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Study: Estrogen Alternative Has Little Effect on Alzheimer's

April 23, 2001|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

An estrogen alternative called raloxifene apparently provides no protection against declining mental function for most women, according to researchers from UC San Francisco and UC San Diego.

Raloxifene, trade-named Evista, is designed to protect against osteoporosis in post-menopausal women without provoking the increased cancer risk associated with estrogen-replacement therapy. Researchers had hoped it would also protect against Alzheimer's disease; estrogen therapy reduces the risk of the disorder by about 30%.

In the new study, 3,478 women were given either raloxifene or a placebo for three years. They were periodically given a series of tests to measure mental functioning. The team reported in the April 19 New England Journal of Medicine that the drug did not have a significant effect on thought processes.

The study did suggest, however, that the drug might make a difference in women older than 70 and in women whose scores on the tests were already declining at the beginning of the study. In these two groups, the scores fell by smaller amounts among those taking raloxifene.

Benefits Short-Lived in Snoring Treatment

The benefits from a laser treatment to prevent snoring may be short-lived, according to an Israeli study. The procedure, called laser uvulopalatoplasty, destroys excess tissue from the soft palate and uvula in the throat, which eliminates the vibrations that cause snoring.

Dr. Gilead Berger of Meir General Hospital in Kfar Saba, Israel, and colleagues studied 14 patients who had undergone the procedure. Four weeks after the surgery, they reported in the April Archives of Otolarynglogy--Head and Neck Surgery (archotol.amaassn.org/issues/v125n7/abs/ooa8171.html) that 11 patients (79%) reported an improvement in snoring. Ten months after surgery, only eight reported continuing improvement. Meanwhile, three patients reported their snoring had actually gotten worse. U.S. experts noted that the procedure sometimes needs to be repeated.

Hormone Therapy for Early Prostate Cancer

An intensive hormone treatment can provide effective therapy for early prostate cancer, according to Los Angeles physicians.

Hormone therapy to block the production of testosterone--which promotes the growth of prostate tumors--is normally used only in conjunction with other therapies. But Dr. Robert L. Leibowitz and Dr. Steven J. Tucker of the Compassionate Oncology Medical Group have found that hormone blockade can be effective when used alone.

They reported in the April issue of the Oncologist (http://www.theoncologist.com) on 110 men they treated with the regimen. The men were treated with a three-drug regimen consisting of a luteinizing hormone-releasing hormone agonist (leuprolide or goserelin), an antiandrogen (flutamide or bicalutamide) and finasteride for 13 months, followed by finasteride maintenance therapy.

The drug combination brought testosterone levels to zero during the therapy, and sharply reduced levels of prostate specific antigen (PSA), a measure of tumor size. No patient reported urological side effects, such as impotence, after treatment concluded, and no patient has required further treatment during a follow-up that has averaged five years.

Routine Screening Urged for Chlamydia

All sexually active women should be routinely screened for chlamydia infections, according to government recommendations.

The U.S. Preventive Services Task Force (http://www.ahrq.gov/clinic/uspstfix.htm) said April 17 that doctors should screen all sexually active women ages 25 and younger--as well as older women who have multiple partners--as part of their regular health-care visits. The panel also urged screening of all pregnant women younger than 25 and other pregnant women who are at increased risk of infection.

ACE Inhibitors May Prevent Type 2 Diabetes

ACE inhibitors, a family of drugs used to treat hypertension, may help prevent type 2 diabetes, according to a new study. High blood pressure is a major risk factor for the development of type 2, or adult-onset, diabetes, which affects about 15 million Americans. And 80% of deaths among diabetics are caused by heart disease.

ACE inhibitors work by blocking enzymes that cause blood vessels to constrict, thereby increasing blood pressure. The new studies suggest, however, that the drugs may have other actions in preventing diabetes.

Dr. James Sowers and his colleagues at the State University of New York at Brooklyn combined the results from several previous studies and reported in the April issue of Hypertension: Journal of the American Heart Assn. that even a 2% reduction in blood pressure produced by taking ACE inhibitors produces a 25% decrease in the risk of premature death from heart disease. They also found a 34% reduction in the development of diabetes among patients taking the drugs.

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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.

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