Low-carb Diet Mistakes (August 31, 2004)

By Stacie Overton, Ivanhoe Health Correspondent ORLANDO, Fla. (Ivanhoe Newswire)

The craze over low-carb diets is still going strong, but many people may not be doing low carb the right way. Molly Kimball, R.D., from the Ochsner Clinic in New Orleans, says there are common mistakes people make that they do not even know they're making.

Kimball says one mistake people make when it comes to low-carb living is an all-or-nothing mentality. She says: "They’re either on a low-carb diet, or they’re completely devouring the bread basket. Finding that middle ground is important for people so they can stay with something long-term. Not having carbohydrates at night is fine. But having a slice of whole-grain bread with breakfast or a little bit of carbs with lunch is fine, and they’re still keeping their carbs under 100 grams for the day."

Another mistake? Not counting sugar alcohols in the total intake of carbohydrates from foods. Kimball says: "Sugar alcohols are basically a type of carbohydrate that are not completely broken down; they're not completely digested. So legally on food labels, food manufacturers are able to say that you can subtract it from the total carbohydrates and it’s not included in net carbs. But it’s still causing your body to produce insulin. By not counting [sugar alcohols] in the carbohydrate content, you’re actually not counting the impact they're going to have on your insulin." However, she adds that you can subtract the total grams of fiber from the total carb count in every food (guilt-free). She says, "Fiber is a type of carbohydrate, but it is not digested at all by the body."

Another dangerous road to travel, says Kimball, is not taking into account the number of calories you're eating. She says: "All [people] look at is carbohydrates, but most of us still don’t take into account the calories of the nuts, cheese and beef. Whenever people do a low-carb diet, they tend to have a lot of saturated fat." So cut calories, not just carbs. Kimball says: "I think if you’re going to do a low-carb diet, chose lean proteins. Go with grilled fish, lean pork, lean beef or chicken. If you’re doing fats, choose healthier fats like nuts, avocadoes and olive oil. Limit the heavier saturated foods, fats like butter, and higher fat meats."

Kimball says, "Another mistake you can make is adding in all these newer low-carb treats, like low-carb chocolate and low-carb ice cream. The calories that they had initially cut out, they’re putting right back in with these low-carb versions of the traditional foods. So, again getting back to the idea that the calories do still matter. People often do stop losing weight when they’re adding in these low-carb treats."

Finally, when looking at the labels of low-carb foods, Kimball says to look at how that product is made to be low carb. She says: "If it lists ingredients like soy protein or oat fiber and that’s how they’re making it low carb, then great. If it’s just enriched flours and sugar alcohols then it’s really not a great low-carb product."

SOURCE: Ivanhoe Interview with Molly Kimball, RD, Ochsner Clinic, New Orleans

 

Environment and Diet Linked to Asthma (August 31, 2004)

(Ivanhoe Newswire)

Environmental factors and diet may explain the higher rates of asthma seen in developed countries, according to a new study.

Investigators from China found asthmatic symptoms were up to three-times more common in children from the more developed Hong Kong than in those from mainland China. In the study involving more than 10,000 primary-school children from three cities in China, the children from Hong Kong had a significantly higher prevalence of wheezing in the past year than those from the cities of Guangzhou and Beijing.

Factors significantly linked to wheezing were cooking with gas, foam pillows, and damp housing. Factors that protected against wheezing were cotton quilts and frequent consumption of fruit and raw vegetables.

According to the article, asthma is more common in developed countries and has increased over the past three decades in many countries. Investigators conclude the differences in asthma prevalence are likely due to different environmental exposures since the study participants had the same genetic background.

SOURCE: British Medical Journal, 2004;329:486-488
 

Relieving Chest Pain (August 31, 2004)

(Ivanhoe Newswire)

Elderly people who have surgery or angioplasty to treat chest pain fare just as well long-term as those treated with medication, according to a new study.

Swiss researchers found chest pain relief and improved quality of life are also similar in patients treated both ways, but those treated with invasive surgery reached these benefits earlier.

Patients treated with surgery appeared to benefit in other ways, as well. Medically treated patients required more antianginal drugs throughout the study. They also experienced more non-fatal events, such as being hospitalized again for chronic chest pain that failed to respond to medication. Nearly half of all medically treated patients continued to experience chronic chest pain and had one of the invasive procedures, usually within the first six months of the study.

According to the study, physicians often choose the more conservative treatment of medication for older patients because of concerns that the risks of surgery outweigh the benefits. However, results of the study, involving patients 75 years and older, show about 91 percent of patients treated invasively and 95 percent treated with medication were alive at six months. Survival remained similar after five years.

SOURCE: To be published in an upcoming edition of Circulation
 

Managing Your Metabolism (August 30, 2004)

PORTLAND, Ore. (Ivanhoe Broadcast News)

Do you want to know how many calories you burn just sitting around? You can find out by taking a 10-minute test at your local gym. But getting this number is just the first step in losing weight.

Barbara Mount knew she needed to exercise more and eat less, but she wanted to know exactly how much she needed to change. So, she took a 10-minute test to find out how much energy her body uses at rest. "I found out that for my body, for my weight, and how active I was, I should be eating approximately 1,690 calories a day," Mount tells Ivanhoe. "Burn rates" vary from person to person, so knowing your personal rate can help you balance the calories taken in with the calories burned.

Still, experts say you don't have to have that number to lose weight. John Crawford, a nutrition and fitness program coordinator at Kaiser Permanente Northwest in Portland, Ore., says, "Whether you do that or whether you don't do that, you've still got to figure out what you're gonna do, behaviorally, to make changes in diet and physical activity." Mount started measuring her food, eating smaller portions, and keeping track of her calories on a chart.

Experts say a food diary is a must. "Even the act of writing things down makes you rethink, or encourages you to rethink, whether this is a good choice or a bad choice," Crawford says. For many people, that's enough to start dropping pounds. Others, like Mount, say it's good to know just how many calories they can eat. "This, for me, was exactly what my body needed in order to burn the most calories the most efficiently." Mount says it was worth it to have her metabolism measured. In four months, she's lost 36 pounds.

Many gyms now offer a metabolic measurement as part of a fitness plan. Costs for the test, called BodyGem or MedGem, range from about $30 to $90.

If you would like more information, please contact:
HealtheTech, Inc.
(877) 310-1200
http://www.healthetech.com
 

A Drug for Many Diseases? (August 30, 2004)

By Stacie Overton, Ivanhoe Health Correspondent ORLANDO, Fla. (Ivanhoe Newswire)

Researchers from the University of Michigan in Ann Arbor have developed a new drug that holds promise not just for Wilson's disease -- for which it was designed to treat -- but for many other diseases as well.

George Brewer, M.D., a hematologist from the University of Michigan, says the drug called tetrathiomolybdate helps Wilson's disease by controlling copper toxicity. In realizing how it worked in Wilson's disease, Dr. Brewer and his team thought TM held hope for other diseases as well. Ongoing studies are proving Dr. Brewer and his team right.

First, TM is being studied for its use in cancers. Dr. Brewer says: "It turns out that when you lower copper, you can inhibit a thing called angiogenesis, which is blood vessel growth. Cancer requires blood vessel growth in order to grow. We've done a lot of early work on TM as an anti-cancer agent. It is quite effective in animals, and we have a lot of human studies ongoing. It has been licensed to a company for commercial development for use in cancer." Currently, there are nine phase 2 cancer studies going on using TM.

Cancer is not the only disease it is benefiting. Dr. Brewer says: "TM inhibits angiogenesis by inhibiting chemical messengers called cytokines, and a lot of other diseases are a result of cytokine overaction. Diseases like idiopathic pulmonary fibrosis and kidney diseases are all dependent on certain chemical messengers, cytokines, that overstimulate, overreact to injury, and cause too much scarring, too much fibrosis, and it occurred to us that that pathway might be inhibited by lowering copper. That has turned out to be true in animal studies. There has been some very nice animal work, which shows that we can reduce fibrotic damage from a variety of injuries both in the lung and in the liver with TM. So we are now doing a clinical trial of TM and idiopathic pulmonary fibrosis."

Dr. Brewer says, "Also, we discovered that TM is inhibiting inflammatory cytokines. Many diseases are a result of overactivity of inflammatory chemical messengers. We are now working on some of the diseases that may be benefited by lowering copper levels that are of an inflammatory nature such as psoriasis and a disease of the intestinal tract called Crohn’s disease. So these interests have caused us to spread out into a variety of different disease areas."

A trial is also planned on a disease of cirrhosis called primary biliary cirrhosis.

