Fertility Hope for Cancer Patients (December 2, 2002)
(Ivanhoe Newswire) -- Two new studies offer hope for preserving fertility for males after cancer treatment. Doctors say patients often have to choose a treatment that may save their life, but ruin their chances of fathering their own children. Both of these studies focus on children as young as age 12.

In one study, Japanese researchers bred mice from frozen immature testicular tissue taken from one mouse and matured in another. Their research also resulted in a rabbit born after maturing testicular tissue in a mouse. To achieve both outcomes, the doctors froze and thawed immature pieces of testicular tissue from immature mouse testes and then placed them into another animal to allow the tissue to mature. It then took over the process of sperm making and 62 mice were born from 123 embryos.

One of the researchers is quoted as saying, "Fertility protection is an urgent clinical problem for very young male cancer patients who undergo chemotherapy or radiotherapy."

In a second study from the UK, doctors determined more than 85 percent of boys ages 12 and up were able to produce a sperm sample suitable for freezing. The researchers say adult patients are often offered cryopreservation as an option for preserving fertility for the future. However, not much has been know about the quality of sperm from adolescent boys.

Both research studies offer hope for the thousands of young boys and men who undergo cancer treatments each year. The researchers are hopeful this will open the door for many more physicians to approach their patients with an option for preserving fertility.

SOURCE: Human Reproduction, 2002;17:3157-3161

Diet Linked to Risk of Chronic Diseases (December 2, 2002)
(Ivanhoe Newswire) -- Researchers have found dietary intake may be an important regulator of high iron stores in the elderly. High body iron stores may increase the risk of several chronic diseases.

Researchers say supplemental iron, red meat, and fruit promote high iron stores. Foods that contain phytate, like whole grains, decrease these stores.

As part of the Framingham Heart Study, researchers in Boston examined the link between diet and the risk of high iron stores in 614 seniors ages 68 to 93. The risk of high iron stores was significantly higher in participants who took 30 mg or more of supplemental iron than in nonusers. The risk of high iron in participants who consumed more than 21 servings of fruit per week was three times higher than participants who consumed less than 14 servings of fruit per week.

Researchers also found the risk of high iron in participants who consumed between four and seven servings of red meat per week was three times higher than in participants who consumed four servings or less per week. Participants who consumed seven or more servings per week had nearly four-times the risk.

Participants who ate more than seven servings per week of whole grains had a lower risk of high iron stores. Fiber was also associated with a lower risk.

Based on their findings, researchers suggest modifying dietary patterns and say unprescribed use of supplemental iron by elderly Americans on a Western-style diet is unnecessary.

SOURCE: American Journal of Clinical Nutrition, 2002;76:1375-1384

What's Your Nutrition IQ? (December 2, 2002)
(Ivanhoe Newswire) -- We may very well have more variety in the foods we eat than even before. People often eat without knowing much about the nutritional content of food. Even if you are concerned with the nutritional content, you may not be eating what you think you're eating. 

Food is an everyday part of life, but how much do we know about what we eat? We put people to the test. True or false: Vitamin D is a vitamin.

Not so fast. It's really a hormone that offers bone protection.

Next question: Is there more calcium in skim, 2 percent or whole milk?

Nutritionist and registered dietician Cynthia Thomson, Ph.D., R.D., of the University of Arizona in Tucson, says skim milk has the most. "With each incremental drop in fat content, we see a slight (10 milligram) increase in calcium."

Do cottage cheese and cream cheese have more, less, or the same amount of calcium as regular cheese?

"Cottage cheese and cream cheese have very low amounts of calcium in them," says geriatrician Evan W. Kligman, M.D., also of the University of Arizona. Cheeses like Colby and mozzarella have more.

True or false: All wheat bread is a good source of fiber.

Dr. Kligman says, "Most wheat bread is just white bread with a little bit of coloring."

"If it's not a whole grain, it's not going to be high in fiber," says Thomson.

What's healthier: butter or margarine?

Dr. Kligman says, "The nod probably now is that butter might be a little more natural, a little bit healthier.

Finally, which type of sugar is more nutritious? Table sugar, fructose or honey?

"Basically, they're all providing about four calories per gram and there's not a lot of difference in how they're metabolized, says Thomson.

Another tip experts add is that calcium is better absorbed when taken with citrus, like orange juice. Also, your body doesn't absorb all of the calcium in supplements. You may be only getting about a quarter of what the dose really says you're getting.

If you would like more information, please contact:

Jean Spinelli
Office of Public Affairs
University of Arizona Health Sciences Center
PO Box 245045
Tucson, AZ 85724
(520) 626-2531
jspinell@u.Arizona.edu

Chronic Fatigue Linked to Stress (December 2, 2002)
(Ivanhoe Newswire) -- A new study gives doctors a better understanding of a disease with many unanswered questions surrounding it. The study indicates chronic fatigue syndrome (CFS) may be linked to subtle changes in the hormonal stress response system called the HPA axis.

A stable and functioning hypothalamus-pituitary-adrenal, or HPA axis, helps the body maintain smooth functioning under stress. The process to maintain control is lengthy and problems can occur at any point. The researchers in this new study suggest a problem in the process may be the cause of chronic fatigue syndrome.

