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Can Antioxidants Diminish Effects of Alcohol During Pregnancy? (June 21, 2004)

(Ivanhoe Newswire)

Taking antioxidants during pregnancy may prevent birth defects in babies born to women who abuse alcohol, according to a new study.

When pregnant mice were exposed to ethanol and also given an antioxidant, researchers saw a 36-percent reduction in limb malformations in the offspring. Ethanol is the intoxicating agent in liquor.

Researcher Kathleen K. Sulik, M.D., a professor of cell and developmental biology at the University of North Carolina at Chapel Hill School of Medicine, says the implications of this study apply directly to alcoholics. “The nutritional status of alcoholics isn’t the best,” she says. “People who are alcoholic by definition can’t control their drinking and often cannot quit drinking during pregnancy.”

She says the idea of adding antioxidants to alcoholic beverages has been proposed as a way of helping women who are unable to quit drinking during pregnancy. She says this study used high amounts of alcohol in order to mimic the blood alcohol level of chronic alcoholics. “Virtually all children born with full-blown fetal alcohol syndrome, with major malformations caused by alcohol, are born to chronic alcoholics,” Dr. Sulik says.

She calls the disease a “huge problem” in our population. According to government statistics, in the last 10 years, the number of Americans over 18 who abuse alcohol or are alcohol dependent rose from 13.8 million to 17.6 million.

SOURCE: Federation of American Societies for Experimental Biology, published online June 18, 2004

Easing Morning Sickness (June 21, 2004)

IOWA CITY, Iowa (Ivanhoe Newswire)

If you've been nauseous during pregnancy, you've most likely heard advice like eat small meals spread throughout the day or eat crackers before getting up in the morning. For many women, these tricks work. But for others, they don't. Here is another possible remedy for those women.

Fresh coffee -- what a way to start the day. "I love coffee," says Stephanie Rosazza. But during her last pregnancy, she says, "I couldn't even stand the smell of it."

Morning sickness. Experts say 90 percent of pregnant women get it. Rosazza says, "I was so sick that I couldn't even get out of bed to brush my teeth."

During Rosazza's last pregnancy, anti-nausea medicines didn't work. This time around, Jennifer Niebyl, M.D., an obstetrician from University of Iowa College of Medicine in Iowa City, recommended something different -- a combination of vitamin B-6 and an over-the-counter sleeping tablet called Unisom.

The Unisom package says do not take it if you are pregnant. But Dr. Niebyl says it's as safe as Tylenol. "This particular combination of drugs has been thoroughly tested," she says. "The risk of birth defects is identical in the women who take the drug and the ones who don't."

"It is one of the more effective remedies for morning sickness," says Dr. Niebyl. Frank Witter, M.D., an obstetrician and gynecologist at Johns Hopkins University School of Medicine in Baltimore, agrees. He says he's prescribed this combination for morning sickness for more than 20 years to hundreds of pregnant women. "Going over all the scientific evidence, my opinion is that this is a safe drug." Dr. Witter says.

The standard dose? Twenty-five milligrams of vitamin B-6 three times a day and 25 milligrams of Unisom at night. Be sure to check with your own doctor first.

Officials from Pfizer, the maker of Unisom, say they don't tout Unisom as a morning sickness solution. They say they have not tested it on pregnant women. But they say doctors are free to recommend what they want to patients. Again, be sure to check with your own doctor first.

If you would like more information, please contact:
http://www.morningsicknesshelp.com

A Drop a day Keeps Glaucoma Away (June 21, 2004)

(Ivanhoe Newswire)

A new study shows pressure-lowering eye drops may delay or possibly prevent the onset of glaucoma in nearly 50 percent of blacks, who are at higher risk for developing the disease.

However, researchers note the therapeutic benefit of medication does not imply that every patient of African descent with glaucoma requires treatment. Factors such as corneal thickness, age, and general health should be considered when determining who should be treated rather than solely relying on race.

Results of the $30 million, 22-center study show only 8.4 percent of black participants who received eye drops developed glaucoma. In comparison, 16.1 percent of the black participants who did not receive the daily eye drops developed glaucoma. About 400 blacks participated in the study.

According to the article, glaucoma is the leading cause of blindness in the black community, and as a group, blacks are three-times more likely than whites to develop the disease. Investigators stress that blacks over age 40 should get a comprehensive dilated eye exam at least once every two years to determine glaucoma risk. If detected early, glaucoma usually can be controlled, preventing serious vision loss.

Glaucoma occurs when the fluid that flows in and out of the eye drains too slowly, gradually increasing pressure inside the eye. Between 3 million and 6 million people over age 40 in the United States are at increased risk for developing glaucoma.

SOURCE: Archives of Ophthalmology, 2004;122:813-820

Alcohol Causes for Rising Pancreatitis Rates (June 21, 2004)

(Ivanhoe Newswire)

Rates of acute pancreatitis, or inflammation of the pancreas, have doubled in England over the past 30 years in younger age groups. Researchers say increasing alcohol consumption may be partly to blame.

Death rates from acute pancreatitis in the first month after hospital admission were 30-times higher for drinkers than in the general population of the same age.

Acute pancreatitis is mainly caused by alcohol abuse and gall stones. It produces a sudden attack of severe upper abdominal pain, often accompanied by nausea and vomiting. An attack usually lasts about 48 hours.

Researchers say pancreatitis has a poor prognosis overall. Death rates have not improved since the 1970s because no major innovations in treatment have been introduced, they conclude.

However, acute pancreatitis is fairly uncommon. Researchers report rates tend to be higher in Scotland, Germany and the United States.

