future heart problems, according to the research. Study authors say this study supports the existing American Heart Association recommendation to increase dietary fiber intake from foods to approximately 25 to 30 grams a day in order to reduce the risk of coronary heart disease and cardiovascular disease.

SOURCE: Archives of Internal Medicine, 2003;163:1897-1904

Risks for Silent Strokes (September 19, 2003) 

(Ivanhoe Newswire)

A silent stroke happens when small blood vessels in the brain become blocked. A silent stroke does not cause classic symptoms but having multiple silent strokes can increase the risk of a future stroke. A new study shows having diabetes and high blood pressure increases a person’s risk for a silent stroke.

For the study, researchers conducted MRIs and 24-hour blood pressure monitoring on 360 Japanese patients. All of the patients had high blood pressure but did not have symptoms of it. Also, 159 of the patients had diabetes. None of the patients had been diagnosed with other cardiovascular diseases. The MRIs were used to determine which participants had suffered multiple silent strokes also known as silent cerebral infarcts.

Researchers report 82 percent of the patients with diabetes and high blood pressure and 58 percent of those with hypertension alone had suffered a silent stroke. They also found three or more SCIs were found in 62 percent of the patients with diabetes and high blood pressure compared to only 35 percent of those with only high blood pressure.

Study authors say if a patient is found to have multiple SCIs, they should be treated as if they had suffered a stroke. For example, doctors say the patient should be put on an aspirin regimen or other drugs to help blood flow in the body.

Researchers also looked at patients who had white coat hypertension. White coat hypertension is when a patient has high blood pressure only when they are in the doctor’s office. Those with diabetes and white coat hypertension had more silent strokes than those who had high blood pressure all the time, but no diabetes.

Investigators say this study shows the risks for patients with both diabetes and high blood pressure. Doctors recommend all hypertensive patients be tested for diabetes as least once a year. Meanwhile they say people with high blood pressure who do not already have diabetes should take steps to control their weight, eat healthy and exercise regularly.

SOURCE: To be published in an upcoming issue of Stroke

Quick Heart Scan (September 19, 2003) 

LOS ANGELES (Ivanhoe Newswire)

CT scanners have been around for years. They help doctors get a clear look at a patient’s vital organs, without operating. But, the latest version of scanning technology makes the others seem almost old-fashioned.

When Marsha Van Nuys goes out to eat, she orders with great care. She’s had high blood pressure for years, but her last visit to the doctor revealed something new. “I went to my physician for my normal three-month blood work, and he discovered an irregular heartbeat. I went, ‘Uh oh!’”

When initial tests offered no explanation, cardiologist Daniel Berman, M.D., of Cedars-Sinai Medical Center in Los Angeles, recommended a mouthful of technology -- an angiogram, using electron beam tomography. It’s similar to a standard CT scan, but with one crucial difference: “With either of these techniques, it’s possible to get images quite fast. But you can get them about 10-times faster with the electron beam approach than you can with the conventional approach,” Dr. Berman says.

The electron beam is so fast, it can render images of a human heart, even as it beats.

Dr. Berman says, “Notice how much the arteries are moving during the cardiac cycle. With a conventional scanner, the motion of the artery can cause blurring of the images.”

In Van Nuys' case, the angiogram revealed a 50-percent blockage in two arteries. She was put on medication, kept a close watch on her diet, and started exercising. She says she’s never felt better. “I feel safe. I feel informed. I feel in control.”

In spite of the new technology, the standard type of CT scan isn’t obsolete. It is still preferred for certain kinds of tests. The electron beam tomography angiogram costs about a quarter of what a regular angiogram costs.

If you would like more information, please contact:

Cedars-Sinai Medical Center
(800) 233-2771

Teens on Sports Teams Live Healthier Lifestyles (September 17, 2003) 

(Ivanhoe Newswire)

Teenagers who are physically active and participate in team sports are less likely to engage in unhealthy behavior such as substance abuse and risky sexual activities, according to a new study.

Researchers say the purpose of the study was to distinguish risky behaviors among adolescents who are specifically associated with participation in team sports rather than those associated with physical activity alone. Researchers also studied whether such associations are specific to sex and racial/ethnic subgroups. More than 15,000 high school students took part in the study.

Only one significant association was found for male students between team sports participation and health risk behavior. Specifically, fewer boys in team sports used “other drugs” like cocaine, heroin and methamphetamines, compared to their active nonteam counterparts. Otherwise, active team males were no less likely to have used cigarettes, marijuana, or alcohol or to have initiated intercourse than their active nonteam or nonactive peers.

For female students, however, the combination of team sports and physical activity is particularly important. Female teens who participated in team sports and who were vigorously active were less likely to engage in risky behaviors than teens who were only part of a team or only exercised vigorously. In other words, just being on a team is not enough to deter such behavior -- teens need to be active members of the team. The study’s authors say team sports, particularly for girls, affords benefits beyond the known physical ones. They write, “Barriers to team sports participation by female students must be eliminated, and schools and communities should coordinate efforts to promote such participation.”

The researchers cite a number of reasons why females may be less likely to engage in risky health behaviors: a time commitment to the team, dedication to not disappointing teammates, fear of jeopardizing their team positions, or greater peer pressure to be fit and healthy. However, male students drawn to more aggressive contact sports or sports that can be perceived as riskier may be more prone to health risk behaviors. Boys may be more motivated to participate in team sports because it is a way to demonstrate their physical strength or achieve status, whereas girls may be more motivated by the social interaction or the health benefits of sports. This reasoning, researchers say, may be why active team females are more distinct from other female students and their male counterparts.

SOURCE: Archives of Pediatrics and Adolescent Medicine; 2003:157:905-912

Bypass Beats Angioplasty (September 16, 2003) 

(Ivanhoe Newswire)

A new study shows patients who undergo bypass surgery to repair clogged arteries fare better in the long run than those who have their arteries cleared by a procedure called stent-assisted angioplasty.

