Disability Law Blog

Exercise May Help Asthma

Since beginning an exercise program, Jacqueline Duda, a 42-year old Washington-area freelance writer and inhaler-dependent asthmatic, has kissed the inhaler goodbye. "Around mid-November, I noticed more subtle changes. Housework no longer provoked respiratory fits, just a sneeze or two. My breathing was less labored. Call me crazy, I even took the vacuum for a spin or two several times a week. I planted a vegetable garden, weeding and sweating in the soupy July air. I began to run and play outdoors with my four children. And as a bonus, fitness conditioning also helped me shed about 10 percent of my body fat and dampened my cravings for junk foods." She writes:

A review of nearly 40 studies (most small, none blinded and only about 15 controlled) in the May 2005 Journal of Allergy and Clinical Immunology found that asthma patients who took part in fitness activities three to five times per week over 18 weeks "used less medication, had fewer doctor visits and reported decreased exercise-related fear and anxiety and less absence from school and work" than before starting their exercise routines. The review also cited growing research blaming inactivity as a factor in the increase of asthma prevalence and severity: According to the Centers for Disease Control and Prevention, newly reported asthma cases doubled from 1980 to 2002; asthma-related doctor visits and hospitalizations have also increased, with the former doubling between 1979 and 1992.

The JACI article is available in text or PDF formats.

Via the Washington Post

New Blood Test Detects Multiple Sclerosis

"A protein pattern or "molecular footprint" in the blood can distinguish patients with multiple sclerosis from healthy subjects, preliminary research suggests, which could make diagnosis of the disease much easier.

Dr. Gary M. Wolfe, at Predictive Diagnostics in Vacaville, California, and colleagues obtained blood samples from 25 patients with newly diagnosed multiple sclerosis and 25 healthy subjects. A special X-ray test and computer software were used to identify protein patterns associated with the neurologic disorder.

According to the report in the Journal of Molecular Neuroscience, the test identified three patterns seen only in patients with multiple sclerosis, not in healthy subjects."

Source: ReutersHealth

Topamax Appears to Impair Cognitive Function

In a study published in Neurology, Dr. M. C. Salinsky, of Oregon Health and Sciences University, and colleagues examined the cognitive effects of topiramate (Topamax) and gabapentin (Neurontin) versus a placebo:

Four of six measurements of cognition revealed significant differences between the gabapentin and topiramate groups, Salinsky's team reports, with the subjects given topiramate having poorer test performance than did the subjects given gabapentin after 12 weeks.

The risk of impaired cognitive function with topiramate "appears to be substantial and is at a level that could have significant adverse effects on daily and occupational functioning," the researchers note.

However, they also point out that lower doses than those used in the study may be effective for patients with epilepsy and might have a lower risk of cognitive impairment.

Source: ReutersHealth eLine

Surgery Can Reduce Frequency and Severity of Migraine Headaches

Via Reutershealth:

Surgical removal of trigger points on the face and head can significantly reduce the frequency and severity of migraine headaches, and in some cases totally eliminate them, investigators report.

The team at Case Western Reserve University in Cleveland, Ohio, first tried this approach after patients undergoing plastic surgery or treatment with Botox reported that their headaches had disappeared, lead author Dr. Bahman Guyuron told Reuters Health.

"The patients can guide us as to where the headaches are coming from," Guyuron explained. Up to four of these sites are then injected with Botox. If this produces at least a 50 percent reduction in intensity and/or frequency of headaches for at least 4 weeks, the site was considered for surgery.

NSAIDS Damage the Small Intestine According to a New Study

Via ReutersHealth: More than 70 percent of patients who took non-steroidal anti-inflammatory drugs (including ibuprofen, aspirin and naproxen) for more than three months suffered damage to their small intestines, according to a new study from the Baylor College of Mediciine in Houston.:

The study is yet another blow to patients trying to find ways to treat arthritis pain, after reports that the most advanced drugs, called COX-2 inhibitors, can raise the risk of heart death.

Dr. David Y. Graham of the Baylor College of Medicine in Houston and colleagues studied 21 patients taking a range of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS. They compared them to 20 patients taking acetaminophen, an unrelated painkiller, or nothing.

"Small-bowel injury was seen in 71 percent of NSAID users compared with 10 percent of controls," they wrote in Monday's issue of the journal Clinical Gastroenterology and Hepatology.

Chronic Back Pain Linked to Brain Tissue Loss

Via ReutersHealth: Researchers have identified a link between chronic back pain and brain tissue loss similar to that seen in the normal aging process:

Because, by definition, chronic pain has adverse effects on mood and increases stress, one explanation is that tissue atrophy is caused by toxic and inflammatory mechanisms, lead author, Dr. A. Vania Apkarian, from Northwestern University Institute of Neuroscience in Chicago, said in a statement.

As reported in the Journal of Neuroscience, Apkarian's team used magnetic resonance imaging (MRI) to compare the brains of 26 patients with chronic back pain with those of 26 matched "controls" without such pain.

Gray-matter volume was reduced by up to 11 percent in back pain patients compared with controls, the investigators found. They estimate that between 10 and 20 years of normal aging would be needed to see this amount of loss.A direct association was noted between pain duration and gray matter loss. For each year of chronic pain, a 1.3-mL drop in gray matter volume occurred, the authors point out.

This is the first study to show brain tissue abnormalities in patients with chronic pain, the researchers note.

Creator of the K-Ration Dies

Via the Washington Post:

"Ancel Keys, a University of Minnesota public health scientist who invented the K rations consumed by millions of soldiers in World War II, discovered that saturated fat was a major cause of heart disease and championed the benefits of the Mediterranean diet, died Nov. 20 at his home in Minneapolis. He was 100."

. . . "He was a giant in the field of nutrition in a variety of ways," said Walter C. Willett, chairman of the nutrition department at the Harvard School of Public Health. "His studies held up in the big picture, yes. He missed some things that are important. Smoking and obesity didn't show up. But the basic conclusion is . . . the vast majority of heart disease is preventable."

An original Type-A personality, and an interesting article.

Pfizer Says Bextra and Heart Problems are Linked

Via Reuters:  Pfizer, Inc. reported on Friday that Bextra, a COX-2 inhibitor like the recently-withdrawn drug Vioxx, increases the risk of stroke and heart attack. "[T]wo small clinical trials showed heart bypass surgery patients taking Bextra, . . . had a higher risk of stroke and heart attack." Bextra can also cause a rare skin disorder called Stevens-Johnson syndrome.

