STUDY: Workouts alter way lipids circulate through body, study finds

JOURNAL: New England Journal of Medicine

AUTHORS: Dr. William E. Kraus

ABSTRACT: Need another reason to exercise? Scientists have discovered it makes cholesterol less dangerous.

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A new study found that even modest exercise changes the size and density of cholesterol-carrying proteins so they do less damage. And the benefits occur even if people’s total amount of cholesterol and their weight stay the same.

COMMENTARY: Staying active has many health benefits, but improving cholesterol is not usually considered one of them. People who exercise often lose weight, and while that can improve their cholesterol levels, exercise by itself was thought to have little or no effect.

Workouts fail to lower LDL, the dangerous form of cholesterol, and only rigorous exercise can nudge up HDL, the good form that protects against heart attacks.

PROTEIN PARTICLES ALTERED

But the study, by Dr. William E. Kraus of Duke University, found a new way that exercise can affect cholesterol — by altering the number and size of the particles that carry cholesterol through the bloodstream.

“People in the exercise field have always wondered why it doesn’t affect total cholesterol and LDL,” Kraus said. “We always knew low levels of exercise are helpful. This helps solve that paradox.”

His work, published in the New England Journal of Medicine, is the latest chapter in an evolving view of cholesterol’s effects. A generation ago, doctors worried only about the total amount of cholesterol. Later, the importance of the main subtypes, especially HDL, became apparent. Now experts are turning their attention to the physical structure of cholesterol in the bloodstream.

Cholesterol is an essential fat, or lipid. It circulates through the body by attaching to protein particles. Cholesterol appears more likely to clog the arteries when it is carried by small, dense protein particles than when it is moved by relatively large, fluffy ones.

The latest study finds that people who exercise develop these bigger particles, even if their total amount of cholesterol stays the same.

“Using this analysis shows clearly that exercise has beneficial effects that are not revealed by standard tests,” said Dr. Ronald M. Krauss of the Lawrence Berkeley National Laboratory, who studies the protein particles.

MODERATE EXERCISE BENEFICIAL

The study, conducted at Duke and East Carolina University, involved 111 sedentary, overweight men and women. They were randomly assigned to three exercise groups: the equivalent of walking 12 miles a week, jogging 12 miles a week or jogging 20 miles a week. All were instructed to eat enough to keep their weight constant.

They found that the cholesterol effects of walking and jogging 12 miles were the same, while jogging 20 miles resulted in more pronounced changes.

Measuring protein particle size is sometimes done in large medical centers, but it is not part of standard physicals. Kraus said he expects the tests, which cost two or three times more than standard cholesterol tests, to become more widely used.

Dr. Joann Manson, head of preventive medicine at Harvard’s Brigham and Women’s Hospital, noted that exercise has already been found to have many other benefits for the heart, including improvements in blood pressure, blood sugar, clotting and inflammation.

Studies show that briskly walking 30 minutes a day can lower the risk of heart disease by 30 percent to 40 percent.

STUDY: Lower cancer risk with dietary antioxidants

JOURNAL: Gastroenterology 2002;123:985-991.

AUTHORS: Dr. Mauro Serafini

ABSTRACT: The total dietary intake of antioxidants is inversely associated with the risk for developing cardia and distal gastric cancer, European researchers report.

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COMMENTARY: For the first time this shows that the total antioxidant capacity of the diet is inversely associated with the risk of developing gastric cancer.

In people exposed to abnormal bio-radical loads, such as smokers and Helicobacter pylori-infected individuals, the increased need for antioxidant equivalents seems even more important.

Dr. Serafini and colleagues collected data on 505 patients newly diagnosed with gastric adenocarcinomas and on 1116 controls to assess their dietary habits for the 20 years before the survey. To convert food frequency into antioxidant potential, Dr. Serafini's team used the total radical-trapping antioxidant potential of different plant foods.

"We believe that the total antioxidant capacity concept is a more complete measurement of the counteracting forces in the multi-factorial pathological process towards invasive gastric adenocarcinoma," Dr. Serafini explained. This approach may provide a new tool for investigating the relationship between dietary antioxidants and oxidative stress-induced cancer pathology, he said.

The researchers also accounted for cancer risk from exposure to higher oxidative stress, including smoking and Helicobacter pylori infection, according to their report.