Bypass surgery is a major operation in which doctors use healthy arteries from the chest or leg to take over for arteries that are blocked, thus restoring normal blood flow to the heart. Angioplasty is a less invasive procedure in which doctors insert a catheter tipped with a small balloon into the clogged artery. Once inflated, the balloon compresses the blockage, opening the artery so blood can flow freely. A wire mesh tube called a stent is then inserted into the artery to keep it open. About one in five people who have the procedure have to have it repeated within a year due to the artery closing back up again.

Researchers compared results of 500 patients who had bypass surgery to restore blood flow to 488 who had stent-assisted angioplasty. All completed a standard chest pain questionnaire before their surgery or procedure and then again six months and one year later. While both groups were highly satisfied with the results of their treatment, patients in the bypass group were significantly more satisfied, reporting greater relief from chest pain and improved quality of life.

However, the researchers fall short of recommending bypass over stent-assisted angioplasty for all patients. William S. Weintraub, M.D., professor of medicine at Emory University School of Medicine in Atlanta, says, “Since there were substantial improvements in chest pain and quality of life in both groups, the findings should be used more as a guide to treating patients with angina rather than viewed as an endorsement of one procedure over another.”

The authors also note much of the difference between the two groups was due to lower scores from patients in the angioplasty group who had to have the procedure repeated. Newer and more effective stents available today may help increase the success rate of stent-assisted angioplasty, thus reducing the need for repeated procedures and increasing patient satisfaction.

SOURCE: To be published in an upcoming issue of Circulation

Physically Fit Women Less Likely to Die (September 16, 2003) 

(Ivanhoe Newswire)

Here’s more reason to get moving, especially if you’re a woman: Physical fitness translates to more years of life.

Previous studies conducted among men have found those who perform better on exercise stress tests have lower death rates. In one study, for every additional minute men were able to exercise before reaching exhaustion, they lowered their risk of death by about 8 percent. Studies have been lacking on the effect of exercise capacity on women.

Researchers conducted a study among about 5,700 women in Chicago and found women also benefit from being physically fit -- but the association is even stronger than that found for men. Their results showed about a 17-percent reduction in the risk of death for every additional minute the women were able to exercise during the stress test.

The study also showed the stress test was better at predicting who would die than a standard measure that accounts for factors like blood pressure, cholesterol, age, diabetes, and smoking status.

The average age of the women in the study was 52, and none suffered from heart disease when the study started in 1992. Many did, however, suffer from high blood pressure, high cholesterol, diabetes, and other risk factors. The women were followed for eight years.

The study’s authors suggest these findings demonstrate a clear clinical rationale for routine stress testing in asymptomatic women. In an accompanying editorial, however, other researchers disagree, noting that while the results do provide a compelling case for the ability of exercise capacity to predict death and disease, more study is needed before routine stress tests are recommended for all women.

SOURCE: To be published in an upcoming issue of Circulation

Treating Recurrent Bone Cancer (September 15, 2003) 

(Ivanhoe Newswire)

Researchers searching for a new and more effective treatment for patients with recurrent bone cancer report disappointing findings in a new study in this month’s Cancer.

Osteosarcoma is a rare form of bone cancer that most often strikes young people whose bones are still rapidly growing. When caught early, treatment with surgery, chemotherapy and radiation results in a fairly high survival rate. When the disease recurs, the prognosis is dismal. Less than 30 percent of patients who experience a recurrence survive. Finding new treatments is, therefore, paramount.

Investigators from Memorial Sloan-Kettering Cancer Center in New York tested a new drug, known as ET-743, in 23 patients who had previously been heavily treated for their cancer but were now experiencing a recurrence of the disease. The median age of the patients was 18. All received the drug as a 24-hour infusion at three-week intervals.

Results showed the drug was relatively well tolerated by the patients but had little effect on their tumors. Only three of the patients had even a minor response to the treatment.

The investigators suggest further study, perhaps combining ET-743 with other anti-cancer drugs such as cisplatin or doxorubicin, to see if they could boost the drug’s anti-tumor activity. They also believe studies are warranted in patients who have not been as heavily treated previously with other anti-cancer drugs as the patients in this study were.

SOURCE: Cancer, 2003;96:832-840

Oncologists Overlook Clot Risk (September 15, 2003) 

(Ivanhoe Newswire)

Cancer patients who receive treatment have a greater risk of developing blood clots, but a new study shows many doctors are not taking the necessary steps to prevent the clots from forming.

Researchers in Manchester, England, surveyed more than 100 oncologists to determine if the doctors were aware of the risk of blood clots and to evaluate preventative measures used by the physicians. About 40 percent of the doctors who were surveyed treated their patients with either chemotherapy or radiotherapy, and less than 10 percent said they used hormone therapy on their patients.

Results of the study show more than 90 of the 160 doctors surveyed thought radiotherapy posed little or no increased risk for blood clots. More than 80 doctors thought the same for chemotherapy, and more than 70 agreed hormone therapy did not increase the risk.

Of the doctors surveyed, 84 did not routinely recommend blood thinners, such as aspirin or warfarin, as a preventative measure for patients treated with chemotherapy. Seventy-nine doctors did not recommend the medication for hormone therapy patients, and 86 did not advise radiotherapy patients to use the blood thinners. Nearly 40 percent of the oncologists said less than 1 percent of their patients were currently using prophylactic measures for preventing blood clots.

Researchers say health care professionals need to be better educated about the potential increased risk of blood clots in cancer patients. Authors of the study conclude, “National guidelines on prophylaxis for venous thromboembolism during cancer treatment are needed.”

SOURCE: British Medical Journal, 2003;327:597-598

Nutrition and Asthma (September 15, 2003) 

(Ivanhoe Newswire)

New research shows certain foods, but not necessarily nutrients, are associated with an increased risk of asthma.

Researchers in Australia studied more than 1,600 young adults. Patients completed questionnaires and underwent skin-pricking, lung functioning, and bronchial hyperreactivity tests. The study was conducted to determine if foods and nutrients consumed by adults with asthma differed from those consumed by adults without asthma. Twenty-five nutrients and 47 food groups were tested.

