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Orlistat Moderately Useful in Weight Loss

July 20, 1998

Orlistat, a weight-loss drug that partially inhibits the body's uptake of dietary fat, is moderately useful for losing weight, according to Swedish researchers. Dr. Lars Sjostrom and his colleagues at Sahlgrenska University Hospital in Goteborg studied 688 obese patients who were placed on a low-calorie diet for four weeks, then given either orlistat or a placebo in conjunction with the low-calorie diet for a year. In the second year of the study, the patients were placed on a maintenance diet, and the drug use was switched.

The team reported in the July 18 Lancet that patients given orlistat during the first year lost an average of 22.7 pounds, compared to 13.4 pounds in the placebo group. Patients switched to orlistat in the second year lost an additional 2 pounds, compared to a weight gain of 5.5 pounds in those switched to placebo. The patients taking orlistat suffered more diarrhea and other gastrointestinal ailments, however.

Protein May Predict Relapse, Remission of Bladder Cancer

USC researchers have identified a molecular marker that will predict which patients treated for bladder cancer will have a remission and which will have a relapse of the disease. The marker is a protein, called p21, that normally suppresses tumor growth. About 50,000 people are diagnosed with bladder cancer each year.

Dr. John P. Stein and Dr. Richard J. Cote of USC's Norris Comprehensive Cancer Center report in the July 15 Journal of the National Cancer Institute that patients whose tumors secrete low levels of p21 are much more likely to suffer a recurrence and die than are those whose tumors secrete a higher level. "Our findings should help us to determine which patients will most likely benefit from continuing treatment after surgery and which patients could be spared its toxic side effects," Stein said.

Increased Transplanted Kidney Survival Reported With Drug

A new anti-rejection drug called sirolimus has demonstrated the first clinically significant improvement in the survival of transplanted kidneys since 1983, researchers reported last week at the 17th World Congress of the Transplantation Society. A team headed by Dr. Barry D. Kahan of the University of Texas-Houston Health Science Center studied 719 kidney transplant patients who received either sirolimus (trade name Rapamune) or azathioprine in combination with standard immunosuppressive therapy.

Over the course of the study, only 2% of the patients receiving sirolimus lost their transplant, compared to 6% of those receiving standard therapy. Moreover, patients treated with the new drug had 60% fewer acute rejection episodes. Such episodes are normally treated with antibody therapy that is costly and can cause complications.

Flatulence Odor Linked to Hydrogen Sulfide Presence

Flatulence collected from 16 healthy volunteers whose diets had been supplemented with pinto beans and a sugar called lactulose showed that the strength of the odor was directly related to the amount of hydrogen sulfide in the gas, Minnesota researchers report in the July issue of the journal Gut. Hydrogen sulfide is a byproduct of sulfate-reducing bacteria which live in the gut and aid digestion. Sulfate is found in cruciferous vegetables such as broccoli and cabbage, nuts, bread, beer and sulfur-containing amino acids in protein, but it is poorly absorbed by the small bowel.

Dr. Michael Levitt and his colleagues at the Veterans Affairs Medical Center in Minneapolis also found that a commercial product called the Toot Trapper--a polyurethane foam cushion with one side coated with activated charcoal--eliminated more than 90% of the odor.

Colon Cancer Screening May Give False Alarms

Widely used stool screening for colon cancer often gives false alarms because it detects blood from elsewhere in the digestive tract, such as ulcers, according to a study in the July 16 New England Journal of Medicine. Researchers at Duke University and UC San Francisco examined 248 people who had positive readings on the fecal occult blood test, which looks for occult, or hidden, blood in stool samples.

The blood can be a sign of bleeding from colon tumors. Those with positive test results typically undergo colonoscopy, a colon exam that can cost $1,000 or more and carries a small risk of harm. Often, though, the exam finds nothing wrong.

The latest study was intended to find the source of the blood. In 54 of the patients, the source was, indeed, the colon, mostly tumors. In 71 patients, however, the blood came from ulcers and other problems in the upper digestive tract.

Cancer Drug Effectiveness Increases With Radiation

A double attack on tumors using a new cancer drug and radiation is more effective in beating the disease than either treatment alone, according to researchers from the University of Chicago. Dr Ralph Weichselbaum and his colleagues found that angiostatin, one of a new class of anti-cancer drugs that block the blood supply to tumors, works even better in mice when it is combined with radiation.

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