Health Discoveries

By: Source: AARP Bulletin Today Date Posted: 2003-07-11 08:54:35

November 2002

Recommended Dosages of New Drugs Often Too High

Of 354 drugs introduced in the United States from 1980 to 1999, 20 percent of recommended dosages were too high.

A study by the Georgetown University Center for Drug Development Science in Washington showed that 79 percent of dosage changes for the drugs were made for safety reasons; others were made because of risks to certain groups such as pregnant women.

"Avoiding needless overdosing could reduce both [adverse] side effects and costs of prescription drugs," says lead author James Cross.

Researchers found dosage changes were more frequent for drugs approved from 1994 to 1999 than for those introduced earlier.

Dutch researchers found similar results with drugs introduced in Europe. The American and Dutch studies were published in the British journal Pharmacoepidemiology and Drug Safety in August.

Self-Exams Don't Reduce Breast Cancer Deaths

Another quandary for women: Told for years to check their breasts monthly for early detection of breast cancer, they're now learning that self-exams don't save lives.

A 10-year study of 266,000 Chinese women by Seattle's Fred Hutchinson Cancer Research Center found no difference in death rates from breast cancer between a group taught self-exam methods and a control group that received no information.

Women doing self-checks did find more benign lumps than the other women, leading to an increase in biopsies.

The results do not mean women should stop self-exams, lead researcher David B. Thomas, M.D., reported in the Journal of the Cancer Institute Oct. 2, but the self-checks are no substitute for routine mammograms.

Caution: Go Easy on the Tylenol

Federal watchdogs are warning against the danger of taking too much Tylenol and other products containing the pain reliever acetaminophen.

The Food and Drug Administration (FDA) reports that each year thousands of people end up in the hospital—and about 100 die—as a result of an inadvertent overdose of acetaminophen, which can cause liver problems. Many of those affected inadvertently used more than one medicine containing acetaminophen.

Some drug manufacturers have already pledged to relabel products containing acetaminophen with warnings of liver toxicity.

An FDA advisory committee stressed that acetaminophen is "a safe and effective over-the-counter analgesic" if used correctly.

October 2002

A Walk Every Day Can Help Snuff Out the Sniffles

Exercise advocates have another reason to trumpet the benefits of working out: Regular physical activity can lower your chances of getting a cold.

Even moderate exercise—such as 30 minutes of brisk walking on most days—seems to hold off upper respiratory infections, researcher Charles E. Matthews of the University of South Carolina School of Public Health reported in the August Medicine & Science in Sports & Exercise.

Among the 547 healthy men and women ages 20 to 70 Matthews and his colleagues studied for a year, the more active people were 20 percent less likely to get a cold over the course of the year and 32 percent less likely during the fall cold season.

Yes, We'll Have Some Bananas…

Eat more bananas, oranges, fish, yogurt and other potassium-rich foods—and you may cut your risk for stroke.

Researcher Deborah M. Green, M.D., of the Queen's Medical Center of the University of Hawaii, found in an eight-year study of 5,600 men and women over 65 that those with low potassium levels had an increased risk of stroke. The risk was even higher for those with low potassium levels who were using diuretics for heart disease and high blood pressure.

For participants who use diuretics and have an irregular heart beat and low potassium levels, the risk of stroke was 10 times as high as diuretics users with a normal heart beat, according to the study published in the Aug. 13 Neurology.

Green stressed the importance of using diuretics and getting sufficient potassium.

Stress Is Less When you're Older

Here's one benefit of aging: Older people have more stress-free days than younger ones.

"Older adults are dealing better with their stressors," reports psychologist David Almeida of the University of Arizona in Tucson. "We learn through our earlier frustrations."

"The older you get," he tells the AARP Bulletin, "you kind of realize that 'hey, it's not worth getting upset about the small things.' "

Tracking 1,000 adults 25 to 74 years old for eight consecutive days, he found that 8 percent of young adults reported one stress-free day, compared with 12 percent of those 40 to 59 and 19 percent of those 60 and older.

What stresses us out changes as we age, Almeida reported in August at the American Psychological Association annual meeting in Chicago. Older people face health problems; the middle-aged are overloaded by demands on them; and younger people worry about tensions in relationships.

September 2002

Surgery for Arthritic Knees? Maybe Not

The placebo effect scores as well as surgery against some kinds of pain, a new study finds.