During the study, more than 5,000 people were admitted to the hospital with acute pancreatitis in Oxford, England. An increase in the occurrence of gall stones may have also contributed to the rise, researchers note.

SOURCE: British Medical Journal, 2004;328:1466-1469

Abdomen fat Linked to Hypertension (June 21, 2004)

(Ivanhoe Newswire)

A new study shows people with normal blood pressure who have large amounts of fat inside the abdomen may be four-times more likely to develop high blood pressure. Measures of fat in other areas, including the waist size, total body fat, and fat under the skin, were not related with increased risk.

In the 11-year study, investigators measured the fat of 300 Japanese Americans in Washington with computed tomography scans. About one in three participants (92 of 300) developed high blood pressure.

Because only Japanese Americans participated in the study, researchers caution that their findings may not apply to other ethnic groups. Researchers note that they did not identify why abdomen fat increases hypertension risk. In addition, amounts of fat were measured only at the beginning of the study and could have changed over time.

Previous studies show people with expanded waists (central or abdominal obesity) have increased risks for high blood pressure.

Obesity and hypertension are well-established components of metabolic syndrome. Other components include insulin resistance, glucose intolerance, hyperinsulinemia, and dyslipidemia.

SOURCE: Annals of Internal Medicine, 2004;140:992-1000

Stopping Allergies Before They Start (June 18, 2004)

DENVER (Ivanhoe Newswire)

Nearly 60 million Americans suffer from hay fever -- that's 20 percent of all Americans. From runny noses to watery, itchy eyes, it can make summer unbearable. Now, a new option under study could prevent symptoms before they start.

Twenty-four year old Torey McFarland loves the great outdoors. "In the summer, I go camping and boating a lot. My summer is pretty much all outside," she tells Ivanhoe. What she doesn't love is the way the outdoors makes her feel. "Runny nose. Stuffy nose. Itchy throat. Sore throat. Watery and itchy eyes."

At National Jewish Medical and Research Center in Denver, allergist Harold Nelson, M.D., is trying to stop those symptoms before they ever start. He's studying a new type of therapy for hay fever. "If it works well, it's the perfect treatment," he says.

After exposure to allergens such as pollen, the body produces a variety of antibodies that sensitize mast cells to produce the chemical histamine. Re-exposure to the allergen causes allergic symptoms. Anti-histamines only block histamine.

Dr. Nelson says, "This drug, instead, tries to block the pathway within the mast cell, so the histamine is never released." He equates it to starting at the tree trunk. "So, you block the histamine branch. You block the branch that generates some later things that cause symptoms. It blocks even later events that set up chronic inflammatory response in the nose."

McFarland was in a study of the new drug. She hopes it will make her life easier. "It's kind of a nuisance to make sure you take your pills twice a day and do your nose sprays," she says, but the less time spent taking her four allergy prescriptions means more time outside.

Currently, the drug does not have a name and is referred to as R112. Dr. Nelson says the effects of the drug will be similar to nasal steroids, but rather than the normal three to four weeks it takes for steroids to reach maximum effect, the new drug works almost immediately.

If you would like more information, please contact:
William Allstetter
Director of Public Affairs
National Jewish Medical and Research Center
allstetterw@njc.org
(303) 398-1002

Statins may Help Arthritis, Too (June 18, 2004)

(Ivanhoe Newswire)

A new study shows statins may relieve symptoms of rheumatoid arthritis as well as keep cardiovascular disease at bay.

The inflammatory nature of rheumatoid arthritis puts sufferers at an increased risk of cardiovascular disease. Statins, which are cholesterol-lowering drugs, have an anti-inflammatory effect and are well-known for reducing vascular risk.

Researchers from the University of Glasgow in England randomly gave 116 patients either 40 milligrams a day of atorvastatin or a placebo in addition to therapy for rheumatoid arthritis. After six months, patients who received the statin had a small but significant improvement in arthritis symptoms, such as pain and swollen joints.

In an accompanying editorial, Lars Klareskog and Anders Hamsten, from the Karolinska Institute in Sweden, call the study almost too good to be true and warn certain restrictions should be considered before statins can be generally recommended for rheumatoid arthritis. For example, statins may have beneficial effects on certain immune conditions, but they have also been shown to cause deterioration of others.

However, the researchers say the restrictions should not reduce the value of the study. They say, "Instead, the results should encourage more work on effects of different statins in rheumatoid arthritis and in other chronic inflammatory conditions." They mention research has already begun on the effects of simvastatin, also known as Zocor, on multiple sclerosis.
 

SOURCE: The Lancet, 2004;363:2015-2021, 2011-2012

Fruit for Your Eyes? (June 18, 2004)

(Ivanhoe Newswire)

Eating more fruit might help protect the eyes against a leading cause of age-related blindness.

Researchers conducting a large study of men and women find those who consumed at least three servings of fruit a day had a 36-percent lower risk of developing age-related maculopathy than those who ate less than one-and-a-half servings.

Previous studies have linked consumption of antioxidant vitamins and minerals to lower rates of ARM, and a recent study also showed taking high doses of some of these vitamins slowed the progression of the disease in those already diagnosed with it.

These researchers looked at fruit and vegetable intake and vitamin-supplement use among about 77,500 women and 41,000 men taking part in larger health studies. All were at least 50 years old at the beginning of the studies and were followed regularly for more than 12 years.

A comparison of dietary records kept by the participants showed eating fruit was associated with a lower risk of developing the worst form of the disease, neovascular ARM, in both men and women. Interestingly, eating more vegetables did not show the same effect. Neither did intake of any of the individual antioxidant vitamins or carotenoids.