SOURCE: Ivanhoe Interview with George Brewer, M.D., University of Michigan, Ann Arbor
 

Do Mammograms Discriminate? (August 30, 2004)

(Ivanhoe Newswire)

A new study shows breast cancer may be more difficult to detect in certain women.

Researchers from the United Kingdom studied more than 122,000 women between ages 50 and 64 years who underwent routine mammograms. Prior to the screening, the women completed a survey that asked about certain personal and lifestyle factors.

Results of the study show some of those factors impacted the outcome of the screening. Women who used hormone replacement therapy, those who had previous breast surgery, and those who had a body mass index of 25 or less were all less likely to have accurate mammogram results.

However, researchers say other factors including age, family history of breast cancer, physical activity, smoking or alcohol consumption, and previous use of oral contraceptives did not have a significant impact on mammogram results.

Authors of the study conclude, “Our results suggest that mammography may thus be less efficient in users of HRT, in women with previous breast surgery, and in thin women compared with other women ... However, it [mammography] still remains the best way of detecting breast cancer when it is still at an early stage.”

SOURCE: British Medical Journal, 2004;329:477-479
 

The Next big Diet? (August 30, 2004)

(Ivanhoe Newswire)

In the latest research on the battle of the bulge, a new animal study provides evidence that a low-glycemic index diet can lead to weight loss, reduced body fat, and reduction in risk factors of diabetes and cardiovascular disease.

In low-GI foods, carbohydrates are low in sugar or release sugar slowly. Unlike the popular Atkins diet, which aims to minimize carb intake, the low-GI diet makes distinctions among carbs.

High-GI foods, which include white bread, refined breakfast cereals and concentrated sugars, are rapidly digested and raise blood glucose and insulin to high levels. Carbs that release sugar more slowly include whole grains, most fruits, vegetables and nuts.

Results of the study show rats eating a high-GI diet had 71-percent more body fat and 8-percent less lean body mass than rats in the low-GI group, despite very similar body weight.

The fat in the high-GI group of rats was concentrated in the rear area in an apple shape instead of a pear shape. According to researchers, having an apple shape is a known risk factor for cardiovascular disease in humans. The high-GI group also had blood triglyceride levels nearly three times that of the low-GI group, another risk factor for cardiovascular disease.

Results also show the high-GI group of rats had significantly greater increases in blood glucose and insulin levels and far more abnormalities in the pancreatic islet cells that make insulin. All of these changes occur in diabetes.

Even after the two diet groups switched to the alternate diet for another three weeks, the rats that switched from low- to high-GI diets showed greater increases in blood glucose and insulin than rats switched from high- to low-GI diets.

Many studies, including small human studies, have revealed low-GI diets are beneficial, but the observed benefits may have possibly come from other aspects of the subjects’ diets, such as fiber or overall caloric intake. Children’s Hospital Boston is now recruiting adults for a large-scale, 18-month study of the low-GI diet.

SOURCE: The Lancet, 2004;364:778-785
 

Statins’ Long-Term Benefits (August 27, 2004)

(Ivanhoe Newswire)

After 10 years, cholesterol-lowering statins appear to still be effective. Researchers found long-term use of statins may decrease mortality rates and even the incidence of cancer.

Authors of the study say the trial is the longest follow-up of patients originally randomized to receive a statin or placebo.

Results show cardiovascular death was reduced by 17 percent and coronary mortality decreased by 24 percent in patients who took the drug simvastatin, also known as Zocor, for 10 years compared to those who took it for five years and those who took a placebo.

Initially, nearly 4,500 patients from Denmark, Finland, Iceland, Norway and Sweden were randomly assigned to simvastatin therapy or a placebo. After three years, more than 80 percent of patients in both groups were using statins. The five-year follow-up showed statins lowered lipid fractions and cholesterol. It also reduced cardiovascular and coronary deaths by 36 percent and 43 percent, respectively.

The researchers add that 10-year statin use was suggested to be associated with a decreased incidence of cancer, but the 12-percent reduction for long-term statin users was not statistically significant.

Investigators conclude that even if the effect of statin therapy was negative, it would be a clinically minimal effect.

SOURCE: The Lancet, 2004;364:771-777
 

No More Casts (August 27, 2004)

PHILADELPHIA (Ivanhoe Broadcast News)

Broken bones and itchy casts are pretty much a rite of passage with active children. But now the inconvenience of casts is a thing of the past when it comes to healing one type of break.

Two years ago, Shannon Kane broke her thigh bone in a car accident. "I remember just hearing lots of sounds and like lots of people talking," she tells Ivanhoe.

Like most kids, Shannon recovered. But unlike most kids, she never had a cast. Instead, she was treated with elastic titanium nails.

Orthopedic surgeon John Flynn, M.D., of The Children's Hospital of Philadelphia, says, "It is a method in which we're able to pass thin pins into the femur bone through small incisions, and that acts as an internal splint to the bone."

In six months to nine months, the nails are surgically removed. Researchers at The Children's Hospital of Philadelphia compared children treated with the traditional body cast and children treated with the nails.

"We found that the kids who were treated with titanium nailing walked sooner, walked independently sooner, and got back to school sooner," Dr. Flynn says. He says the children with body casts returned to school after about three months. For children with the new approach, it took less than two months.

Shannon's mom Maria says, "She was back to school in a month and was able to at least sit up at a table and do her homework even after about two and a half weeks."

Now, nothing can hold Shannon back. The 11-year old keeps a busy schedule that includes gymnastics and soccer. "I pretty much can do everything that I did before the car accident," she says -- all without ever having a bulky cast.

The titanium elastic nail treatment is used on most femur fractures, but there are certain cases in which it is not appropriate. It is rarely used on children younger than age 6 or older than about 15.

If you would like more information, please contact:
Department of Orthopedics
The Children's Hospital of Philadelphia
Philadelphia, PA
(215) 590-1527
 

Steroids Don’t Always Cause Bone Loss (August 26, 2004)

(Ivanhoe Newswire)

A new study shows children who take steroids for a specific kidney condition do not suffer bone loss, though it is a common side effect of steroid treatment in adults and other childhood diseases.

Results of the study show steroids frequently cause obesity, which seems to protect children against bone loss. Researchers found measurements of bone mineral content were higher in children with nephrotic syndrome than in healthy children.The disproportionate obesity among the children with nephrotic syndrome disappears after the patients stop taking steroid treatments.

One explanation for the increased bone mass may be that extra physical load imposed by higher weight stimulates the bones to grow stronger. Obesity might also induce hormones to increase bone mass.

Investigators add that using steroids to treat children with nephrotic syndrome does not raise their risk of osteoporosis later in life.

Other studies show bone loss in children treated with steroids for other diseases including inflammatory bowel disease and juvenile rheumatoid arthritis. Authors of the study suggest these diseases, which involve systemic, persistent inflammation, may damage bones in a way nephrotic syndrome does not.

Childhood nephrotic syndrome is the most common chronic kidney disease in children. It does not impair kidney function but does weaken the body’s ability to remove salt and water from the blood. It also causes swelling in the belly, legs, and around the eyes.

Researchers from the Children’s Hospital of Philadelphia compared 60 children and adolescents with nephrotic syndrome to 195 healthy children for the study.

SOURCE: The New England Journal of Medicine, 2004;351:868-875
 

Mental Decline Among Women With Diabetes (August 26, 2004)

(Ivanhoe Newswire)

Mental decline is usually associated with age, but new research shows it gets even worse for women with diabetes or pre-diabetes.

Based on the study’s findings, elderly women with pre-diabetes or diabetes have worse cognitive performance and are at an increased risk for developing cognitive impairment, including dementia. Risk of developing cognitive impairment among women with pre-diabetes or diabetes was increased nearly two-fold.

Investigators suggest interventions aimed at early diagnosis and treatment of abnormal glucose metabolism and their effects on cognitive impairment to combat the problem.

According to the article, more than 33 percent of women and 20 percent of men over age 65 will develop dementia during their lifetime. Many more will develop a milder form of cognitive impairment.

According to the American Diabetes Association, more than 18 million people in the United States are living with diabetes.

SOURCE: Neurology, 2004;63:658-663
 

Polluted Water Dangers (August 26, 2004)

(Ivanhoe Newswire)

A recent consumer advisory by the Food and Drug Administration and the Environmental Protection Agency is advising pregnant women and young children to reduce their exposure to mercury found in fish.

