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November 12, 2007
By Elizabeth Cooney, Globe Correspondent
Older men in good health who took beta carotene for about 18 years had better memory skills than similar men who took a placebo for the same length of time, a Harvard study shows.
The antioxidant, found in carrots, showed no benefit when taken for only three years, pointing to long duration as a critical factor in possibly slowing cognitive decline, which is a strong predictor of dementia.
The improvement was modest: Brain aging was delayed by about a year in men who took beta carotene long-term, author Francine Grodstein of Brigham and Women’s Hospital said in an interview. The study appears in today’s Archives of Internal Medicine.
She cautioned that it was too soon to recommend that men take beta carotene supplements. Beta carotene also has risks: Previous research has connected beta carotene to increased rates of lung cancer in smokers.
“Even though the changes that we saw are relatively modest, it is known that even modest changes in your memory can have a pretty big impact on the risk of dementia over the long term,” Grodstein, an associate professor of medicine at Harvard Medical School, said. It's the first study, she added, to find something that may help healthy people's memory.
The study followed about 6,000 men enrolled in the Physicians’ Health Study II over two time periods. They were given either 50 milligram pills of beta carotene or a placebo every other day. The first group participated for an average of 18 years and the second group for up to three years. They took tests of memory over the phone.
There was no improvement in the men who took beta carotene for the shorter time. The men who were on long-term beta carotene treatment did better, showing delays in cognitive aging of one to one and a half years, the study says.
In an accompanying editorial, Dr. Kristine Yaffe of the University of California, San Francisco, says it's plausible that long-term treatment may be necessary to have an effect on a disease that takes a long time to develop. But she also suggests there may be other interpretations of the results. In particular, she notes that the study doesn’t consider whether the men who took beta carotene for 18 years, staying in the study until it's completion, might be somehow different from men who did not continue to participate in the trial.
“For the clinician, there is no convincing justification to recommend the use of antioxidant dietary supplements to maintain cognitive performance in cognitively normal adults or in those with mild cognitive impairment,” she writes.
Grodstein said being conservative is appropriate.
“We don’t want to tell people to run out and start taking it immediately,” she said. “If we keep doing the research and keep working at it, it should give people hope we are going to be able to find something to help them keep their memory.”
Posted by Elizabeth Cooney at 05:01 PM
November 12, 2007
The doctors don’t know the questions. Even the category is a secret.
But anesthesiologist Dr. David Feinstein and surgeon Dr. Jonathan Critchlow do know the answers that Jeopardy’s Tournament of Champions contestants will be puzzling over tonight.
Back in June, the gowned and masked Beth Israel Deaconess doctors demonstrated some procedures for the game show’s traveling Clue Crew in the hospital’s Carl J. Shapiro Simulation and Skills Center. The idea was to gather on film some medical clues for questions on surgery.
The mystery will be solved, in the form of a question, at 7:30 p.m. on WSBK-TV 38.
Posted by Elizabeth Cooney at 03:23 PM
November 12, 2007
Men who are overweight when they have locally advanced prostate cancer have almost double the risk of dying from the disease compared with men of normal weight, new research says.
The study, led by a team at Massachusetts General Hospital, is the first to find that excess weight alone is associated with deaths in men whose tumors had grown beyond the prostate or spread to lymph nodes, according to the study, which appears in the journal Cancer.
"The prevalence of overweight and obesity continues to increase in United States, so it’s an issue that's perhaps more important than ever," author Dr. Matthew R. Smith said in an interview. "What we need to do from here are additional studies to understand the mechanisms by which overweight and obesity are associated with worse prostate cancer mortality."
For men with a normal body mass index of 25, the death rate from prostate cancer was 6.5 percent after eight years. For overweight men, with a BMI between 25 and 30, it was 13.1 percent, and for obese men, with a BMI over 30, the death rate was 12.2 percent.
Obesity is not a new suspect in prostate cancer. Previous work has linked being overweight to having more aggressive forms of the cancer and higher rates of recurrence after radiation and surgery to remove the prostate gland. But other potential reasons for the difference in outcomes, from difficulty examining obese patients to possible biases in screenings, had not been isolated in the observational studies.
The study reported in Cancer analyzed data from a large randomized trial originally conducted to study radiation and hormone therapy in about 900 men with prostate cancer. That means the men had similar disease characteristics to be included in the trial. The authors, who also include researchers from Fox Chase Cancer Center and UCLA, looked at the men's BMI at the start of the trial and what happened to them over about eight years of follow-up.
Dr. Oliver Sartor of Dana-Farber Cancer Institute said the researchers have made an important observation from a well-designed trial.
"Now the hypothesis-driven question to ask is whether or not weight loss after diagnosis with prostate cancer will lead to better outcomes," he said in an interview. "That's an important question."
Posted by Elizabeth Cooney at 07:00 AM
November 12, 2007
In an e-mail to Caritas Christi Health Care System staff and physicians, Cardinal Sean P. O'Malley said Caritas Carney Hospital is straining finances and putting at risk the entire six-hospital chain, which is owned by the Archdiocese of Boston.
Viruses such as human papilloma may be the most overlooked bad guys in the war on cancer, silent invaders that contribute to more than a dozen malignancies and may cause 15 percent of the cancer cases worldwide each year.
For Nicholas Christakis (left), this is what it has come to. After an MD and a master's degree in public health from Harvard Medical School, a doctorate in sociology from the University of Pennsylvania, and a distinguished career as a physician, professor, and researcher, Christakis laughs to think that, at age 45, the first line of his obituary has already been written: "Nicholas Christakis, a Harvard University professor who co-authored a study that said you can get fat from your friends . . . " This is the sexy, heavily condensed, and mostly inaccurate way to look at his study.
The past couple of decades have yielded repeated - and lethal - reminders of how animals can make people sick. Think apes and AIDS, mosquitoes and West Nile virus. The latest example: pigs and MRSA, the bacterium that in recent weeks has infected schoolchildren and caused custodians to scour emptied classrooms, dousing any trace of the germ.
Dr. Claes Dohlman (left, with Dr. Ana Fernandez-Hortelano) considered the "founder of modern corneal science," recently received the Laureate Recognition Award from the American Academy of Ophthalmology for his contributions in restoring sight worldwide.
Also in Health|Science, how to maximize three workouts per week and could the space shuttle return to earth slowly and skip heat shields?
In Business & Innovation, a year after safety questions about drug-coated heart stents prompted doctors to change treatment for hundreds of thousands of cardiac patients, many physicians say the medical community overreacted and should reverse course.
Posted by Elizabeth Cooney at 06:57 AM
November 12, 2007
The parents of Eric Valdepenas, one of "New
England's Own" killed in Iraq, visited his grave
in East Providence, R.I.
The First Battalion, 25th Marine Regiment - the reserve infantry unit based in Central Massachusetts and known as "New England's Own" - has a proud history in modern America's many wars, including a record of exceptional valor, and devastating casualties, on Iwo Jima. When they returned home from Iraq last fall to Veterans Day speeches, parades, and accolades, there was more distinguished service to celebrate. And more devastation, Charles M. Sennott writes in Sunday's Globe.
The 878 men who came home have struggled to come to terms with the fact that 11 did not; that 68 others suffered combat wounds; and that many more were hit with injuries less visible but with long-term effects, like bomb-blast concussions.
Posted by Elizabeth Cooney at 06:47 AM