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The researchers also believe they can enhance acupuncture’s effectiveness by coupling the process with a well-known cancer drug — deoxycoformycin — that maintains adenosine levels longer than usual.

“Acupuncture has been a mainstay of medical treatment in certain parts of the world for 4,000 years, but because it has not been understood completely, many people have remained skeptical,” lead author Dr. Maiken Nedergaard, co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center, said in a news release. “In this work, we provide information about one physical mechanism through which acupuncture reduces pain in the body.”

Nedergaard and her team report their findings online May 30 in the journal Nature Neuroscience. They are also scheduled to present the results this week at the Purines 2010 scientific meeting in Barcelona.

Working exclusively with mice, Nedergaard and her colleagues administered half-hour acupuncture treatments to a group with paw discomfort.

The investigators found adenosine levels in tissue near the needle insertion points was 24 times greater after treatment, and those mice with normal adenosine function experienced a two-thirds drop in paw pain. By contrast, mice that were genetically engineered to have no adenosine function gained no benefit from the treatment.

The team also found that if they activated adenosine in the same tissue areas without applying acupuncture, the animals’ discomfort was similarly reduced, strongly suggesting that adenosine is the magic behind the method.

Adenosine, better known for regulating sleep, inhibits nerve signals and inflammation, the authors explained.

In their experiments with deoxycoformycin, which is known to impede adenosine removal from the body, the researchers said the drug almost tripled the amount of adenosine in the targeted muscles and more than tripled the amount of time that the mice experienced pain relief.

The study was funded by the New York State Spinal Cord Injury Program and the U.S. National Institutes of Health.

SOURCE: University of Rochester Medical Center, news release.

The most popular class of drugs remain the so-called SSRIs such as Prozac, the group found. People found newer, pricier antidepressants less desirable because of side-effects.

Patients benefited just as much from therapy — almost any kind of therapy, the consumer group found in its survey of 1,500 readers.

Those surveyed said they improved just as much after seven or more sessions of talk therapy as if they took drugs and it did not matter if the therapist was a psychiatrist, psychologist or social worker.

Nearly 80 percent of people who had been diagnosed with depression or anxiety were prescribed antidepressants.

Patients were happiest with the selective serotonin reuptake inhibitors or SSRIs, a class that includes Eli Lilly and Co’s Prozac or its generic equivalent fluoxetine;, Pfizer Inc’s Zoloft or sertraline, and Celexa or citalopram and Lexapro o escitalopram from Forest Laboratories Inc.

People complained of more side-effects from serotonin-norepinephrine reuptake inhibitors or SNRIs, a newer, often more expensive class of antidepressants, the survey found.

These include venlafaxine, made by Pfizer-owned Wyeth under the Effexor brand name and Lilly’s duloxetine, sold as Cymbalta.

The survey found a range of side-effects, but the most common one — loss of sexual interest or ability — was less common than in past surveys, the consumer group said.

Bleeding is a common complication and can lead to death, but the patients at greatest risk of bleeding are also the least likely to be treated with the lifesaving strategies, the study authors found.

Stent implants and balloon angioplasty — known as percutaneous coronary interventions — are performed an estimated one million times each year in the United States.

In the study, researchers from Saint Luke’s Mid America Heart Institute in Kansas City, Mo., examined how often patients bled after the artery-opening procedures and how those rates were affected by the closing devices and the blood thinner.

After Dr. Steven P. Marso of Saint Luke’s and colleagues analyzed the medical records of over 1.5 million patients who underwent procedures between 2004 and 2008, they found that combined use of the vessel-closing devices and the blood thinner Angiomax (bivalirudin) was most effective at lowering the risk.

Bleeding occurred in 2 percent of cases. However, the combined strategies to prevent it were used more often in low-risk patients (21 percent) than high-risk patients (14 percent).

“The results of this study suggest the need for additional research to better understand why higher-risk patients are least likely to receive bleeding avoidance strategies,” the study authors wrote.

