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Vol. LXIII, No. 21
October 28, 2011
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Digest

NIH Study Finds Doctors Miss Many Alcohol Screening Opportunities

An NIAAA study has found that physicians often fail to counsel their young adult patients about excessive alcohol use.
An NIAAA study has found that physicians often fail to counsel their young adult patients about excessive alcohol use.

Physicians often fail to counsel their young adult patients about excessive alcohol use, according to a study led by the National Institute on Alcohol Abuse and Alcoholism.

NIAAA guidelines for low-risk drinking call for men to drink no more than 4 drinks in a day and no more than 14 drinks per week. For women, the guidelines are 3 or fewer drinks per day and no more than 7 drinks per week.

The findings, reported online in the Journal of General Internal Medicine, show that two-thirds of more than 4,000 people ages 18-39 surveyed had been seen by a doctor in the past year; however, of individuals whose drinking exceeded NIAAA guidelines, only 49 percent recalled being asked about their drinking and only 14 percent were counseled about it.

NIH-Funded Study Shows Increased Prostate Cancer Risk from Vitamin E Supplements

Men who took 400 international units of vitamin E daily had more prostate cancers compared to men who took a placebo, according to an updated review of data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). The findings showed that, per 1,000 men, there were 76 prostate cancers in men who took only vitamin E supplements, vs. 65 in men on placebo over a 7-year period, or 11 more cases of prostate cancer per 1,000 men. This represents a 17 percent increase in prostate cancers relative to those who took a placebo. This difference was statistically significant and therefore is not likely due to chance. The results of this update appeared Oct. 12 in the Journal of the American Medical Association.

An international network of research institutions carried out SELECT at more than 400 clinical sites in the United States, Puerto Rico and Canada. SELECT was funded by the National Cancer Institute and others.

“Based on these results and the results of large cardiovascular studies using vitamin E, there is no reason for men in the general population to take the dose of vitamin E used in SELECT as the supplements have shown no benefit and some very real risks,” said Dr. Eric Klein, a study co-chair for SELECT and a physician at the Cleveland Clinic.

The study began in 2001 and included over 35,000 men. It was started because earlier research had suggested that selenium or vitamin E might reduce the risk of developing prostate cancer.

Experimental Vaccine Protects Monkeys from Blinding Trachoma

An attenuated, or weakened, strain of Chlamydia trachomatis bacteria can be used as a vaccine to prevent or reduce the severity of trachoma, the world’s leading cause of infectious blindness, suggest findings from an NIH study in monkeys.

“This work is an important milestone in the development of a trachoma vaccine,” said NIAID director Dr. Anthony Fauci. “If this approach demonstrates continued success, the implications could be enormous for the tens of millions of people affected by trachoma, a neglected disease of poverty primarily seen in Asia and sub-Saharan Africa.”

In their study, published in the Journal of Experimental Medicine online, scientists from NIAID led by Dr. Harlan Caldwell describe how they tested their vaccine concept in a series of experiments. First they infected 6 cynomolgus macaques with the strain of C. trachomatis that they had weakened by removing a small piece of DNA. The scientists observed that the monkeys spontaneously cleared the infection within 14 days with no or minimal signs of ocular disease. The animals then were exposed twice more to the weakened strain at 4- and 8-week intervals, but the animals still showed no signs of trachoma despite being infected.

According to Caldwell, this finding is particularly significant because repeated C. trachomatis infections typically lead to more severe eye disease in people. The infected animals did not develop eye disease and they all mounted robust immune responses.

The same 6 macaques then were exposed to a highly virulent strain of C. trachomatis as were 6 other macaques in a control group that had not been vaccinated. Three of the macaques in the vaccine group showed no signs of infection or disease and the 3 others showed greatly reduced infection compared with monkeys in the control group. All 6 macaques in the control group became infected and displayed moderate to severe eye disease that persisted for between 2 and 4 months. Macaques are used in trachoma studies because their immune responses closely predict those of humans.


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