The authors conclude, “Further studies are needed to confirm our findings and to identify the relevant compound(s) in fruits.”

SOURCE: Archives of Ophthalmology, 2004;122

Liposuction Doesn't Remove Health Risks (June 17, 2004)

(Ivanhoe Newswire)

Liposuction removes fat but doesn't remove the risk of diabetes, high blood pressure, and heart disease -- factors linked to excessive weight.

Results of a new study show no changes in insulin sensitivity, blood lipids, blood pressure, or inflammatory markers linked to coronary heart disease after liposuction.

Lead investigator Samuel Klein, M.D., from Washington University School of Medicine in St. Louis, says, "Despite removing large amounts of subcutaneous fat -- about 20 percent of our subjects' total body-fat mass -- there were no beneficial medical effects."

Excess abdominal fat is associated with a defect in insulin's ability to regulate sugar and fat metabolism, which can lead to metabolic diseases, such as type 2 diabetes, abnormal blood lipids, hypertension and heart disease.

Though liposuction appears to have no medical benefits, the study shows the procedure is safe to remove large amounts of fat, up to four times the usual amount of 5 liters.

The study also provides clues about how diet-induced weight loss improves health. Dr. Klein says surgery removes entire fat cells located under the skin but does not reduce the size of remaining fat cells or decrease the fat that accumulates in other tissues, such as in the muscle, the liver and the heart.

Results confirm the best way to lose weight is the old way: Eat less and exercise more.

SOURCE: New England Journal of Medicine, 2004;350:2549-2557

Scientists Target B-Cells to Cure Arthritis (June 17, 2004)

(Ivanhoe Newswire)

Investigators are looking to B-cells for permanent relief for the most common and severe form of arthritis to affect younger people.

Previous research shows antibodies directed against the body's own protein may not only cause inflammation in rheumatoid arthritis but may also create a cycle of ongoing disease. Antibodies are made by B-cells. The idea for the new study was to determine if removing B-cells might cause the cycle, and the disease, to collapse.

Of the 161 patients involved in the study, 43 percent of those who received a short course of B-cell targeted therapy found arthritic symptoms reduced by more than half at the six-month follow-up. In many cases, improvements lasted for at least a year. Only 13 percent of those in the control group who took conventional drugs alone had similar results. Symptoms include joint pain, swelling and stiffness.

Researchers caution permanent relief from a single course of treatment is not yet possible. However, the fact that improvement can last for years suggests that the approach is on the right track. Other studies on different autoimmune diseases, such as lupus, are producing similar results.

Professor Jonathan Edwards, from University College London, explains, "The cycle underlying autoimmune diseases such as rheumatoid arthritis may be similar to a bug in a computer that makes it loop and crash. B-cell targeted therapy is like rebooting the computer of your immune system to sidestep the bug. As is often the case, if you have not removed the bug completely the computer system may crash again."

In addition to permanently breaking the cycle, another challenge is targeting "bad" B-cells without harming useful B-cells. The effect on bad antibodies is greater than on useful antibodies, but useful antibodies may be reduced after repeated treatments.

SOURCE: New England Journal of Medicine, 2004;350:2572-2581

Ethnic Differences in Breast Cancer Screening (June 16, 2004)

(Ivanhoe Newswire)

Mammograms are said to be the best means for decreasing breast cancer deaths in women. While research has found minority women are less likely to have regular mammograms, a new study shows it may not be because of their ethnic differences. The current research finds the differences in mammography rates are based on emotions and beliefs, rather than culture.

Study authors of the current research say there is a lack of understanding regarding exactly what causes ethnic differences for breast cancer screenings. They wanted to know which characteristics to focus on to modify screening behavior in women who do not get regular mammograms.

The study included 1,364 women from six ethnic groups including African-American women, U.S.-born white women, English-speaking Caribbean, Haitian women, Dominican women, and immigrant Eastern-European women. The women were interviewed about their demographics; cognitive variables, such as health beliefs and perceived risks; and their socioemotional variables, such as stress and pain of a mammogram. The women were followed for 10 years.

Researchers report African-American women and Dominican women had a mammogram over the 10 years as frequently as European-American women. However, the remaining minority groups were screened less often. Interestingly, ethnicity no longer predicted screening frequency when researchers took into consideration cognitive and emotional variables.

Study authors call the results encouraging because rather than targeting culture for intervention, they can target emotions and beliefs of different women.

SOURCE: Cancer, 2004;100:2300-2307

Laser Allergy Surgery (June 16, 2004)

DALLAS (Ivanhoe Newswire)

Allergies affect more than 50 million Americans each year. In 38 million people, congestion and post nasal drip lead to more serious problems like chronic sinus infections. Now doctors are turning up the heat on hay fever.

"I was severely congested. Had a lot of pressure, in my head, nose runny, eyes -- runny and itchy." Kathy McFarlane's problem was swollen tissues inside her nose made it hard to breathe.

Linda Potter knows that feeling too. She says, "All of it drains downs into my chest, instead of being able to blow my nose."

Potter hopes that will change.

Otolaryngologist/Head and Neck Surgeon Rajiv Pandit, M.D., uses a powerful laser to shrink nasal tissues called turbinates. He says: "This is the tip that is going to be placed in the nose. The idea is to vaporize some of this tissue as well as to cause a heat injury that, over several weeks, will reduce the size of the turbinate through the body's natural healing process."

The procedure -- called laser sub-mucosal resection -- takes about 15 minutes, and results come quickly.

