Health Technology Research Synopsis
23rd Issue Date 22 JAN 2008
Compiled By Ralph Turchiano
Editors Top Five:
1. Lipoic acid could reduce atherosclerosis, weight gain 2. Probiotics affect metabolism, says new study 3. Value of drugs for pre-osteoporosis exaggerated 4. Selective reporting of antidepressant trials exaggerates drug effectiveness 5. 4 health behaviors can add 14 extra years of life
In this issue:
1. More sun exposure may be good for some people 2. Muscles are affected by cigarette smoking 3. 4 health behaviors can add 14 extra years of life 4. New statistical technique shows more informative picture of survival 5. Evidence for Dopamine Toxicity in Neurodegeneration 6. UCLA study finds brain response differences in the way women with IBS anticipate and react to pain 7. High degree of resistance to antibiotics in Arctic birds 8. Stem cells make bone marrow cancer resistant to treatment 9. Editorialist: Scientific Journals Must Provide a Forum for New Discoveries Based on Clinical Observation 10. Vitamin D2 supplements may help prevent falls among high-risk older women 11. Diets high in lutein, zeaxanthin and vitamin E associated with decreased risk of cataracts 12. Selective restraints and reduced medication could reduce nursing home falls says 4-year study 13. Aggression as rewarding as sex, food and drugs 14. Lipoic acid could reduce atherosclerosis, weight gain 15. Celecoxib can adversely affect heart rhythm 16. Combined HRT increases risk of lobular breast cancer fourfold after just 3 years of use 17. Probiotics affect metabolism, says new study 18. Popular osteoporosis drugs triple risk of bone necrosis 19. Cholesterol-lowering drugs may not prevent Alzheimer’s disease 20. Selective reporting of antidepressant trials exaggerates drug effectiveness 21. Indian medicinal plant Acanthus ilicifolius may combat liver cancer 22. How does Fu-Zheng-Jie-Du-Decoction act on PTEN expression in hepatocellular carcinoma? 23. Weight gain induced by antipsychotic drugs can be avoided 24. Toxoplasma Infection Increases Risk of Schizophrenia, Study Suggests 25. Newly discovered virus linked to deadly skin cancer 26. Value of drugs for pre-osteoporosis exaggerated 27. Saline nasal wash helps improve children’s cold symptoms
Public release date: 7-Jan-2008
More sun exposure may be good for some people
UPTON, NY – A new study by scientists at the U.S. Department of Energy’s Brookhaven National Laboratory and colleagues in Norway suggests that the benefits of moderately increased exposure to sunlight – namely the production of vitamin D, which protects against the lethal effects of many forms of cancer and other diseases – may outweigh the risk of developing skin cancer in populations deficient in vitamin D. The study will be published online in the Proceedings of the National Academy of Sciences the week of January 7, 2008.
In the current study, Setlow and his colleagues used a model incorporating information on solar radiation intensity and a vertical cylinder shape to represent the human body’s skin surface to calculate the relative production of vitamin D via sunlight as a function of latitude, or distance from the equator. The cylindrical model more realistically represents human body sun exposure than flat surface exposure measurements used in previous models. The scientists also examined the incidence of and survival rates for various forms of cancer by latitude.
According to the calculations, people residing in Australia (just below the equator) produce 3.4 times more vitamin D as a result of sun exposure than people in the United Kingdom, and 4.8 times more than people in Scandinavia.
“There is a clear north-south gradient in vitamin D production,” Setlow says, “with people in the northern latitudes producing significantly less than people nearer the equator.”
In populations with similar skin types, there is also a clear increase in the incidence of all forms of skin cancer from north to south. “This gradient in skin cancer rates indicates that there is a true north-south gradient in real sun exposure,” Setlow says.
The scientists also found that the incidence rates of major internal cancers such as colon cancer, lung cancer, and cancers of the breast and prostate also increased from north to south. However, when the scientists examined the survival rates for these cancers, they found that people from the southern latitudes were significantly less likely to die from these internal cancers than people in the north.
“In previous work, we have shown that survival rates for these cancers improve when the diagnosis coincides with the season of maximum sun exposure, indicating a positive role for sun-induced vitamin D in prognosis – or at least that a good vitamin-D status is advantageous when combined with standard cancer therapies,” Setlow says. “The current data provide a further indication of the beneficial role of sun-induced vitamin D for cancer prognosis.”
So, how can people get the benefits of vitamin D without running the risk of deadly skin cancer”
“As far as skin cancer goes, we need to be most worried about melanoma, a serious disease with significant mortality,” Setlow says.
Melanoma is triggered by UVA (the long UV wavelengths) and visible light. Vitamin-D production in the body, on the other hand, is triggered by UVB (the short UV wavelengths at the earth’s surface). “So perhaps we should redesign sunscreens so they don’t screen out as much UVB while still protecting us from the melanoma-inducing UVA and visible light,” Setlow says.
Increased UVB exposure may result in an increase in non-melanoma skin cancers. But these are relatively easy to cure and have very low mortality rates compared with the internal cancers vitamin D appears to protect against, Setlow adds.
Another option would be to increase vitamin D consumption while continuing to wear sunscreen. Vitamin D is easily accessible in many foods and liquids, such as cod liver oil and milk, and in dietary supplements.
Public release date: 7-Jan-2008
MUSCLES ARE AFFECTED BY CIGARETTE SMOKING
A new study has revealed the effects of smoking on skeletal muscles. Researchers from Venezuela studied the vastus lateralis muscle in 14 smokers and 20 nonsmoking control subjects. Elements such as muscle structure, enzyme activity, constitutive and inducible nitric oxide synthases, and the presence of macrophages were analyzed. Researchers found that some muscular structural and metabolic damage was present in the smokers, but they did not exhibit local inflammation. In addition, the findings suggest a possible effect of tobacco smoke impairing the normal process of nitric oxide generation. This study is published in the January issue of the journal CHEST.
Public release date: 7-Jan-2008
4 health behaviors can add 14 extra years of life
People who adopt four healthy behaviours – not smoking; taking exercise; moderate alcohol intake; and eating five servings of fruit and vegetables a day – live on average an additional fourteen years of life compared with people who adopt none of these behaviours, according to a study published in the open access journal PLoS Medicine.
Rather than focusing on how an individual factor is related to health, the study calculates the combined impact of these four simply-defined forms of behaviour. The results suggest that several small changes in lifestyle could have a marked impact on the health of populations.