Results of the study show certain foods did affect a person’s asthma disposition. Researchers say whole milk and butter along with apples and pears appeared to protect against asthma. However, soy drinks were associated with an increased risk of the condition. Although these foods were clearly associated with asthma, researchers found no link between nutrients and the condition.

Researchers say their results were surprising. Authors of the study write, “We did not expect to find that whole milk and butter would be negatively associated with asthma, nor did we expect that the consumption of soy beverage, ricotta cheese, and low-fat cheese would be positively associated with asthma.” They say a possible explanation for this could be that asthmatic individuals may change their diets after being diagnosed.

Authors of the study say future research is needed to confirm that diet modification may prevent asthma. They conclude: “We found evidence that food but not nutrient intake is associated with current asthma and alternate definitions of asthma and atopy in young adults ... We were unable to establish a cause-and-effect relation for the food-asthma associations that were found.”

SOURCE: American Journal of Clinical Nutrition, 2003;78:414-421

MRI-Guided Biopsy (September 15, 2003) 

PITTSBURGH (Ivanhoe Newswire)

Since the discovery of mammograms in 1969, screening technologies have become regularly used to detect masses in the breast -- many of which turn out to be cancerous. Once a mass is detected, a biopsy may follow to determine if it is cancerous. Each year, 1.4 million women will need a breast biopsy. Now, doctors have a new way to take a biopsy that is more accurate than ever before.

With three sons, Daria Pistelli has plenty of men in her life. But, it’s the women in her life that keep her concerned about her health. “My mother’s mother died at the age of 32 of a female disease," Pistelli says. "Then my mother had breast cancer. Then, 10 years later, she got ovarian cancer.”

Both Pistelli and her sisters know they are susceptible to the cancers, so when Daria's mammogram showed a spot, there was reason to be concerned. “They weren’t really sure exactly what they were seeing. They were seeing, I guess, masses,” she says.

To get a better idea, radiologist Jules Sumkin, D.O., of Magee-Womens Hospital in Pittsburgh, took advantage of an MRI-guided biopsy. He tells Ivanhoe, “We’re using the MRI to find the lesion, tell us where it is in the breast, then the biopsy part is similar to other types of biopsies.”

With the MRI's sensitivity, doctors can see masses mammograms can’t. It can then be used as guide during the biopsy procedure. “The problem has been, you found something, what am I going to do about it? Well, now I know what to do about it. I can biopsy it,” Dr. Sumkin says.

In just two days, Daria got the results of her biopsy. “It turned out to be OK. There was no cancer.”

Since the MRI detects spots -- both cancerous and non-cancerous -- Daria's unnecessary worry is not uncommon, but at least she can be confident knowing there’s no cancer and knowing she has no daughters to pass the worry on to.

Dr. Sumkin points out the biggest downside to using the MRI to perform biopsies is that the powerful magnet -- which makes up the device -- makes it difficult to find tools that can be successfully used during the procedure.

If you would like more information, please contact:

Heather Szafranski
Marketing Communications Specialist
Magee-Womens Hospital
300 Halket Street
Pittsburgh, PA 15213

Study Evaluates Ovarian Cancer Treatments (September 12, 2003) 

(Ivanhoe Newswire)

A new study shows patients with advanced ovarian cancer may benefit more from a new combination of drugs than the combination now considered standard treatment for the disease.

Despite new treatments developed over the past decade, ovarian cancer remains one of the most deadly cancers. More than 50 percent of patients with advanced disease die within five years of initial diagnosis. In recent years, standard treatment for the disease has combined the anti-cancer drugs paclitaxel and cisplatin. New studies, however, have suggested a greater efficacy using paclitaxel and carboplatin.

In this study, German researchers randomly assigned about 800 patients with advanced ovarian cancer to receive one of the two combination treatments. The main objective was to measure the proportion of patients whose cancer had not progressed after two years. The investigators also looked at overall and progression-free survival times, response to treatment, toxicity of the treatment, and overall quality of life.

Results showed no significant difference in the two treatments in either progression of the disease or overall survival rates. However, patients taking the newer combination reported higher scores on quality of life and also appeared to tolerate the medication better.

The authors conclude, "The paclitaxel and carboplatin regimen achieved comparable efficacy to the paclitaxel and cisplatin regimen but was associated with better tolerability and quality of life, and should, therefore, be considered as an important alternative for standard first-line chemotherapy in patients with advanced ovarian cancer."

SOURCE: Journal of the National Cancer Institute, 2003;95:1320-1230

Life after Breast Cancer (September 12, 2003) 

(Ivanhoe Newswire)

Most breast cancer survivors adjust fairly well over the long-term, but a new study shows for some the effects of the disease and its treatment are present as long as 20 years later.

Many studies have looked at the physiological and psychological effects of breast cancer on survivors of the disease. The vast majority, however, have only measured the impact one or two years after women completed treatment. Researchers from the Dana-Farber Cancer Institute in Boston decided to see how women were doing after two decades of cancer survival.

The study involved 153 women who had originally taken part in a breast cancer chemotherapy study 20 years earlier. All took part in extensive telephone interviews aimed at identifying psychological and physiological problems that might be related to the disease.

Overall, only 5 percent of the women showed signs of clinical levels of distress. However, about 15 percent reported two or more symptoms of post-traumatic stress, between 1 percent and 6 percent said they were still bothered by sights, smells and tastes that reminded them of their treatment, 29 percent reported sexual problems, 39 percent reported lymphedema (a build up of fluid that causes swelling), and 33 percent reported numbness.

The researchers conclude breast cancer treatment has a minimal effect on women over the long haul, but some problems remain, suggesting doctors may have underestimated the long-term effects of the disease.