They found that for both cardia and distal cancer the dietary intake of antioxidant equivalents reduced cancer risk (odds ratio 0.65 for the highest quartile of total antioxidant potential).

When Dr. Serafini's team adjusted the data for smoking, they found a more robust dose-response relationship of antioxidant potential to gastric cancer risk. People who never smoked and who had the highest antioxidant intake had the lowest cancer risk.

Among those who had H. pylori infection, the odds ratio for developing gastric cancer varied from 0.66 to 0.56 from the lowest to the highest antioxidant potential.

STUDY: Study shows increased risk of breast cancer

JOURNAL: Annals of Internal Medicine

AUTHORS: Dr. JoAnn Manson

ABSTRACT: Women who drink alcohol and take hormones are at almost double the risk of breast cancer, researchers with a large ongoing study say.

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COMMENTARY: Previous studies have shown that women who have more than a drink a day raise their risk of breast cancer, and that hormone replacement therapy also increases the cancer risk.

The Nurses’ Health Study assessed the risk of the two factors combined. Researchers said the good news is that alcohol and estrogen together do not greatly magnify the danger through interaction. Some scientists were concerned that might be the case.

Instead, what they found is that a postmenopausal woman who has a lifetime breast cancer risk of 4 percent could increase the risk to 8 percent if she drinks and takes hormones.

“The public health message is that the two will substantially increase your risk of breast cancer and you might want to be particularly vigilant about having both of these risk factors,” said study co-author Dr. JoAnn Manson of Brigham and Women’s Hospital.

During the study years of 1980-94, 1,722 women developed breast cancer. Women who took hormones for at least five years but drank no alcohol increased their risk of breast cancer by about 30 percent, as did women who did not take hormones but consumed more than one drink a day.

For women who took hormones and drank alcohol, the risk nearly doubled.

For those women who still take hormones, a good compromise would be to consume no more than one drink of red wine a day at the most. That way, women can still get the cardiovascular benefits of moderate alcohol use while eliminating the increased breast-cancer risk.

STUDY: Effect exaggerated in overweight, sedentary women

JOURNAL: Journal of the National Cancer Institute

AUTHORS: Dr. Charles Fuchs

ABSTRACT: A diet high in white bread, white rice and potatoes puts women at much higher risk of pancreatic cancer — especially if they are overweight and do not exercise much.

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COMMENTARY: Previously, the only known risk factor for pancreatic cancer, which kills 30,000 people a year in the United States, was smoking.

The take-home message for women who are overweight and sedentary is that a diet high in starchy foods may increase their risk of pancreatic cancer.

Substituting less starchy vegetables such as broccoli for potatoes and rice and snacking on fruit are some simple steps they can take to reduce this potentially serious health risk.

STUDY: Flax good prostate food

JOURNAL: Urology 2002;60:000-000.

AUTHORS: Dr. Wendy Demark-Wahnefried

ABSTRACT: In mice genetically engineered to develop prostate cancer, a diet supplemented with flaxseed, which is rich in omega-3 fatty acids and fiber, inhibits the growth and development of prostatic carcinoma.

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COMMENTARY: A team of scientists from Duke University in Durham, North Carolina reports these findings in the November issue of the journal Urology.

The Duke team randomized 135 male 5- to 6-week-old transgenic mice to a normal mouse diet, the control group, or to a mouse diet supplemented with 5% flaxseed, the experimental group. The animals were sacrificed either at 20 or 30 weeks.

Three percent of flaxseed-fed mice did not develop prostate cancer at all. All of the control mice developed the disease.

According to the team, significant between-group differences in tumor growth and development were evident. Tumor weight was 1.9 grams in flaxseed-fed mice compared with 3.6 grams control mice (p = 0.0005). Tumors in flaxseed-fed mice were also "significantly less aggressive" than tumors in control mice (p = 0.01) and had a higher rate of apoptosis (p < 0.0001).]

While not reaching statistical significance, the prevalence of lung and lymph node metastases was lower in flaxseed-fed than control-fed mice.

This study builds on two other studies published recently by the Duke team. In a pilot study reported in July 2001, they found that men with prostate cancer who ate a low-fat diet supplemented with ground flaxseed for 34 days saw a drop in testosterone and a trend toward lower prostate specific antigen (PSA) level. The diet was well tolerated.

In another study, published in November 2001, flaxseed-derived lignans blocked the growth of three distinct human prostate cancer cell lines.