. . . Pfizer said that following the Vioxx withdrawal it re-examined its clinical data base of 8,000 patients with rheumatoid arthritis and osteoarthritis and found no increased risk of dangerous heart events in patients taking Bextra for up to a year. The company also found no increased risk in a trial of patients taking Bextra in a general surgery setting.

Doctors said it is too early to quantify the potential risk of Bextra or of Pfizer's other COX-2 inhibitor Celebrex as neither have tested for long enough. Pfizer said it is conducting longer term trials in arthritis patients.

The Washington Post has more about the potential risks of COX-2 inhibitors in this article published last Wednesday.

Genetic Factors Influence Development of Knee Arthritis

Via Reuters:

Genetic factors appear to play a role in the development of arthritis of the knee, according to a report in the Annals of the Rheumatic Diseases.

Previous studies investigating possible genetic contributions to knee arthritis have been inconclusive, the authors explain, but recent studies suggest that the amount of cartilage in the knee, which is influenced by genetic factors, may determine the risk of arthritis.

The study was conducted at the Menzies Centre for Population Health Research in Tasmania, Australia.

Patients Don't Tell Doctors They've Cut Back on Taking Unaffordable Meds

Via Reuters:

Many chronically ill patients never tell their doctor or nurse they've had to cut back on prescription drugs because they are too expensive, and many physicians never ask if the drugs are unaffordable, a study said on Monday.

"This study suggests that most patients who fail to alert clinicians about their medication cost problems are not asked about their ability to pay for their medication, and many perceive that clinicians are unwilling or unable to help them with this problem," said the report from the University of Michigan.

"As drug costs continue to escalate and the number of adults with chronic illnesses grows, it will be increasingly important for health care providers to take an active role in discussing patients' medication cost problems and appropriate strategies for addressing them," it added.

The study was based on a survey of 600 chronically ill U.S. adults with an average age of 62 who said they had underused medication in the preceding 12 months because of cost concerns.

The report is published in the current issue of the Archives of Internal Medicine.. Read more about the problem here.

Janet Maslin Reviews The Truth About the Drug Companies in the NY Times

Via the New York Times:

Dr. Marcia Angell is a former editor in chief of The New England Journal of Medicine and spent two decades on the staff of that publication. If much of that time was devoted to reviewing papers on pharmacological research, it must have been spent in a state of near-apoplexy.

Her new book is a scorching indictment of drug companies and their research and business practices. "Despite all its excesses, this is an important industry that should be saved - mainly from itself," she writes.

The Truth About the Drug Companies: How They Deceive Us and What to Do About It is available here.  And there's more on the topic at the HealthLawBlog.

Stem Cell Transplant from Patient's Sister Apparently Cures Rheumatoid Arthritis

Via Reuters:  

Transplanting stem cells from a healthy woman to her sister with severe rheumatoid arthritis apparently cured the disease, researchers report in the journal Arthritis & Rheumatism.

At the Northwestern University in Chicago, researchers led by Dr. Richard K. Burt used stem cells from the sibling to treat a 52-year-old woman with rheumatoid arthritis in 38 joints. Prior to transplantation, the woman was given various drugs to increase the odds that her body wouldn't reject the cells.

Her morning stiffness disappeared before she was discharged from the hospital and did not recur. Her rheumatoid nodules were completely gone 9 months after transplantation and now one year later the patient is disease-free and is not taking any drugs to suppress her immune system.

Amazing stuff!

The Wisdom of Crowds: Making Informed Choices About Medical Care

Interesting article in today's Washington Post by Paul Steinberg, a psychiatrist who had prostate cancer. The opening paragraph:

Life-and-death decisions come slightly easier when they rest on an informed base. I know. For 20 years now, I've had a modus operandi for dealing with potentially life-threatening medical problems, of which I've had several: I follow what finance writer James Surowiecki calls the "wisdom of crowds." I poll independent experts -- many of them -- on what they consider to be my best course of action. Eccentric and out-of-the-mainstream ideas are welcome. Ultimately, as a physician myself, I aggregate these ideas. With my own vested interest in my survival and my well-being, I become the final arbiter of these potential courses of action.

My only question: how can you use the wisdom of crowds when you can't afford access to the wise ones? Dr. Steinberg had ready access to his colleagues and the means to spend a day with a specialist. How does the fellow without a medical degree or health insurance get that kind of access?

Two Drugs Better Than One in Diabetes Care

Via Reuters:  Danish researchers report that treatment with GLP-1 and Actos together lower blood sugar levels more than either drug alone:

"As reported in the medical journal Diabetes Care, Dr. Mette Zander, from Hvidovre Hospital and colleagues conducted a study in which eight patients with type 2 diabetes were alternately treated with GLP-1, Actos, both drugs, or a saline solution, and observed for 48 hours. Saline, which has no specific effects on blood sugar, served as a placebo treatment.

Treatment with either GLP-1 or Actos produced a greater drop in sugar levels than did treatment with saline. Combined treatment with the drugs caused a further decline in sugar levels. . . .

Based on these results, the team concludes, that combination therapy with GLP-1 and Actos could be a "valuable therapeutic approach" for type 2 diabetes."

Caffeine a No-No for Diabetics?

Via Reuters:

"Caffeine could interfere with the body's ability to handle blood sugar, thus worsening type 2 diabetes, U.S. researchers said on Monday.

The team at Duke University Medical Center in North Carolina found a strong correlation between caffeine intake at mealtime and increased glucose and insulin levels among people with type 2 diabetes.

The findings are significant enough that the researchers recommend people with diabetes consider reducing or eliminating caffeine from their diets.

"In a healthy person, glucose is metabolized within an hour or so after eating. Diabetics, however, do not metabolize glucose as efficiently," said James Lane, a psychiatry professor who led the study. "It appears that diabetics who consume caffeine are likely having a harder time regulating their insulin and glucose levels than those who don't take caffeine."

Risperdal Risks Clarified by Janssen Pharmaceutical

Via the Washington Post:  Janssen Pharmaceutical Products LP, the makers of Risperdal, the leading drug used in the treatment of schizophrenia and other psychotic disorders, has sent a 2-page letter to health care professionals clarifying the safety risks associated with the medication. According the the Post article:

The letter stems from a directive issued last year by the Food and Drug Administration, which told several makers of anti-psychotic drugs to update their product labels.

Janssen complied in November 2003, but the FDA determined that the company's promotional materials still minimized the risk of strokes, diabetes and other potentially fatal complications. The agency also said Janssen made misleading claims that the medication was safer in treating mental illness than similar drugs.

