Importance of Staying Physically Active (November 26, 2003) 

(Ivanhoe Newswire)

A new study shows more benefits of staying physically active in your later years. The research finds women who have an active lifestyle are able to perform their daily activities easier later in life.

The focus of aging research has switched from mortality and longevity to health status and quality of life. Study authors write, “No longer is it only important that one lives longer, but the quality of life in later years must also be considered.” Colleagues from the University of Pittsburgh conducted a study to look at how physical activity affects quality of life over a long time.

The study included 229 white, postmenopausal women with an average age of 74 years old. The women were assessed from 1985 to 1999. Researchers looked at the physical activity level of each woman in 1985, 1995 and 1999. Not only were women asked about their physical activity, but they also wore a pedometer and activity monitor. In 1999, the women also answered questions about activities of daily living including eating, dressing, bathing and mobility.

Researchers report the physical activity level in 1985 of a woman was predictive of their walking speed in 1999. They also found the consistency of physical activity during the 14-year study was related to their ability to do everyday activities. Specifically, researchers report about 38 percent of the women who were always active had problems with daily activities. However those numbers increased to 40 percent of women who were inconsistent with their activity and 59 percent of women who were inactive had problems with daily activities.

Study authors conclude the findings of this study show the importance of maintaining an active lifestyle. Researchers point out that with people living longer, it is important to prevent the loss of ability to do regular activities.

SOURCE: Archives of Internal Medicine, 2003;163:2565-2571

Self-Management Program for Back Pain (November 26, 2003) 

(Ivanhoe Newswire)

Acute low back pain accounts for 90 percent of all back pain. Acute low back pain is when symptoms have lasted for less than three months. A new study finds a self-management program that includes group classes, exercise sheet handouts, and telephone follow-up calls may help patients improve and manage their back pain.

A recent study found when compared to whites, black men and women in the United States reported losing more workdays for greater lengths of time because of low back pain. Researchers from Indiana University developed a self-management program for poor, urban patients with low back pain. The program focuses on boosting confidence in order to increase their motivation to incorporate suggestions that would improve their back pain.

For the study, researchers included 211 patients who visited a physician for low back pain. The patients were randomly assigned to the self-management program or the usual care group. The patients in the program attended three group sessions that focused on treatment recommendations, behavioral changes, increased confidence and reducing negative thoughts and behaviors. The patients also received handouts showing exercises for their back pain. Follow-up phone calls were done at four, six and eight weeks after the first class to reinforce what was taught and discuss any concerns. Patients in the usual care group did not receive these three interventions. Researchers assessed the back pain, health status, confidence and time spent in physical activity at the beginning of the study, at four months, and at one year.

Study authors say those patients who were part of the self-management program had less disability, better mental functioning, were better able to manage their back pain, and were more physically active after 12 months compared to the patients in the usual care group. Researchers conclude a self-management program appears to be a beneficial addition for patients with lower back pain.

SOURCE: Archives of Internal Medicine, 2003;163:2632-2638

Reversing Nerve Damage (November 26, 2003) 

NORFOLK, Va. (Ivanhoe Newswire)

Sixty percent of people with diabetes will eventually develop nerve damage, which can lead to foot ulcers and amputations. While there are therapies to treat the disease, no treatment currently available can reverse it. Now, doctors say they may have found one.

This may look easy, but for Greg Stone, walking is becoming a challenging chore. “I started losing feeling in my toes," he says. "They started feeling numb.”

Stone has diabetes. He also has neuropathy -- or nerve damage -- a complication that affects 60 percent of diabetics. “I’m losing more and more feeling all the time. The tingling gets worse and then after the tingling, things get numb, and then after a while, you have no feeling at all.”

Endocrinologist Aaron Vinik, M.D., from Eastern Virginia Medical School in Norfolk, hopes this drug will change Stone's future. Dr. Vinik says, “This compound improves the blood supply to the nerves, so it addresses the basic biology of nerve damage.”

By improving blood supply, PKC inhibitors slow the progression of neuropathy and even reverse it. “Currently, there is no treatment for diabetic neuropathy, so this is the first in its class of compounds that would address the underlying disease,” Dr. Vinik says.

The drug could potentially prevent foot ulcers in diabetics, which would ultimately prevent amputations. There are 85,000 amputations each year. Most of them are a result of neuropathy.

Stone applauds the research. He says, “I think we’re on the edge of a whole new generation of potential drugs that are coming that will see the day when neuropathy can be treated.” And he’s looking forward to the future. “One of these days, there’s hope that someday again in the future, I can regain the feeling that I’ve already lost.”

After 25 years, 60 percent of patients with diabetes have neuropathy. Twelve percent of diabetics already have the complication at the time of diagnosis. Maintaining optimal blood sugar control can reduce the risk of neuropathy by more than 50 percent.

If you would like more information, please contact:

Aaron Vinik, M.D.
Strelitz Diabetes Institutes of Eastern Virginia Medical School
P.O. Box 1980
Norfolk, VA 23501
(757) 446-5912

High Fat, No-Starch Diet Studied (November 25, 2003) 

(Ivanhoe Newswire)

New research sheds more light on high fat, no starch diets. The study shows these diets are effective in helping patients lose weight without adverse effects on their lipid levels.

Obesity affects more than 30 percent of the adult population in the United States. As Americans search for which diet will work for them, researchers from Christiana Care Health Services in Delaware conducted a study looking at the effect of a high fat, no-starch diet on different patients.

Included in the study were 23 obese patients with cardiovascular disease. The patients had been treated with statins (cholesterol-lowering drugs) before the start of the study. These patients were followed for six weeks. The study also included 15 obese patients who had polycystic ovary syndrome and eight obese patients who suffered from low blood sugar or reactive hypoglycemia. The patients in the latter two groups were followed for 24 and 52 weeks, respectively.

Researchers found the patients with cardiovascular disease decreased their total body weight by 5 percent. Researchers also found there was no adverse effect on their lipid levels. Patients with polycystic ovary syndrome lost 14 percent of their total body weight and those with low blood sugar lost nearly 20 percent of their total body weight.

