Health Briefs

March 28, 2002

BACTERIA, ANTIBIOTICS AND HEART DISEASE
I have recently reported (March 15, 2002) on research linking prior infection with the Chlamydia pneumonia (CP) bacteria and coronary artery disease. A new study in the journal Circulation takes this linkage an important step further. The researchers prescribed the antibiotic Azithromycin to male patients (average age was 55) with documented coronary artery disease and evidence of prior CP infection. This antibiotic is effective against CP (as well as other bacteria), and was given to half of the patients for 5 weeks, while the remaining patients received only a placebo (sugar pills).

Among the patients who had taken the antibiotic, the ability of a large artery in the arm to dilate in response to an increased need for arm blood flow was improved significantly compared to patients receiving only the placebo. Although this study did not exclude the possibility that some chemical side-effect of the antibiotic might have caused the improved arterial function, this is nonetheless an intriguing study that sheds further light on possible mechanisms of arterial disease. These results add weight to the theory that infection with CP, a bug that commonly causes respiratory infections, might play a role in the development of coronary heart disease, at least in some cases.

MAMMOGRAMS: THE DEBATE CONTINUES
The World Health Organization (WHO) has weighed-in on the debate regarding the effectiveness of mammography. The WHO impaneled 24 distinguished scientists from around the world to study all previous research on mammography's effectiveness. Their conclusions were similar to those recently reached by the National Cancer Institute (Bethesda, MD).

The WHO has concluded that mammography can-and does-save lives when regularly applied to women aged 50 and over.

CALCIUM & THE RISK OF COLON CANCER
Several studies have recently suggested that a calcium-rich diet might reduce the risk of developing colon cancer. The current issue of the Journal of the National Cancer Institute contains a new study that adds to previous studies on this topic.

Using dietary information collected from two other large studies, the authors compared calcium intake levels with the incidence of colon cancer among 87,998 women and 47,344 men. The authors found that calcium supplements of 700 milligrams or more per day reduced the incidence of colon cancer by 40 to 50%. Daily calcium supplementation above 700 to 800 milligrams per day did not appear to enhance the protective effect of calcium, however. Interestingly, this protective effect only appeared to apply to colon cancers in the lower part of the colon, as calcium supplementation did not seem to reduce the risk of developing cancers in the upper colon.

Before you consider adding calcium supplementation to your daily routine, please check with your doctor to ensure that you do not have any kidney or parathyroid gland ailments, or other conditions that might be exacerbated by adding additional calcium in your diet.

BRIEFLY....
A potential breakthrough in the treatment of smallpox has been reported at the International Conference on Antiviral Research in Prague. Using a drug based upon the same retroviral agents used to treat AIDS, the researchers have developed a pill which appears to kill smallpox virus in infected cells.

Implantable defibrillators have been shown to reduce the risk of dying from "sudden cardiac death" in patients with a history of abnormal heart rhythms secondary to severe coronary heart disease. Indeed, our own Vice President sports one of these devices now. From the New England Journal of Medicine comes a new report on the use of these devices in patients with a history of myocardial infarction (heart attack) and resulting congestive heart failure, but without a history of dangerously abnormal heart rhythms.

After an average follow-up of 20 months, the patients who received the implantable defibrillator had a 14% risk of dying, while patients receiving standard medical care experienced a 20% risk of death. This translated into 31% reduction in the risk of death following implantation of the defibrillator. These findings suggest that a significant percentage of patients with poor heart function due to prior myocardial infarction subsequently die from so-called "malignant heart rhythms," and that many of these deaths can be prevented by the implantable defibrillator.

Dr. Robert A. Wascher