Sunday, November 15, 2009

Distal biceps tendon tear more than likely leads to surgery

As if the Colts secondary has not been tormented by enough injuries this season, we recently learned that safety Bob Sanders will be out with a distal biceps tendon rupture at the elbow which will require season-ending surgery. The surgery was performed by the renowned orthopaedist Dr. James Andrews earlier this week.

The biceps muscle is an important muscle in the upper arm. The distal tendon of the biceps muscle transmits all of the forces of the muscle to the forearm at its insertion (radial or bicipital tuberosity), thereby contributing to an athlete's ability to forcefully flex the elbow as well as rotate their forearm in turning the palm upward (supination).

The distal biceps tendon can tear, preventing the transmission of forces from the muscle to the forearm bones. While it can happen from repetitive injury in athletes, it more commonly results from a single traumatic event in which the flexed elbow is resisted or even traumatically extended as in Sander's case. The event is usually accompanied by a "popping sensation" and sense of sharp tearing around the elbow crease.

Once a distal biceps tendon is ruptured, it unfortunately will not heal on its own. Rather, the tendon will continue to retract away from the bone and slide up the arm as the muscle contracts without resistance. Over time, the tendon will be come stiff and scarred as well. This loss of biceps muscle function results in a loss of elbow flexion (bending the elbow) and forearm rotation strength.

Usually the presentation of a distal biceps tendon is not subtle in the athlete. When compared to the normal arm, the tendon can no longer be palpated at the elbow flexion crease. Frequently, there is swelling and bruising around the elbow flexion crease.

The diagnosis can be made by taking a history from the patient and performing a physical exam. An MRI often can confirm a complete tear of the tendon as well as to assess any potential retraction of the tendon. Over the past few years, surgical techniques and implants have improved, which, when combined with people trying to stay more active, has led to an increasing number of distal bicep tendon repairs being performed.

In the past, 2 incisions were typically needed to repair the tendon whereas now 1 is often used. Patients are protected in a brace for the first 6 weeks after surgery after which they progressively work on strengthening exercises before returning to sports. The best results are achieved when surgery is done within three weeks of the initial injury.

Wednesday, November 4, 2009

H1N1 fears cause boom in natural medicine

New Brunswick's natural medicine industry is seeing a boost in popularity as people look for alternative ways to ward off the swine flu virus.

With more H1N1 vaccine clinics being cancelled and those clinics that are running facing queues that stretch for hours, people like Pam Temple are offering natural ways to stay healthy.

Temple, the owner of Healthy Start in Rothesay, said she has a steady stream of new customers coming through her doors. Almost all of those customers are looking for alternative ways to fight the swine flu.

"We have parents that are looking for immune boosters for their children that are under two years old up to senior citizens," Temple said.

"Everyone is concerned about getting their immunity built up."
Naturopath fielding more calls

Blossom Bitting, a naturopath in Dieppe, said she is swamped with calls about H1N1.

However, Bitting said she doesn't have all the answers people want to hear about natural ways to prevent the contraction of the H1N1 virus.

"Because the H1N1 virus is so new, we don't know of anything in the natural realm that is specific against it," Bitting said.

Bitting said there are many supplements that can help fight influenza generally, such as ginger tea, garlic, multivitamins and extra vitamin C.

Bitting said alternative medicines are best used in combination with conventional medicine to stay healthy this flu season.

"I think the combination is going to be stronger than one on its own," she said.

Wednesday, October 28, 2009

Antipsychotic Drugs in Kids Linked to Weight Gain

Children and teens who took antipsychotic medicines in a study gained weight and developed increased blood-fat levels, possibly harming their future health, researchers in New York State said.

The subjects, taking the antipsychotic drugs for the first time, gained from 9.7 to 18.7 pounds (4.4 to 8.5 kilograms) after about 11 weeks of treatment, depending on which medicine they were given, the scientists said today in the Journal of the American Medical Association. Fifteen patients who didn’t stick with drugs or who declined to participate in the research gained less than half a pound on average.

The study was the largest to show how antipsychotic medicines affect the bodies of children taking the drugs for the first time, the researchers wrote. Many past studies of the drugs involved patients who had also used other treatments -- methodology that may have masked the extent of weight gain, according to an editorial published with the study.

“We were able to show all of these agents can cause quite a bit of body weight changes and body composition changes that are not beneficial to the health,” said Christoph Correll, the study’s lead author, in a telephone interview on Oct. 23.

“What we need to figure out is what are the long-term consequences in the lives of children,” Correll, who is a medical director at Zucker Hillside Hospital in New York City’s Queens borough and an associate professor of psychiatry at Yeshiva University’s Albert Einstein College of Medicine in the Bronx.

Metabolic Syndrome

Gaining weight and changes in blood sugars and fats can be precursors to metabolic syndrome, a group of risk factors linked to heart disease and diabetes, according to the research article. Weight gain, obesity and increases in cholesterol in children are linked to their adult risk of cardiovascular problems and cancer.

Patients in the study had been diagnosed with mood disorders, schizophrenia and disruptive or aggressive behavior. Their doctors had prescribed Abilify, made by New York-based Bristol-Myers Squibb Co.; Zyprexa, made by Indianapolis-based Eli Lilly & Co.; Seroquel, made by London-based AstraZeneca Plc, or Risperdal made by New Brunswick, New Jersey-based Johnson & Johnson.

Risperdal and Abilify are the only two antipsychotics approved for pediatric use. A panel of outside advisers to the U.S. Food and Drug Administration recommended in June that Seroquel, Zyprexa and New York-based Pfizer Inc.’s Geodon be cleared for pediatric use.

Impact in Children

The medicines, so-called atypical antipsychotics, were introduced for adults in the mid-1990s and marketed as having fewer neurological side effects than older drugs. The FDA has grappled with pediatric use for years because of concerns that weight gain, sleepiness and movement disorders reported as side effects in adults may be more pronounced in children.

U.S. sales of antipsychotic drugs reached $14.6 billion last year, the most for any class of medicines, according to IMS Health Inc. in Norwalk, Connecticut. Use of antipsychotic medicines by people younger than 20 years old has more than doubled since 2001, according to data compiled by Medco Health Solutions Inc. of Franklin Lakes, New Jersey.

The study reported today was conducted to determine if weight gain and other changes to the body were related to the start of a psychiatric illness or hospital admission, or to the medicines.

Prescribed for Behavior

Researchers at Zucker Hillside, and at the Feinstein Institute for Medical Research in Manhasset, New York, studied 272 people ages 4 to 19 who were prescribed the antipsychotic medicines for behavioral, mood or psychosis-related problems. The patients were followed for the first 12 weeks.

At about 11 weeks, those taking Zyprexa gained 18.7 pounds on average, compared with 13.4 for Seroquel, 11.7 for Risperdal and 9.7 for Abilify, the study showed.

“The extent and the rate of weight gain is remarkable,” said Christopher Varley, a professor in the psychiatry and behavioral sciences department at the University of Washington in Seattle, in a telephone interview on Oct. 23. “Realistically the kids were exposed to 11 or 12 weeks of medication. Some of them gained over 20 pounds.” Varley co-wrote the editorial in the journal that was published with the study.

