Indian Medicine

NEW YORK (Reuters Health) - A morning jog and a cup of coffee might help protect you against skin cancer, if the results of new animal research can be applied to humans.

In experiments with mice, researchers at Rutgers University in New Jersey found that a combination of exercise and caffeine boosted the number of sunlight-damaged skin cells that self-destructed -- a process called apoptosis.

Apoptosis, also known as programmed cell death, is part of the body's natural defense against cancer; cells that accumulate irreparable genetic damage kill themselves off so they do not develop into tumors.

The new findings, published Monday in the Proceedings of the National Academy of Sciences, suggest that caffeine and exercise may work together to promote apoptosis.

The study involved four groups of hairless mice. For two weeks, one group exercised on a running wheel, another drank caffeinated water, a third exercised and consumed caffeine, and the fourth did neither.

All of the animals were exposed to ultraviolet-B radiation, the component of sunlight primarily responsible for sunburns.

The researchers found that the exercise group and the caffeine group each experienced a modest increase in apoptosis of UVB-damaged skin cells.

However, the combination of the two enhanced apoptosis of these cells. In fact, the effect was "more than additive," meaning exercise and caffeine somehow worked synergistically to boost each other's effects.

Whether the results might translate to humans is not yet known. But some past studies suggest the mouse findings "may have human relevance," Dr. Allan H. Conney, the study's senior author, told Reuters Health.

Population studies have linked coffee drinking to lower risks of non-melanoma skin cancer, as well as lower risks of liver cancer and certain other tumors, explained Conney, who directs Rutgers' Cullman Laboratory for Cancer Research.

Similarly, regular exercise has been tied to lower risks of certain cancers.

Among the next steps is to see whether the exercise-caffeine combo lowers the incidence of actual skin tumors in animals. In previous work, Conney and his colleagues found that caffeine or exercise alone can do this.

It will also be important to uncover the mechanisms at work, according to Conney. One of the "intriguing" findings in the current study, he said, was that exercise and caffeine decreased the animals' body fat.

There's evidence that fat tissue produces substances that impede damaged body cells from apoptosis, and it's possible that decreased fat stores help explain the benefits that caffeine and exercise had on apoptosis, Conney noted.

However, he added, this appears to be only "part of the story," and other mechanisms must play a role.

So should you add a coffee to your morning run? According to Conney, regular exercise is certainly a good habit to develop, but it's too soon for people to take up coffee drinking for cancer prevention. Caffeine can have negative effects, such as increased blood pressure.

However, healthy people who already drink a modest amount of coffee need not feel they should give it up.

"I think coffee, in moderation, can be a good thing," Conney said.

SOURCE: Proceedings of the National Academy of Sciences, July 31, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - The heavier a woman is before pregnancy, the greater her risk of a range of pregnancy complications, a large study suggests.

Using data from more than 24,000 UK women who gave birth between 1976 and 2005, researchers found that the risk of problems, such as high blood pressure, pre-eclampsia and premature delivery climbed in tandem with a woman's pre-pregnancy weight.

The findings, published in the online journal BMC Public Health, add to evidence that obesity is a risk for mothers and newborns.

They also support the belief that all pregnancies in obese women should be considered "high risk," and managed accordingly, conclude the study authors, led by Dr. Sohinee Bhattacharya of Aberdeen Maternity Hospital.

The researchers found that compared with normal-weight women, obese women were 50 percent more likely to have post-delivery bleeding and twice as likely to deliver prematurely. They were also more likely to need an emergency C-section or to have labor induced.

Morbidly obese women had the highest risk of suffering pre-eclampsia, a potentially serious pregnancy complication marked by a sudden rise in blood pressure and kidney abnormalities.

In contrast, the study found that women who were underweight before pregnancy tended to have the lowest risk of all these complications. They were, however, more likely than normal-weight women to have an underweight newborn.

The results add to growing evidence of the importance of a mother's weight in pregnancy outcomes, according to Bhattacharya's team.

"The evidence for obesity as an important complication in pregnancy is mounting," the researchers write, it is time for physicians to be aware of these findings and start using them in their practice.

Besides good prenatal care, they note, this means counseling overweight women to lose weight before they become pregnant.

SOURCE: BMC Public Health, online July 24, 2007.

Copyright © 2007 Reuters Limited.

