Conception Technique Draws Concern
Babies conceived with the relatively new technique of intracytoplasmic sperm injection (ICSI) show mild developmental delays at the age of 1 year, according to a new study in the May 23 Lancet, but show no such delays at 2 years, according to another study in the same issue.
Dr. Jennifer Bowen and colleagues at the Royal North Shore Hospital in St. Leonards, Australia, compared 89 1-year-olds conceived with ICSI to 84 conceived with conventional in-vitro fertilization (IVF) and 80 conceived naturally. They found mild developmental delays in the ICSI children and recommended further studies.
Dr. M. Bonduelle and colleagues at the Dutch-Speaking Brussels Free University in Belgium studied 201 2-year-olds conceived by ICSI and 131 conceived by IVF and found no indication that either group had slower development than the general population. An editorial in the same journal cautioned that further studies are required, but that “the findings so far, especially those of Bowen and colleagues, carry a serious warning.”
Type of Surgery Doubles Ovarian Cancer Survival Rate
A new surgical technique employed by surgeons at the Encino-Tarzana Regional Medical Center can nearly double the survival rate for women with advanced ovarian cancer, from 25% to nearly 50%. In about 75% of women with ovarian cancer, the disease has spread throughout the abdomen by the time the cancer is diagnosed. Traditional surgical techniques leave many cancer cells behind.
Dr. Scott Eisenkop and Dr. Richard Friedman reported last week to the American College of Obstetrics and Gynecology that a technique called complete cytoreductive surgery, in which all visible traces of the disease are removed from the abdomen, greatly improved survival. The technique is followed by chemotherapy to kill any remaining cancer cells.
According to Eisenkop, most surgeons, even those who specialize in female cancer, are reluctant to perform complete cytoreductive surgery because of unfamiliarity with the technique, concerns about operative complications, a lack of precedents and previous uncertainty about the technique’s benefit.
Elders’ Lesser Ailments Often Overlooked, Study Shows
Doctors treating elderly patients for serious chronic diseases such as diabetes or emphysema often neglect lesser conditions such as thinning bones and arthritis, Canadian researchers have found. The researchers said some doctors may fall victim to a common fallacy: that patients with one chronic disease are unlikely to suffer from another.
The study, published in the May 21 New England Journal of Medicine, looked at a prescription drug database for 1.34 million residents of Ontario, Canada, who were 65 or older in 1995. All of the patients could get free prescription drugs through a government program. The researchers identified patients with three chronic diseases--diabetes, emphysema or psychosis--by the drugs prescribed for them: insulin, ipratropium bromide or haloperidol. Then they checked to see whether the patients were getting drugs for other, unrelated ailments.
Women who had diabetes were found to be 60% less likely than those without it to be given estrogen, which helps prevent osteoporosis and heart disease. Patients with emphysema were 31% less likely to get cholesterol-lowering drugs, and those with psychosis were 41% less likely to get arthritis drugs.
Promising Findings in Research on Nerve Regeneration
Brain-damaged rats given an injection of an experimental genetically engineered antibody called IN-1 grew new nerve fibers that once again let them climb ropes, grasp food pellets and remove sticky tape from their front paws, Swiss researchers report in the June issue of Nature Neuroscience. Regeneration of nerves in the brain and spinal cord is normally inhibited by proteins in the protective sheaths of the nerve fibers. The antibody blocked that inhibition by binding to the proteins.
Rats injected with IN-1 sprouted healthy new nerve fibers that took over for the damaged fibers, building new connections, “which automatically seem to be the right connections,” said neuroscientist Martin Schwab of the University of Zurich. The human central nervous system contains similar inhibitors, and the Swiss team is working to construct antibodies against them.
Supplement Found to Be Drug in Disguise
A widely sold dietary supplement once advertised to “lower your cholesterol without drugs” is actually a drug in disguise being sold illegally, the government said Wednesday. The case involving Cholestin, a red yeast product from China, had been closely watched as potentially defining where dietary supplements cross the line into medicine.
The Food and Drug Administration ruled Wednesday that Cholestin never was a dietary supplement--because it contains the same ingredient as the powerful prescription anti-cholesterol drug Mevacor. As such, Cholestin violates federal law forbidding companies to sell products that mimic prescription drugs simply by calling them “natural,” said FDA Deputy Commissioner William Schultz. Manufacturer Pharmanex Inc. is challenging the FDA’s ruling. A hearing is set for June 15 in U.S. District Court in Salt Lake City.
Smoking May Cut Risk of Specific Breast Cancer
Heavy smoking can reduce the risk of breast cancer by as much as 54% in the one in every 250 women who carry either the BRCA1 or BRCA2 cancer genes, but the “embarrassed” physicians who made the discovery cautioned that the risks of smoking were too great to encourage women to take up the habit. “Smoking may reduce breast cancer risk for these women, but cigarettes sharply increase the incidence of other cancers,” said Dr. Jean-Sebastien Brunet of the University of Toronto.
The study does have value, Brunet said, because researchers may be able to find the particular constituent in cigarette smoke that blocks cancer formation and use it without the other adverse effects of smoking.
--Compiled by THOMAS H. MAUGH II
