Health Technology Research Synopsis 105th Issue Date 15MAY2011 Compiled By Ralph Turchiano http://www.vit.bz
Editors Top Five:
1. Drug regulators are protecting profits over patients, warn researchers
2. Washing with contaminated soap increases bacteria on hands
3. ‘Bad’ Cholesterol Not As Bad As People Think, Shows Texas A&M Study Texas A&M News & Information Service
4. DNA from common stomach bacteria minimizes effects of colitis, U-M study says
5. Natural protection against radiation
In This Issue:
1. Public confused about ingredients in pain relievers
2. U of I study: Before you start bone-building meds, try dietary calcium and supplements
3. Washing with contaminated soap increases bacteria on hands
4. Antioxidant may prevent alcohol-induced liver disease
5. Limitations of evidence base for prescribing aripiprazole in maintenance therapy of bipolar disorder
6. Study evaluates relationship of urinary sodium with health outcomes
7. Ecstasy associated with chronic change in brain function
8. US must strengthen efforts to restrict chemicals that threaten health, say researchers
9. Natural protection against radiation
10. New evidence that caffeine is a healthful antioxidant in coffee
11. Research Holds Promise for Heart Failure Patients
12. Estimated costs of environmental disease in children at $76.6 billion per year
13. Study suggests prolonged bottle feeding increases the risk of obesity
14. Study adds weight to link between arsenic in drinking water and heart disease
15. ‘Bad’ Cholesterol Not As Bad As People Think, Shows Texas A&M Study Texas A&M News & Information Service
16. DNA from common stomach bacteria minimizes effects of colitis, U-M study says
17. Bill Gates Talks About Vaccines to Reduce World Population
18. Short term use of painkillers could be dangerous to heart patients
19. Parsley, Celery Carry Crucial Component for Fight Against Breast Cancer, MU Researcher Finds
20. Coffee reduces breast cancer risk
21. Drug regulators are protecting profits over patients, warn researchers
22. Vitamin D deficiency in pneumonia patients associated with increased mortality
23. Beneficial Bacteria Help Repair Intestinal Injury by Inducing Reactive Oxygen Species
24. Study finds highest reported BPA level in pregnant woman and associated abnormalities in infant
25. Lack of exercise linked to higher heart disease risk in healthy children as young as 9
Public release date: 2-May-2011
Public confused about ingredients in pain relievers
Study seeks to raise awareness of ingredients such as acetaminophen to prevent harm
CHICAGO — People take billions of doses of over-the-counter pain relievers like Tylenol every year, but many do not pay attention to the active ingredients they contain, such as acetaminophen, according to a new Northwestern Medicine study. That lack of knowledge about popular pain relievers plus particular ignorance of acetaminophen’s presence in more than 600 over-the-counter and prescription medicines could be a key reason acetaminophen overdose has become the leading cause of acute liver failure in the U.S.
The study reported only 31 percent of participants knew Tylenol contained acetaminophen. In addition, 75 percent of participants knew Bayer contained aspirin; 47 percent knew Motrin contained ibuprofen; 19 percent knew Aleve contained naproxen sodium; and 19 percent knew Advil contained ibuprofen.
The solution proposed by the researchers is to develop a universal icon for acetaminophen that would appear on all medicine labels.
“It’s incredibly alarming,” said Michael Wolf, an associate professor of medicine at Northwestern University Feinberg School of Medicine and senior author of the study that will be published May 3 in the American Journal of Preventive Medicine.
“People may unintentionally misuse these medicines to a point where they cause severe liver damage,” Wolf said. “It’s easy to exceed the safe limit if people don’t realize how much acetaminophen they are taking. Unlike prescription products, there is no gatekeeper, no one monitoring how you take it.”
Individuals don’t understand they may be taking the drug simultaneously in multiple medications, said Jennifer King, lead author of the paper and project leader for medication safety research in Feinberg’s Health Literacy and Learning Program.
The study found only 41 percent of participants read the ingredients on drug labels.
“When you have pain, you aren’t paying attention to what’s in a medicine, you just want relief,” King said. “People think ‘if I can buy it without a prescription, it can’t be harmful’. They don’t realize exceeding the maximum dose can cause liver damage.”
It may also be difficult to identify the drugs in some medicine. Acetaminophen is called APAP on prescription medications. “It’s confusing, so even if a person is looking for acetaminophen on the label,
she wouldn’t know APAP is the same ingredient in her Tylenol,” King said.
In addition to proposing a universal icon for acetaminophen on all medications, consumer focus groups suggested manufacturers place an icon on Tylenol that resembles a red stop sign indicating the maximum dose in 24 hours. Consumers also said they would like to see a more clear warning about potential liver damage on the package.
Wolf and King launched the study after a Food and Drug Administration panel in 2009 determined there was little concrete evidence showing how consumers misuse over-the-counter products. The Feinberg School team focused on acetaminophen because its misuse was of particular interest to the FDA.
Researchers interviewed 45 individuals in six focus groups during 2010 in Chicago and Atlanta. The interviews evaluated knowledge of over-the-counter pain relievers, attention to product label information and literacy level. Forty-four percent of participants, all English speakers, read at or below the sixth-grade level — a low-literacy group at highest risk for drug misuse.
Public release date: 2-May-2011
U of I study: Before you start bone-building meds, try dietary calcium and supplements
URBANA – Has a bone density scan placed you at risk for osteoporosis, leading your doctor to prescribe a widely advertised bone-building medication? Not so fast! A University of Illinois study finds that an effective first course of action is increasing dietary calcium and vitamin D or taking calcium and vitamin D supplements.
“For many people, prescription bone-building medicines should be a last resort,” said Karen Chapman- Novakofski, a U of I professor of nutrition and co-author of a literature review published in a recent issue of Nutrients.
The study reported that adults who increase their intake of calcium and vitamin D usually increase bone mineral density and reduce the risk for hip fracture significantly. These results were often accomplished through supplements, but food is also a good source of these nutrients, she said.
“I suspect that many doctors reach for their prescription pads because they believe it’s unlikely that people will change their diets,” she noted.
The scientist said that prescription bone-building medications are expensive, and many have side effects, including ironically an increase in hip fractures and jaw necrosis. They should be used only if diet and supplements don’t do the trick.
“Bisphosphonates, for instance, disrupt normal bone remodeling by shutting down the osteoclasts— the cells that break down old bone to make new bone. When that happens, new bone is built on top of old bone. Yes, your bone density is higher, but the bone’s not always structurally sound,” she said.
A bone density test measures quantity, not quality, of bone. “Although the test reports that you’re fine or doing better, you may still be at risk for a fracture,” said Chapman-Novakofski.
A woman in midlife can get enough calcium in her diet without gaining weight, said lead author Karen Plawecki, director of the U of I’s dietetics program.
“Menopausal women should consume 1,200 milligrams of calcium a day. Three glasses of 1 percent to
skim milk will get you up to 900 milligrams. The rest can easily be obtained through calcium-rich and calcium-fortified foods,” Plawecki said.
According to Plawecki, the number of foods fortified with calcium and vitamin D is increasing exponentially. Examples are soy milk, orange juice, yogurt, crackers, cereal, bread, breakfast bars, and even pancakes.
The researchers also looked at the effects of dietary protein, vitamin K, soy, and sodium in their literature review. The new USDA food pyramid guidelines recommend that Americans decrease their sodium intake.
“Following a low-sodium diet does seem to have a positive effect on bone density. Some people have the habit of adding a generous sprinkle of salt to most foods before eating, but there’s more involved here than learning not to do that. You have to choose different foods,” Plawecki said.
Smoked or processed meats, bacon, lunch meat, and processed foods all contain a lot of sodium and could sabotage bone health. “Cheese is also very high in sodium so try to get your calcium some other way more often,” Plawecki said.
She recommends a “portfolio diet” that contains a number of nutrients, not just extra calcium and vitamin
D. For bone health, the researchers also encourage consuming adequate protein, less sodium, and more magnesium and potassium.
“That can be done by following a diet that’s high in fruits and vegetables, has adequate calcium and protein, and is light on salt,” she said.
Chapman-Novakofski noted that the National Osteoporosis Foundation recommends more physical activity. She suggests a combination of aerobic, strength, balance, and flexibility exercises with a focus on improving your core muscles so you can catch yourself if you start to fall.
Whatever sort of exercise you’re doing, you have to introduce new forms of activity every so often because your bones will stop responding to the same old routine and rebuilding will slow, she said.
Plawecki and Chapman-Novakofski set out to determine the impact of dietary, supplemental, and educational interventions over the last 10 years and reached their conclusions after reviewing 219 articles in scientific journals.