GAITHERSBURG, Maryland (Reuters) - GlaxoSmithKline Plc's widely used diabetes drug Avandia should be pulled off the market, U.S. Food and Drug Administration scientist David Graham said in a presentation prepared for delivery on Monday.

Graham, in slides prepared for his remarks to an advisory panel, said Avandia increases the risk of cardiovascular problems such as heart attacks while rival drug Actos, made by Takeda Pharmaceutical Co. Ltd., does not.

Senior FDA officials say they do not know if Avandia, known generically as rosiglitazone, increases heart-attack risk and are asking the advisory panel if the drug should come off the market or stay with stronger warnings or limits. Panel recommendations are expected on Monday afternoon.

Graham, a scientist in the FDA office that monitors the safety of medicines after approval, has been outspoken about drug risks and publicly criticized top FDA officials for failing to respond to warning signs with various medicines.

Glaxo said Avandia, which is used by millions of diabetics and had sales of more than $3 billion last year, was no more dangerous than other diabetes pills.

"GSK continues to support Avandia as safe and effective when used appropriately," the drugmaker said in a statement summarizing its presentation to the FDA panel.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Paracetamol (Panadol) , the pain killer known as acetaminophen in the U.S. and sold under the trade names Tylenol in the US and Panadol in the UK, is an effective treatment for the pain following wisdom tooth extraction, according to a review of 21 studies that used the drug to placebo, or an inactive substance.

"It could be considered more readily by dentist and patients both as a first-choice analgesic, or to be taken alternately with doses of other analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs)," Dr. Kiaran Weil of The University of Manchester, UK, and colleagues conclude.

Paracetamol is commonly used to treat pain after wisdom tooth extraction, Weil and his team note. While the drug is frequently classified as an NSAID, they add, its anti-inflammatory effects are "relatively weak" compared to other drugs in the class. However, the drug is effective for pain relief and has few adverse effects.

The researchers conducted a review of the medical literature to gauge the effectiveness of paracetamol compared to placebo for pain relief after removal of the lower wisdom teeth and identify the best dosage and dosing time.

They analyzed 21 trials including 1,968 patients. Four and six hours after taking the drug, the researchers found that patients reported significantly less pain than with placebo. The optimal dosage was 1,000 mg, which the researchers determined could be taken safely every six hours.

Nineteen percent of patients on paracetamol reported adverse events, compared with 16 percent of the placebo group, not a statistically significant difference. The most serious side effect seen with the drug was a severe headache.

The researchers conclude that "Paracetamol is a safe, effective drug for the treatment of postoperative pain following the surgical removal of lower wisdom teeth."

SOURCE: Cochrane Database of Systematic Reviews, 2007, online.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Athletes who consume branched-chain amino acids (BCAAs) while working out may prevent muscle breakdown during moderate endurance exercise, a new study confirms.

BCAAs include the amino acids leucine, isoleucine, and valine, which are found in dairy foods and meat. Some athletes use supplements containing BCAAs to boost strength and endurance.

Past research has found that BCAAs can help prevent muscle breakdown during prolonged exercise, but the exact amount needed to obtain this effect is not clear, Dr. Keitaro Matsumoto of Otsuka Pharmaceutical Company in Saga, Japan and colleagues note.

To identify the most effective dosage, Matsumoto and his team had four men and four women complete three 20-minute cycling sessions, pedaling at half their maximum intensity, with a 15-minute break between each session.

During the first exercise session, volunteers consumed a drink containing 2 grams of BCAAs and 0.5 gram of arginine, or a placebo beverage, 10 minutes into their workout. Arginine is another type of amino acid believed to boost the release of growth hormone and insulin.

Two weeks later, study participants repeated the experiment, and those who originally consumed the BCAA-arginine drink switched to placebo and vice versa.

Blood concentration and muscle absorption of BCAAs rose when the exercisers took the supplement, the researchers found, while muscle protein breakdown was reduced.

The findings suggest that taking BCAA just before exercise can effectively slow the protein break-down triggered by endurance exercise at a modest intensity, Matsumoto and colleagues note. However, they conclude, more research is needed to determine if adding arginine to BCAA will enhance its muscle-protecting effects.

SOURCE: International Journal of Sports Medicine, June 2007.

Copyright © 2007 Reuters Limited.