Ten percent to 36 percent of the patients in the study became overweight or obese within 11 weeks of starting the medicine, the researchers said.

Cholesterol Increases

Those on Zyprexa had larger increases in cholesterol and blood sugars, according to the study. Those on Risperdal had rises in their levels of triglyceride, a type of fat found in the blood, without affecting their blood sugar, the researchers wrote. Those on Seroquel also had an increase in total cholesterol and triglycerides, and patients on Abilify didn’t have any significant worsening in their blood fats or blood sugars, according to the scientists.

Correll recommended that parents monitor their children’s weight and make sure the kids are eating healthy food and exercising.

Doctors in some cases should consider counseling and behavior therapy, as well as parental training, before prescribing the drugs, Correll said. Once the medicines are given to children and adolescents, doctors need to frequently monitor the weight gain and the patients’ blood sugars and blood fats, he said.

In the editorial accompanying the study, Varley wrote, “Given the risk for weight gain and long-term risk for cardiovascular and metabolic problems, the widespread and increasing use of atypical antipsychotic medications in children and adolescents should be reconsidered.”

The study was funded partly by the U.S. National Institutes of Health, based in Bethesda, Maryland.

Friday, October 23, 2009

U.S. drug labels omit vital data

In a shocking revelation, two prominent doctors have revealed that most of the times key information telling about the extent of side-effects or the effectiveness of the medicines is excluded from the drug labels in the country.

Because of the omission of important information, the drug ultimately is presented in a way that makes it seem safer and more effective than it actually is. This was written by the doctors in a commentary in the New England Journal of Medicine.

Drs. Lisa Schwartz and Steven Woloshin of the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, New Hampshire, wrote, “Much critical information that the Food and Drug Administration (FDA) has at the time of approval may fail to make its way into the drug label and relevant journal articles.”

The labels on various medicines are actually written by the manufacturers and the FDA finally gives a stamp of approval after discussing the wording.

However, some relevant information might be missing, said Woloshin. He questioned, “How can I decide if the potential harms of this drug are worth the risk if I don’t know how well the drug works, and vice versa?”

Examples of drug labels where key information was missing
Citing one of the numerous examples, the doctors quoted the case of Sepracor’s four-year-old sleep drug Lunesta that was promoted with an advertising campaign that cost a whopping $750,000 per day in 2007.

The company benefited very much and generated sales of $600 million last year. It even became a wholly-owned subsidiary of Dainippon Sumitomo Pharma Co Tuesday.

The label on the drug only said that Lunesta was superior to a placebo and nothing else was specified.

However, when the tests were conducted and the results were given to the FDA, it came to light that “Lunesta patients still met criteria for insomnia and reported no clinically meaningful improvements in next-day alertness or functioning,” wrote Schwartz and Woloshin.

Another such case in point is that of Takeda Pharmaceutical Co’s insomnia drug Rozerem. The label on the drug did not mention that laboratory statistics have revealed that it still took 31 minutes for adults above 64 years of age, and 24 minutes for younger adults to fall asleep once they consumed the drug.

Not only this, when clinical trials were conducted, the volunteers reported “no subjective improvements in total sleep time, sleep quality, or the time it took to fall asleep.” But all this information was not mentioned on the drug label, the researchers said.

Schwartz and Woloshin stressed in their commentary, “Sometimes what gets lost is data on harms.”

New system to make drug labels clearer in content
Woloshin believes that he and his colleagues have found a better system that can help in clarifying the extent of the dangers and benefits of the drugs to the consumers.

The FDA’s Risk Advisory Committee is also in favor of the new system and the matter will be further discussed next month.

As genetic medicine races ahead, docs are left behind

Genetic tests that can help predict and refine a patient's response to drug therapy may be the first big thing in personalized medicine. But the vast majority of physicians don't know how to use them, a new survey finds.

Individual genetic variations can affect how a patient will respond to many antidepressants, pain medications, cardiovascular medicines and certain drugs that treat cancers and gastrointestinal ailments. In all, roughly one in four American patients take medications whose effectiveness could be tweaked or predicted by a pharmacogenetic test. And purveyors of genomic testing services and devices are rushing to provide tests for them all.

A survey of more than 10,000 U.S. physicians undertaken by the American Medical Assn. and the pharmacy benefits manager Medco Healthcare Solutions Inc. found that just more than one in four had had any type of education in the use of genetic testing to guide medication decisions. And only 1 in 10 felt he or she had the necessary training and knowledge to put pharmacogenetic testing to good use in treating patients. Some 13% had ordered or recommended a genetic test for a patient in the last six months. But twice that many said they would do so in the next six months.

Genes that regulate liver enzymes can have a particularly powerful influence on a patient's response to a medication. Scientists believe that one such enzyme may be responsible for governing the way patients respond to some 30% of all drugs used today. In oncology, a test can help predict if breast cancer patients will respond to the drug tamoxifen. And cancer drugs in the development pipeline are expected overwhelmingly to be administered with the guidance of genetic tests. Genetic tests also can help reduce unwanted side effects; the blood thinner warfarin, for instance, can cause blood clots or serious bleeds in some patients with an identified genetic variance, and physicians are increasingly testing those on a blood-thinning regimen in an effort reduce such risks.

"It's clear there's wide acceptance" on physicians' part for the role that genetic testing can play in guiding medication decisions, said Dr. Robert Epstein, Medco's chief medical officer, who briefed physicians and researchers on the survey at the annual meeting of the American Society for Human Genetics on Thursday. But the AMA and other groups must step up efforts to educate physicians in the use of these tests, added Epstein. "With the number of new drugs coming to market with a companion diagnostic, it's paramount that this education takes place."

Sunday, October 11, 2009

Promising Pre-Med Wins Nobel Prize in Medicine

The Nobel Prize Committee announced today that it is awarding the Prize in Medicine to Jimmy Duncan, a senior at Horace Greeley High School in Chappaqua, New York, for getting a 97 on his bio-chem final.

“The Committee felt that Master Duncan has shown great promise with his outstanding grades,” said Dr. Leif Quisling, chairperson of the Nobel Prize Committee. “It is our fervent hope that this award encourages him to do great things in the future, such as find a cure for cancer.”

The committee was first alerted to Jimmy Duncan when they came across a YouTube clip of Duncan’s class presentation on his career goals.

“We were particularly struck by his unbridled optimism,” said Dr. Quisling. “Duncan closed his passionate talk with these inspiring words: ’And we can end cancer in our lifetimes if we all work together really, really hard!’ It is exactly those kind of empty platitudes that impress this committee. Far more so than anything so gauche as actual achievement.”

Mr. Duncan was somewhat blase’ about the news. “I was lying in bed playing a little X-Box before heading off to school when my mom yelled, ‘Jimmy, you’ve got a phone call from Stockholm!’ It was pretty cool, yeah.”

Dr. Quisling acknowledged that the committee was inspired to award prizes prematurely after giving President Barack Obama a Nobel Peace Prize the year before, despite the fact that nominations had been closed only 11 days after he entered office.

“In Barack Obama’s case, we figured that if the American people were willing to hand over the U.S. presidency to someone who hasn’t accomplished much, why not give him the Nobel Peace Prize before he’s done anything, either?” Dr. Quisling said.