"Research shows that most people's fish consumption does not cause a health concern, and we emphasize that this advisory is directed to the specific subpopulation of women who may become pregnant, pregnant women, nursing mothers, and parents of young children, not the general consumer," the 2004 advisory states. This is important because past research has shown high levels of mercury in the bloodstream of unborn babies and young children may harm the developing nervous system.

The advisory acknowledges that fish and shellfish are an important part of a healthy diet due to their low levels of saturated fat, and high levels of protein, essential nutrients and omega-3 fatty acids, which contribute to heart health and proper growth. Women and young children should include these items in their diet but with extra precautions as stated in the three recommendations of the advisory:

Do not eat shark, swordfish, king mackerel or tilefish because they contain high levels of mercury.
Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury including shrimp, canned light tuna, salmon, pollock and catfish. Albacore tuna and tuna steaks have more mercury than canned light tuna, so you may eat up to only six ounces (1 average meal) of albacore tuna or tuna steak per week.
Check local advisories about the safety of fish caught by family and friends in local lakes, rivers and coastal areas. If no advice is available, eat up to six ounces per week of fish caught from local waters, but don't consume any other fish that week. For information about the safety of locally caught fish and shellfish, visit EPA's Fish Advisory Web site, http://www.epa.gov/ost/fish.
These same recommendations should be followed when feeding fish to young children, only in smaller portions. By following these suggestions, the advisory says, women and young children will receive the benefits of eating fish and shellfish, yet reduce their exposure to the harmful effects of mercury.

In related news, the EPA issued a statement this week that says 35 percent of total lake acres and 24 percent of the river miles in the United States are now under advisory. To find out what bodies of water are polluted, log onto http://www.epa.gov/waterscience/fish/states.

SOURCE: "What you Need to Know About Mercury in Fish and Shellfish," 2004, U.S. Environmental Protection Agency
 

Cholesterol Drug for Diabetes (August 20, 2004)

(Ivanhoe Newswire)

Statins are a commonly used drug for patients with high cholesterol. Now, a new study shows patients with type 2 diabetes could benefit from statins to reduce their risk of cardiovascular disease. Interestingly, researchers say the benefits are there even for those diabetics who do not have high cholesterol.

A number of studies have shown the benefits of statin therapy to reduce cardiovascular disease in various groups. It has not been clear whether type 2 diabetics who are at an increased cardiovascular risk would benefit from the drug therapy. Researchers in Ireland conducted a study to look at the effectiveness of statin therapy among type 2 diabetics.

For the study, 2,800 type 2 diabetic patients in 132 centers in the United Kingdom and Ireland were randomly assigned to statin therapy or a placebo. The patients had no history of cardiovascular disease and low LDL, or bad, cholesterol levels. Researchers followed the patients for about four years to see if they had a heart problem or stroke.

Researchers found patients on the statin therapy had a reduced risk of a heart attack by about one third compared to those on the placebo. The stroke risk was reduced by 48 percent. The study also found the statin drug, atorvastatin (Lipitor), reduced the death rate by 27 percent compared with placebo.

Study authors say statin therapy is safe and effective in reducing the risk of a cardiovascular event in patients with type 2 diabetes. However, they say the debate about whether all type 2 diabetics should receive statin treatment ought to now focus on whether any patients are at such a low risk that the treatment should be withheld.

Not everyone agrees that statins are the answer for type 2 diabetics. In an accompanying commentary, Abhimanyu Garg, of the University of Texas Southwestern Medical Center in Dallas, says while studies like this increase the confidence in using statin therapy for the prevention of heart disease and stroke, it is still important to assess an individual’s risk-benefit ratio. He says for some diabetic patients, diet, exercise, weight loss and glycemic control should be attempted before turning to statin therapy.

SOURCE: The Lancet, 2004;364:685-696, 641-642
 

Stopping Pulmonary Hypertension (August 20, 2004)

NASHVILLE, Tenn. (Ivanhoe Broadcast News)

The drug Viagra has changed the meaning of erectile dysfunction, but it may also be a lifesaving answer for some children with a serious condition known as pulmonary hypertension.

For nine weeks, Tammy Russell has been here at the bedside of her 15-year-old son, Kyle. Kyle loves the beach and vacations. But like many children with Down syndrome, heart problems slow him down. This is his third time in the hospital for heart surgery.

"Right now, my big hope is just to get him home," Tammy tells Ivanhoe.

Kyle takes many drugs to help him recover. Now, he's in a study to see if Viagra could also help.

Pediatric cardiac intensivist Mary Taylor, M.D., is studying whether Viagra can help children with pulmonary hypertension.

"Many children die with pulmonary hypertension that is irreversible, and until now, we have not really had any options or medications to send them home on," Dr. Taylor, of Vanderbilt Children's Hospital in Nashville, Tenn., tells Ivanhoe.com

Pulmonary hypertension occurs when the blood pressure rises inside the lungs making it difficult for the heart to pump blood to the lungs.

Dr. Taylor says, "Viagra works by helping the blood vessels dilate or relax."

The treatment has been successful in adults and in several babies with the condition.

"We are hoping that using it over the course of months that the blood vessels will remodel and relax and allow the pulmonary hypertension to reverse," Dr. Taylor says.

In the current study, Viagra or a placebo is given through an IV to patients for 24 hours after heart surgery to see how the body responds.

"The sad thing is research is the only way to find out if something works, and somebody has got to participate," Tammy says. "If nothing else, maybe one day I can look back and say, 'Hey we helped do that.'"

It's what keeps her strong as her son struggles with his weak heart.

The week after this story was done, Kyle passed away. Doctors say his death was not related to his participation in the study, and they will continue to move forward with the clinical trial.

If you would like more information, please contact:
Carole Bartoo
Public Relations Manager
Vanderbilt Children's Hospital
2200 Children's Way, Suite 2515
Nashville, TN 37232
(615) 322-4747
http://www.vanderbilt.edu
 

What Type of Exercise is Best? (August 19, 2004)

(Ivanhoe Newswire)

Most people consider long, continuous workouts to be beneficial. However, a new study shows exercising in intervals may be a more effective way to lower fat in the bloodstream.

Researchers from the University of Missouri-Columbia studied how intermittent exercises affect triglyceride levels. Triglycerides are artery-blocking fats found in the bloodstream.

Study participants were followed for three days. On the first day, they ate a high-fat meal and did not exercise at all. On the second day, they ate a high-fat meal after exercising continuously for 30 minutes. On the third day, participants ate a high-fat meal after performing intermittent exercises. The intermittent exercises consisted of three, 10-minute bouts of exercise separated by 20-minute rest periods.

Results show when participants exercised intermittently before eating a high-fat meal, their triglyceride levels were reduced by nearly 30 percent. On the other hand, when they performed continuous exercises, their triglyceride levels were only reduced by 15 percent.

Researchers say exercising before a meal is crucial for lowering fat because muscle contractions stimulate a fat-clearing enzyme. That enzyme peaks about 12 hours after an exercise session. Thus, researchers say it’s best to exercise 12 hours before eating a large or high-fat meal.

Authors of the study conclude, “Most Americans exercise about 30 minutes a day. Based on the results of the research, the intermittent approach would probably be best for most Americans at lowering fat in the bloodstream.”

SOURCE: Medicine & Science in Sports & Exercise, 2004;36:1364-1371
 

New Gene Test for Cleft Lip (August 19, 2004)

(Ivanhoe Newswire)

Cleft lip and palate is one of the world’s most common birth defects. Now, researchers say they have a new gene test that will help predict if a couple will have a child with this birth defect.

About one in every 600 babies in the United States is born with an isolated cleft lip and palate, which means the baby is born with cleft only and no other birth defects. The condition can be corrected with surgery, but the child also has to undergo dental care and speech therapy. Study authors say it can be a tremendous emotional and economical hardship on the family.

Isolated clefts happen during early fetal development. Researchers identified the gene IRF6 that has involvement with cleft lip and palate. After tremendous testing, they created a gene test called haplotype. A haplotype gene test is the sum of several recurring variations in the unusual DNA sequence of a species. In this case, they found distinct combinations of sequence variations in and around the IRF6 gene correlated with an increased chance that a child would be born with a cleft.

Further research shows the gene test applies for 12 percent of isolated cleft lip and palate cases. Last year, authors and colleagues identified another gene mutation that accounts for 2 percent of isolated cleft cases. Therefore, researchers say they can now screen for about 15 percent of cases.

“This study shows that we’ve reached a point where it’s possible to take blood samples from parents, test certain genes, and determine whether their risk for a second child with a cleft lip or palate is, say 1 percent or 20 percent,” says Jeffrey Murray, M.D., a scientist at the University of Iowa in Iowa City. “Now is the time to begin thinking about how best to apply these types of tests clinically and ensure that they truly benefit the families and their children.”