CFS is a mystery to many patients and physicians. Patients report intense fatigue, muscle aches, and sleep problems. Doctors often run numerous medical tests and come out with no definitive cause. The authors of this study recruited 40 volunteers (half with CFS and half without) to take psychosocial stress tests, physical stress tests, and undergo other medical tests. The researchers then compared the results of all the tests.

They report significantly lower response levels of one of the HPA hormones among patients with CFS. The CFS patients had lower levels of the hormone prior to testing and after testing. The doctors say this research is early, but hope it will lead to further understanding of this complex disease.
SOURCE: Psychosomatic Medicine.

Exercise cuts inflammation-related protein in blood (December 2, 2002)
(Reuters Health) - Exercise is good for you for a number of reasons, and now researchers think they have found yet one more. Men who are physically fit tend to have lower levels of a protein linked to body-wide inflammation, new research reports.

People with high levels of this protein, known as C-reactive protein (CRP), appear to have a higher than average risk of cardiovascular disease. Indeed, a recent study suggested that testing for CRP could be an even better predictor of heart attack than high cholesterol.

The findings of the new study could help explain why exercise is so beneficial, said study author Dr. Timothy S. Church of The Cooper Institute in Dallas, Texas.

"We know exercise is good for you," Church told Reuters Health. Reducing CRP levels in the body "is one of the potential mechanisms" as to why exercise helps reduce a person's risk of heart disease and a host of other cardiovascular problems, he added.

During the study, Church and his colleagues measured fitness and CRP levels in 722 men. To determine how fit each man was, the researchers asked him to walk on a treadmill of increasing incline for as long as he could. They reasoned that the more fit a man is, the longer he could stay on the treadmill.

The investigators found that men who were the fittest also tended to have the lowest levels of CRP in their bodies, while those deemed the least fit were more likely to show the highest levels of CRP. The relationship between CRP levels and exercise remained even after the researchers eliminated other factors, such as age and obesity.

Specifically, the authors discovered that people who were in the second-to-lowest category of fitness were 57% less likely to have elevated CRP levels, relative to those who were the least fit of the group. The risk of elevated CRP decreased incrementally with increasing fitness, with those who were the most fit appearing to be 83% less likely to have high CRPs than the least fit men.

Church and his team report their findings in the November issue of Arteriosclerosis, Thrombosis, and Vascular Biology, a journal of the American Heart Association.

In an interview with Reuters Health, Church explained that, in women, the relationship between CRP and physical activity is likely similar, but somewhat more complicated. "I think the results will be the same," he said, but might appear less clear because of the dramatic hormonal changes women experience during menopause. For instance, he said, menopause can increase levels of CRP in a woman's body, and hormone replacement therapy can boost CRP even further.

"The main benefit is just getting out of that lowest fitness group," Church added, meaning that the biggest drop in risk of elevated CRP levels in the body occurs between the people who are the least fit, and those who are only moderately more in shape. To graduate to the next-highest level of fitness, the researcher recommended moderate physical activity for 30 minutes each day--even accumulated in bits and pieces, and not all at once--for 5 days a week. And one easy way to get that exercise: walking, he said.

"It's free, you can do it anywhere, you don't need any special equipment," he said.
"Just accumulate those steps throughout the day," Church advised.
SOURCE: Arteriosclerosis, Thrombosis, and Vascular Biology 2002;22:1869-1876.

Prostate Cancer and Vitamins (November 29, 2002)
(Ivanhoe Newswire) -- Overloading on vitamins and minerals may put prostate cancer patients' health at risk, according to new research published in the December issue of the International Journal of Radiology Oncology, Biology and Physics. 
Researchers say tens of thousands of prostate cancer patients self-administer vitamins and minerals, and use untested medical therapies in doses that multiply the daily recommended doses of these substances. Patients take these alternative therapies in hopes of helping their health but inadvertently endanger their health due to the drug interactions of the vitamins and minerals and prescribed cancer therapies. 

Researchers evaluated a case where a prostate cancer patient consumed large doses of various vitamins and minerals on a daily basis without telling his physician. The patient had been consuming 2,250 mg of niacin a day. The recommended dose for niacin is only 12 mg to 20 mg a day. Large doses of niacin mixed with preoperative antibiotics the patient was taking for a brachytherapy procedure put the patient at risk for hemorrhage during the procedure. 

Anthony V. D’Amico, M.D., Ph.D., from Brigham and Women’s Hospital and Dana-Farber Cancer Institute, says, “This case illustrates the need for a heightened sense of awareness among patients and physicians regarding how the excessive use of vitamins and minerals or the use of untested medicines can have a negative impact on a patient's health.” He adds, “Patients and physicians must work together to disclose and discern whether self-administration of unregulated medication is occurring, and, if so, what interactions should be anticipated.” 

