Drinking Daily Cuts Heart Disease Risk For Men, But Not For Women

Men who drink alcohol every day have a lower risk of heart disease than those who drink less frequently, suggests research in this week's BMJ. But the same is not true for women.

This study raises important questions about drinking patterns and heart health among men and women, but an editorial warns that the results should be interpreted with caution and should not be used to justify potentially harmful drinking behaviour.

It is widely known that moderate drinkers have a lower risk of coronary heart disease than those who abstain, but most research in this field has been done on men and little is known about drinking patterns and risk of heart disease among women.

Researchers in Denmark studied over 50,000 men and women aged 50-65 years who were taking part in a national health study. Details on alcohol intake and drinking frequency over the preceding year were collected, and participants were monitored for an average of 5.7 years.

Coronary heart events were recorded and results were adjusted for known risk factors, such as age, smoking, education, physical activity and diet.

A total of 28,448 women and 25,052 men took part in the study. Women consumed an average of 5.5 alcoholic drinks a week and men consumed 11.3. During the study, 749 women and 1,283 men developed coronary heart disease.

Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week.

However, risks were similar for drinking on one day a week (36% reduced risk), or seven days a week (35% reduced risk), suggesting that the amount of alcohol consumed is more important than drinking frequency among women.

In contrast, for men, risks were lowest for the most frequent drinkers. For example, men who drank on one day a week had a 7% reduced risk, while men who drank daily had a 41% reduced risk. This suggests that it doesn't matter how much men drink, as long as they drink every day.

To try to minimise bias, early cases of heart disease were analysed separately, but this did not change the conclusions. However, the authors stress that the benefits of alcohol on coronary heart disease are by far exceeded by the harmful effects of heavy alcohol drinking, and that their findings should be viewed in this context when giving public health advice.

But before the corks start popping, it is worth bearing several caveats in mind, writes Annie Britton, an epidemiology expert, in an accompanying editorial.

For instance, the Danish participants were middle-aged and therefore presumably at a greater risk of heart disease. The low response rate also means that extremes of drinking may not have been captured. Finally, the nature of this report - an observational study - may make it prone to other explanations for the findings.

In the UK, we are drinking well above the optimum level for health, so advice and legislation about keeping consumption safe and healthy are needed, she concludes.

British Medical Journal

Low Carbohydrate Diet Did Not Increase Bone Loss, Study Finds

A strict low-carbohydrate diet had no effect on bone loss for adults following an Adkins-type diet for weight loss, a three-month study by rheumatologists at the University of South Florida found. The clinical study was published this week in the online issue of the journal Osteoporosis International.

Low carbohydrate diets have become popular as a weight loss technique; however, critics contend such diets may have harmful side effects. One concern has been that low carbohydrate diets, which replace calories from carbohydrates with more consumption of high-protein foods like meat and eggs, alter the body's acid balance. This imbalance could lead to increased bone turnover (more rapid depletion than formation of bone) -- increasing the risk for osteoporosis.

"That's not what our study found," said lead author John D. Carter, assistant professor in the Division of Rheumatology, USF College of Medicine. "Patients on the low carbohydrate diet did lose weight, but the diet did not appear to compromise bone integrity or lead to bone loss."

Earlier animal studies suggested that low carbohydrate, high protein diets could adversely affect bone quality.

"I was surprised by the results," Dr. Carter said. "People on low carbohydrate diets absorb less calcium through the gut and excrete more calcium in the urine, so you'd expect they would be leaching their bones."

Dr. Carter emphasized he does not advocate strict low-carbohydrates for long-term weight management. Such diets may adversely overload the kidneys with protein and lead dieters to consume more artery-clogging saturated fats and cholesterol, he said. The USF study followed 30 overweight patients for three months. Half followed a strict low carbohydrate diet - consuming less than 20 grams of carbohydrates a day the first month and then less than 40 grams a day for the remaining two months. The control half ate a normal American diet with no restrictions. The researchers used blood tests to measure the patients' breakdown and formation of bone and checked urine for signs that the dieters were complying with their low-carbohydrate diets.

The difference in bone turnover between the low carbohydrate dieters and the non-dieters was insignificant after three months. But, the dieters lost significantly more weight -- an average of 14 pounds -- than the patients on unrestricted diets.

A potential limitation of the USF study was that the researchers looked for at least a 50 percent difference in bone turnover between the dieters and non-dieters. It's possible that more subtle effects on bone quality might have been found, Dr. Carter said, particularly if the low carbohydrate diet was maintained beyond three months.

Anne DeLotto Baier
abaier@health.usf.edu
University of South Florida Health

Listening To Music Can Reduce Chronic Pain And Depression By Up To A Quarter

Listening to music can reduce chronic pain by up to 21 per cent and depression by up to 25 per cent, according to a paper in the latest UK-based Journal of Advanced Nursing.

