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Posted - 03/01/2006 : 09:19:37
Flawed study a pain in the ... knees
PAUL TAYLOR - Globe and Mail (Feb 24, 2005) ptaylor@globeandmail.ca
The U.S. National Institutes of Health has just spent $12.5-million on a study to find out whether two popular supplements -- glucosamine and chondroitin sulfate -- can ease osteoarthritis knee pain.
Unfortunately, that question is still largely unresolved because of shortcomings with the design of the study itself. For a majority of study participants, who suffered from mild pain, the two supplements seemed to be no more effective than a placebo.
However, patients with moderate to severe symptoms reported significant pain relief in the 24-week trial. About 79 per cent of patients who took both supplements reported an improvement in their condition. That's even better than the results from a prescription drug; 69 per cent of patients in that category who took celecoxib (known by the brand name Celebrex) said they had a significant reduction in pain. (About 54 per cent of those receiving the placebo claimed improvement.)
At first glance, the study seems to suggest the supplements provide the most benefit to those who are in the most pain. But the researchers, led by Daniel Clegg of the University of Utah, caution that there were just too few patients in this category to draw reliable conclusions. Out of a total 1,583 initial participants, only 72 patients in the moderate- to severe-pain group received both supplements. "From a statistical standpoint . . . the numbers just aren't there," Dr. Clegg told a telephone news conference.
He acknowledged "we made no effort to balance the numbers of patients with substantial pain versus the numbers of patients with relatively mild pain" when participants were recruited for the study, the results of which were published this week in the New England Journal of Medicine.
What's needed is another study focusing on higher-pain patients, the research team says. And that's a pity -- many people were hoping for some clear answers because previous trials have produced conflicting results.
Temptation eyes
To see is to want -- especially when it comes to sweet treats.
U.S. researchers have done a study to quantify the so-called "temptation factor." Bowls of chocolate Hershey's Kisses were placed on the desks of 40 female office workers over several days. On some days, the treats were in clear containers. On others, they were in opaque containers. On some occasions, the different containers were located nearly two metres (six feet) away from the women's desks.
Not surprisingly, the volunteers ate more when the candies were in clear view. They gobbled "an average of 7.7 Kisses each day when the chocolates were in clear containers on their desks; 4.6 when in opaque containers on the desk; 5.6 when in clear jars six feet away; and 3.1 when in opaque jars six feet away," according to the study in the International Journal of Obesity.
The findings provide a straightforward message to dieters: Keep food out of sight, and out of easy reach. When the treats were not directly on their desks, the volunteers had "an extra second to pause and reconsider whether they were really hungry enough to want [or need] another candy," the researchers write.
One researcher, Brian Wansink of Cornell University, thinks people could use the "temptation factor" to help improve their diets. He suggests putting bowls of fruit in clear view. That way, you might be tempted to reach for an apple or orange, rather than going to the cupboard for a fattening snack.
In praise of gum chewing
Chewing gum could speed the recovery of abdominal surgery patients -- and save the health-care system millions of dollars, according to researchers at Santa Barbara Cottage Hospital in California.
Abdominal surgery often causes ileus, a form of temporarily bowel paralysis in which food is slowed or stopped from moving through the digestive system. A slow return to normal bowel function can lengthen hospital stay. Even taking a sip of water can make some patients vomit.
But a study of patients recovering from colon operations found that gum chewing got the bowels moving faster. Seventeen patients were asked to chew sugarless gum three times a day. Another 17 patients abstained from chewing. Those who chewed gum left hospital after an average of 4.3 days, compared with 6.8 days for the abstainers, according to findings published in Archives of Surgery.
"We think gum works as 'sham feeding,' " lead researcher Kenneth Waxman said in an e-mail interview. "The brain and the intestine are 'fooled' into thinking the patient is eating and the nervous system and hormones are activated to stimulate intestinal motility."
And, he says, potential health-care savings are substantial. The fee for a typical U.S. hospital room is about $1,500 a day, he points out. By contrast, the price of a few sticks of gum is well under a dollar. The savings, when multiplied over the entire system, could amount to millions.
Shedding light on TB
A century ago, before the advent of antibiotics, some doctors insisted tuberculosis patients get plenty of fresh air and sunshine. A new study confirms they had the right idea. Researchers at the University of California at Los Angeles have found that the human immune system needs vitamin D to help combat tuberculosis bacteria.
Vitamin D is sometimes called the "sunshine vitamin" because it's made by the body when skin is exposed to ultraviolet light.
Social and economic factors have played a major role in the spread of TB over the centuries. But Robert Modlin, the senior researcher on the team, says the study might also partly explain why people with darker skin are more prone to tuberculosis. The extra melanin pigment absorbs the ultraviolet light, reducing their ability to produce vitamin D.
"I think our study raises important issues and now we need to know what is the optimal level of vitamin D and how to achieve it," Dr. Modlin said in a telephone interview. |
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