Indian Medicine

NEW YORK (Reuters Health) - Berberine, an herbal medicine commonly used to treat diarrhea, can also significantly reduce blood sugar and cholesterol levels in people with type 2 diabetes, Chinese researchers report based on a study they conducted.

"Berberine cannot provide adequate single drug therapy for all diabetic patients because the patients in the present study had relatively mild diabetes," they say, but it may be at least useful as an add-on to standard therapy.

Dr. Guang Ning, of Shanghai Jiao Tong University School of Medicine in Shanghai and colleagues randomized 116 diabetes patients to receive one gram of berberine daily or placebo for 3 months.

Fasting blood sugar fell from markedly in patients on the herb, they report. Among the patients on berberine, average hemoglobin A1C -- a measure of long-term blood sugar control -- dropped from 7.5 percent to 6.6 percent.

Patients on the herb also showed significant reductions in total and "bad" LDL cholesterol. Blood pressure also fell in patients taking berberine.

Patients on the herb lost 2.3 kilograms (5.1 pounds), on average, compared to 1.3 kilograms (2.9 pounds) for the placebo group.

All of the differences seen among patients on berberine were significantly greater than those for patients on placebo.

No serious side effects were seen among patients in the study, although patients taking berberine were more likely to report constipation, and two patients in the berberine group had their dosage reduced for this reason.

Given the benefits of berberine in lowering blood sugar, cholesterol, body weight, and blood pressure, "we speculate that berberine may be used for patients with type 2 diabetes and metabolic syndrome," the researchers conclude.

SOURCE: Journal of Clinical Endocrinology and Metabolism, July 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Exposure to low-to-moderate levels of inorganic arsenic in drinking water and food may increase the risk of type 2 diabetes, according to a study released Tuesday, which found that individuals with diabetes had higher levels of arsenic in their urine compared to individuals without diabetes.

High chronic exposure to inorganic arsenic is a documented risk factor for diabetes, but the effect of lower levels of exposure is unknown, Dr. Ana Navas-Acien, from Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues note in the Journal of the American Medical Association for August 20.

The researchers examined urine samples taken from 788 U.S. adults 20 years or older.

They found that subjects with type 2 diabetes had 26 percent higher total arsenic levels than subjects without diabetes. The likelihood of diabetes was more than 3.5-fold higher in subjects with higher urine arsenic levels relative to those with lower arsenic levels in urine.

The primary sources of inorganic arsenic are contaminated drinking water due to naturally occurring arsenic in rocks and soils, and food, the researchers point out. In the U.S., roughly 13 million people live in areas where the concentration of inorganic arsenic in the public water supply exceeds EPA-established standards, primarily in the West, Midwest and Northeast regions. Dietary intake of inorganic arsenic in the U.S. ranges from 8.4 to 14 micrograms per day for various age groups.

"Given widespread exposure to inorganic arsenic from drinking water worldwide, elucidating the contribution of arsenic to the diabetes epidemic is a public health research priority," Navas-Acien and colleagues conclude.

Drs. Molly L. Kile and David C. Christiani, at Harvard University School of Public Health in Boston, advise in a commentary published with the study: "It is prudent to minimize arsenic exposure while its effect on metabolic diseases continues to be researched."

SOURCE: Journal of the American Medical Association, August 20, 2008.

Copyright © 2008 Reuters Limited.

CHICAGO (Reuters) - Ventilator tubes treated with silver to reduce infections cut the risk of pneumonia in gravely ill patients by 36 percent compared with similar, untreated tubes, researchers reported on Tuesday.

The findings, published on Tuesday in the Journal of the American Medical Association, suggest the tubes may offer a way to reduce the incidence of this common and often deadly infection, at least for high-risk patients.

Half of the antibiotics used in hospital intensive care units are prescribed to help prevent bacterial pneumonia in patients put on ventilators to help them breathe, according to a commentary in the journal.

Silver is widely used as an antimicrobial agent and has been shown to reduce bacterial pneumonia infections in animals. Medical device maker C.R. Bard funded the study to ssee if a silver coating would help reduce the infections in humans.

Dr. Marin Kollef of the Washington University School of Medicine in St. Louis and colleagues tested the devices in 1,500 patients expected to be placed on a ventilator for more than 24 hours between 2002 and 2006.

They found ventilator patients given silver-coated breathing tubes had significantly fewer cases of pneumonia than those with untreated ventilator tubes.

Of the 1,509 patients who had tubes in their trachea for 24 hours or longer, 4.8 percent those with silver-coated tubes developed ventilator-associated pneumonia, compared with 7.5 percent of patients with uncoated tubes.

