MONDAY, June 9 (HealthDay News) — The medication rosiglitazone may slow the progression of eye disease in diabetes patients, according to new research from the Jules Stein Eye Institute at the University of California, Los Angeles.

Specifically, researchers found that patients who took the drug were less likely to develop proliferative diabetic retinopathy or to experience reductions in visual acuity (sharpness). But they are not recommending the drug’s use until further studies are done.

In proliferative diabetic retinopathy, existing blood vessels in the retina are blocked or damaged, resulting in the formation of new, tiny blood vessels. The condition is one of the leading causes of severe vision loss among working-age Americans, and there are few effective therapies to slow its progression.

In this study, researchers compared 124 diabetes patients who took rosiglitazone and 158 diabetes patients who didn’t take the drug or a similar medication. At the start of the study, 14 eyes of the people in the rosiglitazone group (6.4 percent) and 24 eyes of people in the control group (9.3 percent) had severe non-proliferative diabetic retinopathy, an earlier stage of proliferative diabetic retinopathy.

Of the patients with severe non-proliferative diabetic retinopathy, 7.7 percent of those in the rosiglitazone group and 29.2 percent of those in the control group progressed to proliferative diabetic retinopathy within one year. After three years, 19.2 percent of the rosiglitazone group and 47.4 percent of the control group had progressed to proliferative diabetic retinopathy. That works out to a 59.5 percent reduced risk for those taking the drug.

The study also found that 0.5 percent of the rosiglitazone group and 14.5 percent of the control group experienced a loss of visual acuity of at least three lines on the vision chart during an average of 2.8 years of follow-up.

The study is published in the June issue of the journal Archives of Ophthalmology.

Rosiglitazone may delay progression of retinopathy by reducing formation of new blood vessels, the researchers said.

"However, because this study does not rigorously prove that rosiglitazone either reduces the incidence of proliferative diabetic retinopathy or prevents loss of visual acuity, and because there may be adverse effects from therapy, rosiglitazone treatment of patients with diabetes specifically to reduce these ophthalmic complications is not advocated at this time," they wrote.

Rosiglitazone can cause such adverse effects as fluid build-up, abnormal liver function test, and worsening of congestive heart failure.

"Determination of the full efficacy and clinical role of rosiglitazone in the treatment of proliferative diabetic retinopathy and other angiogenic conditions awaits confirmation of risks and benefits and possibly large-scale definitive studies," the researchers concluded.

HAVANA - Cuba has authorized sex-change operations and will offer them free for qualifying citizens, an official said Friday. The move is the latest in a series of changes implemented by President Raul Castro since he succeeded his elder brother, Fidel, in February. Raul Castro’s daughter, Mariela, heads Cuba’s National Center for Sex Education, which strongly backs the new policy.

Health Minister Jose Ramon Balaguer signed a resolution approving sex-change surgery, said an official at the center who spoke on condition of anonymity because the measure has not been formally published. The resolution will be posted on the Internet on Saturday, the official said.

The procedure would be available to Cubans for free as part of their country’s health-care system.

The sex education center has said previously that 28 transsexual Cubans have asked to undergo the surgery and that Cuban doctors have trained with physicians from Belgium to prepare for the procedures.

According to the center, a clinic for transsexual health will be created to perform the procedures, but it was not clear when it will start operating.

Cuba carried out a successful sex-change operation in 1988, but future surgeries were canceled because it sparked a negative public outcry.

Since becoming Cuba’s first new president in 49 years, the younger Castro has done away with bans that kept most Cubans from owning cell phones in their own names and renting hotel rooms and cars. His government also has decentralized the floundering state agricultural sector, raised pensions for retirees and hiked salaries for some state employees, among other changes.

 CHICAGO - The percentage of American children who are overweight or obese appears to have leveled off after a 25-year increase, according to new figures that offer a glimmer of hope in an otherwise dismal battle.

"That is a first encouraging finding in what has been unremittingly bad news," said Dr. David Ludwig, director of an obesity clinic at Children’s Hospital Boston. "But it’s too soon to know if this really means we’re beginning to make meaningful inroads into this epidemic. It may simply be a statistical fluke."

In 2003-04 and 2005-06, roughly 32 percent of children were overweight but not obese, 16 percent were obese and 11 percent were extremely obese, according to a study by the federal Centers for Disease Control and Prevention. Those levels held steady after rising without interruption since 1980.

"Maybe there is some reason for a little bit of optimism," said CDC researcher Cynthia Ogden, the study’s lead author.

Some experts said that if the leveling-off is real, it could be because more schools and parents are emphasizing better eating habits and more exercise. Even so, they and Ogden stressed that it would be premature to celebrate.

"Without a substantial decline in prevalence, the full impact of the childhood epidemic will continue to mount in coming years," Ludwig said. That is because it can take many years for obesity-related complications to translate into life-threatening events, including heart attacks and kidney failure.

He co-wrote an editorial accompanying the study in Wednesday’s Journal of the American Medical Association. He had no role in the research.

The results are based on 8,165 children ages 2 to 19 who participated in nationally representative government health surveys in 2003-04 and 2005-06.

