Adding Folic Acid to Food Reduces Birth Defects (September 29, 2004)

(Ivanhoe Newswire)

Fortifying foods like flour, pasta and cornmeal with folic acid markedly reduces the number of infants born with neural tube defects like spina bifida, finds a new study in BMC Pregnancy and Childbirth.

Researchers say doctors have long known folic acid prevents neural tube defects, although they aren’t really sure how the nutrient accomplishes this feat. For that reason, pregnant women are advised to take folic acid supplements in early pregnancy when the neural tube is forming. But women also need to maintain adequate levels of folic acid prior to pregnancy. This led Canada to begin requiring fortification of some foods.

After the Canadian government instituted the rule in 1998, babies born with these birth defects dropped by 78 percent.

The current study compared the number of neural tube defects in babies born in Newfoundland and Labrador -- two areas with some of the highest known rates of neural tube defects in North America -- before and after the requirement went into effect. Between 1991 and 1997 there were an average of 4.36 neural tube defects per 1,000 births in these areas. Between 1998 and 2000, that number dropped to just 0.96 per 1,000 births.

The study also looked at the effect of folic acid fortification on vitamin B12 deficiency in the elderly -- a condition thought to be masked by extra intake of folic acid. Results found no evidence to indicate the additional folic acid intake was causing this to occur.

The authors write, “Based on these findings, mandatory food fortification in Canada should continue at the current levels.”

SOURCE: BMC Pregnancy and Childbirth, 2004; 1-19
 

Glaucoma Laser (September 29, 2004)

ST. PETERSBURG, Fla. (Ivanhoe Broadcast News)

Three million Americans have glaucoma, but only half of them actually know they have it. Glaucoma is an eye disease that can lead to blindness and can only be diagnosed with a vision exam. While eye drops and drugs have been used to treat this disease in the United States, now a new alternative is available.

A flash of red light is essentially all it took for ophthalmologist Mark Sibley, M.D., to fix Ann Quinn's eyesight.

"In medical school, they do not issue a magic wand, but this is the closest thing to getting a magic wand," Dr. Sibley, of Florida Eye Center in St. Petersburg, Fla., tells Ivanhoe.

Quinn says, "The one thing that really scares me is the idea of losing my vision and not being able to see, and frankly, you know, that is scary." She has glaucoma -- an eye disease that destroys sight without warning. Glaucoma is when too much pressure in the eye damages the optic nerve.

Eye drops and drugs can lower the pressure, but Dr. Sibley says the new laser has fewer side effects. According to him, it is the safest glaucoma treatment doctors have ever had in history. It's called selective laser trabeculoplasty or SLT. In the past, hot lasers were used and could only be done once. SLT is a cold laser, meaning it can be repeated.

"It is so precise, it only lasers the drains, and it spares all the delicate tissue," Dr. Sibley says.

Quinn had the treatment on both eyes. She says: "The vision is clearer. I can read signs. I can drive without being a menace to people on the road." An avid traveler, she now says she wants to go back to Egypt with her husband to really see what she missed on their last trip.

Doctors say the SLT treatment is done in a doctor's office and can last up to four years. It is FDA approved and covered by insurance, Medicare and Medicaid.

If you would like more information, please contact:
Tom Linkchorst
Office Administrator
Florida Eye Center
1515 9th Ave. North
St. Petersburg, FL 33705
(727) 895-2020
 

Heavy Drinking in the ER (September 29, 2004)

(Ivanhoe Newswire)

Emergency room staff, there's something quite valuable you can do for heaving drinkers who come through your hospital: Refer them to counseling.

A new study from the Imperial College in London shows referring individuals to counseling during an alcohol-related emergency room visit may help curb drinking habits.

Researchers studied 600 patients by giving half of them an information packet on alcohol and giving the other half the same packet plus an appointment with a substance abuse counselor.

Results show those who received the information package and the appointment consumed less alcohol and had fewer emergency room visits than those who only received the information packet.

