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Novel Egg Freezing Technique Opens The Door

2006-06-27T10:46:00.000-07:00

Vitrification is a novel technique for freezing human eggs (also referred to as oocytes), which is opening the door to long-term human egg storage. Traditional methods of human egg cryopreservation have met with limited success. The scientific team at Georgia Reproductive Specialists (GRS), who were responsible for the first frozen human egg births in North America in 1997, have successfully implemented the new technique of vitrification and celebrate the birth this month of the newest baby born as a result of this technique.

It is GRS' intention to be able to offer egg freezing (oocyte cryopreservation) as a viable solution for women desiring to preserve their eggs for future use. Some of the potential applications of egg freezing are as follows:

- Egg banking for women wishing to preserve their fertility following cancer therapy

- Egg banking for women delaying pregnancy

- Establishment of a donor egg bank

- Rescue of excess eggs from an unexpectedly strong stimulation of the ovaries during an Artificial Insemination (Intrauterine Insemination - IUI) treatment cycle

Currently GRS has research programs in the last two areas; and the latest "frozen egg baby" arrived as a result of the rescue of excess eggs, which would have otherwise been discarded in an IUI cycle. Had these eggs been allowed to remain in the ovaries during the IUI cycle, the woman would have run an extremely high risk of conceiving with a multiple pregnancy potentially endangering both her and her babies.

Ovarian hyperstimulation syndrome, painful ovarian enlargement, is another potential complication that may result from an overly vigorous response to ovulation medications. While traditionally this leads to canceling the treatment cycle or converting to standard IVF, GRS' approach allows both a safe attempt at pregnancy within the IUI cycle and, if the pregnancy does not occur, then the woman is able to use her "rescued" frozen eggs to attempt pregnancy with routine in vitro fertilization.

On June 5th, the first such reported use of this exciting technology established a clear approach for the use of egg freezing to reduce the costs and risks involved in modern reproductive medicine.

Georgia Reproductive Specialists (GRS) applies medical science's most advanced fertility technologies to provide the highest standards of patient- centered, reproductive healthcare. The staff at GRS, including infertility laboratory pioneer Michael Tucker, Ph.D., is focused on providing individualized, innovative solutions for reproductive challenges and infertility, specializing in in vitro fertilization, intracytoplasmic sperm injection and other assisted reproductive technologies.

Fellowship-trained reproductive endocrinologists Dr. Susan C. Conway, Dr. Carolyn Kaplan and Dr. Mark Perloe are experts in female and male disorders including polycystic ovary syndrome (PCOS), repeated pregnancy loss, menstrual disorders and azoospermia. GRS has three offices, Atlanta, Alpharetta and Decatur, to conveniently serve patients across Metro Atlanta. For more information about Georgia Reproductive Specialists, visit http://www.ivf.com.

Studies To Date Say Erectile Dysfunction Drugs Affect Other Systems, Mostly For The Better

2006-06-26T05:10:00.000-07:00

Since the Food and Drug Administration gave Viagra (sildenafil) its approval in 1998, "erectile dysfunction" has become a household term - probably to the chagrin of many parents fielding questions from their kids watching TV. But with sildenafil and the subsequent introduction and marketing of Levitra (vardenafil) and Cialis (tadalafil), many men have found answers to a once-unmentionable condition.

"As more and more patients seek therapy for sexual dysfunction, it is increasingly important for clinicians in a wide range of specialties to become proficient in the mechanisms and systemic effects of these medications," said Ernst R. Schwarz, M.D., Ph.D., a cardiologist at Cedars-Sinai Medical Center who specializes in therapies for men who suffer from erectile dysfunction (ED) and have heart problems, diabetes, high blood pressure or other related conditions.

Schwarz and colleagues recently concluded a review of the medical literature, as well as their own research findings and clinical data, to determine what actually is known about the effects of long-term use of this class of drugs on various organ systems. Their findings appears in the June, 2006 issue of the International Journal of Impotence Research.

Studies so far suggest the drugs, called phosphodiesterase-5 inhibitors (PDE-5i), produce mostly beneficial results, and not just for erectile dysfunction. The FDA recently approved a reformulation of sildenafil for the treatment of primary pulmonary hypertension, a disease that tends to occur in young women, causing elevated blood pressures in the lung that can lead to heart failure and early death.

"When we look at all the different organ systems - the blood, the heart, the lungs, blood flow in the brain - there are hardly any negative side effects. In fact, just the opposite is true. There are beneficial effects for primary pulmonary hypertension, as well as for conditions such as heart failure and lack of oxygen in the heart," said Schwarz. "The only issue is that the data we have are from relatively short-term studies. Viagra has been on the market since 1998 and the other two PDE-5 inhibitors were approved by the FDA in 2003. Therefore, we do not have multi-year follow-up studies. On the other hand, the drugs have been on the market for several years now and there have been no reports of negative long-term effects."

While there are some differences among the three medications, they have many properties in common and work by limiting the activity of the enzyme phosphodiesterase-5, which is found in tissues and vessels of the penis, blood platelets, and smooth muscle of blood vessels. For the treatment of erectile dysfunction, the drugs' constraint of the enzyme's action results in increased levels of cyclic guanosine monophosphate (cGMP) and nitric oxide (NO), biochemicals that promote smooth muscle relaxation and increased blood flow in erectile tissue.

According to the article, PDE-5 inhibitors can be effective in treating erectile dysfunction even for many men who also have diabetes, those who are older, and those who have co-existing ischemic heart disease (reduced blood flow to the heart caused by plaque buildup in the arteries). Furthermore, say the authors, "since PDE-5 is found in smooth muscles of the systemic arteries and veins throughout the body, use of PDE-5i has been associated with various cardiovascular effects."

