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French drugmaker Sanofi-Aventis SA has warned that its antidepressant Norpramin should be given with extreme caution to patients with a history of certain heart problems, the U.S. Food and Drug Administration said on Wednesday.

The label for Norpramin (desipramine hydrochloride tablets USP) will also warn that seizures precede abnormal heart rhythms and death in some patients. The heart conditions include a family history of sudden death, abnormal heart rhythms, and heart conduction disturbances.

The company’s letter to FDA and health professionals also said an overdose of Norpramin has shown a higher death rate than overdoses of other tricyclic antidepressants.

If you’re a middle-age weekend warrior who likes to hit the basketball court or hockey rink, take note: A new study suggests that high levels of physical activity boost the risk of internal knee damage that could lead to osteoarthritis.

The study found that the injuries occurred in middle-age people who showed no symptoms and had a healthy weight. They were more common and more severe in those who exercised more, although lower-impact activities such as swimming and cycling might actually be beneficial, according to the researchers.

The findings “speak to the importance of low-impact aerobic activity, especially in knees that are aging and may not be as resilient as they used to be,” said Dr. Joseph Guettler, an orthopedic surgeon and sports medicine specialist at William Beaumont Hospital in Bingham Farms, Mich.

The problem is that bone and cartilage in the knee can develop cracks and fissures that worsen over time, “much as a pothole or crack in the pavement can become significant as cars keep driving over that area,” said Guettler, who’s familiar with the study findings but didn’t take part in the research.

When people develop these sorts of problems, “we know that they’re going to have an increased risk for arthritis later on in life,” he said.

Osteoarthritis, the most common form of arthritis, develops when cartilage deteriorates in joints and causes bones to rub against each other.

In the study, radiologists examined MRI scans of the knees of 236 people who had enrolled in an osteoarthritis study. The participants, aged 45 to 55, included 136 women and 100 men. All participants completed questionnaires about their physical activity levels, which formed the basis for their assignment to high-, medium- or low-level activity groups.

The researchers then looked for links between levels of physical activity and the health of the participants’ knees. The findings were to be presented Monday in Chicago at the annual meeting of the Radiological Society of North America.

Those who engaged in high levels of physical activity — including such things as sports, exercise, yard work and housework — had the highest levels of injuries. The injuries included fluid buildup in bone marrow and lesions in cartilage and ligaments.

“This study and previous studies by our group suggest that high-impact, weight-bearing physical activity, such as running and jumping, may be worse for cartilage health,” the study’s co-author, Dr. Christoph Stehling, a research fellow in the radiology and biomedical imaging department at the University of California, San Francisco, said in a news release. “Conversely, low-impact activities, such as swimming and cycling, may protect diseased cartilage and prevent healthy cartilage from developing disease.”

Guettler, the Michigan surgeon, said that activities involving twisting, jumping and pivoting are especially hazardous. Don’t overdo it when it comes to activities like basketball and soccer, he advised.

Instead, consider alternatives like walking, swimming, biking, cross-country skiing and training on elliptical machines, he said.

The researchers’ next goal is to figure out whether low-impact and high-impact physical activity affect the progression of osteoarthritis differently, Stehling added.

Low-carb and high-carb diets work equally well for maintaining weight loss, Australian researchers report.

People had the same success in keeping off the weight they’d lost after sharply cutting their calorie intake for 3 months if they followed a low-carb (also called high-protein) diet or a high-carbohydrate regimen for the following year, Dr. Elizabeth A. Delbridge of the Heidelberg Repatriation Hospital in Victoria and her colleagues found.

Some studies have suggested that high protein diets may be a more effective way to lose weight short-term than high carbohydrate diets, Delbridge and her team note in their report. But there’s less evidence on which approach might be better for helping people to keep off weight they’ve lost, and whether the two diets have different effects on heart health.

To investigate, Delbridge and her team assigned 141 men and women who’d completed the weight-loss phase of the diet to a year on a diet in which 30 percent of their calories came from protein, or one consisting of 15 percent protein. Both groups also were instructed to keep their fat intake below 30 percent of total calories, and to focus on reducing saturated fat.

The study participants had lost 16.5 kilograms (36.4 pounds), on average, and only regained 2 kilograms, or about four pounds, over the following year.

While all the study participants saw their blood pressure go down as they lost weight, average blood pressure went up in the high-carbohydrate group during the weight maintenance phase, but the high-protein dieters were able to sustain their blood pressure reduction.

While people found it easy to stick to the high protein diet, Delbridge and her team say, the low-protein dieters “struggled to consume the recommended amount of carbohydrate (55%) and to limit their protein intake to 15%.”

But the low protein group still managed to keep their protein intake at about 22 percent of their calories, significantly below the 30 percent maintained by the high-protein dieters. And there was no significant difference between the two groups in the amount of weight they kept off.

The findings show, the researchers conclude, that “free-living overweight and obese people” (as opposed to those studied in an inpatient clinic, for example) were able to stick with recommended diet and keep off the weight they had lost for 12 months.