There is overwhelming evidence showing that lifestyles such as smoking, diet and physical activity influence health and longevity but there is little information about their combined impact. Furthermore the huge amount of information provided by these studies and the varying definitions of a health behaviour that these studies use can often make them confusing for public health professionals and for the general public. For example: small amounts of alcohol appear to be related to lower risk of cardiovascular disease health but what is the overall impact on longevity ”
In order to examine the combined impact of changes in lifestyle, Kay-Tee Khaw and colleagues from the University of Cambridge and the Medical Research Council used a health behaviour score that is easy to understand in order to assess the participants in the study (who were from Norfolk, United Kingdom). Between 1993 and 1997, 20,000 men and women between the ages of 45 and 79, none of whom had known cancer or heart or circulatory disease, completed a questionnaire that resulted in a score between 0 and 4. A point was awarded for each of the following: not currently smoking; not being physically inactive (physical inactivity was defined as having a sedentary job and not doing any recreational exercise); a moderate alcohol intake of 1-14 units a week (a unit is half a pint of beer or a glass of wine); and a blood vitamin C level consistent with eating five servings of fruit or vegetables a day. Deaths among the participants were recorded unti l 2006.
After factoring in age, the results showed that over an average period of eleven years people with a score of 0 – i.e. those who did not undertake any of these healthy forms of behaviour – were four times more likely to have died than those who had scored 4 in the questionnaire. Furthermore, the researchers calculate that a person who has a health score of 0 has the same risk of dying as someone 14 years older who had scored 4 in the questionnaire (i.e. someone engaging in all four healthy forms of behaviour). This was independent of social class and body mass index. The study forms part of the European Prospective Investigation into Cancer and Nutrition (EPIC), conducted across ten European countries, the largest study of diet and health ever undertaken.
As a related editorial discusses, individuals in isolation often cannot make the lifestyle changes they want and a set of complex processes affect how research is translated into effective public health policy.
The results of this study need to be confirmed in other populations and an analysis of how the combined health behaviours affect quality of life is also needed. Nevertheless the results of the study strongly suggest that these four achievable lifestyle changes could have a marked improvement on the health of middle-aged and older people, which is particularly important given the ageing population in the UK and other European countries.
Public release date: 8-Jan-2008
New statistical technique shows more informative picture of survival
Researchers have developed a new method for presenting clinical trial survival data that includes data from all trial participants unlike the standard method, according to a commentary published online January 8 in the Journal of the National Cancer Institute
In clinical studies, “time-to-event” data represents the time from the start of a study to an event, such as disease recurrence or death. But often many participants in a study do not experience an event before the study is over, so their survival time is not known. To overcome this data gap, the standard statistical method for presenting time-to-event results, known as the Kaplan-Meier survival curve, involves plotting the proportion of individuals surviving without an event over the period of the study. Using this method, researchers get an estimate of the median survival times. However, these plots also tend to make differences in survival between groups visually appear larger than they actually are.
To address this problem, Patrick Royston, D.Sc., of the Medical Research Council Clinical Trials Unit in London and colleagues developed a new method for plotting survival as a bar graph and tested it on data from a kidney cancer trial. In cases where a participant had not experienced an event, the researchers estimated that person’s survival by using their prognosis and length of time in the trial.
Their plots show considerable overlap in survival times between treatment and control groups in the kidney cancer trial, whereas the Kaplan–Meier plots of the same data showed a distinct separation between the two groups. The authors argue that the new method gives a more realistic representation of what are usually small differences between groups.
“The method is surprisingly informative and, we hope, will help physicians and patients to understand more fully the results of clinical trials and the implications of prognostic assessments,” the authors write.
In an accompanying editorial, Janet Wittes, Ph.D., of Statistics Collaborative in Washington, D.C., discusses the challenges in interpreting time-to-events graphs, how this new method addresses these problems, and under what circumstances this method should be used.
“Those of us who work with time-to-event data should now attempt to extend their method to…settings other than survival,” Wittes writes.
Ralph’s Note – It will be interesting if they review all of the prior drug trials now. Since they may all be inaccurate to some extent.
Public release date: 8-Jan-2008
Evidence for Dopamine Toxicity in Neurodegeneration
Linan Chen, Yunmin Ding, Barbara Cagniard, Amber D. Van Laar, Amanda Mortimer, Wanhao Chi, Teresa G. Hastings, Un Jung Kang, and Xiaoxi Zhuang
The symptoms of Parkinson’s disease are caused by loss of dopaminergic neurons in the substantia nigra; therefore, it seems somewhat counterintuitive that dopamine may be a vulnerability factor in the disease. But Chen et al. now provide strong evidence for this hypothesis. Dopamine metabolites are highly reactive species that cause oxidative damage, leading ultimately to degeneration. Dopaminergic neurons sequester dopamine into vesicles, thus protecting these cells from damage. To examine the potential toxic effects of dopamine, Chen et al. engineered transgenic mice to conditionally express the dopamine transporter (DAT) in striatal neurons: targets of dopaminergic neurons that lack the ability to sequester dopamine. When DAT was turned on, the mice exhibited motor dysfunction and neurodegeneration within weeks. These effects depended on the presence of dopamine: if the dopaminergic inputs to the striatum were unilaterally severed, motor function on the contralateral side was spared. In contrast, L-DOPA accelerated neurodegeneration.
Ralph’s Note – It has long been my hypothesis that Parkinson and the like. Is an enzyme malfunction in Dopamine (CMOT spec.) breakdown resulting in neuron death. But ,what do I know?
Public release date: 8-Jan-2008
UCLA study finds brain response differences in the way women with IBS anticipate and react to pain
UCLA researchers found that women with IBS cannot effectively turn-off a pain modulation mechanism in the brain, which causes them to be more sensitive to abdominal pain, compared to women without IBS.
The findings, appearing in the January 9 issue of the Journal of Neuroscience, may lead to a greater understanding of irritable bowel syndrome and new treatment approaches.
Irritable bowel syndrome affects 10 to 15 percent of the U.S. population and causes discomfort in the abdomen, along with diarrhea and/or constipation. Currently there is no cure and treatments only lessen symptoms.
During anticipation of pain, subjects without IBS decreased activity within brain areas involved with pain and emotional arousal, including the insula, amygdala and brainstem. IBS patients could not deactivate these circuits effectively, although they also knew the pain was not dangerous.
“The abdominal hypersensitivity that is a hallmark of IBS may represent an inability to downregulate pain and emotional arousal circuits, said Steven Berman, lead study author and a senior research scientist at UCLA. “IBS patients may have an inability to inhibit the competing tendency to upregulate emotional arousal in order to escape pain faster.”
Public release date: 11-Jan-2008
High degree of resistance to antibiotics in Arctic birds
In the latest issue of the journal Emerging Infectious Diseases, Swedish researchers report that birds captured in the hyperboreal tundra, in connection with the tundra expedition “Beringia 2005,” were carriers of antibiotics-resistant bacteria. These findings indicate that resistance to antibiotics has spread into nature, which is an alarming prospect for future health care.
