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Clinical Activity Of Neratinib In Combination With Trastuzumab And In Combination With Paclitaxel In Advanced HER-2 Positive Breast Cancer
Wyeth Pharmaceuticals, a division of Wyeth (NYSE: WYE), today announced

Women Who Quit Smoking Early In Pregnancy Reduce Risks Of Preterm Birth, Stunted Fetal Growth
Pregnant women who quit smoking during the first trimester and women who never smoked during pregnancy have a similar risk of delivering preterm or very small infants, according to a study published in the journal Obstetrics and Gynecology, Reuters reports. Premature delivery and stunted infant growth are the most well-documented side effects of smoking during pregnancy, and the risks increase for older women, according to study author Laura Polakowski of the Centers for Disease Control and Prevention and colleagues. For the study, the researchers analyzed 915,441 birth certificates for infants born in 2005 in 11 states that include information on whether the woman smoked during pregnancy.The study found that 10% of women who smoked for the entire pregnancy gave birth to "preterm but not too small for gestational age" infants, compared with 8% of women who quit during the first trimester. Fifteen percent of women who smoked the entire pregnancy gave birth to full-term infants who were small for their gestational age, while 2% gave birth to premature infants who were small for gestational age. Among women who quit smoking during the first trimester, these outcomes occurred 9% and 1% of the time, respectively.After adjusting for the women"s age, previous preterm births and other factors, the researchers found that women who quit smoking in the first trimester reduced their risk of giving birth to a preterm, normal-size infant by 31%. The risk of delivering a full-term, unusually small infant was cut by 55% and the risk for delivering a preterm, unusually small infant was reduced by 53%. The risks were also reduced for women who quit smoking during their second trimester, although less significantly. The researchers found that the risk reduction was particularly high for older women -- especially those older than age 40 -- who quit smoking during the first trimester. According to the study, the results indicate that the risk of delivering a preterm or small-for-gestational-age infant for pregnant women who quit smoking during the first trimester is "comparable to those who never smoke during pregnancy" (Reuters, 7/21).
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Annals Of Internal Medicine Tip Sheet For June 16, 2009, Issue

Calcium Supplementation Has No Weight-loss Benefit for Obese Patients One in three American adults is overweight or obese, with a body mass index (BMI) of 25 or greater. As the obesity rate continues to rise, researchers seek an approach that can prevent weight gain or promote weight loss. Some studies suggest that people who eat more dairy products weigh less. Dairy products are a good of calcium. Researchers studied 340 overweight and obese patients to determine whether calcium supplementation might prevent weight gain or promote weight loss. The investigators weighed each participant and then randomly assigned half of them to take calcium pills (1500 mg/d) and the other half to placebo. After two years, researchers found no difference in body weight, BMI, or body fat mass between the two groups. The researchers conclude that while calcium supplementation has health benefits, it is unlikely to prevent weight gain in overweight or obese patients. Red Yeast Rice Capsules Reduce Cholesterol Levels in Statin-Intolerant Patients High levels of low-density lipoprotein (LDL) cholesterol put people at risk for heart attack and stroke. Statins are considered the standard of care for lowering LDL cholesterol levels. While generally well-tolerated, some patients cannot take statins due to adverse events such as muscle pain and weakness. Some studies have shown that red yeast rice pills can lower LDL cholesterol levels. Researchers studied patients with statin-associated muscle pain to determine if red yeast rice supplementation could improve cholesterol levels without causing muscle pain. Sixty-two patients with abnormal LDL cholesterol levels and a history of statin intolerance were randomly assigned to either 1800 mg a day of red yeast rice supplementation or placebo. Patients in both groups were enrolled in a therapeutic lifestyle change program that included weekly 3.5 hour meetings and education on cardiovascular disease, nutrition, exercise, and relaxation techniques. The researchers checked LDL and total cholesterol levels in both groups at 12 and 24 weeks. They found that both cholesterol levels improved more in the red yeast rice group than in the placebo group. Pain, creatinine phosphokinase, and liver enzyme levels did not differ between the groups. Study Raises Questions About Establishing an Upper Age Limit for Colonoscopy The four types of colorectal cancer screening tests are fecal occult blood testing (FOBT), sigmoidoscopy, double-contrast barium enema, and colonoscopy. Of the four tests, colonoscopy is considered the best, but is also the most invasive and has the greatest risk for complications. Medicare covers colonoscopy for beneficiaries after the age of 50. While use of colonoscopy by elderly Medicare patients has increased, colonoscopy-related adverse events in this population have not been studied. Researchers looked at a random sample of 53,220 Medicare beneficiaries between the ages of 66 and 95 who underwent outpatient colonoscopy. Individuals in this sample were matched with individuals who did not have colonoscopy and then assessed at 30 days to determine the rate of cardiac and gastrointestinal events. Rates of adverse events following colonoscopy were low, but were greater in patients who had polyps removed, or had specific, common comorbid conditions. Adverse events also increased with age, another reason for establishing an upper age limit for colonoscopy. Stents Ineffective, Potentially Dangerous for Patients with Renal Artery Stenosis and Impaired Renal Function Renal stents are commonly used to treat atherosclerotic renal artery stenosis (ARAS). However, few data support the efficacy and safety of this practice. Researchers studied 140 patients with ARAS and impaired renal function to determine if stenting could help. They randomly assigned patients to medical treatment plus stenting or medical treatment only and followed them over a two-year period. Medical treatment consisted of antihypertensive treatment, a statin, and aspirin. The researchers found that stent placement with medical treatment had no clear effect on progression of impaired renal function but led to a small number of significant procedure-related complications, including two deaths. The researchers conclude that stenting is not a safe or effective treatment for patients with ARAS and impaired renal funcion. They suggest that physicians treat these patients using a conservative therapeutic approach that focuses on managing cardiovascular risk factors. Angela Collom American College of Physicians


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