It can also make people feel more in control of their pain and less disabled by their condition.

Researchers carried out a controlled clinical trial with sixty people, dividing them into two music groups and a control group.

They found that people who listened to music for an hour every day for a week reported improved physical and psychological symptoms compared to the control group.

The participants, who had an average age of 50, were recruited from pain and chiropractic clinics in Ohio, USA. They had been suffering from a range of painful conditions, including osteoarthritis, disc problems and rheumatoid arthritis, for an average of six and a half years.

90 per cent said the pain affected more than one part of their body and 95 per cent said it was continuous. Before the music study, participants reported that their usual pain averaged just under six on a zero to ten pain scale and their worst pain exceeded nine out of ten.

“The people who took part in the music groups listened to music on a headset for an hour a day and everyone who took part, including the control group, kept a pain diary” explains nurse researcher Dr Sandra L Siedlecki from the Cleveland Clinic Foundation, Ohio.

“Forty people were assigned to the two music groups and the other 20 formed the control group.

“The first group were invited to choose their own favourite music and this included everything from pop and rock to slow and melodious tunes and nature sounds traditionally used to promote sleep or relaxation.

“The second group chose from five relaxing tapes selected by us. These featured piano, jazz, orchestra, harp and synthesizer and had been used in previous pain studies by co-author Professor Marion Good from the Frances Payne Bolton School of Nursing at Case Western Reserve University, Ohio.”

At the end of the trial:

- The music groups reported that their pain had fallen by between 12 and 21 per cent, when measured by two different pain measurement scales. The control group reported that pain increased by between one and two per cent.

- People in the music groups reported 19 to 25 per cent less depression than the control group.

- The music groups reported feeling nine to 18 per cent less disabled than those who hadn't listened to music and said they had between five and eight per cent more power over their pain than the control group.

“Our results show that listening to music had a statistically significant effect on the two experimental groups, reducing pain, depression and disability and increasing feelings of power” says Dr Siedlecki.

“There were some small differences between the two music groups, but they both showed consistent improvements in each category when compared to the control group.

“Non-malignant pain remains a major health problem and sufferers continue to report high levels of unrelieved pain despite using medication. So anything that can provide relief is to be welcomed.”

“Listening to music has already been shown to promote a number of positive benefits and this research adds to the growing body of evidence that it has an important role to play in modern healthcare” adds co-author Professor Marion Good.

Previous research by Professor Good and Hui-Ling Lai, published in the Journal of Advanced Nursing in 2005 and republished in journal's 30th Anniversary issue in 2006, showed that listening to 45 minutes of soft music before bedtime can improve sleep by more than a third.

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Vegans Less Likely To Have Twins Than Women Who Eat Animal Products

According to new research, women who consume animal products, especially dairy, are five times as likely to have twins than vegan women - women who consume no animal products at all. Dr. Gary Steinman, Long Island Jewish (LIJ) Medical Center in New Hyde Park, NY, said the consumption of dairy products, especially, raised a woman's chances of having twins.

You can read about this study in the Journal of Reproductive Medicine, May 20 Issue.

Scientists found that Insulin-like Growth Factor (IGF) is 13% lower in vegan women, when compared to women who consume dairy products. IGF is a protein, released from the liver in response to growth hormone. It circulates in the blood and finds its way into the animal's milk. Sensitivity of the ovaries to follicle-stimulating hormone is increased with the presence of IGF - this increases ovulation.

IGF, according to some studies, helps embryos survive during the early stages of development.

In the USA the percentage of women who have given birth to twins has steadily increased since 1975. Assisted Reproductive Technologies (ART) started around 1975. Also, as women have babies later in life, the chances of having twins also goes up. Another factor has been the introduction of growth-hormone treatment of cows, which started in the 1990s. Growth-hormone treatment of cows makes them produce more milk and beef.

Dr. Steinman compared the twinning rates of three types of women:

-- Vegans (no animal products at all)
-- Vegetarians who consumed dairy products
-- Women who were omnivores and consumed dairy

He found that vegan women's chances of having twins were one fifth of those who consumed dairy.

Twinning rates among women around the world parallels IGF levels. African American women have much higher IGF rates than most other groups, and also the highest twinning rates. Asian women have the lowest IGF levels, and also the lowest twinning rates. Apart from diet, IGF production is genetically linked.

Dr. Steinman said that for the first time, this study shows that the chances of having twins are influences by both nurture and nature. Nature, because it depends on what group you are - African American, Asian, European, etc. Nurture, because your dairy consumption can have an influence. A woman's chances of having twins are influenced by her levels of insulin-like growth factor.

In this text, ‘nurture' means the same has ‘environment' or ‘environmental'.

As multiple births are associated with higher incidences of premature births, congenital defects and pregnancy-induced hypertension, Dr. Steinman suggest woman wanting to get pregnant might consider replacing dairy products with other protein sources - especially in countries where growth hormone administration to cattle is allowed.