"People generally feel more alert -- both at home and on the job. People usually sleep better, so they're more refreshed," Dr. Pandit, of Methodist Dallas Medical Center, tells Ivanhoe. He says that's the case in about 70 percent of his patients.

McFarlane had the surgery and finally has relief. She says, "I have not had a single sinus infection since I had the laser turbinate surgery, so it's been a godsend and an answer to many prayers.

Immediate side effects of sub-mucosal resection can include nose bleeds and congestion. People who have allergy symptoms mainly related to nasal congestion, and those who are not helped by prescription drugs, should be good candidates for this procedure.


If you would like more information, please contact:
Dallas ENT and Allergy Center
(214) 946-3687
http://www.dallasentallergy.com

Vitamin C for Arthritis? (June 15, 2004)

(Ivanhoe Newswire)

New research shows consuming large amounts of vitamin C may protect against rheumatoid arthritis.

Researchers from the University of Manchester in the United Kingdom studied 23,000 men and women between the ages of 45 and 74. Participants' diets were assessed by using seven-day-food-intake diaries.

Researchers say 73 participants developed inflammation in two or more joints for at least one month. Results show participants who did not consume large amounts of vitamin C were three-times more likely to develop rheumatoid arthritis, which involves inflammation in the lining of the joints and other internal organs.

Participants with a lower daily intake of fruits and vegetables had about double the risk of developing inflammatory arthritis than participants who consumed large amounts of fruits and vegetables.

Researchers recommend patients consume about 40 milligrams of vitamin C daily.

Study authors conclude, “Low intake of fruit, particularly dietary vitamin C, is associated with an increased risk of developing inflammatory polyarthritis. These results may have implications for the primary prevention of inflammatory polyarthritis.”

SOURCE: Annals of the Rheumatic Diseases, 2004;63:843-847

Sharing Blame for Lung Cancer (June 15, 2004)

(Ivanhoe Newswire)

Everyone knows smoking is the leading cause of lung cancer, but does that mean people with the disease should take all the blame for their condition?

That’s the question researchers set out to investigate with a new survey of lung cancer patients in Great Britain.

Researchers polled 45 patients on their experience with lung cancer and the "blame game." Regardless of whether they smoked or not, most patients felt stigmatized by the disease because of its close link with smoking. What’s more, these feelings of responsibility sometimes led patients to refrain from getting the help with their disease they needed. It also got in the way of relationships with friends and family at a time when the patients needed those relationships most.

Some respondents blamed the media for stigmatizing the disease, while others pointed the finger squarely at the tobacco companies. A few patients were also concerned the bad press surrounding lung cancer and smoking could lead medical researchers to conduct fewer studies aimed at treating the disease.

While noting efforts must still be made to deter young people from smoking, the authors suggest some anti-smoking campaigns, such as those showing “dirty lungs,” may be unduly upsetting people with smoking-related diseases. They believe placing the blame on the global tobacco industry might encourage young people to stay off cigarettes just as well without placing all the responsibility on the shoulders of smokers.

SOURCE: British Medical Journal, published online June 12, 2004

Chemo Bath (June 14, 2004)

PITTSBURGH (Ivanhoe Newswire)

Chemotherapy often leaves cancer patients feeling sick and with a number of other side effects. For some people with advanced cancer, the treatment and all they go through with it may not even get rid of their cancer. Now, doctors are taking a new, more targeted approach to delivering chemotherapy.

Joe Cangey's philosophy about life is simple. "Surround yourself with the people that you care about and that care about you," he says. That became even more important after his oncologist said his colon cancer spread to his liver. "She told me that, with therapy, there'd be a 75 percent chance that I'd last like five years, and without, maybe a 50 percent chance, so I said, 'I'll take the 75.'"

Hoping to improve those odds even more, Cangey went through an experimental procedure called perfusion therapy.

"It's the most aggressive way available to deliver chemotherapy right to the tumor and avoid the toxicity to the rest of the body," says surgical oncologist David Bartlett, M.D., of the University of Pittsburgh Medical Center.

Blood flow to the liver is disconnected from the rest of the body. Heated chemotherapy is delivered and bathes the organ for an hour. "It's a durable treatment and much more successful than chemotherapy that's given through the vein for this disease," Dr. Bartlett says.

Patients treated with perfusion therapy had a 75-percent chance of having their tumor shrink by half. Results lasted up to 16 months.

Dr. Bartlett says, "The ultimate goal is to prolong survival and prolong quality survival, and that, we believe, we're able to accomplish as well."

"If I wake up tomorrow or the next day, and someone tells me this has been a dream, I'll believe them because I feel good," Cangey says.

Perfusion therapy is being used to treat cancers of the liver, abdomen, and lung. Some patients only need one treatment while others need multiple treatments for the procedure to be most effective.

If you would like more information, please contact:
Clare Collins
Asst. Director, News Bureau
University of Pittsburgh Medical Center
collcx@upmc.edu
http://www.upmc.edu

Sleep for Cancer Patients (June 14, 2004)

CHICAGO (Ivanhoe Newswire)

A diagnosis of cancer brings with it a mixture of emotions, and the treatment has its own share of negative side effects like nausea and fatigue. There's another side effect that often goes ignored -- sleeplessness. People with cancer have three-times the risk of sleeplessness as healthy people. Here are some tips to help these patients -- and anyone else struggling to sleep -- get some much-needed rest.

"When it came down to night, I couldn't sleep. No matter how many sheep fly over that bed, it's not going to help," Angel Colon says. Sleeplessness made life a constant struggle for this father of three. "Fifteen, 11 and 5 are not exactly easy ages to deal with, and especially when you're tired," he says, especially when you're battling cancer like Colon.