SOURCE: To be published in an upcoming issue of the International Journal of Radiology Oncology, Biology and Physics

Mercury Increases Heart Risk (November 28, 2002)
(Ivanhoe Newswire) -- Too much fish and fish oil may not be good for the heart after all. Researchers from Johns Hopkins report mercury is directly associated with a risk of a heart attack. They say it may be smart to eliminate fish with high mercury levels altogether.

Mercury exists in several forms, but eating fish is the main source for exposure by humans. Fish that include high levels of mercury are swordfish, shark, tilefish, king mackerel and fish from contaminated waters. Frozen tuna, marlin and red snapper have moderate levels of mercury. Pregnant women and children are regularly advised to avoid these fish because the high levels can be harmful to fetuses. Now that precautionary net may be cast wider.

Previous research has suggested a possible risk; this study confirms it. Close to 1,400 men took part in the study. Half had a heart condition; half were healthy. They study showed those patients with a heart condition had mercury levels that were 15 percent higher than the control group.

The authors of the study write, "Although it is believed that fish intake may reduce the risk of cardiovascular diseases, current epidemiologic studies of fish intake or fish oil levels and coronary heart disease in the general population are contradictory." They suggest the mercury levels may counteract the beneficial omega-3 fatty acids.

At this time researchers do not recommend people stop eating fish altogether. They suggest you choose fish with lower levels of mercury and try to aim for a weekly intake of no more than two to four servings. Salmon and small oceanic fish appear to be the safest.

SOURCE: New England Journal of Medicine, 2002;347:1747-1754

Say "Nuts" to Diabetes (November 28, 2002)
(Ivanhoe Newswire) -- Just say "nuts" to diabetes, advises a new study by Harvard researchers. The study showed women who consume peanut butter or other forms of nuts five or more times a week have a 27-percent lower risk of getting the disease.

Diabetes is reaching epidemic proportions, affecting about 16 million people in the United States and 135 million people worldwide. By 2025, more than 300 million people are expected to be diagnosed with the disease, which can lead to numerous complications, including blindness and amputations.

Studies have shown changes in diet can significantly modify the risk for diabetes, and evidence suggests unsaturated fats, such as those found in nuts, may be beneficial for controlling blood sugar and insulin, as well as lowering the risk of heart disease. These researchers looked at the effect of nut consumption on diabetes risk among more than 83,000 nurses taking part in the Nurses' Health Study. All completed a dietary questionnaire in 1980 and were then follow-up for the next 16 years. At that point, about 3,200 of the participants had developed type 2 diabetes.

Results on peanut butter and other nut consumption were gathered for the group, with participants classified into one of four categories: never/almost never eaten, eaten less than once a week, eaten one to four times per week, and eaten five or more times a week. Researchers found no change in diabetes risk among the never/almost never eaters. Those who ate peanut butter or nuts less than once a week reduced their risk by 8 percent. Those who consumed the products one to four times a week saw their risk drop 16 percent, and those who ate nuts or peanut butter five or more times a week had a 27-percent lower risk. The findings held true even after researchers adjusted the results to consider other diabetes risk factors.

Although the researchers note peanut butter and nuts are high in calories, they believe these products can and should play a larger role in healthy diets. "Given the observed inverse association between nuts and risk of coronary heart disease as well as type 2 diabetes, it is advisable to recommend regular nut consumption as a replacement for refined grain products or red or processed meats, which would avoid increasing caloric intake," they write.

SOURCE: Journal of the American Medical Association, 2002;288;2554-2560

Folic Acid and Heart Disease (November 26, 2002)
(Ivanhoe Newswire) -- Doctors say patients may be able to lessen the risk of heart disease, vein problems, and stroke by taking folic acid. The new study appears in this week's issue of the British Medical Journal.

Researchers speculated if folic acid decreased the level of an amino acid called homocysteine in the blood, it could reduce some of the dangers of heart disease. They relied on a theory that links increased homocysteine levels to heart disease. The researchers studied more than 100 previous studies that linked homocysteine and heart disease.

Folic acid can be taken via tablet and is available to the public as a nutritional supplement. After reviewing previous studies, researchers believe folic acid could reduce the risk of heart disease by 16 percent, blood clots in the veins by 25 percent and stroke by 24 percent.

Folic acid is already pushed heavily to women of childbearing age and pregnant women. It has been shown to lower the risk of birth defects. The researchers hope folic acid will eventually be seen as a way to reduce death from heart disease or stroke. They write, "Folic acid could be taken as tablets by high risk patients, and possibly supplied to the general public through food fortification or a combination of both."

SOURCE: British Medical Journal, 2002;325:1202-1206

FDA Approves Teriparatide to treat Osteoporosis (November 26, 2002)
FDA has approved teriparatide for the treatment of osteoporosis in postmenopausal women who are at high risk for having a fracture. The drug is also approved to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk for fracture.

An estimated 10 million Americans - 80 percent of them women - suffer from osteoporosis, a progressive thinning of bones that may lead to an increased risk of spine, wrist, and hip fractures. 

Teriparatide is the first approved agent for the treatment of osteoporosis that stimulates new bone formation. Teriparatide is administered by injection once a day in the thigh or abdomen. The recommended dose is 20 mcg per day. 

