In Brief

In Brief

December 08, 2008

New drug may offer relief from jet lag

An experimental drug that mimics the effects of the hormone melatonin can reset the body's circadian rhythms, bringing relief to jet-lagged travelers and night-shift workers, researchers reported last week.

In a study of 450 people who were subjected to simulated jet lag in a sleep laboratory, a team from Brigham and Women's Hospital in Boston found that the drug restored near-normal sleep the first night it was used. There were no after effects, minimal side effects and people who took it performed normally the next day, said Dr. Elizabeth B. Klerman, one of the authors of the study published online in the journal Lancet.

And unlike conventional sleeping aids such as Ambien or Lunesta, she added, the new drug, tasimelteon, has no potential for addiction or abuse. The main limitations of the study were the relatively small size and the researchers' inability to measure performance and mood after the drug was used, experts said.

The study was designed and funded by Vanda Pharmaceuticals Inc. of Rockville, which developed tasimelteon, All of the researchers reported receiving funds from Vanda or other pharmaceutical companies.

"This is a very promising first step," said Dr. Jay Udani, who runs the integrative medicine program at Northridge Hospital Medical Center and who was not involved in the study. But the research "does not prove that it works for jet lag or shift workers," he said. "That needs controlled studies in the field."

The body's sleep-wake cycle is controlled by melatonin, which is produced by the pineal gland in response to patterns of light and darkness. Higher concentrations of melatonin in the blood are associated with greater sleepiness.

Some research has shown that administering melatonin can adjust sleep cycles in travelers and workers, but the results have been mixed. Because melatonin can't be patented, drug companies have been interested in developing melatonin mimics, such as tasimelteon, which can be patented.

Los Angeles Times

New doctors still work too many long hours

Doctors-in-training are still too exhausted, says a new report that calls on hospitals to let them have a nap.

Regulations that capped the working hours of bleary-eyed young doctors came just five years ago, limiting them to about 80 hours a week.

Last week, the prestigious Institute of Medicine recommended easing the workload a bit more: Anyone working the maximum 30-hour shift should get an uninterrupted five-hour break for sleep after 16 hours.

At issue is how to balance patient safety with the education of about 100,000 medical residents, doctors fresh out of medical school who spend the next three to seven years in on-the-job training for their specialty. The long hours are, in some ways, a badge of the profession; doctors can't simply clock out if a patient is in danger. But sleep deprivation fogs the brain, a problem that can lead to serious medical mistakes. So in 2003, the Accreditation Council for Graduate Medical Education issued the first caps. Before then, residents in some specialties could average 110 hours a week.

The government asked the IOM to study the current caps. Violations of current limits are common and residents seldom complain, the committee found. While quality of life has improved, there's still a lot of burnout. And despite one study that found residents made more errors while working longer shifts, patient safety depends on so many factors that it's impossible to tell if the caps helped that problem, the report said.

Los Angeles Times

Mental exercises can help prevent falls

An agile mind may be as important as strong limbs when it comes to the crucial task of preventing falls.

That's the finding of recent research at the University of North Carolina that had exercise classes trying mind-over-matter exercises such as the "four square step test," a regimen that resembles a Scottish sword dance in its focus on memory, movement and speed.

"This is the most wonderful thing that's been offered here," said Elaine Jerome, 81, taking part in a class for older adults. "I've noticed that my balance is 100 percent better since I started taking this."

Previous studies have shown that balance training can reduce falls. But researchers didn't know exactly why, because apparent risk factors such as weak muscles didn't always show improvement.

New results indicate that improving "executive function" - the ability to react mentally to complex situations - may be the missing link in designing the best methods for reducing falls. In other words, honing the mind may be as crucial as toning sagging muscles.

"The idea is to train both systems to work at once," professor Carol Giuliani said of working on both mental and physical skills.

McClatchy Tribune

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