The study findings are published in the issue of the Journal of the American Medical Association.

Osteoporosis is a disease in which the bones become weak and are more likely to break. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 80 percent of the people in the United States with osteoporosis are women. One out of every two women over age 50 will break a bone in their lifetime due to osteoporosis.

People with osteoporosis at high risk for fracture include those that have had an osteoporotic fracture, or have multiple risk factors for fracture; or those who have failed or are intolerant to other available osteoporosis therapy. Prolia works to decrease the destruction of bone and increase bone mass and strength. An injection of Prolia is recommended once every six months.

“Due to its prevalence, osteoporosis is a serious concern to public health,” said Julie Beitz, M.D., director of the FDA’s Office of Drug Evaluation III. “The approval of Prolia provides another treatment option for postmenopausal women with osteoporosis who are susceptible to fractures.”

The safety and efficacy of Prolia in the treatment of postmenopausal osteoporosis was demonstrated in a three-year, randomized, double-blind, placebo-controlled trial of 7,808 postmenopausal women ages 60 to 91 years. In the study, Prolia reduced the incidence of vertebral, non-vertebral, and hip fractures in postmenopausal women with osteoporosis.

The most common side effects reported with Prolia include back pain, pain in the extremities, musculoskeletal pain, high cholesterol levels, and urinary bladder infections. Serious adverse reactions include hypocalcaemia (low calcium levels in the blood), serious infections, including infections of the skin, and dermatologic reactions such as dermatitis, rashes, and eczema.

Prolia causes significant suppression of bone turnover and this suppression may contribute to the occurrence of osteonecrosis of the jaw, a severe bone disease that affects the jaw, atypical fractures, and delayed fracture healing.

Prolia was approved with a risk evaluation and mitigation strategy (REMS) that includes a Medication Guide for patients and communications to health care providers that explains the risks and benefits of the drug.

Prolia is manufactured by Amgen Manufacturing Limited, a subsidiary of Thousand Oaks, Calif.-based Amgen Inc.

Researchers analyzed urine samples from 60 people with colon cancer and 63 cancer-free people. They identified unusual levels of 16 substances in the urine of the cancer patients, including elevated levels of tryptophan, one of the 22 amino acids found in proteins.

The findings demonstrate the potential of using a urine test as a way to diagnose colon cancer, Wei Jia, of the department of nutrition at the University of North Carolina at Greensboro, and colleagues wrote.

The study is published in the Journal of Proteome Research.

A urine test may complement or even reduce the need for colonoscopy, which is the most effective method for early screening of colon cancer. However, colonoscopy can be unpleasant, costly and time-consuming for patients, according to the researchers.

Colon cancer is the third most common type of cancer in the United States.

SOURCE: American Chemical Society, news release.

The latest report on the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2006 shows that 45 percent of those questioned in the survey had at least one of the three risk factors: 30.5 percent with high blood pressure, 26 percent with high blood cholesterol levels and 9.9 percent with diabetes.

About one in eight adults — 13 percent — had two of the conditions and 3 percent had all three, the survey found. These rates were consistently higher among blacks.

What’s even more alarming is that “15 percent of the population is unaware that they have one or more of these conditions,” said survey author Cheryl D. Fryar, a health statistician with the U.S. Centers for Disease Control and Prevention.

That report is the latest in a nonstop pulse-taking effort by the CDC, which has adults answer a questionnaire about their health status and then performs physical examinations and blood tests.

The latest NHANES results were not particularly surprising, Fryar said. While the new report doesn’t give trends over time, other work shows that blood cholesterol levels actually have dropped slightly because of the introduction of cholesterol-lowering drugs such as statins, she noted.

“For hypertension [high blood pressure], there has been no significant change from 1999 to 2006, and the prevalence of diabetes has increased slightly,” Fryar said.