Public release date: 2-May-2011
Washing with contaminated soap increases bacteria on hands
People who wash their hands with contaminated soap from bulk-soap-refillable dispensers can increase the number of disease-causing microbes on their hands and may play a role in transmission of bacteria in public settings according to research published in the May issue of the journal Applied and Environmental Microbiology.
“Hand washing with soap and water is a universally accepted practice for reducing the transmission of potentially pathogenic microorganisms. However, liquid soap can become contaminated with bacteria and poses a recognized health risk in health care settings,” says Carrie Zapka from GOJO Industries in Akron Ohio, the lead researcher on the study that also included scientists from BioScience Laboratories in Bozeman, Montana and the University of Arizona, Tucson.
Bulk-soap-refillable dispensers, in which new soap is poured into a dispenser, are the predominant soap
dispenser type in community settings, such as public restrooms. In contrast to sealed-soap dispensers, which are refilled by inserting a new bag or cartridge of soap, they are prone to bacterial contamination and several outbreaks linked to the use of contaminated soap have already been reported in healthcare settings.
In this study Zapka and her colleagues investigated the health risk associated with the use of bulk-soap- refillable dispensers in a community setting. They found an elementary school where all 14 of the soap dispensers were already contaminated and asked students and staff to wash their hands, measuring bacteria levels before and after handwashing. They found that Gram-negative bacteria on the hands of students and staff increased 26-fold after washing with the contaminated soap.
“This is the first study to quantitatively demonstrate that washing hands with contaminated liquid soap actually increases the number of Gram-negative bacteria on hands. Furthermore, the results directly demonstrate that bacteria from contaminated hands can be transferred to secondary surfaces,” says Zapka.
Zapka notes that all the participants’ hands were decontaminated after testing by washing with uncontaminated soap followed by hand sanitizer. At the conclusion of the study, all the contaminated soap dispensers were replaced with dispensers using sealed-soap refills. After one year of use, not one of them was found to be contaminated.
Public release date: 2-May-2011
Antioxidant may prevent alcohol-induced liver disease
BIRMINGHAM, Ala. – An antioxidant may prevent damage to the liver caused by excessive alcohol, according to new research from the University of Alabama at Birmingham. The findings, published online April 21, 2011, in the journal Hepatology, may point the way to treatments to reverse steatosis, or fatty deposits in the liver that can lead to cirrhosis and cancer.
The research team, led by Victor Darley-Usmar, Ph.D., professor of pathology at UAB, introduced an antioxidant called mitochondria-targeted ubiquinone, or MitoQ, to the mitochondria of rats that were given alcohol every day for five to six weeks in an amount sufficient to mirror excessive intake in a human.
Chronic alcoholics, those who drink to excess every day, experience a buildup of fat in the liver cells. When alcohol is metabolized in the liver, it creates free radicals that damage mitochondria in the liver cells and prevent them from using sufficient amounts of oxygen to produce energy. Moreover, the low- oxygen condition called hypoxia worsens mitochondrial damage and promotes the formation of the fatty deposits that can progress to cirrhosis.
Darley-Usmar and his collaborators say that the antioxidant MitoQ is able to intercept and neutralize free radicals before they can damage the mitochondria, preventing the cascade of effects that ultimately leads to steatosis.
“There has not been a promising pharmaceutical approach to preventing or reversing the long-term damage associated with fatty deposits in the liver that result from excessive consumption of alcohol,” said Darley-Usmar. “Our findings suggest that MitoQ might be a useful agent for treating the liver damage caused by prolonged, habitual alcohol use.”
“Previous studies have shown that MitoQ can be safely administered long-term to humans,” said Balu Chacko, Ph.D., a research associate and co-author of the study. “As it has been shown to decrease liver damage in hepatitis C patients, it may have potential to ameliorate the initial stages of fatty liver disease in patients with alcoholic and non-alcoholic liver disease.”
The Annals of Hepatology estimate that alcohol abuse costs $185 billion annually in the United States, and that 2 million people have some form of alcoholic liver disease. It links as much as 90 percent of cirrhosis of the liver is related to alcohol abuse and up to 30 percent of liver cancer.
Darley-Usmar, who is also the director of the Center for Free Radical Biology at UAB, says his team is in discussions with the National Institutes of Health to develop a whole family of drugs based around interactions with mitochondria. He suggests such drugs might be effective in treating cardiovascular disease, kidney disease and neurodegenerative disorders.
“We know that free radicals play a role in human disease, and we have developed antioxidants that can eliminate free radicals in the laboratory,” he said. “Unfortunately, previous trials using antioxidants in humans have not been as successful as anticipated. The difference with our current findings is that we targeted a specific part of the cell, the mitochondria. This is a unique approach, and this is one of the few pre-clinical trials that shows effectiveness.”
Darley-Usmar says the findings also may have significance for the treatment of metabolic syndrome, a rapidly growing condition that affects some 50 million Americans, according to the American Heart Association.
“Metabolic syndrome describes a complex interaction of factors caused by obesity which includes damage to the liver due to an increase in free radicals, hypoxia and deposition of fat,” said Darley-Usmar. “It’s quite similar to alcohol-dependent hepatotoxicity. It would be interesting to see if an antioxidant such as MitoQ had any therapeutic effect in preventing liver damage in those with metabolic syndrome.”
Public release date: 3-May-2011
Limitations of evidence base for prescribing aripiprazole in maintenance therapy of bipolar disorder
The evidence base for the prescribing of aripiprazole in maintenance treatment of bipolar disorder is limited to a single trial, sponsored by the manufacturer of aripiprazole, according to a rigorous appraisal of the evidence for its use led jointly by Alexander Tsai of Harvard University, Boston USA, and Nicholas Rosenlicht of the University of California San Francisco, USA. In the paper, published in this week’s PLoS Medicine, the authors describe key limitations of the trial, which were not identified in most subsequent review articles and guidelines for the treatment of bipolar disorder in which the trial was cited.
Bipolar disorder (also known as manic depression) is a common and serious psychiatric illness. Individuals with bipolar disorder experience mood swings with manic episodes (where they may feel euphoric, restless, and behave impulsively), along with depressive episodes where they may feel low, worthless, and suicidal. Aripiprazole is a second-generation antipsychotic medication and the newest of such drugs to have received approval by the US Food and Drug Administration (FDA) for use both in treatment of acute episodes and, more recently, for maintenance therapy.
Drs. Tsai and Rosenlicht and their colleagues conducted a systematic search to find all published and unpublished studies relating to use of aripiprazole for maintenance therapy of bipolar disorder, including a request to the FDA under Freedom of Information Act legislation. They critically appraised this evidence and then used citation searches to examine how the primary evidence was subsequently referenced in the medical literature. The authors found only a single trial describing the use of aripiprazole during the maintenance phase of bipolar disorder. Further, they found significant limitations of this trial that constrain its interpretation as supporting the use of aripiprazole for this indication. 1 First, the trial duration was too short to show that the drug was truly helpful in maintaining initial benefit or
preventing mood swings over the long term. 2 Second, very few participants in the trial completed the entire study. 3 Third, the trial was based on a select minority of subjects who had shown an initial response to the drug, making it difficult to extrapolate these findings to patients with bipolar disorder more widely. 4 Fourth, the trial had a design whereby patients assigned to placebo were abruptly taken off aripiprazole treatment given to them during a previous “run-in” phase and reassigned to placebo; differences in risk of relapse seen between trial arms may thus also reflect the potentially harmful effects of rapid drug withdrawal in patients given placebo.
Despite these shortcomings, the authors found that this single trial was subsequently cited by 104 review articles and treatment guidelines, with very few mentioning the study’s limitations.
The authors comment that “…alternative modifications or study designs may improve the probability of generating more useful data from studies in this vulnerable patient population to inform the treatment of similar patients in the future.”
Patients (or their family members) who may learn of this study’s findings are urged to contact their physician if concerned about what these findings may mean for their treatment. Specifically, the findings do not mean patients should cease their medication; despite the limitations of the evidence described here, this drug may be helpful to them. In addition, the study did not assess the evidence for the use of aripiprazole in acute treatment of bipolar disorder.
Ralph’s note – The FDA’s Approval of this drug is a total joke, and should be investigated.
Public release date: 3-May-2011
Study evaluates relationship of urinary sodium with health outcomes
In a study conducted to examine the health outcomes related to salt intake, as gauged by the amount of sodium excreted in the urine, lower sodium excretion was associated with an increased risk of cardiovascular death, while higher sodium excretion did not correspond with increased risk of hypertension or cardiovascular disease complications, according to a study in the May 4 issue of JAMA.
“Extrapolations from observational studies and short-term intervention trials suggest that population-wide moderation of salt intake might reduce cardiovascular events,” according to background information in the article. “The assumption that lower salt intake would in the long run lower blood pressure, to our knowledge, has not yet been confirmed in longitudinal population-based studies.”