(It is unclear from Janssen's webpage on Risperdal risks whether the webpage reflects the contents of Janssen's new letter and thus is consistent with the FDA's directive.)

National Electronic Health Records System Now On the Road to Reality (Maybe)

From Business Insurance comes this article regarding Wednesday's announcement by the U.S. Department of Health and Human Services (HHS) outlining a 10-year strategy to encourage the development of nationwide electronic health record systems.

The report, in pdf format, is available here.

HHS's press release announcing the publication of the report can be found here.

Glucosamine and Methylsulfonylmethane, When Taken Together, are More Effective in Treatment of Osteoarthritis

From Reuters:

"Combined glucosamine and methylsulfonylmethane -- better known as just MSM -- is more effective against osteoarthritis than either agent alone, according to Indian researchers.

In the journal Clinical Drug Investigations, Drs. P. R. Usha and M. U. R. Naidu report that although the individual agents did improve pain and swelling in patients' affected joints, the combined therapy was more effective than the single agents in reducing these symptoms and improving the function of joints.

. . . After 12 weeks of treatment, the average pain score had fallen from 1.74 to 0.65 in the glucosamine-only group. In MSM-only participants, it fell from 1.53 to 0.74. However, in the combination group, it fell from 1.7 to 0.36."

Miscarriage Linked to Risk of Progressive Joint Disease in Rheumatoid Arthritis

Via Reuters :  Researchers at the Leiden University Medical Center report in the Annals of the Rheumatic Diseases that women with a history of miscarriage before they developed rheumatoid arthritis seem to be at increased risk for progressive joint disease.

Boston Scientific Recalls Heart Stents

Via the Boston Globe:

"Boston Scientific Corp. said yesterday it is recalling a large number of its drug-coated cardiac stents, which have been among the fastest-selling medical devices in history, after reports of a death and serious injuries related to the devices. . . ."

The recall is a serious stumble for Boston Scientific. The medical device firm grew into the state's biggest life sciences company over the past year, as its stock rose based on the potential of Taxus. The company says it has dethroned rival Johnson & Johnson as the leader in the $3 billion drug-coated stent market. So far, the two companies are the only ones with drug-coated stents on the market."

See a prior post about the stent wars here.

Synthetic Antibody Helps in Treatment of Rheumatoid Arthritis

Via Reuters:  Blocking the activity of a natural protein involved in inflammation may be a new approach to treating rheumatoid arthritis. Dr. Nishimoto Norihiro from Osaka University and his colleagues have shown that a synthetic antibody targeting the receptor for a hormone-like protein called interleukin 6 (IL-6) significantly reduces disease activity in patients with difficult-to-treat rheumatoid arthritis.

IL-6 regulates the immune response, inflammation, and bone metabolism, Dr. Norihiro's team explains in the medical journal Arthritis & Rheumatism. Overproduction of IL-6 is thought to play a role in rheumatoid arthritis. In a 3 month study using an anti-IL-6 antibody, dubbed MRA, all measures of arthritis activity improved with MRA treatment with benefit seen as early as 4 weeks into treatment.

Food Pyramid Not Responsible for Obesity in US

Via Reuters:  In the Journal of the American Dietetic Association, Dr. Jeanne P. Goldberg and her colleagues argue that most Americans do not follow the United States Department of Agriculture (USDA) food guide pzyramid, so it cannot be blamed for obesity:

"I only wish the pyramid were powerful enough to have an influence on the American diet," Goldberg told Reuters Health. "Because if it did, we would be eating extremely well."

First released in 1992, the latest edition of the pyramid recommends that Americans eat 6 to 11 servings of carbohydrates a day, or the equivalent of 6 to 11 slices of bread. It suggests that people eat between 2 and 4 servings of fruit, between 3 and 5 servings of vegetables, 2 to 3 servings of meat and other protein sources, and up to three daily servings of dairy products.

Hernia Recurrence Rate is Lower with Open Repair

Via Reuters: Findings from a new report suggest that hernia recurrence is more likely following laparoscopic repair than more traditional "open" repair. Lead author Dr. Leigh Neumayer of the VA Medical Center in Salt Lake City, Utah said "Right now, we're trying to tease out why recurrence rates were higher with laparoscopic repair. I think part of it is that it's just a harder procedure to learn and it takes a lot of experience to get good at it."

The rate of immediate postoperative complications was higher in the laparoscopic group, at 24.6 percent, compared with rate in the open group, at 19.4 percent. Although rare, complications during surgery and life-threatening complications were also more frequent in the laparoscopic group. In contrast, the rate of long-term complications was similar in each group.

Pain immediately following surgery and two weeks later was lower in the laparoscopic group, but this only hastened the return to normal activities by one day.

The report is published in the New England Journal of Medicine.

Physical Fitness May Protect An Aging Brain

Via Reuters:   Physical fitness may help the aging brain according to researchers at the Beckman Institute at the University of Illinois at Urbana-Champaign:

By increased fitness we are not talking about going from a sedentary lifestyle to running a marathon but instead to walking a couple of miles a few times a week," he said.

"Older adults can maintain and indeed enhance cognitive and brain function with modest amounts of aerobic exercise," [Dr. Arthur F.] Kramer said.

Several animal studies have shown that aerobic training has a positive effect on the brain. It improves blood flow in the brain, encourages the formation of new neurons and increases the number of connections called synapses that form between neurons.

Hobbies Help Physical and Mental Health

An article from ABCNEWS.com suggests that:

Participating in leisure activities contributes to your physical and mental health and overall life satisfaction. You're healthier, happier and more cheerful. You enjoy life more," says Howard E.A. Tinsley, professor emeritus of psychology at Southern Illinois University and author of Psychological Benefits of Leisure Participation, a summary of 15 years of his research that involved interviewing 4,000 people with hobbies.

Don't know if this has been peer-reviewed or if any double-blind studies have been done to replicate Dr. Tinsley's conclusions. An intriguing theory.

More on Leech Therapy for Blood Clots & Arthritis

I posted a link to an article a while back regarding leech therapy for aching knees. An ABCNEWS.com article goes into more depth on leeches and their uses in several medical treatments. Images of Humphrey Bogart in The African Queen notwithstanding, the little critters apparently do a thankless job well:

" . . . leeches effectively drain clotted blood from the wounds while anti-coagulating agents in the leeches' saliva keep a patient's blood from forming further dangerous clots. What's more, they release an anesthetic from their fangs (each of the worm's three jaws hosts about 100 teeth), so the process is pain-free."

