Antibiotics Have Little Effect on Aspirin-Induced Ulcers
Fighting ulcer-causing bacteria with antibiotics doesn’t help heal ulcers brought on by the overuse of aspirin and other analgesics. Most ulcers are now thought to be caused by the bacteria, Helicobacter pylori, but some are due simply to the analgesics, and it has not been clear before whether using an antibiotic would speed recovery in such cases.
A multinational team led by Dr. C.J. Hawkey of the Queen’s Medical Centre in Nottingham, England, recruited 285 patients with ulcers caused by analgesics and who were also infected with H. pylori. Half received an acid-reducing drug in combination with antibiotics, while the other half received the acid-reducing drug and a placebo. After six months, 56% of those receiving the antibiotics were ulcer-free, compared to 53% of those taking a placebo--an insignificant difference.
A Fourth Genetic Mutation Discovered That Slows HIV
Government researchers said Wednesday they had found another genetic mutation that could delay the progression of HIV infection into AIDS. They said nearly a third of African Americans had the mutation, which slows the progression from HIV infection to full-blown AIDS by an average of 3.8 years.
It is the fourth mutation found to interfere with HIV and is the most common in the population, according to Dr. David McDermott of the National Institute of Allergy and Infectious Diseases.
The mutation affects CCR5--a receptor, or kind of chemical doorway, that HIV has to use to get into the immune system cells that it infects. People who have one or two copies of the mutated gene produce less CCR5, so the virus has less opportunity to get into their cells. The results support the idea that drugs which block CCR could delay the progression of the disease.
Depression Found to Double Likelihood of Patient Death
Patients hospitalized for a variety of diseases are twice as likely to die within two years if they were depressed at the time of admission, German physicians report in the September-October issue of Psychosomatic Medicine. The effect was strongest among patients with heart diseases, but it was present among all patients, even after controlling for the patients’ ages, diagnoses and severity of illness, according to Dr. Christoph Herrmann and his colleagues at the University of Gottingen.
The team interviewed 454 patients admitted to a German teaching hospital, using a standard questionnaire to screen for symptoms of depression. Advanced age and a diagnosis of cancer or blood disease were the strongest predictors of death, but high symptoms of depression also increased risk significantly.
Bacterial Meningitis Becoming More Resistant to Treatment
Bacterial meningitis--the often fatal infection that usually attacks infants--is growing more resistant to drugs, researchers reported in Thursday’s New England Journal of Medicine. Doctors in Paris said the germ responsible for the disease that inflames the membranes around the brain and spinal cord has learned how to shake off the effects of the antibiotic chloramphenicol.
The resistant strain of Neisseria meningitidis was isolated from 11 patients in Vietnam and one in France, said the researchers, led by Marc Galimand of the National Reference Center for Antibiotics in Paris. The resistant bacterium is expected to have its greatest impact in developing countries where chloramphenicol is frequently prescribed because it is cheap and requires only a single injection, the researchers said.
In developed countries, chloramphenicol, sold under the brand name Chloromycetin by Parke-Davis, is far less popular than other medicines because it can cause blood problems, including, in rare instances, a fatal form of anemia, and other drugs are more effective.
Hydrocortisone Is Too Risky for Chronic Fatigue Syndrome
Low doses of the steroid hydrocortisone can cause slight improvement in the symptoms of chronic fatigue syndrome, but the drug carries a serious risk that precludes its use, researchers from the National Institute of Allergy and Infectious Diseases reported Wednesday in the Journal of the American Medical Assn. Taking the drug, a synthetic version of one of the corticosteroid hormones produced by the adrenal gland, suppressed the gland’s own natural output, the study found.
Chronic fatigue sufferers on average have about 30% less natural hydrocortisone in their bodies than healthy people, leading to the idea for the treatment. In the study, two-thirds of those taking hydrocortisone reported some improvement, compared with half of those on placebos. “However, there was clear evidence of adrenal suppression by the drug,” Dr. Stephen Straus said. “It was manageable and completely reversible, but it’s the kind of suppression that in the context of minimal improvement afforded by the drug cannot, in our minds, justify using this treatment for chronic fatigue syndrome.”
Physically, Vets Aren’t Harmed by War Stress
The psychological trauma of combat has had little effect on the physical health of Vietnam veterans 20 years later, researchers reported in Psychosomatic Medicine. They said studies of twins showed the stress of war did not affect physical health much. The only physical health problem that might have been linked to Vietnam service involved the skin, and the researchers at Washington University in St. Louis said this should be studied more.
Dr. Seth Eisen and colleagues surveyed more than 4,700 pairs of twins, some of whom were identical twins, who share all their genes, and some of whom were fraternal twins, who are no more closely related than any brothers.
In some cases one twin went to war while the other did not; in other cases, both twins went; and in still other cases, neither went. Eisen’s team studied them all to see if they could separate out the genetic and environmental causes of disease.
They found that combat exposure seemed to be responsible for less than 1% of cases of high blood pressure, for example. Genetics seemed to play a very large role. For joint disorders like arthritis, combat could be blamed for 2.6% of cases. Overall, Eisen’s team reported, fighting in Vietnam could be blamed for about 10% of all illnesses that Vietnam veterans suffered.
Some problems were obviously caused by war conditions. “We know from previously published research that military personnel who have been exposed to loud artillery or combat noises end up having more hearing problems,” said Eisen, who also works for Veterans Affairs.
--Compiled by THOMAS H. MAUGH II
