grief

Discussing a loved one's death may help some people cope.

* THE QUESTION Mourning the death of someone you love is perfectly natural, but some people cannot shed the grief. They become preoccupied with the death, bitter and unable to accept it and filled with intense longing for the deceased. Might a modified type of psychotherapy help such people?

* THIS STUDY involved 98 adults who had been consumed by grief for six months or more after a death. Participants were randomly assigned to attend weekly psychotherapy sessions for grief-related depression or similar sessions enhanced with methods adapted from the treatment of traumatic stress. Techniques in the enhanced sessions included retelling the story of the death and imagining a conversation with the deceased, as well as exercises to confront situations that the participants were avoiding because they prompted memories of the person who had died. After about five months, grief symptoms had declined in both groups, though people who received the enhanced therapy responded more quickly and in greater numbers (51 percent vs. 28 percent).

* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone consumed by chronic grief. An estimated 10 to 20 percent of all people mourning a loss have this reaction.

* CAVEATS About 10 percent of the enhanced-therapy group described some of the exercises as too difficult and would not do them. About one-fourth of both groups quit the study. Participants who were taking antidepressants responded somewhat better than those who did not take such drugs. The effect of longer-term treatment remains unclear.

* FIND THIS STUDY June 1 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT coping with grief at http://www.nmha.org and www.aarp.org/families.

atrial fibrillation

High-frequency energy waves may substitute for medication.

* THE QUESTION The heart's electrical system normally maintains a steady beat, but if the impulses are blocked, an abnormal rhythm -- atrial fibrillation -- can result. Medication often is used to correct this, but some people experience serious side effects from the drugs, and they do not always work. Might a procedure that uses high-frequency waves to destroy the tissue causing the short circuit be a viable alternative?

* THIS STUDY randomly assigned 70 adults with atrial fibrillation (AF) to take anti-arrhythmic drugs and an anti-clotting drug or to undergo radiofrequency ablation, administered through a catheter. A year later, 13 percent of those in the ablation group had had one AF episode or more, compared with 63 percent of the people who took medication. People who had had ablation described their quality of life as better than those who had taken the medication.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with AF, which becomes more common with age. More than 2 million Americans have this disorder.

* CAVEATS Risks associated with ablation include constriction of the pulmonary vein and stroke; complications occur in about 6 percent of the procedures. Different specialists using different ablation techniques may not produce the same results. The long-term cure rate remains unknown. Quality-of-life findings were based on self-reports.

* FIND THIS STUDY June 1 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT atrial fibrillation at http://patients.uptodate.com; learn about cardiac ablation at www.fda.gov/hearthealth/treatments (click "Treatments," then "Medical Devices").

crohn's disease

Stimulating the immune system may be an effective treatment.

* THE QUESTION No one knows just what causes the gastrointestinal tract disorder known as Crohn's disease, but a popular theory is that the inflammation stems from an immune system reaction to a virus or bacteria. Thus, using medication to suppress the immune system has been the traditional treatment. But if the disease instead develops because of an immune system defect, might boosting that system provide effective treatment?

* THIS STUDY randomly assigned 124 adults with moderate to severe Crohn's disease to be given injections of Leukine (sargramostim) -- a drug given cancer patients to boost their white cell count -- or a placebo daily. Based on a standardized scale (from 0 to 600, with lower numbers indicating less severe disease), scores for about half of both groups had dropped at least 70 points after eight weeks, but declines of 100 points or more were registered by 48 percent of those who took Leukine, compared with 26 percent of the placebo group. More people who took the drug were considered in remission by the end of the study: 40 percent vs. 19 percent. Bone pain and reactions at the injection point were more common in the Leukine group but diminished over time.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with Crohn's disease.

* CAVEATS About 26 percent of the Leukine group and 16 percent of the placebo group quit the study, most citing side effects. Berlex, which makes Leukine and has financial ties to several of the study's authors, supported the study.

* FIND THIS STUDY May 26 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.

* LEARN MORE ABOUT Crohn's disease at www.ccfa.org and http://digestive.niddk.nih.gov.

-- Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.