Gastric Bypass Surgery May Cure Type 2 Diabetes

A new study published in the January issue of the Annals of Surgery shows that gastric bypass surgery may cure Type 2 diabetes:

The antidiabetic effect of gastric bypass surgery in obese patients was first observed in 1982, and has since been affirmed by a more recent, large-scale study published in October of this year. However, it remained unclear if this effect was secondary to the treatment of the obesity and subsequent weight loss or if the surgery actually had a direct effect on controlling Type 2 diabetes.

The authors of the current study, Dr. Francesco Rubino and Professor Jacques Marescaux, have now demonstrated, for the first time, that surgery to bypass the duodenum and jejunum controls Type 2 diabetes even when obesity is not present. The doctors performed the study in non-obese rats with naturally-occurring diabetes. They found that glucose levels in rats undergoing bypass surgery returned to normal after surgery compared to the same type of rats who did not have bypass surgery and whose diabetes worsened. This finding generates new hope for millions of people suffering from the disease, and may revolutionize traditional scientific thinking about diabetes.

The study was conducted at IRCAD/The European Institute of Telesurgery.

Do Migraines Lead to Brain Damage?

Via ABCNEWS.com:   A new study out of the Netherlands, reported in today's issue of the Journal of the American Medical Association, shows that people who suffer frequent migraine headaches may be at an increased risk for developing brain lesions:

The study examined 295 migraine patients, 161 of whom experienced migraines with aura. Auras are slight shifts in neurological function that occur just before the onset of a migraine. The sufferer may see expanding geometric shapes, feel a numb or tingling sensation or have difficulty with speech.

Doctors in the study performed MRIs on migraine patients and checked for the presence of what are called white-matter lesions and blockages of blood to the brain.

They found migraine sufferers without aura were seven times more likely to have lesions in the back of their brains as normal controls; migraine sufferers with auras were nearly 14 times more likely to have the lesions.

Frequency of migraine may contribute to the lesions. People who experienced migraines more than once a month were almost 16 times more likely to have lesions.

There was no evidence, however, that these lesions caused any health or cognitive problems.

Joint Dilemma: Glucosamine, Chondroitin and Bum Knees

Dr. Susan Whiteman describes her journey into the nether world of bad knees and the treatments that may not help in this Washington Post article:

As any of the millions of Americans tottering around on ramshackle cartilage and ruptured ligaments can attest, the knee rates as the most unsound joint in the body. Each year, surgeons condemn more than 260,000 dilapidated knee joints and rebuild them, cementing titanium and polyethylene plastic to their skeletal ruins. Despite meaty muscles to brace it, despite a scaffold of ropy ligaments and tendons to buttress it, despite the bony shingle of a kneecap to shelter it, this load-bearing hinge between the two longest columns of bone in the body is prone to injury. Once damaged, the timbers of a leg shiver with the ravages of osteoarthritis.

. . . As is common in early osteoarthritis, my knees don't hurt. Not yet. But I know what lies ahead. As osteoarthritis progresses, cartilage, which acts as a cushion between the bones of a joint, grinds down. Bone scrapes against bone. That hurts -- a lot. The time for me to act to avoid the pain, debilitation and joint replacement surgery associated with the condition, I figure, is now.

Find out what she discovers from her evaluation of the available treatments.

PTSD Sufferers Store Memories In Different Part of Brain

Via Reuters:   A new study reported in the January 2004 issue of the American Journal of Psychiatry suggests that people with Post Traumatic Stress Disorder (PTSD) store memories of the traumatic event in a completely different area of the brain:

Specifically, people with PTSD showed a high level of activity in the right back region of the brain, which is associated with non-verbal memories, such as the sights, sounds and smells associated with a past event.

In contrast, people without the condition showed much higher levels of activity in the left front of the brain, a region associated with storing verbal memories, such as the narrative of a past event . . .

Dr. Ruth Lanius of the University of Western Ontario, one of the lead investigators on the study, noted that future treatment may focus on use of medications to target the brain connections in areas where people with PTSD store memories. Another approach may be therapy to help PTSD patients transform their memories from visual, non-verbal experiences into verbal events.

Artificial Discs Hold Promise for People with DDD

Via Reuters:  This article discusses a "new" technology that's been used in Europe for 10 years--implantation of manmade discs in people with back pain caused by degenerative disc disease:

After decades of research into alternatives to spinal fusion as a treatment for chronic back pain, U.S. surgeons are testing manmade discs that relieve the aches without sacrificing mobility.

In what business analysts call the "next big thing" in the $3 billion spinal market, companies such as Johnson & Johnson, Medtronic Inc., Swiss implant maker Synthes-Stratec and privately held SpineCore are racing to develop artificial discs for the neck and lower back.

Experts say that the procedure only works for people with degenerative disc disease. The best candidates for implantation are otherwise healthy people in their 30s and 40s.

Institute of Medicine Calls for Universal Health Insurance Coverage by 2010

Via Reuters:   A new report from the Institute of Medicine calls on Congress and the President to develop a comprehensive strategy for universal health insurance coverage by 2010. Dr. Mary Sue Coleman, co-chair of the Institute's committee on uninsurance and president of the University of Michigan in Ann Arbor, says "There is no justifiable excuse for delay. Further delay will only lead to more uninsured Americans forgoing care, resulting in more costly illnesses and premature deaths."

Earlier reports blamed the widespread lack of coverage for endemic problems in the U.S. health system, from overcrowding in emergency rooms to the potential financial ruin of millions of American families confronting overwhelming out-of-pocked medical costs. Approximately 18,000 deaths annually are attributable to inadequate health care in persons who go without health insurance, according to one study quoted in the final report.

The number of Americans without health coverage has risen steadily each year for the past decade and a half. Approximately 29.5 million Americans lacked coverage in 1987, according to figures from the US Census Bureau. In 2002, the last year for which figures were available, 43.3 million Americans did not have insurance.

Meanwhile, the United States remains the only industrialized nation that does not provide health coverage to all its citizens.

The full report is available here.

Joint Replacement Surgery Increasingly Popular

Via ABCNEWS:  Good article on joint replacement surgery. Dr. Joseph D. Zuckerman, professor and chairman of the department of orthopedic surgery at the New York University-Hospital for Joint Diseases, discusses how these surgeries are performed and what factors contribute to their success:

Hip and knee replacements are the most common surgeries. About 300,000 total knee replacement surgeries and approximately 200,000 total hip replacements are performed annually in the United States. Surgeons can also replace other joints, such as the ankle, foot, shoulder, elbow and fingers.