Teriparatide is a portion of human parathyroid hormone (PTH), which is the primary regulator of calcium and phosphate metabolism in bones. Daily injections of teriparatide stimulate new bone formation leading to increased bone mineral density.

Drugs approved to treat osteoporosis must be shown to preserve or increase bone density and maintain bone quality. The effects of teriparatide on bone mineral density and fractures were studied in 1,637 postmenopausal women with osteoporosis who were treated for a median time of 19-months and 437 men with primary or hypogonadal osteoporosis who were treated for ten months. Patients treated with 20 mcg of teriparatide per day, along with calcium and vitamin D supplementation, had statistically significant increases in bone mineral density (BMD) at the spine and hip when compared to patients taking only calcium and vitamin D supplementation. Clinical trials also demonstrated that teriparatide reduced the risk of vertebral and non-vertebral fractures in postmenopausal women. The effects of teriparatide on fracture risk have not been studied in men.

In animal studies with teriparatide, there was an increase in the number of rats developing osteosarcoma, a 
rare but serious cancer of the bone. In the human studies,no osteosarcomas were reported, but the possibility that humans treated with teriparatide may face an increased risk of developing this cancer cannot be ruled out. This safety issue is highlighted in a black box warning in the drug's label for health professionals and explained in a brochure, called a Medication Guide, for patients. To help ensure that patients are aware of important information about teriparatide, the Medication Guide will be distributed by the pharmacist each time the drug is dispensed. Because people with growing bones (i.e., children and adolescents) and people with Paget's disease of the bone have a higher risk for developing osteosarcoma, it is important that they not be treated with teriparatide. 

Most side effects reported in association with teriparatide in clinical trials were mild and included nausea, dizziness, and leg cramps. During the clinical trials, early discontinuation due to adverse events occurred in 5.6% of patients assigned to placebo and 7.1% of patients taking teriparatide.

Persons with hypercalcemia, women who are pregnant or nursing, or persons who have ever been diagnosed with bone cancer or other cancers that have spread to the bones, should not use teriparatide. Because the effects of long-term treatment with teriparatide are not known at this time, therapy for more than 2 years is not recommended. 

Teriparatide is manufactured by Eli Lilly and Company of Indianapolis, Ind., and will be marketed under the trade name Forteo.

FDA clears device to heart fibroids (November 26, 2002)
The Food and Drug Administration (FDA) has cleared the use of a medical device to treat uterine fibroids (benign uterine tumors) by shrinking them instead of surgically removing them. This procedure could save many women from having myomectomies (surgery to remove fibroids that leaves the uterus intact) or hysterectomies (surgery to remove the uterus).

The device is intended to treat symptomatic uterine fibroids in women who no longer intend to become pregnant.

Many women have fibroids without any symptoms and do not need treatment. However, in many other women, fibroids cause heavy bleeding, severe pelvic pain, cramps and frequent urination. These women are currently treated with medication or surgery. The newly cleared use of the device provides another option for these women.

The device is a material called Embosphere Microspheres, made by Biosphere Medical, Inc., of Rockland, Mass. It is used in uterine artery embolization (UAE), a less invasive procedure than surgical removal of fibroids. Embolization is the introduction of an agent into an artery to block blood flow.

In UAE procedures, a catheter is inserted into the femoral artery in the groin. After the catheter is moved to the appropriate location using x-ray video for visualization, the tiny embolic particles are injected through the catheter into the bloodstream just above the fibroid, cutting off its blood supply. Over a period of days to weeks, the fibroids tend to shrink. The embolic particles remain in the body permanently.

FDA cleared the device for UAE based on a clinical study of its safety and effectiveness conducted by Biosphere Medical. FDA also reviewed data on UAE procedures in the medical literature, in FDA's problem reporting database, and in a patient registry maintained by the Cardiovascular and Interventional Radiology Research and Education Foundation.

In the clinical study, 132 women who had problems with uterine fibroids were treated with the Embosphere Microspheres at seven medical centers in the United States. After six months, 65 percent of women had experienced a 50 percent or more reduction in bleeding. All had significant pain requiring intravenous or oral pain medication for one or two days following the procedure, and in four cases the pain persisted beyond that period. Six percent of women (6%) experienced an allergic reaction during or following the procedure. These reactions were generally judged by the treating physicians not to be related to the embolic particles. Nine percent of women experienced either no improvement or a worsening of their bleeding following UAE.

FDA's decision to clear the product for this new use was based on six months follow up, but it is not known whether or how often the fibroids will return after the procedure. Biosphere Medical will continue to follow the patients from the study for at least three years to address this question.

FDA's review of medical literature, the agency's problem reports, and the patient registry highlighted several other, more serious, risks from UAE procedures. These include premature menopause, stoppage of menstrual periods, pelvic infection, destruction of the uterus, hysterectomy, pregnancy complications and delayed diagnosis of uterine cancer that would have been detected sooner if the patient had undergone surgery. In addition, there have been four reported deaths following UAE out of 25,000 to 30,000 procedures performed worldwide. The incidence of these complications is relatively low, but they are nonetheless significant.