Researchers conclude a high fat, low-starch diet results in weight loss after six weeks without having adverse effects on lipid levels. The study also shows further weight loss can happen up to 52 weeks later.

SOURCE: Mayo Clinical Proceedings, 2003;78:1331-1336

Combo Increases Cardiovascular Risk (November 25, 2003) 

(Ivanhoe Newswire)

Researchers have uncovered a deadly combination they believe increases the risk of cardiovascular disease in women.

In a study involving about 15,000 women, those who had the highest blood pressure and levels of a protein marker associated with inflammation were eight-times more likely to have a heart attack or stroke than those with the lowest pressure and levels.

The research is part of the ongoing Women’s Health Study, which is studying heart disease in women. These investigators assessed the participants for a protein marker called CPR along with blood pressure in an effort to confirm other studies that have suggested a role for inflammation in heart disease. The goal was to determine how blood pressure and the protein marker might interrelate.

After adjusting their findings to take other factors into account, researchers found the higher the blood pressure, the higher the levels of the protein marker.

The investigators aren’t sure whether high blood pressure causes elevated levels of the protein or whether elevated levels of the protein cause high blood pressure, but they believe knowledge of the relationship will aid in the overall understanding of heart disease.

Study author Paul M. Ridker, M.D., from Harvard Medical School, comments, “This finding has particular interest for the prevention of stroke because we have known for a long time that high blood pressure predicts stroke risk. These data raise the intriguing possibility that lowering blood pressure might also lower CRP levels. If so, we hope this will not only prevent heart attacks but the devastating consequences of stroke.”

SOURCE: To be published in an upcoming issue of Circulation

Water Exercises for Osteoarthritis (November 25, 2003) 

(Ivanhoe Newswire)

A new study shows hydrotherapy, or water exercise, may improve strength and mobility in patients with osteoarthritis.

Researchers from Australia studied more than 100 patients with osteoarthritis who were older than age 50. Patients were divided into three groups. The first group exercised three times a week in a swimming pool, the second exercised in a gym, and the third did not exercise at all. Both the water and gym programs focused on resistance exercises.

Results of the study show patients in both exercise groups were able to walk faster and further than those in the control group. Researchers say the ability to walk is extremely important in these patients because it allows them to increase and maintain independence while increasing muscle strength around affected joints.

Patients in the gym group reported increased thigh muscle strength in both legs, while those in the water group experienced improved strength in their left thighs only. Patients in the water group, who reported worse symptoms at the start of the study, also experienced a reduction in pain. Researchers say water exercises increase cardiovascular fitness and allow patients to exercise with greater intensity than they might be able to on land.

Researchers say these results show patients with osteoarthritis can engage in higher intensity exercises. They conclude: “Both the gym and hydrotherapy interventions produce positive functional outcomes for patients with osteoarthritis. However, it seems that hydrotherapy may be more suitable for aerobic based exercise programs. Hydrotherapy provides the optimal environment for patients with osteoarthritis to exercise aerobically, and at higher intensities than would be possible on land.”

SOURCE: Annals of Rheumatic Diseases, 2003,62:1162-1167

Who is Most Likely to Survive a Stroke? (November 25, 2003) 

(Ivanhoe Newswire)

A new study shows people who suffer a right-sided stroke are significantly more likely to avoid sudden cardiac death over the long term than those who have a stroke that occurs on the left side of the brain.

What’s more, researchers have found being left-handed or ambidextrous appears to increase the odds for survival.

Strokes are a leading cause of death and disability in America, affecting about 700,000 people every year. They are also linked to sudden cardiac death, which occurs when the heart suddenly stops beating. Previous studies have shown a higher risk of sudden cardiac death in people who have left-sided strokes, but those studies have focused on the period immediately after the stroke.

In this study, researchers assessed the risk of sudden cardiac death among more than 2,800 patients who had suffered left-sided, right-sided, or bilateral strokes (strokes occurring on both sides of the brain) over five years. People who had left-sided strokes (which affect the right side of the body) had a 45-percent higher risk of sudden cardiac death than those with right-sided strokes. People whose strokes occurred on both sides of the brain had about a 40-percent greater chance of sudden cardiac death.

People who were left-handed were 76-percent less likely to experience sudden cardiac death than those who were right-handed. However, the researchers caution against over-interpreting the impact of handedness observed in the study, noting there were only about 200 people in the study who were left-handed or ambidextrous.

The bigger news is that these findings -- if confirmed by other studies -- may help doctors better treat people with left-sided stroke to avoid sudden cardiac death. Says study author Ale Algra, M.D., “The use of beta-blockers, which lower the risk of sudden death, may be considered for patients with left-sided lesions.”

SOURCE: To be published in an upcoming issue of Stroke

New Technique to Diagnose Breast Cancer (November 25, 2003) 

(Ivanhoe Newswire)

Researchers from the University of Minnesota are working on a new way to diagnose breast cancer without having to perform a biopsy on suspected tissue.

The technique uses high-level magnetic resonance imaging, or MRI, along with a method developed by the investigators called spectroscopy that measures levels of key compounds known to be present in breast cancers. These choline (tCho) compounds are found in normal breast tissue as well, but are significantly elevated in women with breast cancer.

The combined technique, known as magnetic resonance spectroscopy, or MRS, is currently being tested in about 100 women, and the researchers are looking for additional women to add to the study. To be eligible, women must enroll before having a biopsy or surgery so that levels of tCho may be measured and then compared against results of a subsequent biopsy.

Study authors are confident the new method may eventually lead to a noninvasive way to diagnose breast cancer and measure its progress. Michael Garwood, Ph.D., says, “We found tCho concentrations to be significantly higher in malignancies than in benign lumps and normal breast tissues using this quantitative method. Using high magnetic fields and this spectroscopic technique may produce a powerful way to diagnose breast cancer and to monitor its response to treatment. We hope this technique will eventually be used to avoid unnecessary biopsy.”