Adding flaxseeds to the diet would be a wise step toward promoting prostate health.

STUDY:

JOURNAL: Journal of Orthopaedic Research

AUTHORS: Stuart Goodman, MD

ABSTRACT: Researchers at Stanford University Medical Center have found that selective COX-2 inhibitors – a class of medications widely prescribed for painful inflammatory conditions such as osteoarthritis and rheumatoid arthritis - interfere with the healing process after a bone fracture or cementless joint implant surgery.

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COMMENTARY: Their findings suggest that patients who regularly take COX-2 inhibitors should switch to a different medication, such as acetaminophen or codeine derivatives, following a bone fracture or cementless implant.

The study, conducted in rabbits, also suggests that physicians should consider changing prescribing patterns since many doctors commonly prescribe anti-inflammatory drugs including COX-2 inhibitors under the very circumstances in which the drugs should be avoided.

"It's very common. You break a bone and go to the ER. The doctor sets it in a splint and prescribes one of these anti-inflammatory drugs (including COX-2 inhibitors) for pain," said Stuart Goodman, MD, professor of orthopaedic surgery at the Stanford School of Medicine and lead author of the study. "We now know that could actually delay healing."

The enzyme Cyclooxygenase-2, or COX-2, is produced by the body in response to injury or inflammation. COX-2 inhibitors, including anti-inflammatory medications such as rofecoxib (Vioxx), celecoxib (Celebrex) and others, block production of this enzyme. Goodman's research shows that COX-2 inhibitors also impede the new bone growth that normally helps heal a fracture or stabilize a joint implant.

Look for alternatives to this class of drugs if you have a recent bone break.

STUDY: Surprising finding may explain HIV’s hold on the body

JOURNAL: Institut Cochin

AUTHORS: France Pietri-Rouxel

ABSTRACT: The AIDS virus, long known to infect immune system cells, also takes up residence in fat cells, French researchers report. They found HIV in the fat tissue of patients with irregular fat deposits known as lipodystrophies — a side-effect of long-term drug treatment for the virus.

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COMMENTARY: THE FINDING could help explain why HIV has proven impossible to eradicate, and it may open a whole new window in understanding how the fatal and incurable virus works.

France Pietri-Rouxel of the Institut Cochin in Paris and colleagues stumbled upon the finding by accident, when she was treating HIV patients whose body fat began to redistribute itself in odd ways — the condition known as lipodystrophy.

A specialist in fat tissue, she was removing fat from the abdomens of the patients and injecting it into their cheeks to fill out their faces. “The thin, gaunt face is one of the disturbing signs of an HIV patient,” she said in an interview.

Jacques Leibowich of Hopital Foch in Suresnes, France, asked her for samples of the fat tissue for an unrelated study he was doing. To his surprise, HIV DNA turned up in the tissue. T

The human immunodeficiency virus, discovered 20 years ago, is known to infect immune system cells. It favors CD4 T-cells, lymphocytes that respond to a viral infection.

The virus grapples the cells, injects its genetic material and forces the cell to manufacture more copies of itself.



To do this it uses receptors, a kind of molecular doorway into the cell. The two main receptors HIV uses are called CD4 and CCR5 — both found on T-cells.

But fat cells also have CCR5 receptors, and now it appears HIV must use these to infect fat cells.

Robert Gallo, head of the Institute and one of the men who discovered HIV, said the finding could help explain why HIV lurks in the body for years despite treatment with drugs that can suppress its activity. Experts believe it must lie low in a pool of cells known as a reservoir.

“That could be a major contributor to the reservoir,” Gallo said. “It could also be the reason that some people with HIV lose fat.”

Pietri-Rouxel said all seven patients she treated had HIV in their fat. All were taking drug cocktails known as highly active antiretroviral treatment or HAART, which had reduced the virus in their body to levels that cannot be detected in blood tests.

“What we don’t know is the relationship between the treatment and the infected cells,” Pietri-Rouxel said.

“Could the treatment have caused it?” asked Leibowich.

Pietri-Rouxel said there was some evidence the virus was acting as it does in other cells and using them as little factories to make copies of itself, but this was not yet certain.

If all fat cells in an HIV patient are infected, the implications could be serious, Leibowich said. “A person has about a kilogram (2 pounds) of lymphocytes,” he said. “But someone like me has 15 kilograms (30 pounds) of fat. So fat cells could be the more important source.”

