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16 January 2007 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2653, or 215-351-2653.

Review: Growth Hormone Doesn’t Prevent or Reverse Changes of Aging in Healthy Elderly People and May Have Bad Side Effects

A review of published data on use of human growth hormone by healthy elderly people found that the synthetic hormone was associated with small changes in body composition but not in body weight or other clinically important outcomes (Review, p. 104). People who took GH had increased rates of unhealthy side effects such as soft tissue swelling, joint pain, carpal tunnel syndrome, and, in men, development of abnormally large mammary glands and were also somewhat more likely to develop diabetes. Authors say, “Although GH has been widely publicized as an anti-aging therapy …scant clinical experience of GH in the healthy elderly suggests that although GH may minimally alter body composition, it does not improve other clinically relevant outcomes … (and) is associated with high rates of adverse events. On the basis of available evidence, GH cannot be recommended for use among the healthy elderly.”

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In Danish Study, Survival of People with HIV Improves in Recent Years

A study of nearly 4,000 HIV-infected people in Denmark, matched with about 380,000 people who were not infected, found that people diagnosed with HIV infection between 1995-2005 had a shorter life expectancy (20 years beyond age 25) than the general population (51 years beyond age 25). However, the life expectancy of a 25-year-old person diagnosed with HIV infection has improved (33 years beyond age 25) for those diagnosed since 2000, when highly active antiretroviral therapy (HAART) became standard treatment. These findings show that HAART has transformed HIV infection into a chronic disease with a long, but not normal, lifespan (Article, p. 87).

Narcotics Are Often Prescribed for Back Pain but Efficacy Data are Poor and Chances for Abuse High, New Review Finds

A review of studies on use of narcotics for chronic back pain found that they are commonly prescribed and may help for short-term pain relief but that substance abuse disorders are common, occurring in up to 24 percent of cases (Review, p. 116). But many of the studies are of poor quality and none evaluated relief of pain lasting 16 weeks or longer.

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