Sleep Medicine Specialist Gina Graci, Ph.D., from Northwestern University in Chicago, says sleeplessness in cancer patients can be caused by the treatment, the disease or emotions. "Things that they did before that didn't fragment their sleep really affect them now," Graci tells Ivanhoe.

Treatment is not always simple. "One of the treatments, say, for insomnia would be to actually restrict their sleep, and that's not something you want to do," Graci says. "You don't really want to sleep deprive a cancer patient."

So, Graci helps patients make other changes, starting with their daytime routine. She says, "Keep them busy. Schedule things to do. It might be going through bills, helping them get dinner ready." She also says avoid naps and do only neutral activities two hours before bedtime. For many, that means no reading. It's mentally stimulating.

Graci says, "If you can get a cancer patient, or any patient, to sleep better, they'll feel better. They'll respond to treatment, perhaps, better." Colon took that advice and says, "I woke up so energetic the next morning, I didn't know whether to do a back flip, run out of the house screaming, or what."

Graci recommends not using over-the-counter sleep-aids because people often don't use them correctly, and they may become dependent on them. They can also cause oversedation. She says if you are a cancer patient experiencing trouble sleeping, don't ignore the problem. Bring it to your doctor's attention.

If you would like more information, please contact:
Tamara Kerrill
Senior Broadcast Editor
Northwestern University
555 Clark, #243
Evanston, IL 60208
tkl@northwestern.edu
http://www.lurie.nwu.edu

Epilepsy Drugs Linked to Bone Loss (June 14, 2004)

(Ivanhoe Newswire)

Older women who take drugs for epilepsy may be risking bone loss.

That’s the key finding from a new study out of the VA Medical Center in Minneapolis and the University of Minnesota. Researchers tested post-menopausal women and found those on epilepsy drugs were significantly more likely to have lower scores on heel and hip tests to measure bone density than women not taking the drugs.

The loss for women taking the drugs was nearly two-times higher in both the heel bone and the hip. Those numbers held true even after the researchers adjusted their findings to take other factors that could be causing bone loss into account. More than 6,000 women participated in the study.

“If this rate of bone loss is not addressed, the risk of hip fracture for these women will jump by 29 percent over five years,” says Kristine Ensrud, M.D., M.P.H., one of the study’s authors. “Older women taking epilepsy drugs should be screened for osteoporosis and counseled about the importance of getting enough calcium and taking vitamin D supplements.”

The investigators say they are not sure how epilepsy drugs might be leading to bone loss, but they speculate the drugs may impair the body’s ability to metabolize vitamin D or absorb calcium.

SOURCE: Neurology, 2004;62:2051-2057

What Causes Autism? (June 14, 2004)

(Ivanhoe Newswire)

Women who experience complications during pregnancy are more likely to have a child who develops autism, but the complications themselves may not be to blame.

According to a new study, the genes that cause the disease and/or their interaction with the environment are most likely responsible for the autism.

Autism is a developmental disorder characterized by severe impairment in the ability to socialize and communicate with other people. Most people who have the condition are diagnosed around the age of 3 or 4 when they fail to develop normal social and communication skills.

Several studies have shown autism runs in families, leading researchers to believe the disease has a genetic basis. Others have suggested a role for obstetric complications. In this study, Australian investigators looked at medical records for children born with autism between 1980 and 1995, comparing them with their siblings and children from the general population who did not have autism.

Results showed autistic children were more likely to have older parents and to be a firstborn child. Their mothers also had a greater incidence of threatened abortion, epidural anesthesia use, induced labor, and a labor lasting less than one hour. Autistic children were more likely to have experienced fetal distress, have low scores on a standard test to measure functioning in newborns, and have been delivered via cesarean section.

The authors write, “The observed complications are generally nonspecific and cannot predict autism development. This research supports the hypothesis that the development of autism … is dependent on the genotype, and the presence of complications can be explained by a compromised prenatal experience for that genotype.”

SOURCE: Archives of General Psychiatry, 2004;61:618-627

Soda Increases Risk of Diabetes (June 12, 2004)

By Julie Monheim, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire)

New research shows consuming sugar-sweetened soft drinks may increase a woman’s risk of developing type 2 diabetes.

Researchers from Harvard School of Public Health in Boston presented the results of their study at the American Diabetes Association’s 64th Scientific Sessions in Orlando, Fla.

They followed women between ages 26 and 46 for eight years. At the start of the study, none of the participants had diabetes or any other serious illnesses.

Results show women who drank one or more sodas a day gained more weight and were nearly twice as likely to develop type 2 diabetes than those who drank less than one soda a day.

Women who reported drinking more soda gained an average of 10 pounds over the four years, whereas women who reported cutting their soda consumption gained an average of only three pounds. Researchers say weight gain was highest among those who increased their soda consumption from less than one per week to one or more per day.

Researchers say the increased risks for gaining weight and developing diabetes remained significant even after adjusting for other dietary and lifestyle factors. They also say diet soft drinks were not associated with these risks.

Authors of the study conclude, “Increased consumption of sugar-sweetened soft drinks is associated with larger weight gain in women ... High intake of sugar-sweetened soft drinks may furthermore increase risk for developing type 2 diabetes, possibly by providing excessive calories and large amounts of readily absorbable sugars.”

SOURCE: Julie Monheim at the American Diabetes Association’s 64th Scientific Sessions in Orlando, Fla., June 4-8, 2004

Eye Rehab (June 12, 2004)

BIRMINGHAM, Ala. (Ivanhoe Newswire)

Patients diagnosed with low vision are often told nothing can be done. In the past, they were sent home to cope on their own. Today, many are heading to eye "rehab." Here is one program that helps patients overcome their vision loss and make the most of what they do have.

