Certain Forms of Lou Gehrig’s Disease May Prove to Be Treatable

The AIDS virus can cause a form of Lou Gehrig’s disease, French and American researchers have found, but symptoms can improve or even resolve with treatment.

The findings support the theory that viruses may cause some other forms of the disease, also called amyotrophic lateral sclerosis (or ALS), and offer hope that those forms may also be amenable to treatment. No treatment is available now.

“This is exciting news because if this form of ALS caused by HIV is treatable, then other forms of ALS may be treatable as well,� said Dr. Burk Jubelt of SUNY Upstate Medical University in Syracuse, who wrote an editorial accompanying the reports.

Dr. Antoine Moulignier and his colleagues at the Adolphe de Rothschild Foundation in Paris identified six HIV-positive people who developed symptoms of ALS. They reported in the October issue of Neurology that, after treatment with anti-HIV drugs, two of the patients recovered completely from their motor neuron symptoms, three improved and one stabilized.

In a second paper in the same journal, Dr. Daniel MacGowan of Beth Israel Medical Center reported on a 32-year-old woman who developed ALS-like symptoms and then was found to be HIV-positive. After treatment with anti-HIV drugs, the woman recovered completely from the ALS symptoms.

Quitting Epilepsy Drug Eases Vision Problems

People taking the epilepsy drug Topamax should be alert to blurred vision and eye pain and should stop taking the drug immediately if such symptoms develop, the drug’s manufacturer cautioned last week.

Immediately stopping drug use seems to cure the eye problems, but continued usage after symptoms develop can lead to glaucoma, said a spokesman for Ortho-McNeil.

The Food and Drug Administration has reports of at least one 5-year-old child and 22 adults who developed severe eye problems after taking Topamax. Ortho-McNeil says the drug has been on the market for four years and that 825,000 people have used it, so the risk is very low.

Drug Speeds Recovery After Abdominal Surgery

An experimental drug speeds recovery from abdominal surgery by blocking the effects of painkillers on the bowels, according to Missouri researchers.

After abdominal surgery, the intestinal tract typically shuts down for two to three days, an effect that is exacerbated by morphine and other opium-based painkillers. Surgeons will generally not release patients from the hospital until bowel motility has been restored.

Dr. Akiko Taguchi and his colleagues at Washington University in St. Louis studied a new drug called ADL 8-2698, which blocks the effects of the narcotic drugs in the colon but not in other parts of the body. They studied 79 patients who were randomly assigned to receive either ADL 8-2698 or a placebo.

The team reported in the Sept. 27 New England Journal of Medicine that bowel function returned in an average of three days for those receiving the drug, compared to an average of 41/2 days for those receiving the placebo. Patients receiving the drug went home a day earlier, on average. The study was sponsored by Aldolor Corp., the manufacturer of the drug.

Lowering Blood Pressure Cuts Risk of New Stroke

Lowering blood pressure reduces the risk of a second stroke, according to a new international study.

A team led by Dr. Stephen MacMahon of the University of Sydney in Australia studied 6,105 patients from 172 centers in Asia, Australasia and Europe.

All had either had a stroke or a transient ischemic attack--a “mini-stroke� that is often a predictor of strokes to come.

The patients were randomized to receive either the ACE inhibitor perindopril or a combination of perindopril and the diuretic indapamide.

The team reported in the Sept. 29 Lancet that patients receiving both drugs had more of a blood pressure reduction than those taking only perindopril. Over four years of follow-up, 10% of patients receiving both drugs suffered a stroke, compared to 14% of those receiving only one drug.

Quick Mastectomies Increase Dramatically

So-called drive-through mastectomies in which patients are sent home the day of the surgery increased dramatically during the last decade, according to researchers from the Agency of Healthcare Research and Quality in Rockville, Md.

Dr. Claudia Steiner and her colleagues reviewed hospital discharge records for all women treated for breast cancer during the period.

They reported in the October issue of Health Services Research that most lumpectomies--in which only the tumor was removed--were performed as outpatient procedures during the decade, with 78% to 88% of women sent home without an overnight stay. The incidence of partial mastectomies performed on an outpatient basis increased from 10% to 50% in 1990, depending on the state, to 43% to 72% in 1996. In Colorado, the rate increased from 10% to 67%.

The incidence of outpatient total mastectomies was virtually zero in every state in 1990. By 1996, however, the incidence had increased to 3% in New Jersey, 4% in New York, 8% in Connecticut, 12% in Maryland, and 22% in Colorado. Patients in HMOs were more likely to be sent home the same day.

Secondhand Smoke Might Pose Adult Asthma Risk

Secondhand smoke has previously been linked to asthma in children, but its effect on adults has not been clearly shown. New results, however, suggest it is a major risk factor for adults as well.

Dr. Maritta Jaakkola and colleagues at the Finnish Institute of Occupational Health in Helsinki studied 718 people in the district of Pirkanmaa in southern Finland. Of these, 231 had been diagnosed with asthma within the past 30 months, while the rest were healthy. None smoked.

After controlling for all risk factors, the researchers found that those exposed to smoke in the workplace had 2.16 times the normal risk of developing asthma, while those with a partner who smoked had 4.77 times the risk. The results were presented Tuesday at a conference in Berlin.

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Medical writer Thomas H. Maugh II can be reached at [email protected].