As for Jimmy Duncan, 17, he says he’s “psyched” about the Nobel Prize. “I should be a shoo-in now to get into Harvard,” he said.

“By the way, I’m not going pre-med anymore,” Duncan volunteered. ”Now that I’ve got the Nobel in Medicine, why bother? I’ll just invest my prize money in a diversified fund and I never have to work another day in my life. In fact, I may just skip Harvard and go to a party school. Arizona State, here I come!”

We contacted Dr. Quisling’s office for a comment on Duncan’s change in plans. Nobody returned our calls by press time.

Thursday, October 8, 2009

Babies Born to Childhood Cancer Survivors Do Well

Cancer treatments can compromise fertility, but new research suggests that when survivors of childhood cancer are able to have children, their babies do not face an increased risk of birth defects.

Women who survived childhood cancer were more likely to have premature or low birth weight babies compared with women who had never had cancer, one study found. But the survivors’ newborns were no more likely to have malformations or die, nor were the mothers at greater risk for pregnancy complications over all.

A companion study of men who had survived childhood cancer found that their offspring were slightly more likely to be of low birth weight (less than five and a half pounds), but they were not at greater risk for birth defects or prematurity than children born to men who had not had cancer.

The two studies, done by researchers at the Fred Hutchinson Cancer Research Center in Seattle, were published in The Archives of Pediatrics and Adolescent Medicine.

The researchers used national cancer registry data from 1973 to 2000 in four regions — Seattle, Detroit, Salt Lake City and Atlanta — to identify boys and girls who had cancer before age 20. They then linked the data to birth records to identify the first children born to cancer survivors after their diagnosis.

They were able to compare the outcomes of babies born to 1,898 female cancer survivors with 14,278 controls, also identified from birth records, and to compare the outcomes of 470 babies of male survivors with 4,150 controls.

“The main take-home message is that most kids born to childhood cancer survivors did very well,” said Dr. Eric J. Chow, an author on both papers and a research associate at the cancer center.

The study was limited because it was only able to count birth defects that were obvious upon delivery, he said. Still, he added, “Most people can feel reassured.”

IBM using nanotech to read DNA

Scientists at IBM are using a combination of nanotechnology and microchips to map out personal genetic code -- a development that could significantly improve the process of diagnosing and treating diseases.

Merging biology with computer technology, researchers at IBM are working on a project that aims to make it easier to decode human DNA, and thus help scientists discover and test new medicines and medical techniques. And, IBM says, a faster and less expensive way to obtain genetic information would help doctors better understand their patients' predisposition to diseases.

The ultimate goal of IBM's project is to create process that could read, or sequence, a person's genome at a cost of $100 to $1,000. In comparison, the first sequencing ever done by the Human Genome Project cost $3 billion, according to IBM.

"The technologies that make reading DNA fast, cheap and widely available have the potential to revolutionize bio-medical research and herald an era of personalized medicine," said IBM research scientist Gustavo Stolovitzky, in a statement today. "Ultimately, it could improve the quality of medical care by identifying patients who will gain the greatest benefit from a particular medicine and those who are most at risk of adverse reaction."

IBM reported today that its researchers have drilled nano-sized holes, or nanopores, into microchips. When DNA strands are passed through the holes, the chips can sequence the genes.

Researchers said one of their challenges has been to figure out how to control the speed of the DNA strand's movement through the tiny nanopore. It needs to move slowly through the hole in order for sensors in the chip to be able to read the sequencing.

IBM reported that its scientists used a multi-layer nanostructure to surround the nanopore. The structure creates an electrical field inside the nanopore, which traps the DNA strand and should allow scientists to have minute control over the speed at which the strand moves through the hole.

Combining DNA with nanotechnology is an idea that's been getting some traction.

Just two months ago, IBM announced that it was using a combination of DNA molecules and nanotechnology to create tiny circuits that could form the basis of smaller, more powerful and energy-efficient computer chips that also are easier and cheaper to manufacture.

The DNA molecules would serve as scaffolding on which carbon nanotubes could assemble themselves into precise patterns. IBM said the process could help chip manufacturers move from 45-nanometer processor technology to 22nm or smaller.

And last winter, researchers at MIT found a way to use a combination of nanotechnology and DNA to fight cancerous tumors. The university announced that a group of scientists there had developed sensors made out of carbon nanotubes that were wrapped in DNA. The sensors then were placed inside living cells to determine whether chemotherapy drugs were reaching their targets or attacking healthy cells.

Tuesday, October 6, 2009

Alternative Medicine Use For Patients Suffering With Chronic Rhinosinusitis

A new study suggests that a growing segment of patients are turning to complementary and alternative medical therapies to help treat the symptoms of chronic rhinosinusitis (CRS).

In a paper presented at the 2009 American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO in San Diego, researchers sought to explore the pattern of complementary and alternative medicine (CAM) use in patients with a prior diagnosis of CRS at a rhinology outpatient clinic in Aberdeen, Scotland.

CRS is defined as a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks duration. The group of CRS disorders annually accounts for as many as 22 million office visits and more than 500,000 emergency department visits in the U.S., according to some estimates.

Questionnaires were provided to 75 patients over a two-month period. The questionnaire consisted of demographic information and whether they had ever used CAM from a list of 49 herbal and non-herbal alternative therapies (such as acupuncture, massage, aloe vera, and cod liver oil). Subjects were also asked why they used CAM, where they learned of CAM, whether they found it efficacious, and whether their general practitioner was aware they were using it.

Sixty-five percent of patients had used CAM. Thirty percent of patients used it for chronic rhinosinusitis. Women were significantly more likely to use CAM than men, according to the statistics. Patients who were employed, married, and had university degrees were also more likely to use CAM. Only 43 percent of CAM users had informed their doctor about the use of the therapy.

Researchers noted that patients were reticent about telling their physician about usage of CAM. Clinicians should enquire as to all the medications being taken by patients, and the dangers of non- compliance with conventional medications should be emphasized to CAM users by their treating physician.

Can Chinese herbal medicine combat endometriosis?

It may, according to a new review published by the Cochrane Collaboration, an international nonprofit that analyzes health care information.

The review, which looked at results of two randomized studies of Chinese herbal medicine involving 158 women, suggested that Chinese herbs may provide better relief of pelvic pain and other symptoms than one of the prescription drugs normally used in the West, Danazol.

Endometriosis occurs when tissue from inside the uterus escapes to other parts of the body. Outside the uterus, this tissue is seen as “foreign’’ by the immune system, which means that the body mounts an inflammatory response that can cause pain and scarring.

In the review, researchers at the University of Southampton in England found that Chinese herbs - which were not specified and which typically vary from patient to patient in Chinese medicine - were better at relieving menstrual pain than Danazol, a testosterone-derived drug, and were also better at shrinking endometrial masses. They did not prove better for other types of endometrial discomfort, such as rectal pain.

Dr. Aaron Styer, a reproductive endocrinologist at the Massachusetts General Hospital Fertility Center, noted that in the West, the first line of treatment for endometriosis is birth control and other hormonal drugs, which suppress secretion of estrogen by the ovaries. Although the Chinese herbal study is not conclusive, he said, “if a patient has not done well with traditional therapy or doesn’t want to proceed with it, she should investigate these approaches more completely, as long as there’s no potential health risk of taking these herbs.’’