SOURCE: Magnetic Resonance in Medicine, 2003

Acupuncture for Acid Reflux (November 24, 2003) 

ST. PETERSBURG, Fla. (Ivanhoe Newswire)

If you are one of the 18 million people who suffers from persistent heartburn, there may be something more than medication that can help. A popular Chinese treatment may be effective at reducing that burning feeling caused by acid reflux.

These days, Bill Moore starts his mornings at his printing company in good spirits. For 35 years, he suffered from acid reflux. Prescription medicine helped, but he still found himself up at night. “It burns like mad,” he says, “And it feels like someone stuck a hot poker down your neck.”

Being the conventional type, Moore didn’t buy into alternative treatments. He says, “My first thought of acupuncture? I said, ‘No way, that can’t help me any.’” But having suffered enough, he turned to acupuncturist Tom Elman, AP, to give it a try.

“The idea is to bring the stomach acid into balance with where it’s supposed to be,” says Elman, who is an acupuncture physician at Jade Tree Wellness Center in St. Petersburg, Fla.

While treatment is different for each person, typical needle points for acid reflux are on the foot, near the knee, and in the middle and on the side of the abdomen. Patients are also given herbs.

“If you are on some sort of treatment, and you’re still getting acid reflux, there’s a potential danger to you. This is ultimately what killed my father,” Elman says. His dad died of esophageal cancer after years of acid reflux disease. “That becomes a driving force for me. I’d like to see that nobody else has to go through that.”

After 18 acupuncture treatments, Moore is finally free from acid reflux. “Now, when I go to bed, I have just one pillow underneath me, and I sleep all night,” he says. And he can even eat his favorite foods.

Elman says an acupuncturist should not tell you to stop taking your prescription medicine without first consulting with your doctor. But, he says some patients are able to stop or reduce their medication with this alternative treatment, while others just find more relief with the combination of acupuncture, herbs and medicine.

Exercise away Depression (November 24, 2003) 

DALLAS (Ivanhoe Newswire)

In the United States, one in six people experience a depressive episode during their lifetime, and only 50 percent of the people who meet the criteria for diagnosis seek treatment for depression. New medications and therapies show great success in fighting it, but experts are pursuing another possibility: perspiration. Fighting depression by working up a sweat.

Depression knocked Monica Porter so far down, she worried she’d never rebound. “I just wanted to stay in bed and let the world pass me by,” she tells Ivanhoe. Porter knew something was wrong but kept it a secret. “I was too embarrassed. I didn’t know how to approach it with my family. I felt like I was failing somewhere.” Once she sought help, medication quickly brought her back to life.

But could regular exercise also help beat the blues? Exercise psychologist Andrea Dunn, Ph.D., of The Cooper Institute in Dallas, says exercise is a viable treatment for depression. “It affects the biology in the brain in the same way that anti-depressant drugs do,” she says.

Researchers say a chemical in the brain called serotonin may be the key. Depressed patients have low levels of serotonin, and exercise can boost those levels.

“It is easy to speculate that when you exercise, there is a change of serotonin system in the brain that could be affected and improve symptoms of depression,” says psychiatrist Madhukar Trivedi, M.D., of University of Texas Southwestern Medical Center in Dallas.

Dunn says, “For some people who are reluctant to take drugs, or it’s contraindicated, like in pregnant women, this may be a very good alternative treatment.”

While it may not work for everyone, for many, exercise may be just what the doctor ordered.

Experts say more than 90 percent of depressed people experience an overwhelming loss of energy. This can cause a person to stop exercising, which just compounds the effects of depression. Lack of exercise often leads to degeneration in physique, strength, and physical well being.

If you would like more information, please contact:

Sarah Grohmann
Director of Corporate Communications
The Cooper Institute
12330 Preston Road
Dallas, TX 75230
(972) 716-7092

Breastfeeding’s Impact on Blood Pressure (November 24, 2003) 

(Ivanhoe Newswire)

Previous research shows women who breastfeed are more likely to have children with low blood pressure. However, a new study suggests breastfeeding’s effect on blood pressure may not be as significant as previously thought.

Researchers from London reviewed 24 studies to determine whether children of mothers who breastfeed are more likely to have lower blood pressure at different ages throughout childhood than children of mothers who do not breastfeed.

Results of the study show systolic blood pressure was slightly lower in breastfed children than in bottle-fed children. However, researchers found no significant difference in diastolic blood pressure between breastfed and bottle-fed groups. In addition, they found no specific trend among the different age groups studied.

Researchers also say most studies that show a strong correlation between breastfeeding and low blood pressure are small, which raises the possibility of publication bias. Authors of the study write, “Our systematic review found that publication bias may partly explain the lower mean systolic blood pressure observed in participants that had been breastfed in infancy, with large studies showing little difference.” Researchers add, even if publication bias did occur, the overall difference in systolic blood pressure was only 1.1 millimeters of mercury, which they say is fairly modest.

However, researchers still recommend that mothers breastfeed their infants because of other long-term benefits such as improved neural and psychological development, potential protection against obesity, and possible allergy immunity. Authors of the study conclude, “Our analysis suggests that any effect of breastfeeding on blood pressure is modest and of limited clinical or public health importance. However, blood pressure is not the only relevant outcome; the case for breastfeeding rests on a combination of short- and long-term benefits.”

SOURCE: British Medical Journal, 2003;327:1189-1192

Football Players Need a Time-out After Concussion (November 19, 2003) 

(Ivanhoe Newswire)

Football players should take a time-out from the game after a concussion because it could take up to a full week for them to fully recover cognitive function and balance.

Concussions, or mild traumatic brain injuries, are the most common injury in collegiate sports. Approximately 300,000 sports-related concussions occur annually in the United States. They account for a significant percentage of total injuries for athletes participating in ice hockey, football, and soccer on the collegiate level. Doctors have known for years that a concussion can result in neurological deficits and cognitive impairment, but lack of data on recovery time has hampered decision-making about when it is appropriate for an athlete to get back into the game following a concussion.

