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Women who take diabetes drugs known as thiazolidinediones, which include Avandia and Actos, are at a greater risk of bone fractures, a new study finds.

Women who took a thiazolidinedione drug for a year were 50 percent more likely to suffer a bone fracture than patients who didn’t take the drug, the researchers found. Women older than 65 were most vulnerable, with a 70 percent higher risk.

“Older women are already at a higher risk of osteoporosis and osteoporosis-related fractures, which might explain why they appeared to be the most affected,” study senior author Dr. L. Keoki Williams, of the Center for Health Services Research at Henry Ford Hospital, said in a news release.

Thiazolidinedione drugs — which include pioglitazone (Actos) and rosiglitazone (Avandia) — help people with type 2 diabetes better control their blood sugar levels. The drugs work by lowering resistance to insulin and cutting the amount of glucose made by the liver.

But doctors have worried in recent years about reports linking the drugs to bone loss and higher risk of fractures.

The researchers studied 4,511 patients who filled at least one prescription for a thiazolidinedione between 2000 and 2007 at Henry Ford Hospital. Men were not found to be at higher risk of fracture in this study group, the study authors noted in the news release, although other recent research has suggested such a link.

The findings are published in the February issue of the Journal of Clinical Endocrinology & Metabolism.

The drugs “may put some patients at increased risk for other health issues, and I encourage patients to talk with their physician about other suitable options,” Williams added.

People who think they’re protecting their lungs by smoking pipes or cigars instead of cigarettes are kidding themselves, a new study shows.

“Inhalation of tobacco smoke by any means is deleterious,” said Dr. R. Graham Barr, assistant professor of medicine and epidemiology at Columbia University Medical Center and lead author of a report in the Feb. 16 issue of Annals of Internal Medicine.

The cancer-causing danger of any kind of smoking has been well-publicized by the American Cancer Society and the U.S. National Cancer Institute, among others. But some smokers believe cigars or pipes can lessen respiratory danger because they think the smoke isn’t inhaled, Barr said.

To test that notion, he and his colleagues looked at the effects of cigar or pipe smoking in more than 3,500 adults ages 48 to 90 who were participants in a study of heart disease. Of these, nine of every 100 said they had smoked a pipe at some time and 11 of every 100 said they had smoked cigars.

To determine whether smoke was inhaled, the researchers measured blood levels of cotinine, a byproduct of metabolized nicotine.

Among pipe or cigar users, they found cotinine levels lower than those produced by cigarette smoking but nevertheless significant.

“For pipe smoking, it was 20 percent compared to cigarette smoking, and for cigars it was 10 percent,” Barr said. “Less, but still quite considerable.”

The effect of smoking on breathing ability was measured by spirometry, a lung function test in which people blow into a tube to determine the maximum amount of air they can move in one second.

Pipe or cigar smokers had more than twice the incidence of airway obstruction than nonsmokers, and the degree of obstruction increased with the amount of smoking, the researchers found.

The study was done because there has been a noticeable shift away from cigarettes to pipes and cigars, partly because of health warnings, partly because of heavy taxes on cigarettes, Barr said.

“There haven’t been good data in the United States from a large study showing that first, people who smoke cigars and pipes inhale the smoke and second, that on a long-term basis they have damage to their lungs,” he said.

The study results show clearly that cigar and pipe smokers are exposed to toxins and run the risk of developing chronic obstructive pulmonary disease (COPD), a progressive destruction of airways than can be crippling. Emphysema and chronic obstructive bronchitis are the two major forms of COPD, which is a leading cause of death among U.S. adults.

“Physicians should consider pipe and cigar smoking a risk factor for chronic obstructive pulmonary disease and counsel their patients to quit,” Barr said.

“There is a public perception that this is a safer habit,” said Dr. Neil Schachter, professor of medicine and community medicine at Mount Sinai Medical Center in New York City. Tobacco companies have promoted that perception, he said.

“Cigarette companies realize there is a decreasing demand for cigarettes and have tried to push tobacco products in different ways,” Schachter said. “They have been able to promote this image that smoking cigars and pipes is safer than smoking cigarettes. This article goes a long way toward showing this is not true.”

