ABSTRACT Context: Use of antibiotics may be associated with risk of breast cancer through effects on immune function, inflammation, and metabolism of estrogen and phytochemicals; however, clinical data on the association between antibiotic use and risk of breast cancer are sparse. Objective: To examine the association between use of antibiotics and risk of breast cancer. Design, Setting, and Participants: Case-control study among 2266 women older than 19 years with primary, invasive breast cancer (cases) enrolled in a large, nonprofit health plan for at least 1 year between January 1, 1993, and June 30, 2001, and 7953 randomly selected female health plan members (controls), frequency-matched to cases on age and length of enrollment. Cases were ascertained from the Surveillance, Epidemiology, and End Results cancer registry. Antibiotic use was ascertained from computerized pharmacy records. Main Outcome Measure Association between extent of antibiotic use and risk of breast cancer. Results: Increasing cumulative days of antibiotic use were associated with increased risk of incident breast cancer, adjusted for age and length of enrollment. For categories of increasing use (0, 1-50, 51-100, 101-500, 501-1000, and =" src="/math/ge.gif" border=01001 days), odds ratios (95% confidence intervals) for breast cancer were 1.00 (reference), 1.45 (1.24-1.69), 1.53 (1.28-1.83), 1.68 (1.42-2.00), 2.14 (1.60-2.88), and 2.07 (1.48-2.89) (P

Objective: To investigate the effect of glucosamine sulfate on long-term symptoms and structure progression in postmenopausal women with knee osteoarthritis (OA). Design: This study consisted of a preplanned combination of two three-year, randomized, placebo-controlled, prospective, independent studies evaluating the effect of glucosamine sulfate on symptoms and structure modification in OA and post-hoc analysis of the results obtained in postmenopausal women with knee OA. Minimal joint space width was assessed at baseline and after 3 years from standing anteroposterior knee radiographs. Symptoms were scored by the algofunctional WOMAC index at baseline and after 3 years. All primary statistical analyses were performed in intention-to-treat, comparing joint space width and WOMAC changes between groups by ANOVA. Results: Of 414 participants randomized in the two studies, 319 were postmenopausal women. At baseline, glucosamine sulfate and placebo groups were comparable for demographic and disease characteristics, both in the general population and in the postmenopausal women subset. After 3 years, postmenopausal participants in the glucosamine sulfate group showed no joint space narrowing [joint space change of +0.003 mm (95% CI, −0.09 to 0.11)], whereas participants in the placebo group experienced a narrowing of −0.33mm(95% CI, −0.44 to −0.22; P < 0.0001 between the two groups). Percent changes after 3 years in theWOMACindex showed an improvement in the glucosamine sulfate group [−14.1% (95%, −22.2 to −5.9)] and a trend for worsening in the placebo group (5.4% (95% CI, −4.9 to 15.7) (P = 0.003 between the two groups). Conclusion: This analysis, focusing on a large cohort of postmenopausal women, demonstrated for the first time that a pharmacological intervention for OA has a disease-modifying effect in this particular population, the most frequently affected by knee OA. Menopause. 2004;11:138-143

Objective To evaluate the effectiveness and safety of a preparation containing echinacea, propolis, and vitamin C in the prevention of respiratory tract infections in children during a 12-week winter period. Design Randomized, double-blind, placebo-controlled study. Subjects Four hundred thirty children, aged 1 to 5 years, were randomized to an herbal extract preparation (n = 215) or a placebo elixir (n = 215). Intervention Administration of an herbal preparation (Chizukit) containing 50 mg/mL of echinacea, 50 mg/mL of propolis, and 10 mg/mL of vitamin C, or placebo (5.0 mL and 7.5 mL twice daily for ages 1 to 3 years and 4 to 5 years, respectively) for 12 weeks. Results Significant mean ± SD reductions of illnesses were seen in the Chizukit group in the number of illness episodes, 138 vs 308 (55% reduction); number of episodes per child, 0.9 ± 1.1 vs 1.8 ± 1.3 (50% reduction, P<.001); and number of days with fever per child, 2.1 ± 2.9 vs 5.4 ± 4.4) (62% reduction, P<.001). The total number of illness days and duration of individual episodes were also significantly lower in the Chizukit group. Adverse drug reactions were rare, mild, and transient. Conclusion A preventive effect of a product containing echinacea, propolis, and vitamin C on the incidence of respiratory tract infections was observed. Arch Pediatr Adolesc Med. 2004;158:217-221.

