OSTEOARTHRITIS

Knee pain and stiffness seem to respond to acupuncture.

* THE QUESTION People with chronically aching knees, caused by worn-away cartilage and cushioning, often turn to painkilling drugs to keep themselves moving. But gastrointestinal side effects and heart risks make these medications a difficult option for some. Might acupuncture offer a viable alternative?

* THIS STUDY randomly assigned 294 people with osteoarthritis of the knee to 12 acupuncture treatments, to fake acupuncture (with the needles only superficially inserted and not at acupuncture points) or to a waiting list. They could continue taking painkilling nonsteroidal anti-inflammatory drugs if needed. About one-third of the participants had been treated previously with acupuncture. After eight weeks, knee pain and stiffness had decreased to half its original level in 52 percent of the acupuncture group, 28 percent of the fake acupuncture group and 3 percent of those on the waiting list. Use of painkillers dropped much more in the two acupuncture groups, compared with the waiting list group. Six months after treatment stopped, the differences in pain and motion had disappeared.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with osteoarthritis, the most common arthritis among Americans. Before age 45, it affects men more than women; after 45, more women have it. Age, obesity, overuse and injury are believed to contribute to its development.

* CAVEATS Findings were based on the participants' ratings of their pain, which may vary by an individual's perception of tolerable discomfort. Eighty-eight percent of the participants indicated that they believed acupuncture would help their condition, which may have affected their ratings.

* FIND THIS STUDY July 9 issue of The Lancet; abstract available online at www.thelancet.com.

* LEARN MORE ABOUT osteoarthritis at www.arthritis.org and www.niams.nih.gov.

aUTISM

Schizophrenia drug may help quell disruptive behavior.

* THE QUESTION The medication generally used to treat children with the aggressive, disruptive behavior that often accompanies autism worries some parents because of the potential for neurological side effects. Might risperidone -- a newer medication, used with few side effects by adults with schizophrenia -- work for autistic children?

* THIS STUDY involved 63 youths, 5 to 17 years old and mostly boys, who had benefited from having taken risperidone for eight weeks. All participants took the drug for 16 weeks more. Overall, about 83 percent were described as much or very much improved in their behavior after the additional 16 weeks, 9 percent improved mildly and 8 percent recorded worse behavior. The participants then were randomly assigned to continue taking risperidone or have it withdrawn gradually and replaced with a placebo. Disruptive behavior returned quickly among those in the placebo group, and it returned in both groups once they completed the study.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Autistic children who exhibit aggressive, disruptive behavior.

* CAVEATS Those taking risperidone gained an average of 11.2 pounds in six months, more than is typical for their ages. The authors speculated that more gradual tapering of the dose may have allowed the behavioral improvements made during treatment to be maintained longer. Longer-term use of the drug was not evaluated.

* FIND THIS STUDY July issue of the American Journal of Psychiatry; abstract available online at http://ajp.psychiatryonline.org.

* LEARN MORE ABOUT autism at www.autism-society.org and www.ninds.nih.gov/disorders.

metabolic syndrome

Fitness level seems linked to the risk of a common disorder.

* THE QUESTION Among its many benefits, exercising regularly can help people control their weight, lower their blood pressure and keep their cholesterol levels in check. Because these factors, clustered together, all contribute to metabolic syndrome, might people's fitness level affect the likelihood of their developing this disorder?

* THIS STUDY analyzed medical data on 10,498 adults, predominantly men, taking part in a long-term study of cardiorespiratory fitness. Participants' fitness levels -- low, moderate or high -- were determined by treadmill exercise tests. Other checks included blood pressure, cholesterol and glucose levels, height and weight. During the six-year analysis period, 1,402 people (who averaged 44 years old) were diagnosed with metabolic syndrome. Men deemed moderately fit were 26 percent less likely to develop the disorder than were those in the lowest fitness category; highly fit men were 53 percent less likely. Moderately and highly fit women were, respectively, 20 percent and 63 percent less likely than the least fit women to develop the syndrome.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with three or more risk factors for metabolic syndrome, which include excess weight, high blood pressure, high triglycerides, low high-density lipoprotein cholesterol and high fasting glucose levels. About one in five people in the United States has metabolic syndrome, which raises the risk of diabetes, heart disease and stroke. Among people over 60, more than 40 percent are thought to have the disorder.

* CAVEATS Most participants were white, and few were older than 60; whether the findings would apply to other groups is unclear. The study was not randomized.

* FIND THIS STUDY July 11 online issue of Circulation; abstract available at www.circulationaha.org (click "Rapid Access").

* LEARN MORE ABOUT metabolic syndrome at www.clevelandclinic.org/health and www.mayoclinic.com.

-- 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.