Drano for the Heart (February 28, 2004) 

OKLAHOMA CITY (Ivanhoe Newswire)

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

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

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

Accidental Addiction (February 28, 2004) 

WEST PALM BEACH, Fla. (Ivanhoe Newswire)

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

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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


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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

Prophylactic Mastectomies Reduce Cancer Risk (February 25, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

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

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

Hormone Replacement and Respiratory Disease (February 24, 2004) 

(Ivanhoe Newswire)

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

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

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

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

Little-Known Asthma Inducer (February 23, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

BALTIMORE (Ivanhoe Newswire)

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

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

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

When Lung Cancer Spreads (February 23, 2004) 

(Ivanhoe Newswire)

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

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

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

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

SOURCE: Cancer, 2004;100:801-806

Little-Known Asthma Inducer (February 23, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

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

SCOTTSDALE, Arizona (Reuters)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Vaccine for Kidney Cancer (February 20, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

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

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

Predicting Cervical Cancer Risk (February 20, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

That’s a lot of cancers.

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

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

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

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

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

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

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

Who are the people that you are treating?

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

These are people with advanced cancers?

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

That’s pretty exciting.

Dr. Agus: Yeah, it’s great.

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

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

What were your thoughts when you saw these results?

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

What’s the next step?

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

What’s been the response from patients?

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

What does it mean for patients?

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

Does that mean somebody could live with a cancer?

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

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

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

By Jackie Shaner, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire)

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

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

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

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

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

Depression Linked to Heart Disease  (February 16, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

Chronic Cough Worse in Women  (February 16, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

SOURCE: CHEST, 2004;125:482-488

Elderly Fear of Falling  (February 16, 2004) 

TAMPA, Fla. (Ivanhoe Newswire)

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

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

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

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

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

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

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

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

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

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

Islet Transplantation for Diabetes Examined  (February 13, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

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

(Ivanhoe Newswire)

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

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

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

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

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

Proteins in Blood Predict Preeclampsia (February 12, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

Hormones Predict Heart Problems  (February 12, 2004) 

(Ivanhoe Newswire)

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

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

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

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

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

Iron Linked to Diabetes  (February 11, 2004)