“Our findings show that resistance to antibiotics is not limited to society and hospitals but is now spreading into the wild. Escalating resistance to antibiotics over the last few years has crystallized into one of the greatest threats to well-functioning health care in the future.”
Ralph’s Note – I issue this warning on a continuous basis. Global warming should be a second priorty to man made genetic alterations on the environment. Changing the bacterial structure of living organisms can have immediate and dire cosenquences. That can have disasterous effects in matter of days not decades.
Public release date: 11-Jan-2008
Stem cells make bone marrow cancer resistant to treatment
Scientists at the Johns Hopkins Kimmel Cancer Center say they have evidence that cancer stem cells for multiple myeloma share many properties with normal stem cells and have multiple ways of resisting chemotherapy and other treatments.
A report on the evidence, published in the Jan. 1 issue of the journal Cancer Research, may explain why the disease is so persistent, the Johns Hopkins scientists say, and pave the way for treatments that overcome the cells’ drug resistance. Multiple myeloma affects bone marrow and bone tissue.
“Cancer stem cells that have distinct biology and drug sensitivity as compared with the bulk of a cancer may explain why multiple myeloma, like many other cancers, so often relapses even after chemotherapy puts patients into remission,” says Richard J. Jones, M.D., professor and director of bone marrow transplant at Hopkins’ Kimmel Cancer Center and one of the scientists who authored the new report.
To their surprise, the research team noted that the multiple myeloma stem cells resemble other types of adult stem cells and exhibit similar properties that may make them resistant to chemotherapy. They found that the stem cells contain high levels of enzymes that neutralize toxins, like cancer drugs, and expel them through miniature pumps on their cell surface. The investigators believe that these drug-fighting enzymes and pumps – also plentiful in normal stem cells – may help cancer stem cells resist treatment.
“Nature made normal stem cells very hearty for a reason, namely to survive and help repair damaged tissues and organs after injury or illness,” says William Matsui, M.D., an assistant professor of oncology at Hopkins and the study’s lead investigator. “To us, it makes sense that the same processes that protect normal stem cells also exist in cancer stem cells to make them resistant to chemotherapy. We need to develop new ways to target the specific biology of cancer stem cells to prevent the continued production of mature tumor cells and disease relapse.”
“Standard cancer therapy is like mowing the weed – it gets rid of the disease transiently but the dandelion always grows back. We need to get rid of the root to cure disease, and therefore need a different type of therapy – mowing won’t work,” says Jones.
Ralph’s Note- When Stem Cells become the disease not the cure. Good science on this double edge sword.
Public release date: 11-Jan-2008
Editorialist: Scientific Journals Must Provide a Forum for New Discoveries Based on Clinical Observation
Recalling some of the great discoveries from research in general practice, Ian McWhinney, M.D., suggests journals need to develop standards that provide space for novel findings that are based on clinical observation and do not fit any of the traditional research categories. This kind of clinical research is often carried out by single practitioners working with their own patients – the essence of general practice. He suggests that if research journals are to provide a forum for, rather than squelch, new discoveries, traditional methodological standards may be less important than plausibility, support from the basic sciences and appropriate literature, clarity of concepts and reproducibility of the procedures.
Assessing Clinical Discoveries
By Ian R. McWhinney, O.C., M.D., F.R.C.G.P., F.C.F.P., F.R.C.P
Ralph’s Note – The public must become aware of how good science is being crushed, by strong financial interest and ego‘s..
Public release date: 14-Jan-2008
Vitamin D2 supplements may help prevent falls among high-risk older women
Vitamin D2 supplements appear to reduce the risk of falls among women with a history of falling and low blood vitamin D levels living in sunny climates, especially during the winter, according to a report in the January 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
“Approximately one-third of women older than 65 years fall each year, and 6 percent sustain a fracture as a result of the fall,” the authors write as background information in the article. “In addition, fear of falling is a major problem in older people.”
Richard L. Prince, M.D., of the Sir Charles Gairdner Hospital, Nedlands, Australia, and colleagues conducted a year-long clinical trial of 302 women age 70 to 90 years living in Perth, Australia. Because vitamin D is produced in response to sun exposure and the study was completed in a sunny climate, the researchers selected women with blood vitamin D levels below the median for the area (24 nanograms per milliliter). All participants had a history of falling in the previous year and received 1,000 milligrams of calcium citrate per day. Half were then randomly assigned to take either 1,000 international units of vitamin D2 (ergocalciferol) and half took an identical placebo. Data on falls were collected from participants every six weeks.
Eighty women (53 percent) in the vitamin D2 group and 95 women (62.9 percent) in the control group fell at least once during the study period. After adjusting for height, which affected the risk of falling and was significantly different between the two groups, vitamin D2 therapy reduced the risk of having at least one fall by 19 percent. “When those who fell were grouped by the season of first fall or the number of falls they had, ergocalciferol treatment reduced the risk of having the first fall in winter and spring but not in summer and autumn, and reduced the risk of having one fall but not multiple falls,” the authors write.
“It is interesting that the ergocalciferol therapy effect was confined to those who were to sustain one fall but not those destined to have more than one fall,” the authors write. “Older people who fall frequently tend to have more risk factors for falling, including greater degrees of disability and poorer levels of physical function.” It is possible that chemically correcting vitamin D levels in the blood is insufficient to prevent falls in these individuals, they note. “Ergocalciferol, 1,000 international units per day, added to a high calcium intake is associated with 23 percent reduction of the risk of falling in winter/spring to the same level as in summer/autumn,” the authors conclude.
Public release date: 14-Jan-2008
Diets high in lutein, zeaxanthin and vitamin E associated with decreased risk of cataracts
Women who have higher dietary intake of lutein and zeaxanthin—compounds found in yellow or dark, leafy vegetables—as well as more vitamin E from food and supplements appear to have a lower risk for developing cataracts, according to a report in the January issue of Archives of Ophthalmology, one of the JAMA/Archives journals
“The oxidative hypothesis of cataract formation posits that reactive oxygen species can damage lens proteins and fiber cell membranes and that nutrients with antioxidant capabilities can protect against these changes,” the authors write as background information in the article. Vitamin E, vitamin C, beta carotene, lutein and zeaxanthin are all believed to have antioxidant properties. Lutein and zeaxanthin are the only carotenoids—yellow plant pigments—present in the lens of the human eye and may also protect against cataracts by filtering harmful blue light
William G. Christen, Sc.D., of Brigham & Women’s Hospital and Harvard Medical School, Boston, and colleagues analyzed dietary information from 35,551 female health professionals who enrolled in the Women’s Health Study in 1993. The women were then followed for an average of 10 years, and the diets of those who developed cataracts were compared with the diets of those who did not.
