Clinical Capsules

Gonorrhea Screening

Physicians should perform routine screening of all sexually active women at increased risk for gonorrhea, because of the high risk for pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain associated with asymptomatic gonorrhea infection, according to the U.S. Preventive Services Task Force.

Those at risk include sexually active women under age 25 years, those with previous gonorrhea or other sexually transmitted infections, those with new or multiple sex partners, those who don't consistently use condoms, sex workers, and drug users.

Pregnant women with these risk factors should be screened at the first prenatal visit, and those with ongoing or new risk factors should also be screened during the third trimester because gonorrhea increases the risk of preterm rupture of membranes, chorioamnionitis, and preterm labor (Ann. Fam. Med. 2005;3:263–7).

The task force recommended against routine screening in women and men at low risk for gonorrhea, and it found insufficient evidence to recommend for or against routine screening in men at high risk.

Soft Cheese Risks

Soft white cheeses made with raw milk present a health risk, the Food and Drug Administration has warned. Such cheeses can cause listeriosis, brucellosis, salmonellosis, and tuberculosis, and they pose a particular risk to pregnant women, newborns, older adults, and those with weakened immune systems.

Consumption of queso fresco-style cheeses imported from or eaten in Mexico were linked with recent cases of tuberculosis in New York City and found to be contaminated with Mycobacterium bovis, according to the FDA. The cheeses of greatest concern are those originating in Mexico and Central American countries and include queso panela, asadero, blanco, and ranchero. The FDA has warned against consumption of any unripened raw-milk soft cheeses, including those obtained at flea markets or from door-to-door sellers or vendors selling out of their trucks, cheeses made at home by individuals, and those shipped or carried in luggage from the areas of concern.

Vitamin B₆ Intake and Colorectal Ca

High intake of vitamin B₆ is associated with a protective effect against colorectal cancer in women, especially those who drink alcohol, reported Susanna C. Larsson of the Karolinska Institutet, Stockholm, and her associates.

In a population-based cohort study of 61,433 women, those who were in the top 20% of vitamin B₆ intake had a 34% lower relative risk of colorectal cancer than did women who were in the bottom 20% of vitamin B₆ intake; this reduction was significant. Among women who drank at least 30 g of alcohol (about two drinks) per week, those with the highest intake of vitamin B₆ had a 72% lower relative risk of colorectal cancer than did women who had the lowest intake (Gastroenterology 2005;128:1830–7).

Intake of vitamin B₆ in the study of 61,433 women from the Swedish Mammography Cohort ranged from less than 1.53 mg/day in the lowest 20% of women to 2.05 mg/day or more in the highest 20% of women. The recommended daily intake of vitamin B₆ for nonpregnant women in the United States is 1.3–1.5 mg. “Findings from our study suggest that women who consume alcohol may benefit from a vitamin B₆ intake above the recommendations,” the researchers wrote.

Treating Antipsychotic-Linked Adiposity

Topiramate appears to help alleviate the weight gain associated with olanzapine use in women, reported Marius K. Nickel, M.D., of Inntalklinik in Simbach/Inn, Germany, and associates.

In a 10-week trial of women on olanzapine (Zyprexa) for 3 months or more who had gained at least 5 kg since beginning treatment, 25 women were randomized to topiramate (Topamax) and 18 to placebo. Every 2 weeks the women were interviewed and weighed.

Topiramate patients had a significant mean weight loss of 4.1 kg at the end of the study, compared with placebo users, though treatment was more likely to be effective if the patients initially gained a lot of weight (J. Clin. Psychopharmacol. 2005;25:211–7).

Health-related measures of functioning and well-being were also significantly better in topiramate patients than placebo patients, except for measures of emotional problems interfering with work and other daily activities. Along with weight loss, “one can also expect an increase in the patients' health-related quality of life, improvement in their current emotional state of health, and a reduction of their psychological impairments,” Dr. Nickel and associates said.