The researchers now plan to look for infected fat cells in other HIV patients, especially those who have not developed lipodystrophies.

STUDY: Cancer Burden is Expected to Rise with an Aging Population

JOURNAL: Cancer

AUTHORS: Brenda K. Edwards, Ph.D.

ABSTRACT: New data for 1999 show that death rates for all cancers combined continued to decline in the United States. However, the number of cancer cases can be expected to increase because of the growth and aging of the population in coming decades, according to a report released in the "Annual Report to the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age and Aging on the U.S. Cancer Burden".

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COMMENTARY: The report is by the National Cancer Institute (NCI); the American Cancer Society (ACS); the North American Association of Central Cancer Registries (NAACCR); the National Institute on Aging (NIA); and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS) and the National Center for Chronic Disease Prevention and Health Promotion.

The initial Report to the Nation, issued four years ago, documented the first sustained decline in cancer death rates. This trend was a notable reversal from increases that had been seen since the 1930s, which was the period when record keeping on deaths first included the entire nation. "The continuing decline in the rate of cancer deaths once again affirms the progress we've made against cancer, but the report also highlights the need for an acceleration of research as the population of the United States ages," said NCI Director Andrew C. von Eschenbach, M.D.

Lung cancer is still the leading cause of cancer death in the United States. During the most recent reporting period, it accounted for almost one-third of cancer deaths in men and about one-fourth of cancer deaths in women. Colorectal cancer is the second leading cause of cancer death, followed by breast and prostate cancer.

"The good news in this report is the continuing fall in cancer death rates by slightly more than one percent per year between 1993 and 1999," said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society. "Of special note is the continuing decline in death rates for the four most common cancers."

STUDY: NSAIDs may fight pancreatic cancer

JOURNAL: J Natl Cancer Inst. 2002;94:1168-1171

AUTHORS: Kristin E. Anderson, PhD

ABSTRACT: Regular aspirin use among postmenopausal women may reduce their risk of developing pancreatic cancer. Laboratory tests have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) may fight pancreatic cancer, but until now there has been only limited evidence in humans to back up this theory.

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COMMENTARY: In this study, researchers looked at NSAID use among more than 28,000 postmenopausal women, from 1992 through 1999.

They found that women who reported any use of aspirin had a 43% lower risk of pancreatic cancer compared with women who never took aspirin. In addition, the more aspirin use a woman reported, the less likely she was to develop pancreatic cancer.

Other NSAIDs did not have the same effect. Use of NSAIDs other than aspirin did not decrease the risk of pancreatic cancer.

Study author Kristin E. Anderson, PhD, of the University of Minnesota in Minneapolis, and colleagues say NSAIDs are thought to help prevent pancreatic cancer by inhibiting a particular enzyme in the body, thereby reducing inflammation.

The researchers say that their study suggests the drugs may also work in other ways to fight cancer because only aspirin was found to have a protective effect. But, they add, the women in the study used aspirin more often than they did other NSAIDs. This may partially explain why there was a stronger association between aspirin use and cancer prevention than was seen with the newer NSAIDs.

The researchers say that if further studies confirm this link, "more than 40% of pancreatic cancers may be prevented by aspirin among people who don't normally take aspirin." Although experts are not exactly sure what puts a person at risk for pancreatic cancer, smoking and obesity are thought to increase the risk.

STUDY: A new exam may help detect ovarian cancer earlier and improve the chances of survival

JOURNAL: Journal of the National Cancer Institute

AUTHORS: Dr. Le-Ming Shih

ABSTRACT: Each year, more than 23,000 American women are diagnosed with ovarian cancer and about 14,000 die from the disease. Yet, while there are mammographies to test for breast cancer and colonoscopies for colon cancer, there is still no standard screening exam for early detection of ovarian cancer. But this might change soon.

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COMMENTARY: Doctors aren’t making such grand claims yet with this new test, but they are heralding the new possibilities this test offers in picking up the cancer faster and getting patients treated earlier. This new test is based on digital SNP (single-nucleotide polymorphisms) analysis, which can detect a genetic imbalance in patients. Typically, we inherit DNA from our parents in equal proportions, one copy from our mother and one copy from our father. But cancer patients develop multiple copies of one parent’s genetic markers and less of the other parent’s. It’s this imbalance that doctors can measure in blood samples and analyze with the specialized digital technology.

