MEDICAL NEWS TIPS: JUNE 1995

June 1995
Media Contact: Name & Phone Number are listed below each individual story

Listed below are story ideas from The Johns Hopkins Medical Institutions. To pursue any of these stories, call the contact person listed.

FAILURE TO GET TREATMENT FOR AIDS-RELATED DISEASE COSTLY

The failure of many people infected with HIV-1 to get preventivetreatment for an AIDS-related pneumonia is needlessly costing lives and increasing medical costs, according to a study at The Johns Hopkins Medical Institutions. These individuals get the disease, called Pneumocystis carinii pneumonia (PCP) because they either never get treatment for it or fail to take medicine prescribed by their doctors, say the study's authors in a report published in the April issue of Chest.

The authors say that if their findings apply to other hospitals in Maryland, the failure of HIV-infected individuals to get preventive treatment for PCP may have cost the state almost five million dollars in 1992.

For media inquiries only, contact Marc Kusinitz at 410-955-8665 or E-mail: mkusinitz@welchlink.welch.jhu.edu

PROGESTERONE-ONLY CONTRACEPTIVES MAY RAISE GALLSTONE RISK

Women using progesterone-only contraceptives or hormone replacement therapy may be at increased risk for gallstones, results of a Johns Hopkins study in prairie dogs suggest. The study could have implications for women ages 25 to 65 who use contraceptives containing only progesterone delivered continuously over a long time. Several studies have indicated that women are twice as likely as men to have gallstones until menopause, when the risk becomes equal.

"Progesterone reduces gallbladder filling and therefore flushing of cholesterol crystals and early gallstones from the system," says Keith Lillemoe, M.D., associate professor surgery and senior author of the study, published in a recent issue of Surgical Forum.

Researchers found that in prairie dogs given slow-release progesterone implants, only 20 percent to 30 percent of the bile traveled into the gallbladder. Most of the bile passed into the small intestine. In untreated animals, 60 percent of the bile went to the gallbladder and only 30 percent to the small intestine. Bile, a yellowish-green to brown liquid secreted by the liver, plays an important role in digesting fats. The differences suggest that if more of the bile goes into the small intestine than into the gallbladder, there may be less bile moving through the gallbladder to flush out cholesterol crystals and early gallstones, says Lillemoe.

The study was supported by grants from the National Institutes of Health.

For media inquiries only, contact John Cramer at 410-955-1534 or E-mail: jcramer@welchlink.welch.jhu.edu

BORNA VIRUS MAY BE LINKED TO DEPRESSION

Some researchers believe that a virus causing a fatal brain disease in animals may cause depression in people, but a Johns Hopkins scientist says more evidence is needed to tell if Borna disease virus, distantly related to the virus that causes rabies, plays a role in human psychiatric illnesses.

In a recent issue of Nature Medicine, Joanna M. Pyper, Ph.D., assistant professor of comparative medicine, reviews an article by German scientists that presents further evidence linking Borna disease and clinical depression. Pyper, who studies Borna disease virus in rats at Hopkins, said the German group's findings are suggestive, but that she remains unconvinced that their work unequivocally demonstrates human infection with the virus.

The virus infects cells of the limbic system, a region of the brain implicated in many psychiatric disorders, including bipolar depression and schizophrenia. But scientists have been unable to find the virus in cerebrospinal fluid in patients. The Hopkins virologist notes that the German group used a sensitive technique to detect genetic material (RNA) from the virus. However, the viral RNA was detected in blood cells from four of only six depressed patients and was not consistently detected in blood samples.

Both Borna disease virus and its distant viral relative, rabies, which causes brain damage in animals and humans, infect cells in the nervous system. Previous studies have shown that a large proportion of psychiatric patients with certain affective disorders, such as depression and manic-depressive disorder, have antibodies specific for proteins of Borna disease virus.

The virus affects various animal species differently. Rats' brains are destroyed, but it causes only subtle abnormal social patterns in tree shrews, a non-human primate species. Currently, researchers do not know how the virus spreads. But Pyper says further animal studies at Hopkins, as well as larger studies of psychiatric patients, may help scientists to better understand how the virus causes disease and to develop a way to diagnose and treat it.

For media inquiries only, contact John Cramer at 410-955-1534 or E-mail: jcramer@welchlink.welch.jhu.edu

THE DANGER OF TOYING WITH TRACTORS

Some lose limbs, others are maimed, still others lose their lives. According to recent statistics from the American Academy of Pediatrics, more than ten thousand children are treated annually for lawnmower-and-tractor related injuries.

"The sad truth is that many of them are avoidable," says orthopedic surgeon Paul Sponseller, M.D., of the Johns Hopkins Children's Center. "Almost all accidents occur when we let our kids play in the yard while we cut the grass, or let them ride along with us."