A total of 2,031 women developed cataracts during the study. When the participants were split into five groups based on the amount of lutein and zeaxanthin they consumed, those in the group who consumed the most (about 6,716 micrograms per day) had an 18 percent lower chance of developing cataracts than those who consumed the least (1,177 micrograms per day). The one-fifth who consumed the most vitamin E from food and supplements—about 262.4 milligrams per day—were 14 percent less likely than the one-fifth who got the least (4.4 milligrams per day).
“In conclusion, these prospective data from a large cohort of female health professionals indicate that higher intakes of lutein/zeaxanthin and vitamin E are associated with decreased risk of cataract,” the authors write. “Although reliable data from randomized trials are accumulating for vitamin E and other antioxidant vitamins, randomized trial data for lutein/zeaxanthin are lacking. Such information will help to clarify the benefits of supplemental use of lutein/zeaxanthin and provide the most reliable evidence on which to base public health recommendations for cataract prevention by vitamin supplementation.”
Public release date: 14-Jan-2008
Selective restraints and reduced medication could reduce nursing home falls says 4-year study
Selectively restraining elderly residents and giving them fewer sleeping pills could significantly reduce falls, according to a survey of 21 nursing home units published in the January issue of Journal of Clinical Nursing.
The researchers found that people using certain drugs were much more likely to experience a fall. Sleeping pills and anti-depressants made people 1.4 times more likely to fall, neuroleptics (antipsychotic drugs) made them 1.9 times more likely and sleeping pills with benzodiazepines (sedatives) made them 2.9 times more likely.
Public release date: 14-Jan-2008
Aggression as rewarding as sex, food and drugs
NASHVILLE, Tenn.—New research from Vanderbilt University shows for the first time that the brain processes aggression as a reward – much like sex, food and drugs – offering insights into our propensity to fight and our fascination with violent sports like boxing and football.
The research will be published online the week of Jan. 14 by the journal Psychopharmacology.
“Aggression occurs among virtually all vertebrates and is necessary to get and keep important resources such as mates, territory and food,” Craig Kennedy, professor of special education and pediatrics, said. “We have found that the ‘reward pathway’ in the brain becomes engaged in response to an aggressive event and that dopamine is involved.”
The Vanderbilt experiments are the first to demonstrate a link between behavior and the activity of dopamine receptors in response to an aggressive event.
“We learned from these experiments that an individual will intentionally seek out an aggressive encounter solely because they experience a rewarding sensation from it,” Kennedy said. “This shows for the first time that aggression, on its own, is motivating, and that the well-known positive reinforcer dopamine plays a critical role.”
Public release date: 14-Jan-2008
Lipoic acid could reduce atherosclerosis, weight gain
CORVALLIS, Ore. – A new study done with mice has discovered that supplements of lipoic acid can inhibit formation of arterial lesions, lower triglycerides, and reduce blood vessel inflammation and weight gain – all key issues for addressing cardiovascular disease.
Although the results cannot be directly extrapolated beyond the laboratory, researchers report that “they strongly suggest that lipoic acid supplementation may be useful as an inexpensive but effective intervention strategy . . . reducing known risk factors for the development of atherosclerosis and other inflammatory vascular diseases in humans.”
The findings were made by scientists from the Linus Pauling Institute and College of Veterinary Medicine at Oregon State University, and the Department of Medicine at the University of Washington. They were just published in Circulation, a journal of the American Heart Association.
Heart disease is the leading cause of death in the United States.
The study found that lipoic acid supplements reduced atherosclerotic lesion formation in two types of mice that are widely used to study cardiovascular disease, by 55 percent and 40 percent, respectively. The supplements were also associated with almost 40 percent less body weight gain, and lower levels of triglycerides in very low-density lipoproteins.
As a result, the authors concluded that “lipoic acid may be a useful adjunct in the prevention and treatment of atherosclerotic vascular diseases.”
“We are excited about these results, particularly since the supplements of lipoic acid appear to provide several different mechanisms to improve cardiovascular health,” said Balz Frei, professor and director of the Linus Pauling Institute. “They are helping in a fundamental way to reset and normalize metabolic processes, in ways that could help address one of the most significant health problems in the Western world.
“These findings also reinforce the need for more comprehensive human studies,” Frei said. “That will be the next step in our research, in double-blind, randomized, clinical studies during the next five years with Oregon Health and Science University.”
Alpha lipoic acid is a naturally occurring nutrient found at low levels in green leafy vegetables, potatoes and meats, especially organ meats such as kidney, heart or liver. The amounts used in this research would not be obtainable by any normal diet, researchers said, and for human consumption might equate to supplements of about 2,000 milligrams per day. Even at low, normal, dietary levels, the compound can play a key role in energy metabolism.
Atherosclerosis, or what used to be called “hardening of the arteries,” is a long-term process that is now seen as a chronic inflammatory disease, which begins when certain types of white blood cells called monocytes bind to “adhesion molecules” on the walls of arteries. This in turn allows the monocytes to enter the arterial wall, there they become inflammatory macrophages that, in the presence of low density lipoprotein, or LDL, can transform into lipid-laden foam cells – ultimately, an arterial fat deposit.
This chronic process often begins during adolescence, can continue for a lifetime, and has been linked to obesity, poor diet, lack of exercise, diabetes, high blood pressure, genetic predisposition and other causes. The fatty deposits in arteries can ultimately trigger a heart attack or stroke.
Researchers now believe that high levels of alpha lipoic acid can be particularly useful in preventing this process, by inhibiting the formation of the adhesion molecules. It can also lower triglycerides, another important risk factor for cardiovascular disease. It may also function as an antioxidant, and helps to normalize insulin signaling and glucose metabolism.
“From what we understand, this supplement would be most valuable as a preventive mechanism before people have advanced cardiovascular disease,” Frei said. “However, it may help retard the process at any stage, and may also be of value in treating diabetic complications.”
Also of considerable interest, Frei said, is the apparent role of lipoic acid supplementation in reducing weight gain. It appears to have this effect both through appetite suppression, an enhanced metabolic rate, and – at least in laboratory animals – has been shown to stimulate higher levels of physical activity, which again would increase caloric expenditure and further reduce weight.
Mice given lipoic acid supplements simply chose to eat less than a control group that did not receive supplements, suggesting a reduced appetite. In another test, mice that received supplements gained less weight than other mice in a control group that were given identical amounts to eat, suggesting a higher metabolic rate and enhanced activity levels.