Katarzyna Stolarz-Skrzypek, M.D., Ph.D., of the University of Leuven, Belgium, and colleagues examined the incidence of death, illness and hypertension in relation to measures of urinary sodium excretion. The study included 3,681 participants without cardiovascular disease (CVD) at the beginning of the study. Of these, 2,096 had normal blood pressure at baseline and 1,499 had blood pressure and sodium excretion measured at baseline and last follow-up (2005-2008).
The researches found that among 3,681 participants followed up for a median (midpoint) 7.9 years, cardiovascular deaths decreased across increasing tertiles (one of three groups) of 24-hour urinary sodium: from 50 deaths in the low (death rate, 4.1 percent), 24 deaths in the medium, (death rate, 1.9 percent) and 10 deaths in the high tertile (death rate, 0.8 percent). Analysis indicated that the risk of cardiovascular mortality was significantly elevated in the low tertile with a significant inverse association between cardiovascular mortality and tertile of sodium excretion. Baseline sodium excretion predicted neither total mortality nor fatal combined with nonfatal CVD events.
Among 2,096 participants followed up for 6.5 years, increasing tertiles of 24-hour urinary sodium were not associated with incidence of hypertension. In the entire hypertension cohort, across increasing tertiles of urinary sodium, the numbers of new cases of hypertension were 187 (27.0 percent) in the low, 190 (26.6 percent) in the medium, and 175 (25.4 percent) in the high sodium excretion group.
Among 1,499 participants followed up for 6.1 years, in multivariable-adjusted analyses, a 100-mmol increase in sodium excretion was associated with 1.71 mm Hg increase in systolic blood pressure but no change in diastolic BP.
“The associations between systolic pressure and sodium excretion did not translate into less morbidity or improved survival. On the contrary, low sodium excretion predicted higher cardiovascular mortality. Taken together, our current findings refute the estimates of computer models of lives saved and health care costs reduced with lower salt intake. They do also not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level. However, they do not negate the blood pressure-lowering effects of a dietary salt reduction in hypertensive patients,” the authors conclude.
Public release date: 3-May-2011
Ecstasy associated with chronic change in brain function
Ecstasy – the illegal “rave” drug that produces feelings of euphoria and emotional warmth – has been in the news recently as a potential therapeutic. Clinical trials are testing Ecstasy in the treatment of post- traumatic stress disorder.
But headlines like one in Time magazine’s health section in February – “Ecstasy as therapy: have some of its negative effects been overblown?” – concern Ronald Cowan, M.D., Ph.D., associate professor of Psychiatry.
His team reports in the May issue of Neuropsychopharmacology that recreational Ecstasy use is associated with a chronic change in brain function.
“There’s tension in the fields of psychiatry and psychotherapy between those who think Ecstasy could be a valuable therapeutic that’s not being tested because of overblown fears, and those who are concerned about the drug’s potentially harmful effects,” Cowan said.
“We’re not on one side or the other; we’re just trying to find out what’s going on in the brain – is there any evidence for long-lasting changes in the brain?”
The message in news reports needs to be accurate, Cowan said. His team’s studies suggest that the current message should be: “If you use Ecstasy recreationally, the more you use, the more brain changes you get.”
Cowan and his colleagues examined brain activation during visual stimulation, using functional magnetic resonance imaging (fMRI), in subjects who had previously used Ecstasy (but not in the two weeks prior to imaging) and in subjects who had not previously used Ecstasy.
They found increased brain activation in three brain areas associated with visual processing in Ecstasy users with the highest lifetime exposure to the drug. The findings were consistent with the investigators’ predictions based on results from animal models: that Ecstasy use is associated with a loss of serotonin signaling, which leads to hyper-excitability (increased activation) in the brain.
The hyper-excitability suggests a loss in brain efficiency, Cowan said, “meaning that it takes more brain area to process information or perform a task.”
The investigators found that this shift in brain excitability did not return to normal in subjects who had not used Ecstasy in more than a year.
“We think this shift in cortical excitability may be chronic, long-lasting, and even permanent, which is a real worry,” Cowan said, noting that the Ecstasy users in the study are young (18 to 35 years old). “The question is what will happen to their brains as they age over the next 60 years.”
Cowan said that the pattern of hyper-excitability is similar to that observed in fMRI studies of individuals at risk for, or with early, Alzheimer’s disease.
“I’m not saying that these people are at increased risk for dementia, but that there’s a loss of brain efficiency in both recreational Ecstasy use and early Alzheimer’s.”
The findings suggest that brain hyper-excitability (increased activation in fMRI scans) may be a useful biomarker for Ecstasy-induced neurotoxicity, which the investigators will continue to study.
“Our goal is to be able to let people know whether or not the drug is causing long-term brain damage,” Cowan said. “That’s really critical because millions of people are using it.”
The 2009 National Survey on Drug Use and Health estimated that 14.2 million individuals 12 years or older in the United States had used Ecstasy in their lifetime; 760,000 people had used Ecstasy in the month prior to being surveyed.
Cowan is also interested in determining the doses of Ecstasy that are toxic, and whether there are genetic vulnerabilities to toxicity. If clinical trials show that the drug has therapeutic benefits, it’s critical to know the risks, he said.
Public release date: 4-May-2011
US must strengthen efforts to restrict chemicals that threaten health, say researchers
Environmental health experts say current law falls short and urge federal government to work with partners to address gaps that leave the public vulnerable
Bethesda, MD—With growing evidence of the link between exposure to toxic chemicals and chronic diseases, especially in children, the United States needs to step up its efforts to protect the public from hazardous chemicals, say researchers writing in the May issue of Health Affairs. The Environmental Protection Agency (EPA), stymied by the outdated Toxic Substances Control Act, must seek partners in academia to help evaluate the risks of industrial chemicals on the market today, say Sarah A. Vogel of the Johnson Family Foundation and Jody Roberts of the Chemical Heritage Foundation.
Some 83,000 chemicals are on the market, and under the 1976 law, companies do not have to prove their chemicals are safe. Instead, the federal government must prove whether a chemical is dangerous. This provision keeps potentially harmful chemicals on the market, increasing the risk to human health. Furthermore, the process required by the law to identify and control hazardous chemicals requires an extensive process of collecting, analyzing and evaluating data. This process consumes considerable government time and resources and acts as a roadblock to efforts to manage chemical risks
and protect the public’s health, according to the authors.
“In the thirty-five years since the Toxic Substances Control Act was enacted, we’ve learned much more about the harms of everyday chemical exposure and its contribution to a growing number of chronic diseases such as reproductive disorders, learning and behavioral disabilities, and diabetes,” says Vogel. “Yet the EPA has had a nearly impossible time regulating the use of hazardous chemicals, such as asbestos, because it is hindered by the very high burden of proof that falls on the agency,” she adds.
With reforms to the Toxic Substances Control Act uncertain, given the current political and budgetary climate, the EPA must look beyond Washington to strengthen its oversight of chemicals and accelerate efforts to reduce exposures to those chemicals that might contribute to poor health, say the authors. They propose that the EPA partner with academic institutions and professional societies to test and evaluate the risks of high-priority chemicals—including those that are produced in the greatest quantities, are commonly found in the human body, and that pose a potential risk to children’s health and development.
According to the authors, these partners can generate independent analyses by using clearly defined and transparent evaluative standards and controlling for conflicts of interest. Building such partnerships will also strengthen the EPA’s existing programs and better position it for any transitions that may come with changes to the Toxic Substances Control Act, they add. In April, a bill was introduced in the US Senate that would reform the country’s chemical policy and align the United States more closely with changes in Europe. The bill would require chemical producers to submit safety data for all chemicals, new and existing, and prioritize substances of concern for review and risk management. Many states have already taken steps to limit the market for hazardous chemicals, such as restricting lead in toys and bisphenol A (BPA) in baby bottles.
Vogel also says public health officials can do more to address environmental conditions as they work to reduce chronic disease and should join with other stakeholders in calling for chemical policy reforms.
A second Health Affairs article examines the impact of toxic chemicals on children’s health and supports Vogel and Roberts’ calls for reforms to the Toxic Substance Control Act to improve health and reduce health care costs.
Because children are uniquely vulnerable to toxic chemicals in the environment, the United States should have a more explicit chemical policy to protect them against disease and dysfunction, say Philip Landrigan at the Mount Sinai School of Medicine and Lynn Goldman, dean of The George Washington University’s School of Public Health. Landrigan, one of the nation’s foremost experts on the link between environment and children’s health, examines how toxic chemicals are strongly linked to diseases in children such as asthma, mental retardation, and cancer, and how preventing them can yield billions of dollars in savings and increase productivity.