Gonorrhea Screening

Physicians should perform routine screening of all sexually active women at increased risk for gonorrhea, because of the high risk for pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain associated with asymptomatic gonorrhea infection, according to the U.S. Preventive Services Task Force.

Those at risk include sexually active women under age 25 years, those with previous gonorrhea or other sexually transmitted infections, those with new or multiple sex partners, those who don't consistently use condoms, sex workers, and drug users.

Pregnant women with these risk factors should be screened at the first prenatal visit, and those with ongoing or new risk factors should also be screened during the third trimester because gonorrhea increases the risk of preterm rupture of membranes, chorioamnionitis, and preterm labor (Ann. Fam. Med. 2005;3:263–7).

The task force recommended against routine screening in women and men at low risk for gonorrhea, and it found insufficient evidence to recommend for or against routine screening in men at high risk.

Soft Cheese Risks

Soft white cheeses made with raw milk present a health risk, the Food and Drug Administration has warned. Such cheeses can cause listeriosis, brucellosis, salmonellosis, and tuberculosis, and they pose a particular risk to pregnant women, newborns, older adults, and those with weakened immune systems.

Consumption of queso fresco-style cheeses imported from or eaten in Mexico were linked with recent cases of tuberculosis in New York City and found to be contaminated with Mycobacterium bovis, according to the FDA. The cheeses of greatest concern are those originating in Mexico and Central American countries and include queso panela, asadero, blanco, and ranchero. The FDA has warned against consumption of any unripened raw-milk soft cheeses, including those obtained at flea markets or from door-to-door sellers or vendors selling out of their trucks, cheeses made at home by individuals, and those shipped or carried in luggage from the areas of concern.

Vitamin B₆ Intake and Colorectal Ca

High intake of vitamin B₆ is associated with a protective effect against colorectal cancer in women, especially those who drink alcohol, reported Susanna C. Larsson of the Karolinska Institutet, Stockholm, and her associates.

In a population-based cohort study of 61,433 women, those who were in the top 20% of vitamin B₆ intake had a 34% lower relative risk of colorectal cancer than did women who were in the bottom 20% of vitamin B₆ intake; this reduction was significant. Among women who drank at least 30 g of alcohol (about two drinks) per week, those with the highest intake of vitamin B₆ had a 72% lower relative risk of colorectal cancer than did women who had the lowest intake (Gastroenterology 2005;128:1830–7).

Intake of vitamin B₆ in the study of 61,433 women from the Swedish Mammography Cohort ranged from less than 1.53 mg/day in the lowest 20% of women to 2.05 mg/day or more in the highest 20% of women. The recommended daily intake of vitamin B₆ for nonpregnant women in the United States is 1.3–1.5 mg. “Findings from our study suggest that women who consume alcohol may benefit from a vitamin B₆ intake above the recommendations,” the researchers wrote.

Treating Antipsychotic-Linked Adiposity

Topiramate appears to help alleviate the weight gain associated with olanzapine use in women, reported Marius K. Nickel, M.D., of Inntalklinik in Simbach/Inn, Germany, and associates.

In a 10-week trial of women on olanzapine (Zyprexa) for 3 months or more who had gained at least 5 kg since beginning treatment, 25 women were randomized to topiramate (Topamax) and 18 to placebo. Every 2 weeks the women were interviewed and weighed.

Topiramate patients had a significant mean weight loss of 4.1 kg at the end of the study, compared with placebo users, though treatment was more likely to be effective if the patients initially gained a lot of weight (J. Clin. Psychopharmacol. 2005;25:211–7).

Health-related measures of functioning and well-being were also significantly better in topiramate patients than placebo patients, except for measures of emotional problems interfering with work and other daily activities. Along with weight loss, “one can also expect an increase in the patients' health-related quality of life, improvement in their current emotional state of health, and a reduction of their psychological impairments,” Dr. Nickel and associates said.