If your vision is failing, Beth Barstow is just the person you want to see. Barstow, an occupational therapist at University of Alabama in Birmingham, is part of a vision rehabilitation team -- doctors, therapists and other specialists who help patients readjust to a life with low vision. "Because we can't bring vision back, we can't make it better, but we can help them use what they have more effectively," Barstow tells Ivanhoe.

For 81-year-old Louise Collier, that means learning to "see" around the blind spot in the middle of her eye caused by macular degeneration. "I go out everyday and crank my car," she says, "but I can't read my Sunday school book. I can't read my bible."

Collier doesn't actually drive, but with the help of a magnifying screen and coaching from Barstow, Collier is rediscovering the words she thought she'd lost forever.

With macular degeneration patients, therapists like Barstow teach someone to move a scar out of the way and use a healthier portion of the retina to be able to read. The team may also make changes in a patient's environment, like installing extra lighting. Patients learn new ways to perform everyday tasks from folding money to distinguish between bills.

"We can get people to a pretty productive, independent lifestyle. The vast majority, we can get them reading independently on their own. It's in a relatively short time that we can get them effectively independent," says Donald Fletcher, M.D., an ophthalmologist at University of Alabama in Birmingham. This team approach that is helping people like Collier stay focused and get on with life.

Patients also receive emotional support to cope with the loss of their vision. Many programs offer counseling and group support sessions. Low vision rehabilitation can help people with macular degeneration, diabetic retinopathy, or glaucoma.

If you would like more information, please contact:
Beth Barstow
UAB Center for Low Vision Rehabilitation
1720 University Blvd. Suite 380
Birmingham, AL 35233
bbarstow@uab.edu

Reducing Unnecessary Cesarean Sections (June 11, 2004)

(Ivanhoe Newswire)

Reducing the high rate of cesarean sections performed in Latin American countries was the objective of a new study published in this week's issue of The Lancet.

The authors explain Latin America has one of the highest -- if not the highest -- cesarean section rate in the world. About 25 percent to 30 percent of all births are delivered via cesarean section. Numerous studies have indicated this is too high a number and is exposing too many women to unnecessary surgery. The World Health Organization’s goal for cesarean section is 15 percent of all births.

In the current study, investigators tested the use of a mandatory second opinion on all non-emergency cesarean section births in 36 hospitals in five Latin American countries to see if it could reduce the high rate of cesareans. The researchers hoped doctors would be more likely to reconsider their decision to deliver via cesarean section if they received a different opinion from a colleague. Their goal was to see the cesarean section rate drop by 25 percent.

The study didn’t reach that goal, but cesarean sections did drop slightly, by 7 percent. Outcomes for mothers and infants didn’t differ regardless of the method of birth.

The authors conclude mandatory second opinions on cesarean births could save 22 out of every 1,000 women from unnecessary surgery.

Writing in an accompanying commentary, British scientists note these findings bode well for women, but may have other implications. “Service providers must balance the potential benefits of a small reduction in cesarean section rates against the wider implications of implementing a mandatory second opinion policy.”

SOURCE: The Lancet, 2004;363:1934-1940, 1921-1922

Is it Asthma, or Just the Weight? (June 11, 2004)

(Ivanhoe Newswire)

Is the shortness of breath often experienced by overweight women asthma or just due to being over weight?

New research in this month’s CHEST suggests it’s just the weight.

Investigators from The Ottawa Hospital and elsewhere studied 58 overweight women who were enrolled in a weight loss program. All were assessed for lung function prior to starting the program and then again three months and six months later. Results showed about a 5-percent improvement on lung function tests for every 10 percent of body weight lost. Women who lost more than 20 percent of their body weight had the greatest improvements. Losing weight, however, had no effect on the hallmark of asthma, which is airway reactivity, in the 24 study participants.

Noting population-based studies have suggested a higher rate of asthma in obese women, the investigators believe the link between poorer lung function and obesity may be leading some women to be diagnosed with asthma when all they really need to do is lose weight.

“Having extra weight compromises all respiratory muscles, making them work harder and less efficiently,” says Shawn D. Aaron, M.D., one of the study’s authors. “As a result, women who are obese may limit their exercise or activity level due to shortness of breath. As women in our study lost weight, less stress was placed on the respiratory system, which ultimately helped them breathe easier and exercise more.”

SOURCE: CHEST, 2004;125:2046-2052

Better Knee Surgery (June 11, 2004)

ORLANDO, Fla. (Ivanhoe Newswire)

Each year, about 250,000 people in the United States undergo total knee replacement surgery, where the knee is replaced with metal and plastic parts. The surgery is highly successful, but the recovery can be long and painful. Now there's an easier, less painful approach.

Peggilou Flick likes to keep things simple, even when it comes to her name. "In high school, I got so lazy, I decided I didn't want to make a capital L, so I combined them both," she say. "That's the way I am."

So when an injury forced her to have a total knee replacement, she looked for the easiest approach available -- minimally invasive surgery. "I said, 'Me. I'm for it.' Anything for, you know, less pain," she says.

Instead of cutting through the muscle, David D. Dore, M.D., simply moves it over. "We're coming underneath the muscles and moving stuff out of the way to get to the knee joint itself," Dr. Dore, a joint replacement surgeon at Florida Hospital Celebration Health in Orlando, tells Ivanhoe.