In a study conducted by doctors at the Neuroscience Center at Waukesha Memorial Hospital in Waukesha, Wis., nearly 2,000 college football players from 15 United States colleges were monitored for three years. Players with and without concussions underwent assessment of symptoms, cognitive functioning, and balance stability immediately, three hours, and one, two, three, five, seven and 90 days after injury. The researchers found that, on average, symptoms gradually resolved by day seven, cognitive functioning improved to pre-injury levels within five to seven days and balance deficits dissipated within three to five days after injury. The researchers say not all athletes should be expected to return to pre-injury form within a week. Ten percent of players in this study needed more than a week for their symptoms to clear up.

Researchers also suggest a new definition of concussion may be needed, one that emphasizes an alteration, as opposed to a loss of consciousness or mental status. They write, “Sports medicine professionals especially should be aware that the diagnosis of concussion does not require loss of consciousness, significant amnesia, or other focal neurological abnormalities associated with more severe head injury.”

In a related article, a group of researchers from the University of North Carolina, Chapel Hill, say athletes who have had at least three concussions are three-times more likely to have another concussion than athletes without previous concussions. They also found that one in 15 college football players with past concussions may have additional concussions within the same season and that these re-injuries typically take place within seven to 10 days of the first concussion.

Researchers write, “Athletes with a high cumulative history should be more informed about the increased risk of repeat concussions when continuing to play contact sports such as football.”

SOURCE: Journal of the American Medical Association, 2003;290:2556-2563

Psoriasis Increases Cancer Risk (November 18, 2003) 

(Ivanhoe Newswire)

People who suffer from the skin disease psoriasis are at an increased risk for cancer, according to new research. Specifically, study authors found patients with psoriasis had a nearly three-fold increased rate of lymphoma.

Psoriasis is a common skin disease that affects about 1 percent to 2 percent of the population. Patients with psoriasis have patches of thickened, red and scaly skin, usually on the torso or arms that can be painful and disfiguring. Lymphoma is a group of cancers that affect the lymph tissues found mainly in the lymph nodes and spleen. Previous research has found an association between psoriasis and lymphoma. Doctors from the University of Pennsylvania studied whether the rate of lymphoma in patients with a history of psoriasis is different from the rate of lymphoma in patients without psoriasis.

Included in the study was a random sample of patients 65 years or older who were registered with a general practitioner. The research included 2,718 patients with psoriasis and 105,203 patients without psoriasis. Researchers kept track of who was diagnosed with lymphoma during a median follow up of 46 months.

During the study period, researchers identified 276 lymphomas. Researchers say the patients with psoriasis were nearly three times more likely to be diagnosed with lymphoma than healthy participants. Furthermore, patients 65 years or older who had psoriasis developed an additional 122 lymphomas per 100,000 patients annually.

After reviewing records, researchers found all the patients with psoriasis who had lymphoma were treated with medications consistent with psoriasis treatment. While researchers conclude there is an association between psoriasis and lymphoma, they feel additional research needs to be done to determine if this association is related to psoriasis severity, psoriasis treatment or an interaction between these risk factors.

SOURCE: Archives of Dermatology, 2003;139:1425-1429

Islets May Lead to Diabetes Cure (November 18, 2003) 

(Ivanhoe Newswire)

Researchers take a step forward in their search for a cure for diabetes. A new study done in mice shows cells from the spleen appear to develop into insulin producing pancreatic islet cells. This could lead to a broad application for patients with diabetes.

The latest research is a follow up to the 2001 report of a treatment that cures advanced type 1 diabetes in mice. The new research focuses on the biological mechanism behind that accomplishment. David Nathan, M.D., director of the Massachusetts General Hospital Diabetes Centers, says: “These exciting findings in a mouse model of type 1 diabetes suggest that patients who are developing the disease could be rescued from further destruction of their insulin-producing cells. In addition, patients with fully established diabetes possibly could have their diabetes reversed.”

Type 1 diabetes happens when the body’s immune cells mistakenly attack the insulin producing islet cells of the pancreas. As islet cells die, insulin production ceases and blood sugar levels rise. This causes damage in organs throughout the body. In the first study, researchers retrained the immune system not to attack the islet cells. But researchers were not clear if the islet cells were there or if they were regenerated. The latest research shows islet regeneration was occurring and that cells were growing from both the recipient’s own cells and from the donor cells.

In order to determine how the new islet cells had developed, researchers carried out the same treatment using spleen cells from healthy male donors to re-educate the immune cells of female diabetic mice. Using male and female mice, researchers could see if the cells had Y chromosomes. A separate experiment also found the regrowth of islet cells can occur in animals that have immune system re-education to eradicate their diabetes, but do not receive the donor cells.

Researchers have developed a protocol to test this approach in humans, but additional grant money is needed before a clinical trial can begin.

SOURCE: Science, 2003;302:1223-1227

Improving Diabetes Management (November 18, 2003) 

(Ivanhoe Newswire)

A new study shows people with diabetes who agree with their doctor’s treatment goals are more successful at managing their disease.

Researchers from the University of Michigan Medical School surveyed more than 120 diabetes patients and their doctors. They asked both groups to list their top three treatment and strategy goals. Results of the study show only 5 percent of patients and doctors had the same top three treatment goals, and only 10 percent had the same top three strategy goals.

However, three out of five patients overlapped with their doctor on at least one treatment goal and more than half shared one treatment strategy. Researchers also found 55 percent of patients included their doctor’s number one treatment goal and strategy in their top three responses.

Researchers say patients who play an active role in making treatment decisions are more likely to agree with their doctor’s strategies. Doctors who reported discussing self-management of diabetes with their patients also saw more agreement in the treatment strategy category. In addition, patients who agreed with their doctors on more treatment goals reported better self-management of their disease.

Michele Heisler, M.D., from the Department of Internal Medicine at U-M Medical School, says patients need to understand their condition and be aware of treatment choices for optimal management. She says: “Patients often may disagree with a doctor’s priority, but they usually don’t share this lack of agreement with their doctor ... It is critically important that doctors work with their patients to develop a workable treatment plan.”

Researchers say results of this study could extend to patients with other chronic illnesses such as coronary heart disease, arthritis, and chronic obstructive pulmonary disorder. Dr. Heisler concludes, “The specific problems chosen to give priority to should be based both on their medical importance and the patient’s motivation and readiness to address the problem.”