Smokers don’t often pursue medical advice about smoking, he said. “It is something patients don’t go to doctors to ask about,” Schachter said.”‘What should I smoke’? The answer is, ‘Nothing’.”

SOURCES: R. Graham Barr, M.D., Dr.P.H., Florence Irving assistant professor of medicine and epidemiology, Columbia University Medical Center, New York City; Neil Schachter, M.D., professor, medicine and community medicine, Mount Sinai Medical Center, New York City

People with high-functioning autism or Asperger’s syndrome were better able to “catch” social cues after inhaling the hormone oxytocin, new research shows.

Oxytocin,which is produced in abundance when a mother is breast-feeding her baby, is known as the “bonding” hormone.

Although there are many kinks to be worked out, experts feel the strategy holds promise to treat one of the core symptoms of autism spectrum disorder.

“When you start thinking of a hormone that can actually encourage pro-social behavior, you’re talking about potentially significant changes in quality of life,” said Clara Lajonchere, a vice president of clinical programs at the advocacy group Autism Speaks and a clinical assistant professor at the Keck School of Medicine, University of Southern California.

“In the absence of intellectual deficits, the areas where they have the greatest struggle is around social communication and social connectedness,” she continued. “These people can’t interpret other people’s perceptions, they can’t read social cues, they don’t make eye contact.”

While there are drugs for the secondary symptoms of autism, such as irritability and aggression, doctors have nothing yet for the core symptoms in the areas of language, social interaction and intellectual deficits.

Prior studies have shown a strong effect of oxytocin on people with autism, as well as on people who are not on the autism disorders spectrum. One study found that autistic people seem to have a lower sensitivity to oxytocin than people without the disorder.

“There’s no doubt that oxytocin has a big effect on social interactions in anyone. It’s almost like a designer drug, a drug which has a selective effect on a behavior in the normal range,” said Keith Young, vice chairman of research in psychiatry and behavioral science at the Texas A&M Health Science Center College of Medicine in Temple and the neuroimaging and genetics core leader at the VA Center of Excellence for Research on Returning War Veterans at the Central Texas Veterans Health Care System.

The new study, led by Angela Sirigu at the Center for Cognitive Neuroscience in Lyon, France, was published in this week’s issue of Proceedings of the National Academy of Sciences. It involved 13 adults, most of them men, aged 17 to 39. All had high-functioning autism or Asperger’s syndrome.

Participants performed different tasks — either after inhaling oxytocin or without using the hormone.

When observed playing a virtual ball game, individuals who had inhaled oxytocin were able to interact better with their virtual partners compared to untreated participants.

Also, after inhaling oxytocin, participants showed more alertness to socially important visual cues in pictures of human faces.

There were, however, wide variations in individual responses, the team noted.

“It’s not clear whether this would be effective at all in children or in young adults who had intellectual problems,” warned Young.

The long-term effects of the hormone are also uncertain.

“I really want to encourage clinical trials in this area because of its potential significance, but we have to be very careful in terms of safety data,” Lajonchere said. “Safety data is really critical.”

Also, scientists would need to come up with a different method of delivery, Young said.

“The nasal [inhaled] drugs only work for a few minutes. Potentially it would be very difficult to be using this drug once an hour or something. It doesn’t make a whole lot of sense,” he pointed out. “But it does point the way to the possibility of raising oxytocin levels with other kinds of compounds to increase oxytocin levels more generally over a longer period of time. I don’t know whether this is a realistic therapy as we have it now but, potentially, in the future it could really help these people whose primary autistic symptoms are having to do with reduction in social activity.”

SOURCES: Clara Lajonchere, Ph.D., vice president, clinical programs, Autism Speaks, and clinical assistant professor, Keck School of Medicine, University of Southern California; Keith Young, Ph.D., vice chairman, research in psychiatry and behavioral science, Texas A&M Health Science Center College of Medicine, Temple, and neuroimaging and genetics core leader, VA Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System