The less-invasive approach allows for less than a five-inch incision, instead of up to 12 inches. Special instruments are needed fit inside. It's also less painful, so patients are back on their feet more quickly.

Millie Hyde had the surgery eight days ago. She says, "There's no pain in the knee, now, at all."

As far as recovery time is concerned, Dr. Dore says, "What I would expect a six-week patient to look like, they're now looking that way at a week or two."

Also, studies show patients who have the minimally invasive surgery have a better range of motion. "And the invariable comment is, 'My gosh, I should have done this years ago,'" Dr. Dore says.

Just five weeks after her surgery, Flick is back to being active. She says: "People I talked to who had the other surgery, that wasn't less-invasive, they said, 'Oh, how lucky you are.' I said, 'I know.'"

Dr. Dore says pain caused by osteoarthritis is the most common reason patients have total knee replacement surgery. He says about 50 percent of his patients qualify for the minimally invasive approach. Patients who are obese, have very large leg muscles, or those with knock knees are not optimal candidates for this less-invasive approach.

If you would like more information, please contact:
Margaret Gaffney
Joint Replacement Center Coordinator
Florida Hospital Celebration Health
(407) 303-4359
margaret.gaffney@flhosp.org

Blood Thinner Poses Problem for Patients (June 11, 2004)

(Ivanhoe Newswire)

A common blood thinner given to heart attack patients may not work as expected and cause them to be at an increased risk for recurrent blockages. The blood thinner is called clopidogrel (Plavix) and is used to help prevent blood clotting.

Researchers say this is the first study to find an association between clopidogrel resistance and cardiovascular disease. Investigators in Israel conducted the research focusing on heart attack patients who were given the drug.

The study included 60 patients who were treated with angioplasty and stenting after heart attacks. The patients all received chewable aspirin throughout the study. They were also given a high dose of clopidogrel right after angioplasty and smaller doses for three more months. The patients were examined three and six months after being released from the hospital.

Study authors say, in order to measure clopidogrel resistance, they looked at results from a platelet aggregation test. Platelets are disk-shaped blood components that clump together to form blood clots. Patients who are resistant to clopidogrel have a higher score for platelet aggregation.

Researchers split the patients into four groups based on their platelet activity after six days of treatment compared to platelet activity before the drug was given. After six months, researchers found those who did not respond initially had the most recurrent blockages.

While researchers say this study was a small, observational study, they feel further investigation is warranted. Study authors point out that the question of whether an increased dose of clopidogrel could overcome this resistance in patients who do not respond needs to be studied.

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

Exercise OK for Those With Heart Problem (June 09, 2004)

(Ivanhoe Newswire)

Certain genetic heart conditions can put children, teens and young adults at an increased risk for sudden death during physical activity. A new statement published this week helps doctors advise patients about what exercises are safe and which to avoid.

“The impetus of this document is to emphasize that the mere presence of a genetic cardiovascular disease should not be regarded as a reason to be sedentary,” says Committee Chair Barry Maron, M.D., director of Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation. “Instead, this document tries to discern which exercises are preferable and which should be avoided, as well as help clinicians make decisions about how they advise their patients when it comes to recreational exercises.”

The statement does not focus on competitive sports but instead on recreational activities. For example, the statement points out activities that require a burst of energy like sprinting should be avoided. These activities put patients at greater risk of a sudden cardiac event or disease progression. Other examples of activities to be avoided include weight lifting, downhill skiing, diving, and rock climbing. Furthermore, the statement says patients should avoid extreme sports such as hang gliding and bungee jumping.

“There is no simple formula that tells you what to avoid and what not to avoid; but the guidelines offer some prudent recommendations governing recreational activities for patients with known cardiovascular diseases,” says Dr. Maron.

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

Soda Increases Risk of Diabetes (June 09, 2004)

By Julie Monheim, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire)

New research shows consuming sugar-sweetened soft drinks may increase a woman’s risk of developing type 2 diabetes.

Researchers from Harvard School of Public Health in Boston presented the results of their study at the American Diabetes Association’s 64th Scientific Sessions in Orlando, Fla.

They followed women between ages 26 and 46 for eight years. At the start of the study, none of the participants had diabetes or any other serious illnesses.

Results show women who drank one or more sodas a day gained more weight and were nearly twice as likely to develop type 2 diabetes than those who drank less than one soda a day.

Women who reported drinking more soda gained an average of 10 pounds over the four years, whereas women who reported cutting their soda consumption gained an average of only three pounds. Researchers say weight gain was highest among those who increased their soda consumption from less than one per week to one or more per day.

Researchers say the increased risks for gaining weight and developing diabetes remained significant even after adjusting for other dietary and lifestyle factors. They also say diet soft drinks were not associated with these risks.

Authors of the study conclude, “Increased consumption of sugar-sweetened soft drinks is associated with larger weight gain in women ... High intake of sugar-sweetened soft drinks may furthermore increase risk for developing type 2 diabetes, possibly by providing excessive calories and large amounts of readily absorbable sugars.”

SOURCE: Julie Monheim at the American Diabetes Association’s 64th Scientific Sessions in Orlando, Fla., June 4-8, 2004

Got your Diabetes Ph.D.? (June 08, 2004)

ORLANDO, Fla. (Ivanhoe Newswire)

A new tool called Diabetes PHD (personal health decisions) may help patients monitor their risk of developing diabetes and diabetes-related complications.

Researchers say Diabetes PHD is an interactive Web-based technology that allows people with diabetes or those at risk for the disease to make better decisions about their health care. The tool will debut on the American Diabetes Association’s Web site later this year.