SOURCE: Journal of General Internal Medicine, Nov. 2003

Genetic Connection with Low “Good” Cholesterol Levels (November 18, 2003) 

(Ivanhoe Newswire)

Researchers have discovered two genetic defects that may contribute to low levels of “good” cholesterol. The discovery was made when researchers were studying a family who has premature heart disease but normal cholesterol levels.

High-density lipoprotein (HDL) is considered the “good” cholesterol. The average HDL in a man is about 45 mg/dL and about 55 mg/dL in a woman. Anything lower than 35 is considered low and if the level is below 20, it’s considered very low. Low HDL is the most common cholesterol abnormality in heart disease patients. But a very low HDL level only occurs in 1 percent of the population.

Researchers from the University of Maryland School of Medicine studied a family whose members had very low HDL cholesterol levels. Study author Michael Miller, M.D., from the University of Maryland Medical Center, says: ”We used to believe that heart attacks do not occur when total cholesterol levels are under 150 mg/dL. However, recent studies suggest that, despite healthy cholesterol levels, heart disease risk may still be increased if levels of HDL are too low, and there is early heart disease in the family.”

Scientists began their genetic detective work in 1995 by looking at two genes that are responsible for low HDL levels. In 1999, researchers discovered mutations in a gene called ABCA1. This gene plays a role in the regulation of cholesterol and HDL metabolism. Because the gene has 50 segments, researchers say it’s taken a lot of time for them to determine if there is something there. But they did find something: two defects in the gene that would lower the HDL levels to a very low range. Researchers say the family they are studying has these defects that cause them to have low HDL levels.

Researchers say, while medications are available to reduce the progression of heart disease, they still need to determine how to reverse heart disease which could come down to HDL levels. Dr. Miller says, “This is a very exciting area of research which is now, finally, capturing a great deal of attention in the field of coronary disease prevention.”


SOURCE: Circulation Research, 2003

Impact of Heart Attack on Women (November 17, 2003) 

(Ivanhoe Newswire)

In the past, heart attacks were considered a man’s problem. But heart attacks are a major health concern for women, too. Now a new study finds women who have a heart attack appear to be more seriously affected than men.

Unstable angina is a heart condition caused by insufficient oxygen reaching the heart muscle that causes pain in the chest. Research has shown that gender does play a role in the probability of death from unstable angina or a heart attack. Researchers from the University of Alberta, Edmonton, Canada, conducted a study to examine both unstable angina and heart attack to explain this gender difference.

For the study, researchers used a database of 22,967 patients who had a heart attack and 8,441 patients who had unstable angina. All of the patients were seen and discharged from a hospital in Canada between 1993 and 2000. Researchers compared the differences in outcomes when looking at men vs. women.

Researchers report older women with more health problems were frequently diagnosed with unstable angina. Women were also 30 percent less likely to undergo a procedure to unblock clogged vessels than men. The study found the five-year death rate was similar between men and women after suffering unstable angina. However, women were more likely to die after a heart attack than men. After adjusting for other health factors, researchers found gender was a significant predictor of five-year death rate after unstable angina but not after a heart attack. The research also found women younger than 65 were at a higher risk for problems after a heart attack.

Study authors write, “In conclusion, our population-based research demonstrated that women have a survival advantage when afflicted with unstable angina; however, this advantage is lost when afflicted with heart attack.” Researchers say this shows that a heart attack has a more serious impact on a woman than a man.

SOURCE: Archives of Internal Medicine, 2003;163:2476-2484

Better Preparation for Birth Needed (November 17, 2003) 

(Ivanhoe Newswire)

A new study shows pregnant women need better preparation and understanding about how the delivery of their child may happen. Researchers say women are unprepared for operative deliveries including cesarean section or use of forceps.

For most women, the birth of their child is a joyous experience. But if the experience does not go as planned, it can have a detrimental impact on the woman. Researchers from the University of Dundee in England conducted a study to obtain the views of women on the impact of an operative delivery in the second stage of labor.

The study included information from 27 women who had undergone an operative delivery between January 2000 and January 2002. The women were asked about their preparation for birth, understandings of the indications for operative delivery, and explanation after the experience.

Results show the women felt unprepared for an operative delivery and thought their birth plan classes had not adequately prepared them. The women also said they had difficulty understanding the need for operative delivery despite review by medical or midwifery staff before they were discharged. Furthermore, an operative delivery had a negative impact on the women’s views about pregnancy and delivery for the future. Some women said they want another child but they can’t bear to go through a delivery like that again.

Study authors say this research shows improvements are needed in preparation for delivery and explanations to the woman after an operative delivery. They say maternal satisfaction also needs to be addressed. They suggest the medical staff give a woman an in-depth explanation of the delivery when they have recovered from the trauma.

SOURCE: British Medical Journal, 2003;327:1132

Changing Partners may Lead to Premature Delivery (November 17, 2003) 

(Ivanhoe Newswire)

With divorce rates at record levels, more and more women are remarrying and having children with different partners. This trend may be putting expectant mothers and their unborn children at risk.

New research finds that women who change partners between the births of their first two children are more likely to deliver pre-term babies with a low birth weight than women who have the same partner. These babies are also more likely to die within the first year of life. The results are the same even when researchers take into account the mother’s age and education, the interval between births, and the decades of birth.

Scientists in Norway examined the records of nearly 2 million births between 1967 and 1998. During those 30 years, the proportion of women who changed partners between their first two births tripled, and more women had a higher-level education. Researchers say a change between partners is more likely in women with a low level of education than in women with a high level of education.

The researchers say the risk of infant mortality decreases from the first child to the second in women who have the same partner, but increases if a woman changes partners. The same trend holds true when comparing risks of delivering prematurely and having a baby with a low birth weight. Researchers also looked specifically at a woman’s level of education. They found that, for second births, the more education a mother has, the less likely she is to lose her baby during its first of life -- even if a woman changed partners. Pre-term birth and low birth weight were less common in women with more education, but only if they had the same partner. However, a high level of education does not seem to protect against premature delivery or low birth weight if she changes partners between births.

