US Pharm. 2007;32(10):71.

Omega-3 Fatty Acids Reduce Risk of Type 1 Diabetes in Children
Preliminary research published in a recent issue of JAMA suggests that the dietary intake of omega-3 fatty acids by children at increased genetic risk for type 1 diabetes is associated with a reduced risk of pancreatic islet autoimmunity, which is linked to the development of this disease.

According to the authors, "Type 1 diabetes mellitus is an autoimmune disease that is characterized by the destruction of insulin-producing beta cells in the pancreatic islets. Although it is not yet known what initiates the autoimmune process, it is likely that both genetic background and environmental factors contribute to the disease process."

ED Drug Useful in Men with Spinal Cord Injury
Researchers at Raymond Pointcaré Hospital in Garche, France, reported that tadalafil may help some men with erectile dysfunction secondary to spinal cord injury have erections sufficient for satisfactory sex compared to those who took a placebo.

The results, published in the Archives of Neurology, reported on a group of men who took tadalafil and had a significantly higher mean per-patient percentage of successful penetration attempts compared to the placebo group. The drug group also had a significantly higher percentage of successful intercourse attempts and greater frequency of ejaculation. The patients' ages ranged from 18 to 36.

Vitamin D Linked to a Reduction in Mortality
While the medical literature is full of praises for vitamin D for improving bone health, a meta-analysis of 18 randomized trials found that it may also reduce all-cause mortality by a small but statistically significant degree.

The findings, which were published in the Archives of Internal Medicine, showed an 8% reduction in all-cause mortality when vitamin D was taken daily for three or more years. According to Philippe Autier, MD, of the International Agency for Research on Cancer in Lyon, France, and coauthor Sara Gandini, PhD, of the European Institute of Oncology in Milan, Italy, while the mechanisms by which vitamin D would decrease mortality are not clear, there are several possibilities. One such possibility is that some effects of activation of the vitamin D receptor "such as inhibition of cellular proliferation and activation of cellular differentiation, could reduce aggressiveness of cancerous processes and expansion of atheromatous lesions."

The authors conclude that "population-based, placebo-controlled randomized trials in people 50 years or older for at least six years with total mortality as the main end point should be organized to confirm these findings."

Tamoxifen May Be Effective in Some Bipolar Patients
A small pilot study showed that tamoxifen, approved to treat breast cancer, may be effective in significantly decreasing symptoms of acute mania in patients with bipolar disorder as early as five days after beginning treatment.

According to Carlos A. Zarate, Jr., MD, of the National Institute of Mental Health, and colleagues, tamoxifen maintained its effect throughout a three-week trial with a response rate of 63% compared to 13% for a placebo. The results were published online in Bipolar Disorders.

The authors reasoned that tamoxifen, a relatively selective protein kinase C inhibitor with the advantage that it crosses the blood–brain barrier, would produce antimanic effects more rapidly than previously achieved with lithium or valproate. They said that lithium and valproate exert their effects "considerably upstream of protein kinase C" and ultimately work more indirectly than tamoxifen. Another advantage of tamoxifen, according to the researchers, is that it responds more rapidly than drugs that are traditionally used to treat mania in bipolar disorder. However, they caution that it is important to take into consideration the risk-to-benefit ratio, as tamoxifen may cause endometrial cancer if taken for extended periods.

The authors caution that the results of this relatively small study need to be interpreted with care. Also, the results may not be generalized to patients with certain characteristics; for example, those with current substance abuse disorders. They also conclude that the results may not apply beyond the acute-treatment phase of bipolar mania.

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