vaccinations

MMR vaccine does not appear linked to serious disease.

* THE QUESTION With more than 90 percent of American children getting the MMR vaccine, which protects against measles, mumps and rubella (German measles), it's now rare for children to have these diseases. Nonetheless, questions of serious side effects -- particularly a suspected link to autism or bowel disease -- have dogged the vaccination process. Might these concerns be justified?

* THIS STUDY reviewed data from 31 studies, involving more than 12 million children who were given the MMR vaccine; some studies included comparison groups that were given a placebo or no injection. The analysis found that vaccinated children had fewer upper respiratory infections and more reported incidents, shortly after the shots, of irritability, fever and achy joints. It found no association between the vaccine and autism or such inflammatory bowel disorders as ulcerative colitis or Crohn's disease.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Children. Medical experts recommend, and many U.S. schools require, that children have the MMR vaccine, which is given in stages, usually starting when a child is 12 to 15 months old.

* CAVEATS The review did not report on the effectiveness of the vaccine, only on unintended effects. Not all of the studies reviewed included children who could be used for comparison with the vaccinated group.

* FIND THIS STUDY Oct. 19 online edition (Issue 4) of the Cochrane Library; abstract available at www.thecochranelibrary.com (search for "vaccines for measles," using quotation marks).

* LEARN MORE ABOUT childhood vaccines at http://kidshealth.org/parent and www.familydoctor.org.

alzheimer's disease

In short term, antipsychotic drugs may boost death risk.

* THE QUESTION The more severe behavioral changes that sometimes occur with Alzheimer's disease often are treated with antipsychotics. The drugs may calm the person's aggression, delusions or hallucinations, but do they carry substantial risks?

* THIS STUDY reviewed data from 15 studies, nine of them previously unreported, that had randomly assigned 5,110 people with dementia to be given an antipsychotic or a placebo. Drugs used in the studies were aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal). About 87 percent of the participants, who averaged 81 years old, had Alzheimer's, and most were women. After about 10 to 12 weeks, 118 people taking the drugs (3.5 percent) had died, compared with 40 in the placebo group (2.3 percent)

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with Alzheimer's or severe dementia. About 10 percent of people older than 65, and nearly half of those over 85, have Alzheimer's.

* CAVEATS The review did not differentiate risk by specific drug. Longer-term studies would be needed to determine whether risks would diminish or increase over time. Not all studies in the review included information on other medical conditions that may have affected the participants. Antipsychotics are approved by the Food and Drug Administration to treat schizophrenia but not to treat behavioral disorders in people with dementia; the agency has asked drug makers to note that on medication labels. Eight of the nine unreported studies were funded by drug manufacturers.

* FIND THIS STUDY Oct. 19 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT Alzheimer's disease at www.alz.org and www.alzinfo.org.

hypertension

Beta blockers may not be the most effective treatment.

* THE QUESTION Beta blockers, which make the heart beat more slowly and less forcefully, are among the most common drugs taken to lower blood pressure. They have been shown to prevent recurrences when used by heart attack survivors and people with heart failure, but is their popularity as an anti-hypertensive warranted?

* THIS STUDY reviewed the findings of 20 studies, involving 133,384 people with hypertension, that compared beta blockers with other antihypertensive drugs -- such as ACE inhibitors, calcium channel blockers and diuretics -- or with a placebo. The risk of stroke was 16 percent higher for people who took beta blockers, compared with those who took other drugs; it was not higher for a heart attack. Compared with no treatment, beta blockers reduced the risk of stroke by 19 percent, which the authors said was half the expected rate.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People who take beta blockers for hypertension. More than one in three Americans have high blood pressure, marked by a reading of 140/90 mmHg or higher. Normal pressure is less than 120/80.

* CAVEATS The review did not determine whether different dosages produced differing results. People take beta blockers for various reasons and should talk with their physician before making any changes.

* FIND THIS STUDY Oct. 18 online issue of The Lancet; abstract available at www.thelancet.com (click "Early Online Publication").

* LEARN MORE ABOUT treating hypertension at www.nhlbi.nih.gov/hbp 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.