Dr. Hope Riccotti, clinical director of obstetrics and gynecology at the Dimock Community Health Center, cautioned that “herbs are drugs and drug interactions can be dangerous,’’ which makes it important for women to tell their health care providers if they are taking these herbs.

Tuesday, September 29, 2009

Making full use of dad's knowledge of traditional medicine


ALTHOUGH Tan Leok Kwee has little memory of his late father, he could relate every detail about his old man. From small, Tan loves listening to stories about his father especially on how he saved lives using traditional medicine.

The father had helped to treat the sick villagers at his hometown in Kluang, Johor, with his knowledge in traditional medicine.

“When my mother told me about it, I was amused because my father was not a doctor and due to this, I had always wanted to find out more,’’ he said, adding his father died when he was only six.

Upon completing his secondary education, Tan joined Hai-O Enterprise, a company dealing with traditional medicine and herb-based products. He also took up courses on Chinese traditional medicine and acupuncture.

Today, the 40-year-old Tan has become a certified practitioner in Chinese traditional medicine.

He has also been promoted to become the product development manager by his company due to his hardwork over the years and wide knowledge in the field.

“But this is not enough. I want to see people leading a healthy life. To achieve this, we must live and eat healthy because prevention is better than cure,’’ he said.

Tan was among the first batch of 21 people who completed a four-month certificate course on Chinese medicine nutritional treatments conducted by Hai-O recently.

In conjunction with the graduation, a book containing recipes on healthy dishes using traditional herbs and medicated food was launched.

It is free for Hai-O customers with purchase of RM150 and above, while stock last.

Monday, September 28, 2009

UAE firm gets nod for swine flu medicine production

Abu Dhabi-based drug manufacturer Neopharma today said it has received clearance from the UAE Ministry of Health for the production of an antiviral medication Oseltamivir BR Flu.

The approval comes at a time when the entire region is stepping up efforts to tackle the swine flu pandemic, and it is being considered as a potential choice to prevent and treat the disease.

Neopharma, Vice-Chairman, Abdulla Humaid Al Mazroei and Managing Director and CEO, Dr BR Shetty thanked the Health Ministry on behalf of the Board of Directors of the company.

"As a leading manufacturer of life-saving drugs, we believe it is our responsibility to play a vital role in helping the community at this critical juncture. We are confident the approval for Oseltamivir will significantly facilitate medical professionals and the wider community to effectively combat the lethal H1N1 virus in the region," Dr Shetty said.

Monday, September 21, 2009

The Alternative Medicine Cabinet

More than a third of American adults use some form of complementary or alternative medicine, according to a recent government report. Natural remedies have an obvious appeal, but how do you know which ones to choose and whether the claims are backed by science? Today, New York Times “Really?” columnist Anahad O’Connor begins a weekly series exploring the claims and the science behind alternative remedies that you may want to consider for your family medicine cabinet.

The Remedy: Arnica

The Claim: It relieves pain.

The Science: Arnica Montana, a plant native to mountainous areas of Europe and North America, has been used for centuries to treat a variety of pain. Athletes rub it on muscles to soothe soreness and strains, and arthritis sufferers rub it on joints to reduce pain and swelling. It’s believed that the plant contains derivatives of thymol, which seems to have anti-inflammatory effects.

Either way, scientists have found good evidence that it works. One randomized study published in 2007 looked at 204 people with osteoarthritis in their hands and found that an arnica gel preparation worked just as well as daily ibuprofen, and with minimal side effects. Another study of 79 people with arthritis of the knee found that when patients used arnica gel twice daily for three to six weeks, they experienced significant reductions in pain and stiffness and had improved function. Only one person experienced an allergic reaction.

The Risks: Arnica gels or creams can cause allergic reactions in some people, but it is generally safe when used topically. However, it should never be rubbed on broken or damaged skin, and it should only be ingested when in a heavily diluted, homeopathic form.

Wednesday, September 16, 2009

OhioHealth buys Max Sports Medicine

OhioHealth Corp. is growing its sports medicine program with the acquisition of an 11-physician Columbus practice.

Central Ohio’s largest hospital system said Tuesday that it has acquired Columbus-based Max Sports Medicine. In addition to its 11 physicians, the practice has 33 staff members at four locations in the area. The practice is headquartered at OhioHealth’s McConnell Heart and Health Campus near Riverside Methodist Hospital.

Christina Fitzer, a spokeswoman at Riverside, said the company isn’t disclosing financial terms of the deal. The acquisition retains all employees, branches and Max’s name.

Max is now part of the more than 200-doctor OhioHealth Medical Specialty Foundation, which added its first member a year ago with the acquisition of MidOhio Cardiology & Vascular Consultants. That was the largest such transaction on the region’s health-care landscape since Mount Carmel Health System bought the New Albany Surgical Hospital in December 2006. OhioHealth two months ago added Columbus-based Millhon Clinic Inc., a practice with 12 physicians and 44 staffers.

Max Sports offers primary care and sports medicine for school-age, college and professional patients and active adults. They’re also team physicians for Otterbein College, Ohio Wesleyan University, Denison University and a number of area high schools.

“The sheer breadth of sports medicine expertise and experience of the physicians and staff at Max Sports Medicine is impressive,” Dr. Bruce Vanderhoff, chief medical officer for OhioHealth, said in a release. “To bring that experience and successful practice model into the OhioHealth Medical Specialty Foundation will benefit our patients and provide a deeper knowledge base as we continue to expand and enhance our sports medicine expertise.”

Sunday, September 13, 2009

MOH commended for introducing book on herbal medicines


A traditional herbalist at the Ajumako Liberty Herbal clinic has commended government, the Ministry of Health (MOH) and the Ghana Food and Drugs Board for introducing a book on herbal medicines, essential for health services.

The book titled “Recommended list of Herbal Medicines essential for Health Service” produced by the MOH and dated November, 2008, spells out various medicines for the treatment of Anaemia, Diabetes, Hypertension, Malaria, Arthritis, Typhoid, Peptic Ulcer, skin diseases and others.

Mr Adu Mohamed, speaking to the Ghana News Agency at Ajumako, said the move was laudable and a step in the right direction because it would help weed out quacks in the herbal medicine practice.

He appealed to the MOH and the government to make available logistics and machinery to herbal medicine practitioners to enable them to produce in large quantities for both export and local use.

This, he said would relieve the nation of its over dependence of foreign drugs and also save money, which would have been used in the importation of such drugs and at the same time help to create employment in the country.

Tuesday, September 8, 2009

Prevent Periodontitis To Reduce The Risk Of Head And Neck Cancer

Chronic periodontitis, a form of gum disease, is an independent risk factor for head and neck squamous cell carcinoma. This suggests the need for increased efforts to prevent and treat periodontitis as a possible means to reduce the risk of this form of cancer.

"Prevent periodontitis; if you have it already, get treatment and maintain good oral hygiene," said Mine Tezal, D.D.S., Ph.D., assistant professor in the Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, and NYS Center of Excellence in Bioinformatics and Life Sciences at the University of Buffalo. She is also a research scientist in the Department of Dentistry and Maxillofacial Prosthetics at Roswell Park Cancer Institute, which is where the study was conducted.

