By Amy Norton

NEW YORK (Reuters Health) – Iodine supplements may improve mental function in children with even mild deficiencies in the nutrient, a small study suggests.

Iodine is a chemical element necessary for normal growth and development of the brain and body. Because the body does not make iodine, it must be obtained from the diet — from sources like seafood, dairy products, plants grown in iodine-rich soil and iodized table salt.

Severe iodine deficiency has long been known to cause mental impairment, stunted growth and other problems in children. Such deficiency remains a major problem in parts of the world — typically where the soil is iodine-poor, people eat little seafood and salt is not iodized.

But there has also been a recent re-emergence of milder iodine deficiency in certain countries, including New Zealand and Australia — thought to be due to factors like declining use of iodized salt and changes in dairy-product manufacturing that have lowered iodine levels.

Whether mild deficiency affects children’s mental functioning, and whether the problem should be treated, is still in question.

To study the issue, researchers in New Zealand randomly assigned 184 mildly iodine-deficient children to take either a tablet containing 150 micrograms of iodine or a placebo pill every day for 28 weeks.

At the end of the study, children in iodine group showed an overall improvement on two standard cognitive tests that gauge problem-solving abilities. And they outperformed children who received the placebo.

Iodine is necessary for the body to produce thyroid hormones, which regulate metabolism. The traditional view was that since these hormone levels are still within normal range when a person is mildly iodine deficient, the lack of iodine may have no health effects.

The current findings, however, suggest that mild iodine deficiency “could prevent children from attaining their full intellectual potential,” the researchers report in the American Journal of Clinical Nutrition.

Still, it is too soon to start routinely treating children with mild deficiencies, according to Dr. Sheila A. Skeaff, a senior lecturer at the University of Otago in Dunedin and one of the researchers on the work.

“More studies should be done,” she told Reuters Health in an email. “We found a small effect in children (and) we don’t know if this is permanent or not.”

Skeaff pointed out that there are no standard tests for mild iodine deficiency. The best solution for people who think they might be deficient is to regularly eat foods high in iodine and use iodized table salt.

In the U.S., Skeaff noted, most children are not iodine-deficient, as the typical American diet provides adequate levels.

SOURCE: American Journal of Clinical Nutrition, October 2009.

By Joene Hendry

NEW YORK (Reuters Health) – Women dread a diagnosis of endometrial cancer, but those who drink at least two cups of caffeinated coffee a day may have a lower risk for this cancer of cells lining the uterus.

Coffee drinking seemed to particularly protect overweight and obese women, study co-author Dr. Emilie Friberg, at the Karolinska Intstituet in Stockholm, Sweden, told Reuters Health by email.

Friberg’s team twice surveyed 60,634 Swedish women about their coffee intake – when they enrolled in the Swedish Mammography Cohort study between 1987 and 1990, and again in 1997.

During the 17 years, on average, that the researchers followed patients, 677 women – about 1 percent — developed endometrial cancer. The average age at diagnosis was 67.

In the overall study group, those who daily drank 2 or more cups were significantly less likely to develop endometrial cancer, compared with those who drank fewer cups of coffee.

Each additional daily cup seemed tied to a 10 percent lower risk for endometrial cancer, after allowing for age and other factors potentially tied to endometrial cancer risk among all the women.

However, they observed the strongest effect among overweight and obese women, who, Friberg’s team notes, have “the highest risk for endometrial cancer.”

Each additional cup of coffee seemed to decrease endometrial cancer risk by 12 percent among overweight women and by 20 percent among obese women, Friberg and colleagues report in the International Journal of Cancer.

The investigators suggest that coffee may affect blood sugar, fat cells, and estrogen, all of which play a role in endometrial cancer. However, they write that the current findings should be confirmed in other populations.

In particular, “a study also including de-caffeinated coffee would make it possible to separate the effect of coffee and caffeine,” Friberg said.

SOURCE: International Journal of Cancer, November 15, 2009.

NEW YORK (Reuters Health) – Corticosteroid shots provide quick relief for people suffering from a common type of hip pain, but the benefits don’t last, a new study in The American Journal of Sports Medicine shows.

Known as greater trochanter pain syndrome (the trochanter is the upper part of the femur where it joins the pelvis), this condition is typically treated with physical therapy, training error correction, and non-steroidal anti-inflammatory drugs, Dr. Jan D. Rompe of the OrthoTrauma Evaluation Center in Mainz, Germany and his colleagues note.

If these measures don’t work-or even if they do-”a local corticosteroid injection is regarded as the standard of care,” Rompe and his team say.

But there have been no studies comparing various approaches to treating the hip pain syndrome. To investigate, the researchers randomly assigned 229 people with greater trochanter pain syndrome that hadn’t improved with standard treatment to home training, a single corticosteroid injection, or several low-energy shock-wave treatments, in which a machine is used to deliver energy pulses to the painful area.