The surveys are considered the most accurate reflection of obesity levels because they are based on in-person measurements, not on people’s own reporting of their height and weight.

CDC data reported last year showed obesity rates for men also held steady from 2003-04 to 2005-06 at about 33 percent after two decades of increases. The rate for women, 35 percent, remained at a plateau reached in 2003-04.

The CDC’s analysis of data for 2007-08, due next year, may be the best evidence for determining what direction children’s rates are really heading, Ludwig said.

Dr. Reginald Washington, a children’s heart specialist in Denver and member of an American Academy of Pediatrics obesity committee, said "the country should be congratulated" if the rates have in fact peaked.

"There are a lot of people trying to do good things to try to stem the tide," Washington said. Some schools are providing better meals and increasing physical education, and Americans in general "are more aware of the importance of fruits and vegetables," he said.

On the other hand, he noted that he recently treated an obese young patient "who in three days did not have a single piece of fresh fruit.

"We still have a long ways to go," he said.

 WEDNESDAY, June 4 (HealthDay News) — Your nerves, rather than your eating habits, may have a more direct role in whether you are fat or thin, according to new research.

A study on worms shows that serotonin levels in the nervous system influence feeding and fat. Serotonin, a neurotransmitter, also acts independently to control eating and what your body does with those calories once they’ve been consumed, the study said.

"It says that the nervous system is a key regulator coordinating all energy-related processes through distinct molecular pathways," Kaveh Ashrafi, of the University of California, San Francisco, said in a prepared statement. "The nervous system makes a decision about its state leading to effects on behavior, reproduction, growth and metabolism. These outputs are related, but they are not consequences of each other. It’s not that feeding isn’t important, but the neural control of fat is distinct from feeding."

Ashrafi said that given serotonin’s ancient evolutionary origins, you can apply what’s learned from the worms to humans.

"From a clinical perspective, this may mean you could develop therapeutic strategies to manipulate fat metabolism independently of what you eat," he said. "Now, the focus is primarily on feeding behavior. As important as that is, it’s only part of the story. If the logic of the system is conserved across species, a strategy that focuses solely on behavior can only go so far. It may be one reason diets fail."

The findings were published in the June issue of Cell Metabolism.

At its most basic level, fat regulation is the balance between energy intake and expenditure; however, Ashrafi said the physiology is very complicated.

In the worms, serotonin affected feeding by involving nerve receptors not normally required for fat control. The byproducts of the signaling process ended up affecting the control of feeding behavior, Ashrafi said.

In the worms and in mammals, high serotonin levels are associated with fat reduction, while low serotonin levels lead to fat accumulation, the researchers noted. However, in the worms, when serotonin goes up, the worms desire to eat increases even as fat melts away. But in humans, high serotonin leads people to eat less and shed fat.

Serotonin’s effects on fat and eating habits in the worms fit the nerve messenger’s role as a sensory gauge of nutrient availability, the researchers said. When resources are scarce, worms build up their fat reserves and switch metabolic gears to save energy and direct nutrients to fat stores.

Ashrafi said serotonin’s role in balancing energy across species leads him to believe that "human counterparts of feeding-independent fat regulatory genes identified in our study may similarly regulate energy balance."

More information

The U.S. National Library of Medicine has more about serotonin.

 NEW YORK - More people are hurt snowboarding than any other outdoor activity, accounting for a quarter of emergency room visits, according to the first national study to estimate recreational injuries.

Trailing snowboarding are sledding and hiking, researchers at the Centers for Disease Control and Prevention report in the journal Wilderness and Environmental Medicine.

The most common problems were broken bones and sprains, accounting for half of all cases. About 7 percent of ER visits were for concussions or other brain injuries.

"We want people to participate in outdoor recreational activities. But we want people to recognize that there’s cause for concern and people can and do get injured," study co-author Arlene Greenspan said Tuesday.

She said injuries can be avoided through planning and preparation: making sure your fitness level and skills match the activity and using proper equipment like helmets.

Greenspan said the study is the first to look at injuries from all activities, instead of individual sports or geographic areas.

The researchers looked at data on nonfatal injuries from outdoor activities treated at 63 hospitals in 2004 and 2005. They calculated that almost 213,000 people annually were treated for such injuries nationwide. About half of those injured are young, between ages 10 and 24 and half of the injuries are caused by falls.

Males are injured at twice the rate of females, but the research didn’t look at the reasons.

"It could be that males are more risky or it could be that males just participate more than females, or a combination of both," said Greenspan.

Nearly 26 percent of the injures were from snowboarding followed by sledding (11 percent); hiking (6 percent); mountain biking, personal watercraft, water skiing or tubing (4 percent); fishing (3 percent) and swimming (2 percent).

From his experience on ski patrols, "it makes perfect sense to me that snowboard injuries rank high," said Dr. Paul Auerbach, of Stanford School of Medicine.

Auerbach, who writes a blog on outdoor medicine, said such studies allow researchers to look for patterns in injuries that can be used in prevention programs. He’s one of the founders of the Wilderness Medical Society, which publishes the journal.

"Some activities have risks and you can’t take all the risks out of the wilderness," said Auerbach. "But what you’d like to do is take the unnecessary risk out."

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