Results of this study are published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Chronic periodontitis is characterized by progressive loss of the bone and soft tissue attachment that surround the teeth. The researchers assessed the role of chronic periodontitis on head and neck squamous cell carcinoma, as well as the individual roles on three subsites: oral cavity, oropharyngeal and laryngeal. They used radiographic measurement of bone loss to measure periodontitis among 463 patients; 207 of whom were controls.

Findings showed that chronic periodontitis might represent a clinical high-risk profile for head and neck squamous cell carcinoma. The strength of the association was greatest in the oral cavity, followed by the oropharynx and larynx, according to Tezal.

When they stratified the relationship by tobacco use, they found that the association persisted in those patients who never used tobacco. The researchers did not expect the periodontitis-head and neck squamous cell carcinoma association to be weaker in current smokers compared to former and never smokers, according to Tezal. However, this interaction, although statistically significant, was not very strong.

"Confirmatory studies with more comprehensive assessment of smoking, such as duration, quantity and patterns of use, as well as smokeless tobacco history are needed," she said.

"Our study also suggests that chronic periodontitis may be associated with poorly differentiated tumor status in the oral cavity. Continuous stimulation of cellular proliferation by chronic inflammation may be responsible for this histological type. However, grading is subjective and we only observed this association in the oral cavity. Therefore, this association may be due to chance and needs further exploration," Tezal added.

Andrew Olshan, Ph.D., said these results lend further support to the potential importance of poor oral health in this form of cancer. Olshan is professor and chair of the Department of Epidemiology at the Gillings School of Global Public Health, and professor in the Department of Otolaryngology/Head and Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill.

"The study of poor oral health including the possible carcinogenic role of microorganisms is part of a rapidly growing interest in how a community of microbes that live in the various environments of the human body can affect health," Olshan said. "Although the study is comparatively small, the researchers were able to also see an association between bone loss and the risk of head and neck cancer."

Monday, September 7, 2009

Food is your best medicine


Fresh fruits are packed with vitamins & minerals. Because fruits can be eaten raw, they are extremely beneficial for the enzymes they offer. Enzymes are important to proper digestive function. Here are some benefits of five of this season’s best local fruits:

Blackberries Contain vitamins A, C and B-complex along with calcium, iron, phosphorus, potassium, magnesium and niacin. All berries are high in fiber.

They are good for the colon. Since blackberries contain natural sugar they are good for energy. They are also used as a blood cleanser. They have an alkaline affect in the body and make a good tonic.

While blackberries are best if they are eaten uncooked, they also make good cobblers, jams and pies.

Blueberries are high in manganese and vitamin A and C and some B-complex. They also contain calcium, potassium, silicon, phosphorus, iron, silicon. They are an excellent source of fiber and are a good antiseptic and blood purifier. They are also good for the skin, hypoglycemia, and the blue pigment may be a powerful in protecting the liver.

Eaten in their fresh, natural state, they are very nourishing. They can also be added to muffins, pancakes, cereals and salads. They make an excellent addition to a chicken salad too!

Cantaloupes are abundant in vitamin A and C. They are also a rich source of potassium.

Melons are best eaten alone or with other melons rather than mixed with other fruits. Their high water content can interfere with digestion since water dilutes the digestive juices. Melons in general are a cleansing food. They are good for bladder and kidney problems.

Grapes contain some vitamin A and C, phosphorus and calcium. They are also a good source of B complex which is essential for a healthy nervous system. Grapes are considered the “queen” of fruits. They help to purify the blood, are a good source of energy and contain cleansing properties. They help stimulate the liver and are effective in helping constipation, edema, reducing fever, and preventing cancer. Grape juice is excellent to help recover from illness.

Peaches are high in vitamin A, B complex, protein, calcium, iron, phosphorus, potassium and fiber. They are valuable for those suffering from anemia, asthma, bronchitis, cancer, constipation, heart disease and skin disease. They are excellent to include in a diet for the elderly.

The best pick are ones that smell peachy and look creamy yellow and red in color. They are great when eaten fresh or made into jelly or jams, used for cobblers and can be used in fruit salads with apricots, apples, bananas, pineapple and pears. Ripe peaches should be stored in the refrigerator.

Friday, September 4, 2009

Alternative medicine, acupuncture to be discussed at AARP meeting

Dr. William Boggs, board certified in internal medicine, will be speaking at the High Springs Area AARP meeting on Sept. 10.

He will discuss treating illnesses with alternative medicine and acupuncture and without totally relying on drugs or surgery for relief. A question and answer session will follow the talk.

In addition, registered nurse Tammy James will be returning to the AARP meetings to do blood pressure screenings.

The meeting is open to anyone over 50 years old and is held at the First Presbyterian Church, 205 N. Main Street in High Springs and begins at 10:30 a.m. Guests planning to attend are asked to bring a covered dish for the luncheon following the meeting.

Wednesday, September 2, 2009

Health-care reform isn't socialized medicine

People against health-care reform don't know the facts or are being fooled by other special interests, such as big health-care insurance companies and the rich that have money invested, and their only interest is big profits.

Health-care reform isn't socialized medicine. If I like my actual insurance, I'll still be able to keep it, but if I can't afford it, I will have another affordable choice.

We can't afford not to change. If we do nothing, the cost of health care will increase to a point that only the very rich are going to be able to afford it.

Health-care reform will strengthen Medicare, ensure we can choose our doctor, and cut the cost of medicine.

Jose Nunes

New Bedford

Tuesday, September 1, 2009

Solutions to child obesity


To make it easier for children to eat healthfully and move more, local governments in towns and cities across the country need to help create a better environment, a new report says.

Children and their families should have access to grocery stores that offer plenty of healthful food such as fruits and vegetables, and schools shouldn't be surrounded by fast-food restaurants. Children should be able to ride their bikes or walk safely to school, and they should have safe places to play afterward, says the report out today from the Institute of Medicine (IOM) and National Research Council.

The healthy choice should be the easy choice, says family physician Eduardo Sanchez, chairman of the expert committee that prepared the report and vice president and chief medical officer of Blue Cross Blue Shield of Texas.

"That statement captures the essence of this particular challenge. Too often the easiest thing to do is the least healthy, and that goes for kids."

The environment influences the decisions people make, and local regulations can make a difference in the fight against childhood obesity, he says.

About a third of the nation's children ages 2 to 19 — or about 23 million kids — are overweight or obese. That puts them at higher risk for type 2 diabetes, high cholesterol, sleep apnea and other health problems.

Some cities and towns in the USA already have made changes that make living healthfully easier. Other community officials need to figure out their areas' biggest problems and work on those first, the report's authors say.

Among their suggestions are several dealing with access to healthful food in underserved areas. They urge communities to offer financial incentives to the owners of corner markets and convenience stores in poor areas so they can carry more affordable healthful foods such as fruits and vegetables, and fat-free and low-fat dairy.

They also suggest offering tax credits, grants, loans and other economic incentives to attract new, bigger supermarkets and grocery stores to underserved communities to increase their access to healthful foods.