To reduce this preventable disease burden, Landrigan and Goldman suggest a fundamental overhaul of current policy that would include a legally mandated requirement to test the chemicals already on the market for toxicity and stepped-up research to both identify new toxins and document the environmentally induced diseases in children.
Public release date: 4-May-2011
Natural protection against radiation
In the midst of ongoing concerns about radiation exposure from the Fukushima nuclear power plant in Japan, scientists are reporting that a substance similar to resveratrol — an antioxidant found in red wine, grapes and nuts — could protect against radiation sickness. The report appears in ACS Medicinal Chemistry Letters.
Michael Epperly, Kazunori Koide and colleagues explain that radiation exposure, either from accidents (like recent events in Japan) or from radiation therapy for cancer, can make people sick. High doses can even cause death. The U.S. Food and Drug Administration is currently evaluating a drug for its ability to protect against radiation sickness, but it is difficult to make in large amounts, and the drug has side-effects that prevent its use for cancer patients. To overcome these disadvantages, the researchers studied whether resveratrol — a natural and healthful antioxidant found in many foods — could protect against radiation injuries.
They found that resveratrol protected cells in flasks but did not protect mice (stand-ins for humans in the laboratory) from radiation damage. However, the similar natural product called acetyl resveratrol did protect the irradiated mice. It also can be produced easily in large quantities and given orally. The authors caution that it has not yet been determined whether acetyl resveratrol is effective when orally administered.
Public release date: 4-May-2011
New evidence that caffeine is a healthful antioxidant in coffee
Scientists are reporting an in-depth analysis of how the caffeine in coffee, tea, and other foods seems to protect against conditions such as Alzheimer’s disease and heart disease on the most fundamental levels. The report, which describes the chemistry behind caffeine’s antioxidant effects, appears in ACS’ The Journal of Physical Chemistry B.
Annia Galano and Jorge Rafael León-Carmona describe evidence suggesting that coffee is one of the richest sources of healthful antioxidants in the average person’s diet. Some of the newest research points to caffeine (also present in tea, cocoa, and other foods) as the source of powerful antioxidant effects that may help protect people from Alzheimer’s and other diseases. However, scientists know little about exactly how caffeine works in scavenging the so-called free radicals that have damaging effects in the body. And those few studies sometimes have reached contradictory conclusions.
In an effort to bolster scientific knowledge about caffeine, they present detailed theoretical calculations on caffeine’s interactions with free radicals. Their theoretical conclusions show “excellent” consistency with the results that other scientists have report from animal and other experiments, bolstering the likelihood that caffeine is, indeed, a source of healthful antioxidant activity in coffee.
Damaged Hearts Pump Better When Fueled With Fats
News Release: Wednesday, May 4, 2011
Research Holds Promise for Heart Failure Patients
CLEVELAND – Contrary to what we’ve been told, eliminating or severely limiting fats from the diet may not be beneficial to cardiac function in patients suffering from heart failure, a study at Case Western Reserve University School of Medicine reports. Results from biological model studies conducted by assistant professor of physiology and biophysics Margaret Chandler, PhD, and other researchers, demonstrate that a high-fat diet improved overall mechanical function, in other words, the heart’s ability to pump, and was accompanied by cardiac insulin resistance. “Does that mean I can go out and eat my Big Mac after I have a heart attack,” Dr. Chandler says “No, but treatments that act to provide sufficient energy to the heart and allow the heart to utilize or to maintain its normal metabolic profile may actually be advantageous.” The research, published in American Journal of Physiology-Heart and Circulatory
Physiology, suggests that for a damaged heart, a balanced diet that includes mono- and polyunsaturated fats, and which replaces simple sugars (sucrose and fructose) with complex carbohydrates, may be beneficial. In a healthy person, the heart uses both fats and carbohydrates to obtain the energy it needs to continue pumping blood 24/7. Ideally, fats are utilized because they yield more energy. However, if a person develops heart failure (or suffers from ischemia – a lack of blood supply), the heart seems to prefer using glucose for fuel, because glucose requires less oxygen to produce energy. While heart disease remains the leading cause of death in the United States, more people are surviving heart attacks that ever before. Survivors though pay a price for this improved survival, living with a damaged heart that usually progresses to heart failure. And unfortunately, medications and procedures have yet to “cure” heart failure, or halt the deterioration of heart function. Upon initiation of these dietary intervention studies, researchers previously thought a high-fat diet fed to animal models that have suffered a heart attack, would overload their tissues with fat, which in turn would have a toxic effect on their hearts. Surprisingly, the heart’s pump function improved on the high-fat diet. Through further testing, the researchers found that animal models suffering from heart failure and receiving a low fat diet were able to produce insulin and take up glucose from the blood, just as healthy hearts do.
However, the biological models with heart failure that were fed high-fat diets showed signs of insulin resistance, exhibited by a decreased amount of glucose taken up by the heart, as might be expected in a diabetic patient. One of the main implications of these findings is that contrary to previously held beliefs, a state of insulin-resistance might actually be beneficial to a failing heart. The hypothesis, according to Dr. Chandler, is that because the heart is being provided with excess amounts of fats, it is forced to utilize its preferred energy source. After suffering an injury that leads to failure, the heart cannot do this on its own, so the researchers have to manipulate its metabolism to use the energy source that maximizes or maintain its function as near to “normal” as possible. “We want to provide an environment for the heart which allows it to be as effective and efficient a pump as possible, regardless of the damage it has undergone,” Dr. Chandler says. This study was funded by the National Institutes of Health, the American Heart Association, and the Case Center for Imaging Research. Prepared by Salam Kabbani, a third-year student at Case Western Reserve University.
Public release date: 4-May-2011
Estimated costs of environmental disease in children at $76.6 billion per year
Experts suggest new policy to reduce toxic chemical exposure and subsequent burden of disease
In three new studies published in the May issue of the journal Health Affairs, Mount Sinai School of Medicine researchers reveal the staggering economic impact of toxic chemicals and air pollutants in the environment, and propose new legislation to mandate testing of new chemicals and also those already on the market.
Leonardo Trasande, MD, Associate Professor of Preventive Medicine and Pediatrics at Mount Sinai School of Medicine, analyzed the costs of conditions – including lead poisoning, childhood cancer, asthma, autism, and attention deficit hyperactivity disorder (ADHD) – associated with exposure to toxic chemicals. Dr. Trasande and his team calculated the annual cost for direct medical care and the indirect costs, such as parents’ lost work days, and lost economic productivity caring for their children, of these diseases in children.
The researchers found the annual cost in the United States to be an estimated $76.6 billion, representing
3.5 percent of all U.S. health care costs in 2008. The breakdown includes: lead poisoning ($50.9 billion), autism ($7.9 billion), intellectual disability ($5.4 billion), exposure to mercury pollution ($5.1 billion), ADHD ($5 billion), asthma ($2.2 billion), and childhood cancer ($95 million).
“Our findings show that, despite previous efforts to curb their use, toxic chemicals have a major impact on health care costs and childhood morbidity,” said Dr. Trasande. “New policy mandates are necessary to reduce the burden of disease associated with environmental toxins. The prevalence of chronic childhood conditions and costs associated with them may continue to rise if this issue is not addressed.”
Dr. Trasande also reviewed an earlier study of 1997 data, which was conducted by Philip J. Landrigan, MD, and documented $54.9 billion in annual costs for childhood diseases associated with environmental toxins in the United States. Reviewing this prior analysis, Dr. Trasande found that while exposure to lead and costs associated with asthma had diminished, new chemicals and new environmentally-induced diseases, like attention deficit hyperactivity disorder, have increased the overall burden of disease. Dr.
Landrigan is currently Dean for Global Health, and Professor and Chair of Preventive Medicine, and Professor of Pediatrics, at Mount Sinai School of Medicine.
In a related article also in the current issue of Health Affairs, Dr. Landrigan and Lynn R. Goldman, MD, Dean of the School of Public Health at George Washington University, propose a three-pronged approach to reduce the burden of disease and rein in the effects of toxic chemicals in the environment:
•Conduct a requisite examination of chemicals already on the market for potential toxicity, starting with the chemicals in widest use, using new, more efficient toxicity testing technologies.
•Assess all new chemicals for toxicity before they are allowed to enter the marketplace, and maintain strictly-enforced regulation on these chemicals.
•Bolster ongoing research and epidemiologic monitoring to better understand, and subsequently prevent, the health impact of chemicals on children.
“Implementing these proposals would have a significant impact in preventing childhood disease and reducing health costs,” said Dr. Landrigan. “Scant legislation has been passed to reduce the risks associated with childhood exposure to toxic chemicals in the environment. Even though only six chemicals have been banned, we have seen dramatic benefits from that action alone. The removal of lead from gasoline and paint is an example of the importance of this type of regulation.”
