COLDS

An herbal remedy seems of no more benefit than a placebo.

* THE QUESTION The sniffling, coughing and congestion of the common cold afflicts the typical adult two to four times a year. Does echinacea, an over-the-counter herbal preparation, provide relief?

* THIS STUDY randomly assigned 128 adults with colds to take either a 100-milligram tablet of Echinacea purpurea (EchinaFresh), derived from the purple coneflower, or a placebo three times daily until symptoms eased, but for no more than 14 days. All participants joined the study within 24 hours of the onset of cold symptoms, took no other cold medications and kept daily logs of the severity of sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches and cough. The logs, coupled with examinations by doctors, showed that people who took echinacea had comparable symptoms and colds that lasted about as long as did those who took the placebo.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with a cold.

* CAVEATS The echinacea used in the study was derived from stems, leaves and flowers; whether a preparation derived from the plant's roots would produce similar results is unclear. Also unknown is how a stronger dose might affect the outcome. EchinaFresh was provided by Enzymatic Therapy, which markets the supplement. Finally, the study was not large.

* BOTTOM LINE Previous research has shown that echinacea can stimulate the immune system and possibly treat cold symptoms successfully, but this study, like some others, failed to show any benefit from using it.

* FIND THIS STUDY June 14 issue of Archives of Internal Medicine; abstract available online at www.archinternmed.com.

* LEARN MORE ABOUT treating the common cold at www.niaid.nih.gov and at www.familydoctor.org.

pain

Acupuncture appears capable of providing relief for years.

* THE QUESTION Persistent pain in the neck and shoulders frequently afflicts office workers. Might acupuncture provide long-lasting pain relief?

* THIS STUDY involved 24 women, most of whom worked on computers for five to six hours a day and who had experienced neck and shoulder pain for an average of 12 years. The participants were randomly assigned to receive either acupuncture or a fake acupuncture treatment in 10 45-minute sessions over three to four weeks. Treatments consisted of regular needle and electroacupuncture at 22 points on the body; recipients also applied pressure four times daily to six points on their ear. For the fake acupuncture, needles were placed at inappropriate points on the body and ear, and electroacupuncture was administered with a beep but no voltage. Pain was assessed by a doctor using an algometer (a pain-measuring instrument) and via questionnaires. Once treatment ended, the acupuncture recipients reported pain at 26 percent of the level it had been before treatment, compared with 75 percent for the fake treatment recipients. When checked three years later, pain remained low among those who had received acupuncture while pain among the others had returned to 92 percent of the pre-treatment level.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with chronic neck and shoulder pain.

* CAVEATS The study involved a small number of participants. The effects of acupuncture may vary depending on the practitioner's expertise.

* BOTTOM LINE People with persistent neck and shoulder pain may want to consider acupuncture.

* FIND THIS STUDY June issue of Pain; abstract available online at www.elsevier.com/locate/pain.

* LEARN MORE ABOUT neck pain at www.mayoclinic.com and at http://orthoinfo.aaos.org (search for "neck pain").

DEMENTIA

Estrogen supplements may not be beneficial for older women.

* THE QUESTION In women, cognitive problems increase after menopause, when the body's natural estrogen supply wanes. Does taking an estrogen supplement alter this decline?

* THIS STUDY analyzed the effect on memory of hormone supplements taken by 7,479 older women for seven to nine years. The women were among the 27,000 participants in the Women's Health Initiative (WHI) study of hormone therapy and had been randomly assigned to take a daily supplement of estrogen (Premarin, 0.625 milligrams), combined estrogen and progestin (Prempro, 0.625 milligrams estrogen, 2.5 milligrams progestin) or a placebo. All were dementia-free at the start of the study. Periodic interviews, examinations and neuropsychological testing revealed that women who took estrogen alone had a 49 percent higher risk of dementia than those taking a placebo. The study also reiterated results released last year that women taking the estrogen-plus-progestin combination had a 105 percent increased risk of dementia.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Older post-menopausal women. More women than men have dementia, at least in part because women generally live longer than men.

* CAVEATS The WHI estrogen-plus-progestin study was stopped earlier than planned because the increased risk for heart attack, stroke and breast cancer outweighed the benefits of decreased risk for colon cancer and bone fracture. The estrogen-only study was also interrupted because of an increased risk for stroke and no reduction in heart disease risk. Women in the study ranged from 65 to 79 years old; whether the findings apply to other age groups was not determined. Different doses of estrogen or methods of administration also might affect the results. Medical experts emphasize that the increases in risk for any one woman remain quite small. Wyeth Pharmaceuticals provided the supplements and placebos and partially funded the research. Two authors consulted for or received grants from various pharmaceutical companies.

* BOTTOM LINE Older women concerned about cognitive decline may wish to consider options other than estrogen.

* FIND THIS STUDY June 23/30 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT dementia at http www.4woman.gov and at www.niapublications.org.

-- Linda Searing