Indian Medicine

NEW YORK (Reuters Health) - A synthetic version of the hormone prolactin, which triggers breast milk production in women during and after pregnancy, may be suitable for increasing lactation when breast milk volume is inadequate, according to a pilot study by Massachusetts-based researchers.

"While ... more extensive investigation is needed," Dr. Gabrielle Page-Wilson told Reuters Health, "we are nonetheless excited about the implications of these early data."

In a study published in the International Breastfeeding Journal, Page-Wilson of Harvard Medical School, Boston and colleagues note that agents currently used to boost prolactin "can be associated with side effects such as drowsiness and depression and alternative therapies are need."

To examine the effects of recombinant (i.e., synthetic) prolactin, the team conducted a study with 21 healthy women who had regular menstrual periods and had not recently had a child. The women were randomly assigned to receive a daily injection of recombinant prolactin or an inactive placebo for 7 days.

Five of the nine women who received the active agent lactated and were able to express breast milk.

While lactation makes demands on the body for calcium, there was no apparent adverse effect on bone turnover in the group studied, the team found. Prolactin also did not affect the women's menstrual cycle.

"Lactation insufficiency in newly lactating women is a really common problem," Page-Wilson commented. The results of her group's study "makes us hopeful that in the future we may be able to safely use recombinant human prolactin to enhance breast milk production, allowing mothers with otherwise inadequate milk supplies to fully meet their infant's nutritional needs."

SOURCE: International Breastfeeding Journal, online July 24, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Women with early-stage cancer of the left breast who are treated with radiation as a component of breast-sparing treatment, have an increased risk of developing radiation-related coronary damage, researchers report.

Nevertheless, "the benefits of radiation therapy for breast cancer still clearly outweigh the risks," Dr. Candace R. Correa told Reuters Health. "However," she added, "there may still be room for improvement in radiation techniques," when radiation is applied to the breast on the same side as the heart.

Correa, at the University of Michigan, Ann Arbor, and colleagues examined the medical records of 961 stage I-II breast cancer patients to look into this issue of radiation damage to the heart's arteries.

At the time they were diagnosed, women with left-sided and those with right-sided breast cancers had the same likelihood of developing coronary artery disease. At an average of 12 years after radiation treatment, 46 of the 485 left-sided women and 36 of 476 in the right-sided group had needed cardiac stress testing, the team reports in the Journal of Clinical Oncology.

The results showed that among those tested, 59 percent in the left-sided group had abnormalities, significantly more than the 8 percent in the right-sided group.

"Careful monitoring and long-term follow-up to assess these risks ... is important," Correa stressed.

For patients, she added, "it is most prudent to optimize their cardiovascular health by living a healthy lifestyle and speaking with their doctors about risk reduction tools and interventions that may be appropriate for their situation."

SOURCE: Journal of Clinical Oncology, July 20, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Children who are still wetting the bed at age 7 have lower IQ scores, on average, than their peers who stay dry through the night, UK researchers report.

The findings support the theory that bed-wetting is a genetic phenomenon due to delayed maturation of the central nervous system (CNS), say Dr. Carol Joinson of the University of Bristol and colleagues. They call for more research to better understand the intellectual functioning of children who wet the bed, and to determine if bedwetting is also related to learning and academic problems.

Wetting is a common problem among children, Joinson and her team note, with up to 22 percent of boys and 15 percent of girls still wetting the bed by age 7. At this age, 2 to 4 percent of children will wet during the day, while 2.3 percent of boys and less than 1 percent of girls soil themselves.

Children who wet the bed are thought to either have difficulty waking up when their bladders fill, or to have trouble suppressing the reflex to urinate while they are sleeping, Joinson and her team note in the medical journal Pediatrics. To investigate the relationship between bedwetting and intellectual capacity, as well as soiling and daytime wetting, the researchers looked at more than 6,000 children ranging in age from 7 to 9.

Bed-wetters had lower average IQ scores than children who did not wet the bed, and the relationship remained after the researchers excluded children with IQs below 70, who are considered to be mentally retarded, from their analysis.

The link was strongest for performance IQ, which "represents practical, or 'fluid,' intelligence and reflects innate intellectual abilities that are thought to be largely influenced by neurologic and biologic factors rather than knowledge that is acquired and influenced by education, family and social context," the investigators note.

While soiling also was linked to lower IQ, most of the relationship could be attributed to study participants with IQs below 70, the researchers found.

Children who wet during the day didn't have lower IQs than those who didn't, although they did score worse on certain subsets of the IQ test. Daytime wetting is usually related to bladder problems, so it may have a weaker link with central nervous system function, while soiling is probably more closely related to toilet training problems than neurological development.