In a separate article in Health Affairs, Perry Sheffield, MD, Assistant Professor of Preventive Medicine at Mount Sinai School of Medicine, evaluated the little-studied correlation between air pollution and infectious respiratory illness in children, and the resultant health care costs.
Dr. Sheffield and her team analyzed hospitalization data between 1999 and 2007 for children aged one month to one year who had bronchiolitis – a type of viral lung infection with symptoms similar to asthma
– and monitored the air quality surrounding in the hospitals where the patients were treated. They found a statistically significant association between levels of fine particulate matter pollutant surrounding the hospitals, and total charges and costs for infant bronchiolitis hospitalizations.
Her team revealed that as the amount of air pollutants increased, infant bronchiolitis hospitalization costs increased by an average of $127 per patient. As a result, they concluded that reducing the average level of fine particulate pollutant by just seven percent below the current annual standard could save $15 million annually in U.S. health care costs.
“While more research is required to understand the full effect of air pollutants on infectious disease severity and health care costs, our findings are indicative of the tremendous impact new legislation on air quality control standards could have on the health of our children,” said Dr. Sheffield.
Ralph’s Note- Interesting what they classify as environmental disease…
Public release date: 5-May-2011
Study suggests prolonged bottle feeding increases the risk of obesity
Cincinnati, OH, May 5, 2011 — Experts agree that obesity prevention should begin before children enter school. But due to a lack of conclusive data, health care providers often have trouble advising parents about which interventions are the most beneficial. A new study soon to be published in The Journal of Pediatrics suggests that limiting prolonged bottle use in children may be an effective way to help prevent obesity.
Dr. Robert Whitaker and Rachel Gooze of the Center for Obesity Research and Education at Temple University, and Dr. Sarah Anderson of The Ohio State University College of Public Health, analyzed data from the Early Childhood Longitudinal Study, Birth Cohort, a large national study of children born in 2001. They analyzed data from 6750 children to estimate the association between bottle use at 24 months of age and the risk of obesity at 5.5 years of age.
Of the children studied, 22% were prolonged bottle users, meaning that at 2 years of age they used a bottle as their primary drink container and/or were put to bed with a calorie-containing bottle.
Nearly 23% of the prolonged bottle users were obese by the time they were 5.5 years old. “Children who were still using a bottle at 24 months were approximately 30% more likely to be obese at 5.5 years, even after accounting for other factors such as the mother’s weight, the child’s birth weight, and feeding practices during infancy,” Dr. Whitaker notes.
Drinking from a bottle beyond infancy may contribute to obesity by encouraging the child to consume too many calories. “A 24-month-old girl of average weight and height who is put to bed with an 8-ounce bottle of whole milk would receive approximately 12% of her daily caloric needs from that bottle,” Rachel Gooze explains. She notes that weaning children from the bottle by the time they are 1 year of age is unlikely to cause harm and may prevent obesity. The authors suggest that pediatricians and other health professionals work with parents to find acceptable solutions for stopping bottle use at the child’s first birthday.
Public release date: 5-May-2011
Study adds weight to link between arsenic in drinking water and heart disease
Research: Arsenic exposure from drinking water and mortality from cardiovascular disease in Bangladesh: Prospective cohort study
Exposure to even moderate levels of arsenic in drinking water is associated with an increased risk of heart disease, especially among smokers, finds a study published on bmj.com today.
Arsenic is a natural element of the Earth’s crust and high concentrations in groundwater pose a public health threat to millions of people worldwide.
High levels of arsenic exposure from drinking water have already been related to an elevated risk of heart disease. Given the huge burden of heart disease worldwide, a small increased risk associated with moderate arsenic exposure could be of major public health importance.
So a team of researchers from USA and Bangladesh, led by Dr Yu Chen from New York University School of Medicine and Dr Habibul Ahsan from the University of Chicago, set out to test the association between arsenic exposure and death from cardiovascular disease and to assess whether cigarette smoking influences the association.
The study involved 11,746 men and women living in Araihazar, Bangladesh, where groundwater is contaminated by arsenic.
At the start of the study, participants were interviewed and underwent a physical examination. Urine samples were also taken and tested for levels of arsenic. This procedure was repeated at two year intervals for an average of 6.6 years.
Water samples were collected from 5,966 tube wells used by the study participants for drinking and arsenic levels were measured.
After adjusting for factors such as age, gender, smoking status and education level, the authors found a dose-response relation between arsenic exposure and deaths from heart disease at a lower level of arsenic exposure than previously reported.
The death rate for cardiovascular disease was 271 per 100,000 person years among individuals drinking water containing moderate levels of arsenic (12 – 864 parts per billion, or ppb) compared with 214 per 100,000 person years among individuals drinking water containing low levels of arsenic (less than 12ppb).
They estimate that almost 30% of these deaths in the study population can be attributable, in part, to moderate levels of arsenic concentrations in well water (12-864 ppb).
The risk of dying from heart disease associated with arsenic exposure was consistently higher in current and former smokers compared with never smokers, suggesting that the cardiovascular effects of arsenic exposure, even at moderate levels, are further intensified by smoking.
The ways in which arsenic leads to heart disease are not clear, but studies suggest that it can induce atherosclerosis (hardening of the arteries), say the authors. “Exposure to arsenic in drinking water is adversely associated with mortality from heart disease, especially among smokers,” they conclude.
Arsenic poses far higher health risks than any other known environmental exposure, say Professors Allan Smith and Craig Steinmaus from the University of California, Berkeley, in an accompanying editorial. Yet water contaminated with arsenic is tasteless, looks crystal clear, and boiling the water only concentrates the arsenic in it.
They suggest that, in all parts of the world where groundwater is used for drinking, clinicians should ask patients about their drinking water and, if it comes from a well, urge them to have it tested for arsenic. “It is too late to identify exposure after diseases caused by arsenic have been diagnosed, because many are fatal,” they conclude.
News Release: Wednesday, May 4, 2011
‘Bad’ Cholesterol Not As Bad As People Think, Shows Texas A&M Study Texas A&M News & Information Service
May 4, 2011 – The so-called “bad cholesterol” – low-density lipoprotein commonly called LDL – may not be so bad after all, shows a Texas A&M University study that casts new light on the cholesterol debate, particularly among adults who exercise.
Steve Riechman, a researcher in the Department of Health and Kinesiology, says the study reveals that LDL is not the evil Darth Vader of health it has been made out to be in recent years and that new attitudes need to be adopted in regards to the substance. His work, with help from colleagues from the University of Pittsburgh, Kent State University, the Johns Hopkins Weight Management Center and the Northern Ontario School of Medicine, is published in the Journal of Gerontology.
Riechman and colleagues examined 52 adults from ages to 60 to 69 who were in generally good health but not physically active, and none of them were participating in a training program. The study showed that after fairly vigorous workouts, participants who had gained the most muscle mass also had the highest levels of LDL (bad) cholesterol, “a very unexpected result and one that surprised us.
“It shows that you do need a certain amount of LDL to gain more muscle mass. There’s no doubt you need both – the LDL and the HDL — and the truth is, it (cholesterol) is all good. You simply can’t remove all the ‘bad’ cholesterol from your body without serious problems occurring.
cholesterol plaque in an artery
Cholesterol is found in all humans and is a type of fat around the body. A person’s total cholesterol level is comprised of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol.
LDL is almost always referred to as the “bad” cholesterol because it tends to build up in the walls of arteries, causing a slowing of the blood flow which often leads to heart disease and heart attacks.
HDL, usually called the “good cholesterol,” often helps remove cholesterol from arteries. “But here is where people tend to get things wrong,” Riechman says.
“LDL serves a very useful purpose. It acts as a warning sign that something is wrong and it signals the body to these warning signs. It does its job the way it is supposed to.
“People often say, ‘I want to get rid of all my bad (LDL) cholesterol,’ but the fact is, if you did so, you would die,” the Texas A&M professor adds. “Everyone needs a certain amount of both LDL and HDL in their bodies. We need to change this idea of LDL always being the evil thing – we all need it, and we need it to do its job.”
According to the American Heart Association, about 36 million American adults have high cholesterol levels.
“Our tissues need cholesterol, and LDL delivers it,” he notes. “HDL, the good cholesterol, cleans up after the repair is done. And the more LDL you have in your blood, the better you are able to build muscle during resistance training.”
Riechman says the study could be helpful in looking at a condition called sarcopenia, which is muscle loss due to aging. Previous studies show muscle is usually lost at a rate of 5 percent per decade after the age of 40, a huge concern since muscle mass is the major determinant of physical strength. After the age of 60, the prevalence of moderate to severe sarcopenia is found in about 65 percent of all men and about 30 percent of all women, and it accounts for more than $18 billion of health care costs in the United States.