. . . The best candidate for [joint replacement surgery] is somebody with arthritis that has not responded to other treatment measures who is a motivated patient and in reasonably good health. The best candidates are those who can participate in the recovery plan after surgery because these operations are only successful if you participate in the exercise regimen.

Inhaled Insulin is Safe & Effective

Via Reuters:   Danish researchers conclude in a new study that inhaled insulin controls blood sugar levels just as well as the injectable form in people with type 2 diabetes:

To investigate, the research team treated 107 diabetic patients with either inhaled or injectable insulin. The inhaled form was given with [an inhaler devic called] AERx immediately before meals, whereas the injectable type was given 30 minutes before meals. In addition, doses of both types were given at bedtime.

At the end of the 12-week study, there were no significant differences between the groups in terms of long-term sugar control. However, fasting blood sugar levels were significantly lower in the inhaled insulin group.

The study is available in the January issue of Diabetes Care.

Study: Inhaled Steroid Use in COPD Patients Doesn't Improve Survival or Prevent Flare-Ups

Via Reuters:   A new study suggests that the regular use of inhaled steroids does not improve survival or prevent disease flare-ups in patients with chronic obstructive pulmonary disease (COPD), contrary to some reports:

The new study was conducted to address possible bias in previous research.The benefits of inhaled steroids for COPD is a controversial topic, lead author Dr. Vincent S. Fan, from the University of Washington in Seattle, and colleagues note. While some studies have suggested an improvement in survival, others have failed to demonstrate this. . . . To avoid this type of study bias, they conducted a study using "time-dependent" methods. Specifically, the authors wanted to determine if using inhaled steroids for at least 80 percent of the time reduced death rates and prevented flare-ups in COPD patients.

Of the 8,033 patients included in the study, nearly 2,700 were prescribed an inhaled steroid for at least 80 percent of a three-month interval. There was no evidence that average steroid use at low or high/medium doses reduced the risk of death, the authors note. Similarly, recent steroid use was not associated with a survival benefit. Inhaled steroid use also did not appear to affect hospitalizations or flare-ups due to COPD, the researchers report in the American Journal of Respiratory and Critical Care Medicine.

Anodyne Therapy System Appears to Improve Sensation in Diabetics

Via Reuters:  First there was the vibrating insole, now there's an infrared light that may help diabetics (at least those without severe impairment of sensation):

Treatment with the device, marketed as the Anodyne Therapy System (ATS), appears to restore sensation, reduce pain, and improve balance in patients with nerve damage known as diabetic peripheral neuropathy. ATS is a non-invasive treatment that is thought to increase blood flow by dilating blood vessels.

Efficacy of Spinal Fusion v. Laminectomy Questioned

A long article in today's New York Times raises questions about the merits of spinal fusion surgery, a procedure many Social Security Disability claimants undergo each year:

" . . . a number of researchers say there is little scientific evidence to show that for most patients, spinal fusion works any better than a simpler operation, the laminectomy. And laminectomies get patients out of the hospital and back to their daily routine much faster. Some people, experts add, would be better off with no surgery at all. Even doctors who favor fusions say that more research is needed on their benefits."

The article suggests that Medicare payments (which pay up to four times as much for spinal fusions as laminectomies) may drive the decision to recommend fusion in many cases. It also cites the influence of fusion hardware manufacturers

"The reality of it is, we all cave in to market and economic forces," said Dr. Edward C. Benzel, a spine surgeon who is chairman of the Cleveland Clinic Spine Institute. Though doctors, as a rule, should favor the least complicated treatment - with surgery being the last resort - Dr. Benzel estimated that fewer than half of the spinal fusions done today were probably appropriate. He described the current system of paying doctors as "totally perverted."

The article also includes this graphic illustrating the difference between a fusion and a laminectomy.

A Part of the Brain is Much Smaller in People with Bipolar Disorder

Via the New York Times:   A recent study finds that the amygdala, a small area in the front temporal lobe of the brain, is much smaller in people with bipolar disorder. The study is reported in the current issue of The Archives of General Psychiatry:

Earlier studies of adults with bipolar disorder, also known as manic depression, had reported that the amygdala was smaller among adults with the disorder than among those without it. The researchers in this study, led by Dr. Hilary P. Blumberg of Yale, also looked at adolescents to try to determine whether the abnormality was caused by the brain's deterioration over the course of the disorder or whether it was an early feature of it.

When they used M.R.I. scans to examine the brains of 36 people with the disorder, including 14 teenagers, and the brains of people without it, they found that the smaller amygdala was common to young and older people with the disease.

"These abnormalities are likely manifested early in the course of illness," the authors wrote. The researchers said the findings may eventually give doctors a tool to diagnose the disorder early. Teenagers with bipolar disorder are at high risk for suicide, Dr. Blumberg said.

Bipolar disorder is characterized by severe shifts in mood. Federal health officials say more than two million American adults have the disease.

The smaller amygdala, the researchers said, could be the underlying cause of the disease. Or it may reflect other problems elsewhere in the brain.

New Study Suggests Vibrating Insole May Aid Diabetic Nerve Damage in Feet

Via Reuters:   A new study by researchers at Beth Israel Deaconess Medical Center in Boston finds that "exposing patients' bare feet to imperceptible vibration improved sensation in the sole of the foot."

The study results suggest that diabetic nerve damage can be treated with shoes outfitted with specially designed insoles:

However, the new study is just a "proof of concept," and more research is needed to see whether such foot stimulation provides long-term improvements in nerve function.

The study is reported in the December issue of the journal Diabetes Care.

Celebrex May Protect Osteoarthritic Cartilage

Via Reuters:  Results of lab studies are a balm to my aching knees. The studies suggest that not ony does celecoxib (sold as Celebrex) relieve osteoarthritic pain, it may also have a beneficial effect on cartilage in patients with this condition:

[C]certain moderately selective COX-2 inhibitors may inhibit the synthesis of cartilage proteoglycans. Proteoglycans, along with hyaluronan, are required to provide cartilage with its elasticity and stiffness on compression. These entities are depleted in osteoarthritis and other conditions. To assess the possible effects of celecoxib, the researchers exposed prepared osteoarthritic cartilage specimens to both diclofenac, a non-selective COX inhibitor, and to celecoxib.