SOURCE: Cancer, 2003;98:679-689

FDA Approves First in New Class of Antibiotics (September 12, 2003) 

The Food and Drug Administration (FDA) today announced the approval of Cubicin (daptomycin for injection) for the treatment of complicated skin and skin structure infections. These are serious infections, usually occurring in hospitalized patients, and include major abscesses, post-surgical skin wound infections, and infected ulcers.

Cubicin is the first approved product in a new class of antibiotics called cyclic lipopeptide antibacterial agents. Cubicin treats infections in a way that is distinct from any other antibiotic.

The approval of Cubicin is part of FDA’s ongoing efforts to help bring new types of antibiotics to patients to make sure there are treatment options available for serious infections. In 2002, doctors prescribed an estimated seven million courses of IV antibiotics for patients with complicated skin and skin structure infections in US hospitals.

Cubicin is specifically indicated for the treatment of complicated skin and skin structure infections caused by susceptible strains of the following gram-positive microorganisms: Staphylococcus aureus (including methicillin-resistant strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae subspecies equisimilis and Enterococcus faecalis (vancomycin-susceptible strains only). Cubicin is not indicated for the treatment of pneumonia.

FDA based its decision to approve Cubicin on a review of clinical studies involving over 1400 adults that demonstrated the drug’s safety and efficacy. The clinical studies demonstrated Cubicin was equivalent to standard treatments (i.e., vancomycin or a semi-synthetic penicillin such as oxacillin or nafcillin) in the treatment of complicated skin and skin structure infections.

Most adverse events reported in the clinical studies of Cubicin were mild to moderate in intensity. The most common adverse events included gastrointestinal disorders, injection site reactions, fever, headache, insomnia, dizziness, and rash.

Blood tests showing muscle injury were found rarely in patients in clinical trials. Most of these patients had no symptoms, and the blood tests returned to normal after therapy. Patients receiving Cubicin should be monitored for the development of muscle pain or weakness. Blood tests measuring creatine phosphokinase (CPK) levels should be monitored weekly in patients who receive Cubicin. Those who develop unexplained elevations in CPK while on Cubicin should be monitored more frequently.

Cubist Pharmaceutical Inc., of Lexington Mass., is the sponsor of the approved New Drug Application (NDA) for Cubicin.

Study Looks at Knee Osteoarthritis (September 11, 2003) 

(Ivanhoe Newswire)

Results from a new study on people with knee osteoarthritis is helping researchers better understand factors that may cause the condition to worsen.

Researchers say the findings may one day play a role in developing better treatments for the disease.

Knee osteoarthritis is a common condition that worsens over time in some people but not in others. Some patients also show signs of bone marrow edema, or the retention of fluid in the bone marrow, and/or malalignment of the upper and lower bones of the leg. These investigators used magnetic resonance imaging and other tests to measure these factors over time and assess their progression in relation to the progression of the disease.

The research involved 223 patients with knee osteoarthritis that could be documented on regular X-rays. All underwent MRIs to scan for bone marrow edema and were tested for malalignment of their leg bones. Patients were retested for the same factors 15 and 30 months later to measure progression.

Results showed those with initial signs of bone marrow edema were more likely to develop worsening knee osteoarthritis over the next 15 to 30 months. Patients with malaligned bones also tended to get worse, and an association between bone marrow edema, misaligned bones, and worsening condition was noted, as well.

However, the researchers point out these findings alone are not enough to conclude bone marrow edema or malalignment actually cause knee osteoarthritis to worsen. They also note knowing about these factors will not lead to better outcomes for patients and argue against including routine MRIs and X-rays in the treatment of patients unless or until further study proves the information can help patients.

SOURCE: Annals of Internal Medicine, 2003;139:330-336

Healthier Life Doesn’t Mean Lower Costs (September 11, 2003) 

(Ivanhoe Newswire)

Living a longer and healthier life doesn’t mean you’ll cost the government any less in health care expenditures.

That’s the finding from a new study in this week’s New England Journal of Medicine that compared people who were healthy at age 70 with those who had at least one functional limitation.

Life expectancy has been increasing for many decades, and studies also suggest the overall health of the elderly is improving as well. Health policy experts concerned about the fiscal viability of the Medicare system -- particularly now that the baby boom generation is entering its latter years -- have wondered how longer life might affect health care costs over the long run. The authors of this study decided to find out, asking, “What is the trade-off between better health, which means lower annual expenditures, and longer life, which means more years in which to accumulate costs?”

Using Medicare data from 1992 to 1998, they classified elderly people into groups according to functional limitations and institutionalization at age 70. Results show those who were without functional limitations at age 70 lived, on average, another 14.3 years. Those with at least one functional limitation lived another 11.6 years. Costs for the two groups, however, were similar: the healthier, but longer-living seniors racked up average costs of $136,000, while the shorter-living, but less healthy group had costs of about $145,000. People who were already living in a nursing home or other institution at age 70 had significantly higher costs.

Researchers believe these results suggest little benefit in terms of health care costs to living a healthier and longer life. However, they also note living longer doesn’t appear to cost more. They conclude, “Our analysis shows, not only that persons in good health at 70 years of age can expect to live longer and to have more years of good health than those in poor health at age 70, but also that their total expected medical care expenses appear to be no greater than those for less healthy persons, even though healthier persons live longer.”

SOURCE: New England Journal of Medicine, 2003;349:1048

More Good News for Red Wine Drinkers (September 10, 2003) 

(Ivanhoe Newswire)

Scientists now have further proof that red wine is good for the heart. New tests identified saponins -- plant compounds believed to lower cholesterol -- in varying levels in both red and white wine. Previously, researchers credited the chemical compound resveratrol, which acts as an antioxidant, with reducing heart disease in moderate red wine drinkers. The new findings show the role of saponins could be just as important.

At the University of California, Davis, scientists looked at saponin levels in six types of California wines, four red and two white. In general, they discovered red wines contained three to 10 times as many levels of saponin than white wines. Of the red wines, red Zinfandel had the highest levels, Syrah had the second highest, and Pinot noir and Cabernet Sauvignon contained about the same amounts of saponin. Sauvignon Blanc and Chardonnay, the two whites tested, contained much less than the reds.

