Do Inhaled Steroids Affect Bone Density? A report from Harvard in the New England Journal of Medicine says they may, but not in the most critical areas. Dr. Elliot Israel and colleagues found that each daily puff of these important asthma medications caused a tiny (0.00044 g/cm²) loss of bone per year of treatment. But the bone loss was found in the total hip – not in the neck of the femur (hip bone) where almost all fractures happen). And it was not seen in the spine either.

is possible with pamidronate (Aredia) injections. This is the conclusion of Dr. Matthew Smith and researchers at Massachusetts General Hospital. Also writing in the NEJM, they say that conventional prostate cancer leuprolide (Lupron) treatments reduced bone density 3% in the spine, 2% at the hip over 48 weeks. With Aredia, there was no bone loss.

Another Winner: Marion Sriubas is our latest winner of 2 Hollywood Video rentals. She got her colon cancer (guaiac) cards in promptly. Remember: everyone who does this test is a winner in the fight to reduce this preventable cancer!

I’m again teaching Physical Diagnosis to 2^nd year students; and this fall I’ve been asked to be a small group leader also. Tuesdays 10/30, 11/13, 11/27 & 12/11 will be 7:30am-2:30pm. Thursdays 11/1, 11/15, 11/29 & 12/13 will be 1-6pm

The FDA has approved a new approach to treating hepatitis C. This disease, affecting some 170 million world-wide, causes chronic disease in 85%, and significant liver scarring (cirrhosis) in 20%. The new therapy is a combination of PEG-Intron (long-acting interferon 2-alpha) and Rebetol (ribavirin). The combination is about twice as effective as older therapy – some 56% became free of disease after 48 weeks of treatment and 24 weeks of follow-up. The PEG-Intron is given as a weekly shot; the Ribavirin as twice daily capsules. Side effects include feeling "fluey" with muscle aches and drops in blood cell counts.

Dr. Ira Pastan and colleagues at the National Cancer Institute report that 11 of 13 patients with hairy cell leukemia had complete remissions with a genetically engineered immunotoxin. And the other 2 had partial remissions. They’re planning larger trials of the drug, called BL22.

Chronic Fatigue Syndrome Update: this illness of debilitating fatigue lasting more than 6 months still has no proven cause and no specific therapy. Now a British trial shows that home-based graded exercise can improve physical function. In a University of Manchester study of 148 patients, fatigue, sleep, disability and mood improved in the exercise group.

Boomers Don’t Raise Pot-head Kids: is the conclusion of an analysis by the Substance Abuse and Mental Health Administration. Some observers had suggested that the children of those who grew up during the marijuana years might have been led down the potted path. But the recent increase in young people’s use of marijuana is not associated with their parents habits, the agency says. See www.samhsa.gov "Hot topics."

Our NYMC colleague Dr. Harriet Mogul reports that metformin (Glucophage) in combination with a diet low in added sugars can help men with midlife weight gain. She reported to the Endocrine Society in Denver that 14 over-weight men lost an average of 21.2 lbs after 6 months. All of the men had excess insulin levels. This study supported a study she reported last year showing the same trend in women.