Written by: Christian Nordqvist
Editor: Medical News Today

Environmental Tobacco Smoke Linked To Allergic Rhinitis, Hay Fever, In Infants

University of Cincinnati (UC) epidemiologists say it's environmental tobacco smoke--not the suspected visible mold--that drastically increases an infant's risk for developing allergic rhinitis by age 1.

Commonly known as hay fever, allergic rhinitis occurs when a person's immune system mistakenly reacts to allergens (aggravating particles) in the air. The body then releases substances to protect itself, causing the allergy sufferer to experience persistent sneezing and a runny, blocked nose.

This is the first study to show a relationship between environmental tobacco smoke exposure and allergic rhinitis in year-old infants, the UC team reports in the June issue of Pediatric Allergy and Immunology and an early online edition May 17.

"Previous studies have addressed risk factors for allergic rhinitis, but they failed to examine multiple environmental exposures, and some yielded contradictory results," says Jocelyn Biagini, lead author and an epidemiologist in UC's environmental health department.

The study evaluated the effects of numerous indoor exposures to such things as environmental tobacco smoke, visible mold, pets, siblings and the day-care environment on 633 infants under age one.

"We found that infants who were exposed to 20 or more cigarettes a day were three times more likely to develop allergic rhinitis by their first birthday than those who were not exposed," says Biagini.

These findings, she says, suggest that for the health of their children, it's important for parents to eliminate tobacco smoke from their homes.

"An infant's lungs and immune system are still developing in the first year of life," says Grace LeMasters, PhD, coauthor and principal investigator of the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). "Environmental tobacco smoke puts harmful particulates in the air that--when inhaled regularly at such an early age--could lead to serious allergic conditions like asthma."

CCAAPS, funded by the National Institute of Environmental Health Sciences, is a five-year study examining the effects of environmental particulates on childhood respiratory health and allergy development.

About 43 percent of children, says Dr. LeMasters, are exposed to home environmental tobacco smoke. According to the Centers for Disease Control and Prevention, about 21 percent of all American adults smoke cigarettes. Of them, 12 percent report smoking 25 or more cigarettes daily.

While household mold, long thought to be a major cause, did not contribute to allergic rhinitis development, Biagini says, it did increase the infant's risk for ear infections.

Infants exposed to a mold patch about the size of a shoebox were five times more likely to contract ear infections requiring antibiotics than those living in mold-free homes, she explains.

The UC study also suggests that infants with older siblings are less likely to have allergic rhinitis.

"Research has shown that exposure to certain infections early in life may decrease your risk for allergic diseases," explains James Lockey, MD, professor of environmental health and pulmonary medicine. "We found a 'sibling protective effect' for allergic rhinitis--this may mean the more siblings infants have, the more infections they are exposed to. As a result, the infant's body may be better equipped to fight off allergic diseases later in life."

Collaborators in the study were David Bernstein, MD, Gurjit Khurana Hershey, MD, PhD, Patrick Ryan, Linda Levin, PhD, Tiina Reponen, PhD, Jeff Burkle and Manuel Villareal, MD.

Ohio's Governor Bob Taft recently proclaimed May Allergy and Asthma Awareness Month to encourage citizens to make their respiratory health a priority. According to the Asthma and Allergy Foundation of America, more than 50 million Americans suffer from allergies, many of which are can be triggered by airborne environmental pollutants.

Amanda Harper
amanda.harper@uc.edu
University of Cincinnati News

Effect Of Non-Steroidal Anti-Inflammatory Drug Use On The Incidence Of Erectile Dysfunction

UroToday.com - Arthritis and erectile dysfunction (ED) affect men more as they age. In this article, R. Shiri and colleagues of the Tampere School of Public Health of Tampere Finland first list several prior articles that show that the occurrence of these two diseases correlates well.

They then correlate the use of non-steroidal anti-inflammatory drugs (NSAID) used for treatment of arthritis and other ailments with their effects on ED. Their study used a sub-set of the Tampere Aging Male Urological Study and involved data derived from 1,126 men who began the study without evidence of ED. Of these, 101 used NSAIDs and most (58%) also reported arthritis symptoms.

However, of 256 men who separately reported arthritis symptoms, only 23% used NSAIDS. After multivariate adjustment, the relative increased risk for ED amongst those using NSAIDs versus not using, was 1.8. Also, ED risk was low in men without arthritis and who used no NSAIDs. When age adjustment was applied, the relative risk of ED with NSAIDs climbed to 2.4. In men without arthritis who still used NSAIDs, the relative risk of ED was 2.0, still elevated when compared to non-NSAID users.