“Saponins are a hot new food ingredient. People are just starting to pay attention to it,” says study author Andrew Waterhouse, Ph.D., Professor of Enology (wine chemistry) at UC Davis. He says this is the first time they have been found in wine because he says no one ever thought to look for it.

According to researchers, saponins come from the waxy skin of grapes and are dissolved into wine during the fermentation process. Foods like olive oil and soybeans also contain high levels of saponins. Usually they make up the waxy coating of plants, functioning primarily for protection.

Waterhouse says red wine contains about the same amount of saponins as resveratrol. Resveratrol is believed to block cholesterol oxidation with its antioxidant action, but Waterhouse says saponins work by binding to and preventing the absorption of cholesterol.

SOURCE: The 226th National Meeting of the American Chemical Society, New York City, Sept. 7-11, 2003

Smoking and its Effects (September 10, 2003) 

(Ivanhoe Newswire)

A new study shows young adults who had very low birth weights are likely to experience more damage to their lungs from smoking than others born at higher birth rates. The study, conducted by researchers from the University of Melbourne in Australia, reports respiratory function is more drastically reduced with smoking among this group.

A study of 60 individuals with low birth weight, defined as weighing less than 2.2 pounds, yielded these results. Respiratory function was measured around age 8 and then again around age 20. The data was compared between 14 smokers and 30 nonsmokers. The researchers evaluated the force airflow measures and total lung capacity.

They report active smoking by young adults, who were born weighing 2.2 pounds or less, reduces respiratory function. They say many low birth weight children require assisted ventilation and oxygen therapy soon after birth. Previous studies show these children grow up to have good respiratory function unless they are exposed to secondhand smoke. This new study went a step further with active smoking.

At age 20, several respiratory functions were diminished in the smokers. Lung volumes were nearly the same in smokers and nonsmokers. The greatest difference was observed in the reduction of airflow. Lung growth was also negatively affected in those exposed to cigarettes.

Another reported finding is that significantly more smokers had asthma at both 8 and 20 years of age. The researchers speculate it is possible that smoking triggered asthma in some of the individuals. They feel there are other factors that will reveal more understanding of the connection between smoking and lung function in this patient group, but more studies are needed.


SOURCE: Pediatrics, 2003;112:565-569

Exercise to Prevent Breast Cancer (September 10, 2003) 

(Ivanhoe Newswire)

A new study shows exercise may help decrease the risk of breast cancer in postmenopausal women.

Researchers from the Fred Hutchinson Cancer Research Center studied more than 74,000 women who were between ages 50 and 79 years old. The women were assessed according to their level of physical activity, which was based on how many hours per week they exercised. The level of activity the women had at ages 18, 35 and 50 years was also considered. Researchers documented cases of breast cancer in this group for nearly five years to determine if a lack of physical activity is linked to the disease.

Results of the study show women who engaged in regular strenuous physical activity at age 35 had a 14-percent reduced risk of breast cancer. Similar findings were also reported in women who engaged in strenuous physical activity at ages 18 and 50. High total current physical activity scores were also associated with a reduced risk of breast cancer. The effect of exercise was most evident in women with the lowest body weight.

Researchers say the results are encouraging, but older women should not feel they need to overexert themselves. Authors of the study write, “The finding that increased total recreational and walking physical activity reduces this risk is promising, although it may not be necessary for women to engage in strenuous activity in their older years to enjoy the protective effects of exercise.”

Another positive finding from the study is that physical activity reduced the risk of breast cancer in women who were using hormone therapy. Previous studies have shown women who take hormone therapy are at a higher risk for breast cancer.

SOURCE: Journal of the American Medical Association, 2003;290:1331-1336

Obesity Increases Risk of Cervical Cancer (September 10, 2003) 

(Ivanhoe Newswire)

A new study shows obesity may increase the risk of certain types of cervical cancer. The study, led by researchers at the National Institutes of Health, reveals obesity and body fat distribution are associated more with adenocarcinoma than with squamous cell carcinoma.

The study involved 124 women with adenocarcinoma, 139 with squamous cell carcinoma, and 307 women without cancer as the control group. Adenocarcinomas involve cells from the walls of many different organs. Squamous cell carcinomas originate from the squamous cell, which comprise the upper layer of skin. The researchers theorized hormonal factors, such as obesity, would affect adenocarcinomas more than squamous cell carcinomas.

They put the women through testing for the human papillomavirus, calculated body mass index, and took waist-to-hip measurements. They found women with the highest body mass index numbers and largest waist-to-hip ratio were more likely to have adenocarcinoma than squamous cell carcinoma. The disease was also more advanced at the time of diagnosis in women who were obese.

The authors write, “Obese women and overweight women appeared to be at a higher risk of cervical adenocarcinoma compared with women who were not overweight or obese.” They say previous studies indicate obesity is a risk factor for endometrial cancer and the association between endometrial cancer and obesity is stronger than with cervical cancer. Nevertheless, they say, there is cause for concern.

SOURCE: Cancer, 2003;98:814-821

More Good News for Red Wine Drinkers (September 10, 2003) 

(Ivanhoe Newswire)

Scientists now have further proof that red wine is good for the heart. New tests identified saponins -- plant compounds believed to lower cholesterol -- in varying levels in both red and white wine. Previously, researchers credited the chemical compound resveratrol, which acts as an antioxidant, with reducing heart disease in moderate red wine drinkers. The new findings show the role of saponins could be just as important.

At the University of California, Davis, scientists looked at saponin levels in six types of California wines, four red and two white. In general, they discovered red wines contained three to 10 times as many levels of saponin than white wines. Of the red wines, red Zinfandel had the highest levels, Syrah had the second highest, and Pinot noir and Cabernet Sauvignon contained about the same amounts of saponin. Sauvignon Blanc and Chardonnay, the two whites tested, contained much less than the reds.