Several studies show that some people, especially in poorer communities, don't have easy access to a major grocery store, so they have to rely on small stores, convenience markets and hybrid gas stations where there is a smaller selection of healthful food items at higher prices.

"I believe (benefits from) the relative costs involved far outweigh the cost of doing nothing," Sanchez says. "Obesity in children leads to some diseases, and the cost of their medical care will go up fairly quickly."

Many of the strategies have other benefits. For instance, the report urges better community policing, which may increase safety, and better grocery stores could create more jobs, he says. "These are worthwhile investments because the gain is more than the upfront expense."

Similar ideas for changing the environment were discussed this summer at the Weight of the Nation meeting in Washington, D.C., which was sponsored by the Centers for Disease Control and Prevention and others.

Monday, August 31, 2009

Cost of defensive medicine is indeed significant

Jay Hancock in his article regarding health care malpractice costs ("Health care myths obscure the much tougher decisions," Aug. 6) cites information from the Congressional Budget Office that "malpractice costs make up only 2 percent of health care spending" and WellPoint Insurance, which says litigation and defensive medicine "are not considered a significant recent significant factor in the overall growth of health care spending."

Well, I guess it depends on who you talk to.

In a Massachusetts Medical Society survey of 900 doctors published last November, 83 percent of Bay State physicians cited the fear of being sued in their decisions to practice defensive medicine. According to the doctors anonymously surveyed, on average, 18 percent to 28 percent of tests, procedures, referrals and consultations and 13 percent of hospitalizations were ordered to avoid lawsuits. All of this adds at least $1.4 billion to annual health care costs in Massachusetts alone, and national estimates range as high as $200 billion.

A 2006 Harvard School of Public Health study found that four out of every 10 medical malpractice lawsuits filed in America each year were "without merit." Nonetheless, defending against such lawsuits imposes costs on doctors, hospitals and insurers that invariably are passed on to health care consumers. Beyond the obvious costs of litigation, more subtle costs related to the practice of "defensive medicine" are contributing to runaway health care inflation.

Texas has joined 24 other states in enacting reforms that include a reasonable limit on noneconomic damages for pain and suffering of up to $750,000 per incident. This reform does not limit compensatory awards for calculable lost wages and medical expenses, but it does balance the interests of patients and care providers while helping to ensure access to necessary care. Now, according to Gov. Rick Perry, doctors' insurance rates have declined by an average of 27 percent while the "number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In ... just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time."

Thursday, August 27, 2009

Major Genetic Determinant Of Psoriasis

A specific genetic region that has been increasingly identified as the strongest genetic link to psoriasis has an even more significant role in the chronic skin disease than has been suspected, University of Utah medical researchers show in a new study.

n the Aug. 13 issue of PLoS Genetics, researchers in the U School of Medicine's Department of Dermatology confirm that the presence of HLA-Cw*0602, a gene variation or allele on chromosome 6 found to be associated with psoriasis by numerous investigators, is the "major genetic determinant" of psoriasis, but that other nearby genetic variations also play an independent role in contributing to the disease

"The HLA-Cw*0602 gene variation stands alone as a high risk for psoriasis," said Gerald G. Krueger, M.D., professor of dermatology, Benning Presidential Endowed Chair holder, and a co-author on the study. "A major question has been: are there other genetic variations in this region that associate with psoriasis?"

The study reported in PLoS Genetics identifies two other genetic variations on chromosome 6 that also have significant association with psoriasis. People who have all three genetic variations are nearly nine times more at risk for psoriasis.

Psoriasis is a chronic disease that causes red scaly patches on the skin and affects up to 7.5 million people in the United States. About 25 percent of subjects with the disease also develop a painful inflammation of the joints called psoriatic arthritis.

University researchers, led by first author Bing-Jian Feng, Ph.D., postdoctoral fellow, and senior author David E. Goldgar, Ph.D., research professor of dermatology in the U of U School of Medicine, reached their conclusion after an expanded analysis of data from a study published earlier this year by investigators at Utah in collaboration with colleagues from the University of Michigan and Washington University.

That study (Nature Genetics, Jan. 25) used new technology to scan nearly 500,000 genetic variants (single nucleotide polymorphisms or SNPs) in 1,359 people with psoriasis and 1,400 without to find those with the strongest relationship with psoriasis. After identifying 18 SNPs with the highest associations with psoriasis, the researchers expanded the study to include 5,048 people with psoriasis and 5,051 without the disease. From that, they identified four new genetic "hotspots" for psoriasis and confirmed two others that Krueger and colleagues identified in previous studies.

Using the data from the Nature Genetics study, Feng, Goldgar, and colleagues employed two statistical methods, imputation and logistic regression analysis, to determine with a much greater degree of accuracy those genes that have the highest association with psoriasis. Using imputation they were able to reliably predict the *0602 status of all subjects in the recent Nature Genetics study. This did two things; first, it increased the confidence that *0602 is the major genetic variation on this chromosome and, second, it permitted them to determine if there was any other associated genetic variation in this region.

Removing the strong effect of *0602 resulted in the identification of two other loci (fixed position on a chromosome) that are independently associated with psoriasis (MICA/HLA-B and c6orf10). These two loci increased the risk for the disease by 1.23 and 1.6 times, respectively. However, when all three genetic variations that Feng, Goldgar, and colleagues report are present, the risk for psoriasis is 8.9 times higher than when none of these is present.

To confirm the results, the researchers examined an independent patient population in China, which corroborated their conclusions.

While *0602 and the associated, but independent, genetic variations reported have a major genetic contribution to psoriasis, many other genes undoubtedly play a role, according to Krueger. The number of DNA sites discovered to have strong associations with psoriasis has more than doubled in the past two years.

Prepares for swine flu season

With an expected increase in the number of H1N1 virus cases as the school year kicks off, Texas Tech has ordered extra flu vaccines as well as updated a Web site designed to help students protect themselves against the flu.

According to a report released by the White House earlier this week, the H1N1 virus will kill between 30,000 and 90,000 Americans in 2009 with the season peaking mid-October.

In preparation, Dr. Kelly Bennett of the Family Medicine department said Tech has ordered 500 additional doses of the regular flu vaccine.

She said no Tech students were infected with H1N1 last year, but the university has been preparing for an outbreak projected to be more severe than last year.

According to Tech's flu Web site, students with the flu or flu-like symptoms are not to attend class or work for at least 24 hours after fever returns to normal and to consider vaccinations as they become available.

This follows the Centers for Disease Control and Prevention swine flu response guidelines for higher education released Aug. 20, which recommends students and faculty infected with H1N1 be isolated as much as possible.

"Texas Tech has been designated a point of dispensing, by the CDC," said Managing Director of Family Medicine Evelyn McPherson. "This should give students and faculty easy access to the vaccine."

The H1N1 vaccine, which must be taken as two separate doses, should be available to students in late September, Bennett said, and does not replace the regular flu vaccine.

"The CDC is setting up a provider registry of doctors and health departments to receive vaccines for H1N1," said Lubbock Public Health Preparedness Coordinator Sandy Fortenberry. "Of the 45 million expected vaccines, about 4 million will be allocated to Texas which will then go to registered providers."

In addition to getting the H1N1 vaccine, she said, students must take responsibility for their own health so they do not become infected.

