Nasal Strips Preferred by Women in Delivery: In a DB PC study of 150 primigravida women in active labor, those wearing a dilator spring-loaded nasal strip had a satisfaction rate was significantly higher in parturient women wearing nasal strips with a dilator spring than in parturient women wearing a placebo spring (P < 0.0001).  No differences were found between the study and the control group regarding rate of induction or augmentation of labor as well as Montevideo units reached, frequency of rupture of membranes, duration of the active phase and second stage of labor, usage of epidural analgesia, normal fetal heart pattern, meconium-stained amniotic fluid, and neonatal well being. Length of maternal and neonatal hospitalization also did not differ between the groups. The effects of an external nasal dilator on labor. Sadan O, Shushan S, et al. Tel-Aviv University. Am J Rhinol. 2005 Mar-Apr;19(2):221-4. v

Olive Oil Helped Stable Heart Patients: The Mediterranean diet, in which olive oil is the main source of fat, has been associated with a reduced incidence of coronary heart disease (CHD) and low blood pressure levels. Virgin olive oil (VOO), besides containing monounsaturated fat, is rich in phenolic compounds (PC) with antioxidant properties. In a six week study of 40 males with stable heart disease, olive oil lowered oxidized LDL (p<0.001) and lipid peroxide levels (p=0.003), together with higher activities of glutathione peroxidase (p=0.033). Systolic blood pressure also decreased (p=0.001) in hypertensive patients. No changes were observed in diastolic blood pressure, glucose, lipids, and antibodies against oxidized LDL. Antioxidant effect of virgin olive oil in patients with stable coronary heart disease: a randomized, crossover, controlled, clinical trial. Fito M, Cladellas M, et al. Barcelona, Spain. Atherosclerosis. 2005 Jul;181(1):149-158. For more, see Diet and Heart Disease.

Intimal Thickness and Homocysteine Both Decrease with Folate, B-6, and B-12: Carotid intima-media thickness (IMT) as an accepted marker of atherosclerotic changes. In a 1-year DB PC study of 50 patients (60+/-8 years) with IMT>/=1mm, daily 2.5mg folic acid, 25mg Vitamin B6, and 0.5mg Vitamin B12 decreased homocysteine from 10.50 to 6.56 mumol/l (P<0.0001) vs. no change with placebo. IMT decreased from 1.50 to 1.42 mm (P=0.034) vs. an increase from 1.47 to 1.54 mm for placebo (P=0.019). The IMT effect was independent of Hcy concentration. Decrease of carotid intima-media thickness in patients at risk to cerebral ischemia after supplementation with folic acid, Vitamins B6 and B12. Till U, Rohl P, et al. Friedrich-Schiller-University, Jena, Germany. Atherosclerosis. 2005 Jul;181(1):131-5. For more, see Folic Acid.

Vitamin C Lowers Uric Acid Levels: In a 2-month DB PC study of 184 nonsmokers, vitamin C 500 mg/d reduced uric acid levels by -0.5 mg/dl vs. +0.09 for the placebo group (P < 0.0001). The same pattern of results was evident in subgroups defined by age, sex, race, body mass index, chronic illness, diuretic use, and quartiles of baseline serum ascorbic acid levels. In the subgroups, from the lowest to the highest quartile of baseline serum uric acid, changes in serum uric acid with vitamin C supplementation were -0.4, -0.5, -0.5, and -1.0 mg/dl (P = 0.06, 0.005, 0.003, and 0.002, respectively). Compared with placebo, vitamin C increased the estimated glomerular filtration rate. Vitamin C might be beneficial in the prevention and management of gout and other urate-related diseases. The effects of vitamin C supplementation on serum concentrations of uric acid: Results of a randomized controlled trial. Huang HY, Appel LJ, et al. Johns Hopkins. Arthritis Rheum. 2005 Jun 2;52(6):1843-1847. For more, see Vitamin C.