SOURCE: The New England Journal of Medicine, 2004;351:769-780
 

Diagnosis Advancement in Breast Cancer (August 19, 2004)

(Ivanhoe Newswire)

A new study could help doctors better define a woman’s breast cancer. The research looks at the number of circulating tumor cells as an indicator of the woman’s prognosis. Study authors say this blood test could one day spare some patients from toxic chemotherapy and offer others a more aggressive approach from the start.

Metastasis is the most life-threatening aspect of cancer. When cancer cells metastasize, they leave the site of the primary tumor and travel through the blood to a new place in the body. Within the last few years, researchers have found several methods to isolate the tumor cells in the blood.

In the current research, 177 women with metastatic breast cancer were part of the study. The patients’ blood was tested for circulating tumor cells before therapy and again three to four weeks later.

Researchers report women with five or more circulating tumor cells in one blood draw had a more aggressive cancer. These women had a shorter cancer-free survival and a shorter overall survival. This finding remained consistent with the second follow-up test as well.

“This is the first time we can actually stratify metastatic breast cancer patients based on their risk,” says Massimo Cristofanilli, M.D. from the University of Texas M.D. Anderson Cancer Center in Houston. “When a physician assesses a woman with metastatic breast cancer, it is very difficult to make an accurate prediction of her prognosis. Now we may know more about what the prognosis will be, based on a simple blood test and a new technology. One day we may be able to suggest to a patient -- based on personal risk -- a more aggressive treatment, a less aggressive treatment, or no treatment at all.”

Study authors say more clinical trials on circulating tumor status need to be done to look at gene expression to try to determine how a patient is responding to treatment.

SOURCE: The New England Journal of Medicine, 2004;351:781-791
 

Two Surgeries in One (August 19, 2004)

(Ivanhoe Newswire)

Two birds with one stone ... that’s the basis behind a recent medical study. New research shows doing a cesarean section and hernia repair at the same time is a safe and effective alternative for patients.

A hernia is the bulging of a portion of an organ through an abnormal opening. Surgery is often required to repair a hernia. Researchers from Switzerland conducted a study to see if combining a hernia repair surgery with a gynecological surgery would be beneficial for the patient.

For the study, researchers looked at eight patients who had a cesarean section combined with hernia repair and 305 patients who underwent a cesarean section alone. Researchers compared operation time, blood loss, pain relief use, complications, hospital stay, hernia recurrence, and patient impression.

The study finds the combined procedure took much longer than the cesarean section alone. However, the length of the operation also depended upon the type of hernia that was being repaired. Researchers also report there were no major complications with the combined procedure. They say only one patient had a short delay in healing. The study shows blood loss, pain relief use, and hospital stay did not differ much between the two groups. Furthermore, there was no recurrence of the hernia in any of the patients, and seven of the patients would recommend the combined procedure.

Study authors conclude combining the two procedures has many benefits including one incision, single anesthesia, and a single hospital stay. They also say there are valuable advantages for the patient and in the time, cost and convenience of the combined surgeries. While they recommend the combined procedure as an option for patients, they feel a larger study needs to be done to confirm these results.

SOURCE: Archives of Surgery, 2004;139:893-895
 

Longer Rehab Better for Broken Hips (August 18, 2004)

(Ivanhoe Newswire)

A new study shows elderly patients with broken hips may benefit from longer, structured rehabilitation programs.

Researchers from Washington University School of Medicine in St. Louis studied 90 hip fracture patients who already completed standard rehabilitation therapy.

Standard rehabilitation for these patients usually involves between four weeks and 16 weeks of therapy conducted at home, and most patients do not get referred to outpatient facilities after rehab.

Patients in the study were divided into two groups. The first group received six months of supervised physical therapy and resistance training. The second group received brief training on how to perform exercises at home for six months. Both groups received standard doses of calcium and vitamin D during the study.

Results show patients who participated in the supervised physical therapy program functioned better. They also reported better strength, balance and mobility and a better quality of life than those on the home-based regimen.

Authors of the study conclude, “The most important thing about our study is that we show functional improvements. It’s great to improve strength and balance, but the key is whether that translates into being able to do more with less outside help.”

SOURCE: Journal of the American Medical Association, 2004;292:837-846
 

Nose Cream Traps Allergens (August 17, 2004)

(Ivanhoe Newswire)

Researchers have come up with a new way to stop those seasonal sniffles and sneezes: trap allergy-causing pollens in a cream applied to the inside of the nose.

The ointment was tested in a study conducted in Russia and Germany among about 90 patients with a history of allergic rhinitis, a condition more commonly known as hayfever. Participants in the study, who ranged in age from 18 to 55 years, were randomly assigned to receive the active pollen-blocking cream or a placebo cream. All were instructed to apply the ointment to the lower inside of their noses four times a day. Researchers measured participants’ reaction to pollens before they started using the creams and then again at various points during the nine-day study. Midway through the study, the participants switched creams -- those who had been getting the active cream got the placebo cream and visa versa.

Results showed the active cream was effective in reducing allergy symptoms. Specifically, when the participants used the active cream, their allergy symptom scores dropped from a median of four to one. When they used the placebo cream, their scores also declined, but only from four to three.

The investigators believe these findings suggest the pollen-blocking cream may be welcomed by allergy sufferers, especially since the cream didn’t have adverse effects -- something that can’t be said for many traditional allergy medications. The authors note, for example, 84 percent of people in a recent survey said they considered adverse effects of conventional allergy medications to be hazardous.

SOURCE: Archives of Otolaryngology -- Head & Neck Surgery, 2004;130:979-984
 

Strong Pelvic Muscles Help Childbirth (August 16, 2004)

(Ivanhoe Newswire)

A new study challenges the myth that strong pelvic floor muscles obstruct labor. Researchers from Norway now say strong pelvic floor muscles may actually facilitate labor.

Previous studies have shown pregnant women who exercise their pelvic floor muscles can prevent urinary incontinence. But the study authors say the effects of this training on labor have been scarcely scientifically reported.

The study consisted of 301 healthy first-time pregnant women. Half of the women took part in an intensive pelvic floor muscle training program between the 20th and 36th week of pregnancy. These women trained for 60 minutes once a week with a physiotherapist and were advised to perform eight to 12 intense contractions twice a day on their own. The other half of the sample served as the control.

The researchers looked at the length of the second stage of labor, measured by the time of active pushing, and the number of prolonged deliveries, which were defined as longer than 60 minutes of active pushing. Thirty-eight percent of the women in the control group had a prolonged delivery compared to just 24 percent in the training group.

However, there was no significant difference in the length of the second stage of labor between the two groups, 40 minutes compared to 45 minutes.

The authors conclude that even though these results have borderline significance, they show intensive training of the pelvic floor muscles during pregnancy facilitates rather than obstructs labor, as well as improves control and flexibility of muscles.

SOURCE: British Medical Journal, 2004;329:378-380
 

Strengthening Corneas (August 13, 2004)

NASHVILLE, Tenn. (Ivanhoe Broadcast News)

One hundred fifty thousand people are losing their vision because of a genetic condition called keratoconus. Until now, there has been no treatment for the disease other than a cornea transplant, which can be risky. Now there is a new option for those with this blinding disorder.

Reading the paper is a common way to start the day. But a month ago, it would have been difficult for Steve Howell to read the news. "With the glare off the newspaper," he says, "I would have been sitting here squinting hard to strain to see it."

One out of every 2,000 people like Howell suffer from a condition called keratoconus. Normally, the cornea has a round dome shape. In eyes with keratoconus, the cornea weakens, causing it to bulge out like a cone. The result: Vision loss.

Howell says, "You go and try to see your kids play ball on the football field, and you try to figure out which one is yours, and you can't see the number, and you can't see what's there."

Corneal specialist Ming Wang, M.D., of the Wang Vision Institute in Nashville, Tenn., says, "It's very frustrating for the doctors because we know what's wrong with the cornea, which is due to weakness. We know the root cause, but we have no way to address the problem."

Small pieces of plastic could change that. Dr. Wang inserts them into the cornea to strengthen it. "Almost like if we have a tent that has weakened and is not very strong, so you thread a little ring within the tent itself to tent it up," she says -- a difficult task when you consider the cornea is only about half a millimeter thick. That's why Dr. Wang uses a laser to perform the surgery. She says it improves the accuracy of the procedure and its safety.

Howell had the procedure on his left eye one month ago. "I'm already seeing a difference right now, and that's just phenomenal to be able to see that," he says. Now, when he looks at a street sign, he can actually read it.