Daniel W. Hungerford, Dr.PH, with the Centers for Disease Control and Prevention, says, "The [researchers] highlight the value of the physician's encounter with the patient and show that the emergency department visit can be used to start a clinical pathway for care of alcohol problems. Physicians can take heart that the act of referral itself might motivate patients to reappraise their drinking behaviors."

SOURCE: The Lancet, published online September 28, 2004
 

Behavior Therapy for a Better Night’s Sleep (September 29, 2004)

(Ivanhoe Newswire)

People who have trouble falling asleep catch more ZZZZs after taking part in a behavior therapy program aimed at improving their sleep habits than with the use of sleep medications, report investigators from the Sleep Disorders Center at Beth Israel Deaconess Medical Center in Boston and other facilities.

The study compared four treatment options in a group of young and middle-aged adults suffering from insomnia. One group received cognitive behavior therapy alone. The program consisted of four, one-on-one therapy sessions lasting 30 minutes each in which a trained counselor provided information aimed at helping the individual get a good night’s sleep. The counseling included tips like maintaining a consistent arising time, using the bedroom primarily for sleep and sex, going to bed only when drowsy, and getting up if sleep doesn’t arrive within 20 to 30 minutes. Participants were also taught relaxation techniques and stimulus control.

The second group received both the therapy and a sleep medication. The third group received the medication alone. The fourth group received no special care and served as controls.

Results showed equally positive results for both the therapy alone and the therapy plus medication groups. The medication group had improved sleep only while on the medication. The improvements disappeared when they stopped taking the drug. The control group showed little or no change in sleep quality.

Researchers say more widespread use of behavior therapy could improve the quality of life of a large number of patients with insomnia.

SOURCE: Archives of Internal Medicine, 2004;164:1888-1896
 

Exercise Test may Predict Heart Events (September 28, 2004)

(Ivanhoe Newswire)

The treadmill may be more than just a way to stay healthy. That’s because researchers in Boston have linked poor performance on an exercise treadmill to having more than twice the risk for heart attack or other coronary heart disease events.

The link was observed in men who did not have heart disease, but who did have significant cardiac risk factors.

Results of the study involving more than 1,400 men show a change in electrocardiogram tracing or failure to reach the target heart rate during exercise testing more than doubled the 10-year risk of a coronary event in men. Investigators say these men should reduce their risk by aggressively controlling blood pressure and lipids and quitting smoking. They also suggest more diagnostic tests, such as imaging stress tests, or invasive procedures like angiography to determine the extent of disease.

The study did not provide evidence to support exercise testing for asymptomatic women because the event rate in women was too low to suggest any significant correlations between the exercise results and future events.

Researchers caution exercise treadmill testing is not generally recommended as routine screening for people with no history or symptoms of heart disease.

SOURCE: To be published in an upcoming issue of Circulation
 

Pregnancy and Restless Legs Syndrome (September 28, 2004)

(Ivanhoe Newswire)

Pregnant women are at a higher risk of developing restless legs syndrome, new research shows.

Investigators from Milan, Italy, report pregnant study participants most affected by the condition were older, had low iron and a higher prevalence of insomnia, and snored more than the unaffected group. Symptoms after delivery rapidly improved, leading researchers to believe hormones, rather than iron deficiency, play a role in this form of RLS.

Restless legs syndrome is marked by an urge to move the legs and is generally accompanied by unpleasant numbness, tingling or burning sensations. Patients also report an increase in symptoms during rest, a partial, temporary relief from symptoms through activity, and a worsening of symptoms at night. Symptoms tend to progress with age.

Of the 606 women in the study, about 26 percent reported having RLS. Of these women, 101 reported experiencing the condition for the first time. One-fourth of the women experienced RLS symptoms at least once a week, and 15 percent reported symptoms at least three times a week. RLS symptoms appeared or worsened generally around the sixth month, reaching a peak at the seventh and eighth months of pregnancy. RLS prevalence dramatically decreased around the time of delivery.

Restless legs syndrome is a movement disorder that affects up to 10 percent of the general population.