Diabetes Care - February 2004 OBJECTIVE—Pharmacologic agents currently approved for use in children with type 2 diabetes (metformin and insulin) are less than optimal for some patients. We evaluated the use of a ketogenic, very-low-calorie diet (VLCD) in the treatment of type 2 diabetes. RESEARCH DESIGN AND METHODS—We conducted a chart review of 20 children (mean age 14.5 ± 0.4 years) who consumed a ketogenic VLCD in the treatment of type 2 diabetes. Several response variables (BMI, blood pressure, HbA1c, blood glucose, and treatment regimens) were examined before, during, and up to 2 years after the diet and compared with a matched diabetic control group. RESULTS—Before starting the diet, 11 of 20 patients were treated with insulin and 6 with metformin. Mean daily blood glucose values fell from 8.9 ± 1.1 to 5.5 ± 0.38 mmol/l (P < 0.0001) in the first 3 days of the VLCD, allowing insulin and oral agents to be discontinued in all but one subject. BMI fell from 43.5 ± 1.8 to 39.3 ± 1.8 kg/m2 (P < 0.0001) and HbA1c dropped from 8.8 ± 0.6 to 7.4 ± 0.6% (P < 0.005) as the diet was continued for a mean of 60 ± 8 days (range 4–130 days), and none required resumption of antidiabetic medications. Sustained decreases in BMI and insulin requirements were observed in patients remaining on the VLCD for at least 6 weeks when compared with those of the control group. CONCLUSIONS—The ketogenic VLCD is an effective short-term, and possibly long-term, therapy for pediatric patients with type 2 diabetes. Blood glucose control and BMI improve, allowing the discontinuation of exogenous insulin and other antidiabetic agents. This diet, although strict, has potential as an alternative to pharmacologic therapies for this emerging subset of diabetic individuals.

The effect of acupuncture on pain perception is controversial. Because late amplitudes of somatosensory evoked potentials (SEPs) to noxious stimuli are thought to correlate with the subjective experience of pain intensity, we designed this study to detect changes of these SEPs before and after acupuncture in a double-blinded fashion. Sixteen volunteers were anesthetized by propofol and exposed to painful electric stimuli to the right forefinger. Then, blinded to the research team, the acupuncture group (n = 8) was treated with electric needle acupuncture over 15 min at analgesic points of the leg, whereas the sham group (n = 8) received no treatment. Thereafter, nociceptive stimulation was repeated. SEPs were recorded during each noxious stimulation from the vertex Cz, and latencies and amplitudes of the N150 and P260 components were analyzed by analysis of variance. P260 amplitudes decreased from 4.40 ± 2.76 µV (mean ± SD) before treatment to 1.67 ± 1.21 µV after treatment (P < 0.05), whereas amplitudes of the sham group remained unchanged (2.64 ± 0.94 µV before versus 2.54 ± 1.54 µV after treatment). In conclusion, this double-blinded study demonstrated that electric needle acupuncture, as compared with sham treatment, significantly decreased the magnitudes of late SEP amplitudes with electrical noxious stimulation in anesthetized subjects, suggesting a specific analgesic effect of acupuncture. IMPLICATIONS: This double-blinded study demonstrates that electric needle acupuncture, as compared with sham treatment, significantly decreases the magnitudes of late somatosensory evoked potential amplitudes with electrical noxious stimulation in anesthetized subjects, suggesting a specific analgesic effect of acupuncture.

Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease. This article reviews the evidence regarding fish oils and coronary disease and outlines the mechanisms through which fish oils might confer cardiac benefits.

