In The News This Week … August 31–September 6, 2008: Heart Health, Cancer, SAD, Kids, & Drug Advertising

Bypass Versus Stents

A study presented at the European Society of Cardiology meeting reports that both CABG procedures and drug-coated stents are equally safe, but those who receive a stent are more likely to require a repeat procedure than those who have a CABG. Researchers found that nearly 14% of stent cases needed another procedure after a year, while only about 6% of CABG patients needed another procedure in the same period. The study also found that the death rate was virtually the same (7.7% among surgery patients and 7.6% among angioplasty patients), but the stroke rate was about 2% for surgery, versus near zero for the stent cases.

Stairs for Heart Health

Also from the European Society of Cardiology meeting is the finding that climbing a few flights of stairs at work for three months provides a big benefit for heart health. Researchers looked at 69 employees of the University of Geneva, all of whom lived a sedentary lifestyle, and asked them to use the stairs rather than the elevators. The average number of stairs ascended or descended increased from an average of five per day to 23 per day, and this resulted in an increase in aerobic capacity equivalent to approximately a 15% decrease in all-cause mortality risk. Additionally, subjects experienced a statistically significant decline in waist circumference, weight, fat mass, diastolic blood pressure, and LDL cholesterol.

ICD Shocks & Future Trouble

An article published in the September 4 issue of The New England Journal of Medicine looked at 811 patients with heart failure who had received an implantable cardioverter-defibrillator (ICD). Subjects were followed over a median period of 45.5 months. Researchers found that that those who needed a shock were more than five times more likely to die over the next four years than those who didn't require one. An inappropriate ICD shock was also associated with a significant increase in the risk of death.

Future in Targeting Telomerase in Tumors?

A common hallmark of human cancers is the overexpression of telomerase, which normally adds short sequences of DNA (telomeres) to the ends of chromosomes, thus preventing damage and the loss of genetic information when cells divide. Now, research published online on August 31 in Nature reports that scientists have deciphered the structure of the active region of telomerase. It is hoped that the discovery could lead to new drugs to target cancer. The leader of the study, Emmanuel Skordalakes, PhD, said in a news release, "Telomerase is an ideal target for chemotherapy, because it is active in almost all human tumors, but inactive in most normal cells. That means a drug that deactivates telomerase would likely work against all cancers, with few side effects." In addition to its role in cancer, telomerase holds significant implications for the development of therapies to combat aging and other age-related diseases.

Tobacco-Related Cancer Numbers

According to a September 5 CDC Surveillance Report, tobacco use caused 2.4 million cancer cases in the United States from 1999 to 2004. Tobacco use kills 438,000 people prematurely every year, including 38,000 people who are victims of secondhand smoke. The report also found that tobacco-related cancers were more common among blacks, non-Hispanic whites, and men, reflecting the groups that use tobacco more.

Sequencing Brain and Pancreatic Cancers

According to two articles published online on September 4 in Science Express, scientists have sequenced the genes for a form of brain cancer (human glioblastoma multiforme) and pancreatic cancer. As stated in a news release from Howard Hughes Medical Institute, "(I)nvestigators have detected a multitude of broken, missing, and overactive genes in pancreatic and brain tumors, in the most detailed genetic survey yet of any human tumor. Some of these genetic changes were previously unknown and could provide new leads for improved diagnosis and therapy for these devastating cancers. … Taken together, the two studies suggest that a small number of commonly mutated genes – or 'mountains' – and a larger number of rarer, low-frequency gene changes – 'hills' – cause these cancers, said the researchers." They found that each individual tumor had its own particular assortment of gene changes, so, as stated by investigator Dr. Bert Vogelstein, "If you have 100 patients, you have 100 different diseases." Vogelstein also said, "It's suggesting that maybe we shouldn't even be focusing so much on the individual genes that are mutated. Instead, we should be thinking about the functional pathways in which these genes operate. This is a different way of looking at how cancer develops."

Do You Suffer From SAD?

A study published in the September issue of Archives of General Psychiatry was based on brain scans of 88 healthy volunteers carried out between 1999 and 2003. They found that a protein known as a serotonin transporter was significantly more active in all areas of the brain in scans performed in the autumn and winter. The more active the protein, the lower the levels of serotonin in the brain, and the greater the likelihood of a depressed mood. Researchers believe that light impacts the activity of the protein.

Older Dads & Kids' Bipolar Risk

Studies have previously linked older dads to a higher risk of autism and schizophrenia in offspring. Now, findings published in the September issue of Archives of General Psychiatry show a link between older dads and bipolar risk. The findings were based on Swedish registry data concerning more than 80,000 people, and showed that risks began increasing around age 40, but were strongest in those 55+. Kids born to dads aged 55+ were 37% more likely to develop bipolar disorder than kids of men in their early 20s. They also found that the maternal age effect was less pronounced.

Maternal Stress & Overweight Kids

An article published in the September issue of Pediatrics looked at a sample of 841 children aged three to 17, whose mothers had incomes below the poverty line, and were in the 1999–2002 National Health and Nutrition Examination Survey. Researchers found that kids to age 10 who were living in poverty, and with stressed moms, but were in "food secure" homes, were more likely to be overweight or obese than those in the same circumstances, but who were in "food insecure" homes. Although both groups were stressed, those with plentiful food were able to find refuge from stress in food – particularly less-healthy "comfort foods" – whereas those with scarce food could not. The same results were not found among those aged 11 to 17.

Drugs & Direct to Consumer Advertising

Research published online on August 2 in the British Medical Journal has found that costly direct-to-consumer drug ads have mixed results in getting people to buy. The study was based on two groups of Canadians – English-speaking Canadians who have regular exposure to drug ads via American television channels (direct to consumer ads are prohibited in Canada) and French-speaking Canadians, who have little exposure to such ads. The researchers wrote that there were three major implications of their findings – first, that cross-border exposure to direct to consumer advertising has the potential to modify drug use, even when such advertising is technically prohibited; second, that "direct to consumer advertising can increase use of a drug that was removed from the market as a result of concerns about safety"; and third, "the effectiveness of direct to consumer advertising campaigns is mixed, as they seem to work for some drugs and not others."

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