According to the article, the link between pregnancy and RLS was first noted in 1940 and confirmed later by a few investigations.

SOURCE: Neurology, 2004;63:1065-1069
 

Lymphoma Patients Undertreated (September 27, 2004)

(Ivanhoe Newswire)

A new study shows about half of patients with non-Hodgkin's lymphoma are not receiving the recommended dose and schedule of chemotherapy, therefore reducing their chances for remission or cure.

The researchers from the University of Rochester Medical Center in New York say the data point to an alarming pattern in the treatment of patients with aggressive and potentially curable NHL. Specifically, researchers say 48 percent to 53 percent of NHL patients received less than 85 percent of the recommended chemotherapy dose due to treatment delays of one week or reduced doses.

Some of the reasons for undertreatment were expected and planned for from the beginning of chemotherapy, but others were unplanned. For example, a common and potentially serious side effect of chemotherapy is neutropenia, or a shortage of infection-fighting white blood cells. At this point in treatment, the patient's risk of developing infections increases and chemotherapy has to be delayed.

White blood cell boosters can be given to manage neutropenia. However, the study found only half of the patients received this preventative measure.

In the study of about 4,500 patients, factors found to increase undertreatment include older age (over 60), advanced disease stage, year of treatment, and failure to use white blood cell boosters preventatively.

The study authors say that identifying risk factors for reducing the doses of chemotherapy should encourage the use of supportive care for patients so they can receive full treatment doses on schedule.

Malignant lymphoma, including both Hodgkin's disease and non-Hodgkin's lymphomas, afflicts more than 50,000 individuals annually in the United States, resulting in nearly 20,000 deaths.

SOURCE: Journal of Clinical Oncology, published online Sept. 20, 2004
 

Mental Health Starts in the Womb (September 24, 2004)

(Ivanhoe Newswire)

When it comes to mental health, good mothering may play a role as soon as the day of birth. Certain factors at birth, such as a mother's mental health, could contribute to the risk of her child committing suicide later in life.

New research also links low birth-weight babies (four pounds and under) and those born to teenage mothers to an increased risk of suicide later. These babies were more than twice as likely to commit suicide than babies in the average population during the study.

A significantly increased risk of attempted suicide was reported for individuals with a short birth length, those born fourth or more in their families' sibling order, and those born to mothers of poor socio-economic status and low education level.

Hypertensive disease during pregnancy and Caesarean section were the only obstetric complications significantly linked to an increased risk of attempted suicide in offspring.

An older maternal age of 29 years or more at delivery was protective against suicidal behavior of the children, the study shows.

Authors of the study from the National Centre for Suicide Research and Prevention in Stockholm, Sweden, suggest suicidal behavior could be due to parental mental health and aggregation of suicide in the family.

Researchers followed more than 700,000 young adults in Sweden for the study.

SOURCE: The Lancet, 2004; 364:1135-1140
 

Addition of DHA may not Help eye Disease Long Term (September 23, 2004)

(Ivanhoe Newswire)

For patients suffering from retinitis pigmentosa, the addition of docosahexaenoic acid to vitamin A therapy may not provide long-term benefits, according to two journal articles.

Retinitis pigmentosa, a progressive eye disease targeting the light-collecting cells of the retina, affects one in 4,000 people worldwide and can cause vision loss.

Researchers followed 221 patients, ranging in age from 18 to 55 years, over four years. All were given 15,000 international units of vitamin A (as retinyl palmitate) along with a placebo or 1,200 milligrams of DHA, an omega-3 fatty acid.

Researchers did not find any significant differences in the progression of the eye disease between those taking vitamin A plus a control and those taking vitamin A plus DHA over four years.

In a separate analysis of the same study, researchers investigated the effect of DHA on patients not already taking vitamin A prior to the study.

Researchers found patients not taking vitamin A before the study who were part of the vitamin-A-plus-DHA group had a slower decline in vision loss than those in the control group. These effects lasted over the first two years but not into years three and four of follow-up.