Researchers divided 180 people who had osteoarthritis knee pain into three groups. Two had arthroscopic surgery that uses miniature tools to wash or clean out the knee. The third group was led to believe they had surgery—but only tiny incisions were made on the knees. Yet all participants reported less pain and more function during two-year follow-ups.

"Our study shows that the surgery is no better than the placebo—the procedure itself is useless," says Nelda Wray, M.D., of the Houston Veterans Affairs Medical Center, where the trial was held.

The improvement resulted from patient expectations that surgery would make them better, Wray, a co-author of the study in the July 11 New England Journal of Medicine, told the AARP Bulletin.

How to Reduce Your Risk for Alzheimer's

While scientists zero in on the genetic causes of Alzheimer's, experts have found ways individuals can protect against the degenerative disease.

The number-one piece of advice: "Don't get too big, eat a healthy diet and stay active, physically and mentally," William Thies, vice president of the Alzheimer's Association, said at July's International Conference on Alzheimer's Disease in Stockholm. "Know your numbers—blood pressure, cholesterol and glucose."

Other news from the meeting:

What you eat in your 40s and 50s affects your risk of Alzheimer's. Researchers recommend a low-fat diet with five servings of fruits and vegetables a day, fish and vitamins B and E.
New links found between vascular problems and Alzheimer's reinforce the need to control cholesterol and blood pressure with diet, exercise and medications.
Cholesterol-lowering statin drugs such as Zocor or Pravachol may protect against Alzheimer's.

Housework Won't Make You Healthier

Sorry, ladies. A British study of 2,341 women ages 60 to 79 found that doing housework as exercise does not seem to improve health.

Washing floors and vacuuming do not result in weight loss or lower resting heart rates, a measure of physical fitness. Brisk walks do.

The study, led by Debbie Lawlor, M.D., of the University of Bristol, appears in the May Journal of Epidemiology and Community Health.

July/August 2002

An Aspirin at Bedtime May Lower Blood Pressure

The low-dose aspirin many people take daily to prevent a heart attack may have another big benefit—it may lower their blood pressure.

One caveat—it only works if taken at bedtime, Ramon Hermida of the University of Vigo in Spain told the annual meeting of the American Society of Hypertension in May.

Hermida tracked 109 people with mild-to-moderate hypertension and found their systolic (upper number in blood pressure) and diastolic (lower) pressure had decreased after taking aspirin at bedtime.

In another study, reported in the May Archives of Internal Medicine, Harvard Medical School researchers found naproxen (Naprosyn, Aleve) to be the only nonsteroidal anti-inflammatory drug to protect against heart attacks.

Chemical in Broccoli Fights Ulcers, Stomach Cancer

Broccoli—though much maligned—is your friend.

The vegetable appears to combat ulcers better than antibiotics and may help prevent most stomach cancers.

Broccoli contains a chemical that boosts the body's production of the substance sulforaphane, which destroys the Helicobacter pylori bacteria responsible for ulcers and most stomach cancers.

Jed Fahey and a team from the Johns Hopkins University and researchers from the National Center for Scientific Research in France report on their laboratory experiments in the May 28 issue of the Proceedings of the National Academy of Sciences.

New Fibroid Procedure Avoids Hysterectomy

A new procedure offers an alternative to hysterectomy for women with harmful fibroids of the uterus.

Almost 80 percent of women will develop fibroids, usually harmless noncancerous tumors that range in size from a pea to a cantaloupe. In some cases, however, fibroids can cause pain and heavy bleeding and interfere with other bodily functions.

A hysterectomy to remove the uterus is the typical treatment. The new, less invasive procedure spares the uterus but destroys the growths.

Bruce Lee, M.D., told the AARP Bulletin he is pioneering a technique in which needle electrodes are inserted through two tiny incisions in the abdomen to deliver heat from radio waves that "zap" the fibroids.

Lee, of California's Monterey Peninsula Surgery Center, described his technique, called radio frequency ablation, at a meeting of the American College of Obstetricians and Gynecologists in May.

June 2002

Salmon a Heart Saver? That's Not a Fish Story

Eating fish can protect your heart—and your life, say two major studies.

"We found that eating fish at least twice a week could reduce the risk of heart disease by more than 30 percent," JoAnn Manson, M.D., Harvard Medical School professor and co-author of both studies, told the AARP Bulletin.

One study, published in the April 11 New England Journal of Medicine, found that men without heart disease were 81 percent less likely to die later of sudden cardiac arrest, despite their age or smoking habits, if they had high blood levels of omega-3 acids found in oily, fatty fish.