“Saponins are a hot new food ingredient. People are just starting to pay attention to it,” says study author Andrew Waterhouse, Ph.D., Professor of Enology (wine chemistry) at UC Davis. He says this is the first time they have been found in wine because he says no one ever thought to look for it.

According to researchers, saponins come from the waxy skin of grapes and are dissolved into wine during the fermentation process. Foods like olive oil and soybeans also contain high levels of saponins. Usually they make up the waxy coating of plants, functioning primarily for protection.

Waterhouse says red wine contains about the same amount of saponins as resveratrol. Resveratrol is believed to block cholesterol oxidation with its antioxidant action, but Waterhouse says saponins work by binding to and preventing the absorption of cholesterol.

SOURCE: The 226th National Meeting of the American Chemical Society, New York City, Sept. 7-11, 2003

Heart Failure and Ethnicity (September 9, 2003) 

(Ivanhoe Newswire)

People from South Asia are more likely to have heart failure, but are less likely to die from it than their white counterparts, according to researchers from the United Kingdom. The new study appears in the current issue of the British Medical Journal.

Researchers compared hospital admissions from heart failure in 5,789 South Asian and white patients. They found the incidence of heart failure was four-times higher in South Asian patients than in whites. South Asians also were, on average, eight years younger and more likely to be male. Researchers also found South Asians were more likely to have previous heart attacks or diabetes.

South Asians make up the largest ethnic minority group in the United Kingdom. This research shows they are 40-percent more likely to have heart disease than whites. Researchers say one positive finding is that death rates are similar for whites and South Asians. They write, “This phenomenon is likely to be multifactorial and could be explained by heart failure being less advanced at the point of first admission, by a differing cause of heart failure in ethnic minority populations, or by better family support after discharge.”

The research supports the theory that ethnicity plays a large role in how diseases develop. Authors say this study is important to the South Asian population, in which heart disease and diabetes are common. Further studies are necessary to determine if this finding will be duplicated in other ethnic groups.

SOURCE: British Medical Journal, 2003;327:526-530

Healing Foot Wounds (September 5, 2003) 

ST. LOUIS (Ivanhoe Newswire)

Seventeen million Americans live with diabetes. One of the major complications from the disease is foot wounds that won’t heal. Those wounds can cause infections that can then lead to amputations. Now one approach to healing those wounds can reduce the chance of amputation.

A simple walk in his garden is relief to John Hunter. Until recently, wounds on his feet made walking nearly impossible. “The worse it got, and the larger it got, the more painful it would be,” Hunter tells Ivanhoe.

The wounds were ulcers -- complications from diabetes. Visits to his foot surgeon’s office left him anxious. “I’d see people sitting in there one week, and a month later, I’d see the same people sitting there, but they’re minus a foot, minus two feet.”

When ulcers don’t heal, amputations follow. Orthopedic foot and ankle surgeon Jeffrey Johnson, M.D., has a new way to reduce the recurrence of ulcers. He surgically lengthens the Achilles tendon -- or heel cord.

“What we thought was that if we could lengthen this heel cord, we could reduce the pressure on the ball of the foot, which is the source of the ulcer in the first place,” Dr. Johnson, of Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis, tells Ivanhoe.

Studies show, in patients with heel cord lengthening, ulcers were 80-percent less likely to recur after seven months. Recurrence was 50-percent less after two years.

Dr. Johnson says, “The best thing to hear is somebody that says, ‘I’ve had this ulcer for two years, and you were finally able to heal it for me.’”

After the lengthening, feet are put in casts. “The casting not only lets patients walk, but it’s a very effective method of ulcer healing," Dr. Johnson says. "Basically, we’re just putting a certain percent less pressure over the area of the ulcer, and then it heals on its own.”

Hunter says, “I don’t think I’d have a foot on my left side if it had not been for him, and it really did help. I’ve not had the problems. I feel like I’m one of the lucky ones.”

About 85 percent of non-traumatic amputations in the United States are due to diabetes. Dr. Johnson’s study on heel cord lengthening was published in august this year in the Journal of Bone and Joint Surgery.

If you would like more information, please contact:

Diane Duke Williams
Media Coordinator
Washington University at St. Louis
Campus Box 8508
4444 Forest Park Ave.
St. Louis, MO 63108-2259
(314) 286-0111
williamsdia@msnotes.wustl.edu

A Possible Cause for Obesity (September 4, 2003) 

(Ivanhoe Newswire)

It seems a naturally occurring peptide that contributes to weight maintenance is reduced in obese people compared with thin people. Doctors from London report obese patients have lower levels of the fragment peptide YY3-36, otherwise known as PYY. They also found that obese patients are not resistant to its effects.

The gut hormone PYY suppresses appetite and decreases food intake when given to people without weight problems. Similar to the hormone leptin, PYY works with the hypothalamus to reduce food intake. Previous studies show obese people are resistant to the effects of leptin. The purpose of this study was to determine if obese individuals are also resistant to the effects of PYY. Researchers enrolled 12 obese people and 12 lean people in the study.

In the placebo-controlled study, a buffet lunch was served after the subjects received an infusion of PYY. The researchers write, “Caloric intake was decreased by 30 percent in the obese subjects and 31 percent in the lean subjects.” Over 24 hours, there was also a decrease in the caloric intake. It was the same in both obese and thin patients.

The researchers found natural levels of PYY were lower in obese people than others, but by infusing the hormone, they were able to reduce the appetite and calorie consumption of obese people. They suggest this might play a part in obesity and even “may be a useful treatment for obesity.” However, further research will be necessary to confirm that. It is still unclear whether low levels of PYY cause obesity or are a result of obesity.

SOURCE: New England Journal of Medicine, 2003;349:941-948

Kidney Failure after Non-Kidney Transplants (September 4, 2003) 

(Ivanhoe Newswire)

Doctors have long known that kidney failure is a complication of organ transplantation. Now, they know more about which types of transplants are most likely to lead to chronic kidney failure. Researchers from the University of Michigan, Ann Arbor, report patients who have intestine transplants are more likely to have kidney failure compared to those who receive heart-lung transplants.