Authors of this study conclude, "For patients with retinitis pigmentosa beginning vitamin A therapy, addition of DHA, 1,200 milligrams per day, slowed the course of the disease for two years."

SOURCE: Archives of Ophthalmology, 2004;122:1297-1305,1306-1314
 

Exercise Benefits the Mind (September 22, 2004)

(Ivanhoe Newswire)

Your mind will surely reap the benefits from your good habits. That's the word from two new studies published this week.

According to researchers from Harvard School of Public Health in Boston and the University of Virginia School of Medicine in Charlottesville, seniors who integrate cardiovascular activity into their lives, such as walking, lower their risk of mental decline.

In the first study, Harvard researchers surveyed nearly 18,800 women, ages 70 to 81 years, and asked them to rank their physical activity.

The data show women who walked for at least 1.5 hours weekly at a comfortable pace had better cognitive health than those who walked less than 40 minutes per week.

The second study from the University of Virginia shows men, too, can benefit from the routine of exercise. Researchers studied nearly 2,300 men, ages 71 to 93 years, and ranked their exercise levels for two years.

The research shows men who walked more than two miles per day decreased their risk for dementia. Men who walked less than one mile per day increased their risk for dementia by 71 percent.

Both research teams conclude exercise and active lifestyles are associated with a reduced risk of cognitive decline in both women and men.

SOURCE: Journal of the American Medical Association, 2004;292:1447-1453, 1454-1461
 

Mediterranean Diet Healthier (September 22, 2004)

(Ivanhoe Newswire)

A new study shows a Mediterranean-style diet might be effective in treating the metabolic syndrome and its associated symptoms.

The metabolic syndrome is becoming increasingly common in the United States, affecting about a quarter of the adult population. It consists of several factors that increase the risk of cardiovascular disease and type 2 diabetes. These factors include excessive fat tissue in and around the abdomen, raised blood pressure, and insulin resistance or glucose intolerance. The underlying causes of the syndrome are obesity, physical inactivity, and genetic factors.

The Mediterranean diet in the study included whole grains, fruits, vegetables, nuts, and olive oil. One group followed this diet, while the control group followed a prudent diet. The prudent diet included about one-half carbohydrates, one-fifth protein, and less than one-third total fat.

Researchers found after two years, the Mediterranean diet had beneficial effects on two metabolic syndrome symptoms. These were the endothelial (a layer of flat cells lining the closed internal spaces of the body) function and vascular inflammatory markers. Also, patients following the Mediterranean diet had significant decreases in body weight, blood pressure, levels of glucose, insulin, total cholesterol, and triglycerides. Their levels of high-density lipoprotein (good) cholesterol significantly increased. Patients on the Mediterranean diet had half the amount of metabolic syndrome risk factors as the control group.

The researchers conclude, "A Mediterranean-style diet ... might be effective in reducing both the prevalence of the metabolic syndrome and its associated cardiovascular risk."

SOURCE: Journal of the American Medical Association, 2004;292:1440-1446
 

Vitamin E may Restore Sudden Hearing Loss (September 22, 2004)

(Ivanhoe Newswire)

A preliminary study from Israel shows vitamin E may be effective in restoring sudden onset hearing loss.

Researchers say about 4,000 Americans each year experience sudden hearing loss, which occurs within three days or less. The cause of the sudden hearing loss can be identified in only 10 percent to 15 percent of the cases, which includes viral and bacterial diseases, and metabolic, neurologic and immunologic sources. The rest of the cases are termed idiopathic, which means there is no known cause.

Previous research shows antioxidants could prevent consequences of damage in the inner ears of animals. With this evidence, the study authors assumed antioxidants could reduce the damage and enhance recovery of idiopathic sudden hearing loss.

Sixty-six participants were enrolled in the study within eight days from onset of the hearing loss. They were all treated with bed rest, magnesium, inhalation of carbogen and steroids, and the patients in the study group received 400 milligrams of twice-daily vitamin E in addition.

The success of the treatment, defined as improvement of 75 percent or more, was better in the study group (about 78 percent vs. about 45 percent). This was also true at follow-up. However, the difference in complete recovery between the groups was insignificant.

