WEDNESDAY, April 9 (HealthDay News) -- The osteoporosis drug raloxifene is safe and effective for women with mild to moderate chronic kidney disease (CKD), a condition that increases osteoporosis risk, according to a new study.

The use of osteoporosis drugs in women with CKD has been controversial because it wasn't known if the drugs were safe for these women.

In this study, Dr. Areef Ishani, of the Minneapolis VA Medical Center and University of Minnesota, and colleagues analyzed data on 7,705 postmenopausal women with osteoporosis who took part in the Multiple Outcomes of Raloxifene Evaluation (MORE) trial.

The authors examined raloxifene effects over three years on the rate of bone mineral density, incidence of fractures, and adverse effects in women with and without CKD. They found that women with and without CKD had a greater increase in spine bone mineral density and a reduction in vertebral fractures than women taking a placebo. Women taking the drug -- especially those with mild to moderate CKD -- also had increased hip bone mineral density.

The findings were published online Wednesday and were expected to be published in the July print issue of the Journal of the American Society of Nephrology.

The study authors said their findings have significant clinical relevance, because many postmenopausal women have unidentified CKD. This study shows that raloxifene is safe and effective in women with decreased kidney function, information that will help doctors provide better care for these patients.

The study was released during National Women's Health Week, which includes initiatives to encourage women to make their health a top priority and to take steps to have a longer, healthier and happier life. The ways they can achieve this include physical activity, nutritious diet and preventive health screenings, such as bone density tests.

More information

The American Academy of Family Physicians has more about chronic kidney disease  .

TUESDAY, March 18 (HealthDay News) -- In fields as varied as heart disease, bone health and post-traumatic stress disorder (PTSD), an explosion of knowledge in genetics is poised to revolutionize medicine, said scientists gathered at a special news conference Tuesday.

The findings are highlighting why some people appear to be more vulnerable to certain illnesses than others -- and how they might be helped.

"People are trying to get a better understanding of disease causes and how genes underlie that," said Dr. Georgia Wiesner, director of the Center for Human Genetics at University Hospitals Case Medical Center in Cleveland. "Genetics and genomics are giving us a better biological understanding and then we can start to develop therapies."

Wiesner and others spoke at a conference to unveil results of a number of studies in the March 19 issue of the Journal of the American Medical Association, a theme issue focused on genomic medicine.

The identification of genes that are key to disease is greatly advancing diagnostics and scientific research, one expert said.

"There has been a big shift in the practice of genomic medicine. When genes are discovered, this translates very quickly into the availability of genetic tests," noted Dr. Maren T. Scheuner of the nonprofit RAND Corporation in Santa Monica, Calif. "Fifteen years ago, there were 100 genes for which tests were available. Today, there are about 1,500 of these genes. Things are really moving rapidly."

In one of the JAMA studies, scientists found that lowered activity of a gene called paraoxonase 1 (PON1), which is linked to HDL or "good" cholesterol, may be related to a higher risk of developing adverse cardiac events. The gene has both anti-inflammatory and antioxidant activities and had been shown to protect against atherosclerosis ("hardening of the arteries") in mice.

Although the findings will not immediately impact clinical practice, they do provide a focus for future research into both prevention and treatment of heart disease, said the study's senior author, Dr. Stanley L. Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Foundation.

"The test is not available for clinical practice, but the long-term impact is that we now have a way of helping to identify individuals who are at risk," he told reporters. "We also know a pathway that is mechanistically linked to the disease process. This serves as a way of focusing attention on this gene [for prevention and therapy]."

A second study of more than 37,000 participants found that variants of the LRP5 gene are associated with an increase in the risk of bone fractures (up to 20 percent), as well as lowered bone mineral density.

"This gene by itself changes the risk of osteoporosis only by a small amount," stressed lead author Joyce B. J. van Meurs, of the department of internal medicine at Erasmus Medical Center in Rotterdam, the Netherlands. She added that, going forward, "several genes need to be discovered to make a robust, useful clinical tool for osteoporosis and that's what we're going to do."

A third study found that adults who experienced abuse during childhood and who also have variations in the FKBP5 gene were at greater risk for symptoms of PTSD as adults. The gene is related to the stress response which, in PTSD, appears unable to turn itself down after a trauma or series of traumas, explained study co-author Rebekah G. Bradley of the departments of psychiatry and behavioral sciences at Emory University School of Medicine and the Atlanta VA Medical Center.

The study was conducted in a low-income, urban population of Atlanta where 25 percent of participants reported symptoms consistent with PTSD -- high even when compared to rates experienced by recently returned combat veterans from Iraq.

The stress-linked gene variations "may predict both risk and resilience to PTSD among survivors of [childhood abuse]," Bradley explained. "The gene was not related to depression," she added.

Still, putting genomics into everyday medical practice is in its infancy, Scheuner's study suggested. Her team at the RAND Corporation found that the healthcare workforce is woefully unprepared for the dawning genetic area, especially as more tests are developed for common diseases.