FDA's review also showed that women who have hysterectomies or myomectomies also face a small risk of significant complications.

An estimated 600,000 hysterectomies are performed in the U.S. annually, and at least one-third are for fibroids.

Although embolization procedures have been performed for more than 25 years, the Embosphere Microspheres material is the first embolic agent to be cleared specifically for uterine fibroid embolization. Two years ago, FDA cleared this device for two other types of conditions (arteriovenous malformations and hypervascular tumors). FDA's latest decision gives an additional indication, that of treating symptomatic uterine fibroids.

Cream Treats Sun Damage (November 25, 2002)
(Ivanhoe Newswire) -- A new topical medication can effectively treat signs of aging due to repeated exposure to the sun, report researchers in this month's Archives of Dermatology. 

In a long-term study of tazarotene cream, researchers found the treatment successfully reduced fine wrinkling and mottled skin in more than 50 percent of those tested, and it continued to show additional benefit as the length of use increased.

Ultraviolet radiation from the sun is known to have numerous ill effects on the skin, leading not only to the typical signs of aging, but also to skin cancer. Tazarotene has been shown in several studies to reduce these effects, but none have tested the treatment for longer than six months. These researchers measured the safety and effectiveness of the cream in a 24-week study, which was followed by an additional 28-week period in which participants were allowed to continue using the cream while being followed by the investigators.

In the first study period, about 560 subjects were assigned to receive either 0.1 percent tazarotene cream or treatment with a placebo cream for comparison purposes. All applied the creams on their faces once a day. Researchers then assessed each for various measures related to skin health. About 20 subjects in the tazarotene group dropped out due to skin irritation, compared to one in the placebo group. Blood levels of the medication, however, remained in the acceptable range.

After the initial 24-week period, all participants were offered the active treatment, and as of the one-year follow-up, the beneficial effects of the cream had yet to level off in the subjects. The authors write, "Efficacy was further improved with continued treatment and had not plateaued after 12 months, suggesting that additional efficacy may be achievable with longer-term treatment."

SOURCE: Archives of Dermatology, 2002;138:1486-1493

Young Adults and High Blood Pressure (November 21, 2002)
(Ivanhoe Newswire) -- Impatient? In a time crunch? Young adults may want to re-think how they handle the feeling of being pressed for time. According to new research, time urgency/impatience, or TUI, among young adults may increase the risk of high blood pressure for in later years. 
TUI is associated with an unhealthy lifestyle that includes smoking drinking, high hostility and little social support. Along with competitiveness, tenseness and aggression, TUI is also a marker for a Type A behavior pattern. Previous studies have analyzed health problems associated with different Type A personality traits, however, this new study is the first to investigate the link between TUI and high blood pressure. 

In the study, 3,142 participants ages 18 to 30 were tracked for 15 years by researchers from Northwestern University, the University of Pittsburgh, and the University of Alabama at Birmingham. Researchers tested TUI levels of the participants at the beginning of the study and two years later. Anyone with high blood pressure was excluded from the study and the rest of the participants were followed for 13 years. 

Researchers found that participants with high TUI levels at the beginning of the study were more than twice as likely to have high blood pressure as compared to participants with low TUI levels. LiJung L. Yan, Ph.D., of Northwestern University in Chicago, says: “Our findings indicate that TUI assessed during young adulthood is associated with increased risk of hypertension years later. In general, the stronger the feeling of impatience and time pressure, the higher the risk of developing hypertension in the long term.” 

SOURCE: American Heart Association's Scientific Sessions 2002, Chicago, Nov. 17-20, 2002

Option for Healing Broken Bones (November 21, 2002)
(Ivanhoe Newswire) -- Research shows an alternative treatment can help mend slow-to-heal broken bones.

At the American Academy of Orthopaedic Surgeons Orthopaedics Update 2002 Web conference, Fred Ritchie Trew Nelson, M.D., from Sharp Memorial Hospital in San Diego, explained that physical fields include specific magnetic, electrical and sonic fields applied to an area of bone fracture healing. Physical field treatment is based on the concept of natural physiologic events that already exist in our bodies. It is natural for bone to bend slightly under normal physiological forces. This bending causes small electrical charges. When a bone breaks, blood vessels are broken and bleeding around the bone occurs. Cells in the immediate neighboring tissue send out chemical messages that, within days, incite a large number of small vessels to grow into the fracture area.

Under proper conditions for healing, the cells will divide and form different connective tissues such as cartilage and bone. If this process is delayed or does not happen, a physical field applied at the point can be used to stimulate increased calcium, which appears to be essential in healing the bone.

Physical field therapy is not widely used. Dr. Nelson says: "It's not new technology, in fact physical field stimulation has been shown to heal broken bones in documented cases dating all the way back to 1812." He says one reason it is not widely used is because few studies have been done on return rates to work and specific activities. Another factor is cost. However, Dr. Nelson says the benefits outweigh the costs and there are no side effects.

About 6 million people in the United States each year experience bone fractures. Of these, about 300,000 are slow to heal or do not heal at all with standard treatment.