Researchers speculate that women who change partners between births may belong to a selected group with characteristics that increase risk or they may change their lifestyle or behavior in ways that could negatively impact their pregnancy. They cite risky behavior such as smoking or drinking during pregnancy and poor nutrition.

SOURCE: British Medical Journal, 2003;327:1138-1141

Preventing the Onset of Arthritis (November 17, 2003) 

(Ivanhoe Newswire)

A new study could help lead doctors towards a drug to prevent the onset of arthritis. The research pinpoints the molecular pathway and an enzyme that play a pivotal role in the onset of the condition.

Arthritis is a common health problem worldwide. Both osteoarthritis and rheumatoid arthritis cause joint pain and stiffness in patients. More than 20 million Americans suffer from osteoarthritis making it the most common form of the disease. There is no cure for arthritis and no effective treatment to repair damaged cartilage. Researchers from Cardiff University conducted research to better understand the molecular pathway involved in the onset of arthritis.

Early research has shown activity levels of two enzymes, MMP-2 and MMP-9, are frequently increased in the cartilage of people suffering from osteoarthritis. Researchers also know, in patients with arthritis, the cartilage releases a substance called proteoglycan. Scientists cultured cartilage cells in vitro to study this pathway as osteoarthritis develops.

The researchers stimulated the cells with two molecules that activate the arthritis processes. This caused the increased release of proteoglycan and the production and activation of MMPs. Study authors then inhibited the enzyme PKR in the cells. This time they found no increase in the activation of MMPs and that the release of proteoglycan was significantly reduced.

Researchers say the results of this study imply that PKR is involved in the molecular pathways that are implicated in the progression of arthritis. They hope this understanding will help in the discovery of novel targets for arthritis drugs.

SOURCE: Arthritis Research & Therapy, 2003;6:R46-R55

Best Mattress for Low Back Pain (November 14, 2003) 

(Ivanhoe Newswire)

If you have lower back pain, the right mattress can make a difference. Three-quarters of physicians say your best bet is a firm bed mattress, but a new study says they could be wrong. The new research finds medium-firm mattresses are more effective at relieving back pain.

Physicians often get frustrated when patients ask them what type of bed is best for their lower back pain. Few studies have been done on this issue to support their answers. Therefore, researchers from Kovacs Foundation in Spain conducted a study to test the effectiveness of a firm vs. a medium-firm mattress when it comes to lower back pain.

The study included 313 people who had their own bed mattresses replaced with either a firm or a medium-firm mattress. The participants did not know what type of mattress they were given. The individuals reported the degree of low back pain experienced while lying in bed, and after waking up in the morning as well as their degree of disability before and three months after the start of the study.

Study authors say the people who used the medium-firm mattress had more of their back pain symptoms alleviated. Specifically, those who slept on a medium-firm mattress were twice as likely to report improvements in low back pain while lying in bed, when getting out of bed and in disability associated with back pain. The participants who used the medium-firm mattresses also reported a decrease in the need for pain killing drugs.

Lead author Francisco Kovacs say, “Our findings stress that recommendations for daily living, such as what kind of mattress to use, may have a relevant effect on the clinical course of low-back pain.”

In an accompanying commentary, Jenny McConnell from the University of Melbourne, Australia, says these findings are a relief for clinicians. She says studies like this give doctors help in answering questions from patients about day-to-day management of their lower back pain.

SOURCE: The Lancet, 2003;362:1599-1604, 1594-1595

Reducing Pain from Knee Surgery (November 13, 2003) 

(Ivanhoe Newswire)

New research shows taking nonsteroidal anti-inflammatory drugs (NSAIDs) before and after knee replacement surgery significantly reduces pain from the procedure.

Researchers from Rush University Medical Center in Chicago studied 70 patients who were undergoing knee replacement surgery. Some of the patients were randomly assigned to receive 50 milligrams of an oral NSAID at 24 hours and two hours before the surgery, 50 milligrams each day for five days after surgery, and 25 milligrams of the drug for another eight days. The remaining patients received a placebo at the same times.

Results show patients receiving the NSAID rofecoxib had significantly less pain, consumed fewer painkillers, and had significantly fewer sleep disturbances. Those taking the drug also had an increased range of motion of the knee after surgery.

Experts say controlling pain after knee replacement surgery, while also reducing the use of pain medication remains an important challenge to anesthesiologists and surgeons alike. Authors of the study write, “This study validates the efficacy of perioperative use of rofecoxib to reduce postoperative pain and improved outcome after major orthopedic surgery.”

SOURCE: Journal of the American Medical Association, 2003;290:2411-2418

Smokers: Drink Your OJ! (November 12, 2003) 

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

Diet self-help books have become increasingly popular in the last few years, and a new study shows some of the regimens many of these books endorse can help Americans lose weight and lower their risk of heart disease.

Researchers from the New England Medical Center in Boston presented their findings at the American Heart Association’s Scientific Sessions in Orlando, Fla. They studied 160 overweight men and women who followed one of four popular diet approaches: the Atkins diet (low-carbohydrate); the Zone program (moderate carbohydrate); the Ornish approach (vegetarian); or the Weight Watchers plan (calorie restricted). Participants were given diet books and attended four educational classes taught by the same doctor and dietician. Researchers examined the patients at two months, six months, and 12 months.

Results of the study show, after one year, all participants benefited from following their diet regimens. The average weight loss percentage was nearly 4 percent for those following the Atkins diet, more than 6 percent for those following the Ornish diet, and about 4.5 percent for those following the Weight Watchers and Zone plans. Researchers say all the approaches, with the exception of the Ornish diet, also helped participants lower their heart attack risk.

Authors of the study conclude, “Using very divergent approaches, all four popular diets promoted weight loss ... indicating that a variety of dietary strategies can be effective in this regard.”

SOURCE: The American Heart Association’s Scientific Sessions in Orlando, Fla., Nov. 9-12, 2003

Diets that Work (November 11, 2003) 

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

Diet self-help books have become increasingly popular in the last few years, and a new study shows some of the regimens many of these books endorse can help Americans lose weight and lower their risk of heart disease.