Gonorrhea Screening

Physicians should perform routine screening of all sexually active women at increased risk for gonorrhea, because of the high risk for pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain associated with asymptomatic gonorrhea infection, according to the U.S. Preventive Services Task Force.

Those at risk include sexually active women under age 25 years, those with previous gonorrhea or other sexually transmitted infections, those with new or multiple sex partners, those who don't consistently use condoms, sex workers, and drug users.

Pregnant women with these risk factors should be screened at the first prenatal visit, and those with ongoing or new risk factors should also be screened during the third trimester because gonorrhea increases the risk of preterm rupture of membranes, chorioamnionitis, and preterm labor (Ann. Fam. Med. 2005;3:263–7).

The task force recommended against routine screening in women and men at low risk for gonorrhea, and it found insufficient evidence to recommend for or against routine screening in men at high risk.

Soft Cheese Risks

Soft white cheeses made with raw milk present a health risk, the Food and Drug Administration has warned. Such cheeses can cause listeriosis, brucellosis, salmonellosis, and tuberculosis, and they pose a particular risk to pregnant women, newborns, older adults, and those with weakened immune systems.

Consumption of queso fresco-style cheeses imported from or eaten in Mexico were linked with recent cases of tuberculosis in New York City and found to be contaminated with Mycobacterium bovis, according to the FDA. The cheeses of greatest concern are those originating in Mexico and Central American countries and include queso panela, asadero, blanco, and ranchero. The FDA has warned against consumption of any unripened raw-milk soft cheeses, including those obtained at flea markets or from door-to-door sellers or vendors selling out of their trucks, cheeses made at home by individuals, and those shipped or carried in luggage from the areas of concern.

Vitamin B₆ Intake and Colorectal Ca

High intake of vitamin B₆ is associated with a protective effect against colorectal cancer in women, especially those who drink alcohol, reported Susanna C. Larsson of the Karolinska Institutet, Stockholm, and her associates.

In a population-based cohort study of 61,433 women, those who were in the top 20% of vitamin B₆ intake had a 34% lower relative risk of colorectal cancer than did women who were in the bottom 20% of vitamin B₆ intake; this reduction was significant. Among women who drank at least 30 g of alcohol (about two drinks) per week, those with the highest intake of vitamin B₆ had a 72% lower relative risk of colorectal cancer than did women who had the lowest intake (Gastroenterology 2005;128:1830–7).

Intake of vitamin B₆ in the study of 61,433 women from the Swedish Mammography Cohort ranged from less than 1.53 mg/day in the lowest 20% of women to 2.05 mg/day or more in the highest 20% of women. The recommended daily intake of vitamin B₆ for nonpregnant women in the United States is 1.3–1.5 mg. “Findings from our study suggest that women who consume alcohol may benefit from a vitamin B₆ intake above the recommendations,” the researchers wrote.

Treating Antipsychotic-Linked Adiposity

Topiramate appears to help alleviate the weight gain associated with olanzapine use in women, reported Marius K. Nickel, M.D., of Inntalklinik in Simbach/Inn, Germany, and associates.

In a 10-week trial of women on olanzapine (Zyprexa) for 3 months or more who had gained at least 5 kg since beginning treatment, 25 women were randomized to topiramate (Topamax) and 18 to placebo. Every 2 weeks the women were interviewed and weighed.

Topiramate patients had a significant mean weight loss of 4.1 kg at the end of the study, compared with placebo users, though treatment was more likely to be effective if the patients initially gained a lot of weight (J. Clin. Psychopharmacol. 2005;25:211–7).

Health-related measures of functioning and well-being were also significantly better in topiramate patients than placebo patients, except for measures of emotional problems interfering with work and other daily activities. Along with weight loss, “one can also expect an increase in the patients' health-related quality of life, improvement in their current emotional state of health, and a reduction of their psychological impairments,” Dr. Nickel and associates said.