"The original intention was to develop PDE-5 inhibitors as a treatment for angina, chest pain that occurs when the heart is starved for oxygen," Schwarz said. "As such, their effects on the heart appear to be all beneficial. Nitrates and other substances commonly used to improve blood flow and oxygenation to the heart muscle have a side effect that we call the 'steal phenomenon,' in which blood is taken away from underperfused (flow-restricted) areas to improve blood flow in normal areas. In contrast, PDE-5 inhibitors actually improve blood flow even in areas where there is a blockage of an artery, thereby having a protective effect on the heart muscle."

The drugs' potential impact on visual function became a matter of controversy when a suspected link between PDE-5 inhibitors and vision loss led to lawsuits filed last year against the maker of Viagra. According to the article's authors, however, "analysis of clinical trial data in more than 13,000 men and on more than 35,000 patient-years of observation" found occurrence of the visual disorder to be similar to that of the general population. "Even though individual cases have been reported for all PDE-5i, these recently published data do not suggest an increased incidence of NAION (non-arteric anterior ischemic optic neuropathy) in men who took PDE-5i for ED," the article states.

Among other findings:

* Although the enzyme PDE-5 has been found in tissue and arteries of the brain, sildenafil does not appear to dilate cerebral arteries or have an effect on cerebral blood flow or blood flow velocity, an indication that there is no increased risk of stroke or hemorrhage.
* PDE-5 exists in blood platelets, cells that play a major role in the blood clotting process, but sildenafil appears to have no direct impact on platelet function. However, the drug's effects have not been specifically evaluated in patients with bleeding disorders or in those taking drugs that reduce clotting.

"Experimental and human studies indicate that PDE-5 inhibitors are effective and well tolerated, and there is evidence that they are not being used to their utmost potential. We suggest that these drugs may prove beneficial in treating a wide variety of disorders," said Schwarz, the article's first author and a specialist in cardiology, interventional cardiology, heart failure, and transplantation. "Some studies are underway to determine the effects of long-term use of PDE-5 inhibitors, and others are warranted, especially in patients who are considered at high risk because of chronic cardiovascular disorders."

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Contact: Sandy Van
Cedars-Sinai Medical Center

Animal Studies Suggest Vegetables May Reduce Hardening Of Arteries

2006-06-25T06:34:00.000-07:00

New research suggests one reason vegetables may be so good for us - a study in mice found that a mixture of five common vegetables reduced hardening of the arteries by 38 percent compared to animals eating a non-vegetable diet. Conducted by Wake Forest University School of Medicine, the research is reported in the current issue of the Journal of Nutrition.

"While everyone knows that eating more vegetables is supposed to be good for you, no one had shown before that it can actually inhibit the development of atherosclerosis," said Michael Adams, D.V.M., lead researcher. "This suggests how a diet high in vegetables may help prevent heart attacks and strokes."

The study used specially bred mice that rapidly develop atherosclerosis, the formation on blood vessel walls of fatty plaques that eventually protrude into the vessel's opening and can reduce blood flow. The mice have elevated low-density lipoprotein ( LDL), or "bad" cholesterol, which is also a risk factor for atherosclerosis in humans.

Half of the mice in the study were fed a vegetable-free diet and half got 30 percent of their calories from a mixture of freeze-dried broccoli, green beans, corn, peas and carrots. These five vegetables are among the top-10 vegetables in the United States based on frequency of consumption.

After 16 weeks, the researchers measured two forms of cholesterol to estimate the extent of atherosclerosis. In mice that were fed the vegetable diet, researchers found that plaques in the vessel were 38 percent smaller than those in the mice fed vegetable-free diets. There were also modest improvements in body weight and cholesterol levels in the blood.

The estimates of atherosclerosis extent involved measuring free and ester cholesterol, two forms that accumulate in plaques as they develop. The rate of this accumulation has been found to be highly predictive of the actual amount of plaque present in the vessels.

Adams said it is not clear exactly how the high-vegetable diet influenced the development of plaques in the artery walls.

"Although the pathways involved remain uncertain, the results indicate that a diet rich in green and yellow vegetables inhibits the development of hardening of the arteries and may reduce the risk of heart disease," said Adams.

He said that a 37 percent reduction in a certain marker of inflammation in mice suggests that vegetable consumption may inhibit inflammatory activity.

"It is well known that atherosclerosis progression is intimately linked with inflammation in the arteries," Adams said. "Our results, combined with other studies, support the idea that increased vegetable consumption inhibits atherosclerosis progression through antioxidant and anti-inflammatory pathways."

Numerous studies in humans have shown that a high-vegetable diet is associated with a reduced risk of cardiovascular disease, as well as with reductions in blood pressure and increases in "good" cholesterol. This is believed to be the first study to address the effect of increased vegetable consumption on the development or progression of atherosclerosis.

Despite compelling evidence supporting the health benefits of increased vegetable consumption, intake remains low, Adams said. The mean consumption is 3.2 servings per days, with about 40 percent coming from starchy vegetables such as potatoes.

Wake Forest University Baptist Medical Center

Raloxifene Reduces Breast Cancer Risk

2006-06-22T10:41:00.000-07:00

Raloxifene, an osteoporosis drug, is effective at protecting high risk women from breast cancer. Research has found that raloxifene is as effective as Tamoxifen, the well known breast cancer drug - it is also safer.

You can read about this US nationwide study in the Journal of the American Medical Association. The University of Pittsburgh study involved almost 20,000 menopausal and post-menopausal women who were at high risk of developing breast cancer.

It seems that raloxifene, like Tamoxifen, can lower a woman's breast cancer risk by about 50%. Raloxifene treatment also causes fewer uterine cancers, blood clots, cataracts and cancers when compared to Tamoxifen.

Both Tamoxifen and raloxifene do other have side effects. Raloxifene is associated with muscle ache, bone ache, painful sexual intercourse and weight gain. Tamoxifen is associated with leg cramps and bladder control problems. However, women told researchers that raloxifene's side effects do not have a negative impact on their general quality of life.