Diclofenac did not affect the metabolic balance of hyaluronan and proteoglycans. However, in a "relatively dose-dependent" manner celecoxib increased their synthesis. Celecoxib also reduced the loss of these components from cartilage tissue. Thus, "in contrast to several other nonsteroidal anti- inflammatory drugs . . . celecoxib might be beneficial to osteoarthritic joints by enhancing the cartilage content of both hyaluronan and proteoglycans."

Read more about it in the November issue of the Journal of Rheumatology (subscription required).

NIH Panel Says Total Knee Replacement Very Effective

Via the New York Times:   An 11-member panel convened by the National Institutes of Health (NIH) reports that Total Knee Replacement surgery is underutilized and that replacing a joint quickly relieved pain and improved mobility and quality of life in 90 percent of the patients:

The surgery is so effective, the panel said, that many more people from all classifications should consider it. Just 1 percent of the artificial joints fail each year. By 20 years out, studies show, 20 percent will require replacement. "Many studies show that total knee replacement may be an underutilized procedure," Dr. Marc Hochberg, a panelist from the University of Maryland School of Medicine, said. "There are no data suggesting it is being overutilized."

About 300,000 Americans have replacements each year. The number has been increasing, and doctors expect it to increase further as the population ages.

The report is available at the NIH website.

Blocking Brain Receptor May Aid in Alcoholism

From Reuters:   Researchers at the University of North Carolina at Chapel Hill report in a new study that an experimental compound called L-152,804 blocks a brain receptor for a chemical called neuropeptide Y (NPY), keeping alcohol-preferring mice from drinking for a substantially longer time than normal. The compound appeared to lessen the reinforcing, or rewarding, effects of alcohol.

According to [Dr. Clyde W.] Hodge, these findings imply that a drug that blocks the Y5 receptor might help prevent relapse in alcoholism by curbing the motivation to drink. Much research remains, however, and Hodge said the next step is to test L-152,804 in animals using a "more stringent" model of relapse.

The researchers will also search for other drugs that, like L-152,804, can cross the blood-brain barrier to block the Y5 receptor -- which means they can be taken orally.

On a broader level, Hodge noted, the findings support the "intriguing" possibility that there is a common brain system underlying so-called disorders of consumption, be it alcoholism or obesity.

The findings are published in the December issue of the journal Alcoholism: Clinical & Experimental Research.

Multiple Cups of Java Don't Raise Rheumatoid Arthritis Risk

From Reuters:   A new study in the November issue of Arthritis & Rheumatism reviewed information from more than 80,000 women over an almost 20 year period, and concluded that the risk of rheumatoid arthritis (RA) appeared unrelated to the amount of decaffeinated coffee, coffee, tea and total caffeine women consumed.

Although women's choice of beverage appeared to have no influence on their risk of RA, their smoking habits did. Specifically, the researchers found that heavy smokers were more likely to develop RA than non-smokers, a finding that other researchers have discovered, as well.

[Dr. Elizabeth W.] Karlson, who is based at Brigham and Women's Hospital in Boston, said that coffee drinkers may be more likely to be long-term smokers than non-coffee drinkers, and this tendency may help explain why previous reports linked drinking coffee with RA.

New Guidelines Warn of Diabetes Drug Risks

From Reuters:   In a joint release, the American Heart Association and the American Diabetes Association warn that new diabetes drugs such as Avandia and Actos may worsen heart failure, a chronic condition that kills half of its victims within five years. An excerpt from Reuters:

The drugs are in a new class called thiazolidinediones or TZDs, and seem to work well to help patients with type-II or adult-onset diabetes keep blood sugar levels under control. But many doctors have reported that some patients with heart failure seem to have extra fluid buildup when they take the drugs, which could in turn worsen the heart failure. . . .

The new statement urges patients taking TZDs to report weight gain of more than 3 kilograms (6.6 pounds), sudden swelling of the feet, shortness of breath or fatigue.

New Insole Helps Diabetics with Foot Sores

From Reuters:   Investigators at the University of Michigan have developed a shoe insole that's designed to decrease both pressure and friction on foot sores. Many Social Security disability claimants have diabetes and the usual problems associated with it, like diabetic neuropathy, diabetic retinoapthy and foot sores. Researchers say that existing insoles, which focus on alleviating pressure but do nothing to stop friction in the area of the sore, often didn't work.

The new design, in contrast, is made of materials that enable the foot to stay fixed in one place while walking, preventing friction from aggravating a sore and causing an infection . . .   In preliminary studies with about 10 diabetic patients with ulcers . . . the insole cut healing time by one half, enabling an ulcer that would typically heal in three months to disappear in six weeks.

Unfortunately the new insoles cost $400 per set and are not widely available yet. You can read the University's information about the insoles here.

One other note:   "According to the National Institute of Diabetes and Digestive and Kidney Diseases, more than 60 percent of non-injury related amputations in the lower limbs occur among people with diabetes, and programs aimed at comprehensive foot care can reduce amputation rates by up to 85 percent."

Timing Of IQ Test Can Be A Life Or Death Matter

A study published in the October issue of American Psychologist ( Vol. 58, No. 10, pp. 778-790), a journal of the American Psychological Association, reports that:

The year in which IQ is tested can make the difference between life and death for a death row inmate. It also can determine the eligibility of children for special services, adults' Social Security benefits and recruits' suitability for certain military careers, according to a new study by Cornell University researchers.

That's because IQ scores tend to rise 5 to 25 points in a single generation. This so-called "Flynn effect" is corrected by toughening up the test every 15 to 20 years to reset the mean score to 100. A score from a test taken at the end of one cycle can vary widely from a score derived from a test taken at the beginning of the next cycle, when the test is more difficult, says Stephen J. Ceci, professor of human development at Cornell. . . .

"Caution must be used when IQ scores are used to base important financial, social or legal decisions. It may not be sufficient to simply look to see if an IQ score is below some cutoff point," concludes Ceci. "The most important times to be particularly careful are when the test is either at the beginning or the end of its cycle."

Update:   Re the "Flynn Effect," David Traver provides this link on the Connect board to Professor Flynn's book, How to Defend Humane Ideals: Substitutes for Objectivity on Amazon. From the "Book Description" comes this excerpt:

James R. Flynn rejects attempts to salvage ethical objectivity as futile and counterproductive. Instead, he uses philosophical analysis to demonstrate the relevance of logic and evidence to moral debate. He then uses modern social science to refute racists, Social Darwinists, Nietzsche, and the meritocracy thesis of The Bell Curve. Flynn concludes that the great post-Enlightenment project—justice for all races and classes, the reduction of inequality, and the abolition of privilege—retains its moral dignity and relevance.