SOURCE: American Academy of Orthopaedic Surgeons Orthopaedics Update 2002 Web conference, Oct. 16, 2002

Patch Treats Depression (November 18, 2002)
(Ivanhoe Newswire) -- A patch with the drug selegiline is effective in treating adults with major depression, according to new research.

Traditional monoamine oxidase inhibitor (MAOI) antidepressants have proven effective but are not used often because they can increase a person's sensitivity to certain foods such as cheeses, which can lead to severe migraines. Transdermal selegiline delivers the drug via a patch.

Researchers from McLean Hospital in Boston and the University of Pennsylvania in Philadelphia conducted the study to see if transdermal selegiline is effective for depression. They assigned 177 adult outpatients with major depressive disorder either transdermal selegiline or placebo for six weeks. The patients restricted their diet to not include the foods with which MAOIs cause sensitivity. Researchers then rated their depression levels using two different scales.

The study showed those on selegiline achieved a 46-percent greater improvement than those on placebo on one of the scales used. A second testing scale showed those on the drug showed a 79-percent improvement over those on placebo. The researchers say the differences in improvements between the drug group and the placebo group were clear as early as week one.

Overall, researchers say selegiline was well tolerated and there were no major differences between the drug and placebo group when it came to adverse effects. The only side effect was a reaction on the skin where the patch was put seemed to be more common with those receiving the drug than the placebo.

Researchers conclude transdermal selegiline may offer an effective alternative to currently available antidepressants for adults with major depressive disorder.

SOURCE: The American Journal of Psychiatry, 2002;159:1869-1875

Exercise Improves Life in the Elderly (November 18, 2002)
(Ivanhoe Newswire) -- Study after study points to the health benefits of exercise. Now, a new study shows older people who engage in aerobic activities are less likely to develop disabilities and have lower mortality rates.

Researchers from Stanford University School of Medicine studied 370 members of a runners club, all of whom were 50 and older, and 249 community members, ages 50 to 72, who did not belong to a running club.

After the 13-year follow-up, researchers found significantly less disability among the members of the runners club and community members who ran on their own compared to community members who never ran. Researchers also found a much slower rate of progression to various levels of disability among the runners, signaling a delay in disability for several years. Community participants had more than three times the rate of death than runners club participants, with higher death rates in every disease category.

Authors of the study write, this study "...Suggests that in individuals with healthy lifestyles, disability can be postponed until a few years before death, when it develops at an increasing rate." The authors add, "The postponement of disability seen herein, even to minimum levels of impairment, is significant and compels us to consider the role of exercise in the elderly population as an important element of a disability-free life."

Previous studies show aerobic exercise may increase longevity by increasing muscle strength, cardiovascular reserve, bone mineral density, and glucose tolerance.

SOURCE: Archives of Internal Medicine, 2002;162:2285-2294

Obesity Independently Linked to Heart Disease (November 15, 2002)
(Ivanhoe Newswire) -- A new study gives overweight women one more important reason to lose weight. The research shows obese women are more likely to have thickening buildup in their carotid arteries, which is a sign of impending heart disease.

The association between obesity and atherosclerotic disease has been controversial. While past research has linked obesity and damage to the heart, it has not been clear if obesity has an independent effect on the carotid arteries. The carotid arteries are in the neck and supply blood to the brain. Researchers from the Progetto ATENA study, an ongoing study of chronic diseases in more than 5,000 middle-aged women from southern Italy, conducted research to examine the relationship between carotid arteries and obesity.

For the study, 310 women had ultrasound testing to examine their intima-media thickness (IMT), which is the lining and middle muscle layers of the carotid artery. Researchers then compared body mass index and waist-to-hip ratio to the health of the carotid arteries.

Researchers found a significant association between obesity and the level of wall thickness in the carotid artery. This association remained even after adjusting for other factors such as age, blood pressure and cholesterol. Specifically, researchers report lean women had an average thickness in the artery of 0.94 millimeters, overweight women had an average of 0.98 millimeters, and obese women had an average of 1.02 millimeters. Researchers say it is clear that obesity is associated with carotid artery wall thickening in middle-aged women.

Study author Paolo Rubba, M.D., from Federico II University, comments: "Controlling blood pressure is not enough to prevent the cardiovascular damage from being overweight. Doctors should face the difficult challenge of encouraging patients to lose weight to prevent premature atherosclerosis and stroke." The results also suggest ultrasound screening in obese women could help identify those at high risk of a heart problem.

SOURCE: To be published in an upcoming issue of Stroke

Predicting Women's Heart Problems (November 14, 2002)
(Ivanhoe Newswire) -- Twenty years ago, 246 risk factors for coronary heart disease were identified, and that list continues to grow. Researchers from Brigham and Women's Hospital and Harvard Medical School say the C-reactive protein level may be another predictor of future cardiovascular problems, but not everyone agrees.

In response to acute injury, infection, or other inflammatory stimuli, the body releases C-reactive protein (CRP). Studies have shown a positive association between CRP and coronary artery disease. In the current study, researchers looked at CRP and LDL, or "bad" cholesterol levels as a predictor for future heart problems in women.