Weight gain and obesity is a major risk factor for atherosclerosis and heart disease, and lower weight and abdominal fat may be one of the mechanisms by which lipoic acid has beneficial effects, Frei said. The study concluded that “lipoic acid supplementation may be a promising approach to prevent weight gain and to lower cardiovascular disease risk in humans.”
Although some of the most compelling research with lipoic acid research has been done in mouse models, scientists say, there should be a reasonable extrapolation to humans, because the lipoprotein profile is similar, as well as the composition of the atherosclerotic lesions. These mouse models are routinely used in studies of human atherosclerosis.
Public release date: 14-Jan-2008
Celecoxib can adversely affect heart rhythm
COX-2 inhibitors like Celecoxib have come under scrutiny lately due to adverse cardiovascular side-effects stemming from COX-2 reduction. In both fruit fly and rat models, researchers reveal another adverse effect of Celecoxib; this drug can induce arrhythmia. More interestingly, this effect is independent of the COX-2 enzyme.
Satpal Singh and colleagues tested various Celecoxib doses on the heart rate of Drosophila, a good model for human cardiac pharmacology. To their surprise, administering 3 ƒÝm Celecoxib (not much higher than the plasma levels in humans taking the drug) reduced heart rate and increased beating irregularities, while 30 ƒÝm was enough to stop the heart within a minute.
The surprise arises from the fact that Drosophila do not have COX-2 enzymes. Rather, Celecoxib could directly inhibit the potassium channels that help generate the electric current that drives heartbeat.
The researchers could achieve similar heart-stopping results in rat cardiac cells, whereas aspirin, another potent COX-2 inhibitor, had no effect, confirming that another mechanism is at work. The drug also inhibited rat and human potassium channels expressed in a human cell line.
Singh and colleagues point out that since these arrhythmia effects bypass COX-2, it is unclear if other COX-2 inhibitors would yield similar results. They also stress it is too early to speculate on human effects, although their results suggest Drosophila are a valuable tool to investigate other COX-2 drugs.
Ralph’s Note- The dosage required to stop the heart was 10 times the normal level. While not pratical , those with liver disorders may have been extremely vulnerable to the drug.
Public release date: 15-Jan-2008
Combined HRT increases risk of lobular breast cancer fourfold after just 3 years of use
SEATTLE – Postmenopausal women who take combined estrogen/progestin hormone-replacement therapy for three years or more face a fourfold increased risk of developing various forms of lobular breast cancer, according to new findings by researchers at Fred Hutchinson Cancer Research Center.
“Previous research indicated that five or more years of combined hormone-therapy use was necessary to increase overall breast-cancer risk,” said Christopher I. Li, M.D., Ph.D., the lead author of the report, published in the January issue of Cancer Epidemiology, Biomarkers and Prevention. “Our study, the first specifically designed to evaluate the relationship between combined HRT and lobular breast cancers, suggests that a significantly shorter length of exposure to such hormones may confer an increased risk.
The researchers found that current users of combined HRT had a 2.7-fold and 3.3-fold elevated risk of lobular and ductal-lobular cancer, respectively, regardless of tumor stage, size or number of lymph nodes involved. Only women who used combined HRT for three or more years faced an increased risk of lobular cancer. Among mixed ductal-lobular cases, hormone therapy increased the risk of tumors that were predominantly lobular but not tumors that had predominantly ductal characteristics.
The incidence of invasive lobular and ductal-lobular breast cancers has risen rapidly in the United States, increasing 52 percent and 96 percent, respectively, between 1987 and 1999, whereas rates of ductal cancer have increased only 3 percent during this time.
“These findings are still of considerable public-health importance considering the estimated 57 million prescriptions for menopausal hormone therapy that continue to be filled in the United States,” Li said.
Ralph’s Note- This tsunami of problems was forecast years in advance by good Doctors. Yet the science was pushed under the carpet. The Pharmaceutical companies who participated in this cover up, should be responsible for the medical bills of the coming storm. In another words, we have not seen the end of this.
Public release date: 15-Jan-2008
Probiotics affect metabolism, says new study
Probiotics, such as yoghurt drinks containing live bacteria, have a tangible effect on the metabolism, according to the results of a new study published today (Tuesday 15 January) in the journal Molecular Systems Biology.
The research is the first to look in detail at how probiotics change the biochemistry of bugs known as gut microbes, which live in the gut and which play an important part in a person’s metabolic makeup. Different people have different types of gut microbes inside them and abnormalities in some types have recently been linked to diseases such as diabetes and obesity.
For the study, researchers from Imperial College London and Nestlé Research Center, Lausanne, Switzerland, gave two different types of probiotic drink to mice that had been transplanted with human gut microbes. Probiotics contain so-called ‘friendly’ bacteria and there is some evidence to suggest that adding ‘friendly’ bacteria to the gut can help the digestive system.
The researchers compared the levels of different metabolites in the liver, blood, urine, and faeces, of mice who had received treatment with probiotics and those that had not.
They found that treatment with probiotics had a whole range of biochemical effects and that these effects differed markedly between the two probiotic strains, Lactobacillus paracasei and Lactobacillus rhamnosus. Adding ‘friendly’ bacteria changed the makeup of the bugs in the gut, not only because this increased the number of such bacteria, but also because the ‘friendly’ bacteria worked with other bacteria in the gut, amplifying their effects.
One of the many biochemical changes observed by the researchers was a change in how mice treated with probiotics metabolised bile acids. These acids are made by the liver and their primary function is to emulsify fats in the upper gut. If probiotics can influence the way in which bile acids are metabolised, this means they could change how much fat the body is able to absorb.
Professor Jeremy Nicholson, corresponding author on the study from the Department of Biomolecular Medicine at Imperial College, explained “Some argue that probiotics can’t change your gut microflora – whilst there are at least a billion bacteria in a pot of yoghurt, there are a hundred trillion in the gut, so you’re just whistling in the wind.
“Our study shows that probiotics can have an effect and they interact with the local ecology and talk to other bacteria. We’re still trying to understand what the changes they bring about might mean, in terms of overall health, but we have established that introducing ’friendly’ bacteria can change the dynamics of the whole population of microbes in the gut,” he said.
The researchers hope their new insights about how probiotics and gut microbes interact will ultimately enable the development of new probiotic therapies, which can be tailored for people with different conditions and different metabolic makeups.
Dr. Sunil Kochhar, another author on the study from the Nestlé Research Center, added: “Understanding changes in the molecular events triggered by the so-called beneficial bacteria in the host metabolism is an important prerequisite in our efforts to develop customized nutritional solutions to maintain and/or enhance our consumer’s health and wellness at an individual level. The results of this study are highly promising to address personalized nutrition.”
