Depression: Shock therapy gets a magnetic alternative
Roughly 20% of us go through at least one period of depression in our lives. People with mild or moderate depression have many therapies from which to choose. In the future, magnetic therapy might be the answer for severely depressed patients who don't respond to conventional treatments.
A study at the University of Illinois at Chicago compared repetitive transcranial magnetic stimulation (rTMS) to a traditional treatment for severe depression -- electroconvulsive therapy (ECT, often called "shock therapy") -- on 25 patients who had been diagnosed with depression or bipolar disorder (also called manic depression). The patients were randomly divided into two groups. One received a course of the conventional ECT treatments; the other got a course of rTMS therapy.
For rTMS, a doctor holds a wire coil over the patient's left prefrontal cortex, the part of the brain that's just behind the forehead. The coil emits a fluctuating magnetic field that's about as strong as you'd find in an MRI, but it's more narrowly focused. Approximately 1,000 magnetic pulses from rTMS stimulate the brain during the 10- to 15-minute procedure.
Later, the patients were evaluated according to the Hamilton Depression Rating Scale, a standard psychological test. Both groups significantly improved to an almost equal degree.
What edge does rTMS have? ECT patients have to be sedated while electrodes attached to the head trigger a seizure, but rTMS treatments require no seizure, thus no sedation. ECT patients typically lose memory and cognition skills temporarily after treatment, but the rTMS patients do not.
But there are downsides to rTMS. Patients might feel their facial muscles contract during the procedure, and they might have a mild headache afterward, notes Philip G. Janicak, head of the study and medical director of UIC's Psychiatric Clinical Research Center. In the worst-case scenario, he says, rTMS could trigger an accidental seizure, but that's a very small risk.
More: www.psych.uic.edu/research/rtms.htm
Mammography: Padding cuts pain
Many women put off getting a mammogram because they fear it will hurt. Gail Lebovic, a Stanford University Medical Center breast surgeon, wanted to encourage women to get mammograms, so she invented a pillow-like cushion that softens the squeeze.
The Woman's Touch MammoPad won FDA clearance and now is made and distributed by BioLucent in Aliso Viejo, Calif. It's as simple to use as self-stick postage stamps. When the patient is ready for her mammogram, the technician just peels the paper backing from the pad and affixes one self-adhesive pad to the compression paddle and a second pad to the "bucky," or flat surface the breast rests against during the procedure. The foam is radiolucent, so it doesn't interfere with the mammogram image; the picture is just as clear as a mammogram taken without using the pads. They come in two sizes that fit any standard mammogram machine.
It does add $5 per pad to the cost of having a mammogram, but 70% of women in a BioLucent trial of MammoPads said the cushions reduced their mammography discomfort by 50%. BioLucent also offers a recycling plan for used MammoPads.
More: 1-866-460-4141 or MammoPad.com
Overweight: Human growth hormone may yield new diet drug
A weight-loss drug now in the works is based on a component of human growth hormone known to reduce body fat. Biochemistry professor and obesity expert Frank Ng at Monash University in Melbourne, Australia, working in partnership with Metabolic Pharmaceuticals Ltd., developed the drug called "Advanced Obesity Drug 9604" (or AOD9604 for short). It already has been tested in clinical trials, and researchers report that it appears to be safe, effective and free of side effects. In the most recently completed study, a Phase 2 clinical trial, 22 men were given a single small-dose injection of the drug, then followed for four weeks. The drug worked best on older people. On average, the participants lost a little more than 1 pound each by the end of that month. Another human trial is under way in the United Kingdom. Meanwhile, a Boston company is developing AOD9604 in capsule form to begin the first oral-dose trial this May. The trials are a key step toward winning approval to market the drug in the USA.
Another weight loss drug, under investigation by Merck Research Laboratories in New Jersey, suppresses appetite. Animals were fed a high-fat diet, but one group also had an insulin-like compound mixed into their food. The compound prevented obesity and didn't appear to cause any side effects. But the researchers caution it has been tested only in rodents, and it will be a while before it's ready for human trials.