If all goes according to plan, the FDA should approve raloxifene for breast cancer within the next twelve months. This will be good for women as they will have more choice. It is thought that raloxifene will be more indicated for post-menopausal women who are at increased risk of breast cancer.

Meditation May Improve Cardiac Risk Factors In Patients With Coronary Heart Disease

2006-06-20T17:24:00.000-07:00

A relaxation technique known as transcendental meditation may decrease blood pressure and reduce insulin resistance among patients with coronary heart disease, according to a report in the June issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Transcendental meditation, derived from the ancient Vedic tradition in India, is taught through a standard protocol involving lectures, personal instruction and group meetings, according to background information in the article. It has previously been shown to lower blood pressure but its effect on other risk factors associated with coronary heart disease, including those linked to the metabolic syndrome, has not been thoroughly examined. The metabolic syndrome refers to a cluster of symptoms that increase cardiac risk, including high blood pressure (hypertension), abdominal obesity, high cholesterol and insulin resistance, which occurs when the body is unable to use the insulin produced by the pancreas to process sugar into energy.

Maura Paul-Labrador, M.P.H., Cedars-Sinai Medical Center, Los Angeles, and colleagues conducted a 16-week trial of transcendental meditation in patients with coronary heart disease. Fifty-two participants (average age 67.7 years) were instructed in transcendental meditation and 51 control patients (average age 67.1 years) received health education. At the beginning and end of the trial, the patients fasted overnight and then gave a blood sample, participated in a medical history review and underwent tests of blood vessel function and heart rate variability. Heart rate variability testing assesses the functioning of the autonomic nervous system, which controls the heart and other involuntary muscles.

Overall, of the 103 participants who were enrolled, 84 (82 percent) completed the study. At the end of the trial, patients in the transcendental meditation group had significantly lower blood pressure; improved fasting blood glucose and insulin levels, which signify reduced insulin resistance; and more stable functioning of the autonomic nervous system. "These physiological effects were accomplished without changes in body weight, medication or psychosocial variables and despite a marginally statistically significant increase in physical activity in the health education group," the authors write.

"These current results also expand our causal understanding of the role of stress in the rising epidemic of the metabolic syndrome," they continue. "Although current low levels of physical activity, unhealthy eating habits and resultant obesity are triggers for this epidemic, the demands of modern society may also be responsible for higher levels of chronic stress." Such stress causes the release of cortisol and other hormones and neurotransmitters, which over time damage the cardiovascular system.

"Our results, demonstrating beneficial physiological effects of transcendental meditation in the absence of effects on psychosocial variables, suggest that transcendental meditation may modulate response to stress rather than alter the stress itself, similar to the physiological impact of exercise conditioning," the authors write. This method of controlling the body's response to stress may provide a new target for the treatment and prevention of coronary heart disease, warranting further study, they conclude.

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This study was supported by grants from the National Center for Alternative and Complementary Medicine, National Institutes of Health; and a General Clinical Research Centers grant from the National Center for Research Resources.

Contact: Sandy Van
JAMA and Archives Journals

Eating Vegetables Protects Your Arteries

2006-06-19T22:22:00.000-07:00

Eating vegetables can significantly protect your arteries from the accumulation of fatty deposits, according to a study on mice carried out at Wake Forest University School of Medicine. You can read about this study in the Journal of Nutrition.

In this study, scientists used mice that are very susceptible to developing atherosclerosis. Atherosclerosis is a condition in which fatty deposits (plaques) build up in the arteries - eventually blood flow is blocked and patients have a serious risk of heart attack or stroke.

Half the mice received a diet rich in vegetables, including peas, corn, carrots, green beans and broccoli. The rest of the mice did not have any vegetables at all. Both groups of mice were fed the diets for 16 weeks, at the end of which scientists checked them for cholesterol content, bodyweight and plaques in the arteries. The vegetable-fed mice had 38% less plaques than the vegetable-free mice. The vegetable-fed mice also had a reduction of 37% in serum amyloid levels - serum amyloid is an indicator of inflammation. It is likely, said the researchers, that a high intake of vegetable may also lower inflammatory activity.

The vegetable-fed mice also weighed less than the others and had lower levels of cholesterol. However, the scientists said the reduction in atherosclerosis was not necessarily due to the lower weight and cholesterol levels.

Dr. Michael Adams, lead researcher, said that although we all know vegetable are supposed to be good for the health, no studies have yet shown that eating lots of vegetables can actually protect you from developing atherosclerosis. He added that the pathways involved remain uncertain. However, it is more evident now that vegetables do inhibit the hardening of the arteries, which in turn reduces the risk of heart attack and stroke.

Scientists say this study is encouraging and that further studies are needed.

Nutritionists say humans should consume five portions of fruit and/or vegetables per day. Many say we should include a variety of different colours of fruit and veg.

Written by: Christian Nordqvist
Editor: Medical News Today

Menopausal Women Don't Get Enough Guidance On Treatment Options

2006-06-18T22:06:00.000-07:00

Few women are consulting their doctors before opting to use herbal therapies and soy products to treat their menopausal symptoms, researchers at the Stanford University School of Medicine have found.

The trend is of particular note because growing numbers of women are turning to alternative therapies to relieve such symptoms as hot flashes, headaches, mood swings and sleep disruptions because of concerns about health risks associated with hormone therapy, which is still considered the most effective way of treating such difficulties. The researchers recommend that physicians learn more about these products so that they can help their patients choose safe, effective methods of treating their symptoms.

"We're not promoting the use of these alternative therapies," said lead author Jun Ma, MD, PhD, research associate at the Stanford Prevention Research Center. "We're just saying that the demand for these therapies is growing and that physicians should be prepared to talk to their patients about it."

The study appears in the May/June issue of The Journal of the North American Menopause Society. The study was funded by GlaxoSmithKline Consumer Healthcare, which had no role in the study design, data collection or preparation of the manuscript for publication. The pharmaceutical company manufactures the herbal product RemiFemin Menopause.