In the second study, women who ate fish five times a week cut their risk of dying later from a heart attack by half, says a report in the April 10 Journal of the American Medical Association.

Omega-3 fatty acids, found in fish like salmon, tuna, mackerel and herring, appear to lower cholesterol and prevent dangerous blood clots and irregular heart rhythms that can lead to sudden cardiac arrest.

Fixing Farsightedness Without Lasers

A new procedure to correct farsightedness—without lasers or incision—has received approval from the Food and Drug Administration (FDA).

Farsightedness, the inability to see clearly at short distances, results from a flattened cornea in the eye. The new technique, conductive keratoplasty, uses a thin probe to change the shape of the cornea with heat produced by radio waves. It takes about three minutes, using eyedrop anesthesia, says Refractec, Inc., of Irvine, Calif., which makes the equipment for the procedure.

FDA spokeswoman Sharon Snider cautions that vision can deteriorate for a year after the procedure before it stabilizes.

Cool Down Heartburn With Red Hot Jalapeños

Those fiery, belly-burning little peppers may in fact ease chronic indigestion.

Some participants in an Italian study took capsules of capsaicin, a chemical abundant in hot peppers, before meals for five weeks, while others took a placebo. All participants had chronic digestive problems without a known cause. Those taking the capsaicin, rather than a placebo, experienced a 60 percent decrease in pain, feelings of fullness and nausea.

Researcher Mauro Bortolotti, M.D., of the University of Bologna said in the March 21 New England Journal of Medicine that the capsaicin may block pain signals going from the stomach to the brain.

May 2002

Keeping the Beat in Heart Attack Patients

A small device implanted in the chest to control heart rhythms can help save the lives of high-risk patients who have had heart attacks.

In a study of 1,232 heart patients, researchers found that the death rate was 31 percent lower among those who had the defibrillating device than those who didn't.

So far the implants have been prescribed only for patients with known arrhythmia. Arrhythmia is a fluctuating heartbeat, a condition that can cause sudden cardiac arrest if not treated immediately.

A defibrillator, the size of a deck of cards, monitors heart rhythm. When it senses an erratic heartbeat, it sends an electric shock to restore normal rhythm.

The study, led by Arthur Moss, M.D., of the University of Rochester Medical Center in New York, indicates that the devices can help prevent problems in patients who have had heart attacks even if they do not have arrhythmia.

"The therapy is excellent, and evolving," says Indiana University's Douglas Zipes, M.D., former president of the American College of Cardiology (ACC).

One drawback, he told the AARP Bulletin, is cost. The device runs about $20,000 and surgical implantation about $10,000. Manufacturers need to make "a Volkswagen as well as a Rolls Royce," Zipes says.

Health coverage for defibrillators varies among insurers. Medicare currently pays in cases of known arrhythmia but not to prevent it.

The new findings were presented at the annual ACC meeting in March and in the March 21 New England Journal of Medicine.

Looking for Trouble

Researchers have found that a treadmill stress test can pick up signs of future heart disease in healthy individuals.

Stress tests are generally used to evaluate patients with chest pain, shortness of breath and other symptoms of heart disease.

But new studies tracking symptom-free participants—2,001 women (ages 40 to 80) and 3,775 men (30 to 79)—over 20 years indicated that those with tests showing slight irregularities that did not require treatment were at higher risk for heart trouble than those with normal responses.

The bottom line, researcher Samia Mora, M.D., told the AARP Bulletin, is that those with abnormal results were almost twice as likely to die of heart disease as those with normal results. Mora, of the Johns Hopkins School of Medicine, presented her studies to the March meeting of the American College of Cardiology.

The findings suggest that exercise tests could benefit people with high cholesterol or a family history of heart disease.

A stress test checks pulse rates, blood pressure and oxygen levels as treadmill speed gradually increases. Results may show blockages and irregular heart rhythms.

April 2002

High Odds for High Blood Pressure

New findings from a long-running heart study are raising red flags that mid-life Americans need to do more to prevent high blood pressure.

An evaluation of 1,298 participants in the 54-year-old Framingham (Mass.) Heart Study shows that up to 90 percent of individuals ages 55 to 65 could develop high blood pressure, or hypertension.

Hypertension can cause heart disease and stroke but is preventable, the study's co-authors wrote in the Feb. 27 Journal of the American Medical Association.