The study included 27,939 healthy American women who were followed for eight years. Researchers recorded heart attacks, strokes, or deaths from cardiovascular causes. At the beginning of the study, the women's CRP and LDL cholesterol was noted. Researchers used these measurements to determine if they were associated with future heart health problems.

Researchers adjusted for age, smoking status, diabetes, levels of blood pressure, and hormone replacement therapy. After making these adjustments, they found women with higher CRP levels were more likely to have a coronary event. According to the American Heart Association, an optimal LDL level is below 100. An LDL level between 100 and 129 is near or above optimal, while a level between 130 and 159 is considered "borderline high." Seventy-seven percent of the health problems occurred among women with LDL cholesterol levels below 160 mg per deciliter, and 46 percent of the health problems occurred among women with an LDL cholesterol level below 130 mg per deciliter. Researches say CRP and LDL cholesterol measurements identified different high-risk groups, however they say CRP is a stronger predictor of cardiovascular events than LDL cholesterol level.

In an accompanying editorial, Lori Mosca, M.D., Ph. D., from Columbia University in New York agrees there is evidence to support an association of higher levels of CRP with an increased risk of cardiovascular disease. However, Dr. Mosca writes, "The predictive power of this association is markedly diminished when adjusted for other risk factors. Any clinical significance of the added value of C-reactive protein over conventional markers of coronary heart disease is debatable."

SOURCE: The New England Journal of Medicine, 2002;347:1557-1564 and 1615-1616

New Migraine Meds (November 14, 2002)
(Ivanhoe Newswire) -- Living with chronic pain can be debilitating. That's what 28 million people with migraines deal with, sometimes on a daily basis. Now preventing those migraines is becoming more realistic. 

At 56, Miriam Escobar is back in school studying for a business degree. She says, "I graduated in Cuba just before I came to this country. Due to the government, however, I never could get my degree out."

What also slowed her down, though, were excruciating migraines. "Sometimes they were so severe that I ended up in the hospital," Escobar tells Ivanhoe.

Clinical Neurologist Priscilla Potter, M.D., Ph.D., from the University of Miami School of Medicine, tells Ivanhoe, "Some people will be left without a job because of their headaches. It can be that debilitating for them."

Miriam finally got relief with the help of Dr. Potter.

"I have patients who will doctor shop for medicines," says Dr. Potter. "I also have patients who will hoard medicine," she says.

Previous migraine drugs worked to treat the migraine at the time of the attack.

Dr. Potter says, "Probably in the last five years or so, we started focusing more and more on prevention."

The newer preventive medications, such as Topomax, Depakote, Keppra and Zonegran, are a different class of drugs.

Dr. Potter says, "As we developed more and more anti-epileptic medicines, we noticed in the patients that had epilepsy and also headaches that their headaches got better."

"Now I can say, 'It's been two months without a migraine,'" says Escobar. "It's wonderful."

Now she's focused on business problems, instead of migraines.

Patients who are on the preventive medications say they have a migraine once every few months, instead of every few days. When a migraine does occur, doctors prescribe medications such as Maxalt and Zomig to immediately treat the pain.

Which Sperm are Successful? (November 11, 2002)
(Ivanhoe Newswire) -- Until now, it's been anyone's guess as to which sperm will reach a female egg first. Now, research suggests the female is largely in control. Researchers from Syracuse University report the conditions in the female reproductive tract determine which sperm will grow and succeed.

One of the scientists, Scott Pitnick, has published multiple works on the topic of sperm. In 1995, he first wrote about the largest sperm cell known to scientists. It came from a fruit fly and, when unrolled, spread to two inches. It has always been thought sperm are more likely to be plentiful, rather than large in size. This research was aimed at understanding how some species develop large sperm.

Researchers found all males competed equally well within females that had short sperm-storage organs. However, among females with longer sperm-storage organs, the longer sperm out-competed their less endowed rivals. The findings of this research indicate longer sperm are able to compete better within the female reproductive tract because of the length of the tract. Pitnick writes: "This means that the length of the sperm-storage organ is a mechanism dictating female choice among potential sires of her offspring. Females choose among males based on the length of their sperm. Long sperm tails are thus the post-copulatory, cellular equivalent of long peacock tail feathers."

It is important to point out the research was conducted in a species of fruit fly called Drosophila melanogaster.

SOURCE: Science, 2002;298:1230-1233

Mental Health Therapies for Chronic Conditions (November 11, 2002)
(Ivanhoe Newswire) -- New research shows certain mental health interventions may help patients with chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain, three common somatic conditions.

Researchers from the West Middlesex University Hospital in London tested the effectiveness of cognitive behavior therapy, behavioral therapy, and antidepressants in the three conditions. Results showed cognitive behavior therapy and behavioral therapy were both effective in primary and secondary care chronic back pain patients.

Researchers found cognitive behavior therapy yielded mixed results for irritable bowel syndrome patients. They say, in the studies that showed effectiveness, positive results may reflect the training and experience of the therapist rather than the efficacy of the intervention. However, antidepressants seemed effective in both primary and secondary care patients.