The study was based on a 2004 online survey of a random sample of 781 U.S. women between the ages of 40 and 60. Because the sample size was small, Ma cautioned that the findings may not accurately represent all women, but said the data provide useful insights into women's attitudes toward menopause treatments and how much physician guidance they have received in deciding which therapies to use.

Among the women surveyed, nine out of 10 reported having experienced at least one menopausal symptom at some point. When it came to treating their symptoms, 37 percent reported using hormone therapy while slightly less than that - 31 percent - used herbal products. Soy supplements were used by 13 percent.

What interested Ma and her colleagues was that three-quarters of the women who had formerly taken hormone therapy said they stopped primarily because of concern about potential risks. "A majority of the women who had discontinued their hormone therapy were not on any therapy - not because of lack of need or desire to continue, but because they didn't know which therapy would best suit their clinical needs," Ma said.

The concerns about hormone therapy stem largely from the federally funded Women's Health Initiative, a long-term study that turned the conventional wisdom about hormone therapy on its head. For many years, observational studies indicated that in addition to relieving menopausal symptoms, hormone therapy helped protect women against heart disease. However, the WHI found that neither estrogen nor the combination of estrogen and progestin helped prevent heart disease. Instead, although both forms of hormone therapy offered some benefits in easing menopausal symptoms, they both posed substantial health risks.

Despite these risks, hormone therapy is still considered the most effective approach for treating menopausal symptoms. Women are advised to use the lowest possible dose of hormones and to limit the duration of the treatment in order to minimize the risks.

But the new study shows that many women are instead turning to herbal and soy products to ease their menopausal symptoms. The most commonly used herbal products reported by survey participants were ginkgo biloba, ginseng, St. John's wort, black cohosh or a combination product.

"The reduced use of menopausal hormone therapy, while an appropriate response to the WHI findings, has left both patients and their physicians in a difficult position," said Randall S. Stafford, MD, PhD, associate professor of medicine and senior author of the study. "While other pharmaceuticals and alternative therapies are available, many physicians are not fully prepared to discuss these options, particularly given the limited data available about the effectiveness of these options."

Among the women who used herbal therapies, 55 percent chose the products because of concerns about hormone therapy while 45 percent said they wanted to use a natural remedy. But Ma said many women mistakenly equate the term "natural" with "safe," and falsely believe that herbal products won't interact with other medications. "That misperception really needs to be corrected," she said.

In fact, herbal products may have side effects. For instance, some studies have shown that St. John's wort interacts with selective serotonin-reuptake inhibitors, which are the most commonly prescribed class of antidepressants, and it is recommended that the two not be combined.

Additionally, Ma said there is little in the way of high-quality data on the efficacy of many of the alternative therapies, adding that most of the data are limited to short-term use of the products.

The women in the study regarded physicians as their most-trusted source of information about alternative therapies, yet many said they didn't get enough guidance in choosing a remedy for their menopausal symptoms. Nearly 75 percent of the women said that they - not their doctors - initiated discussions about possible treatments for their symptoms. And when it came to alternative therapies, 20 percent of the women weren't confident in their doctors' ability to discuss the treatments knowledgeably.

"Hormone therapy is unique in that patient preference is important in deciding what therapy to use," Ma said. "A balanced dialogue is essential because it's a treatment decision that a physician should make with a patient, not for a patient."

Ma suggested that physicians know enough about alternative menopause therapies to put them in four categories: those that have data suggesting some effectiveness, those that have data demonstrating concerns about side effects, those with neutral data and those lacking any data.

"It's OK to tell patients that little is known about a product, despite any anecdotal stories they may have heard. Anecdotal stories should not be taken as a substitute for rigorous clinical evidence," Ma said.

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Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu/

Contact: Susan Ipaktchian
http://med.stanford.edu/

Pregnancy Complications Still High For Women With Diabetes

2006-06-17T19:09:00.000-07:00

Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales. The risk of death and major birth defects are still high in babies born to women with diabetes, despite an international strategy to raise standards of diabetes care, say researchers in a study published on http://www.bmj.com/

They also warn that these problems will get worse as the number of young women diagnosed with type 1 and type 2 diabetes continues to rise.

Researchers analysed deaths shortly after birth (perinatal mortality) and congenital anomalies in babies born to women with type 1 or type 2 diabetes who delivered between 1 March 2002 and 28 February 2003 in England, Wales, and Northern Ireland.

Of 2,359 women with diabetes, 1,707 had type 1 diabetes and 652 had type 2 diabetes. Women with type 2 diabetes were more likely to come from an ethnic minority group and from a deprived area.

Perinatal mortality was similar in babies of women with type 1 (31.7 per 1000 births) and type 2 diabetes (32.3 per 1000 births), and was nearly four times higher than that in the general maternity population.

The rate of major congenital anomaly (mainly heart and nervous system defects) was 46 per 1000 births in women with diabetes (48 per 1000 births for type 1 diabetes and 43 per 1000 for type 2 diabetes), more than double than that in the general maternity population.

Because of this increased risk, the authors say that women with diabetes should take a higher than usual dose (5 mg) of folic acid from before conception up to week 12 of pregnancy. They also suggest that pregnant women with diabetes should be routinely screening for heart defects.

In the past, type 2 diabetes has been viewed as a less serious condition than type 1 diabetes and may have been subject to less vigilant care, add the authors. However, in view of these findings, and the increasing prevalence of type 2 diabetes in young adults, raised awareness of the increased risk of adverse pregnancy outcomes in this group of women is needed.

This study is substantially larger than any previous ones in this field, but more work is needed to find out how women with either type of diabetes can best be enabled to improve the outcomes of their pregnancy, they conclude.