Dr. Wang says it takes three to four months for the cornea to completely heal after the surgery. Also, this surgery has received limited approval for use from the FDA.

If you would like more information, please contact:
Wang Vision Institute
Palmer Plaza
Suite 1150
1801 West End Ave.
Nashville, TN 37203
(615) 321-8881
http://www.wangvisioninstitute.com
 

Biofeedback cuts Meds for Asthmatics (August 13, 2004)

(Ivanhoe Newswire)

A new study finds practicing daily biofeedback can help people with asthma reduce their need for inhaled steroid medications. The study authors explain biofeedback is the conscious control of body functions through the use of electronic monitoring devices.

Researchers tested the therapy in 94 adults with moderate persistent asthma. The participants were divided into four groups. Two of the groups used a biofeedback device that provided information about their heart rate variability. HRV was selected for the study because previous research has shown asthmatics have decreased HRV. Increasing HRV can improve respiratory symptoms.

In addition to the biofeedback, one group also learned to use a special pursed-lip breathing technique during their biofeedback sessions. A third group received a placebo, or sham, biofeedback therapy, and a fourth group received no treatment at all and served as controls. The three biofeedback groups participated in 10 weekly sessions and also practiced the technique at home for 20 minutes twice a day.

All participants had regular checkups and kept a record of daily asthma symptoms.

People in both of the HRV biofeedback groups reduced the amount of inhaled steroid medication they needed to keep their asthma under control. Asthma severity also dropped from moderate persistent to mild persistent. Asthma symptoms improved in all three therapy groups, but the group that got the sham biofeedback therapy did not see a reduction in medication use or disease severity. No changes were noted in the control group.

The investigators believe these findings suggest HRV biofeedback may prove to be a useful adjunct to asthma treatment and may help to reduce dependence on steroid medications.

SOURCE: CHEST, 2004;126:352-361
 

Common Drugs Linked to lip, Tongue Swelling (August 12, 2004)

(Ivanhoe Newswire)

Drugs commonly prescribed to treat high blood pressure and other conditions, such as congestive heart failure and diabetes, may cause angioedema, a condition characterized by the swelling of the lip and tongue. AE is not only uncomfortable for patients, but can also lead to serious respiratory problems.

Researchers publishing in this month’s CHEST studied 70 patients who came to the hospital with troublesome swelling of their lips and tongues. Results showed the condition was caused by angiotensin-converting enzyme inhibitors (ACE-inhibitors or ACEIs) in 45 of the cases, or 64 percent of the time. The remaining cases were attributed to other factors, such as food allergies, antibiotic reactions, or infections.

In 18 of the cases, the patient had to be admitted to the intensive care unit for treatment. Five patients also required endotracheal intubation and mechanical ventilation. All of the patients recovered with treatment.

The researchers note most of the patients who developed the swelling due to their ACE-inhibitors did so within a couple months of beginning the drug therapy. But a significant minority -- 24 percent -- came down with the symptoms after longer treatment, in some cases up to five years. Respiratory complications attributed to the swelling ranged from shortness of breath to cough and even respiratory failure.

Since nearly a quarter of the patients had a previous history of lip and tongue swelling, the researchers believe these findings suggest doctors should inquire about previous episodes of swelling before prescribing ACE-inhibitors to patients. They write, “Patients with any history of AE should avoid the use of ACEIs.”
 

Pain-Free Heart Attack Dangerous (August 10, 2004)

(Ivanhoe Newswire)

A person grabs his chest in pain and announces he is having a heart attack. This is the scene most people have in their mind when they think of a heart attack. But new research shows heart attacks without chest pain are more often fatal. The study finds doctors do not give this group of patients the treatment they need.

Chest pain is just one sign of a heart attack. Instead of chest pain, some patients experience symptoms like fainting, shortness of breath, excessive sweating, or nausea and vomiting.

Researchers in Sydney, Australia, conducted a study to see how patients who have a heart attack without chest pain are treated and how they recover.

The study included information on 20,881 patients from 14 countries. All patients were hospitalized with a variety of heart conditions. Researchers report 1,763 of the patients did not have chest pain and 13 percent of them died in the hospital compared to 4 percent of those who experienced chest pain. Furthermore, the patients without chest pain were more often misdiagnosed when they arrived at the hospital and were not given proper medication to help their heart.

“Often, when a patient arrives at the hospital without chest pain, it is only after blood test results come back or other diagnoses are excluded that the physician reassesses the situation and determines it is an acute cardiac event after all,” says lead study author Professor David Brieger. “We hope that our findings will remind physicians that these events do occur in the absence of chest pain and will prompt them to make the diagnoses and institute the appropriate treatment more rapidly.”

SOURCE: CHEST, 2004;126:461-469
 

More Surgeries Means Better Outcome (August 10, 2004)

(Ivanhoe Newswire)

Heart patients have a better chance of surviving if they are treated at a hospital that treats a lot of heart patients, according to new research. The study finds the improved survival rate is seen in both low-risk and high-risk patients.

Previous research has found benefits of a high-volume hospital for only high-risk patients. This latest research was done to look at both high-risk and low-risk bypass patients based on the number of procedures a hospital performs each year. The study was led by researchers from the State University of New York in Albany.

For the study, more than 57,000 bypass patients in New York were included. Researchers compared the death rate for the patients based on the number of bypass operations a hospital did. For example, a hospital was considered low volume if it did less than 200 bypass operations a year.

Researchers report low-risk patients had a 47-percent lower in-hospital death rate if they were treated in a high-volume hospital compared to a low-volume hospital. The death rate for moderate and high-risk patients was 38-percent lower at higher volume hospitals.

“Our findings support applying a volume-based referral to all bypass patients, not just those at high risk, when there are no better quality indicators available,” says lead study author Chuntao Wu, M.D., Ph.D. “But performing most bypass surgeries in high-volume hospitals could overburden them and cause hardships for many patients.”

Instead researchers say it would be better to improve the quality of care at all hospitals than to send more bypass patients to high-volume facilities. They say certain factors can increase a patient’s risk for death including age, female gender, a previous heart attack, the amount of blood the heart pumps and a variety of other conditions. They point out that not all low volume hospitals have poor outcomes and instead their research is based on average outcomes.

SOURCE: To be reported in an upcoming issue of the journal, Circulation
 

Risks and Benefits of Hormone Therapy (August 10, 2004)

(Ivanhoe Newswire)

Hormone therapy has received a lot of press in the past couple of years. Now new research focuses on the risks and benefits of short-term use of hormone therapy in menopausal women. The study finds women can increase their quality of life, but they may also shorten their life expectancy if they use hormone therapy.

Deciding whether or not to use hormone therapy can be a difficult decision. Hormone therapy can be an effective treatment for menopausal symptoms, but are the risks worth the benefits? Researchers from Rhode Island Hospital in Providence conducted a study to investigate the precise risks and benefits of short-term hormone therapy and published their findings in this month’s Archives of Internal Medicine. Short-term therapy was defined as two years.

For the study, researchers developed a Web-based computer model to simulate the effects of two years of hormone therapy use. They looked at life expectancy and the improved quality of life among 50-year-old menopausal women. The computer model was based on findings from the Women’s Health Initiative, a 15-year-long research project.

Researchers report for women without any menopausal symptoms, short term hormone therapy resulted in a net loss in life expectancy and quality of life expectancy of one to three months. Women with symptoms gained seven to eight months of improved quality of life, but a shortened overall survival.

Study authors say short-term hormone therapy can be both harmful and beneficial. The decision to use it depends on a woman’s treatment goals. If the goal is to maximize the quality of life, then hormone therapy is beneficial. However, if the goal is to live longer, they do not recommend hormone therapy.

SOURCE: Archives of Internal Medicine, 2004;164:1634-1640

 

Eyes Reveal Blood Pressure Risks (August 10, 2004)

(Ivanhoe Newswire)

The vessels in the eyes may be the window to detecting future hypertension. A new study reports the vessels in the retina appear to narrow before blood pressure exceeds normal range.

This new research is the second to find this association between eyes and blood pressure. A study published earlier this year called Atherosclerosis Risk in Communities found changes in the retina predicted the onset of hypertension within three years.

For this study, researchers from Center for Vision Research at the University of Sydney and Westmead Hospital in Australia used special cameras to photograph the retinas of more than 3,500 people. Most of the participants were 49 years or older. Researchers also measured the blood pressure of the patients and categorized them as normal, high-normal, mild hypertension or severe hypertension.