Diabetes PHD works by assessing users’ personal health records. Patients are asked to provide information such as their height, race, sex, weight, cholesterol, blood pressure, A1C score, and use of current medications.

The program then uses these factors to calculate a patient’s risk of diabetes, heart attack, stroke, kidney failure, blindness, and amputation. Users have access to their complete risk profile in about five to 20 minutes.

Once patients assess their risks, the program allows them to adjust certain factors to determine how lifestyle changes can affect future risk. For example, patients can see how quitting smoking reduces the risk for certain complications.

Eugene Barrett, M.D., president of the American Diabetes Association, says, “The hope is that after patients see what the future likely holds for them, they can use the tool to learn what steps they can take to live healthier and longer lives.”

Dr. Barrett says Diabetes PHD can also be used by physicians to track and determine certain risk factors for their patients.

Diabetes PHD will be a free tool for patients and physicians. Dr. Barrett says, “It is by far the most exciting tool we will have featured, thus far.”

To visit the American Diabetes Association web site, log onto http://www.diabetes.org.

SOURCE: Julie Monheim at the American Diabetes Association’s 64th Annual Meeting & Scientific Sessions in Orlando, Fla., June 4-8, 2004

Diabetes Treatment Shows Success (June 07, 2004)

(Ivanhoe Newswire)

The results from the first international study of the so-called Edmonton Protocol are in, and they are encouraging. This procedure that transplants islet cells in diabetics with the goal of breaking them free from daily insulin injections appears to be working.

Type 1 diabetics do not make insulin and therefore have to check their blood sugar and inject themselves with insulin daily, often multiple times during the day. The Edmonton Protocol, headed by James Shapiro, M.D., Ph.D., from the University of Alberta, transplants the cells that make insulin. The cells come from cadavers and are purified before being delivered through infusion directly into the portal vein that goes to the liver. Once the cells create a new blood supply they are able to respond to natural fluctuations in blood sugar by making the needed insulin.

In the study of 36 patients, 19 are free from insulin injections one year after their transplant. Five of those achieved these results after only one infusion. Seven others required two infusions, and the other seven required three treatments. Of those who still need insulin, seven have improved control over their condition.

Dr. Shapiro presented the results at the American Diabetes Association’s 64th Annual Scientific Sessions being held in Orlando, Fla., this week. About the findings, he says, “We are delighted that the success of the Protocol has now been replicated internationally in our Immune Tolerance Network trial, in which nine centers in the United States, Canada and Europe have participated over the past four years.”

More than 18 million Americans have diabetes, and more than 1 million have type 1 diabetes. While many of these are able to keep their blood sugar under control, some have an unstable form of the disease that causes wide swings in their blood sugar levels that can prove fatal. These individuals are the ones considered the ideal candidates for islet transplantation. Other inclusion criteria includes recurrent low blood glucose and diabetic complications. Patients must have adequate kidney function to be considered for the study.

Dr. Shapiro points out that this procedure is not a cure for diabetes but an alternative treatment for carefully selected patients. Those who undergo the treatment are required to take potent immunosuppressive drugs for the rest of their lives to eliminate rejection of the cells. The benefit, though, is that they are no longer at risk for the many complications that go along with diabetes.


SOURCE: American Diabetes Association’s 64th Annual Scientific Sessions in Orlando, Fla., June 4-8, 2004

Questioning Surgery in Pregnant Women (June 04, 2004)

(Ivanhoe Newswire)

A common surgical procedure believed to reduce the risk of preterm delivery is now being questioned for its effectiveness.

For the past 50 years cervical cerclage, a procedure to stitch the cervix closed, has been used to reduce the number of premature births.

Kypros Nicolaides, from King’s College Hospital in London, and colleagues studied nearly 250 pregnant women who were screened with ultrasound to identify if they had short cervixes. Women with short cervixes are believed to be at a higher risk of premature delivery. Patients received either cervical cerclage or no surgery.

The data showed a 4-percent difference between the women who had the surgery and the women who had not.

Nicolaides states, “The insertion of a Shirodkar structure [a medical utensil used in the procedure] in women with a short cervix does not substantially reduce the risk of early preterm delivery. Routine sonographic measurement of cervical length at 22 to 24 weeks identifies a group at high risk of early preterm birth.”

SOURCE: The Lancet, 2004; 363:1849-1852

Acne Drug Treats Multiple Sclerosis (June 04, 2004)

(Ivanhoe Newswire)

A drug currently used to treat conditions including acne has been found to decrease the lesions in the brains of people with multiple sclerosis.

Researchers from the University of Calgary in Alberta treated 10 patients with relapsing-remitting multiple sclerosis with the drug minocycline. Patients had a magnetic resonance imaging (MRI) performed before the study and then four weeks later.

Luanne Metz, M.D., lead author of the study, reports that the drug seems to significantly reduce the activity of lesions in the brain. They believe the drug, an antibiotic, works on the immune system of this group of individuals who are known to have immune system malfunctions that trigger the attacks in the nervous system. Dr. Metz says these findings could lead doctors to a new and safe treatment option for patients with MS.

Dr. Metz and colleagues are currently involved in another study looking at the benefits of minocycline when combined with Copaxone, also known as glatiramer acetate, a drug approved to treat MS.

Multiple sclerosis is a chronic, disabling disease that affects one in every 10,000 people. Symptoms vary, but include vision problems, numbness in limbs, balance and coordination problems, and loss of muscular control. Although the disease does not typically lead to death, it can destroy quality of life. There is no cure for multiple sclerosis.

SOURCE: Annals of Neurology, 2004;55:756