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Contact: Teresa Hagan

BMJ-British Medical Journal

Exploring New Ways To Increase Consumption Of Healthy Polyunsaturated Fats

2006-06-15T22:13:00.000-07:00

Although eating oily fish is widely recognised to have beneficial effects on human health - including a reduced risk of coronary heart disease - most people in the UK do not eat enough of it. Now, in order to increase the consumption of the healthy n-3 polyunsaturated fats found in oily fish, scientists at the University of Reading are suggesting the possibility of ‘enriching' foods that we eat more commonly, such as meat and poultry, with these healthy fats.

Writing in the June edition of the British Nutrition Foundation's Nutrition Bulletin, Professor Ian Givens of the University's Nutritional Sciences Research Unit argues that the recommended intakes of these types of fats are not being met in the majority of the population mainly because of low consumption of oil-rich fish.

Professor Givens said: "It's an unfortunate fact that only about 27% of adults in this country eat any of the oil-rich fish which contain beneficial polyunsaturated fatty acids. It's also true that for much of the population, the contribution that animal-derived foods currently make to intake of these fatty acids, although small may be crucial.

"But in the future, animal-derived foods such as meat (especially poultry meat), dairy products and eggs are likely to have an important function in increasing intake of these fats, and studies have shown that feeding fish oils to animals can increase, or ‘enrich', the polyunsaturated fat content of the resulting food products.

"Because of this, we felt there was a real need to examine the current and projected consumption trends of meat and other animal products, which could be enriched with the fats."

There have been very large changes in the consumption of meat over the past 50 years: the decline in consumption of meat from cows and sheep, and the sustained increase in the consumption of poultry meat have been marked.

"The potential of enriched animal-derived foods, especially poultry meat, could be crucial in achieving increased intake of fatty acids," said Professor Givens. "If successful and accepted by the consumer, this could prove to be a major advance in the health of the nation. Of course in the long term sources other than fish oil will be needed to ensure a sustainable supply of these important fatty acids."

University of Reading
information@reading.ac.uk

Coffee Protects Alcohol Drinkers From Liver Disease

2006-06-14T17:20:00.000-07:00

Drinking coffee protects alcohol drinkers from developing liver disease, says a new study carried out at the Kaiser Permanente Medical Care Program, California, USA. According to the researchers, one cup of coffee per day lowered the incidence of cirrhosis of the liver for alcohol drinkers by 22%.

Study leader, Dr. Arthur Klatsky, stressed that alcohol drinking, especially excess drinking, is linked to various different physical risks. As such, said Klatsky, the study's findings should not be interpreted as a licence to booze to your heart's content. He advised people not to consumer more than three alcoholic drinks a day.

This is not the first study to link coffee consumption to less liver disease. Another study published in Gastroentorology in December, 2005, had similar findings.

This new study was much larger than last years'. The new study was able to look more into each cause of cirrhosis and how coffee is linked a lower incidence of them.

The Kaiser Permanente study looked at information on 125,000 people with healthy livers from 1978 to 1985. Information had been collected about their alcohol, coffee and tea drinking habits. Of the 330 people who had developed cirrhosis of the liver by 2001, 199 had done so as a result of consuming alcohol. The researchers found that the incidence of cirrhosis went down 22% for each cup of coffee consumed per person per day.

You can read about this study in the Archives of Internal Medicine, June 12 issue.

Scientists are still unsure what it is in the coffee that provides the protection. It cannot be the caffeine because tea has caffeine but does not provide the same protection. Clinical trials are needed to further identify the relationship between coffee and how it lowers the incidence of liver disease.

Written by: Christian Nordqvist
Editor: Medical News Today

US Smokers Invited To Test Vaccine Against Nicotine Addiction

2006-06-13T09:53:00.000-07:00

UCSF's Habit Abatement Clinic is testing a vaccine that enlists help from the immune system to keep nicotine away from the brain. The vaccine is designed to help smokers quit and to limit the urge to start smoking again.

Called NicVax, the investigational vaccine is being developed by Nabi Biopharmaceuticals to prevent and treat nicotine addiction and to help people quit smoking. Normally when a smoker inhales, nicotine is carried by the bloodstream to the brain, where it triggers neuro-receptors to generate positive sensations that can lead to addiction. The vaccine stimulates the immune system to produce antibodies that recognize the small nicotine molecule. Bound to these antibodies, nicotine molecules no longer can cross the blood-brain barrier and enter the brain.

"With little or no nicotine reaching the brain, smoking is less rewarding. That gives the smoker a chance to change the behavioral and social factors that also influence smoking," said Victor Reus, MD, principal investigator for the study at UCSF.

Because immune antibodies remain in the body for some time, Reus said it is hoped that the vaccine also will prevent relapse. When a vaccinated smoker lights up months after quitting, the person should not experience the nicotine-triggered reward that tempts most people back into the habit.

Northern California smokers over 18 are invited to join a national study to determine whether NicVax can help people abstain from smoking and help them avoid relapsing within the next 12 months. Participation is free and requires a one-year commitment to come to San Francisco for injections and follow-up visits. The study also includes five behavioral counseling sessions. Participants will be paid for each visit and given validated parking at the clinic.

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For information, interested persons should call the UCSF Habit Abatement Clinic at (415) 476-7453, visit http://www.ucsf.edu/ nosmoke, or email rpilato@lppi.ucsf.edu.

UCSF is one of nine centers nationwide to participate in this phase II proof-of-principle clinical trial, which is sponsored by Nabi Biopharmaceuticals of Boca Raton, Florida, and the National Institute on Drug Abuse.

The FDA granted a "fast track" designation for the NicVax vaccine in March, to speed development and review of the drug if trial results are promising.

"Most people who smoke want to quit, and they now have a number of options to help them reduce nicotine dependence and quit smoking," said Sharon Hall, PhD, co- principal investigator and director of the UCSF Habit Abatement Clinic. "A vaccine that could prevent the addictive action of nicotine is a promising alternative option."