Doctors studied more than 11,000 patients who received transplants. Of these patients, nearly 29 percent eventually required maintenance dialysis or a kidney transplant. The risk of kidney failure differed according to the type of transplant originally received. Nearly 7 percent of heart-lung transplant patients developed kidney failure, while nearly 22 percent of intestine transplant patients suffered from it. Researchers say older patients are more likely to have complications than younger patients.

Researchers write, “The risk of chronic renal failure and the need for long-term renal-replacement therapy will increase further, given the trend toward increasing longevity in the overall population of recipients of non-renal transplants, which currently numbers more than 100,000.” Patients with high blood pressure, diabetes, or preexisting hepatitis C were more likely to have renal failure.

In this study, researchers say chronic kidney failure was associated with an increased risk of death “by a factor of more than four.” They say this alarming finding points to the need for doctors to educate patients on the high risk of kidney failure following non-renal transplant surgery.

SOURCE: New England Journal of Medicine, 2003;349:931-940

Targeting Breast Cancer (September 3, 2003) 

GAINESVILLE, Fla. (Ivanhoe Newswire)

The American Cancer Society says more than 211,000 new cases of invasive breast cancer will be diagnosed in the United States by the end of 2003. The fight against breast cancer continues with a new study that shows a radiation technique rarely used in the United States has several benefits.

Earlier this year, Suanne Knopf's life hit a speed bump when she was diagnosed with breast cancer. "I was an interstate person. I was a go, and I had a very full schedule," she tells Ivanhoe. "I'm now more down to a -- I'd call it a Sunday rural."

These days, she has time to sit and read -- one chapter for each day of her cancer treatment -- 35 chapters total. Knopf'can relax, knowing her therapy is showing success.

Radiation oncologist Nancy Mendenhall, M.D., says, "We don't offset any gains we might make in terms of disease control by injuring an important structure."

Earlier studies show standard radiation with photons or X-rays can increase the risk of heart disease. Results just released on electron radiation show the reduced penetration doesn't hurt the heart. "The electrons are aimed directly at what you're hitting, so there's less likelihood of error," says Dr. Mendenhall, of University of Florida College of Medicine in Gainesville.

The procedure also showed excellent disease control and survival rates -- all without damaging the heart. "Whatever that risk was, it was reduced by radiation to about a third," Dr. Mendenhall says.

Any news is good news for Knopf', a teacher who's also weaving her basket business between treatments. "My long-term goals are to retire from teaching with hair," she says.

The side effects of electron radiation are primarily skin reactions similar to sunburn. The technique can also be used for other cancers such as skin cancers.

If you would like more information, please contact:

University of Florida
Department of Radiology
http://www.xray.ufl.edu

Gene Increases Cancer Risk (September 3, 2003) 

(Ivanhoe Newswire)

Researchers have identified a gene that increases the risk of getting cancer. Investigators say this discovery could allow people to know in advance if they are at an increased risk for cancer and to take precautionary measures.

The gene, called the Transforming Growth Factor Beta Receptor 1*6A (TGFBR1*6A), is present in nearly one in eight people. Researchers from Northwestern Memorial Hospital’s Cancer Genetics Program analyzed published studies to conclude that this gene is associated with cancer. Researchers say TGFBR1*6A may be to blame for 7 percent of all breast cancers, 11 percent of all ovarian cancers, and 5.5 percent of all colon cancers. “These findings should put TGFBR1*6A on the map with better known cancer susceptibility genes such as BRCA1 and BRCA2 that have been implicated in an estimated 5 percent to 10 percent of all breast and ovarian cancers,” says Boris Pesche, M.D., Ph.D., from Northwestern’s Cancer Genetics Program.

Authors of the study say this gene may be the most common inherited cancer susceptibility gene identified so far. Overall researchers say having this gene increases your cancer risk by 26 percent. Genetic counselors say being able to identify genes that could increase your risk of cancer can help you take steps to prevent cancer. These steps include preventive drug therapy, increased screenings, lifestyle changes, or preventive surgery.

Testing for this gene is only offered as part of a research study at Northwestern, but study authors predict testing for TGFBR1*6A could become more widely available in the near future. Study authors say the goal is to be able to identify high-risk individuals based on their genes and prevent many cases of cancer.

SOURCE: Journal of Clinical Oncology, 2003;21:3236-3243

Low-Dose Hormones Help the Bones (September 2, 2003) 

(Ivanhoe Newswire)

Osteoporosis is a major cause of disability in older women. Estrogen therapy is often prescribed to prevent osteoporosis. However, many women are reluctant to take hormone therapy because of the increased risk of breast cancer, heart disease, stroke and deep vein blood clots. Now, new research finds a lower dosage of estrogen increases bone density in women without possibly causing the problems typically associated with the standard dose of estrogen therapy.

For the study, researchers from the University of Connecticut investigated the effects of one quarter of the dose of estrogen typically prescribed for conventional hormone therapy. Researchers included 167 women older than 65 in the study. The women were randomly assigned to receive the smaller amount of estrogen or placebo. Researchers measured the bone mineral density of the hip, spine, wrist and the total body every year for three years. They also looked at markers for bone resorption and bone formation during the study.

Researchers found women who were on the low dose of estrogen had an increase in their bone mineral density at all the sites measured compared to women on the placebo. They found the markers for bone loss were also significantly decreased in women taking the low-dose estrogen compared to the placebo group. Furthermore, researchers report the number of adverse effects was similar in both groups.

Study authors conclude these results show a low dose of estrogen is effective at preventing bone loss. They hypothesize that lowering the dose of estrogen may also reduce the number of adverse events.

SOURCE: Journal of the American Medical Association, 2003;290:1042-1048

A Better Approach to Rickets (September 2, 2003) 

(Ivanhoe Newswire)

A drug commonly used as an anti-inflammatory medication could also help children with an inherited form of rickets avoid complications from their disease, a new study shows.