The antimicrobial tubes also delayed the time it took for ventilator-associated pneumonia to develop compared with those using a similar, uncoated tube, the team found.

But the tubes did not reduce death rates, and the findings were limited because many patients could not provide informed consent, reducing the size and overall power of the study, Dr. Jean Chastre of the Groupe Hospitalier Pitie-Salpetriere in Paris, said in a commentary.

Chastre said the findings suggest high-risk patients may benefit from the devices, but said more study is needed before they are recommended for all ventilator patients.

In November, the U.S. Food and Drug Administration gave Bard clearance to market its silver-coated endotracheal tube, known as Agento, but the company said it would wait to launch the product until its study was published in a major journal.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Cheerleading is behind a greater share of severe injuries in student-athletes than previously thought, according to a new report.

In fact, researchers found, over the past 25 years, the sport has accounted for two-thirds of catastrophic injuries among female high school and college athletes. Catastrophic injuries include fatalities, permanently disabling injuries and traumas that are serious but not permanent -- such as a non-paralyzing spine fracture.

Injuries like these are not common in high school and college sports.

In 2007, for example, two U.S. high school cheerleaders sustained a catastrophic injury, according to the report, from researchers at the University of North Carolina at Chapel Hill.

However, the rate of such injuries among female student-athletes has been increasing over the years, lead researcher Dr. Frederick O. Mueller said in a statement released by the university.

For the past 25 years, Mueller and colleagues at the UNC-based National Center for Catastrophic Sports Injury Research have been issuing an annual report on rates of such injuries at the high school and college levels.

Past estimates have had cheerleading accounting for 59 percent of all sports-related catastrophic injuries to female student-athletes. For this year's report, however, Mueller's team had additional injury data from a California non-profit called the National Cheer Safety Foundation.

They now estimate that between 1982 and 2007, there were 103 fatal or severe injuries among female high school athletes, with cheerleading accounting for 67. By comparison, the next two most risky sports were gymnastics and track sports, which accounted for nine and seven injuries, respectively.

At the college level, there were 39 catastrophic injuries among female athletes over the 25-year period; 26 were related to cheerleading.

"A major factor in this increase has been the change in cheerleading activity, which now involves gymnastic-type stunts," Mueller said.

"If these cheerleading activities are not taught by a competent coach and keep increasing in difficulty," he added, "catastrophic injuries will continue to be a part of cheerleading."

It may never be possible to eliminate such injuries from school sports, Mueller noted, but rates can be reduced.

He and his colleagues recommend that besides ensuring that all coaches have the ability to teach the fundamental skills of their sport, schools should also have a certified athletic trainer on their faculty, and have emergency plans in place in the event of a serious injury to one of their students.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - When a family is created through sperm donor insemination, it is likely that other families exist who share the same sperm donor. Results of a new survey suggest that most sperm-donor inseminated parents seeking contact with other families who share the same donor may be interested in creating a genetic family for their children.

"One's origins hold considerable significance to people -- something that's very important when considering how much donor information should be accessible to donor-conceived people," Dr. Joanna E. Scheib told Reuters Health.

Parents seem to be moving away from being private about using a donor, said Scheib, of the University of California, Davis. Contact between shared-donor families and individuals can serve as a resource for learning more about one's donor.

Scheib and colleagues surveyed 14 families who participated in the family-matching service of The Sperm Bank of California. The service enables parents who had children via donor insemination to contact families of the same sperm donor.

Half the surveyed parents were single women, while 43 and 7 percent, respectively, were lesbian and heterosexual couples, they report in the medical journal Fertility and Sterility. All had one child (57 percent female), ranging from 6 months to 9 years of age at the time they entered the matched-family program.

Of the 12 families who answered questions regarding their initial contact, five said they "clicked" with the other family, and four expressed excitement about the meeting. Just two families reported initial discomfort.

Another three families said they did not "connect" reportedly because the families were at different points on issues of openness or the amount of contact they wanted with each other.

During initial contact, which was most often by phone, most of the families compared their children's physical features and personality traits, and discussed donor disclosure issues. After about one year, most families have maintained ongoing contact, the researchers note.

Parents of the children old enough to understand their genetic parentage and aware of their matched family said the children were generally curious about and excited in knowing they have genetic siblings.

"Some of the older donor-conceived individuals from our program seem more interested in their peers/half-siblings than in the donor himself," Scheib told Reuters Health.

Research that continues to assess relationships between donor siblings and their families and the long term impact of these relationships, Scheib's team concludes.

SOURCE: Fertility and Sterility, July 2008

Copyright © 2008 Reuters Limited.