According to the Centers for Disease Control and Prevention, cigarette smoking contributes to 440,000 deaths each year - one-fifth of all U.S. deaths. Quitting smoking has immediate as well as long-term benefits, improving overall health as well as reducing risk for diseases caused by smoking.

The mission of the UCSF Habit Abatement Clinic is to develop and evaluate innovative treatment strategies aimed at helping people quit smoking and stay quit. Funded by the National Institute on Drug Abuse and the National Cancer Institute, the Habit Abatement Clinic has been evaluating the effectiveness of smoking cessation treatment since 1980.

UCSF is a leading university that consistently defines health care worldwide by conducting advanced biomedical research, educating graduate students in the life sciences, and providing complex patient care.

Contact: Janet Basu

University of California - San Francisco

Spending on specialty drugs soar

2006-06-11T08:12:00.000-07:00

Spending on high cost specialty drugs soared 17.5 percent last year and is expected to more than double by 2009, according to a report released Wednesday.

In contrast, spending on traditional drugs increased only 10 percent.

Specialty drugs are typically biotech medications that treat complex, chronic conditions and often need to be injected. Spending on such drugs reached $40 billion last year or 19 percent of the total on all medicines, according to Express Scripts Inc., a Missouri-based pharmacy benefit manager.

By 2009, Express Scripts predicts specialty drug spending to reach $90 billion or 28 percent of $316 billion, the projected total for all medications. It expects spending on traditional medicines to grow 32 percent to $226 billion. The growth in specialty drug spending will be driven by several factors including new products, additional uses for existing medicines and more patients, said Express Scripts spokesman Steve Littlejohn.

The explosive growth is spending on specialty drugs is especially problematic because there is no pathway for generic competitors to enter the market.

Spending on injectable drugs for inflammatory diseases such as rheumatoid arthritis and crohn's disease soared 35 percent, the largest increase in the group.

An average prescription for an inflammatory disease costs $1,417.

Drugs to treat blood clotting factor deficiencies such as hemophilia registered a 25 percent spending increase, the second largest rise in the group. Annual treatment costs about $100,000 per patient.

Spending on cancer drugs known as antineoplastics, which were administered outside a doctor's office, rose 19.2 percent, the third largest jump. The price per prescription rose by almost 15 percent to nearly $1,600 on average, making inflation the primary driver of the spending increase.

Only two types of specialty drugs had spending declines_ antivirals and fertility treatments. The decreases were due to a decline in utilization.

Express Scripts based the overall projections on data from the government and IMS Health, a pharmaceutical market research firm.

The statistics on the drug categories were from its own business, which manages pharmacy benefits for more than 55 million people.

By THERESA AGOVINO, AP Business Writer
http://www.express-scripts.com

Cervical Cancer Vaccine, Gardasil, Gets FDA Approval

2006-06-10T07:06:00.000-07:00

Gardasil, an HPV vaccine which protects women from developing 70% of cervical cancers, has been approved for sale by the FDA. This is the first vaccine designed specifically to protect patients from cancer.

The Human Papillomavirus (HPV) causes cervical cancer as well as genital warts. Cervical cancer is the second largest killer of women among cancers worldwide.

Gardasil protects women from 4 types of HPV, including types 16 and 18, which cause 70% of all cervical cancers.

According to a study carried out by Gardasil makers, Merck, less than 20% of American women know that HPV is the main cause of cervical cancer.

Over half a million women are diagnosed with cervical cancer each year worldwide. In the USA, where Pap smear screening is more widespread than in the developing world, 14,000 women are diagnosed each year. 3,900 women die each year from cervical cancer in the USA.

Estimates say about 50% of all sexually active adults are infected with HPV.

GlaxoSmithKline is developing another vaccine, Cervarix, to protect from HPV. Cervarix does not protect from genital warts, Gardasil does. Gardasil protects women from 90% of all genital warts.

How widely the vaccine will be used in the USA will be better known when the CDC makes its recommendations on June 29. They will make a recommendation on various aspects of the vaccine, among which is at what age a girl should be given the vaccine. This will then decide whether or not Pediatricians include Gardasil in their childhood and adolescent vaccinations schedules.

Globally, nearly 300,000 women die each year as a result of cervical cancer. Merck says Gardasil could save the lives of nearly 200,000 of them each year.

A course of three shots over six months will cost from $300 to $500. This will be too expensive for some countries wishing to carry out a national vaccination program.

At first, there was some opposition to Gardasil. There was concern that vaccinated girls may become more sexually active at a younger age. This opposition soon ebbed when people realised how many lives could be saved.

Merck stressed that the vaccine should not replace screening. The company would like to see vaccinations given to girls before they become sexually active.

The vaccine is not recommended for people already infected with HPV as there is a higher risk of having precursors to cervical cancer.

Written by: Christian Nordqvist
Editor: Medical News Today

Diets With Group Support May Help Keep Weight Off Longer

2006-06-08T05:04:00.000-07:00

Commercial diets are a useful way to lose weight. And those based on group support seem to fare better at keeping the weight off in the long term, finds a study in this week's BMJ.

Researchers compared the effectiveness of four popular commercial weight loss programmes with a control group. The study was sponsored by the BBC as part of its reality TV series, BBC Diet Trials.

The diets were the Slim-Fast Plan (a meal replacement approach), Weight Watchers pure points programme (an energy controlled diet with weekly group meetings), Dr Atkins' new diet revolution (a self-monitored low carbohydrate eating plan), and Rosemary Conley's eat yourself slim diet and fitness plan (a low fat diet and weekly exercise class). The control group was asked to maintain their current diet and exercise pattern.

Weight and body fat changes were monitored over six months and dieting behaviour was checked again at 12 months.

After six months, all diets resulted in significant loss of body fat and weight compared to the control group. Average weight loss was 5.9 kg and average fat loss was 4.4. kg (5-10% of body weight). The Atkins diet resulted in significantly higher weight loss during the first four weeks, but by the end, was no more or less effective than the other diets.

