September 7, 2000 Research Update

Vaginal Drug As Effective As Oral For Bacterial Vaginosis

I would have to agree that a topical treatment is going to produce less side effects than an oral agent, but it is unquestionable that a portion of a topically applied substance will get absorbed into the circulation. For bacterial vaginosis I would like to see a trial using probiotics instead of drugs.

Obstet Gynecol 2000;96:256-260 A 3-day course of vaginal clindamycin is as effective as a 7-day course of oral metronidazole in the treatment of bacterial vaginosis. Moreover, the intravaginal regimen is better tolerated than oral treatment, Dr. Jorma Paavonen, of the University of Helsinki, in Finland, and a multinational research team say in the journal.

COX-2 inhibitors delay gastric wound healing in rats

Evidence is starting to accumulate on the potential adverse effects of these new anti-inflammatories. This article suggests that, even though they lower your chances of getting an ulcer, COX-2 may hinder any ulcer that were already present from healing.

Journal of Gastroenterology and Hepatology 15 (7), 752-761 The present study demonstrated that cyclo-oxygenase-2 inhibitors delay gastric wound healing by suppressing expansion of the mucosal proliferative zone. These results provide evidence that cyclo-oxygenase-2 has an important role in gastric mucosal regeneration.

Dietary fatty acids and cardiovascular disease

This is a perfect example of how vastly different types of fats can be. This article is a nice review of the benefits of unsaturated fats and the harmful effects of saturated and trans fats.

While it may be a while before nutrition authorities are ready to suggest specific guidelines for how much and which fatty acids should be included in a heart-healthy diet, new research provides surprising information on the biological effects of individual fatty acids on CVD risk factors such as plasma lipids and lipoproteins, blood pressure, endothelial and platelet function, hemostasis and insulin sensitivity. " ... we should be emphasizing, at this point, a mix of unsaturated fats because we have evidence for a benefit for monos, the n-6 polys and the n-3 polys." Dr Frank Sacks. The exact mechanism by which saturated fatty acids raise serum cholesterol continues to elude researchers. The widespread view that saturated fatty acids somehow modify the expression of low-density lipoprotein (LDL) receptors and reduce the clearance of LDL remains controversial. Speaking at an American Heart Association conference recently, Dr Thomas Pearson (University of Rochester) reviewed recent epidemiological and clinical trial evidence that appears to challenge the current orthodoxy. The Western Electric Study, for example, identified associations between dietary cholesterol (and less so saturated fat) and CVD endpoints. The Lyon Diet Heart Study demonstrated profound declines in CVD endpoints despite little difference in classical risk factors between treatment groups who received a diet higher in oleic (monounsaturated) and alpha-linolenic (precursor to n-3 polyunsaturated) acids and lower in linoleic (n-6 polyunsaturated) and saturated fatty acids than a prudent western diet. The rapidity of decline in CVD events in some studies also suggests mechanisms other than atherogenesis, he noted. Declines of 25% to 65% in CVD endpoints in recent observational and experimental studies over brief periods of time places dietary intervention at par with pharmacologic approaches to CVD prevention, he said. Speaking at the same conference, Dr Frank Sacks (Harvard School of Public Health) said he believes the evidence "supports Dr (Scott) Grundy (University of Texas Southwestern Medical Center at Dallas) and Dr (Peter) Zock's (Wageningen Centre for Food Sciences, Wageningen, Netherlands) perspective that we should be emphasizing, at this point, a mix of unsaturated fats because we have evidence for a benefit for monos, the n-6 polys and the n-3 polys." However, there is not yet enough evidence to support specific recommendations regarding the ideal proportion of these 3 unsaturated fatty acids.

Vanilla Scent May Help to Lose weight

This is news to me, but it is a safe method to try. I would recommend adding it to a patients' lifestyle changes that are designed to cut weight.

Dietitians at St. George's Hospital in London said Monday they have tested a skin patch that releases whiffs of vanilla and other scents that help to reduce cravings for chocolates and other high-calorie sweet snacks. People who wore the patch on the back of their hand in early tests experienced a change in appetite and lost an average of two kilograms or 4.5 pounds. The study was led by Catherine Collins, who presented her findings last Wednesday at the 13th International Congress of Dietitians in Edinburgh, Scotland. She is unsure how the vanilla patch works but she thinks it may influence satiety. Although the patch reduced the urge for chocolate and sweets, it had no impact on the desire for fatty or starchy food or alcohol.

Cold-Like Virus May Cause Obesity

This is also new information to me, but if this holds out in the research, then it is yet another reason to use healthy lifestyle changes to lose weight. These changes would help battle the multifactorial concerns that cause all human disease, not just obesity.

researchers at the University of Wisconsin in Madison have found that mice and chickens infected with a common human virus put on much more fat than uninfected animals. They have also discovered that the same virus is more prevalent among overweight people, a strong indication that it may also cause obesity in humans.

Th1 and Th2 responses: what are they?

This is an excellent review article to one of the more powerful routes to which human disease is connected and controlled. Th1 and Th2 are types of white blood cells, and each group has a job to do. The body normally keeps a good balance, but in many conditions the balance is tipped one way or another and all hell breaks lose. bmj.com Berger 321 (7258): 424 http://bmj.com/cgi/content/full/321/7258/424

James Bogash, D.C. Mesa, AZ
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