Researchers from the New England Medical Center in Boston presented their findings at the American Heart Association’s Scientific Sessions in Orlando, Fla. They studied 160 overweight men and women who followed one of four popular diet approaches: the Atkins diet (low-carbohydrate); the Zone program (moderate carbohydrate); the Ornish approach (vegetarian); or the Weight Watchers plan (calorie restricted). Participants were given diet books and attended four educational classes taught by the same doctor and dietician. Researchers examined the patients at two months, six months, and 12 months.

Results of the study show, after one year, all participants benefited from following their diet regimens. The average weight loss percentage was nearly 4 percent for those following the Atkins diet, more than 6 percent for those following the Ornish diet, and about 4.5 percent for those following the Weight Watchers and Zone plans. Researchers say all the approaches, with the exception of the Ornish diet, also helped participants lower their heart attack risk.

Authors of the study conclude, “Using very divergent approaches, all four popular diets promoted weight loss ... indicating that a variety of dietary strategies can be effective in this regard.”

SOURCE: The American Heart Association’s Scientific Sessions in Orlando, Fla., Nov. 9-12, 2003

SIDS Linked to Protein Build-up (November 11, 2003) 

(Ivanhoe Newswire)

Researchers from Belgium have linked Sudden Infant Death Syndrome to abnormal amounts of a key protein in the brain.

The study may help explain why some infants die from SIDS, which strikes seemingly healthy infants and is the major cause of post-neonatal death in developed countries.

The study analyzed the brains of 19 infants who died of SIDS and 8 who died from other causes. Specifically, investigators were looking for a type of protein called cytokines in the brains of the infants. These proteins normally assist in fighting infections, but if levels are too high, they could throw brain functions, such as breathing, off track. All of the babies with SIDS had moderate to high levels of a cytokine called interleukin-1 in their brain stems. Comparatively, only two of the non-SIDS babies had moderate levels of interleukin-1 and the rest had negligible levels or none at all.

“We detected a pattern of cytokine in the SIDS brain that could overturn a delicate balance in molecular interactions in vital brain centers,” says author Hazim Kadhim, M.D., Ph.D. “It seems that high levels of interleukin-1 could be a common denominator in SIDS.”

In an accompanying editorial, however, other researchers point out the study did not compare the SIDS and non-SIDS infants for exact age. That, they say, could compromise these results because the investigators could not rule out the possibility that older babies might have developed different levels of cytokines. They also believe it is important to determine what causes higher cytokine levels in infants with SIDS before drawing any conclusions.

SOURCE: Neurology, 2003;61:1256-1259, 1170-1171

New Drug Benefits Heart Patients Too (November 11, 2003) 

(Ivanhoe Newswire)

Researchers say a new type of drug called an angiotensin-receptor blocker is just as effective in reducing death and disability among high risk-heart attack patients as a standard angiotensin-converting-enzyme (ACE) inhibitor.

Studies have shown ACE inhibitors can improve mortality and morbidity among patients who have suffered a heart attack that’s complicated by left ventricular systolic dysfunction, heart failure, or both. But these ACE inhibitors don’t work for some people.

In a new study in this week’s New England Journal of Medicine -- which were released early at the American Heart Association’s Scientific Sessions in Orlando, Fla., this week -- investigators compared patients receiving standard treatment with the ACE inhibitor captopril with those receiving the newer drug, valsartan. Researchers also looked at another group of patients who were receiving both drugs to determine if combining the two would have an additional benefit. Each group consisted of about 4,900 patients.

Results show no difference in overall survival among the three groups. Among all three groups, almost 3,000 patients died during the two year follow-up. Patients taking the combined therapy, however, did report more unwanted side effects than those taking just one of the drugs. The most common side effects among those on captopril alone were cough, rash, and taste disturbance. Those on valsartan alone were more likely to suffer hypotension and renal dysfunction.

In an accompanying editorial, other researchers note ACE inhibitors should remain the first-line therapy for high-risk heart attack patients. However, they say the new study offers hope for people who cannot take those drugs. They write, “The good news provided by the current trial is that there is now a safe and equally effective alternative strategy that will reduce the risks of death and adverse cardiovascular events among patients who have had an acute myocardial infarction.”

SOURCE: New England Journal of Medicine, 2003;349:1893-1906

Chemo for the Elderly (November 10, 2003) 

TAMPA, Fla. (Ivanhoe Newswire)

Should age be a determining factor when considering whether a cancer patient should be offered chemotherapy? Some doctors feel older patients cannot tolerate the toxic treatment and as a result, don’t offer it as an option. But new research shows just the opposite.

At 72, Mario Donato does something most cancer patients his age are not likely to do. He’s getting chemotherapy. “This is our day out of the house,” says Mario's wife, Maria.

Mario was diagnosed with cancer 10 years ago. It recently returned. His doctor said there was nothing they could do -- something his wife Maria didn’t accept. “Maria, she didn’t want to buy this story that I’m gonna live 12 to 18 months, you know,” Mario says.

The couple came to Senior Adult Oncologist Martine Extermann, M.D., at the Moffitt Cancer Center in Tampa, Fla. “We are not anymore in saying just because you are old, you cannot have chemotherapy,” Dr. Extermann says.

Sixty percent of all cancer occurs in patients over 65. Studies show older patients are less likely to be offered chemotherapy, but Dr. Extermann’s research shows most older patients tolerate the treatment well. “These patients do well with chemotherapy. They will be a bit more tired. They will have some side effects, but they will still be able to function decently,” she says.

Mario has colon cancer. Half of colon cancer patients don’t get chemotherapy after surgery, but one study shows a 30-percent reduced death rate in those who receive chemo with surgery.

Mario says, “I feel very strong. I think I’m gonna make it.” Being Italian, Maria has her own cure for her husband. She says, “As long as he eats his pasta, he’s gonna live forever.” And that’s a treatment plan Mario is happy to follow.

