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Black cohosh and other botanicals widely used to relieve the hot flashes and night sweats of menopause are no more effective than a placebo, according to a new study.
Researchers tested 351 women over one year, dividing them into five groups. The first took 160 milligrams of black cohosh daily, the second took black cohosh in combination with a group of other botanicals including pomegranate, chaste tree and ginseng. A third group took the multibotanical regimen and received counseling that recommended two soy food servings per day to provide 12 to 20 grams of soy protein. The fourth received daily doses of estrogen with or without progestin, and the fifth took an inactive placebo.
Neither the researchers nor the women themselves, who kept diaries of their symptom severity, knew which group they were in.
The study, published in the Dec. 19 issue of the Annals of Internal Medicine, found that hormone treatment reduced night sweats by an average of one per night and hot flashes by an average of three per day, but that none of the botanical treatments differed from the placebo.
"We don't want our message to be that all women should rush back to hormone treatment," said Katherine Newton, the lead author and associate director for research at the Group Health Center for Health Studies in Seattle. "Women should remember that the menopause transition is a normal event and that their symptoms will pass with time. Those who are very troubled by their symptoms should discuss treatment with their health care providers."
Family size linked to tumors - Researchers writing in the Dec. 12 issue of Neurology reviewed the records of 13,613 Swedish brain cancer patients and found that those with four or more siblings were almost twice as likely to develop a brain tumor as those with no siblings at all. The risk increased with the number of younger siblings and in children under 15, where it increased nearly four- fold for one type of tumor.
According to background information in the paper, the established risk factors for nervous system tumors are high doses of ionizing radiation, family history and some rare genetic syndromes. But these factors explain only a minority of brain cancers.
The authors suggest that infection may also be involved. Having large numbers of siblings increases the overall pool of infections, and children in close contact with one another share exposures to many infectious agents.
The authors caution, however, that any conclusions about an infectious cause remain speculative because molecular studies have not identified a specific germ. Dr. Andrea Altieri, the lead author, said the study did not prove that brain tumors were caused by infection or that living in a large family was in any way dangerous.
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RELIEVING BACK PAIN - Psychological treatments of lower back pain have a real but modest effect on pain intensity, quality of life and physical and emotional functioning, a systematic review of recent studies has found. The paper appears in the January issue of Health Psychology.
Researchers reviewed 22 randomized controlled trials that tested psychological treatments for noncancerous chronic lower back pain against control groups that received no treatment or the usual medications and exercises. The interventions included cognitive behavioral treatment, biofeedback, relaxation and hypnosis.
The researchers concluded that such interventions had moderate effects on pain intensity and quality of life.
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'SWORD THROATS' - A British survey of 46 sword swallowers, including six women, reveals that practitioners rarely seek medical attention, and the most common problem they face - no surprise - is a sore throat.
Still, there were some serious injuries reported. Six suffered perforations of the pharynx or esophagus, and three of these required surgery to the neck. But no one died from swallowing a sword, and 19 of the respondents reported no more than the occasional sore throat. The survey's results were published in the Dec. 23 issue of The British Medical Journal.
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