"We need to educate the workforce about the role of genetics in disease and risk assessment and the potential for new therapeutics, and we need to think about training more genetic professionals who have a background in adult medicine," Scheuner said. "We need to understand how this information is going to fit into the way we practice medicine, how it makes a difference for patients, and how best to deliver services."

More information

There's more on genomics at the National Human Genome Research Institute.

WEDNESDAY, Oct. 10 (HealthDay News) -- When it comes to picking footwear, runners should follow Prince Charming's lead and consider a shoe's fit, not its price tag, new research suggests.

Using high-tech methods, a team of Scottish scientists found no differences in either comfort or shock absorption between $80 pairs of running shoes and pairs made by the same companies costing more than $150.

"My advice to runners is to make sure that, first, the footwear fits your feet, and that if you are paying more, that doesn't mean that you're getting something better," said lead researcher Rami Abboud, director of the Institute of Motion Analysis and Research at the University of Dundee.

His team published its findings Oct. 10 in the online edition of the British Journal of Sports Medicine.

Over the past few decades, the lowly sneaker has been transformed from a humble canvas-topped loafer to something that, according to advertisers, uses space-age technology to protect and enhance the human foot. Those lofty claims often come with lofty prices, however.

"What we wanted to check was, are you really getting value for money?" Abboud said. "Or are you just paying for advertisement?"

In their study, the Scottish researchers had 43 men, averaging about 29 years of age, try on nine pairs of running shoes -- three models each from three of the world's leading manufacturers. The men were sizes ranging from 8 to 10 (considered average male foot sizes) and had no foot or gait abnormalities.

The retail price of each of the three shoes within each brand spanned in price from $80-$90, $120-$130, and $140-$150, respectively. The men had no way of knowing the brand or cost of the shoes they were testing.

Participants were asked to test out the footwear and give the researchers a subjective assessment of each shoe's comfort. They also ran in the shoes while wearing high-tech sensors that gauged pressures at various points on the foot, including plantar pressure, the force generated by the impact of the sole hitting the ground.

"I believe that sports manufacturers are using similar, if not the same, equipment for measuring pressure inside the shoes," Abboud said.

Tabulating the results, the researchers reported no significant differences in comfort between the shoes, regardless of their price.

When it came to shock absorption, some shoes performed better than others on different areas of the foot, but no clear pattern emerged. In fact, plantar pressure was actually lower for the cheap-to-moderately priced footwear compared to more high-end gear, although this difference did not reach statistical significance, the researchers said.

"The perception is that if you pay more, you might end up having something more protective within the shoes, but that's something that we just couldn't find," Abboud said. "From what we found, [the difference] seems to be pure advertisement."

Efforts by HealthDay to reach shoe manufacturers Nike and Adidas for comment were unsuccessful.

Podiatrists and footwear experts have their own views on the findings.

"I don't think there's anything shocking in this article -- to find out that maybe some of the high-end running shoes really aren't necessary for the average person that's running," said Dr. James Christina, a podiatrist and director of scientific affairs at the American Podiatric Medical Association. Big-name companies "come out with a new model [of running shoe] every year," he said. "How much of an improvement has really been made?"

But he also pointed out that people who buy sneakers are paying for a shoe's longevity, not just its comfort and protection.

The Scottish study is just a "snapshot of the cushioning ability of that shoe in time," Christina noted. "It would have been interesting to have the subjects run a certain length of time, a certain schedule of months or a year, and then compare how the cushioning held up."

Another expert agreed, and added that fit -- not price tag -- should remain the most important consideration when selecting shoes.

The study's methodology "didn't tell me if the shoes are appropriate for a particular runner," said Dr. Gerard Varlotta, director of sports rehabilitation at the Rusk Institute of Rehabilitation Medicine, part of New York University Medical Center.

"You have to not look at the price but look at the sneaker itself," he said. "Is someone who runs 300 miles a week the same as someone who runs 3 miles a week?"

Bruce Wilk is a physical therapist, a former board member of the American Medical Athletic Association and owner of the Runner's High, a Miami store catering to avid runners. He said too many runners just try on a few sneakers in a store without giving them a "test run."

They "often spend money on something that just doesn't fit," he said. "New shoes always feel 'comfortable' -- if it doesn't dig in or squeeze my foot, then, hey, it's comfortable. But when they have a real good run in it, and you teach them what to look for, that's a whole other thing."

To that end, Wilk has customers run in a variety of sneakers on a treadmill before they pick the shoe they think is right for them.

As for cost, Wilk agreed that "at $80 versus $200, there really may not be a big advantage at all. It's just how the shoe feels to the beholder."

Varlotta agreed. "You don't have to go to the most expensive [shoe] to get something that's adequate for your needs," he said, "just like you don't need a Bentley to get a nice smooth ride."

More information

There's more on selecting the right running shoe at the American Academy of Podiatric Sports Medicine  .