The study authors call for further studies to be directed toward a better understanding of the role of antioxidants in idiopathic sudden hearing loss. They add this should include determining the most effective antioxidant and its optimal dose.

SOURCE: American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting in New York City, Sept. 19-22, 2004

 

Chemotherapy not Delayed After Breast Reconstruction (September 22, 2004)

(Ivanhoe Newswire)

While there is an increased risk of wound complications in patients undergoing breast reconstruction directly after a mastectomy, the procedure does not delay the start of postsurgical chemotherapy, according to researchers publishing in the September issue of Archives of Surgery.

Researchers at the University of California Davis Medical Center in Sacramento reviewed the medical records of 128 women who underwent a combined total of 148 mastectomy procedures. Of those patients, 62 had a mastectomy immediately followed by breast reconstruction and 81 had postoperative chemotherapy.

Results show that 22.3 percent of patients who underwent breast reconstruction right after their mastectomies developed wound complications, compared to 8.3 percent of those patients who did not have immediate breast reconstruction.

These complications, however, did not delay the initiation of postoperative chemotherapy.

According to the article, breast cancer is the most common cancer affecting women in the United States today. Breast reconstruction has been shown to reduce the negative impact on self-image and psychosocial well-being that women may experience following a mastectomy.

Authors conclude, "Although we observed an increased incidence of wound complications when immediate breast reconstruction was combined with mastectomy, there was no delay in the initiation of adjuvant therapy. Immediate breast reconstruction should remain an important treatment option after mastectomy even when postoperative chemotherapy is anticipated."

SOURCE: Archives of Surgery, 2004;139:988-991

Bigger Family, Bigger Waistline? (September 21, 2004)

(Ivanhoe Newswire)

Low-income women in large households with less than a high school education and limited parental support may be at greater risk for obesity, according to a new study.

Researchers from Texas Tech University Health Sciences Center in Amarillo surveyed 274 low-income women who attended a family planning clinic.

Results show nearly half of the participants were obese (having a body mass index of more than 30). Of those living in households of four or more people, nearly 65 percent were obese compared to about 30 percent who lived alone.

Researchers say 60 percent of women with less than a high school education were obese. On the other hand, only about 40 percent of those with a degree were obese. Also, about 10 percent of participants who received little or no parental support were obese.

Women with household incomes within the $10,000 to $20,000 range were the least likely to be obese. Researchers say that may have something to do with income determining eligibility for food programs.

Authors conclude, "[Our results], nevertheless, have significance for public health practice related to weight control. Health promotion programs that seek to encourage healthier eating behaviors in low-income female populations should focus on women who are not receiving support from their parents and who have large families of their own."

SOURCE: BMC Family Practice, 2004;5:20

Cornea may Affect Glaucoma Treatment (September 20, 2004)

(Ivanhoe Newswire)

Are you at risk for glaucoma? If so, make sure your doctor checks your cornea when determining treatment.

A recent study from Columbia University in New York shows the thickness of the cornea may be an important factor when determining glaucoma treatment.

Incidence of glaucoma is usually determined after measuring the eye's central corneal thickness, which affects the accuracy of the intraocular pressure measurements, or the pressure in the eye. Patients with decreased corneal thickness are at risk for glaucoma.

After examining the corneal thickness of nearly 188 glaucoma patients, researchers found themselves adjusting the treatment they had originally chosen for their glaucoma patients.

Sixteen patients had a change in eye drop medication, four had a change in laser therapy, and six had a change in glaucoma surgery.

The study's authors conclude, "…central corneal thickness has a significant effect on the clinical management of patients with glaucoma and suspected glaucoma."

SOURCE: Ophthalmology, 2004;122:1270-1275
 

Infertility Help for Select Women (September 20, 2004)

PALO ALTO, Calif. (Ivanhoe Broadcast News)

About one in 20 women suffer from polycystic ovarian syndrome. It is the most common female hormone disorder in the United States. It usually strikes during adolescence and leads to excess hair and weight gain and ultimately a struggle to get pregnant. Now, doctors may have a new option for these women facing infertility.