There were no significant differences in cardiac risk factors between the diet groups and the control group. The Atkins diet did not lead to substantial increases in cholesterol levels.

At 12 months, 158 participants (54% of the original sample) returned data. Only 58 (45%) were still keeping to their allocated diets (nine to Atkins, 20 to Weight Watchers, nine to Slim-Fast, 20 to Rosemary Conley). More participants in the unsupported programmes (Atkins diet and Slim-Fast) withdrew from the study than in the supported group based programmes, and weight rebound after the initial six months was higher in the unsupported programmes.

The authors conclude that clinically useful weight loss and fat loss can be achieved in adults who are motivated to follow commercial diets for a substantial period. People need to find a diet that best suits them.

"Our study provides data on how much weight patients can expect to lose by dieting," they write. "These data could help practitioners in managing patients' expectations of weight loss targets."

An accompanying editorial suggests that the challenge to researchers is to take weight loss studies to the next level by evaluating long term health outcomes, cost effectiveness, and novel strategies of improving adherence and weight maintenance.

Randomised controlled trial of four commercial weight loss programmes in the UK: Initial findings from the BBC 'diet trials;' BMJ Volume 332, pp 1309-11

Emma Dickinson
edickinson@bmj.com
BMJ-British Medical Journal

Enrollment In Amoxicillin PULSYS Phase III Trial Completed

2006-06-06T07:27:00.000-07:00

Advancis Pharmaceutical Corporation (Nasdaq: AVNC), a pharmaceutical company focused on developing and commercializing novel anti-infective products, today announced that it has completed enrollment in the Company's Amoxicillin PULSYS Phase III clinical trial for the treatment of pharyngitis/tonsillitis due to Group A streptococcal infections. Advancis concluded enrollment with a total of 620 adult/adolescent patients as of close-of-business May 31, 2006.

Advancis' adult and adolescent pivotal program is designed as a 600- patient, double-blind, double-dummy, non-inferiority Phase III trial and began on November 9, 2005. Over the coming weeks, patients will complete their treatment and follow-up visits, and Advancis and its clinical research organization will collect and analyze the clinical data. The Company expects to publicly report top-line results around mid-August 2006. If the trial is successful, Advancis expects to file a 505(b)(2) New Drug Application (NDA) with the U.S. Food and Drug Administration for the product early in the first quarter of 2007.

"We are very pleased to have completed enrollment in our adult and adolescent Phase III trial on schedule," said Edward M. Rudnic, Ph.D., Advancis president and CEO. "We are hopeful that, if successful, Amoxicillin PULSYS will provide physicians a tool to deliver the established safety and efficacy of amoxicillin in the first and only once-daily presentation in the U.S."

Advancis is comparing its Amoxicillin PULSYS dosage form for the treatment of pharyngitis/tonsillitis in adults delivered in a once-daily, 775 milligram tablet for a period of 10 days to 250 milligrams of penicillin dosed four times daily, for a total of one gram per day, for 10 days. The primary endpoint for the study is bacterial eradication, as measured by throat cultures obtained both before and after treatment.

More than 59 million prescriptions for Amoxicillin were written in 2005 with total retail sales of approximately $640 million. Amoxicillin is indicated for a broad range of infections, and is commonly prescribed as a first-line therapy for common infections such as otitis media (middle ear infection), pharyngitis (sore throat), and sinusitis (sinus infection). According to data from IMS Health, a pharmaceutical research company, approximately one-quarter of amoxicillin prescriptions are written for pharyngitis, strep throat, and tonsillitis in adults and children.

Advancis Pharmaceutical Corporation

How Blood Vessels Sense And Change In Response To Shear Stress

2006-06-04T05:05:00.000-07:00

Blood vessels must be able to quickly sense and adapt to increasing and decreasing rates of blood flow in order to maintain consistent blood pressure throughout the body. The endothelial cells (ECs) lining the vessel wall recognize shear stresses and transduce signals to vascular muscular cells and others in order to modify vessel shape and structure accordingly. In a study in the May issue of the Journal of Clinical Investigation, William Sessa and colleagues from Yale University show that the protein caveolin-1 (Cav-1) and structures known as caveolae act as sensors along the cell membrane of ECs in order to detect shear stress and help bring about appropriate reactionary remodeling of affected blood vessels.

Caveolae are distinct flask-shaped invaginated structures at the surface of ECs and consist of Cav-1 and other proteins. Sessa et al. used mice lacking Cav-1 as well as mice overexpressing Cav-1 specifically in ECs. After tying off the left carotid artery in these mice for 14 days, thereby modifying the blood flow, they found that the inside diameter of the ligated vessels was reduced in normal mice but not in Cav-1 deficient mice. In turn, re-expression of Cav-1 in ECs was sufficient to induce this change in Cav-1 deficient mice.

In an accompanying commentary, Michael Lisanti and Philippe Frank from Thomas Jefferson University further discuss the Cav-1 regulated signaling pathways in ECs and conclude that "these data suggest that endothelial caveolae and Cav-1 allow arteries to sense, organize, and mediate signal transduction, thereby giving arteries the ability to change their physical properties and to maintain/regulate normal blood flow in the face of altered shear stress conditions."

Contact: Brooke Grindlinger
Journal of Clinical Investigation

Exercise Reverses Unhealthy Effects Of Inactivity

2006-06-03T03:03:00.000-07:00

Many of the detrimental effects of physical inactivity can be reversed, and in some cases improved, by a similar period of moderate exercise, Duke University Medical Center researchers have found in a new analysis of data from the first randomized clinical trial to evaluate the effects of exercise in sedentary overweight men and women.

Just as important, the trial participants who exhibited the greatest decline in physical status during inactivity benefited the most from exercise training, according to the researchers.

These findings linking the ability of exercise training to reverse the negative effects of inactivity can be attributed to the exercise alone, because the participants did not alter their diets during the trial, the researchers said.