Dr. Extermann says chemotherapy has improved over the years and is not as harsh on patients. She says while seniors will have a few more side effects, they are usually treatable, which makes them easier to tolerate.

If you would like more information, please contact:

Andrea Brunais
Media Relations Coordinator
Moffitt Cancer Center
(813) 632-1478
mediarelations@moffitt.usf.edu

Diet and Breast Cancer (November 10, 2003) 

(Ivanhoe Newswire)

Does what you eat play a role in whether you’ll end up with breast cancer?

Maybe, find researchers who studied about 200 healthy women between ages 20 and 40 for one year. Their research finds those who ate a low-fat, high-fiber diet containing at least eight servings of fruits or vegetables a day had lower levels of the hormone estradiol in their blood than those who ate their usual diets.

The study stemmed from previous research indicating lifetime exposure to ovarian hormones may play a role in the development of breast cancer. Doctors know, for example, that earlier menarche, later menopause, fewer children, and delayed childbirth all increase a woman’s risk of getting breast cancer. The role diet plays in the process, however, has been less clear, although studies do suggest low-fat, high-fiber diets might reduce the amount of hormones in a women’s system.

The current study measured several factors related to ovarian hormones, including estradiol and progesterone. A link between diet and the hormones was seen only for estradiol.

The authors write, “The results of this randomized trial indicate that an isocaloric diet (characterized by low-fat, high-fiber, and a high fruit and vegetable content) did not produce substantial changes in ... ovarian hormone levels in premenopausal women ... However, the observed 7.5 percent reduction in estradiol could have biologic significance if it persisted over many years.”

SOURCE: Cancer, 2003;98

Grandmothers at Risk for Heart Attack (November 06, 2003) 

(Ivanhoe Newswire)

New research shows grandmothers who help care for their grandchildren may be at an increased risk for heart attacks.

Researchers from the Harvard School of Public Health and Harvard Medical School examined data from the Nurses Health Study, which surveyed more than 54,000 women ages 46 to 71 from 1992 to 1996. They excluded patients who had been diagnosed with heart disease, stroke or cancer before 1992.

Results show more than 300 heart attacks occurred among the women studied. Researchers say women who cared for their grandchildren for more than nine hours a week had a 55 percent increased risk of heart attack. Women who cared for their children more than 21 hours a week were also at an increased for heart disease.

Previous studies have shown grandmothers who care for their grandchildren are also more likely to suffer from depression. Sunmin Lee, Sc.D., author of the study, says these women simply may not have time to take care of themselves. She says, “It is possible that women -- especially grandmothers -- with high levels of child-care demands have less opportunity to engage in their own self-care and in preventative health behaviors.”

About one in seven American women have raised a grandchild for six months or more. Lee’s findings show these women may be compromising their health. She concludes, “In comparison to women not providing child care, providing care to grandchildren nine hours or more per week was associated with a significantly increased risk of coronary heart disease even after control for a number of potential factors.”

SOURCE: American Journal of Public Health, Nov. 2003

Low-Sugar Breakfasts May Help Kids Stay Fit (November 06, 2003) 

(Ivanhoe Newswire)

Eating a breakfast that’s low in sugar may help preadolescent children keep off those extra pounds, report researchers publishing in this month’s Pediatrics.

Previous studies have linked a low-sugar breakfast to decreased appetites at lunchtime, but most of these have been conducted among adults. These investigators decided to see how low-sugar breakfasts would affect children age 9 to 12 who were already enrolled in a breakfast program at their school.

Fifteen boys and 22 girls, about a third of which were considered overweight or obese, participated in the study. Each was randomized to receive either a low-sugar breakfast consisting of All-Bran, muesli, porridge, or soya and linseed bread; a low-sugar breakfast with added sucrose (basically, the low sugar breakfast with a little added sugar); or a high-sugar breakfast consisting of Corn Flakes, Coco-Pops, Rice Krispies, or white bread.

All kids ate each of the different breakfasts at one time or another during the study. Researchers questioned the children about their feeling of fullness after the breakfasts, then monitored what they ate at lunch, which consisted of a buffet where kids could choose whatever they wanted. The children were instructed not to eat between breakfast and lunch, except for a small fruit snack that was provided.

Researchers noted no difference in the feeling of fullness the kids reported after eating the different breakfasts. But when the low sugar or low sugar plus added sucrose breakfasts were eaten, kids ate significantly less at lunchtime. Kids also reported feeling hungrier right before lunch when they had consumed the high sugar breakfast. Findings were similar for boys and girls, and overweight/obese and normal weight children.

The researchers conclude low sugar breakfasts may have a role to play in managing childhood weight.

SOURCE: Pediatrics, 2003

Liquid Drano for Your Arteries (November 06, 2003) 

(Ivanhoe Newswire)

A new study shows infusing heart attack patients with high density lipoprotein may reverse years of heart disease damage.

Researchers from the Cleveland Clinic injected patients with a laboratory-produced version of HDL, or good cholesterol, which naturally removes fatty buildups from arteries. Thirty-six patients received doses of HDL, and 11 patients who served as a control group received doses of saline.

Researchers say they got the idea for their study after observing a group of people who lived in Limone sul Garde, a town in northern Italy. These Italians had exceptionally low levels of good cholesterol but lived long, healthy lives. Researchers later discovered that these people had a mutation in their HDL gene that caused good cholesterol to break down quickly even though their bodies made plenty of it. Researchers then turned this same strain of HDL into an experimental drug and gave it to heart attack patients.

Results of the study show after just five weekly infusions of HDL, patients saw a 4-percent reduction in the amount of plaque on their artery walls. Patients in the placebo group saw no significant change. Researchers say the 4-percent reduction actually represents years of plaque buildup. Current drugs that are used to treat heart disease -- called statins -- take years to produce more modest results.

Authors of the study say the concept is like liquid Drano for the coronary arteries. They say larger studies are needed to determine if this treatment will help prevent heart disease deaths. Authors conclude, “Administration of an exogenously produced HDL mimetic offers the opportunity to explore an entirely new approach to atherosclerosis treatment.”

SOURCE: Journal of the American Medical Association, 2003;290:2292-2300