In this recent study, researchers were able to identify the imbalances in 87 percent of women with early-stage ovarian cancer and 95 percent of women with advanced disease. To make sure the test was specific for ovarian cancer, researchers collected blood samples from 31 cancer-free women. There were no genetic imbalances found in any of the healthy women—more support that this test could differentiate between those with cancer and those who are disease-free.

Dr. Le-Ming Shih, the lead researcher on the study, cautions that while these results are extremely encouraging, they are only preliminary. “This study is important, because it tells us that this technology can detect ovarian cancer early. Now we will do more studies to see if we can combine the test with others to achieve an even higher detection rate.” Shih added that one of the remaining concerns is cost. This new blood test could be expensive, costing as much as $350. The goal would be to get the test closer to $100.

For a long time, health advocates have pushed for more research dollars to find better ways to diagnose ovarian cancer earlier in women. With this digital SNP blood test, their efforts may pay off—and thousands of lives may be saved.

STUDY: Bextra has been associated with serious allergic reactions

JOURNAL: FDA and drugmaker Pharmacia

AUTHORS: FDA

ABSTRACT: The US Food and Drug Administration (FDA) and drugmaker Pharmacia are advising doctors that the firm's COX-2 inhibitor valdecoxib (Bextra) has been associated with serious allergic reactions and should not be prescribed to patients allergic to sulfa.

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COMMENTARY: In a notice issued on Friday, the FDA said it has received post-marketing reports regarding various allergic events, including skin and anaphylactoid reactions.

Although the events were rare, some patients required hospitalization, the FDA added.

The FDA said the Bextra label has been updated to reflect the new case reports and contraindication.

On November 13, according to the FDA, Pharmacia sent similar letters to healthcare professionals, advising them of the post-marketing reports and new warnings that will be included on the updated label.

In a copy of the letter posted on the agency's Web site, Pharmacia said these cases occurred in patients with and without a history of allergic-type reactions to sulfonamides and included cases of Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis and erythema multiforme.

The company said the label would be updated to carry two separate warnings for the skin and anaphylactoid reactions, as well as a section to outline the post-marketing experience. According to the label included in the Pharmacia letter, an estimate of the frequency was not possible because the reactions were voluntarily reported from a population of uncertain size.

STUDY: Rat study hints one drink a day during pregnancy may be dangerous

JOURNAL: Alcoholism: Clinical and Experimental Research, 26, 1752 - 1758

AUTHORS: Daniel Savage

ABSTRACT: A new animal study hints that even a little alcohol during pregnancy may affect a baby's brain. A group of adult rats flunked a navigation test1. Their mothers had consumed quantities of alcohol while pregnant that were analogous to one drink a day for a human during the first six months.

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COMMENTARY: Britain's Royal College of Obstetricians and Gynaecologists advises pregnant women to limit their daily alcohol intake to one small glass of wine or beer or a measure of spirits. This is to reduce the risk of fetal alcohol syndrome - the learning and behavioural difficulties seen in children whose mothers drank heavily throughout pregnancy.

The rodent research, carried out by Daniel Savage and colleagues from the University of New Mexico Medical School, suggests that there may be more subtle effects of low-level alcohol intake that become obvious only later in life, as more complex tasks are taken on.

"Behavioural deficits appeared in rats that are relevant to humans," says psychologist Charles Goodlett of Indiana University-Purdue University, Indianapolis. But, he warns, "there is an enormous step between the gestation periods of rats and humans, so we must be careful about extrapolating the data too much".

Savage and his colleagues also found altered levels of glutamate in their rats. Levels of this key messenger molecule were one-third lower than normal in the hippocampus, the brain region that is responsible for learning and memory.

So how much alcohol is safe? "We really don't know the magic number," says Savage. "In the absence of definitive information, it is better to abstain," he says. "Why take a chance?

"Neurologist Michael Charness at Harvard Medical School agrees. "For every kid with fetal alcohol syndrome, there are another ten who have been exposed to alcohol, have no obvious physical defects but do have cognitive problems." The rat results are striking and not entirely surprising, he says.