Public release date: 15-Jan-2008
Popular osteoporosis drugs triple risk of bone necrosis
A University of British Columbia and Vancouver Coastal Health Research Institute study has found that a popular class of osteoporosis drugs nearly triples the risk of developing bone necrosis, a condition that can lead to disfigurement and incapacitating pain
The research is the largest study of bone necrosis and bisphosphonates, a class of drugs used by millions of women worldwide to help prevent bone fractures due to osteoporosis. It is also the first study to explore the link between bone necrosis and specific brands of bisphosphonates, such as Actonel, Didrocal and Fosamax. Researchers found that all three brands had similar outcomes
Bone necrosis, a relatively rare disease diagnosed in approximately 1 in 20,000 people per year, leads to permanent loss of blood supply to the bones. Without adequate blood supply, the bone tissue dies and causes the bone to collapse. The disease primarily affects shoulders, knees and hips at the joints, causing severe pain and immobility.
Published online by the Journal of Rheumatology today, the findings follow a recent U.S. Food and Drug Administration alert about bisphosphonates that highlighted the possibility of severe and sometimes incapacitating bone, joint and/or muscle pain in patients taking the drugs. (To view the FDA alert, visit: http://www.fda.gov/cder/drug/infopage/bisphosphonates/default.htm.)
According to the American Dental Association, more than 190 million prescriptions have been written for bisphosphonates worldwide. The drugs are promoted in direct-to-consumer advertisements on U.S. television stations.
The message for women taking these medications is to pay attention to your pain,” said principal investigator Dr. Mahyar Etminan of the Centre for Clinical Epidemiology and Evaluation at UBC and VCHRI. “Given the widespread use of these drugs, it is important that women and their doctors know the risks that come with taking them.”
Etminan cautions that bisphosphonate use may increase in the future as the possible link between estrogen use and breast cancer prompts women to switch from estrogen therapy to bisphosphonate therapy to prevent osteoporotic bone fractures. Another reason may be the availability of new bisphosphonates that come in once-a-month or once-a-year doses.
Public release date: 16-Jan-2008
Cholesterol-lowering drugs may not prevent Alzheimer’s disease
ST. PAUL, Minn. – Contrary to some reports, taking statins, which are cholesterol-lowering drugs, offers no protection against Alzheimer’s disease, according to research published in the January 16, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“Some studies have suggested people taking cholesterol-lowering drugs are less likely to have Alzheimer’s disease, but our longitudinal findings found no relation between statin use and Alzheimer’s,” said study author Zoe Arvanitakis, MD, MS, Associate Professor of the Department of Neurological Sciences at Rush University Medical Center in Chicago and member of the American Academy of Neurology. “The study also found no association between taking statins and a slower cognitive decline among older people.”
In addition, researchers performed brain autopsies on more than 250 people who died during the study to examine the relation of statins to Alzheimer’s disease pathology and stroke in the brain, the two common pathological causes of dementia. The study found statin use at any time during the course of the study had no effect on pathology of Alzheimer’s disease or strokes
Public release date: 16-Jan-2008
Selective reporting of antidepressant trials exaggerates drug effectiveness
PORTLAND, Ore. – Selective publication in reporting results of antidepressant trials exaggerates the effectiveness of the drugs, according to a report in the January 17 issue of the New England Journal of Medicine. The report’s primary author is Erick Turner, M.D., assistant professor of psychiatry, physiology and phamacology at Oregon Health & Science University (OHSU) and Medical Director of the Portland Veterans Affairs Medical Center’s Mood Disorders Program.
Turner and his colleagues examined reviews from the Food and Drug Administration (FDA) for trials of 12 widely prescribed antidepressant drugs approved between 1981 and 2004, involving 12,564 patients. They also conducted a systematic literature search to identify whether results of these studies had been published in medical journals. For trials that had been published, they compared the published version of the results with the FDA version of the results
Whether and how the studies were published depended on how they turned out, Turner’s team found. According to the published literature, nearly all studies conducted (94 percent) had positive treatment results, but FDA data showed that in fact only about half (51 percent) of the studies were positive. Positive studies, with one exception, were all published. Most studies (33 out of 36) that were not positive either were not published or were published as if they were positive, in conflict with the FDA conclusions. These 33 studies involved 5,212 patients.
“Selective publication can lead doctors and patients to believe drugs are more effective than they really are, which can influence prescribing decisions, said Turner. He also cautioned that the surprisingly large number of negative studies does not mean that antidepressants are ineffective. His team found that each drug, when all its studies were combined using a statistical technique called meta-analysis, was superior to treatment with a placebo (sugar pill). On the other hand, this analysis also showed that each drug, based on the FDA data, was less effective than it would appear from the published literature.
Turner said that he and his colleagues don’t know whether the bias resulted from a failure of authors and sponsors to submit manuscripts, from decisions by journal editors and reviewers not to publish, or both. “Regardless, doctors and patients must have access to evidence that is complete and unbiased when they are weighing the risks and benefits of treatment,” he emphasized.
Public release date: 16-Jan-2008
Indian medicinal plant Acanthus ilicifolius may combat liver cancer
Liver cancer is the fifth most common cancer in the world with a poor prognosis. About three quarters of the cases of liver cancer are found in Southeast Asia, including China, Hong Kong, Taiwan, Korea, India, and Japan. The frequency of liver cancer in Southeast Asia and sub-Saharan Africa is greater than 20 cases per 100,000 population. Moreover, recent data show the frequency of liver cancer in the U.S. overall is rising.
With the increasing trend in the incidence of cancers in our country, biomedical research directed at early detection and diagnosis, prognosis and survival, as well as prevention of progression of malignancy, is of prime importance. The aim of cancer chemoprevention is to circumvent the development and progression of malignant cells through the use of non-cytotoxic nutrients, herbal preparations/natural plant products, and/or pharmacological agents. Encouraging dietary intake with herbal supplements may therefore be an effective strategy to limit DNA lesions and organic injuries leading to cancers and other chronic degenerative diseases. A research article published in the December 28 issue of the World Journal of Gastroenterology explores this point.
A research article published on December 28, 2007 in the World Journal of Gastroenterology (volume 13, issue 48) addresses this problem. The research team led by Prof. Malay Chatterjee from Jadavpur University investigated the primary chemopreventive mechanisms of Acanthus ilicifolius in an in vivo tumor-transplanted murine model. A. ilicifolius, popularly known as ¡°Harkach Kanta¡± is distributed widely throughout the mangroves of India, including Sunderbans in West Bengal, west coasts, and the Andamans, and in other Asian countries like Singhal, Burma, China, Thailand etc.