Blacks had a particularly high incidence of hypertension, 42.5 percent, compared to 29.1 percent of non-Hispanic whites and 26.1 percent of Mexican-Americans. High blood cholesterol was more common among non-Hispanic whites (26.9 percent) than among blacks (21.5 percent) and Mexican-Americans (21.8 percent), while diabetes was more common among blacks (14.6 percent) and Mexican-Americans (15.3 percent) than among non-Hispanic whites (8.3 percent), according to the report.

The percentage of people who had one or more risk factors and were unaware of it was consistent across the three ethnic categories, the survey found.

The CDC survey doesn’t attempt to learn the reason why the incidence of these major risk factors is so high, Fryar said.

Dr. Clyde W. Yancy, medical director of the Baylor Heart and Vascular Institute at Baylor University Medical Center, and president of the American Heart Association, thinks he knows the reason: obesity.

“The burden of risk is directly related to the burden of obesity,” Yancy said. “Obesity is directly related to high blood pressure, directly related to diabetes, directly related to an abnormal lipid profile.”

And with 60 percent of adult Americans and 30 percent of younger Americans overweight or obese, the burden threatens to become worse, he said.

While the message about obesity and what causes it — lack of exercise, poor diet, overeating — is sent repeatedly, “people don’t get it,” Yancy said. “They are putting us at the risk of having a generation of Americans that has worse health than the previous generation, which has never happened before,” he said.

The CDC report is “a call to arms,” Yancy said. “Targeting obesity should now be on the top of the radar screen for everybody.”

A report of the findings by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, appears online this week in the Proceedings of the National Academy of Sciences.

“This important advance sustains our hope for the potential of genome-wide association techniques to further the study of complex genetic disorders such as alcoholism,” notes NIAAA Acting Director Kenneth R. Warren, Ph.D. Genome-wide association studies (GWAS) allow researchers to rapidly scan the complete set of DNA of many individuals to find genetic variations associated with a particular disease or condition.

“One of the challenges in identifying the genes that underlie alcoholism is the large degree of genetic and environmental variability associated with the disease,” explains first author Colin A. Hodgkinson, Ph.D., a geneticist in the NIAAA Laboratory of Neurogenetics. “Such variability has impeded even GWAS efforts to identify alcoholism genes. To overcome those difficulties, we used GWAS techniques to search for genetic variants related to EEG, or brain wave, patterns in a comparatively small sample of several hundred Native American individuals.”

As unique as an individual’s fingerprints, EEG (electroencephalogram) patterns are highly heritable, and have been associated with alcoholism and other psychiatric disorders. The high degree of genetic similarity and common environmental exposure shared by the Native American individuals that comprised the study sample aided this search.

Working with David Goldman, M.D., chief of the NIAAA Laboratory of Neurogenetics, Dr. Hodgkinson and colleagues identified multiple genes that were associated with the amplitude, or height, of two of the four characteristic electrical frequencies that make up the wave patterns found in EEG recordings.

One of the genes, for example, was found to account for nearly 9 percent of the EEG theta wave variability seen in the Native American sample. Theta waves are relatively low-frequency brain waves, and previous studies have shown that their amplitude is altered among alcoholics. The researchers then showed that the same gene accounted for about 4 percent of theta wave variability in a sample of North American whites. The gene’s diminished effect among whites, they noted, was likely a reflection of the greater genetic variability present in that sample. In the same study Dr. Goldman’s group went on to show that genetic variation in one of the genes identified for theta wave variability was also associated with an altered risk for alcoholism.

“While our main findings are for genes that influence EEG wave patterns, this study represents an important step toward the use of EEG as a surrogate marker for alcoholism,” notes Dr. Goldman. “It also reveals new molecular pathways involved in addiction processes.”

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at www.niaaa.nih.gov.

Makers of medical devices are required to report when a device malfunctions or may have contributed to the death or serious injury of a patient. The FDA said it has seen a sharp rise in the number of “adverse events” related to insulin pumps, which have become increasingly popular in recent years, the Dow Jones news wire reported.