After a month, 75 percent of the injection group reported significant improvements in pain, compared to 7 percent of those doing the home exercises and 13 percent of those who received the shock-wave therapy. But at four months, 51 percent of those given corticosteroid injections reported sustained improvements in pain, while 68 percent of patients in the shock wave group and 41 percent of the home training group reported significant improvements.

Finally, at 15 months, just 48 percent of patients given steroid shots said their pain was better, compared to 74 percent of the shock wave group and 80 percent of the home training group.

“The role of corticosteroid injection for greater trochanter pain syndrome needs to be reconsidered,” Rompe and his colleagues say, adding that patients need to be informed of the “advantages and disadvantages of the treatment options, including the economic burden.”

Given that shock wave therapy and home exercise training produced about the same results at 15 months, they add, the choice of which to offer patients could be made based on costs, because home exercise is less expensive.

SOURCE: The American Journal of Sports Medicine, October 2009.

By Anthony J. Brown, MD

NEW YORK (Reuters Health) – Worried about what to do with fat you’ve had liposuctioned from pudgy areas? Researchers have turned it into stem cells in the lab, but here’s a more immediate use: Fat liposuctioned from other parts of the body can safely be used to increase a woman’s breast size, according to study findings presented this week at the Plastic Surgery 2009 meeting in Seattle.

Many surgeons are already “using liposuctioned fat to reconstruct breasts after mastectomy,” Dr. Luis Zapiach, a plastic surgeon in Hackensack, New Jersey not affiliated with the study, told Reuters Health.

However, injecting fat into the “breast for cosmetic purposes has been a controversial issue ever since the American Society of Plastic Surgeons banned the procedure in 1987,” Dr. Roger K. Khouri, a plastic surgeon in Key Biscayne, Florida, who performed the current study, told Reuters Health.

“The procedure had the reputation of being ineffective, unreliable and potentially dangerous,” Khouri said, and at present is not permitted outside of clinical studies.

With reconstructions following breast cancer surgery, Zapiach explained, all of the breast tissue is removed before the fat is injected, so there is no danger that fat – which excretes estrogen, a hormone that stimulates breast cell growth – will bring the cancer back.

With cosmetic augmentations, the tissue still remains, so “there is a theoretical risk that use of fat for augmentations could increase the risk of breast cancer,” Zapiach said.

In the current study, however, which was small, there was no evidence to support concerns that the transferred fat may increase the risk of breast cancer.

The current study featured 50 women who had their liposuctioned fat used for breast augmentation. X-rays were used to look for dead tissue and breast cancer 3 to 12 months after the operation.

A key component of the operation, according to Khouri, was the use of a bra-like device he invented called the Brava. The device includes a small battery-operated pump that creates suction on the breast. That, in turn, increases volume and promotes the growth of blood vessels in the area. The device was worn for 4 weeks before the operation and for a few weeks afterward.

Women saw a moderate increase in breast size at 6 to 12 months – on average, about 210 milliliters, which could represent a variety of cup sizes depending on a woman’s body type. Over a period of 3 years, breast size fluctuated with weight. All of the subjects were “pleased” with their cosmetic outcomes, the Khouri reported.

Tests indicated that, on average, 18 percent of the transferred fat in each patient died or “did not take.” Zapiach said that this rate is “very low” considering that prior studies have shown rates between 30 and 70 percent.

There was an infection following the procedure in one of the 50 women.

According to Zapiach, Brava was initially introduced as a non-surgical means of increasing breast size. He added that while Khouri has had good success with Brava, many surgeons testing fat for augmentations do not use the device.

Zapiach said that the new findings are encouraging, but that the American Society of Plastic Surgeons will wait for results from a number of similar studies currently underway before reconsidering their position on the procedure.

NEW YORK (Reuters Health) – Could high blood pressure-related complications during pregnancy be tied to thinking skills in children years later?

A study from Denmark hints at “a modest association” between such complications and poorer reasoning, intuition, and perception skills in young adult men, report Dr. Vera Ehrenstein, at Aarhus University Hospital, and colleagues.

The study compared intelligence tests measures for more than 17,000 men drafted into Danish military service. Of these men, tested at the age of 19, about 15 percent had poor thinking skills, measured by IQs below 85, the researchers report in the American Journal of Epidemiology.

The mothers of about 5 percent of the men in the study had either blood pressures above 140/90, protein in the urine, or swelling of the extremities. All of those are signs or symptoms of a life-threatening condition known as pre-eclampsia.

Poorer thinking skills were slightly more common among men whose mothers had any of those signs or symptoms. About 19 percent of the adults of affected mothers had poorer thinking skills, versus 15 percent among those whose mothers were not affected.

When the researchers accounted for being born small, which places infants at risk for delayed or impaired brain development, and for other factors, poor thinking skills were still as much as a third more likely among men whose mothers suffered from pre-eclampsia symptoms.

Ehrenstein’s team notes the current findings cannot determine whether high blood pressure-related complications of pregnancy cause poorer thinking skills, nor why such complications would have any effect on those skills.

SOURCE: American Journal of Epidemiology, October 15, 2009.