“The bottom line is that LDL – the bad cholesterol – serves as a reminder that something is wrong and we need to find out what it is,” Riechman says.
“It gives us warning signs. Is smoking the problem, is it diet, is it lack of exercise that a person’s cholesterol is too high? It plays a very useful role, does the job it was intended to do, and we need to back off by always calling it ‘bad’ cholesterol because it is not totally bad.”
Contact: Steve Riechman at (979) 862-3213 or email@example.com or Keith Randall, News & Information Services, at (979) 845-4644 or firstname.lastname@example.org
Public release date: 5-May-2011
DNA from common stomach bacteria minimizes effects of colitis, U-M study says
Administration of Helicobacter pylori DNA reduces symptoms, new research reveals pathway for future treatments
ANN ARBOR, Mich. — DNA from Helicobacter pylori, a common stomach bacteria, minimizes the effects of colitis in mice, according to a new study by University of Michigan Medical School scientists.
The study published in Gut this month was performed by a team of investigators assembled by senior author John Y. Kao, M.D. of the University of Michigan’s Division of Gastroenterology and assistant professor in U-M’s Department of Internal Medicine. The findings indicate that DNA from H. pylori significantly ameliorates the severity of colitis, say lead authors Jay Luther, M.D. and Stephanie Owyang, an undergraduate student on the team.
Colitis involves inflammation and swelling of the large intestine that leads to diarrhea and abdominal pain. Approximately 3.3 million people in the U.S. suffer from colitis.
More than half of the people in the world are infected with H. pylori, although only about 20 percent of
U.S. residents have it. In the U.S., H. pylori infection is treated in patients with stomach ulcers or cancers with antibiotics, but the majority of infected individuals don’t notice they have it and may not develop ulcers or cancers. “This research shows further evidence that we should
leave the bugs alone because there may be a benefit to hosting them in the stomach”, says Kao.
“H pylori has co-existed with the human race for more than 50,000 years and although it is linked with peptic ulcer disease and stomach cancer, only a minority of infected patients will develop those complications,” says Luther, adding that less than 15 percent of H. pylori-infected patients develop peptic ulcer disease and less than 1 percent develop cancer.
The researchers aren’t advocating infecting people with H. pylori to treat colitis, but say this may indicated that those already carrying the bacteria should not be treated unless they develop symptoms. These findings also raise significant concerns about global vaccination against H. pylori.
“This bug could be good for you, and we need to understand better what it does,” says Owyang.
The H. pylori infection is more commonly found in developing countries or those with poor sanitation, where colitis, Salmonella and inflammatory bowel diseases are less common. Most people contract H. pylori in their first seven years of life, most commonly through an oral-fecal route.
In the study, researchers found that H. pylori DNA is uniquely immunosuppressive containing high numbers of sequences known to inhibit inflammation. They isolated the DNA from both H. pylori and
another bacterium, E. coli, for further comparison. They found that mice receiving H. pylori DNA displayed less weight loss, less bleeding and greater stool consistency compared with mice infected with E coli DNA.
“With one dose, there was a significant difference in the bleeding and inflammation in the colon,” says Luther. “However, further study is needed to define other potential protective measures that H. pylori may provide and its safety as a treatment in patients.”
In previous research, U-M gastroenterologists also found that H. pylori reduced the severity of inflammation of the colon caused by Salmonella in mice.
“It is amazing that the bacterial DNA not only directs the biological behavior of the bacteria, but also has a significant influence on gut immunity of the host. This information might have important implications down the line in our understanding of disease manifestation,” says Owyang.
Public release date: 6-May-2011
Bill Gates Talks About Vaccines to Reduce World Population
Microsoft founder and one of the world’s wealthiest men, Bill Gates, projects an image of a benign philanthropist using his billions via his (tax exempt) Bill & Melinda Gates Foundation, to tackle diseases, solve food shortages in Africa and alleviate poverty. In a recent conference in California, Gates reveals a less public agenda of his philanthropy—population reduction, otherwise known as eugenics.
Gates made his remarks to the invitation-only Long Beach, California TED2010 Conference, in a speech titled, “Innovating to Zero!.” Along with the scientifically absurd proposition of reducing manmade CO2 emissions worldwide to zero by 2050, approximately four and a half minutes into the talk, Gates declares, “First we got population. The world today has 6.8 billion people. That’s headed up to about 9 billion. Now if we do a really great job on new vaccines, health care, reproductive health services, we lower that by perhaps 10 or 15 percent.”
Ralph’s Note – Thought the excerpt deserved posting. Should be titled when the ignorant control policy. Education has been proven over and over to be the most effective way of stabilizing population. Build Schools, Secure environments, and Infrastructure, not temporary medical dispensaries.
Public release date: 9-May-2011
Short term use of painkillers could be dangerous to heart patients
Even short-term use of some painkillers could be dangerous for people who’ve had a heart attack, according to research published in Circulation: Journal of the American Heart Association.
Researchers analyzed the duration of prescription non-steroidal anti-inflammatory drugs (NSAIDs) treatment and cardiovascular risk in a nationwide Danish cohort of patients with prior heart attack. They found the use of NSAIDs was associated with a 45 percent increased risk of death or recurrent heart attack within as little as one week of treatment, and a 55 percent increased risk if treatment extended to three months.
The study was limited by its observational nature and the lack of clinical parameters, researchers said. NSAIDs are commonly used by the general population and are associated with increased cardiovascular
risk in people with heart disease or those at high risk.
In a 2007 statement, the American Heart Association advised physicians about the risks of NSAID use among heart patients and provided a stepped care approach. In addition, the statement advised extra caution for when NSAIDs might be used, noting that they should “be limited to patients for whom there are not appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary.”
In the current study, researchers undertook the first time-to-event analysis of a nationwide group and investigated if the duration of prescription NSAID treatment influenced the cardiovascular risk among heart patients. Among 83,697 heart attack survivors (average age 68; 63 percent men), 42.3 percent had a least one prescription for an NSAID.
The most common NSAIDs prescribed were ibuprofen (23 percent) and diclofenac (13.4 percent). Selective COX-2 inhibitors — rofecoxib (4.7 percent) and celecoxib (4.8 percent) — were also used.
The non-selective NSAID diclofenac was associated with early onset risk similar to the selective COX-2 inhibitor rofecoxib.
All NSAIDs were associated with an increased risk of death or recurrent heart attack, with diclofenac having the highest risk (nearly three times). “Overall, NSAID treatment was associated with a statistically significant increased risk of death,” said Anne-Marie Schjerning Olsen, M.B., lead author of the study and research fellow at Copenhagen University in Hellerup, Denmark. “Our results indicate that there is no apparent safe therapeutic window for NSAIDs in patients with prior heart attack.”
The NSAID naproxen was not associated with an increased risk of death or recurrent heart attack. However, previous studies found increased gastrointestinal bleeding with naproxen.
Olsen said “a very conservative approach to use NSAIDs in patients with prior heart attack is warranted.
“If NSAID therapy is necessary for patients with known heart attack, the doctors should choose an NSAID less selective for COX-2 and a minimum for the shortest period.”
Low-dose ibuprofen was the only available over-the-counter NSAID available in Denmark and was only dispensed in limited quantities (100 tablets at a time). So over-the-counter use of NSAIDs was unlikely to have had a major effect on the study results, researchers said.
In some countries, diclofenac is available as an over-the-counter drug without warnings about potential side effects. Recently, the U.S. Food and Drug Administration issued a warning that diclofenac should not be used by patients recovering from heart surgery.
But “the accumulating evidence suggests that we must limit NSAID use to the absolute minimum in patients with established cardiovascular disease,” researchers said. Further study is warranted to establish the cardiovascular safety of NSAIDs, they said.
“The American Heart Association applauds this research that adds to our knowledge about the adverse effects of NSAID use in patients with coronary artery disease,” said Elliott Antman, M.D., lead author 2007 NSAIDs advisory. “The authors further confirm our prior practical advice that NSAID use should be avoided and if unavoidable should be used at the smallest doses for the shortest time possible. Naproxen has not been shown to have an increased cardiovascular risk and may be safer than other NSAIDs.”
Public release date: 9-May-2011
Parsley, Celery Carry Crucial Component for Fight Against Breast Cancer, MU Researcher Finds
COLUMBIA, Mo. — Parsley is usually used as a decorative accent to a scrumptious meal, but don’t set it aside just yet. In a new study, a University of Missouri researcher has found that a compound in parsley and other plant products, including fruits and nuts, can stop certain breast cancer tumor cells from multiplying and growing. The study was published recently in Cancer Prevention Research.
Salman Hyder, a University of Missouri researcher, has found that a compound in parsley can stop certain breast cancer tumor cells from multiplying and growing.