The panel of outside medical advisors met to discuss the increase in problems and whether anything could be done to minimize potential risks to patients. Panel members said more information is needed in adverse-event reports to help the FDA gauge if an insulin pump contributed to a patient’s problem, the news service reported.

“It could be a pump failure or it could be people failure,” said Marc Rendell, a panel member and director of the Diabetes Center at Creighton University in Omaha, Neb., noting it can be difficult to train patients to properly use the devices. Other doctors on the panel — the General Hospital and Personal Use Devices Panel — also said they find many pump problems are due to patients not following instructions, such as changing some pump parts every three days or using the proper settings, Dow Jones reported.

Problems with the pumps have resulted in deaths and injuries. This prompted the FDA to ask the advisors to review the matter and come up with ways to get manufacturers to do a better job of finding, reporting and fixing the problems.

According to an FDA review of insulin pump problems, there have been 16,849 adverse-event reports since 2006, including 310 deaths, 12,093 injuries, and 4,294 malfunctions of pumps. The problems have been spread across various manufacturers and include both hardware and software issues.

While the reason for most of the deaths is unknown, a number were due to diabetic coma; blood sugar that was too low; blood sugar that was too high; diabetic ketoacidosis, a complication of diabetes; and unresponsiveness, according to the agency.

Since 2004, there have been 18 recalls of pumps. In many cases, the pump makers failed to identify and report the specific difficulties with the devices, according to the FDA. The agency has said that in most cases the manufacturers’ response to the problems had been incomplete, including incomplete details about deaths related to the pumps.

Insulin pumps are small self-contained devices that supply measured doses of the hormone insulin to diabetics. The pumps are primarily used by people with type 1 diabetes, a disease in which the pancreas does not produce insulin, which is essential for controlling the body’s blood sugar levels. In 2007, some 375,000 type 1 diabetics were using these pumps, according to the FDA.

The FDA asked the panel to consider several questions, including: What should be taken into account in looking at the risk of pump failure? Are there risks in patients changing from an insulin pump to another method of delivering insulin? What are the risks of using a defective pump? And what can be done to get manufacturers to do a better job of reporting and diagnosing pump problems.

The FDA isn’t obligated to follow the recommendations of its advisory panels, but it typically does so.

SOURCE: U.S. Food and Drug Administration.

A study in nearly 70,000 women found that those who drank at least a cup of coffee with lunch were one-third less likely to develop type 2 diabetes over several years than non-coffee drinkers. This was true for decaf and caffeinated coffee, with or without sugar. But drinking coffee at any other time of the day didn’t influence diabetes risk at all.

“Our findings strongly suggest that only coffee taken with lunch may reduce diabetes risk,” Dr. Daniela S. Sartorelli of the University of Sao Paulo in Ribeirao Preto, Brazil, and her colleagues wrote in the American Journal of Clinical Nutrition.

Over a dozen studies have linked coffee drinking to a lower risk of type 2 diabetes — the type closely linked to obesity. But the mechanism behind the relationship hasn’t been established and no studies have looked at whether the timing of coffee drinking influences this effect.

To investigate, Sartorelli’s team looked at 69,532 French women participating in a large European nutrition study. The women ranged in age from 41 to 72 when they were enrolled in the study, and were followed for 11 years, on average.

During that time, 1,415 of them developed type 2 diabetes. Overall, those who drank at least three cups of coffee daily were 27 percent less likely to become diabetic.

But when the researchers looked at the timing of coffee consumption, they found that only lunchtime coffee drinking reduced type 2 diabetes risk; women who drank more than a cup with lunch every day were 33 percent less likely to develop diabetes.

The lunchtime effect was seen only for black coffee, not for coffee with milk added, but because the number of study participants who drank coffee with milk at lunch was small, the significance of this finding isn’t clear, the researchers say.

Lunchtime coffee benefits could have something to do with timing, or they might be related to the types of food that people eat at lunch, Sartorelli and her team suggest.

SOURCE: American Journal of Clinical Nutrition.