December 7, 2003

Plaque Build-up May Occur Faster in People with Rheumatoid Arthritis

From Reuters:  New findings reported in the medical journal Arthritis & Rheumatism suggest that:

Thickening of blood vessel walls -- a sign of "plaque" build-up -- seems to occur faster in people with rheumatoid arthritis, Japanese researchers report. This may explain why the disease has been linked with an increased risk of death from heart disease.

The results also indicate that blood tests that measure inflammation and bone changes can predict how fast such thickening will occur.

Rheumatoid arthritis is an "autoimmune" disease in which the body attacks its own tissues. The disease show not be confused with osteoarthritis, which is more common, less serious and results from wear and tear on the joints with age.

One Third of Symptoms Have No Known Cause

From Reuters:  A new study finds that more than one third of the physcial symptoms patients describe to their doctors have no clear cause. According to a study conducted by Dr. Kurt Kroenke at the University of School of Medicine in Indianapolis:

[A]fter answering questions about their symptoms and submitting to diagnostic tests, patients are often "left with what I call a 'symptom diagnosis,'" said study author Dr. Kurt Kroenke, in which the doctor says they have pain, for example, but can give no reason why.

But a lack of an underlying illness does not mean the symptom isn't real, and Kroenke urges patients and doctors alike to take all physical symptoms seriously, regardless of what diagnostic tests reveal.

"Testing can be very focused," he told Reuters Health. "And (a negative test result) by itself doesn't mean there's no symptom."

Most patients visited their doctors with complaints of back pain, headache or pain in the arms and legs.

December 03/January 04 Edition of MS Newsletter Now Online

The Central North Carolina Chapter of the National Multiple Sclerosis Society publishes a bimonthly newsletter called the MS Connection. The
December 2003/January 2004 edition (in PDF format) is now online.

Treatment for Sick Building Syndrome

From a November 28th post on Blog 702:

Researchers Announce Treatment for Sick Building Syndrome
The Washington Post is reporting on research to be published in Saturday's edition of The Lancet in which the use of ultra-violet light in building ventilation systems significantly ameliorated respiratory complaints and other health problems commonly associated with "sick building syndrome." The use of UV light to cleanse the air of bacteria, microbes, and endotoxins resulted in a 40% drop in respiratory symptoms. Reportedly, a typical office building capable of housing 1000 occupants could be outfitted with a UV system for approximately $52,000, plus about $14,000 in annual operating costs.

Some of my Social Security disability clients, especially those with Chronic Fatigue Syndrome, reported problems with their workplace before they developed CFS symptoms. Maybe there's a link?

BTW:   If you're interested in medical expert issues in light of Daubert (and who isn't?) check out Blog 702, a great resource for all things Daubert.

Monthly Dosing of Aranesp Can Control Anemia in Chronic Kidney Disease

From Reuters:  Monthly dosing of Aranesp gives good results:  "Amgen Inc., the world's largest biotechnology company, on Sunday said a six-month study of Aranesp, a longer-lasting version of its blockbuster drug Epogen, showed it controlled anemia in 85 percent of kidney disease patients not on dialysis when given just once a month. The study was presented at a meeting of the American Society of Nephrology in San Diego."

Medium-firm Mattress Best for Low Back Pain

From Reuters:   A myth debunked. According to this article, Americans spend 50 billion dollars per year for treatment of lower back pain. Now a study of 313 people over a 3-month period has concluded that a medium-firm mattress is better at relieving lower back pain than a firm mattress:

The patients were randomly selected and given either a firm or medium firm mattress and were asked to report on the amount of back pain they suffered while lying in bed and rising in the morning. After three months people who slept on the medium-firm mattress reported greater pain relief and less disability than the other group. "The use of a mattress of medium firmness improves the clinical course of low back pain in a higher proportion of patients than the use of a firm mattress," Kovacs said in a report in The Lancet medical journal.

Heart Valves Made with Patient's Own Cells

From Reuters:   German scientists, in an impressive display of bio-engineering, have made heart valves with a patient's own cells. An excerpt from this article describes the process:

The scientists started with valves from human cadavers and pigs, and then removed the living cells until only a scaffold of collagen and elastin remained. The scaffold retained the valve's original shape. They then took endothelial cells, the cells that make up the lining of blood vessels, from a patient's vein in a leg or forearm and grew them on the scaffolding in the laboratory. The valves have been implanted in 23 patients with an average age of 44, according to data presented at an annual meeting of the American Heart Association. Dohmen said the patient's own cells form a completely new scaffold after about a year. His patients have been studied for up to three years since receiving the tissue-engineered valves. "The patients are in very good shape," he said.

Experimental Drug Eases RA Symptoms in Some

From Reuters:  A company-sponsored study released Wednesday suggests that an experimental drug may ease symptoms of rheumatoid arthritis. An excerpt:

Rheumatoid arthritis, which attacks the joints, affects about 2.1 million Americans and conventional treatments fail in 1 out of 7 cases. The experimental drug, the first of a new class of medicines known as co-stimulation blockers, is variously known as CTLA4Ig or BMS-188667. It works by slowing the body's response to inflammation. In the six-month experiment, researchers found that the drug reduced pain, swelling and stiffness in the joints by at least 20 percent in 3 out of 5 patients with rheumatoid arthritis.

Breathe Easier: Guideline-based Asthma Care Saves Lung Function

Researchers--who evaluated changes in lung function in 13 adults with moderate to severe asthma treated according to National Asthma Education and Prevention (NAEP) program guidelines--said that there was
no statistically significant difference in lung function measured after one year and after ten years.

"Initially these patients had significantly reduced lung function, but after we stabilized them and their lung function improved, they were able to maintain it. This . . . shows that patients who . . . follow prescribed treatment according to NAEP guidelines for asthma will be able to preserve their lung function within 10 years."

Boston Scientific's New Stent Just Keeps Going and Going and Going . . .

More interesting news from the American Heart Association's annual meeting: a new drug-coated stent, called Taxus, made by Boston Scientific, appears to reduce the incidence of heart attack and restenosis as compared to a group of patients with traditional bare-metal stents:

No patients with Taxus had a heart attack between the nine-month and 12-month intervals. Seven patients with traditional bare-metal stents had heart attacks. Overall, about 7.9 percent of patients receiving Taxus had restenosis, or significant reclogging of their artery, a year after the device was implanted, compared with 26.6 percent implanted with bare metal stents.