Zoster Vaccine Markedly Reduced Suffering from Herpes Zoster: Up to 60% of adults over age 60 will at some point have a recurrence of the chicken pox/herpes zoster virus in the form of a painful skin rash. In a DB PC study of 38,546 adults over age 59, those given the live attenuated Oka/Merck VZV vaccine had half as many cases of herpes zoster (315 among vaccine recipients vs. 642 with placebo) and 107 cases of postherpetic neuralgia (27 vaccine vs. 80 placebo). The use of the zoster vaccine reduced the burden of illness due to herpes zoster by 61.1% (P<0.001), reduced the incidence of postherpetic neuralgia by 66.5% (P<0.001). A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. Oxman MN, Levin MJ, et al. University of California, San Diego. N Engl J Med. 2005 Jun 2;352(22):2271-84. v

Atypical Anti-Psychotic Helped Repetitive Autistic Behaviors But Not Communications: Risperidone has been found helpful for decreasing severe tantrums, aggression, and self-injurious behavior in children and adolescents with autistic disorder (autism). In a study analyzing the results from a DB PC trial of 101 autistic children and 16-week open-label continuation study of 63, risperidone led to significant improvements in the restricted, repetitive, and stereotyped patterns of behavior, interests, and activities of autistic children but did not significantly change their deficit in social interaction and communication. Risperidone for the core symptom domains of autism: results from the study by the autism network of the research units on pediatric psychopharmacology. McDougle CJ, Scahill L, et al. Indiana University. Am J Psychiatry. 2005 Jun;162(6):1142-8. For more, see Autism and It's Treatment.

Sabal Fruit and Urtica Root Helped Benign Prostatic Hypertrophy: In a 24-week DB PC study of 257 patients with benign prostatic hypertrophy, those taking a combination of 160 mg sabal fruit extract WS 1473 and 120 mg urtica root extract WS 1031 per capsule (PRO 160/120) had a substantially higher total score reduction in prostate symptoms (6 points vs 4 points; P=0.003) at 24 weeks with a tendency in the same direction after 16 weeks. This applied to obstructive as well as to irritative symptoms, and to patients with moderate or severe symptoms at baseline. Patients randomized to placebo showed a marked improvement in LUTS (as measured by the I-PSS) after being switched to PRO 160/120 during the control period (P=0.01, one tailed, in comparison to those who had been treated with PRO 160/120 in the double-blind phase). The tolerability of PRO 160/120 was comparable to the placebo. The tolerability of the herbal extract was excellent. Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms-a placebo-controlled, double-blind, multicenter trial. Lopatkin N, Sivkov A, et al. Moscow, Russia, . World J Urol. 2005 Jun 1. For more, see BPH.

Xuezhikang Chinese Medicine Reduced Heart Attacks and Death in Huge Study: In a 4-year DB PC study of 4870 heart attack victims, the incidence of nonfatal myocardial infarction and deaths from CHD in patients taking Xuezhikang were 5.72% vs. 10.41% for placebo, with a reduction of relative risk by 45.1% (P = 0.0000). The incidence of deaths from CHD was 3.79% in the treatment group and 5.49% for placebo, with a reduction of relative risk by 31.0% (P < 0.0048); The incidence of nonfatal myocardial infarction reduced by 60.8% (1.93% vs 4.92%, P < 0.0000); Stroke, tumor, and PCI/CABG also decreased by 31.1% (6.92% vs 10.04% P < 0.0004). There were no significant differences in side effects and abnormal laboratory references between the two groups. China coronary secondary prevention study (CCSPS). Lu ZL et al. Peking Union Medical College, Beijing, China. Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Feb;33(2):109-15.

L-Arginine Might Help Heart Attacks a Little: L-arginine is a substrate for nitric oxide synthesis in vascular endothelial cells, NO bioavailability is decreased during myocardial infarction (MI). In a 30-day DB PC study of 792 patients with heart attacks within 24 hours, oral L-arginine (3.0 g t.i.d for 30 days) had a composite of 30 day cardiovascular death, reinfarction, successful resuscitation, shock/pulmonary edema or recurrent myocardial ischemia in 24% patients treated with L-arginine and 27% with placebo (OR 0.63, p=0.06). The end point was observed less frequently in 226 patients with hyperlipidemia (19 vs 31, p<0.05). No serious adverse effects were observed during L-arginine supplementation. Efficacy and safety of oral l-arginine in acute myocardial infarction. Results of multicenter, randomized, double-blind, placebo-controlled ARAMI pilot trial. Bednarz B, Jaxa-Chamiec T, et al. Grochowski Hospital, Warsaw. Kardiol Pol. 2005 May;62(5):421-427. For more, see Arginine and Coronary Heart Disease.