"Students should do the same as they would with seasonal flu by practicing good hygiene, staying healthy and getting their seasonal flu shot," Fortenberry said.

The CDC also urges balance, and according to CDC H1N1 response guidelines, strategies employed by organizations should reduce the number of people who become ill or die from the flu while minimizing disruption.

"We are working to follow CDC guidelines which sometimes change from one day to the next depending on the severity of outbreak," McPherson said.

Incorporate traditional medicine into primary healthcare

Incorporating traditional medicine into primary healthcare system will improve the management of public health diseases, practitioners and experts agreed in Lagos on Wednesday. At a ceremony commemorating the African Traditional Medicine Day, marked every August 31, the Lagos State Commissioner for Health, Jide Idris, said that without traditional medicine, the realization of the millennium development goals will be a mirage.

"Traditional medicine which has been long neglected is the corner stone of an integrated healthcare system. We have yielded to the WHO's call as it is now part of our primary healthcare system in Lagos because we know that 80 per cent of the population patronize it. For about 33 years, the World Health Organization (WHO) had passed resolutions calling on member nations to give recognition to traditional medicine, but up till the moment, Nigeria has not passed the Bill on Traditional Medicine which will give it formal recognition in hospitals and regulation of the practice."

"There are challenges in making traditional medicine recognized in Nigeria," said Bunmi Omoseyindemi, the chairman of the Lagos State Traditional Medicine Board. "Insufficient evidence regarding safety and efficiency, inadequate coordination of existing practice and practitioners, lack of coordination among stakeholder and so on," Dr. Omoseyindemi added.

In a bid to effect these, the Lagos State passed the Health Sector Reform Law 2006, but many states are yet to incorporate it into their health system, and experts clamour for a national bill.According to the director general of the Nigeria Natural Medicine Development Agency, Tamuno Okujagu, the Bill was last heard in the National Assembly five years ago and nothing is being done up till now."Yet the WHO has reported that at least 80 per cent of the population patronize one form of Traditional Medicine or the other."

The head of sellers of herbs for women and children, Ashabi Olomowewe told NEXT that she inherited the practice for over 40 years from her for parents and it has never failed her."I trained all my children with herbs, today they are grown up alive and well." Mrs Olomowewe who is in her mid sixties said that her experience has saved many pregnant women from going for caesarean operation."The doctors will say that the baby has crossed (breach birth), but there are certain herbs that if given the women, the baby will take the normal position and the woman give birth normally not needing an operation.

Attesting to the power of the practice also is the chairman of the Nigerian Traditional Medical Association, W. Oshodi; "The practice of using herbs is a blessing from God. There are many diseases that doctors cannot cure, but herbs can cure, so we call on the government to give it more recognition and to stop the orthodox doctors from looking down on us."

Citing India and China as examples of countries that have taken advantage of traditional medicine, Mr. Okujagu added: "If we can give traditional medicine its due recognition, it will not only help our health care, it has the potential of yielding billions of naira yearly export."

Wednesday, August 26, 2009

UPDATE 1-Dainippon schizophrenia drug meets trial goals

apan's Dainippon Sumitomo Pharma Co Ltd (4506.T) said its experimental schizophrenia drug, lurasidone, was significantly better than placebo in a pivotal late-stage clinical trial, according to data released on Wednesday.

The company said it plans to submit its application seeking U.S. approval to sell the medicine early next year.

Dainippon Sumitomo will decide by autumn whether it will market the new drug, if approved, via its own sales network or a co-promotion deal with another firm or if it will acquire a U.S. company, a spokesman for the mid-sized drugmaker said.

Patients with acute schizophrenia in the 478-subject, six-week, Phase III trial received either 40 milligrams or 120 milligrams of lurasidone daily or a placebo.

Both doses of the drug proved to be statistically significantly better than placebo in the primary goal of the study, which was 30 percent or better improvement in the Positive and Negative Syndrome Scale, the company said.

Fifty-three percent of patients who received 40 mg of lurasidone and 47 percent of those on the 120 mg dose achieved the primary goal compared with 38 percent on placebo.

Both doses of lurasidone were also significantly more effective than placebo on a secondary measure used to test antipsychotic drugs called the Clinical Global Impressions Severity scale, the company said.

In previous trials, lurasidone was also tested at 80 mg and Dainippon Sumitomo said it would submit all three doses for FDA approval.

Lurasidone belongs to a class of drugs known as atypical antipsychotics and works by blocking serotonin receptors in the brain. If approved, it would join an already crowded field of such treatments.

"We're still searching for the right drug for many of these patients. There's no one size fits all," Dr Herbert Meltzer, one of the study's lead investigators and professor of psychiatry at Vanderbilt University School of Medicine, said in a telephone interview.

Patients in the trial had been diagnosed with schizophrenia on average for more than 13 years and most had been previously hospitalized prior to entering the study.

"If you look at the weight gain, the lipid changes, it's among the most benign of any antipsychotic drugs, clearly better than olanzapine, clozapine and Seroquel," Meltzer said.

Olanzapine is the chemical name for Eli Lilly and Co's (LLY.N) widely-used Zyprexa; clozapine in sold by Novartis AG (NOVN.VX) under the brand name Clozaril; and Seroquel is sold by AstraZeneca Plc (AZN.L).

Zyprexa and similar drugs can cause significant weight gain and have been linked to increased risk of diabetes.

But "this class of drugs as a whole is so superior to the first generation drugs," said Meltzer, who plans to present the data from the lurasidone trial at a major medical meeting in December.

Lurasidone was well tolerated with a discontinuation rate nearly identical to placebo -- 40 percent versus 39 percent -- and the adverse events were generally mild, such as restlessness and sleepiness.

"From the point of view of efficacy and side effect profile, once a day administration, the fact that the lower dose works as well as the higher dose, I think this is going to have a very good chance of major acceptance among my colleagues," Meltzer added. (Additional reporting by Yumiko Nishitani in Tokyo; Editing by Andre Grenon and Edwina Gibbs)

Tuesday, August 25, 2009

Use traditional medicine to fight flu

The head of a Manitoba First Nations organization is calling on his fellow chiefs to look to traditional aboriginal medicine to help fight the next wave of swine flu, also called H1N1.

Acting grand chief Norman Bone of the Southern Chiefs' Organization said he wants to drive home the fact that First Nations have access to traditional remedies to improve their health and treat the flu on their own, rather than waiting for funding announcements.

"It's more taking a step, doing what we can for ourselves," he said, adding that SCO would also welcome federal or provincial funding for traditional treatment, if an arrangement could be made.

Bone declined to say what types of roots, herbs or other remedies would be used to treat or prevent H1N1, based on the advice of elders. He said he's not suggesting people avoid vaccines in favour of traditional medicine.

"What I'm also promoting is the use of both methods," he said.

Residents of the northern Manitoba First Nations communities of St. Theresa Point and Garden Hill were the worst affected by the H1N1 flu so far, with hundreds of patients sick and dozens flown to Winnipeg for treatment.

Aboriginals make up less than four per cent of Canada's population but have accounted for 11.1 per cent of the total number of reported H1N1 cases, 15.6 per cent of the hospitalized cases, 15 per cent of the patients admitted to intensive care with it, and 12.3 per cent of the deaths.