Three years ago, Thelma and Miguel Bonilla got married and were ready to start a family. Then Thelma developed irregular periods -- each time it didn't come, she thought she was pregnant. Each time, she was disappointed.

It turned out Thelma had polycystic ovarian syndrome, or PCOS.

"There is a small percentage of women who do ovulate with PCOS, and those women can become pregnant and have successful pregnancies, but it is a very small percentage," says Linda Giudice, M.D., Ph.D., a reproductive endocrinologist at Stanford University Medical Center in Palo Alto, Calif.

Dr. Giudice explains women with PCOS have high levels of testosterone and insulin. She's involved in a study taking place at 14 centers across the United States to see if the fertility drug Clomid and the insulin sensitizer metformin can help these women.

"Not only are we looking at the ability to ovulate on these various medications, but we are comparing the effectiveness of each medication, or in combination, to the ability to get pregnant," Dr. Giudice says.

So far, the results have been encouraging. Many of the women who have completed the study have become pregnant, including Thelma. "Oh, my God. I was crying. I was on the street, and everybody saw me, and there was one person who came to me and said, 'Are you OK?'"

Thelma and Miguel are more than OK -- with a whole new future to look forward to as parents.

If you are interested in taking part in the research, please contact:
(866) 878-8452
http://rmn.dcri.duke.edu/
 

Mother’s Diet Prevents Childhood Cancer (September 14, 2004)

(Ivanhoe Newswire)

A new study shows women who consume more fruits, vegetables and proteins before becoming pregnant are less likely to have a child who develops leukemia.

Researchers from the University of California, Berkeley, studied more than 130 women who had a child diagnosed with acute lymphoblastic leukemia. They compared the women’s diets to those of more than 130 women with healthy children.

Results show women who consumed more vegetables, fruits and proteins during the year prior to becoming pregnant had a lower risk of having a child with leukemia.

Researchers say they were surprised that consuming protein sources, such as beef and beans, lowered the risk of having a child with leukemia. Gladys Block, Ph.D., lead author of the study, says: “The health benefits of fruits and vegetables have been known for a long time. What we found in this study is that the protein foods group is also very important.”

The researchers believe glutathione is the nutrient in protein that lowers the cancer risk. Nutrients such as carotenoids are thought to be responsible for the protective benefits offered by fruits and vegetables.

Authors of the study conclude, “Fetal exposure to nutritional factors has a lot to do with what mom eats. These findings show how vital it is that women hoping to get pregnant, as well as expectant moms, understand that critical nutrients in vegetables, fruit and foods containing protein, such as meat, fish beans and nuts, may protect the health of their unborn children.”

SOURCE: Cancer Causes and Control, 2004;15:559-570
 

Fibromyalgia Relief for Women (September 13, 2004)

(Ivanhoe Newswire)

The antidepressant duloxetine, also known as Cymbalta, may significantly reduce symptoms of fibromyalgia in women, according to a new study.

Fibromyalgia is a chronic musculoskeletal disorder that is characterized by body pain, muscle tenderness, headaches, sleep disturbances, and fatigue. The condition is nearly six-times more common in women than it is in men.

Researchers from the University of Cincinnati College of Medicine studied more than 200 men and women with the disorder. Nearly 90 percent of these patients were women.

About half of the participants received 60 milligrams of duloxetine twice a day, while the other half received a placebo.

Researchers say the women in the study reported significant improvement in symptoms, while the men did not. The female patients treated with duloxetine reported improvements in pain and tenderness. However, the men did not report any significant changes.

Researchers say, “The reasons for the sex differences in response are unclear. Because the male subgroup was small, reflecting the much higher prevalence of fibromyalgia in women, the results of the study may not be generalizable to all men with fibromyalgia. There may also be sex differences in fibromyalgia that affect treatment response.”

Duloxetine works by stopping the reuptake of serotonin and norepinephrine, two of the brain’s neurotransmitters that are linked to mood.

