NEW YORK, (Reuters Health) – Postmenopausal women with a high intake of dietary isoflavone have higher bone mineral density (BMD) than women whose isoflavone intake is low. However, isoflavone intake has no effect on the BMD of premenopausal women, Chinese researchers report.

Dr. Annie W. C. Kung, and colleagues from the University of Hong Kong, collected data for 650 Chinese women between 19 and 86 years of age. The researchers used a food frequency questionnaire to determine the intake of isoflavone. They also measured the women's BMD at the lumbar spine and hip.

After adjusting for age, height, weight, years since menopause, smoking, alcohol intake, hormone replacement therapy use, and daily calcium intake, postmenopausal women who had the highest intake of isoflavone had significantly higher BMD compared with postmenopausal women who had the lowest intake of isoflavone.

Mean BMD at the lumbar spine was 0.820 g/cm2 for postmenopausal women with the highest isoflavone intake compared with 0.771 g/cm2 for those with the lowest isoflavone intake (p < 0.05), the researchers found. This difference was also seen at Ward's triangle (0.450 g/cm2 versus 0.415 g/cm2, p < 0.05).

However, among premenopausal women, with high endogenous estrogen levels, no link between isoflavone intake and BMD was found, according to the report in the November issue of the Journal of Clinical Endocrinology and Metabolism.

Dr. Kung and colleagues conclude that "customary high isoflavone intake may help to reserve the state of secondary hyperparathyroidism associated with estrogen withdrawal and, hence, lower the rate of bone turnover in postmenopausal women."

J Clin Endrocrinol Metab 2001;86:5217-5221.

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[EPID] – CDC suspects coccidioidomycosis outbreak

Last Updated: 2001-12-13 16:16:55 EST (Reuters Health)

By Emma Hitt, PhD

ATLANTA (Reuters Health) – A UK resident has been diagnosed with coccidioidomycosis (Valley fever) after attending a model airplane show in Kern County California in October, and more cases among attendees could exist, according to the US Centers for Disease Control and Prevention (CDC).

Coccidioidomycosis is caused by inhalation of spores of the fungus Coccidioides immitis, which is endemic in the soil of Mexico and parts of the southwestern US and California.

British public health officials reported the case of the 72-year-old man to the CDC after he was tested because of flu-like symptoms approximately 1 week after the event.

"So far, we know of a couple of other possible cases, but we are waiting on laboratory tests to confirm them," Dr. Tom Clark with the CDC's National Center for Infectious Diseases told Reuters Health.

According to Dr. Clark, several suspected but unconfirmed cases have surfaced so far; "a couple in the US, one in Europe, and one in New Zealand–it seems like quite a few," he said.

The World Championship of Model Airplane Flying is an "international event with competing teams from 30 countries in the Americas, Europe, and the Pacific," CDC researchers note. "Each participating team had up to 11 members. In addition, several spectators may have traveled with each team," they write in the December 14th issue of the Morbidity and Mortality Weekly Report.

A picture taken at the event, included in the report, depicts a dusty haze around a few participants who are standing on soil and flying their model airplanes.

"Persons who attended this event and develop symptoms [flu-like illness with fever, chest pain, cough, malaise, chills, night sweats, arthralgias, and rash] should seek appropriate medical care," the CDC advises.

According to the CDC, infants, pregnant women, persons of Filipino and African descent, and immunosuppressed persons are at increased risk for disseminated infection.

"Clinical evaluation should include a serum specimen for IgG and IgM titers and appropriate cultures if evidence of disseminated disease exists," they write.

"A physician in endemic areas would be expected to know about coccidioidomycosis," Dr. Clark said. "But those in other areas and countries may miss the diagnosis. So, it's important for physicians, if they suspect a febrile illness, to consider testing for coccidioidomycosis," he said.

He also pointed out that clinicians should be especially careful to ask about recent travel history.

"CDC is undertaking an investigation into this outbreak, so any cases that physicians can report to the CDC would be especially useful," Dr. Clark said.

MMWR 2001;50:1106-1107.