The results showed the aqueous leaf extract (ALE) of the plant was substantially effective in preventing hepatic DNA alterations and sister-chromatid exchanges (a type of chromosomal damage) in tumor-bearing mice. The study further demonstrated that ALE treatment was able to limit liver metallothionein expression, a potential marker for cell proliferation, and lengthen the mean survival of animals to a significant extent. The findings suggest that A. ilicifolius may be used as a potential chemoprotector against hepatic neoplasia.
This research from Prof. Chatterjee¡¯s laboratory opens up a promising avenue in cancer chemoprevention with the use of indigenous plants. The results obtained from this in vivo study seem interesting and encouraging. Lack of toxicity favors further preclinical evaluation of A. ilicifolius in a defined chemical carcinogenesis model. Elucidation of its anticarcinogenic mechanisms of action at the intricate molecular circuits, and isolation and characterization of its active principles, will provide a better understanding of the anti-cancer/chemoprevention strategy of A. ilicifolius. If these studies are found to be really functional, we will have the beginning of a new chemoprevention program with herbal supplements that could have the broadest implications for the well-being of society.
Public release date: 16-Jan-2008
How does Fu-Zheng-Jie-Du-Decoction act on PTEN expression in hepatocellular carcinoma?
Many hepatocellular carcinoma (HCC) patients in China may be treated with Traditional Chinese medicine (TCM). Some say it works, others doubt its effectiveness. These stated that a research group in China had found TCM can down-regulate the expression of PTEN in HCC, which may suppress tumor cell growth and regulate tumor cell invasion and metastasis.
A research article published on January 7, 2008 in the World Journal of Gastroenterology (volume 14, issue 1) addresses this problem. The research group imbedded hepatoma carcinoma tissue in the livers of 48 male athymic mice. The mice were distributed randomly into two groups: The chemotherapy group was treated by intragastric administration with FT207 (Tegafur). The TCM group was treated by intragastric administration with FZJDT (complex prescription of Chinese crude drug) that had been deliquated into 3 kinds of density as the low, middle, and high.
Four weeks later, the researchers found the TCM group had distinct superiority in their survival rate compared with the chemotherapy group. There was less tumor metastasis in the livers of the TCM group than in the chemotherapy group. Particularly the results of immunohistochemistry showed the intensity of PTEN (Phosphatase and Tensin Homolog deleted on Chromosome 10) in the TCM group was higher than in the chemotherapy group.
PTEN was recently identified as a tumor suppressor gene by three American research teams. They found PTEN may suppress tumor cell growth and regulate tumor cell invasion and metastasis through inhibiting many signal pathways of cell proliferation.
FZJDT has been widely used to treat HCC for years in The First Affiliated Hospital of Sun Yat-Sen University. Just what is the mechanism of the Chinese herbs that strengthens the body’s resistance and removes toxic substances? Our research showed TCM could markedly increase expression of PTEN in the athymic mice, compared with the chemotherapy group treated with FT207, indicating the anticancer mechanism of the TCM used in this study.
Mechanisms of TCM healing HCC may partially be explained by the enhancing of the expression of PTEN in the liver. The results of this study suggest a promising future for TCM as a combined therapy to treat HCC in China .
Public release date: 16-Jan-2008
Weight gain induced by antipsychotic drugs can be avoided
Quebec City, January 16, 2008—A research team from Université Laval’s Faculty of Medicine and Robert-Giffard Hospital has demonstrated that weight gain induced by the use of antipsychotic drugs—which in extreme cases can be as high as 30 kilos in only one month—can be avoided through a specially designed weight control program. The researchers supervised by psychiatrist Marie-Josée Poulin and kinesiologist Angelo Tremblay report the details of their findings in a recent edition of the Australian and New Zealand Journal of Psychiatry.
To evaluate the program’s effectiveness, the research team regularly measured the participants’ key biochemical and physical parameters and compared them to those of a control group made up of 51 sedentary or moderately active patients also taking antipsychotic medication.
In the control group, subjects’ weight, waist size and body mass index increased on average more than 4% from the beginning to the end of the study. Their levels of bad cholesterol and triglycerides also went up 15% and 12% respectively.
In contrast, the subjects who took part in the weight control program saw their average weight, waist size and body mass index decrease by 4% or more while their levels of good cholesterol went up 21%, their bad cholesterol went down 14%, and their triglycerides levels decreased by 26%.
“This is encouraging news for people suffering from mental illness because weight gain induced by antipsychotic drugs has several negative effects: it disrupts the lipid profile, increases cardiovascular and diabetes risk, and interferes with effective treatment follow-up,” points out Jean-Philippe Chaput, co-author of the study. “Our results highlight the importance of a weight control program designed specifically for people who take antipsychotic drugs. In an ideal world, every prescription for antipsychotic medication should be accompanied by a prescription for physical training,” concludes the researcher.
Public release date: 16-Jan-2008
Toxoplasma Infection Increases Risk of Schizophrenia, Study Suggests
Findings from what is believed to be the largest comparison of blood samples collected from healthy individuals and people with schizophrenia suggest that infection with the common Toxoplasma gondii parasite, carried by cats and farm animals, may increase the risk of schizophrenia.
A report on the study, conducted among U.S. military personnel by researchers from Walter Reed Army Institute of Research and Johns Hopkins Children’s Center appears in the January issue of the American Journal of Psychiatry.
Researchers found that of the 180 study subjects diagnosed with schizophrenia, 7 percent had been infected with toxoplasma prior to their diagnosis, compared to 5 percent among the 532 healthy recruits. Thus, people exposed to toxoplasma had a 24 percent higher risk of developing schizophrenia. The difference, while seemingly small, is important, researchers say, because the ability to explain even a small portion of the 2 million cases of schizophrenia in the United States may offer clues to the disease and some possible treatments.
For example, the investigators say they plan to study whether aggressive treatment of toxoplasma infection with antiparasitic drugs in patients with schizophrenia could halt the progression of the mental disorder, characterized by paranoia, delusions and hallucinations.
Previous studies have reported on the link between schizophrenia and the presence of toxoplasma antibodies, which are evidence of past infection, but this is the first study to show that infection with the parasite can precede the initial onset of symptoms and subsequent diagnosis with schizophrenia, Yolken says.
Because the U.S. military routinely tests its active personnel for toxoplasma, among other infectious agents, and stores blood samples in a central repository, researchers were able to determine the time line between infection and a diagnosis of schizophrenia.
“Until now, the only thing we could say is that some people with schizophrenia also had been infected with toxoplasma at some point, but we couldn’t tease out which came first,” Yolken says. “With our current study, we were able to show that infection came first.”
While most people infected with toxoplasma never develop schizophrenia, the parasite may be a trigger in those genetically predisposed to the disorder, a classic example of how genes and environment come together in the development of disease, Yolken says.
