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Fluoride May Help Reduce Fractures

October 09, 2000|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

Fluoridated water reduces the risk of getting fractures of the hip and vertebrae in elderly women and may be one of the most cost-effective approaches for reducing such fractures and combating osteoporosis, according to Oregon researchers.

Previous studies of fluoridation have shown mixed results, but critics charge that they failed to take into account confounding factors, such as estrogen use, smoking and body weight. Those factors were included in the new research.

Dr. Kathy R. Phipps of the Oregon Health Sciences University and her colleagues there and at the University of Pittsburgh studied 3,218 women who had continuous exposure to fluoridated water over a 20-year period and 2,563 who had no exposure. They reported in the Oct. 7 British Medical Journal (http://www.bmj.com) that women exposed to the fluoride had a 2.6% higher bone density in their hips and a 2.5% higher density in the lower spine. They also had a 31% reduced risk of hip fracture and a 27% reduced risk of vertebral fracture.

In a separate study in the same journal, Dr. Paul Wilson and his colleagues at the University of York reviewed more than 200 studies of the health effects of fluoridation. They found that adding fluoride reduced tooth decay by an average of 15%. But they also concluded that about 12.5% of people exposed to the fluoridated water had an increased incidence of fluorosis, or mottling, of the teeth.

Toxin Shown to Speed Post-Stroke Recovery

A form of botulinum toxin can relieve the pain and muscle spasms that often paralyze a limb after a stroke, according to British researchers. The toxin is already commonly used to treat a number of muscle conditions, such as squinting of the eyes and cerebral palsy, and to smooth facial wrinkles.

Dr. A.M.O. Bakheit and his colleagues at Mount Gould Hospital in Plymouth, England, enrolled 82 patients suffering post-stroke spasticity. Nineteen patents received a placebo (an ineffective substance, such as water or sugar) and the rest received one of three different concentrations of a form of botulinum toxin, known as Dysport, injected into the affected limbs. The researchers reported in the October issue of Stroke: Journal of the American Heart Association that Dysport was much more effective than a placebo at relieving spasticity. The effects persisted for three to four months. The primary side effects were a rash and mild flu-like symptoms.

In a separate study in the same journal, Japanese researchers report that a high blood level of vitamin C associated with high intake of fruits and vegetables sharply reduces the risk of stroke. Dr. Tetsuji Yokoyama and his colleagues at Tokyo Medical and Dental University studied 880 men and 1,241 women in rural Japan who were divided into four groups according to the level of vitamin C in their blood.

Throughout the 20 years of the study, the risk of stroke was 70% higher in those with the lowest amount of vitamin C in their blood compared with those with the highest amount. The stroke risk was 58% lower among those who consumed vegetables six to seven days per week compared with those who consumed them only two days per week. Most of the subjects were not taking vitamin C supplements and the researchers cautioned that the beneficial results might arise from other ingredients in the foods containing the vitamin.

Elderly Sometimes Get Wrong Antidepressants

As many as a quarter of elderly patients who receive antidepressants or anti-anxiety drugs receive inappropriate prescriptions, according to researchers from South Dakota State University. That amounts to 4.5 million visits to the doctor annually in which the wrong drug is prescribed, Dr. Jane Mort and her colleagues reported in the October Archives of Internal Medicine (http://archinte.ama-assn.org). As people age, Mort noted, their ability to metabolize drugs declines and the drugs produce undesirable effects.

The most commonly misused drug was the antidepressant amitriptylene, which makes elderly patients excessively sleepy and can lead to constipation and an inability to urinate. Although long-acting benzodiazepines increase the likelihood that a patient will fall, they are often prescribed for patients with a history of falls, Mort said.

Cancer Study Touts Benefits of Garlic

Garlic, eaten cooked or raw, can reduce the risk of stomach and colorectal cancer, but garlic supplements do not provide similar benefits, according to researchers from the University of North Carolina at Chapel Hill. Dr. Lenore Arab and her colleagues reviewed more than 300 papers studying diet and nutrition and then combined the results from the best 22 providing data on garlic.

They reported in the October American Journal of Clinical Nutrition that garlic reduced the risk of stomach cancer by half and the risk of colorectal cancer by about a third. Supplements showed no benefit, however. Arab speculated that the active ingredients were destroyed in processing to produce the supplements or by sitting on store shelves too long.

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