More: monash.edu.au/pubs/monmag/issue7-2001/obesitymay2001.html
Day-care colds: They help immunity
Parents who feel guilty when their babies and preschoolers pick up colds at day care can relax -- those colds are a nuisance now, but they protect children from getting more colds between ages 6 and 11, a new study finds. Confirming previous research that showed babies and preschoolers in day care do get more colds than same-age stay-at-home children, the new study also found that those day-care early colds help build immunity through age 13. By the teenage years, they found, children have the same level of immunity from colds whether they were in day care or stayed at home.
More: archpedi.ama-assn.org
Oral cancer: A new diagnostic tool for your dentist
Oral cancer is bad news: Only half the people who get it survive. But with early detection, the survival rate can soar to 80%, according to dentist Martin S. Greenberg, chief of oral medicine at the University of Pennsylvania's Penn Medical Center in Philadelphia.
One way dentists can improve the early detection rate is to use a brush called OralCDx, a diagnostic tool that's just gone through year-long clinical trials at the University of Pennsylvania School of Dental Medicine and other sites. Developed by OralScan Laboratories of New York, the brush is easy to use. When the dentist spots a suspicious lesion, he swabs the spot with the brush, which looks like a mascara wand. The bristles of the brush pick up cells better than the old method of scraping ever could. Next, the samples collected are sent to a laboratory to be scanned by a computer. It's so accurate that the rate of false-positives has plummeted from 30% for scraper-collected samples to a stunning 0% for brush-collected samples.
Prevention is still the best bet, and Greenberg says avoiding smoking and cutting back on alcohol as well as getting regular exams are key.
More: www.oralcdx.com
Multiple sclerosis: New help is available
At last, there's an effective therapy to combat the fatigue that plagues the 350,000 Americans who have multiple sclerosis. MS is a nerve disease that can cause varying degrees of symptoms, including numbness, muscle weakness, vision loss, and bowel and bladder dysfunction.
Fatigue is one of MS's most disabling symptoms. Between 75% and 90% of MS patients experience fatigue; about half endure it every day. Now a study published in February's Journal of Neurology, Neurosurgery and Psychiatry reports that MS patients who suffered from severe fatigue showed significant improvement when given modafinil (brand name Provigil), a drug usually used to treat daytime sleepiness in narcolepsy patients. In this study, just one 200mg dose of modafinil a day was enough to give MS patients significant improvement with minimal side effects. No other drug has done so well, says study leader Kottil W. Rammohan, a Ohio State University Medical Center neurologist.
More: www.acs.ohio-state.edu/units/research/archive/rammohan.htm
Birth control: Popular herb interferes
Women taking contraceptives may get a surprise if they also take the popular antidepressant herb St. John's wort (shown below). The herb -- known to affect HIV drugs, blood thinners and cyclosporine (an anti-rejection drug for transplant recipients) -- also interferes with hormone-based contraceptives. The key is hyperforin, a component of the herb that boosts liver function so chemicals break down more efficiently. Two Swedish women who took contraceptives and St. John's wort got pregnant, and there have been seven such reports in England in two years. Women who take contraceptives and use any herbal medicines, especially St. John's wort, should check with their doctors about interactions.
More: www.fda.gov/cder/drug/advisory/stjwort.htm
Sickle cell anemia: Zinc may help aid in children's growth
Children whose growth is delayed by sickle cell disease may benefit from taking zinc supplements, researchers report in February's American Journal of Clinical Nutrition. Researchers at the Children's Hospital of Philadelphia tracked 42 boys and girls ages 4 to 10 who had sickle cell anemia, noting body measurements including how high their knees were and how tall the children were when they sat in a chair. Baseline data were collected at the start of the study, and again at three, six and 12 months. Both groups of children were given a cherry syrup to drink each day, but for half the kids, that drink also contained 10mg of elemental zinc. By the end of the year, 38 children finished the study, and the zinc drinkers were significantly taller than the non-zinc drinkers. Conclusion: Children who have sickle cell disease also may have a zinc deficiency; for kids who are deficient in zinc, supplements can help them gain height and weight.