The authors conclude that use of NSAIDs increased risk of ED and could not be correlated directly with the presence or absence of arthritis. They suggest that NSAIDs compete with arachidonic acid and inhibit the synthesis of prostaglandins and thromboxane. NSAIDS may therefore interfere with the nitric oxide pathway that is essential for the erectile process. They believe that their stratification of the results shows that increased risk of ED was related to NSAID use but not to the disease arthritis itself. They estimate that the “population etiological fraction of ED due to NSAID drug use was 16.7%”.

In an editorial comment, Kevin T. McVary of Northwestern University, Chicago, USA, notes that for their 2 questions used to estimate ED, “the question of validation remains.” He then suggests more elaborate questionnaires (Short Form 30) that might better estimate the relationship between ED, arthritis and NSAID use. Finally, he calls on use of more stringent epidemiologic principles (Hill's causality method) that might be able to verify a stronger relationship. Clearly, “additional confirmatory studies” are needed.

By George W. Drach, MD
Copyright © 2006 - UroToday

How Beneficial Are Multivitamins? We Don't Know

You see multivitamins for sale in supermarkets, health shops, pharmacies, general grocery stores and health clubs. Hundreds of millions of people worldwide take them regularly, without fail. But, what good do they do us? We simply don't know.

According to a US panel of experts from the NIH Office of Medical Applications of Research and the Office of Dietary Supplements, there is scant information on the benefits and safety of multivitamins.

Multivitamins, in the USA alone, bring in revenues of over $20 billion a year for those who sell them. Half of all American adults take multivitamins.

The panel looked at two days of expert presentations and public discussions. It concluded that more rigorous scientific research is needed on multivitamins use to prevent chronic diseases.

NIH Panel Chairman, Dr. M McGinnis, said the science base is especially thin with respect to the health impact of multivitamins. He said that insufficient available data makes it impossible for the panel to make a firm recommendation for or against the use of multivitamins. He said what little data there is, is not in-depth enough.

The theory goes that if you eat badly, multivitamins can compensate. But we just don't know whether this really happens. Some studies have indicated that the people who take multivitamins the most are also the most health-conscious ones. People who eat well and do exercise consume much larger quantities of multivitamins than those who eat badly and exercise the least.

Several studies have shown, though, that if you eat your fruit and vegetables regularly, you will be consuming the right amounts of vitamins needed for good health.

The panel did manage to make the following recommendations:

-- The combined use of calcium and vitamin D supplementation helps protect postmenopausal women's bone health.

-- Anti-oxidants and zinc should be considered for use by non-smoking adults with early-stage, age-related macular degeneration.

-- Women of childbearing age should take daily foliate to prevent neural tube defects in infants.

-- There is evidence that smokers should avoid taking beta carotene supplements regularly as there is a raised risk of lung cancer.

Written by: Christian Nordqvist
Editor: Medical News Today

What Does Prozac Target?

Researchers at Cold Spring Harbor Laboratory on Long Island have identified which among several different kinds of cells in the brain is the chief target of the widely prescribed antidepressant Prozac. This discovery might enable a new generation of more specific treatments for depression, with fewer side effects, to be developed.

The findings also lay the foundation for many studies of the factors that control how, when, and where new neurons are generated from stem cells in the brain. Such work could eventually lead to cell replacement therapies for neurodegenerative and other brain disorders including Alzheimer's and Parkinson's disease.

It has been known for some years that Prozac (fluoxetine) likely to relieve the symptoms of depression by somehow causing more neurons to be present in a particular region of the brain (the "dentate gyrus"). But the origins of these neurons, and how Prozac promotes their existence, have been a mystery until now.

By profiling the telltale marker proteins produced by different kinds of cells in the brains of adult mice, the researchers first defined discrete steps in the complex process, called neurogenesis, that converts unspecialized stem cells into mature, specialized neurons.

Next, knowing that Prozac treatment somehow increases the number of neurons in the brain, the researchers tested which step in the neurogenesis pathway might be stimulated by Prozac. They found that Prozac treatment specifically stimulates the generation of a kind of cells they dubbed "amplifying neural progenitors" or ANPs--the second step in the neurogenesis pathway from stem cells to mature neurons. (Illustration available on request)

The study is published in the published in the Proceedings of the National Academy of Sciences (advance on-line this week, in print on May 23). It was led by Grigori Enikolopov and spearheaded by postdoctoral fellow Juan Manuel Encinas.

To address the controversy surrounding the use of Prozac in children and in pregnant women, Enikolopov's group is currently testing the effects of the drug on brain neurogenesis in juvenile and pregnant mice. The results of those experiments may provide valuable information for assessing the possible effects of Prozac and related drugs on fetal and adolescent brain development.

The researchers are currently using the approach and tools they've developed to explore whether other treatments for depression--including other drugs and deep brain stimulation--act in the same way as Prozac or in different ways. In addition, the scientists are screening for new drugs that expand the production of brain neurons by stimulating ANP cells to multiply.