Five years later the participants underwent another examination. Researchers say 390 of the patients had developed severe hypertension. They say people with narrow retinal vessels are twice as likely to develop severe hypertension in five years as compared to people with wider vessel openings. These findings remained true even when study authors considered other risk factors for hypertension.

Researchers conclude the findings of this study suggest visible changes in the eye may precede the development of severe hypertension. They say this sign could be a more stable measure of risk than other measures that can vary over time.

SOURCE: Hypertension, 2004;44:1-6
 

Healing Yoga (August 9, 2004)

LOS ANGELES (Ivanhoe Broadcast News)

Although researchers believe yoga was developed more than 5,000 years ago, its popularity in the United States has recently exploded. You may know about the relaxing benefits of this ancient practice, but what about the health perks? Yoga helps people with various illnesses find relief.

More than 50 years ago, Eric Small found out he had multiple sclerosis. "I couldn't pick up things," he says. "I couldn't go out. I couldn't read, and my speech got a little funny."

When medications failed, Small turned to an ancient remedy. "The yoga is the medicine. My drug of choice is the Hatha yoga practice," he says.

Sonia Gaur used yoga to heal her back. She says, "I just go into about four poses -- two or three times a day -- for like two days, and my back pain goes away."

A growing number of Americans are turning to alternative practices like yoga. Neurologist Barbara Giesser, M.D., says there are good reasons.

"Yoga enables them to control or reduce symptoms, specifically pain, spasticity, fatigue," Dr. Giesser, of UCLA MS Achievement Center in Los Angeles, tells Ivanhoe.

Studies show yoga can help patients with arthritis and carpal tunnel by improving grip strength and relieving pain. It also lowers stress, reducing the risk of heart attack and stroke.

Two recent studies also show yoga may help cancer patients sleep better and asthmatics reduce their medication. Of course, it can benefit healthy individuals, too.

Dr. Giesser says, "These are strategies that are going to increase their flexibility, improve their endurance."

For Small, yoga was more than just a way to stay fit. "I wouldn't be here. If I didn't put the yoga in place, I don't think I would have coped," he says. Now, just two hours a day is all this 74-year old needs to cope.

Experts say there are more than 25 different types of yoga. Some require easy stretches and slow breathing, while others are more intense.
 

Salt: The Sneaky Spice (August 9, 2004)

ATLANTA (Ivanhoe Broadcast News)

Could you be consuming too much salt? Experts say the average American probably takes in too much of the spice, and new research shows salt may do more than just raise your blood pressure. Here's why salt can be the sneaky spice you should watch for.

Whether you use a pinch or pour it on, dietician Nancy Anderson, R.D., says you're probably eating too much salt. "The average American probably consumes around 4,000 to 5,000 milligrams a day, easily," says Anderson, who is with Emory Heartwise Risk Reduction Program in Atlanta.

But, for healthy adults, the American Heart Association recommends no more than 2,400 milligrams of sodium a day.

"Most people don't realize that half a can of soup can give them their daily intake of sodium for a day," Anderson says. Even a small can has as many as 930 milligrams. A half-cup of a meat-based pasta sauce -- 710. Regular tomato sauce -- 380, and the "no salt added" version -- only 15 milligrams of sodium.

Erica Brownfield, M.D., a general internist at Emory University School of Medicine in Atlanta, says one concern is high blood pressure, which can lead to early death. She says, "High blood pressure is the number one risk factor for developing strokes in this country and one of the risk factors for heart disease."

About 26 percent of Americans with normal blood pressure and nearly 60 percent of those with high blood pressure are salt-sensitive, raising the risk of heart and kidney disease. Sodium is also thought to raise the risk of stomach cancer and rob bones of calcium.

So, play it safe, choose low sodium products, eat fewer processed foods and skip the salt shaker.

People who are at high-risk of being salt-sensitive are elderly people, blacks and people who have kidney disease. Experts say if you're looking to add flavor without sodium, try cooking with herbs, spices, garlic, lemon and onions.

If you would like more information, please contact:
Emory Health Connection
Heartwise Program
(800) 753-6679
 

Delay in Pre-term Delivery Beneficial (August 6, 2004)

(Ivanhoe Newswire)

If a fetus starts to have complications in utero, how early should the child be born? It is a question many obstetricians would answer differently. Now a new study may shed some light on the benefits of delaying the birth. The study finds even a small delay could reduce the risk of a disability for the baby.

Until now, no study has ever compared the effect of delaying a delivery to an immediate delivery for a premature baby. Researchers from the University of Nottingham in the United Kingdom compared these two methods. For the study, 588 babies were randomly assigned to have immediate delivery or delayed delivery. The babies had fetal trauma, and the mothers were between 24- and 36-weeks pregnant.

The delayed delivery meant the physician waited as long as possible before the baby was born. The delay ended up being about four days later compared to the babies who were born immediately. Researchers then looked at the survival of the infants and the rate of disability at age 2.

Study authors say the overall survival was the same in both groups. However, they found 8 percent of the babies born immediately had disabilities at age 2 compared to 4 percent of the babies who had their delivery delayed.

Lead study author Jim Thornton says, “The lack of difference in mortality suggests that obstetricians are delivering sick preterm babies at about the correct moment to minimize mortality. However, they could be delivering too early to minimize brain damage.” Researchers feel the results of this study should discourage doctors about an immediate delivery and promote waiting to deliver until it cannot be delayed longer.

In an accompanying commentary, David Grimes, from Family Health International in Research Triangle Park, N.C., says, “When given identical clinical scenarios, experience clinicians disagree on the timing of delivery.” He says this is why studies such as this one are important to help ensure fetuses are born at the optimum time.

SOURCE: The Lancet, 2004;364:513-519, 483-484
 

No Need for Reading Glasses (August 6, 2004)

NEW ORLEANS (Ivanhoe Broadcast News)

There are more than 77 million baby boomers in the United States, and very soon, most are going to need reading glasses to see close-up. Aging eyes are a way of life that, for years, we've just had to live with. Now there maybe a new way to get rid of those granny glasses for good.

Kay Kerrigan is taking time to stop and smell her roses today, now that she can see them. "I was always grabbing for the glasses everywhere, you know, and then I wouldn't have them with me, or I'd misplace them," she says.

Kerrigan had good vision most of her life, but her 50-something eyes couldn't stay up with the rest of her. She developed presbyopia, or "old-age sight."

Ophthalmologist Marguerite McDonald, M.D., of Tulane University School of Medicine in New Orleans, had something to offer Kerrigan -- conductive keratoplasty, simply called CK.

"CK is the use of radio frequency energy emitted through a very small wand or probe that is pressed into, but not through, the outer wall of the eye," Dr. McDonald tells Ivanhoe.

In less than seven minutes, the eyes are given a new shape. "It's as if somebody tightened the belt around the cornea," Dr. McDonald says. "The center part gets much steeper and that sharpens the focusing power."

Studies show 90 percent of people who get the procedure no longer need glasses. Dr. McDonald says: "It's just such a thrill to watch people respond to the surgery and have vastly decreased dependence on their reading glasses, if not total elimination. It's really a joy, and you can see people feel rejuvenated."

Rejuvenated might be an understatement for Kerrigan, who had CK earlier this year. She says, "It is the best thing I have ever done in my life." She spends much of her time now enjoying the details she'd been missing -- especially with her grandson, Thomas. "It was the most wonderful experience to be able to pick up that baby and look at him without any glasses."

If you would like more information, please contact:
Caroline Cleveland
Surgical Coordinator for Dr. McDonald
Tulane University School of Medicine
New Orleans, LA 70115
(504) 896-1240
http://www.refractec.com
 

Doctors Ignoring Obesity Problem (August 5, 2004)

(Ivanhoe Newswire)

A new study shows pediatricians are not doing enough during wellness visits when it comes to identifying and managing obesity.

Researchers from the University of Pittsburgh and the University of Utah in Salt Lake City conducted a study to assess how pediatricians are doing in identifying and managing obesity among their patients. The study included a review of medical records for visits at a large in a primary care pediatric facility. Researchers reviewed all health visits for children 3 months to 16 years of age between December 2001 and February 2002.

Of the 2,515 visits reviewed, results show 244 patients were considered obese. (Researchers say that percentage is lower than expected because of the large number of very young children seen.) Researchers say for those considered obese, only half of the time did the doctor document it in their chart. While 69 percent of the charts included a dietary history, only 15 percent included a description of the child’s activity level or television viewing. Researchers also report obesity levels were lowest among preschool children and highest among adolescent children.