Researchers also found cognitive behavior therapy was effective for chronic fatigue syndrome in secondary care patients. Cognitive behavior therapy fared the same as counseling in primary care patients.

Previous studies show patients with functional somatic symptoms are common in primary care and may not receive effective mental health interventions.

SOURCE: British Medical Journal, 2002;325:1082-1085

New Dental Procedure Appears Effective (November 11, 2002)
(Ivanhoe Newswire) -- A new technique to restore gum-line defects in teeth appears to be effective. Andre Ritter, M.S., D.D.S., from the University of North Carolina, Chapel Hill, says of 90 restorations done during clinical trials, none have failed.

Gum-line defects are generally caused by toothbrush abrasion and erosion from acidic foods and drinks. The teeth lose their protective coat on the crown. People who have gum-line defects can feel a notch shape between the tooth and the gum. The sensitive part of the tooth is exposed and thus needs a protective enamel layer. Unlike cavities, these are defects in otherwise healthy teeth.

Researchers used an adhesive to bond, instead of drill, the material onto the defect. They began clinical trials to test the procedure earlier this year. So far, 30 percent to 40 percent of participants have been evaluated for the six-month follow-up. All of the restorations have been successful.

Dr. Ritter says participants were very receptive to the new procedure. He adds, "We have not had any types of complaints."

Dr. Ritter adds the technique is an improvement because it does not require anesthetic, drilling or cutting of healthy teeth. The procedure is not new and the adhesive is a modified version of an existing one. However, this technique makes restoration simpler, faster, and more effective with fewer side effects. He says, "People will have a conservative alternative for this type of problem."

Researchers plan to follow-up participants in the study in another 12 months and possibly after three years.

Preventing Food Allergies (November 11, 2002)
(Ivanhoe Newswire) -- Imagine having to ask what's in every piece of food you put into your mouth. That's what 7 million Americans with severe food allergies have to do every time they eat. Just one bite of the wrong food can be deadly. We don't often think of being able to prevent an allergic reaction until the first one occurs. But now researchers say starting early could prevent future food allergies. 

It's not easy for Nicki Grimm to find something to eat in a restaurant. She is one of millions of Americans with a severe food allergy.

"We really have to look over the menu. There are a lot of things that you don't realize that have peanuts in them," Nicki's mother, Erika Mullins, tells Ivanhoe.

For Nicki, one bite of a peanut or shellfish could cause a potentially fatal allergic reaction.

Allergist Barbara Magera, M.D., says there's no cure for allergies, only prevention -- prevention that she says should start before a child is even born.

"If you try to have the mother not eat the foods before conception, during pregnancy and prevented in breast-feeding; as well as not feed it to the child first 6 months of life. There's some evidence now that you can decrease the food allergy," Dr. Magera, of Asthma, Allergy and Immunology Clinics in Mt. Pleasant, S.C.

Doctors hope avoiding the trigger foods will keep the developing baby from producing the antibodies that cause the allergic reaction. It's a new recommendation that's important if either parent has any type of allergy.

Dr. Magera says, "All you need to do is have allergy in both parents, and it doesn't matter to what latex, bee stings, drug allergy -- that's enough to induce allergy in a child."

A new precaution doctors hope will one day make eating out a little easier for everyone.

New research is also examining ways to genetically alter some foods like peanuts. If researchers can reduce the natural allergens, they hope peanuts will no longer cause severe allergic reactions.

If you would like more information, please contact:

Karen Jernigan
Asthma, Allergy and Immunology Clinics, LLC
561 Belle Station Blvd.
Mt. Pleasant, SC 29464
(843) 388-0471
http//:www.aah-choo.com

Diet and Heart Disease (November 11, 2002)
(Ivanhoe Newswire) -- The Mediterranean diet has long been touted as being a healthy option, and new research shows it may be effective even in patients with heart disease.

Researchers from India conducted a trial in 1,000 patients with chest pain, a previous heart attack, or other risk factors for heart disease. Half consumed a Mediterranean diet rich in whole grains, fruits, vegetables, walnuts, and almonds. The other half consumed a diet referred to as a prudent diet, similar to that recommended by the National Cholesterol Education Program.

The group on the first diet ate more soybean oil and had a greater intake of alpha-linolenic acid (ALA), an essential nutrient that comes from plants. ALA serves as the parent substance to omega-3 fatty acids, compounds that regulate blood pressure, blood clotting, heart rate, blood vessel dilation, the immune response, and breakdown of fats.

Due to the higher intake of ALA, those patients had a reduction in cholesterol levels, fewer sudden cardiac deaths and more improvement in their heart disease than compared to the other group. Investigators write, "The intervention diet showed improvements in the number of surrogate traditional risk factors, which were better than those seen in controls who adhered to the prudent diet."

They say the intervention diet is a safe addition to other treatment methods such as medication and exercise. They say it is a safe and economical way to improve the health of poor populations because the whole grains, fruits, vegetables and oils used in the study were seasonal and produced by farmers at the cost of about a dollar a day. It is not yet know what the long-term benefits of this change in diet will be.
SOURCE: The Lancet, 2002;360:1455-1461