Public release date: 17-Jan-2008
Newly discovered virus linked to deadly skin cancer
PITTSBURGH, Jan. 17 – A new strategy to hunt for human viruses described in this week’s issue of the journal Science by the husband-and-wife team who found the cause of Kaposi’s sarcoma has revealed a previously unknown virus strongly associated with another rare but deadly skin cancer called Merkel cell carcinoma. In the paper, University of Pittsburgh Cancer Institute (UPCI) researchers, Huichen Feng, Ph.D., Masahiro Shuda, Ph.D., Yuan Chang, M.D., and Patrick Moore, M.D., M.P.H., explain a nearly decade-long effort to harness the sequencing technology to identify the virus, which they call Merkel cell polyomavirus (MCV). While the research team emphasizes that their work does not prove MCV to be the cause of Merkel cell carcinoma, if the findings are confirmed, they may lead to new cancer treatment and prevention options.
“This is the first polyomavirus to be strongly associated with a particular type of human tumor,” said Dr. Moore, professor of microbiology and molecular genetics at the University of Pittsburgh School of Medicine and leader of the molecular virology program at UPCI. “Although polyomaviruses have been studied in relation to cancer development for years, the weight of scientific evidence had been leaning toward the view that these viruses do not cause human cancers.”
Polyomaviruses are a group of viruses that have been shown to cause cancers in animals for more than 50 years. But Dr. Moore noted that additional research is needed to determine what role, if any, MCV plays in human cancer development.
Clues from elsewhere in the biomedical literature point to the existence of MCV, which has a genetic structure that is closely related to an African green monkey virus found in Germany in the 1970s. Researchers have found antibody evidence from blood tests that indicates some 15 percent to 25 percent of adults are infected with the still undiscovered human relative of this monkey virus. If MCV turns out to be this long-sought infection, then more than 1 billion people worldwide could already be infected
“But again, look to the example of HPV,” said Dr. Moore. “Although up to 50 percent of sexually active young women are infected with HPV, a small proportion may actually get cervical cancer.”
Even if MCV is proven to play a role in MCC, Dr. Chang also cautioned that the virus is likely to be just a part of a much larger picture.
“Now we need to find out how it works,” she said. “Once the virus integrates, it could express an oncoprotein, or it could knock out a gene that suppresses tumor growth. Either way, the results are bound to be interesting.”
Ralph’s Note – Hmmm. 15 to 25 percent of adults infected with the monkey virus. By any chance could that have all come from the Polio vaccine? That was in the 1970’s Germany, I could only wonder what it is 2008 U.S.A..
Public release date: 17-Jan-2008
Value of drugs for pre-osteoporosis exaggerated
Drugs for pre-osteoporosis: Prevention or disease-mongering?
A series of recent scientific publications have exaggerated the benefits and underplayed the harms of drugs to treat pre-osteoporosis or “osteopenia” potentially encouraging treatment in millions of low risk women, warn experts in this week’s BMJ.
The authors believe that this represents a classic case of disease-mongering: a risk factor being transformed into a medical disease in order to sell tests and drugs to relatively healthy people.
Osteopenia or “pre-osteoporosis” is said to affect around half of all older women and, in at least one country, drug companies have already begun to market their drugs to women with osteopenia, based on re-analyses of four osteoporosis drug trials.
But the authors of this week’s BMJ paper argue that this move raises serious questions about the benefit-risk ratio for low risk individuals, and about the costs of medicalising and potentially treating an enormous group of healthy people.
These reanalyses tend to exaggerate the benefits of drug therapy, they say. For example, the authors of one reanalysis cite a 75% relative risk reduction, though this translates into only a 0.9% reduction in absolute risk.
In other words, up to 270 women with pre-osteoporosis might need to be treated with drugs for three years so that one of them could avoid a single vertebral fracture.
Most of the reanalyses also play down the harms of drug therapy, they add. For example, the reanalysis of data for the drug raloxifene focuses solely on the potential benefits, with no mention of an increased risk of blood clots.
Finally, like much of the published literature on osteoporosis, these analyses have potential conflicts of interest, they write. For instance, all of the original drug trials being re-analysed were funded by industry and, in three out of four cases, drug company employees were part of the team conducting the reanalyses.
The World Health Organisation is currently developing guidance on how to deal with women categorised as having osteopenia. Whether this will stop industry efforts to encourage treatment in low risk women is, however, questionable, they say.
“We need to ask whether the coming wave of marketing targeting those women with pre-osteoporosis will result in the sound effective prevention of fractures or the unnecessary and wasteful treatment of millions more healthy women,” they conclude.
Public release date: 21-Jan-2008
Saline nasal wash helps improve children’s cold symptoms
A saline nasal wash solution made from processed seawater appears to improve nasal symptoms and may help prevent the recurrence of respiratory infections when used by children with the common cold, according to a report in the January issue of Archives of Otolaryngology, one of the JAMA/Archives journals.
Ivo Šlapak, M.D., of Teaching Hospital Brno, Brno, Czech Republic, and colleagues randomly assigned 401 children age 6 to 10 with cold or flu to two treatment groups, one receiving standard medication and the other also receiving a nasal wash with a modified processed seawater solution. “Patients were observed for a total of 12 weeks, from January to April 2006, during which health status, symptoms and medication use were assessed at four visits over the course of the trial,” the authors write. “Acute illness was evaluated during the first two visits (up to three weeks), prevention during the following two visits (up to 12 weeks). The third visit, scheduled for week eight after study entry, could be conducted over the telephone.”
For children in the nasal wash group, the formula was administered six times per day during the first phase and three times per day during the prevention phase, in one of three strengths: medium jet flow (9 milliliters per nostril), fine spray (3 milliliters per nostril) and a dual eye/nose formula with fine spray (3 millimeters per nostril).
In addition, during the prevention phase, fewer children in the saline group were using fever-reducing drugs (9 percent vs. 33 percent), nasal decongestants (5 percent vs. 47 percent), mucus-dissolving medications (10 percent vs. 37 percent) or antibiotics (6 percent vs. 21 percent). During the same period, children using saline had fewer days of illness, missed school days or complications.
The nasal wash was well tolerated, although participants reported less discomfort using the fine spray formulations. “We did not hear substantial complaints about compliance, and good compliance seemed to be confirmed by the weight of returned empty bottles,” the authors write.
Saline washes may work by reducing the production of inflammatory compounds or by creating a favorable environment for cilia, tiny hairs in the respiratory system, to sweep away mucus and particles. “It is not clear whether the effect is predominately mechanical, based on clearing mucus, or whether salts and trace elements in seawater solutions play a significant role,” the authors write.