Heart specialists say eating a low-salt diet, maintaining a healthy weight, exercising regularly and not smoking are ways to control blood pressure.

Blood Test May Offer Clue to Alzheimer's

It's possible that a simple blood test will help determine a person's chances of developing Alzheimer's disease and other dementias.

Older people with high levels of the amino acid homocysteine in their blood have nearly twice the average risk of later developing Alzheimer's, says neurologist Sudha Seshadri, M.D., of Boston University School of Medicine.

Seshadri and her team studied 1,092 participants whose homocysteine levels were tracked for 20 years in the Framingham (Mass.) Heart Study. Their report appeared in the Feb. 14 issue of the New England Journal of Medicine.

Excessive homocysteine has been linked to heart disease, stroke and Parkinson's disease. A diet rich in fruits and vegetables, folic acid and vitamins B-6 and B-12 can reduce homocysteine levels.

So Long, Cavities…

A genetic tweaking of bacteria normally present in the mouth may enable them to fight off cavity-causing bad guys.

After modifying the streptococcus mutans bacteria in rats, researcher Jeffrey Hillman of the University of Florida College of Dentistry in Gainesville found the animals had lifelong protection against cavities.

Human trials of the bacteria he developed could begin next year.

Hillman reported his findings to the American Academy for the Advancement of Science in February.

Depression Hinders the Immune System

Treating mild depression that can weaken the immune system in older people may help them fight disease more effectively.

Researchers at Ohio State University College of Medicine say that people 60 and over often have mild depression. In a study of the emotional health and infection-fighting ability of 78 older adults, they concluded that the link between depression and a weakened immune system may explain why older adults are at greater risk for cancer and severe infections.

Lead author Lynanne McGuire writes in the February Journal of Abnormal Psychology that exercise and talk therapy as well as antidepressants help relieve mild depression in older people.

March 2002

Aspirin—Precaution Against Heart Attack

Aspirin has long been prescribed after a heart attack to avoid another attack. Now a panel of leading experts recommends that healthy adults over 40 at risk for heart disease also take aspirin as a precaution.

The U.S. Preventive Services Task Force, sponsored by the federal Agency for Healthcare Research and Quality, reported in January that aspirin reduces the risk of heart disease by 28 percent. But the group cautions people to discuss the pros and cons of taking aspirin with their doctors.

"Do not assume that an aspirin a day is without risk," says Alfred Berg, M.D., of the University of Washington in Seattle, who led the panel. Aspirin can cause intestinal bleeding and hemorrhagic stroke.

Those at risk for coronary heart disease include men over 40, postmenopausal women, smokers and people with diabetes, high blood pressure, high cholesterol or a family history of heart disease.

Berg told the AARP Bulletin it does not seem to matter if the aspirin is buffered and that 75 milligrams (mg) a day (standard tablets are 325 mg) may be as effective as higher doses.

New Role for Folic Acid in Parkinson's

New research indicates the vitamin folic acid may protect against Parkinson's disease.

Experiments conducted with mice—who closely resemble humans genetically—offer "the first direct evidence that folic acid may have a key role in protecting adult nerve cells against age-related disease," says Mark Mattson, chief of the neurosciences laboratory of the National Institute on Aging. The study findings were reported in the January Journal of Neurochemistry.

Mice deprived of folic acid had fewer dopamine-producing cells, and more damaged cells, than mice given folic acid. Low levels of dopamine, a chemical in the brain that affects movement, are symptomatic of Parkinson's.

The National Academy of Sciences recommends 400 micrograms daily of folic acid, which is found in many B-complex vitamins.

'And So to Sleep…'

Counting sheep doesn't do it. "Too boring," says Oxford University researcher Allison Harvey.

A study of 50 Oxford students with insomnia shows that the best way to get to sleep is to picture a relaxing scene like a sunset.

Doing so put one group of students to sleep 20 minutes earlier than two other groups—one counting sheep and one following usual routines for falling asleep.

Insomniacs often use distractions to try to fall asleep. "Picturing an engaging scene takes up more brain space than the same dirty old sheep," says psychologist Harvey, whose study was reported in the Jan. 26 issue of New Scientist. "Plus it's easier to stay with it, because it's more interesting."

Correction

The correct dosage recommended in the February Bulletin to help prevent loss of bone mass is 600 to 800 international units, not milligrams, of vitamin D.

February 2002

A Wake-up Call on Losing Bone Mass

More older American women than previously suspected are showing signs of osteoporosis, the thinning of the bones that can lead to life-threatening fractures.