In collaboration with NASA researchers, experiments are also under way at Cold Spring Harbor Laboratory to assess how neurogenesis in the adult brain might be influenced by long-term, Mission-to-Mars levels of exposure to a particular kind of damaging radiation that's prevalent in space.

Peter Sherwood
sherwood@cshl.edu
Cold Spring Harbor Laboratory

Fast Pharmacy Access To The Morning-after Pill Could Prevent 10% More Unwanted Pregnancies

Pharmacies who provide fast and convenient access to the morning-after pill could be helping to prevent 10 per cent more unwanted pregnancies, according to a study in the latest British Journal of Clinical Pharmacology.

UK researchers from South West Kent Primary Care Trust and the University of Bradford looked at 203 females aged from 13 to 20 who got the medication from family planning clinics and community pharmacies.

They discovered that those who went to a pharmacy to get the morning-after pill obtained it more than twice as quickly as those who went to their local clinic - in 16 hours rather than 41.

Figures from the World Health Organization suggest that taking emergency contraception up to 24 hours after unprotected sex prevents 95 per cent of pregnancies, while taking it between 24 and 48 hours later prevents 85 per cent.

The study also found that:

Older teenagers tended to seek help quicker, with 14 year-olds taking almost four times as long (37 hours) as 20 year-olds (10 hours).

The time it took to get the morning-after pill from family planning clinics was much more consistent, with the majority waiting between 38 and 42 hours.

72 per cent of those who obtained the morning-after pill from clinics were aged between 15 and 17, while 74 per cent who went to pharmacies were between 16 and 18.

25 per cent visited the pharmacy over the weekend and 26 per cent on a Monday.

Two-thirds of girls under 16 said they needed the morning-after pill because they hadn't used any contraception. The other third blamed split condoms.

Two-thirds of those in the 16 plus age group sought the morning-after pill because they had had a contraception failure - either the condom had split or they had missed taking the pill.

“The UK currently has the highest rate of teenage pregnancies in Western Europe and the highest rate of live births among teenagers” says Dr Kay Marshall from the School of Pharmacy at the University of Bradford.

“The morning-after pill - often referred to by health professionals as emergency hormonal contraception - has long been recognised as a safe and effective method of preventing unintended pregnancies.

“The name is a bit misleading, because it can actually be taken within 72 hours of unprotected sex, not just the morning after. But as the effectiveness of the morning-after pill declines significantly with time - it works best if taken within 24 hours - it's essential that it can be obtained as soon as possible.

“We believe that the females in our study were able to access the pill much more quickly from local pharmacists as they tend to be open outside normal working hours and at weekends.”

The morning-after pill has traditionally been provided free in the UK by family doctors and family planning clinics. It became available over-the-counter at pharmacies in 2001.

Selected community pharmacists can now provide it free of charge to females under 20 as long as they feel that all the appropriate conditions have been satisfied and that she is competent to make the decision to take it.

This is an important development, especially for young girls who can't afford to pay the over-the-counter cost, which recently increased to £25.

Pharmacists providing the item free are required to submit a return to the Primary Care Trust, which includes the age of the client and the number of hours between unprotected sex or contraception failure and dispensing.

The researchers collated data from 116 pharmacy request forms and compared them with 87 requests for emergency contraception from two of the busiest family planning clinics in the Primary Care Trust area.

“Our study suggests that community pharmacists are providing a valuable role in preventing unwanted pregnancies by supplying the morning-after pill and backing this up with advice on contraception and sexual health” says Gaye Lewington from SouthWest Kent Primary Care Trust, which oversees and commissions local health services in the area.

“Recent studies have suggested that allowing pharmacies to supply the morning-after pill does not compromise contraceptive practice or sexual behaviour. This is very important because encouraging females to practice safe sex is just as much a priority as preventing unwanted pregnancies.

“It is essential that the morning-after pill is available promptly if a female feels there is a pregnancy risk, but it is also very important that it continues to be seen as an emergency measure rather than an alternative to using contraception as a matter of routine.”

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New Prescription Pain Treatment Completes European Mutual Recognition Procedure

JURNISTA(TM) prolonged-release tablets (Hydromorphone HCl), a new prescription treatment for severe pain, has successfully completed the Mutual Recognition Procedure in Austria, Czech Republic, Estonia, Finland, Germany, Hungary, Italy, Latvia, Lithuania, Norway, Portugal, Slovak Republic, Slovenia and Spain. The countries mutually agreed to recognize the approval of JURNISTA granted by the Reference Member State, Denmark.

JURNISTA was developed by ALZA Corporation and utilizes the OROS(R) Push-Pull delivery system to release the opioid hydromorphone at a consistent rate. It will be registered and marketed by Janssen-Cilag companies in Europe. ALZA and Janssen-Cilag are affiliates of Johnson & Johnson.

