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Study Suggests Link Between Day Care, Stronger Immune System

August 28, 2000|THOMAS H. MAUGH | TIMES MEDICAL WRITER

Although infants placed in day care contract more respiratory infections than those cared for at home, the infections may reduce the likelihood that the children will later develop asthma, a new study says.

"This paper reflects the growing belief that the more sterile the early environment, the more problems later in life," said Dr. Leonard Bielory, director of the Asthma and Allergy Research Center at the University of Medicine and Dentistry of New Jersey in Newark.

The so-called hygiene theory speculates that exposure of the immune system to a broader variety of organisms strengthens it, making it less likely to produce asthma and autoimmune problems.

Dr. Anne L. Wright and her colleagues at the University of Arizona College of Medicine studied about 1,000 children, following them for more than 15 years. They reported in the Aug. 24 New England Journal of Medicine (http://www.nejm.com) that infants who attended day care before they were 6 months old were only half as likely to have asthma at age 13 as those who did not attend day care.

Two other recent studies also found that asthma is less common in children who started day care early. Related studies have found that growing up in the country, on a farm with animals, or in a home with a dog provides protection against asthma. Such experiences would all increase exposure to microorganisms in the environment.

Stem Cell Transplants Test Well Against Lupus

Stem cell transplants, which have had some success in treating victims of multiple sclerosis, may also be useful for severe forms of systemic lupus erythematosus, an often-fatal disorder in which the victim's immune system attacks organs throughout the body.

As in the treatment of MS, the idea in the lupus treatment is to destroy immune cells that are targeted against the patient's own body and then to replace them with cells that are not so dangerous.

Dr. Ann Traynor and her colleagues at Northwestern University in Chicago studied seven patients who suffered from severe, life-threatening lupus despite the fact that they were receiving intensive immune-suppressing therapy. The team removed stem cells from the patients' blood and replicated them in the laboratory to increase their numbers. The patients received high-dose chemotherapy to destroy their remaining immune cells, then the stem cells were re-infused into their bodies.

The team reported in the August 26 issue of Lancet (http://www.thelancet.com) that all seven patients were still free of signs of active disease an average of two years after the procedure. Their kidney, heart, lung and immune systems--all of which were failing before treatment--were all functioning normally afterward.

Study Questions Hemorrhoid Stapling

Although conventional surgery to remove hemorrhoids is a safe and effective procedure, many surgeons have been gravitating toward a newer procedure in which staples are used to block blood flow to the hemorrhoids, causing the swollen portion of the veins to die and fall off.

The conventional procedure requires about two weeks off work for recovery, while the stapling technique requires only a few days. But a new British study cautions that patients using the new method may suffer extra pain and fecal urgency.

Dr. Robin K.S. Phillips and his associates at St. Mark's Hospital in Harrow, Middlesex, studied 16 patients who had undergone the stapling procedure. They reported in the Aug. 26 Lancet (http://www.thelancet.com) that five of the patients developed pain and fecal urgency that persisted for as long as 15 months after the operation--a "disturbingly high" proportion.

A thorough examination showed that one of the five had a polyp next to the hemorrhoid; the other four had small bits of muscle incorporated into the stapled segment. By contrast, only one of the 11 who suffered no pain was found to have stapled muscle tissue.

CLA Seems to Aid Weight Loss

A popular dietary supplement called conjugated linoleic acid, or CLA, can help people lose weight and keep it off, and can help diabetics control their blood sugar levels, according to studies presented last week at an American Chemical Society meeting in Washington, D.C.

In one six-month study, conducted by nutritionist Michael Pariza of the University of Wisconsin in Madison, 80 overweight people dieted and exercised. Half took CLA and half did not. After an initial weight loss, most of the subjects put some of the lost weight back on. But the patients who took CLA regained less fat and retained more lean muscle mass, Pariza said. Norwegian researchers reported similar results.

In another study, nutritionist Ola Gudmundson of Scandinavian Clinical Research in Kjeller, Norway, followed 60 overweight people who did not diet and exercise. Those in this group taking CLA showed a statistically significant weight loss over 12 weeks--the equivalent of a 160-pound person losing two to three pounds, she said.

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