In his study, Salman Hyder, the Zalk Endowed Professor in Tumor Angiogenesis and professor of biomedical sciences in the College of Veterinary Medicine and the Dalton Cardiovascular Research Center, exposed rats with a certain type of breast cancer to apigenin, a common compound found in parsley and other plant products. The rats that were exposed to the apigenin developed fewer tumors and experienced significant delays in tumor formation compared to those rats that were not exposed to apigenin. Hyder believes this finding could impact women who are taking certain hormone replacement therapies.
“Six to 10 million women in the United States receive hormone replacement therapy (HRT),” Hyder said. “We know that certain synthetic hormones used in HRT accelerate breast tumor development. In our study, we exposed the rats to one of the chemicals used in the most common HRTs received in the United States – a progestin called medroxyprogesterone acetate (MPA) – which also happens to be the same synthetic hormone that accelerates breast tumor development.”
When tumor cells develop in the breast in response to MPA, they encourage new blood vessels to form within tumors. The blood vessels then supply needed nutrients for the tumors to grow and multiply. Hyder found that apigenin blocked new blood vessel formation, thereby delaying, and sometimes stopping, the development of the tumors. Hyder also found that the compound reduced the overall number of tumors.
However, while apigenin did delay tumor growth, it did not stop the initial formation of cancer cells within the breast.
Apigenin is most prevalent in parsley and celery, but can also be found in apples, oranges, nuts and other plant products. However, apigenin is not absorbed efficiently into the bloodstream, so scientists are unsure of how much can or should be ingested.
“We don’t have specific dosage for humans yet,” Hyder said. “However, it appears that keeping a minimal level of apigenin in the bloodstream is important to delay the onset of breast cancer that progresses in response to progestins such as MPA. It’s probably a good idea to eat a little parsley and some fruit every day to ensure the minimal amount. However, you can also find this compound in pill supplements in the health food section of many stores. Of course, you should always check with your doctor before making any major changes to your diet or lifestyle.”
The next phrase of studies should include human clinical trials to determine the appropriate dosage amount, Hyder said. He believes further study on humans is necessary to address any health and safety issues that might exist
Public release date: 10-May-2011
Coffee reduces breast cancer risk
Recently published research shows that coffee drinkers enjoy not only the taste of their coffee but also a reduced risk of cancer with their cuppa. More detailed research published today in BioMed Central’s open access journal Breast Cancer Research shows that drinking coffee specifically reduces the risk of antiestrogen-resistant estrogen-receptor (ER)-negative breast cancer.
Researchers from Sweden compared lifestyle factors and coffee consumption between women with breast cancer and age-matched women without. They found that coffee drinkers had a lower incidence of breast cancer than women who rarely drank coffee. However they also found that several lifestyle factors affected breast cancer rates, such as age at menopause, exercise, weight, education, and a family history of breast cancer. Once they had adjusted their data to account for these other factors they found that the protective effect of coffee on breast cancer was only measurable for ER-negative breast cancer.
The group from Karolinska Institutet explained that, “There is often conflicting information about the beneficial effects of coffee – when we compared our results to that of a German study we discovered that their data showed the same trend, but the relationship was much weaker. We suggest that this may have something to do with the way the coffee was prepared, or the type of bean preferred. It is unlikely that the protective effect is due to phytoestrogens present in coffee since there was no reduction in the incidence of ER-positive cancer in this study.”
So while it is evident that coffee may have beneficial effects in protecting women from ER negative breast cancer the exact mechanism and compounds involved are not yet clear and not all types of coffee are the same.
Public release date: 10-May-2011
Drug regulators are protecting profits over patients, warn researchers
Analysis: Opening up data at the European Medicines Agency
Medicines regulators are protecting drug company profits rather than the lives and welfare of patients by withholding unpublished trial data, argue researchers on bmj.com today.
They call for full access to full trial reports (published and unpublished) to allow the true benefits and harms of treatments to be independently assessed by the scientific community.
Despite the existence of hundreds of thousands of clinical trials, doctors are unable to choose the best treatments for their patients because research results are being reported selectively, write Professor Peter Gøtzsche and Dr Anders Jørgensen from the Nordic Cochrane Centre in Denmark.
Selective reporting can have disastrous consequences. For example, Rofecoxib (Vioxx) has probably caused about 100,000 unnecessary heart attacks in the USA alone, while anti-arrhythmic drugs have probably caused the premature death of about 50,000 Americans each year in the 1980s.
This must be remedied, they say, and they describe a three-year struggle to access unpublished trial reports for two anti-obesity drugs, submitted by the manufacturers to the European Medicines Agency (EMA) for marketing approval in the European Union.
“The information was important for patients because anti-obesity pills are controversial,” say the authors.
“People have died from cardiac and pulmonary complications or have experienced psychiatric disturbances, including suicidal events, and most of the drugs have been de-registered for safety reasons.”
But the EMA refused access, arguing that this would undermine commercial interests and that there was no overriding public interest in disclosure. They also cited the administrative burden involved and the worthlessness of the data after they had edited them.
The authors appealed to the European ombudsman, who criticised the EMA’s refusal to grant access. But only after the ombudsman accused EMA of maladministration, did it agree to widen public access to documents.
“There is something fundamentally wrong with our priorities in healthcare if commercial success depends on withholding data that are important for rational decision making by doctors and patients,” say
Gøtzsche and Jørgensen.
Public release date: 10-May-2011
Vitamin D deficiency in pneumonia patients associated with increased mortality
A new study published in the journal Respirology reveals that adult patients admitted to the hospital with pneumonia are more likely to die if they have Vitamin D deficiency.
Vitamin D is known to be involved in the innate immune response to infection.
The team of researchers at Waikato Hospital and the Universities of Waikato and Otago, measured vitamin D in the blood samples of 112 adult patients admitted with community acquired pneumonia during the winter at the only acute-care hospital in Hamilton, New Zealand.
The researchers found that Vitamin D deficiency was associated with higher mortality within the first 30 days after hospital admission for pneumonia. The association between vitamin D deficiency was not explained by patient age, sex, comorbidities, the severity of the systemic inflammatory response, or other known prognostic factors.
The authors conclude that “improved understanding of Vitamin D and its role in immunity may lead to better ways to prevent and/or treat pneumonia. We now need to investigate whether Vitamin D supplements could be a useful addition to pneumonia treatment and whether using supplements could help to prevent or reduce the severity of pneumonia among high-risk populations.”
Public release date: 10-May-2011
Beneficial Bacteria Help Repair Intestinal Injury by Inducing Reactive Oxygen Species
Intestinal epithelial cells exposed to probiotic bacteria. Red indicates focal adhesions that help the cells
migrate and repair gaps.The gut may need bacteria to provide a little bit of oxidative stress to stay healthy, new research suggests.
Probiotic bacteria promote healing of the intestinal lining in mice by inducing the production of reactive oxygen species, researchers at Emory University School of Medicine have shown.
The results, published online this week in Proceedings of the National Academy of Sciences Early Edition, demonstrate a mechanism by which bacterial cultures in foods such as yogurt and kimchi have beneficial effects on intestinal health. The insights gained could also guide doctors to improved treatments for intestinal diseases, such as necrotizing enterocolitis in premature babies or intestinal injury in critically ill adults.
The laboratories of Andrew Neish, MD and Asma Nusrat, MD, both professors of pathology and laboratory medicine, teamed up for the study. The paper’s co-first authors are postdoctoral fellow Philip Swanson, PhD and associate research professor Amrita Kumar, PhD.
“It’s been known for years that probiotic bacteria can have these kinds of helpful effects, but it wasn’t really clear how this worked,” Neish says. “We’ve identified one example, among many, of how certain kinds of bacteria have specific biochemical functions in the body.”
Recent research has shown that the bacteria in our intestines influence our metabolism and immune systems. For example, an imbalance in the proportions of harmful and beneficial bacteria seems to over- activate immune cells in the intestines, driving inflammatory bowel disease.
Intestinal epithelial cells, the cells that line the intestine, live in close contact with bacteria and normally form a barrier that keeps bacteria away from other organs. They can repair small gaps in the barrier, which breaks down in intestinal diseases, by migrating into the gaps.
The researchers showed that Lactobacillus rhamnosus bacteria can accelerate this healing process, both in culture dishes and in mice with intestines damaged by chemicals. Lactobacillus rhamnosus, a species of bacteria found naturally in human intestines and often used as a probiotic, is a relative of other kinds of Lactobacillus bacteria found in fermented foods.
“Unlike most cell types that can not tolerate bacterial contact, intestinal epithelial cells respond to Lactobacillus rhamnosus by increasing their motility,” Neish says.