As with all opioid analgesics, hydromorphone exerts its pharmacological effects by binding to specific opioid receptors predominantly located in the central nervous system. Following oral dosing of JURNISTA, data show that hydromorphone hydrochloride is released continuously for 24 hours. The continuous release of hydromorphone results in relatively consistent plasma concentrations for approximately 24 hours post-dose. JURNISTA will be available in four dosage strengths - 8 mg, 16 mg, 32 mg and 64 mg prolonged-released tablets.

In clinical trials with JURNISTA, the most commonly reported adverse reactions were constipation, nausea, and vomiting. These symptoms are common with opioid analgesics and can usually be managed by laxatives, antiemetics, or dose reduction, as needed.

ALZA Corporation is leading the next generation of drug delivery, with the world's broadest array of technology platforms, including oral, transdermal, implantable, and liposomal technologies. More than 30 products marketed in over 80 countries worldwide now incorporate ALZA's drug delivery technologies.

(This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or unknown risks or uncertainties materialize, actual results could vary materially from Johnson & Johnson 's expectations and projections. Risks and uncertainties include general industry conditions and competition; economic conditions, such as interest rate and currency exchange rate fluctuations; technological advances and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approvals; domestic and foreign health care reforms and governmental laws and regulations; and trends toward health care cost containment. A further list and description of these risks, uncertainties and other factors can be found in Exhibit 99 of Johnson & Johnson 's Annual Report on Form 10-K for the fiscal year ended January 1, 2006. Copies of this Form 10-K, as well as subsequent filings, are available online at http://www.sec.gov or on request from the Johnson & Johnson. Johnson & Johnson assumes no obligation to update any forward-looking statements as a result of new information or future events or developments.)

ALZA Corporation
http://www.sec.gov

Antiviral Drugs May Help Relieve Nerve Pain Related To Shingles

A small trial suggests that treatment with intravenous and oral antiviral medications may reduce the nerve pain that occurs following shingles, according to a study posted online today that will appear in the July 2006 print issue of Archives of Neurology, one of the JAMA/Archives journals.

Shingles (herpes zoster) is caused by the varicella-zoster virus, the same virus that causes chickenpox, according to background information in the article. The virus lays dormant in the nervous system for decades after infection with chickenpox. When it becomes reactivated, the virus causes a rash and nerve pain (postherpetic neuralgia). Postherpetic neuralgia can that lasts for months or years and affects as many as one million people in the United States.

Dianna Quan, M.D., and colleagues at the University of Colorado and Health Sciences Center, Denver, administered antiviral therapy to 15 patients (12 men and three women) with moderate to severe nerve pain following shingles. Participants received 10 milligrams of the medication acyclovir intravenously every eight hours for 14 days and then took three 1,000-milligram pills of the medication valacyclovir per day for one month. The patients were asked to rate their pain on a scale of zero to 10 at the beginning of the study, then again after finishing each therapy and one month after finishing valacyclovir.

One month after therapy, eight (53 percent) patients reported that their pain had reduced significantly (by two or more points). This was similar to the percentage of patients who reported such an improvement after day 15 (seven) and after day 45 (eight). Most patients tolerated the treatment well, although five dropped out of the study early, three of them because of complications related to the therapy.

"Although our study was small and without placebo control, the findings suggests a promising effect of antiviral treatment on postherpetic neuralgia," the authors conclude. "Treatment of postherpetic neuralgia with IV acyclovir will be expensive. However, elimination or reduction of pain coupled with reduced burden of disease and use of health care resources would offset treatment costs."

###

(Arch Neurol. 2006; 63: (doi: 10.1001/archneur.63.7.noc60049))

This study was supported in part by grants from the National Institutes of Health and a grant from the Avenir Foundation.

Contact: Tonya Ewers
JAMA and Archives Journals

Nuvaring® Better Tolerated Than Other Hormonal Contraceptives - Most Users Report Greater Feeling Of Safety And Control Over Their Lives

Women who switch to NuvaRing® - the once-a-month contraceptive ring - from other forms of hormonal contraception experience a significant reduction in hormone-related adverse events, according to results from a study involving 900 Spanish women presented today at the European Society of Contraception [1].

The study also showed that eight out of ten women reported an improvement in quality of life after starting NuvaRing. The reasons that contributed most to this improvement were ‘a greater feeling of safety' followed by ‘a greater feeling of control over their lives'.

Lead investigator, Dr Lete Lasa, consultant gynecologist commented: “It is easy to understand the growing popularity of NuvaRing among Spanish women in the context of these findings. NuvaRing is extremely well tolerated and women clearly appreciate the convenience of its once-a-month action.”

NuvaRing is a highly reliable contraceptive offering the advantage of a once-a-month regimen, while minimizing women's exposure to estrogen. Comparative studies show NuvaRing offers superior cycle control to the Pill, while reducing the incidence of estrogen-related side effects.