The U.S. Patent and Trademark office has awarded Dr. Joan Fallon patent # 6,632,429 entitled Methods for Treating Pervasive Developmental Disorders. The patent covers the use of digestive and pancreatic enzymes as a treatment for children with ADD, ADHD and Autism. The patent, which will remain in effect until 2019, represents a breakthrough for children with pervasive developmental disorders including ADD, ADHD and Autism. Autism is characterized by profound delays in communication and social interaction and is thought to affect over 1.5 million individuals in the U.S. ADD and ADHD have a prevalence of between 5 and 10% in the population. It is estimated that upwards of 10% of the population is medicated for some type of attention disorder. Dr. Fallon's invention employs the use of digestive and pancreatic enzymes for children with these conditions based upon the presence of a low level of chymotrypsin in the stool. Chymotrypsin is an enzyme secreted by the pancreas in an inactive form which becomes active in the presence of protein in the small intestines as well as a favorable pH. Without sufficient protein digestion, the formation of amino acids, the building blocks of new proteins, cannot occur. The lack of protein synthesis can underlie a significant neurological deficit in the child. Fallon's patent demonstrates that the administration of digestive and pancreatic enzymes produce profound changes in the autistic symptomotology including increases in social interactions, eye contact and speech and reductions in repetitive actions and hyperactivity. It further demonstrates changes in bowel habits including an increase in bowel control and formed movements. In the child with ADD and ADHD, the therapy significantly reduces the levels of medication the child is taking and, in many cases, the child no longer needs the medication, based upon observed increases in attention. "The patent recognizes a deficiency in the children with ADD, ADHD and Autism, and offers a biological solution. Digestive and pancreatic enzymes have been used safely and effectively for children and adults with cystic fibrosis for many years," said Dr. Fallon, inventor and patent holder. "I intend to continue to refine the use of digestive and pancreatic enzymes for these and other indications. This form of treatment opens new avenues for children and adults with these debilitating conditions. Contact: Dr. Joan Fallon 914-779-9300

Ear problems can be excruciatingly painful, especially in children. With 10 million new cases every year, ear infections are the most common illness affecting babies and young children and the number one reason for visits to the pediatrician -- accounting for more than 35 percent of all pediatric visits. Before yet another round of "maybe-they'll-work-and-maybe-they-won't" antibiotics or the drastic step of surgery, more parents are considering chiropractic to help children with chronic ear infections, according to the American Chiropractic Association (ACA). See www.acatoday.com . Dr. Joan Fallon, a doctor of chiropractic who practices in Yonkers, New York, has published research showing that, after receiving a series of chiropractic adjustments, nearly 80 percent of the children treated were free of ear infections for at least the six-month period following their initial visits (a period that also included maintenance treatments every four to six weeks). "Chiropractic mobilizes drainage of the ear in children, and if they can continue to drain without a buildup of fluid and subsequent infection, they build up their own antibodies and recover more quickly," explains Dr. Fallon. She'd like to see her pilot study used as a basis for larger-scale trials of chiropractic as a therapeutic modality for ear infections. When treating children with ear infections, Dr. Fallon focuses on the back of the skull and the first vertebra in the neck. After an adjustment to these areas, which helps the fluid in the ears to drain -- and depending on how chronic the problem is and where they are in their cycle of antibiotics -- children can generally fight the infection off themselves. That means, for the average child, between six and eight treatments. If a child's case is acute, Dr. Fallon will check the ear every day, measuring the ear and tracking the movement of the eardrum to make sure that it's draining. "I'll do adjustments every day or every other day for a couple of days if they're acute, and then decrease frequency over time." Dr. Fallon, whose research garnered her the acclaim of childrearing magazines like Parenting and Baby Talk, often sees great success when she treats a child for an ear infection. "Once they fight it themselves, kids tend to do very well and stay away from ear infections completely. Unless there are environmental factors like smoking in the house, an abnormally shaped Eustachian tube, or something like that, they do very well," she says. "I have two large pediatric groups that refer to me on a regular basis. In the winter, when ear infections are most prevalent, I see five or six new children each week from each group," says Dr. Fallon. "It's safe and effective and something that parents should try, certainly before inserting tubes in their children's ears."