Joinson's team concludes that immaturity of the central nervous system underlies both lower IQ scores and bed-wetting.

SOURCE: Pediatrics, August 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Data from 10 studies conducted in Europe and Japan suggest that people who drink coffee may be reducing their risk of liver cancer, although the reasons for the apparent protective effect of coffee remain to be determined.

The 10 studies reviewed by Dr. Francesca Bravi from Milan's Istituto di Ricerche Farmacologiche "Mario Negri" and colleagues included 2,260 cases of HCC. Collectively, the results showed a 41 percent reduction in the risk of liver cancer (or hepatocellular carcinoma, HCC) among coffee drinkers compared to those who never drank coffee.

Low to moderate coffee drinkers -- defined in some studies as those who drank less than 3 cups per day and in others as less than 1 cup per day -- had a 30 percent lower risk of HCC compared to coffee abstainers. High coffee consumption -- defined in some studies as 3 cups or more each day and in others as 1 cup or more per day - had a 55 percent lower risk of HCC.

"Moreover, the apparent favorable effect of coffee drinking was found both in studies from southern Europe, where coffee is widely consumed, and from Japan, where coffee consumption is less frequent, and in subjects with chronic liver diseases," the researchers note in their report in the medical journal Hepatology.

Animal and laboratory studies have suggested that certain compounds in coffee may block harmful enzymes involved in the development of cancer. Coffee drinking has also been linked to a lower risk of cirrhosis of the liver and chronic liver disease, which are the major risk factors for HCC. "Thus, there seems to be a continuum of the favorable effect of coffee on liver enzymes, cirrhosis, and HCC," note the authors.

Liver cancer is the third leading cause of cancer deaths in the world after lung and stomach cancer, with about 600,000 deaths in 2002.

Although a cause-and-effect relationship between coffee and liver cancer can not be determined based on the data, the current analysis provides "quantitative evidence" of a protective effect of coffee drinking on liver cancer, Bravi and colleagues write.

As reported by Reuters Health earlier this month, Japanese researchers recently found that drinking three or more cups of coffee a day may cut the risk of colon cancer in women by half.

SOURCE: Hepatology, August 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - A new study suggests that many adult survivors of childhood leukemia get little or no exercise, a fact that may boost their already elevated risks of long-term health problems.

The problem, according to researchers, appears largely related to long-term treatment side effects -- in particular, the effects of radiation therapy to the brain.

The study included 2,648 adult survivors of acute lymphoblastic leukemia (ALL), the most common childhood cancer. In ALL, the bone marrow produces large numbers of immature, abnormal white blood cells that quickly replace normal cells.

Before the mid-1960s, few children survived ALL, but treatment advances in recent decades have meant that most children are now cured, and the number of adult survivors is growing.

These survivors are, however, at some risk of "late" effects from their cancer treatment -- obesity, cardiovascular disease and osteoporosis among them. Because exercise helps lower the risk of these conditions, the current study surveyed ALL survivors on their physical activity habits.

Overall, researchers found, survivors were 74 percent more likely than the average American to be sedentary. In addition, they were 44 percent more likely to fall short of recommended exercise goals for adults -- at least 30 minutes of moderate exercise on most days of the week.

ALL survivors who'd been treated with cranial radiation were particularly likely to be sedentary. This finding suggests that the late effects of the treatment, which include growth hormone deficiency and balance and coordination problems, may prevent many survivors from being active, according to the researchers.

"It's important to remember that these patients are not couch potatoes or lazy," Dr. Kevin C. Oeffinger, the study's senior author, said in a statement. Oeffinger specializes in long-term follow-up of childhood ALL survivors at Memorial-Sloan Kettering Cancer Center in New York City.

Instead, Oeffinger explained, the findings suggest that cranial radiation therapy affects the central nervous system in a way that can interfere with physical activity.

However, this obstacle can be overcome, he told Reuters Health.

"We think that through training we can promote more active lifestyles among these patients," Oeffinger said. He and his colleagues are currently studying ways to help young adult ALL survivors be more active.

It may also help to intervene when children are first coming off their cancer therapy, rather than years later, Oeffinger noted.

Cranial radiation therapy is no longer used for childhood ALL as regularly as it once was. However, some children with particularly aggressive cases still receive the treatment, as do most children with brain tumors -- the second-most common cancer of childhood.

In addition, Oeffinger said, he and his colleagues believe that some ALL survivors who received chemotherapy alone may be at risk of physical inactivity and would benefit from more exercise.

SOURCE: Cancer Epidemiology, Biomarkers and Prevention, July 2007.

Copyright © 2007 Reuters Limited.