Dr Lete Lasa attributed the low incidence of hormone-related adverse events with NuvaRing to its low and steady release of hormone. Previous research shows that total monthly serum exposure to estrogen is 3.4 times lower among women using NuvaRing than those using the transdermal patch, and 2.1 times lower than those using an oral contraceptive containing 30 mcg of estrogen. At the same time, NuvaRing users experience fewer fluctuations in blood hormone levels than women using the contraceptive patch or the pill do.

NuvaRing is proving particularly popular in Spain. Accordingly, Dr Lete Lasa and colleagues at the Santiago Apostol Hospital in Vitoria Spain set up a clinical experience program to investigate aspects of its use. They invited all women requesting contraceptive advice at a number of centres to participate in a six-month observational, prospective open study with NuvaRing. Women were classified as either new users of hormonal contraception if they were not previously using hormonal contraception or switchers if they switched to NuvaRing from another hormonal contraceptive.

The results showed that among switchers, the incidence of nausea, headache and breast tenderness was significantly lower after 3 cycles of NuvaRing use compared to baseline and this improvement was maintained and strengthened at cycle 6. More specifically, the percentage of women with breast hypersensitivity decreased from 6.4 % at baseline to 1.7 % after 6 cycles of use and headache fell from 10% at the start of the study to 1.2%.

About Organon

Organon - with shared head offices in Roseland, NJ, USA and Oss, The Netherlands - creates, manufactures and markets prescription medicines that improve the health and quality of human life. Through a combination of independent growth and business partnerships, Organon strives to remain or become one of the leading pharmaceutical companies in each of its core therapeutic fields: gynecology, fertility, neuroscience and anesthesia. Organon products are sold in over 100 countries, of which more than 60 have an Organon subsidiary. Organon is the human health care business unit of Akzo Nobel.

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Low Estrogen Levels In Men Linked To Increased Risk For Hip Fracture

A new study has found that men with low estrogen levels have an increased risk for future hip fracture, and those with both low estrogen and low testosterone levels have the greatest risk.

The study, to be published in the May issue of The American Journal of Medicine, was conducted by Shreyasee Amin, M.D., Mayo Clinic rheumatologist, and colleagues studying men from the National Heart, Lung and Blood Institute's Framingham Heart Study (http://www.framingham.com/heart) prior to her career at Mayo Clinic.

The study examined 793 men who had their estrogen and testosterone levels measured between 1981 and 1983 and no record of prior hip fracture. They were followed until 1999. The men were categorized as having low, midrange or high levels of each hormone. The researchers also recorded hip fractures not associated with high trauma occurring since the study start. During the study, 39 men experienced a low trauma hip fracture (for example, incurred due to a fall from a standing height or less). Those with low estrogen levels (total estradiol levels below 18 picograms per milliliter) had 3.1 times the risk of hip fracture compared to men with high estrogen levels. There was no significant increase in hip fracture risk for men with low testosterone levels alone. However, men with both low estrogen and low testosterone levels had the greatest risk, with 6.5 times the risk of hip fracture compared to the men who had both estrogen and testosterone levels in the high range or midrange.

This study is the first to report the link between low estrogen and hip fracture in a study group of men from the general population followed over time.

Though many people associate testosterone with men and estrogen with women, men possess both hormones, according to Dr. Amin.

The researchers who undertook this study knew that low estrogen levels had been associated with low bone mineral density in elderly men, but any link to hip fracture, an important health risk in the elderly, was unknown. Hip fractures are worrisome in the elderly, especially in men, explains Dr. Amin. Up to 50 percent of men require institutionalized care after the fracture. Hip fracture also is linked to higher levels of mortality: up to 37 percent of men die within one year of fracture.

"These findings add further evidence to the important role of estrogen in the bone health of older men," says Dr. Amin. "It's important for us to know what puts men at risk for hip fracture so that we can better determine how we may prevent these fractures."

Currently, no tests are routinely performed in men to determine estrogen levels. A man known to have low estrogen levels, however, may potentially benefit from interventions to improve his bone density and prevent hip fracture, says Dr. Amin. This may be especially important if he has low testosterone levels as well.

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Other researchers involved in this study include Yuqinq Zhang, D.Sc.; David Felson, M.D.; Clark Sawin, M.D.; Marian Hannan, D.Sc.; Peter W.F. Wilson, M.D.; and Douglas Kiel, M.D. None of these researchers are from Mayo Clinic.

Contact: Lisa Lucier
Mayo Clinic

Study Shows Fish Oil To Be Safe And Effective For Neck And Back Conditions

Fish oil given to patients with chronic neck and low-back pain has proven to be effective, according to a study published in the April 2006 issue of Surgical Neurology.