Using a fluorescent dye that is sensitive to reactive oxygen species (ROS), the researchers showed that intestinal epithelial cells produce ROS internally when in contact with Lactobacillus rhamnosus. The ROS induced by the bacteria stimulate the formation of focal adhesions, structures on intestinal epithelial cells that act as anchors for their movement.
“Focal adhesions are where cells attach to the matrix that surrounds them,” Neish says. “The cells lay them down on one side and remove them on the other side, like the tracks of a bulldozer.”
In studying the effect of Lactobacillus rhamnosus on intestines in mice, Neish’s team focused on the small intestine, which normally has fewer bacteria than the colon. This allowed them to avoid using antibiotics to remove naturally existing bacteria beforehand, and to see ROS production in tissue from live animals.
Antioxidants that mop up ROS prevent the bacteria from promoting wound healing in the laboratory, the researchers showed. Neish says his team’s finding suggests that large amounts of antioxidants by humans could interfere with the ability of bacteria to promote intestinal healing.
Previously, it was known that immune cells respond to bacteria by producing ROS, but Neish and his colleagues believe the ROS production they observed stimulates tissue maintenance and is a marker of
cohabitation and adaptation, rather than defense.
Oxidative stress, or an imbalance of reactive oxygen species throughout the body, has been linked to diseases such as heart disease and stroke. However, scientists have learned in recent years that cells can also use reactive oxygen species in a controlled, local way to send signals needed for normal functions.
Neish says his team is working to determine which part of the bacteria is responsible for inducing cells to produce ROS. Once identified, this component could be used to encourage intestinal healing in situations where contact with large amounts of live bacteria might be dangerous, such as in premature babies or critically ill adults.
The research was supported by the National Institutes of Health.
Public release date: 11-May-2011
Study finds highest reported BPA level in pregnant woman and associated abnormalities in infant
Possible link between high prenatal BPA levels and neonatal neurobehavioral abnormalities; study advises pregnant women to reduce exposure levels
SEATTLE, May 11, 2011 — A new case study examining an infant’s neurobehavioral abnormalities and extremely high bisphenol A (BPA) concentration of the baby’s mother suggests a link between the two. The study, Environmental Health Perspectives: A Case Study of High Prenatal Bisphenol A Exposure and Infant Neonatal Neurobehavior, was led by researcher Sheela Sathyanarayana, MD of Seattle Children’s Research Institute, and recently published online in Environmental Health Perspectives.
BPA, a synthetic, man-made chemical, is used in a wide variety of products including: can linings; hard polycarbonate plastics such as baby bottles and reusable cups; and dental sealants. Food may be the single largest source of BPA exposure due to contamination of foods during preparation and processing. BPA has estrogenic (hormone-like) properties. In animal studies, exposure to BPA early in life can lead to a variety of abnormalities in early development of the brain, behavior, prostate gland and breast tissues.
In human studies, exposure to BPA early in life has not been studied extensively. However, one study found an association between BPA exposure in pregnancy and abnormal acting out behaviors in female children. In adults, increased BPA exposure has been associated with changes in hormone concentrations, sperm quality, and endometriosis.
“Pregnant women are often exposed to BPA in their daily lives,” said Sathyanarayana, pediatrician and environmental health specialist at Seattle Children’s and assistant professor of pediatrics at the University of Washington School of Medicine. “It’s important that they are aware of the potential sources of BPA, so they can take steps to avoid unnecessary exposures.”
In this case study, Sathyanarayana and co-investigators reported on a specific mother/infant pair from a larger study (Health Outcomes and Measures of the Environment – HOME study) that examined BPA exposures in pregnant women and then examined their infants for neurodevelopmental outcomes. At 27 weeks of pregnancy, the mother had the highest reported urinary BPA concentration of anyone in the general population. She reported consuming canned foods and beverages, and using and microwaving plastic food storage containers consistently during this pregnancy time period. All of these exposures could have led to her extremely high BPA concentration. Her infant had a normal newborn neurobehavioral exam but had many neurobehavioral abnormalities at the one-month study visit
including: increased muscle tone, tremors, and abnormal movements. The child went on to have normal neurobehavioral assessments yearly from one to five years of age.
This case study confirms previous studies documenting multiple sources of BPA exposure in humans. Additionally, it highlights the need for medical providers to be aware of the harmful effects of BPA exposures so they may counsel families appropriately about prevention. The study also identifies potential sources of BPA exposure that can be targeted to reduce exposures in the future. “Families can decrease their exposure to BPA by eating fresh fruit and vegetables (as opposed to processed and canned foods) and by decreasing use of plastic food storage containers,” said Sathyanarayana. “Check the recycling code of your plastics on the bottom. If it shows #7, then the plastic may contain BPA.”
This research project was supported by grants from the National Institutes of Health and the National Institute of Environmental Health Sciences. Along with Sathyanarayana, the research team included: Joe
M. Braun, PhD, from Harvard School of Public Heath; Kimberly Yolton, PhD, and Bruce P. Lanphear, MD, from Cincinnati Children’s Hospital Medical Center; and Stacey Liddy, MS, from BC Children’s Hospital.
Tips for reducing exposure of BPA for pregnant women and other parents and caregivers:
You may not be able to completely avoid BPA, but there are steps you can take to reduce your family’s exposure to it:
1. Limit the amount of canned foods your family eats.
2. Rinse canned fruits and vegetables before eating. When possible, choose fresh fruits and vegetables instead.
3. Limit the amount of canned beverages your family drinks.
4. Avoid using plastic food and beverage storage containers with #7 on the bottom. If the recycling code is
#7, then the plastic may contain BPA.
5. Avoid using plastic baby bottles with #7 on the bottom. 6.Decrease the use of all plastic food storage containers.
7. Avoid using plastic food storage containers to heat food in the microwave. (High temperatures increase the chance of food absorbing BPA.)
8. Use ceramic, glass, or other microwaveable dishes when heating food in the microwave.
9. Avoid canned infant formula. Instead, use powdered formula or liquid formula sold in plastic or glass containers.
Public release date: 12-May-2011
Lack of exercise linked to higher heart disease risk in healthy children as young as 9
Even healthy children as young as nine-years-old can start to show an increased risk of future heart problems if they are physically inactive, according to a study in the May issue of Acta Paediatrica.
A team of researchers from Sweden and Denmark studied 223 children – 123 boys and 100 girls – with an average age of 9.8 years, assessing their physical activity levels over four days.
They found that the children who were more physically active had a lower composite risk factor score for cardiovascular disease (CVD) than the children with lower amounts of moderate to vigorous physical activity and vigorous physical activity.
“It is well known that physical inactivity in adults is associated with a wide range of diseases and all causes of death” says lead author Dr Tina Tanha from the Department of Clinical Sciences at Skane University Hospital in Malmo, Sweden.
“We believe that our study now demonstrates a clear clinical association between physical inactivity and multiple CVD risk factors in children. It reveals that up to 11 per cent of the variance in composite CVD risk factor scores in the children could be explained by differences in their physical activity.”
The children wore an accelerometer strapped to an elastic waist belt for four consecutive days to measure physical activity levels, using parameters set by two large accelerometer studies. Children were only included in the study if they wore the belt for a minimum of eight hours a day for three days. They also underwent tests for various CVD risk factors, including blood pressure, resting heart rate, fitness and body fat.
Key findings included:
•The children’s average body mass index was 17.5 for the girls and 17.4 for the boys.
•The boys were significantly more physically active than the girls, with higher levels of general physical activity (746 mean counts per minute versus 620), moderate to vigorous physical activity (45 minutes versus 35 minutes) and vigorous physical activity (15 minutes versus 11 minutes).
•There were no significant differences between the genders when it came to systolic and diastolic blood pressure, mean arterial pressure and pulse pressure. However the resting heart rate was significantly higher in the girls (85 versus 80 beats per minute).
•The boys had lower total body fat mass than the girls (6.3kg versus 8.3kg) and lower percentage body fat (16.2 per cent versus 22.6 per cent), but a higher peak oxygen uptake (41.7mL/min/kg versus 35.7).
•Vigorous physical activity accounted for ten per cent of the variance in the accumulated cardiac risk scores and moderate to vigorous physical activity accounted for eight per cent of the variance. The results were similar for boys and girls.
•But there was a difference when it came to general physical activity. This accounted for 11 per cent of the variance in the boys, but showed no significant variance in the girls.
“Previous research into CVD risk factors in children have focused on quite specific single risk factors, but our study covers multiple risk factors” explains Dr Tanha.
“Our results show a significant association between low levels of activity and high composite risk factors
for CVD, even in young children. Much of the association was driven by body fat measurements and oxygen intake.
“This is important because the accumulation of these risk factors, if started in early childhood and sustained over a long period, is believed to have greater impact on CVD and mortality than one single risk factor.”
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