Authors conclude, “Our results suggest that duloxetine improves pain and tenderness, the hallmark characteristics of fibromyalgia. The effect of duloxetine on the reduction of pain appears to be independent of its effect on mood.”

SOURCE: Arthritis & Rheumatism, 2004;50:2974-2984
 

Strengthening Corneas (September 13, 2004)

NASHVILLE, Tenn. (Ivanhoe Broadcast News)

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

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

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

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

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

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

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

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

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

Treating Alcoholism With Drugs (September 13, 2004)

(Ivanhoe Newswire)

Doctors have known topiramate (Topamax), a drug used to prevent epileptic seizures, reduces the craving for alcohol use in alcohol-dependent individuals when used with psychotherapy. Now, a new study reveals the drug is effective alone as well.

Researchers from the University of Texas Health Science Center in San Antonio studied 150 men and women, ages 21 to 65, who were classified as alcohol-dependent based on the DSM-IV -- the manual used to diagnose psychiatric disorders. Before enrollment, each drank 21 or more (women) and 35 or more (men) drinks per week. A standard drink was considered 0.35 liters of beer, 0.15 liters of wine, or 0.04 liters of 80-proof liquor.

In the 12-week study, half of the patients received increasing doses of topiramate starting at 25 mg/d and up to 300 mg/d. The other half received a placebo.

Both before and after drug treatment, researchers measured three elements of psychological and social well-being: severity of alcohol dependence, reported quality of life, and consequences of drinking.

Results showed patients taking topiramate were twice as likely to experience improved well-being than those on placebo. The were also 2.5-times more likely to report abstinence from alcohol, twice as likely to report overall satisfaction with life, and reported fewer instances of harmful drinking consequences.

Bankole A. Johnson, M.D., Ph.D., lead author of the study, says, "Topiramate's effect at improving psychosocial functioning was robust, with an increasing trend toward better outcomes as treatment progressed."

The drug maker, Ortho-McNeil Pharmaceutical, Inc., provided the study drugs. Research grants were provided by the drug maker and the National Institute on Alcohol Abuse and Alcoholism. The University of Texas Health Science Center provided additional funding through its Division of Alcohol and Drug Addiction.

SOURCE: Archives of General Psychiatry, 2004;61:905-912
 

Changing the Diabetic Menu (September 13, 2004)

BOSTON (Ivanhoe Broadcast News)

Sugary foods like cookies, cake and candy have traditionally been off limits for people with diabetes but not anymore. Now dieticians are dispelling the most common myths surrounding the diabetic diet of the past.

Nancy DelPrato is about to break one of the oldest rules of a diabetic diet. And surprisingly, she's doing it with the help of registered dieticians, Karen Chalmers and Amy Peterson, who are co-authors of "16 Myths of a Diabetic Diet."

"When people have diabetes, their first focus is always sugar, thinking they have to avoid it," Chalmers, of Joslin Diabetes Center in Boston, tells Ivanhoe.

But the focus should be on all carbohydrates, from the sugar in candy to the starch in potatoes and bread.

DelPrato is allowed 60 grams of carbs at dinner, so when she has apple pie for dessert -- 45 grams -- Chalmers and Peterson, also of Joslin Diabetes Center, suggest she eat only one slice of bread at 20 grams.

"You can eat any food you want in proportion as long as you stay within the guidelines of the carbs," DelPrato says.

Another common myth is that diabetics can eat as many sugar-free foods as they want. But the words "sugar-free" can be misleading. This ice cream bar is sweetened with NutraSweet but still has 13 grams of carbohydrates, the same amount as a regular ice cream bar.

"If a food has carbohydrate listed on the label, then it's going to affect your blood sugar. If it says zero on the label, like a can of diet soda, then it will not affect your blood sugar," Chalmers says.

She and Peterson say the old, strict diabetic diet is a thing of the past.

"People often call us and say, 'Could I have a copy of the diabetic diet,?' and we just have to say, 'There is no diabetic diet, anymore,'" Peterson says.