"Continuing to lead an inactive lifestyle leads to a gradual decline in many important markers for cardiovascular health," said Jennifer Robbins, an exercise physiologist at Duke, who presented the results of the study June 2, 2006, at the annual meeting of the American College of Sports Medicine in Denver.

"The good news is that a small amount of physical activity can make a big difference in reducing the risks for developing such conditions as heart disease, stroke or diabetes," she said. "Our findings demonstrate that while the cost of choosing a sedentary lifestyle can be high, switching to an active way of life can be beneficial at any time."

The current study stemmed from a recently completed trial known as STRRIDE (Studies of a Targeted Risk Reduction Intervention through Defined Exercise). The trial, funded by a $4.3 million grant from the National Heart, Lung and Blood Institute, investigated the effects of exercise on sedentary overweight adults at risk for developing heart disease, diabetes, or both.

The STRRIDE trial, in which the intervention ran for six months, randomly assigned 334 participants into three different exercise groups and one control group.

"At the end of the trial, we were surprised to see that many markers of cardiovascular health declined in participants in the control group, who did not exercise," Robbins said. "Our Duke group decided to see if these negative effects could be reversed after the participants spent the same amount of time in an exercise program."

Of the 61 STRRIDE participants randomly assigned to the control group 53 agreed to the take part in the new study, which ran an additional six months. The researchers measured 17 biological factors known to increase cardiovascular risk, including waist size, physical fitness, visceral fat levels, body mass index, cholesterol levels, insulin sensitivity and indicators of metabolic syndrome, a precursor of diabetes.

"In the new analysis, we found that waist size, time to exhaustion, visceral fat and metabolic syndrome scores deteriorated significantly during the six-month period of inactivity during the original STRRIDE trial," Robbins said. "However, after six months of exercise training in the study, 13 of the 17 variables had either reverted to original baseline levels or even improved."

According to Robbins, only a moderate amount of exercise is needed to counteract the detrimental effects of inactivity in these individuals. The STRRIDE trial measured three levels of physical activity: the equivalents of 12 miles of walking per week, 12 miles of jogging per week or 20 miles of jogging per week. Participants worked out on treadmills, elliptical trainers or cycle ergometers in a supervised setting.

"When looking at the group as a whole, we found it wasn't the participants with the highest intensity of exercise who accounted for the combined beneficial effects," Robbins said. "That should be reassuring for people to know they don't have to do a high-intensity workout to get these benefits of exercise."

A previous analysis by the Duke group of the same STRRIDE participants, reported in 2005, found another unhealthy effect of physical inactivity: inactive participants gained an average of 2 pounds in six months.

"At that rate, it can be assumed that this group of inactive people would gain 20 pounds in five years," Robbins said. "This means this population of sedentary people needed to exercise just to maintain their current weight. However, our earlier studies have shown that people who exercise can derive many of the cardiovascular risk benefits even in the absence of weight loss."

The STRRIDE trial was led by Duke cardiologist William Kraus, M.D. The Duke team is currently enrolling patients in STRRIDE II, in which the team will study the effects of weight training, aerobic training, and aerobic and weight training combined on cardiovascular health.

Richard Merritt
Merri006@mc.duke.edu
Duke University Medical Center
http://www.dukemednews.org/

Healthy Pregnant Women's Iron Intake Advice Too High

2006-06-01T05:43:00.000-07:00

A new study conducted by researchers at Children's Hospital Oakland Research Institute (CHORI), in close collaboration with scientists at the National Institute of Perinatology in Mexico, is the first to show that the current iron supplement recommendation for pregnant women who are not anemic is too high and could lead to birth complications for infants such as premature birth and low birth weight. This new research conflicts with recommendations from the World Health Organization (WHO) and the Centers for Disease Control (CDC). It is hoped that the results of this study will lead to new recommendations from both organizations.

The study, featured in the May issue of Archives of Medical Research, suggests that pregnant women who are not anemic should take iron supplements weekly rather than daily. Women who are anemic have low levels of healthy red blood cells and need higher doses of iron supplementation. The study shows that pregnant women who are not anemic and follow the recommended daily dosage can suffer from iron overload and are more likely to experience birth complications.

Iron deficiency is common among women of childbearing age. Consequently, doctors have ordered daily supplements of 60 to 120 mg of iron to prevent or correct anemia and iron deficiency during pregnancy. "What happens is that excess iron in pregnancy can drive the hemoglobin levels above desirable levels, so that by the end of the second trimester of pregnancy, 27 percent of the non-anemic women in our study had hemoglobin levels that were undesirably high," said Fernando Viteri, MD, Scientist at Children's Hospital Oakland Research Institute (CHORI). "In these women, the risk of delivering premature babies or newborns with low birth weight quadrupled."

In contrast, only 7 percent of the women on weekly supplements developed high hemoglobin levels. The reason for the weekly dose - and in far smaller amounts - is biological and corresponds with the turnover of the intestinal lining, which renews itself every five to six days. The fresh cells are programmed to absorb iron according to the person's iron reserves and needs. The cells absorb more if reserves are depleted and less if they are adequate. Dr. Viteri's research concludes that iron supplementation is still beneficial, but must be regulated based on whether a woman is anemic.

Diana Yee
dyee@mail.cho.org
Children's Hospital & Research Center at Oakland
http://www.childrenshospitaloakland.org

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

2006-05-29T04:12:00.000-07:00

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

2006-05-27T06:21:00.000-07:00

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

2006-05-25T02:31:00.000-07:00

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.

dpeters@bos.blackwellpublishing.com
BLACKWELL PUBLISHING LTD
108 Cowley Road
Oxford OX4 1JF

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

2006-05-23T08:27:00.000-07:00

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

2006-05-22T03:12:00.000-07:00

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

2006-05-20T07:53:00.000-07:00

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

2006-05-19T01:56:00.000-07:00

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