A study of 200,000 healthy post-menopausal women found that almost half of them had low bone mass, and 7 percent had full-blown, but previously undetected, osteoporosis.

"Nudge your doctor," advises Ethel Siris, M.D., head of the Toni Stabile Osteoporosis Center at Columbia Presbyterian Medical Center in New York. "If you're 65 or over, get tested. Now."

Advancing age is "the prime risk factor," Siris tells the AARP Bulletin.

Some protective measures:

Take 1,200 to 1,500 milligrams (mgs) of calcium daily.
Take 600 to 800 international units of vitamin D, which helps the body absorb calcium.
Do strength and balance exercises to help prevent falls.
Learn about drugs that can treat or slow osteoporosis.

Siris and her colleagues reported on the National Osteoporosis Risk Assessment study in the Dec. 15 Journal of the American Medical Association.

Easing Recovery

A little soft jazz or maybe the sound of ocean waves piped into the operating room along with whispers of encouragement from doctors and nurses might help post-surgery patients get back on their feet.

Swedish researchers found that patients soothed by music and words of comfort during surgery have less pain and fatigue during recovery.

A team led by Ulrica Nilsson, M.D., of Örebro Medical Center Hospital confirmed that the brain is aware of sounds even when the patient is anesthetized. They reported their findings recently in Acta Anaesthesiologica Scandinavica.

New Way to Test Heart Attack Risk

Testing levels of certain cholesterol-carrying proteins may better predict the risk of fatal heart attack than measuring cholesterol levels alone.

The apoA-1 protein carries "good" HDL cholesterol, and the apoB protein carries "bad" LDL cholesterol.

A five-year study tracking 175,000 participants found that high rates of apoB were strongly related to heart attack, even among those with normal or low LDL cholesterol, reports Göran Walldius, M.D., of the Karolinska Institute in Sweden. The study was reported in the Dec. 15 Lancet.

January 2002

New Treatments for Cancer Not as Hard on Patients

New techniques to fight certain prostate and breast cancers may make treatment less traumatic for patients.

Medical researchers in Celebration, Fla., report that an outpatient procedure known as "focused cryosurgery" can destroy some prostate tumors without the side effects often experienced after other types of prostate surgery.

The operation is performed by inserting a probe tube into the prostate to "freeze" and destroy the tumor. The procedure preserves a key nerve, thus lowering the risk of impotence and incontinence.

According to Gary M. Onik, M.D., of the Center for Surgical Advancement at Florida Hospital, men who had the procedure were able to return to work in five days.

In the United Kingdom, scientists found that breast cancer patients undergoing small-tumor removal via a lumpectomy may be able to eliminate the usual six weeks of follow-up radiation.

Surgeon Jayant Vaidya of the University College London Medical School said women in the study who received a concentrated 25-minute dose of radiation immediately after surgery did as well 18 months later as women who had the longer period of radiation.

Both cancer studies were presented in November at the annual meeting of the Radiological Society of North America in Chicago.

Lower Cholesterol? Eat Less More Often

It's not only what you eat, but how often you eat that affects your cholesterol levels.

A British study with 14,600 adults ages 45 to 75 found that those who ate at least five or six times throughout the day had lower cholesterol levels than those who ate one or two large meals—even though the frequent eaters consumed more fat and calories.

"Bad" cholesterol levels declined in those eating often; "good" cholesterol levels did not go up.

Kay-Tee Khaw of the University of Cambridge said in the Dec. 1 British Medical Journal that variations in metabolic responses that turn food into energy may account for the lower levels among those who eat often.

Khaw told reporters that there is no evidence that supports "frequent snacking on junk food."

More Protection Against Alzheimer's

Anti-inflammatory drugs such as ibuprofen and naproxen—but not aspirin—may help protect against Alzheimer's disease.

For seven years researchers in the Netherlands tracked about 7,000 men and women who initially showed no signs of dementia. By examining pharmacy records of participants' drug prescriptions, the researchers at Erasmus Medical Center in Rotterdam found "a significantly reduced risk of Alzheimer's" in those who had taken prescription nonsteroidal anti-inflammatory drugs (NSAIDs) regularly for at least 24 months.

Even shorter periods of use may offer some protection, researchers said in the Nov. 22 issue of the New England Journal of Medicine.

Over-the-counter NSAIDs with lower active ingredients are now being tested in America for their effects on Alzheimer's.

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