Schizophrenia: Could it be triggered in fetuses?
A new piece has been added to the puzzle of what causes schizophrenia: vitamin D, which is critical for healthy fetal brain development. The journal New Scientist reported Feb. 8 that growing evidence indicates mothers-to-be who are not exposed to enough sunlight can develop a vitamin D deficiency that may alter their baby's brain in the womb, potentially laying the groundwork for schizophrenia in the child. Some researchers question the link, because vitamin D deficiencies are so common, while schizophrenia is not.
More: www.awsc07100.pwp.blueyonder.co.uk/Papers/McGrath-D-Imprinting.pdf
Testicular cancer: Mold-contaminated food may plant the seed
Doctors have been stumped about what causes testicular cancer, the most common form of cancer in young white men. Now there's a new clue: Scientists knew testicular cancer typically strikes men between ages 15 and 35, and they strongly suspected that whatever the trigger was, it had to get into the body in early childhood or sooner, perhaps in the womb before birth.
Now a Wake Forest University cancer researcher thinks he has found the mysterious trigger. In the journal Cancer Causes and Control (February 2002), cancer biology professor Gary G. Schwartz points to a cancer-causing agent called ochratoxin A. Molds that grow in grains and coffee beans produce ochratoxin A, he explains, and when we consume mold-contaminated cereals, pork products (animals -- especially pigs -- eat moldy grains), milk and coffee, the toxin gets into our bodies. Mothers can pass it to their unborn babies through the placenta and later through breast milk. He theorizes that ochratoxin A alters testicular DNA in the fetus or infant, then lies dormant until puberty triggers testicular growth. When the growth spurt starts, those dormant DNA changes develop into testicular cancer.
If Schwartz is right, that would explain why testicular cancer is more prevalent in young white men, particularly in northern European men, who consume more grains and live in areas where weather conditions promote mold.
To prove the theory, Schwartz hopes testicular cancer researchers will focus on breast feeding and consumption of foods that contain ochratoxin A. Schwartz says it may be possible through public health efforts to reduce exposure to ochratoxin A or to reduce its toxicity by giving pregnant women aspirin, indomethacin and vitamins A, C and E.
More: www.wfubmc.edu/news_sys/fullstory.php?articleid=1662
Stroke: Flu shots reduce risk
New research suggests that people who get flu vaccinations may cut their risk of stroke. Each year, 600,000 Americans have a stroke.
A study in France followed 270 people age 60 or older and found that people younger than 75 who received influenza vaccinations had 20% fewer strokes than unvaccinated people, the authors report in the February 2002 issue of Stroke: Journal of the American Heart Association. (Flu shots didn't make a significant difference in people age 75 and older.)
Why would flu shots cut stroke risk? Previous studies have shown that infection increases the risk of heart attacks and stroke. Houston researchers reported in 2000 that people who had flu shots had 67% fewer second heart attacks and angina than others. It may be that preventing flu also prevents infection, thus reducing heart attack and stroke risk. Or it could be that people who get flu shots take better care of their health, and that's what reduces their risk.
More: stroke.ahajournals.org/cgi/content/abstract/33/2/513
Brains: Babies learn in their sleep
Sleep learning may be every student's dream -- a trick to achieve a great grade-point average without working for it -- but what about infants? New research by Marie Cheour at the University of Turku in Finland shows that sleeping infants exposed to Finnish vowel sounds for 2 1/2 to 5 hours learned to discriminate those sounds. That could be a boon to babies at risk for language disorders, because they could be taught while they snooze.