While eating dessert isn't the healthiest choice, these dieticians say indulging from time to time is OK as long as you know how to fit it in.

Neither dietician promotes junk food but rather good health and flexibility for diabetics. By the way, both women say a candy bar has the same amount of carbohydrates as a baked potato, so the effect on a person's blood sugar is exactly the same.

If you would like more information, please contact:
American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
http://www.diabetes.org/
 

Drug Combo Saves the Heart (September 10, 2004)

ANN ARBOR, Mich. (Ivanhoe Broadcast News)

According to the National Institutes of Health, about 1 million Americans will have a heart attack every year. More than half of those people will survive, but not all of them will leave the hospital with the drugs they need to keep them alive. Here are the drugs patients need to keep their hearts on the right track.

Today, Dick Croake is recovering from a heart procedure that cleared a 90-percent blocked artery. "The physician who did the procedure said, ‘If you hadn't come in, something bad would have happened,'" Croake tells Ivanhoe.

To prevent a heart attack, Croake is taking a quartet of drugs.

Interventional cardiologist Debabrata Mukherjee, M.D., says it's a smart step. "There are four classes of drugs that are currently recommended in all patients that present to the hospital either with worsening chest pain or with a heart attack," Dr. Mukherjee, of University of Michigan in Ann Arbor, tells Ivanhoe.

Those drugs are: ace inhibitors to lower blood pressure; statins to lower cholesterol; anti-platelets, which include aspirin and Plavix (clopidogrel bisulfate); and beta-blockers, which lower blood pressure but have other benefits too.

"All four should be started at once, rather than individually one at a time," Dr. Mukherjee says.

Doctors know each of the drugs is important, but they didn't realize the cumulative effect of taking all four until now. A new study shows taking all four lowers the risk of death more than 90 percent after six months.

The American Heart Association recommends the drugs for heart patients, but that doesn't always happen. Dr. Mukherjee says there is still a gap between optimal care of patients and what is recommended in the guidelines. She tells heart patients to ask their doctors about the drugs.

Croake feels safer knowing he's getting the best care. "I feel guardedly optimistic," he says. "I said to my wife this morning, ‘It is great to be alive.'" Now, he's focusing more on the scenery and less on his heart.

All of the recommended drugs are available in generic forms. Even without insurance, the drugs should cost no more than $50 a month. They are recommended for prevention of a second heart attack, for those who have already had one, or for those who have a history of heart disease. Side effects may occur in some people, so be sure to discuss each of the drugs with your doctor.

If you would like more information, please contact:
Kara Gavin
Public Relations
University of Michigan Health System
Ann Arbor, MI
kegavin@umich.edu
 

Antibiotic Increases Sudden Death Risk (September 10, 2004)

(Ivanhoe Newswire)

Erythromycin is a commonly used antibiotic, but new research suggests it could be dangerous when used in combination with other drugs. The study shows patients should not be given erythromycin along with antifungal agents such as diltiazem, verapamil and troleandomycin because it increases the risk of sudden death. These drugs are also known as CYP3A inhibitors.

Researchers from the Vanderbilt School of Medicine in Nashville, Tenn., conducted the study to determine if there is any association between the use of erythromycin and sudden cardiac death. Researchers used information on 1,476 cases of confirmed sudden death due to cardiac causes. They looked at what medications the patients were on including the drugs erythromycin or amoxicillin. Amoxicillin is another commonly used antibiotic, but does not have the same effect on the heart as erythromycin.

Researchers report the rate of sudden death from cardiac causes among patients on erythromycin was twice as high compared to those who had not used any antibiotics. The research also shows the rate of sudden death from cardiac causes was five-times as high among patients on erythromycin and a CYP3A inhibitor. There was no increased risk of death among patients on amoxicillin.

Study authors conclude the combination use of these drugs should be avoided. Researchers say there are alternative drugs that doctors can prescribe without putting patients at a higher risk for sudden death.

SOURCE: The New England Journal of Medicine, 2004;351:1089-1096