Study authors write, “Although the prevalence of childhood obesity has now reached epidemic proportions, it was under-recognized and under-treated by pediatric primary care providers in our study.” They say the results of this study are disheartening. They believe this research highlights the need for increased awareness and identification of obesity in the doctor’s office, especially among younger children and those with mild obesity.

SOURCE: Pediatrics, 2004;114:e154-e159
 

Fiber Helps Cough (August 4, 2004)

(Ivanhoe Newswire)

Tired of that wet cough? Try eating more fiber.

A new study shows a diet high in fiber from fruit and soy foods may reduce the incidence of chronic respiratory symptoms -- especially cough with phlegm.

Researchers from Singapore studied more than 570 patients who experienced cough with phlegm and more than 44,000 patients without the respiratory problem. Participants were given a food frequency questionnaire to determine if certain foods were associated with a reduced risk of respiratory symptoms.

Results show fruits, such as apples and grapes, and other high-fiber foods were associated with a reduced risk of cough with phlegm. Researchers say nutrients known as flavonoids may be responsible for the reduced risk.

The trend was observed in both smokers and nonsmokers. However, they say smoking is still the most important factor in determining whether patients will experience the respiratory condition.

Study authors conclude, “Preventing the initiation of smoking is still the most important primary prevention method for chronic respiratory symptoms ... However, our data provides evidence that promoting a diet high in sources of fiber and flavonoids, such as fruit and soy, may be an important contribution to primary prevention strategies.”
 

Asthma Drugs Don’t Lead to Broken Bones (August 3, 2004)

(Ivanhoe Newswire)

A new study is easing fears among parents of asthmatics. Researchers from Switzerland and the United States find no increase risk of bone fractures among kids who take inhaled steroids to control their asthma.

National asthma guidelines recommend inhaled steroids -- drugs like beclomethasone (Beconase or Vancenase), budesonide (Rhinocort), and fluticasone (Flovent) -- as the first line of defense for children with persistent forms of the disease. But doctors have long worried these drugs might be weakening the bones of youngsters who take them. The fear stems from research showing a link between oral forms of the drugs and osteoporosis in adults. Other studies have suggested a similar link between bone problems and the inhaled forms, but the evidence has not been conclusive.

In the current research, investigators conducted a large population-based study of kids age 5 to 17, matching about 3,740 asthma patients with nearly 21,760 kids without asthma. A comparison of fractures between the two groups showed similar rates of broken bones for asthmatics on the inhaled drugs and kids without asthma. The finding held true even for children who had been on the drugs for a long period. A small increased risk of fracture was seen, however, for long-time users of inhaled steroids who had also taken or were taking an oral form of the medication.

The authors write, “Our study shows that treatment with inhaled steroids does not seem to materially affect the risk of bone fractures in children or adolescents.”

SOURCE: Pediatrics, 2004;114:469-473
 

Better Help for Lungs (August 2, 2004)

(Ivanhoe Newswire)

A new study shows patients with inoperable lung tumors may benefit from a procedure known as radiofrequency ablation.

Radiofrequency ablation uses electrodes to heat and destroy abnormal tissue.

Researchers from the IRCCS Hospital of Oncology in Bari, Italy, studied 18 patients with inoperable lung tumors. Most lung tumors are considered inoperable because of poor respiratory function or other health conditions in patients.

The researchers used radiofrequency ablation on 40 tumors. Results show, at follow-up, the procedure was a success for 94 percent of the patients.

Doctors often treat inoperable lung tumors with radiotherapy and chemotherapy. However, radiotherapy can be toxic to patients, and chemotherapy is not always well-tolerated.

Cosmo Gadeleta, M.D., lead author of the study, says, “Lung radiofrequency ablation can get around all those problems. It is minimally invasive, with only a small needle being inserted into the patient. It is also advantageous because of potentially low costs, short hospitalization times, and good patient tolerance without mortality.”

Researchers say side effects of the procedure were minimal. Only three patients experienced a collapsed lung, but were then successfully treated. Researchers say the benefits of the procedure outweighed this risk.

Authors conclude, “We feel that lung radiofrequency ablation could become more prevalent, first for patients who are not candidates for surgery, but also as an alternative to surgery for operable primary lung tumors, as long as the tumor is not too large.”

SOURCE: American Journal of Roentgenology, 2004; 183:361-368
 

Going for Gold (August 2, 2004)

MINNEAPOLIS (Ivanhoe Broadcast News)

Doctors say there are more than 85,000 people waiting for an organ transplant in the United States. Bumper stickers and T-shirts can educate the public about the need, but there's a bigger event coming up.

For Harvel Douglas, every step here represents another beat of his heart. Just a year and a half ago, he was told he would die without a heart transplant. "Never crossed my mind, because actually when they told me I needed transplant, I wasn't happy. I was like, 'No way,'" he tells Ivanhoe.

Harvel spent several months in the hospital waiting for a heart. His wife Gwen says his musical gift got him through the difficult moments. "After he had the transplant, he tried to hum to see if he could still sing," she says. "I don't know what it was, but he tried, and he said, 'I'm back, and I can sing.'"

Now Harvel plans to use that gift at the 2004 U.S. Transplant Games in Minnesota. He'll open the games with the national anthem.

This Olympic-style competition takes place every two years. Around 2,000 athletes -- who are all recipients of organ transplants -- compete in 13 events. The real goal, they say, is to tell people about organ donation.

"One person, basically, can save like 15 people with all the different stuff you can donate, you know," Harvel says. So he is getting ready, because after he sings, he'll be going for the gold in both basketball and track and field.

This year's games were held in Minneapolis July 27 through August 1. The National Kidney Foundation organizes them. You can find out more about the games by logging on to http://www.transplantgames.org.


If you would like more information, please contact:
National Kidney Foundation
Ellie Schlam
Public Relations Director
30 East 33rd Street
New York, New York 10016
(212) 889-2210
 

Blood Test Could Save Legs (August 1, 2004)

(Ivanhoe Newswire)

A simple blood test could predict which patients with diabetes will respond to a less-drastic amputation procedure.

When diabetics develop severe foot ulcers, doctors often perform a complete below-knee amputation, where the entire lower leg is removed. However, an alternative approach, known as a transmetatarsal amputation, only removes the front portion of the foot that contains the ulcer.

The problem is the TMA amputation is not always successful, so many doctors decide to perform a BKA right off the bat. Until now, doctors have had no way of determining who is a good candidate for the partial foot amputation surgery.

Researchers from St. Paul’s Hospital in Vancouver, British Columbia, studied about 20 patients with diabetes who received partial foot amputations and about 20 patients who had failed amputations.

Researchers found patients who had better control of their blood sugar had a high success rate with partial foot amputation.

Blood sugar control is measured by a test called HbA1c, which shows what a person’s average blood sugar level has been over the previous three months. The American Diabetes Association says the target diabetics should be aiming for is less than 7 percent.

Researchers found people whose A1c was 7 percent or lower had a high success rate with the partial foot amputation and did not need a BKA.

Alastair Younger, M.D., from St. Paul’s Hospital in Vancouver, says “When glucose is greater than 10 percent of the blood, the TMA is bound to fail.”

Researchers say this discovery gives them one more tool in predicting which patients are good candidates for a TMA.

Study authors conclude, “With these new discoveries we can save more limbs than were able to in the past.”

SOURCE: The 20th American Orthopaedic Foot and Ankle Society Meeting in Seattle, July 29-31, 2004
 

Caffeine may Worsen Diabetes (August 1, 2004)

(Ivanhoe Newswire)

That cup of coffee you have with breakfast may be making your diabetes worse, report researchers who conducted a study to determine how caffeine impacts blood sugar control and insulin levels.

The authors note as long ago as 1967, research was showing a link between caffeine and diabetes. The early study suggested drinking two cups of instant coffee a day significantly impaired glucose tolerance in men with type 2 diabetes. More recent studies have associated caffeine with decreased insulin sensitivity in young adults without diabetes.

In this study, investigators from Duke University Medical Center in Durham, N.C., gave standard tests for diabetes to 14 regular coffee drinkers with type 2 diabetes. First, the participants had a fasting blood sugar test, followed by the ingestion of a capsule containing caffeine or placebo. The fasting blood sugar test was then repeated to determine how caffeine affected blood sugar. Second, the participants were given an additional capsule with either caffeine or placebo along with a meal so researchers could see how caffeine taken with carbohydrates would impact their diabetes.

Results showed caffeine alone had no effect on blood sugar or insulin when compared with the placebo capsule. However, when taken with food, caffeine significantly raised blood sugar and had detrimental effects on insulin.