STUDY: A shorter course of radiation therapy (RT) achieved the same results as the longer

JOURNAL: J Natl Cancer Inst. 2002;94(15): 1114-1115, 1143-1150

AUTHORS: Timothy Whelan

ABSTRACT: A shorter course of radiation therapy (RT) achieved the same results as the longer, now standard, course of RT for women with clean margins at the time of lumpectomy for breast cancer, according to the results of a randomized trial published in the Journal of the National Cancer Institute.

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COMMENTARY: "A shorter fractionation schedule will lessen the burden of treatment for women, many of whom may also receive adjuvant chemotherapy, and will have important quality-of-life benefits with respect to convenience and less time away from home and work," write Timothy Whelan, BM, BCh, MSc, from the Hamilton Regional Cancer Centre in Ontario, Canada, and colleagues.

In this study, 1,234 women who had undergone lumpectomy for invasive breast cancers without lymph node metastases were randomized to receive either a shorter or longer course of whole breast radiation. The fractionation schedule was 42.5 Gy in 16 fractions over 22 days in the short treatment group, or 50 Gy in 25 fractions over 35 days in the long treatment group. Median follow-up was 59 months.

At five years, local recurrence-free survival was 97.2% in the short group and 96.8% in the long group (absolute difference, 0.4%; 95% confidence interval, -1.5% to 2.4%). There was no difference in disease-free or overall survival. The proportion of patients with excellent or good global cosmetic outcome was similar in both groups, and was greater than 76% at three years and at five years.

In an accompanying editorial, Carolyn I. Sartor, MD, and Joel E. Tepper, MD, of the University of North Carolina School of Medicine in Chapel Hill, ask whether this study sets a new standard for adjuvant radiation for early-stage breast cancer. Newer technologies such as brachytherapy may allow even more convenient, less invasive therapies without compromising long-term outcome.

However, they caution against extrapolating the good outcomes in this study beyond a select group with small tumors completely resected with clean margins.

"In carefully selected patients, use of shorter, less expensive, and more convenient radiotherapeutic approaches can produce excellent local control of breast cancer with acceptable cosmesis," they write. "It is premature to generalize these results beyond the categories of patients actually treated in the trial, but, with further technologic and biologic advances, perhaps we can ultimately do even 'less.' "

STUDY: A supplement of probiotics increases the effectiveness of conventional antibiotic therapy for H pylori.

JOURNAL: Alimentary Pharmacology & Therapeutics (2002;16:1669–75).

AUTHORS:

ABSTRACT: Taking a supplement of “friendly bacteria” (probiotics) increases the effectiveness of conventional antibiotic therapy in eradicating Helicobacter pylori (H. pylori), the organism that causes peptic ulcers.

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COMMENTARY: H. pylori is an organism that can infect the lining of the stomach. Infection with this organism is an important contributing factor to gastric and duodenal ulcers, and may also increase the risk of developing stomach cancer.

H. pylori is a persistent bug that can be difficult to eradicate. Research has determined that the most reliable way to kill this organism is by using three drugs simultaneously for a week: two antibiotics and a medication that blocks the production of stomach acid. However, as many as 50% of individuals given this triple-therapy regimen experience side effects including nausea, vomiting, diarrhea, a metallic taste, or allergic reactions. Some people are unable to complete the therapy because of these side effects.

In the new study, 160 people infected with H. pylori were randomly assigned to receive a triple-therapy regimen (lansoprazole, amoxicillin, and clarithromycin) for one week, or the same triple therapy combined with five weeks of a daily yogurt supplement that contained live lactobacilli and bifidobacteria.

Eight weeks after the triple therapy, participants were tested for the presence or absence of H. pylori in their stomach. The eradication rate was significantly higher among those who received yogurt than among those given triple therapy alone (91% vs. 78%). However, when only those who completed the full seven days of triple therapy were considered, eradication rates were similar (93.5% for the yogurt group, 89% for triple therapy alone).

That finding suggests that the main benefit of the yogurt was to help people tolerate triple therapy better and to complete the full week of treatment.

Other natural treatments may be potentially helpful in eradicating H. pylori infection; these include garlic, mastic gum, vitamin C, and certain essential fatty acids.

However, most of the studies that support the use of these treatments have been done in test tubes, and there is little evidence that these natural remedies can kill H. pylori in infected people. At present, conventional triple therapy—perhaps combined with probiotics—appears to be the most effective regimen for eradicating the ulcer bug.

STUDY: Farmers want the corn blocked until tests can determine whether it caused some hogs and cattle in Midwestern states to become infertile.

