Health & Medicine
A Bone Breakthrough
It's no wonder that half of women taking drugs for osteoporosis are doing a bad job of it within a year of starting. Anyone on Fosamax or Actonel must stay upright and fast for 30 minutes after swallowing the weekly pills. And it's easy to forget, since the drugs don't change the way you feel. Now, a study in last week's New England Journal of Medicine suggests that a breakthrough is around the corner. Women who received once-yearly infusions of zoledronic acid (Reclast) had a 70 percent lower risk of vertebral fracture over three years than those on a placebo; previous studies put the Fosamax number at 40 percent. One caveat: The drug also resulted in high rates of atrial fibrillation, a side effect shown by an earlier study to be caused by Fosamax, too. Steven Cummings, director of the California Pacific Medical Center Research Institute and author of that study, says women who do not yet have full-blown osteoporosis should be wary of taking Fosamax. The heart risk of the other drugs is not known.
Into the Hospital, and Home Again
There's good news on the heart front: The rate of death among people hospitalized for a heart attack has been cut in half over the past few years. According to a large study that appeared in last week's Journal of the American Medical Association, the percentage of heart attack patients who died in the hospital dropped from 8.4 percent to 4.6 percent between 1999 and 2005. The proportion experiencing heart failure dropped from 19.5 percent to 11 percent; of those getting another heart attack within six months, from 4.8 percent to 2 percent. Results were based on the cases of more than 44,000 patients at 113 hospitals in 14 countries.
The new guidelines responsible for the improvements include aggressive efforts to reopen blocked coronary arteries quickly and better drugs for heart failure and to prevent future attacks. Joel Gore, a coauthor of the study and a cardiologist at the University of Massachusetts, notes, however, that these are lifesaving, last-resort measures. The best treatment, he emphasizes, is preventing trouble in the first place. - A.V.
Better Be Wary of Faulty Wiring
The longer you've had hardware in your heart, the more regularly you should check the wiring. According to a study by researchers from Herzzentrum Ludwigschafen, a German cardiovascular research institute, 15 percent of patients who had a defibrillator implanted to correct their abnormal heart rhythms needed a surgical fix to remedy a defective lead, the wire that sends a charge to the faulty muscle. The average time from implantation to failure was 4.7 years, and after 10 years, 20 percent of patients needed a fix. The study appeared last week in the journal Circulation.
The longer you've had your defibrillator, the more frequently you should be checked by your arrhythmia specialist, says Kenneth Ellenbogen, vice chairman of the division of cardiology at Virginia Commonwealth University Health Systems. Frequency depends on the nature of your disease, but as your device ages, between one and three months is typical. The study also compared newer silicone-insulated leads with older polyurethane-insulated models and found that the older versions fared better over the first five years. - Sarah Baldauf
Talk Is Good, for the Right Reasons
Group therapy improves life for patients battling cancer, but it doesn't help them live longer. That's the conclusion of researchers at the University of Pennsylvania and the American Cancer Society, who examined the literature on the topic published after one paper in 1989 reported that women with advanced breast cancer who attended group therapy survived nearly twice as long as those who didn't. Writing in the current issue of the Psychological Bulletin, the authors say that those findings haven't held up and that doctors should promote therapy for the support and sense of well-being it provides, rather than as a life-extender. "Groups are great for most people," says study author James Coyne, a psychologist at the University of Pennsylvania. But quality of life, he notes, is what they gain. A full quarter of cancer patients believe therapy can help them live longer, he says. David Spiegel, author of the original 1989 study and a psychiatrist at Stanford University School of Medicine, thinks that the topic merits further study, saying there's still a lot to learn about how stress hormones affect cancer. - Katherine Hobson
This story appears in the May 14, 2007 print edition of U.S. News & World Report.
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