Rickets, specifically X-linked hypophosphatemia, causes bones to soften and weaken because the kidneys waste phosphate. Phosphate is a primary mineral that combines with calcium to make bones and teeth. Rickets is similar to osteoporosis but occurs in children with growing bones. Not enough phosphate leads to rickets. The condition also causes children to be abnormally short and have problems with their teeth and muscles.

Researchers from the University of Texas Southwestern Medical Center at Dallas found an FDA-approved drug called Indomethacin keeps the body from wasting necessary amounts of phosphate without causing the potentially life-threatening complications of conventional therapies. Indomethacin is a drug similar to aspirin or ibuprofen. It is commonly used to relieve pain, swelling and stiffness caused by gout, arthritis and other inflammatory conditions.

Investigators examined mice that have the same genetic mutation as people with X-linked hypophosphatemia and a control group of mice with the same genetic background. The genetically altered mice were injected with Indomethacin twice a day for four days. Researchers found phosphate levels in the altered mice's urine were much lower than before treatment. The drug had no effect on phosphate levels in the control group.

Currently, doctors try to counteract the effect of rickets by prescribing phosphate supplements and vitamin D. This forces the intestines to absorb more phosphate before the body can wash it away. However, this prolonged treatment can damage kidneys.

SOURCE: To be published in Proceedings of the National Academy of Sciences

Dental Procedure Reduces Preterm Births (September 1, 2003) 

By Julie Monheim, Ivanhoe Health Correspondent

A non-surgical dental procedure -- known as scaling and root planing -- may reduce the risk of preterm birth in pregnant women with periodontal disease, according to a new study.

Researchers from the University of Alabama at Birmingham school of dentistry studied more than 350 pregnant women who had periodontitis -- a gum infection that destroys the fibers and supporting bone that hold teeth in the mouth. Study participants were between 21 and 25 weeks into their pregnancies and had at least three sites with periodontal attachment loss of three millimeters or greater. Participants received one of three treatments: dental prophylaxis with a placebo; scaling and root planing with a placebo; or scaling and root planing plus metronidazole -- an antibiotic used to treat infections.

Results of the study show women who received the scaling and root planing procedure had an 84-percent reduction in preterm births. Scaling and root planing is a common treatment that involves cleaning the tooth and root surfaces to remove plaque, tarter, and bacterial toxins. Marjorie Jeffcoat, D.M.D., author of the study, told Ivanhoe that the procedure is only performed on patients with periodontitis. She says it works because it reduces the inflammation and infection that is thought to induce early labor.

Results also show adjunctive metronidazole therapy did not improve pregnancy outcome. In fact, women who were given the antibiotic after scaling and root planing had more pre-term births than patients receiving scaling and root planing along with a placebo. Dr. Jeffcoat says more research needs to be conducted to determine why this increase occurred.

SOURCE: Journal of Periodontology, 2003;74:1214-1218

Walkers and Bikers Beware! (September 1, 2003) 

(Ivanhoe Newswire)

If walking or biking is your preferred method of transportation, researchers say you may be at a high-risk for death, but only if you live in the United States.

John Pucher, Ph.D., and colleagues from Rutgers University examined official data from national sources on travel behavior and traffic accidents in three different countries. They found Americans are two- to six-times more likely to be killed while walking or biking than people living in Germany or the Netherlands. They also found pedestrians are 23-times more likely to get killed on the road than those traveling in a car are. Bicyclists are 12-times more likely to die than car occupants.

Researchers say the Germans and the Dutch have reduced their rates of pedestrian and cyclist deaths in recent years. Streets in Germany and in the Netherlands have more car-free zones, median islands, well-marked crosswalks, and bike paths than streets in the United States. Some other attempts adopted by Germans and Dutch to reduce pedestrian and biking deaths include reducing speed limits, putting in more speed bumps, and banning trucks from residential areas.

Researchers also say more people are apt to travel by foot or by bicycle in these countries. Dr. Pucher says, “Dutch and German bikeway systems serve practical destinations for everyday travel, not just recreational attractions, as with most bike paths in America.”

Dr. Pucher also says traffic laws in Germany and the Netherlands are strictly enforced, and citizens living in these countries are often better educated about how to stay safe on the streets. “They are taught not just the traffic regulations but how to walk and bicycle defensively, to anticipate dangerous situations and to react appropriately. That sort of safety education is completely lacking in the United States,” he says.

SOURCE: To be published in an upcoming issue of the American Journal of Public Health

Drug Effective for Diabetic Foot Ulcers (September 1, 2003) 

(Ivanhoe Newswire)

A new study finds the drug dalteparin is beneficial for diabetic patients with severe foot ulcers.

Chronic foot ulcers cause a lot of suffering for diabetic patients and are one of the most expensive diabetic complications. This common complication can threaten the life and limb of the diabetic patient. A new study led by investigators from Karolinska Hospital in Sweden reveals at the effect of the drug dalteparin on foot ulcers in diabetic patients.

For the study, 87 patients were randomly assigned to receive either injections of dalteparin or an injection of a saline solution each day for up to six months. Researchers tracked each patient’s progress to see if the foot ulcer healed or if the patient ended up needing their foot amputated.

Researchers report the patients on dalteparin fared much better than the patients receiving the saline solution. Specifically, 29 patients of the 43 on dalteparin had their ulcers healed or at least saw a 50 percent improvement. In contrast, 20 of the 42 patients in the placebo group saw an improvement. Five patients in both groups had their ulcers get worse. As for amputation, two patients in the dalteparin group had their foot amputated compared to eight in the placebo group.

Study authors write, “The present study shows for the first time that treatment with dalteparin improves the ulcer outcomes in diabetic patients.” Researchers add these results need to be confirmed in a larger trial. However, they say the positive effects of this drug on ulcer healing could affect the costs and care of diabetics.

SOURCE: Diabetes Care, 2003;26:2575-2580