Drug Abuse: Early Smoking, Alcohol, Drugs, Sex, Crime Dramatically Increase Risk:  A population-based group of 578 male and 674 female twins reported whether they had ever engaged in, and the age of initiation of, five adolescent problem behaviors: smoking, alcohol use, illicit drug use, police trouble, and sexual intercourse. Participants also completed a structured interview at both ages 17 and 20 covering substance use disorders, major depressive disorder, and antisocial personality disorder. Each problem behavior was significantly related with each clinical diagnosis. The association was especially marked for those who had engaged in multiple problem behaviors before age 15. Among those with four or more problem behaviors before age 15, the lifetime rates of substance use disorders, antisocial personality disorder, and major depressive disorder exceeded 90%, 90%, and 30% in males and 60%, 35%, and 55% in females, respectively. Early adolescent problem behavior identifies a subset of youth who are at an especially high and generalized risk for developing adult psychopathology. The association of early adolescent problem behavior with adult psychopathology. McGue M, Iacono WG. University of Minnesota. Am J Psychiatry. 2005 Jun;162(6):1118-24. For more, see Causes of Depression.

CortiSlim Bogus: A California supplement manufacturer approached Shawn Talbott, an adjunct prof in nutrition at the University of Utah to devise a weight loss product.  Since 2003, they have been making millions pushing CortiSlim, which Talbott initially claimed controlled cortisol, a hormone that he claims promotes weight gain. However, obese people don't have higher cortisol levels than lean people. Talbott never published any research supporting his claims. In fall, 2004, the FTC charged Talbott with consumer fraud for claiming that CortiSlim results in rapid, permanent weight loss of 10-50 pounds by lowering cortisol levels. CortiSlim has changed it's advertising which now promotes the "CortiSlim Lifestyle" of diet, exercise, stress management, and up to $5 a day of CortiSlim pills. CortiSlim contains a magnolia bark extract standardized for honokiol content (to "de-stress" you), chromium, green tea, banaba leaf, and vanadyl which supposedly stabilize blood sugar levels, and moderate insulin reaction and Citrus Aurauntium (bitter orange) standardized for synephrine, an "ephedra  cousin." v

Honokiol Research: Honokiol is an extract from magnolia bark, which has been used in Chinese medicine, but does sound that popular in China. It has 102 studies on PubMed as of 6/9/05, which is a very small number (e.g. melatonin has over 15,000). Not one single study was on weight loss or was done with animals larger than rats. It seems to be mainly being studied as a possible anti-cancer agent. A few recent rat and lab studies are as follows: The natural product Honokiol induces caspase-dependent apoptosis in B-cell chronic lymphocytic leukemia (B-CLL) cells. Battle TE, et al. Harvard. Blood. 2005 Mar 31; Magnolol and honokiol enhance HL-60 human leukemia cell differentiation induced by 1,25-dihydroxyvitamin D3 and retinoic acid. Fong WF, et al. Hong Kong. Int J Biochem Cell Biol. 2005 Feb;37(2):427-41. Honokiol induces apoptosis through p53-independent pathway in human colorectal cell line RKO. Wang T, Chen F, et al. Cancer Institute, Second Hospital of Medicine, College of Zhejiang University, Hangzhou. World J Gastroenterol. 2004 Aug 1;10(15):2205-8. A couple studies have found an anxiolytic effect in rats in maze testing, however, nothing that could be extrapolated to human beings. v

Enova Little Benefit for Weight Loss: Archer Daniels Midland produces a diglyceride vegetable oil from canola and soybean oils, which are natural triglycerides. In the largest published study of DAG oil, 65 obese adults consumed 15% of their calories from Enova oil for 6 months, while 62 others used ordinary cooking oil. The Enova group lost an average of 2 more pounds with all of the weight loss in the first 2 months. Amer J Clin Nutr 76:1230, 2002. A Japanese study of 155 overweight or obese adults who just switched to Enova for one year lost an average of two pounds. (Nutrition Action 5/2005). v