The authors write, “Our results raise concerns about the potential hazards of caffeine for patients with type 2 diabetes and possibly for individuals who are glucose intolerant or ‘pre-diabetic.’”

SOURCE: Diabetes Care, 2004;27:2047-2048
 

Increase in Foot Injuries (August 1, 2004)

(Ivanhoe Newswire)

A growing number of elite athletes are seeing their careers come to an end because of misdiagnosed injuries.

A new study shows there to be an increase of midfoot injuries, known as Lisfranc injuries, in professional athletes. These injuries often go misdiagnosed due, in part, to their subtle appearance in X-rays. This can mean the end of an athlete's career.

Robert Anderson, M.D., lead author the study, says, "Physicians need to be aware that any midfoot injury is potentially serious and aggressive treatment may be needed."

Dr. Anderson attributes Lisfranc injuries to the light-weight shoes athletes wear, changes in playing surfaces, and the increase in size and endurance of athletes, which has added more stress to the foot.

Researchers studied nine athletes who had been diagnosed with some form of a Lisfranc injury, two were college football players and seven were professional football players. Seven had surgery, and all returned to play.

The authors of the study conclude that injuries cannot be avoided, but "when properly diagnosed, the opportunity to achieve a full recovery can be reached."

SOURCE: The 20th American Orthopaedic Foot and Ankle Society Meeting in Seattle, July 29-31, 2004
 

Diabetics may Need More Than Diet (August 2, 2004)

(Ivanhoe Newswire)

People with type 2 diabetes who try to control the condition with diet alone may not be receiving all the health services they need.

That’s the key finding from a new study out of England that compared health services provided to diabetics on medication with those provided to diabetics not on medication. The study involved nearly 7,700 diabetic patients being treated in various locations throughout the country. About a third attempted to manage the condition with diet alone.

Researchers found people trying to manage their diabetes through diet alone were more likely to have high blood pressure, but less likely to be on medication for high blood pressure. They were also more likely to have high cholesterol, but less likely to be on cholesterol-lowering drugs. While the diet-alone patients had fewer complications from their diabetes than those on medication (68 percent vs. 80 percent), they still experienced more complications than people in the general public.

Also interesting, say the authors, was the wide variation found among different practice locations in the study. In some health practices, as few as 15 percent of patients were on diet alone, while in others as many as 75 percent were trying to control their diabetes without medication.

Study author Julia Hippisley-Cox, M.D., notes while some people with type 2 diabetes are able to manage the condition with diet alone, these results suggest many are going without necessary care. She writes, “Although some individuals with type 2 diabetes might be effectively managed by diet only, there is a case for better routine surveillance ... and for greater consistency of clinical practice concerning the decision to start medication.


SOURCE: The Lancet, 2004;364:423-428

 

Cleft Lip Linked to Mom’s Smoking (August 1, 2004)

(Ivanhoe Newswire)

Moms-to-be have one more good reason not to smoke -- researchers find smoking during the early months of pregnancy increases the risk of having a baby with a cleft lip.

The study, which appears in this month’s Cleft-Palate-Craniofacial Journal, involved women from Scotland and England who were interviewed when their babies were about six months old. Researchers asked about the mother’s smoking habits before and during pregnancy, including how many cigarettes she smoked and whether she was exposed to secondhand tobacco smoke. The study was conducted between 1997 and 2000.

Researchers found women who smoked during the first three months of pregnancy were more likely to have a baby with a cleft lip occurring with or without a cleft palate. While the increased risk was small, researchers say it was still significant. The study also showed a trend toward more cleft lips in the infants of women exposed to secondhand smoke, but the researchers could not make a firm connection between the two.

Given the emotional and physical trauma experienced by children with these deformities and the significant costs associated with repairing the problem, the investigators believe their findings point to a need for greater public awareness of the link between cleft lip and smoking while pregnant.

They write, “We suggest that OFCs [orofacial clefts] should be incorporated into public health campaigns on the consequences of maternal smoking.”

SOURCE: Cleft-Palate-Craniofacial Journal, 2004;41:381-386
 

MRI vs. Mammography (August 1, 2004)

(Ivanhoe Newswire)

Women at high risk of developing breast cancer may want to ask their doctors about screening with magnetic resonance imaging instead of mammography.

A new study finds MRIs are significantly better at detecting cancers in this group than standard mammograms or clinical breast exams.

The study involved around 1,900 women with a lifetime breast cancer risk of 15 percent. The group included 358 women who also carried one of the genes known to put women at particularly high risk for the disease. All of the women received a clinical breast exam every six months and annual MRIs and mammograms. They were followed for about three years.

Results showed MRI was significantly more sensitive in detecting breast cancers than mammography. Overall, 45 breast cancers were detected during the study and included in the analysis. MRI detected 32 cancers, 22 of which were missed by mammography. Mammography detected 18 cancers, eight of which were missed by MRI. One of the cancers was detected by clinical breast exam alone, and the other four were detected in-between screenings.

There was a downside to the study -- researchers also found MRIs were more likely to lead to false-positive results. MRI resulted in twice as many unnecessary additional exams than mammography, 420 vs. 207, and three times as many unnecessary biopsies, 24 vs. seven.

The authors write, “A drawback of MRI screening is that it has a lower specificity than mammography, and, as a result, MRI will generate more findings judged as uncertain.”


SOURCE: The New England Journal of Medicine, 2004;351:427-437
 

Women’s Monthly Headache (August 1, 2004)

(Ivanhoe Newswire)

Many women claim they get a migraine each month when they menstruate, now a new study confirms this happens. Plus, a second study finds an effective drug treatment for women with menstrual migraines.

Nearly one in five adult women experience migraine headaches compared with one in 20 adult men. Menstrual migraine is when the headache happens around the same time as menstruation each month. Large studies focusing on menstrual migraines have not been done previously. Now, researchers from the City of London Migraine Clinic analyzed data from 155 female patients to look at menstrual migraines.

Their research shows that in the five days before menstruation, women were 25-percent more likely to have a migraine, and a migraine was 71-percent more likely to happen during the two days before menstruation. Women were also more likely to have a migraine associated with vomiting during menstruation. Researchers say this study supports new diagnostic criteria regarding menstrual migraines.

In a second unrelated study, researchers from Thomas Jefferson University in Philadelphia studied the use of the drug frovatriptan, also known as Frova, in the prevention of menstrual migraines. For the study, they included 443 patients from 36 different centers in the United States. The patients were randomly assigned to placebo, frovatriptan once a day, or frovatriptan twice a day. They took the drug for six days beginning two days before the start of menstruation.

Researchers report 67 percent of those on placebo had a migraine, 52 percent of those on the drug once a day had a migraine, and 41 percent of those on the drug twice a day had a migraine. The drug also seemed to reduce migraine severity, duration and the use of other medications. Authors say this treatment seems to be effective for those who suffer from menstrual migraines.

SOURCE: Neurology, 2004;63:351-353, 261
 

Computer-Assisted Knee Surgery (August 1, 2004)

OKLAHOMA CITY (Ivanhoe Broadcast News)

The path to middle age has taken its toll on active baby boomers. Arthritis followed by knee replacement surgery could become the norm for many of the 78 million middle-aged Americans. Now a new technique offers hope for active years ahead.

Michael Baroli is finally back on his feet, crouching and clicking, kneeling and directing. His glamour photography business depends on his knees. "My knees are like my lifeblood," he says. "If they don't work, I don't work." But knee pain nearly put an end to his work.

Oklahoma City Orthopedic Surgeon Stephen Davenport, M.D., had a solution for Baroli -- computer-assisted knee surgery that can last up to 30 years. Standard surgery usually lasts less than 20 years.

"Instead of guessing where the mechanical axis or points of reference are, the computer tells us accurately where they are, and it's accurate to within one or two degrees," Dr. Davenport tells Ivanhoe. He says the surgery is more expensive but worth it. "I really like the accuracy component of it. I can be absolutely confident that every one of my patients has the potential to have the same exact result."

After his surgery, Baroli says he's able to work a full day and even do more physical activity. "We started riding bikes. We're back exercising. We're walking on a regular basis," he says. "The weight is coming off."

Michael says with his new knees -- and his new regime -- he plans on being able to work another 30 years.

According to the American Academy of Orthopaedic Surgeons, about 267,000 total knee replacement surgeries are performed each year in the United States. The computer-assisted surgery is now available at many major medical centers across the country.


If you would like more information, please contact:
Damon Gardenhir
Spokesperson Integris Health
(405) 951-4819
Damon.Gardenhire@Integris-Health.com