The patented fish oil supplement was administered to 250 patients under physician's care, most of whom suffered from degenerative disc conditions.Back problems are "one of the greatest causes of pain and disability in the United States," according to Joseph Maroon, MD, the study's lead author and vice chairman of the Department of Neurological Surgery at the University of Pittsburgh School of Medicine. Maroon's study team chose ProEPA(TM)/EPA(TM) from Nordic Naturals, Inc. ProEPA provides omega-3 essential fatty acids (1,230 mg/2 capsules) with a high concentration of eicosapentanenoic acid (EPA). Patients took 2 or 4 capsules a day.

After beginning supplementation, subjects were given a questionnaire asking for clinical improvements and any side effects. After an average of 75 days of fish oil supplementation, 60% of respondents reported significant improvements, including reduction in overall pain and 59% were able to stop taking other pain medicine. None of the patients experienced significant side effects and 88% of the respondents planned to continue using the fish oil omega-3s.

"It is important for patients to know that safer alternatives to pain medications are available," said Dr. Maroon. "A fish oil supplement containing EPA and DHA omega-3s is an effective choice with fewer or no side effects. People should be careful to choose a pharmaceutical-grade fish oil supplement that is fresh and free of potentially harmful heavy metals, such as the mercury, PCPs, and dioxins that can be found in fish.

"Our study adds to the numerous publications showing the widespread health benefits of fish oil omega-3s. Additional clinical trials, along with ours, now show that patients with chronic joint pain who take an adequate amount of natural purified fish oil, for a long enough period of time, can get meaningful relief without relying on medications," said Dr.Maroon.

Founded by husband-and-wife team Joar and Michele Opheim, Nordic Naturals is the leader in omega-3 fish oils and EFA blends with exceptional taste, freshness, and purity levels. The company offers over 50 different fish oil products and EFA blends, including liquids, capsules, and children's chewables.

Nordic Naturals, Inc.
http://www.nordicnaturals.com

How Organisms Manage To Create Self-medications Discovered By MIT Chemist

MIT scientists have just learned another lesson from nature.

After years of wondering how organisms managed to create self-medications, such as anti-fungal agents, chemists have discovered the simple secret.

Scientists already knew that a particular enzyme was able to coax a reaction out of stubborn chemical concoctions to generate a large family of medically valuable compounds called halogenated natural products. The question was, how do they do it?

Chemists would love to have that enzyme's capability so they could efficiently reproduce, or slightly re-engineer, those products, which include antibiotics, anti-tumor agents, and fungicides.

Thanks to MIT chemistry Associate Professor Catherine L. Drennan's recent crystallography sleuthing, the secret to the enzyme's enviable prowess has come to light and it appears almost anti-climactic. It's simply a matter of the size of one of its parts.

"If an enzyme is a gun that fires to cause a reaction, then we wanted to know the mechanism that pulls the trigger," Drennan said. "In chemistry, we often have to look at 'molecules in, molecules out.' With halogenated natural products, though, we couldn't figure out how it happened, because the chemicals are so nonreactive. Now that we have the enzyme's structure and figured out how it works, it makes sense. But it's not what we would have predicted."

To make halogenated natural products, enzymes catalyze the transformation of a totally unreactive part of a molecule, in this case a methyl group. They break specific chemical bonds and then replace a hydrogen atom with a halide, one of the elements from the column of the periodic table containing chlorine, bromine and iodine. In the lab, that's a very challenging task, but nature accomplishes it almost nonchalantly. The trick involves using a turbo-charged enzyme containing iron.

A clue to how these enzymes operate emerged from a 2005 study by Christopher T. Walsh of Harvard Medical School, Drennan's collaborator and co-author of the study published in the March 16 issue of Nature. Looking at the SyrB2 enzyme that the microorganism Pseudomonas syringae uses to produce the antifungal agent syringomycin, he discovered it had a single iron atom in the protein's active site, the part responsible for the chemical reaction.

Drennan and her graduate student Leah C. Blasiak, who was first author of the study, crystallized SyrB2 and then used X-ray crystallography to discover the physical structure of the protein. The X-rays scatter off the crystal, creating patterns that can be reconstructed as a three-dimensional model for study.

Normally, iron-containing enzymes have three amino acids that hold the iron in the active site. In this enzyme, however, one of the typical amino acids was substituted with a much shorter one.

That smaller substitute leaves more room in the active site -- enough space for the halide, in this case a chloride ion, to casually slip inside and bind to the iron, without the grand theatrics chemists had anticipated. After the iron and the chloride bind, the protein closes down around the active site, effectively pulling the trigger on the gun.

"We were surprised," Drennan said. "The change in activity required for an enzyme to be capable of catalyzing a halogenation reaction is so radical that people thought there must be a really elaborate difference in their structures. But it's just a smaller amino acid change in the active site. Things are usually not this simple, but there's an elegant beauty in this simplicity," and it may be what gives other enzymes the prowess required for making other medicinally valuable halogenated natural products, too.

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The research was partially funded by the National Institutes of Health.

Contact: Elizabeth Thomson
Massachusetts Institute of Technology