Boston Scientific is looking for marketing advantages for Taxus when it reaches the U.S. market, expected late in the first quarter of 2004. Taxus is already taking market share from Cypher [a similar device made by Johnson & Johnson] in Europe, where both devices are available, Boston Scientific has said. The drug-coated stents, which offer a significant advantage over bare metal stents because they emit clot-busting drugs while in the patient's body, are expected to generate billions of dollars in annual sales.

Update (November 18, 2003):  Some problems have been reported with the Cypher stent. See this article in the New York Times for more.

Mediterranean Diet is Good For Your Ticker

Another benefit of being married to an Italian (who also cooks): The findings of a new study presented at the annual meeting of the American Heart Association suggest that a Mediterranean diet (fruits, vegetables, fish and olive oil, and very little meat) is good for your heart.

In the new study, researchers tracked the eating habits of about 3,000 men and women in Greece, aged 18 to 89, who did not have cardiovascular disease. The closer people adhered to the Mediterranean diet, the lower their levels of various measures of inflammation, which recent research shows plays a major role in development of heart disease. . . . findings held true even when differences in body mass index, physical activity, age, sex and education level were accounted for.

Dyslexics Can't Coordinate Sight and Sound

Dr. Mark Wallace, a researcher here in Winston-Salem at the Wake Forest University School of Medicine, has confirmed that dyslexics are unable to coordinate sight and sound.

To test whether people with dyslexia are less able to link sounds to what they see, the researchers asked 36 dyslexics and 29 people without the disorder to sit in a darkened room and look at a series of closely-placed lights, and indicate which light came first. In an interview, Wallace explained that the second light appeared very soon after the first, and previous research has shown that adding a sound around the time the lights appear helps people distinguish which light came first. Why that is remains a mystery, he said, but suggested that sound may alert the brain to focus on the task at hand. Indeed, people discriminated better between the lights when they also heard sounds. However, non-dyslexics only improved when the sound appeared within 150 milliseconds of a light, while dyslexics improved even after an interval of 350 milliseconds between light and sound.

Low-dose Painkillers are Easy on Tummy

According to a new study, aspirin, acetaminophen and ibuprofen, taken at low doses intermittently, are easy on the stomach; however, findings suggest that when taken in combination with other analgesics and corticosteroids, the rate of stomach problems increases two- to six-fold.

Cannabis of limited value in treatment of MS

From the Guardian Unlimited comes this article regarding a 3-year study of 600 persons with MS that concludes that cannabis treatment doesn't reduce spasticity or other symptoms of MS.

Tissue Engineer Joins Baptist Medical Center

"Anthony Atala, M.D., an internationally recognized leader in tissue engineering, a science devoted to growing new tissues and organs from a patients own cells, will join Wake Forest University Baptist Medical Center in January 2004." He will chair the Department of Urology and direct a new Regenerative Medicine and Tissue Engineering Institute.

This is stunningly good news in two respects: First, I didn't know that there was such a thing as tissue engineering (at least engineering that didn't involve stem cells), and success in this field can mean the difference between life and death for thousands of people each year. Second, Dr. Atala is coming to an area that is in the throes of a painful transition from tobacco and manufacturing to something approximating high-tech industry. Here's an excerpt from the press release:

Atala has also successfully created blood vessels, muscle, bladders, wombs, and vaginas that have been tested in large animals and are close to being ready to test in humans. “The advantage of these engineered organs and tissues is that they are made from the patient’s own cells so there is no risk of rejection,” said Atala.

“Every year in this country, people die because there are not enough donated organs available for transplantation,” said Dean [Richard H. Dean, CEO of WFU Health Sciences]. “This technology is exciting because it does not rely on cloning or stem cells.”

The bioengineering process works by taking healthy cells from a patient’s organ or tissue. These cells are grown in a culture until there are enough to place onto a specially constructed biodegradable mold, where they continue to grow. The molds are shaped like a heart valve, bladder, ureter tube, or whatever organ is needed. The newly engineered organ or tissue is transplanted into the body, where it continues to grow.

Gene therapy improves blood flow in heart

An article from Reuters says gene therapy improves blood flow in coronary arteries.

New Drug Reduces Plaque in Coronary Arteries

Exciting news for those with coronary artery disease. Study Finds New Drug Acts Quickly on Clogged Arteries

After five weekly infusions, those who got the experimental drug had a 4.2 percent decrease in the volume of plaque in their coronary arteries, while those who had saline infusions had, if anything, a slight increase in their plaque. By contrast, according to Dr. Steven E. Nissen, a Cleveland Clinic cardiologist who directed the study, the most powerful statins, which lower levels of low-density lipoproteins, or L.D.L., which deliver cholesterol to coronary arteries, take years to show more modest effects.

"It is astonishing, you have to admit that,'' said Dr. Scott Grundy, a cholesterol expert, who is director of the Center for Human Nutrition at the University of Texas Southwestern School of Medicine in Dallas. "A 4 percent reduction in the size of the lesions is remarkable.''

Leeches Help Knee Pain

Leech farm owners were heartened to hear that leeches help with arthritis pain. (Of course, there's a sucker born every minute.)

Hormonal link between obesity & osteoarthritis

From Reuters Health, French researchers (sorry "Freedom researchers") conclude that anobesity hormone contributes to osteoarthritis. So it's not just weight that wears out the joints of the obese, it's Leptin, a hormone that is detected in higher levels in the obese. (Read the obesity ruling again.)

Obesity: in the Genes?

BBC NEWS reports on a study that identifies a gene that may play a role in obesity:

The Imperial study, of more than 1,200 people, identified two forms of the GAD2 gene. One protected against obesity, the other made it more likely by stimulating the appetite. Thinner volunteers were found to be more likely to carry the protective form of the gene, while the other version was more common in obese people. It seems to stimulate overeating by speeding up production of a chemical messenger in the brain called GABA, or gamma-amino butyric acid. When combined with another molecule GABA stimulates us to eat.

Virus-related muscle damage tied to chronic fatigue

Encouraging news for sufferers of CFS:
Virus-related muscle damage tied to chronic fatigue

Obsessive-Compulsive Disorder Gene Discovered

The gene, called the human serotonin transporter gene (hSERT),

helps control how the body uses serotonin, a message-carrying chemical or neurotransmitter linked with mood. Some anxiety drugs and antidepressants target serotonin, but the researchers said patients with the mutations are not helped by these drugs.

"In all of molecular medicine, there are few known instances where two variants within one gene have been found to alter the expression and regulation of the gene in a way that appears associated with symptoms of a disorder," said Dr. Dennis Murphy of the National Institute of Mental Health, who worked on the study.