Tonalin CLA Little Value for Weight Loss and Troubling Lab Tests: In the best study, a 1-year DB PC trial of 93 overweight Norwegian adults, those on Tonalin CLA 3.4 grams/day lost five pounds of body fat vs. those on placebo gaining one pound.  However, the Tonalin groups had higher white blood cells counts, a sign of infection and well as higher levels of thrombocytes (blood clotting cells) and lipoprotein(a), a relative of LDL bad cholesterol which is associated with an increased risk of heart disease and stroke. J Nutrition 135:778, 2005. v

Complicated Grief Therapy: In a study of 83 women and 12 men with complicated grief, patients were randomly assigned to receive interpersonal psychotherapy or complicated grief treatment for 16 weekly sessions each. The response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%; P = .02) and time to response was faster for complicated grief treatment (P = .02). Treatment of complicated grief: a randomized controlled trial. Shear K, Frank E, et al. University of Pittsburgh School of Medicine. JAMA. 2005 Jun 1;293(21):2601-8. v

Cerebral Blood Flow Linked to Depression, Insomnia, Cognitive Performance: In a study of 15 patients with Major Depressive Disorder and off meds, single photon emission computed tomography (SPECT) showed that the severity of depressive mood was inversely correlated with the rate of cerebral blood flow (rCBF) in the left amygdala, lentiform nucleus, and parahippocampal gyrus, and directly correlated with rCBF in the right postero-lateral parietal cortex (p<0.001). Insomnia severity was inversely correlated with rCBF in the right rostral and subgenual anterior cingulate cortices, insula and claustrum. Anxiety severity was directly correlated with rCBF in the right antero-lateral orbitofrontal cortex, while cognitive performance was directly correlated with rCBF in the right postero-medial orbitofrontal cortex and in the left lentiform nucleus. Relationship between regional cerebral blood flow and separate symptom clusters of major depression: A single photon emission computed tomography study using statistical parametric mapping. Perico CA, Skaf CR, et al. University of Sao Paulo, Brazil. Neurosci Lett. 2005 May 24. v

Intelligence: 4 SNPs Associated with Mild Mental Impairment: Mild mental impairment (MMI) represents the low extreme of the quantitative trait of general intelligence and is highly heritable. Using SNP-MaP (SNP Microarrays and Pooling), we have identified four loci associated with MMI. These four loci have been replicated in two SNP-MaP studies and verified by individual genotyping. The two SNP-MaP studies conducted were a case-control comparison (n = 515 and n = 1028, respectively) and a low versus high general intelligence extremes group comparison (n = 503 and n = 505, respectively). Twelve loci showing the largest significant differences in both SNP-MaP studies were individually genotyped on 6154 children. Of the four loci positively associated with MMI, the minor allele of each conferred the greater risk for MMI. Although each SNP accounts for a small amount of variance, their effects are additive and they can be combined in a 'SNP set' that can be used as a genetic risk index for MMI in behavioral genomic analyses. SNPs, microarrays and pooled DNA: identification of four loci associated with mild mental impairment in a sample of 6000 children. Butcher LM, Meaburn E, et al. Institute of Psychiatry, London, UK. . Hum Mol Genet. 2005 May 15;14(10):1315-25. v

Cholecystokinin A Receptor Gene Mutations Linked to Slightly Lower IQs: In a study of cholecystokinin A receptor (CCKAR) genotypes and intelligence in 2251 Japanese adults ages 40-79, the CCKAR gene promoter polymorphisms A-81G and G-128T were determined. Intelligence was assessed by Japanese Wechsler Adult Intelligence Scales - Revised Short Forms (JWAIS-R SF). The average IQ levels of the wild-type allele and the mutation allele at nucleotide -128 were 103.4 and 101.6, respectively (p=0.008). The difference in IQ for A-81G was also significant (p=0.011): IQs of 103.6 with the wild-type allele and 102.0  with the mutation. Cholecystokinin A receptor gene promoter polymorphism and intelligence. Shimokata H, Ando F, et al. National Institute for Longevity Sciences, Obu Aichi, Japan. . Ann Epidemiol. 2005 Mar;15(3):196-201.

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Thomas E. Radecki, M.D., J.D.

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