Back on the Right Beat; The New Cost of Taking Accutane; Knee-jerk Surgery Isn't a Great Idea; Eat Salmon, Be Happy
Back on the Right Beat
Atrial fibrillation--an irregular heartbeat that results from an out-of-control quivering of the heart's upper chambers--puts more than 2 million Americans at serious risk of heart failure, stroke, and death. Drugs don't always work, and they have side effects. But a quick procedure that snakes a catheter into the heart to zap the area sending erratic signals with radio waves appears to be an effective treatment. A study out last week in the New England Journal of Medicine looked at 146 people, some of whom had undergone catheter ablation plus a short course of drug therapy, and found that a year later, 74 percent of that group were symptom free--a much better record than for the group on drugs alone. Their hearts were also healthier than those of people who had not received the procedure. The study didn't look at how patients fared long term, however, and ablation shouldn't automatically be the first step, says coauthor Hakan Oral, a cardiologist at the University of Michigan Medical School. "It's a very good option for people who have failed with drugs," he says. - Katherine Hobson
The New Cost of Taking Accutane
Accutane, practically a miracle cure for severe acne, has side effects from chapped lips to liver problems. Most infamously, it causes birth defects and miscarriages. As of last week, you can't get the medication unless your doctor adds your name to the Food and Drug Administration's new iPLEDGE registry ( ipledgeprogram.com). Sexually active women must use two forms of birth control, and all women must take a monthly pregnancy test; pharmacists will check the registry for the results before filling prescriptions. Boys and men have to register, too, and promise never to share the drug with anyone. As always, everyone who takes Accutane needs regular blood tests to check on liver function and cholesterol levels. Dermatologists fear the system will discourage patients from getting treatment; the FDA launched iPLEDGE over their protests. - Helen Fields
Knee-jerk Surgery Isn't a Great Idea
A knee surgery used to treat osteoarthritis might actually make matters worse. In a meniscectomy, the doctor removes all or part of a damaged meniscus, tissue that acts as a shock absorber and lubricator for the knee when healthy and can cause pain and limited range of motion when torn. But Boston University Medical School researchers following 257 people with osteoarthritis discovered that even damaged tissue may protect the joint. People whose meniscuses covered the least amount of joint surface had nearly three times as great a risk of worsening their arthritis over 30 months as people with the most meniscus tissue. Although the study, reported in this month's Arthritis & Rheumatism, did not evaluate meniscectomy patients in particular, researchers think anyone considering the surgery should take note. "Removing [the meniscus] will only enhance the rate of structural change," warns lead author David Hunter. Doctors should try exercise, weight loss, braces, and medication first, he says. - Cory Hatch
Eat Salmon, Be Happy
In the past few years, researchers have been intensely interested in the discovery that the brains of people with schizophrenia, depression, and Alzheimer's disease have lower-than-normal levels of omega-3 polyunsaturated fatty acids. Now, a small study of healthy people adds evidence of omega-3s' key role in the brain. A team of researchers at the University of Pittsburgh reported last week that volunteers with higher blood levels of EPA and DHA, the omega-3s found in fatty fish like salmon and sardines, were less likely to report symptoms of depression or negative mood. People with lower levels of LNA, found in plants, were more likely to report impulsive behavior. Pitt neuroscientist Sarah Conklin says people should follow the American Heart Association's recommendation: Eat fish twice a week, or take fish oil supplements. - Nancy Shute
This story appears in the March 13, 2006 print edition of U.S. News & World Report.
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