JOURNAL:

AUTHORS:

ABSTRACT: Farmers and an environmental group worry that a biotech corn suspected of containing toxic mold could contaminate the food supply, prompting them to ask Agriculture Secretary Ann Veneman to keep it off the market.

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COMMENTARY: They want the corn blocked until tests can determine whether it caused some hogs and cattle in Midwestern states to become infertile.

Agriculture Department researchers suspected some Iowa cattle and hogs became sterile after eating the potentially moldy corn. An environmental group, Friends of the Earth, has sent letters to Veneman urging her to hold it from the market for more testing.

Larry Bohlem, a spokesman for the group, said farmers in Minnesota, Michigan and Iowa who have had problems with the corn produced by Garst Seed Co. don't want to discuss it publicly.

"They're kind of afraid because they're afraid to lose the value of their corn," he said Tuesday.

Bohlem said the agencies that regulate grain, including the Agriculture Department and the Food and Drug Administration, have failed to act quickly. He said he is concerned the grain will end up in tacos and tortilla chips.

That would be a replay of a scare that occurred two years ago when Aventis' StarLink corn, which wasn't approved for human consumption, was found in the food supply. Recovery efforts cost the food and farming industry billions of dollars.

Maria Bynum, spokeswoman for the Agriculture Department, said the potentially moldy corn is the FDA's responsibility to investigate. FDA officials said they were looking into the matter.

The corn is a variety known as Bt corn, genetically designed so it won't contain molds. Initial tests have indicated, however, that it contains the mold fusarium, which can sicken animals and humans. Researchers for the USDA's Agricultural Research Service have said, though, that a biological chemical compound may be to blame.

Scientists were alerted to the problem by Jerry Rosman, a farmer who operates Rolling R Farms in Harlan, Iowa. He told them he believed the corn was the root of his problems when reproductivity in his hog herd dropped from 90 percent to 20 percent from October

2000 to August 2001.

Officials with the Slater, Iowa-based Garst Seed said they've conducted their own investigation but nothing seemed amiss.

"We are confident that corn seed has not caused the problems he has experienced," company spokesman Jeff Lacina said in a statement. "The hybrids that Mr. Rosman purchased have been widely grown for several years and no one else who has grown them has reported similar experiences to us."

Rosman said his sows appeared to be pregnant but produced no litters. He destroyed the herd, he said, but notified the Agriculture Department when he discovered four of his neighbors had similar problems. His cattle also were showing a decrease in reproductivity, he said.

The corn "was the common denominator" in all the cases, Rosman said.

Scientists began testing Rosman's corn last fall but had to stop this summer because of a court battle between Rosman and his father over dividing the farm's assets. To settle the dispute, a district court judge in Shelby County, Iowa, ordered the corn sold and the cattle, which also auctioned, Rosman said.

"That's the wrinkle in this. Otherwise, this wouldn't be an issue, and this corn would be in my control and the livestock would be in my control and we'd just hang onto it for research," he said.

Rosman hopes Veneman's office will hold the corn.

Although the corn was sold, publicity about the grain led the elevators that bought it to reject it.

Rosman's case has drawn attention from farmers in surrounding states. He said nearly a dozen Midwestern farmers and some veterinarians have come forward, saying they saw reproductivity drop in hog and cattle herds because of the grain.

STUDY:

JOURNAL: New England Journal of Medicine.

AUTHORS: Christopher Crum

ABSTRACT: Early testing shows an experimental vaccine to be 100 percent effective against the virus that causes cervical cancer, raising doctors’ hopes of someday sending the lethal disease into retreat in the same way as smallpox and polio.

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COMMENTARY: The new vaccine, aimed at the viral strain Type 16 responsible for about half the cases of cervical cancer, was tested on women ages 16 to 23 at 16 sites around the country in a study led by Merck & Co. and the University of Washington. Merck developed the vaccine and funded the research. The women were watched on average for almost a year and a half.

Of 768 women who got vaccine injections, none showed Type 16 infections or precancerous tissue. Of 765 who took dummy injections, 41 came down with persistent infections, and nine developed precancerous tissue.

Inoculated women built up almost 60 times the concentration of virus-fighting antibodies seen in naturally infected women. Some researchers had suspected that the mucous membrane on the cervix would pose a barrier to such antibodies.