In Manitoba more than one in four of the 886 individuals diagnosed with H1N1 are First Nations.

SCO health director Shirli Ewanchuk said the organization has been working with communities on pandemic planning since 2007, and is working to ensure there's a stockpile of traditional medicine for communities, including urban First Nations people.

Bone said he was pleased by last week's announcement that the province would spend $1.5 million to provide 15,000 medical kits including masks, tissue, hand sanitizer, rubber gloves and other supplies to First Nations.

Ewanchuk said with the kits paid for, the SCO can focus on making sure health centres in southern First Nations have the proper protective equipment and training, and lining up training for chiefs to deal with a flu pandemic, among other priorities.

Asthma sufferer fined $300 for ganja 'medicine'

SAN JUAN resident Lester Faustin was fined $300 yesterday for possession of 20 grammes of what he described as his "asthma medicine".

In this case, the "medicine" turned out to be the illegal drug marijuana.

Faustin who was arrested last Saturday after a warrant was executed at his girlfriend's Bourg Mulatrasse home, told Magistrate Andrew Stroude that he bought the "herbs" on the advice from an old lady named "Dolly", who prescribed the medication, minus the dosage.

Faustin added that "Dolly does sell bush", but quickly pointed out that it was not the kind of "bush" that he was arrested for.

"Since I start drinking the tea I breathing normal," said the 33-year-old shopkeeper.

He added that he was diagnosed with asthma since his birth but the problem got worse about four years ago when he "got a cut" on his chest.

Faustin was accompanied by his father who told Stroude that he tried speaking to his son about the illegal habit, without a favourable response.

Faustin said that he had trouble breathing at nights before he took the "medicine".

He told Stroude that the marijuana he was arrested for was "shake off", which was useless for smokers.

Faustin, who confessed to smoking marijuana in the past, added that he would "draw it and drink it in the morning".

Faustin then apologised for his actions and promised never to do it again, after which Stroude told him to "put aside his tea" and to seek medical attention for his bronchial problem before sentencing him.

Foreclosures Make for Subprime Mental Health

t's official: The economy is bad for your health.

Researchers at the University of Pennsylvania School of Medicine questioned 250 homeowners going through foreclosure in Philadelphia and found that 47 percent showed symptoms of depression, with 37 percent exhibiting signs of major depression. The rate was especially high considering previous research showed that only about 12.8 percent of people living in poverty were depressed, the study found.

"Although the health status of homeowners has traditionally tended to be better than that of renters, the financial and emotional stress of foreclosure may undermine the potential benefits of homeownership," said the study, which will appear in the October edition of the American Journal of Public Health.

The researchers found deep attachment to homes. "There is a sense of hope when people buy their homes," said Craig Evan Pollack, an internist who recently completed a fellowship at Penn's medical school and is now an associate scientist at Rand Corp. "The difference between those dreams and hopes and [the] reality that people are finding themselves in may be part of the stress that people are feeling, and a sense of sadness as well."

Borrowers facing foreclosure were more likely to forgo filling prescriptions, and nearly 60 percent reported that they had skipped or delayed meals, according to the study. "We've barely begun to think about the health consequences of the foreclosure crisis," Pollack said.

And it's likely to get worse. Nearly 2 million homeowners are expected to lose their homes to foreclosure this year, according to some economists.

"It's surprising to me that the rates of depression aren't even higher," said John Taylor, president of the National Community Reinvestment Coalition, a nonprofit group. "All aspects of their life are just disrupted. They lose their center."

Thursday, August 20, 2009

What killed Mozart?


For more than two centuries, the music of Wolfgang Amadeus Mozart has endured — as has the speculation about what led to his sudden death at age 35 on Dec. 5, 1791.

Was the wunderkind composer poisoned by a jealous rival? Did he have an intestinal parasite from an undercooked pork chop? Could he have accidentally poisoned himself with mercury used to treat a bout of syphilis?

A report in Tuesday's Annals of Internal Medicine suggests the exalted Austrian composer might have succumbed to something far more commonplace: a streptococcal infection — possibly strep throat — that led to kidney failure.

The researchers looked at death records in Vienna during the months surrounding Mozart's death — November and December 1791 and January 1792, and compared causes of death with the previous and following years.

"We saw that at the time of Mozart's death there was a minor epidemic in deaths involving edema (swelling), which also happened to be the hallmark of Mozart's final disease," said Dr. Richard Zegers of the University of Amsterdam, one of the study's authors.

There was a spike in swelling-related deaths among younger men in Vienna at the time of Mozart's death compared to the other years studied, suggesting a minor epidemic of streptococcal disease, Zegers said.

The cause of death recorded in Vienna's official death register was "fever and rash," though even in Mozart's time those were recognized to be merely symptoms and not an actual disease.

His surviving letters and creative output suggest that he was feeling well in the months before his death and was not suffering from any chronic ailment. Many accounts note that he fell ill not long before he died — suffering from swelling so severe, his sister-in-law recalled three decades later, that the composer was unable to turn in bed.

Others who reported to have been witnesses to Mozart's final days also described swelling, as well as back pain, malaise and rash — all symptoms that indicate Mozart may have died of kidney disease brought on by a strep infection.

"It's not definitive, but it's certainly food for thought," said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center who was not involved in the study.

He said it was not unreasonable to presume that Mozart died from strep complications, based on the information presented, but he pointed out that the authors had scant data to go on.

"Serious streptococcal infections were much more common than they are now and, indeed, they had very serious complications," he said. "This is sure to set off many discussions going forward."

US warns businesses to brace for H1N1


The federal government is urging employers to offer flexible sick leave policies as the nation braces for a second wave of the H1N1 influenza pandemic.

Commerce Secretary Gary Locke, Health and Human Services Secretary Kathleen Sebelius, and Homeland Security Secretary Janet Napolitano offered guidance to businesses on how to prevent the spread of H1N1, also known as swine flu, and to prepare for a major outbreak. They stressed allowing employees who exhibit flu symptoms to go home and to stay home until at least 24 hours have passed since their fevers subsided. They also said businesses should consider eliminating policies that require a doctor’s note or other proof to justify a sick day and that employers should be prepared to operate with fewer people.

“It’s more than just a significant health issue. It has the potential to affect every aspect of our lives,’’ Locke said. “It will take Americans from every walk of life pulling together and doing our part to mount an effective response.’’

As the first pandemic in more than 40 years, it has the potential to cause massive disruptions for businesses, schools, and governments. The United States and other northern nations have been scrambling to prepare for a resurgence of the virus by stockpiling flu treatments and vaccines.

US officials said yesterday that data from tests on adults show it is safe to start trying out the new vaccine in children. The National Institute of Allergy and Infectious Diseases said it would soon start two trials of a Sanofi-Aventis vaccine in children ages 6 months to 17 years. US health officials said 45 million doses of the H1N1 vaccine will be on hand in mid-October, when mass vaccinations are to begin.

Wednesday, August 19, 2009

Induced Labor May Prevent Need for Cesarean Section

Inducing labor doesn't necessarily increase the risk of Cesarean section delivery, according to a study that challenges the widely held opinion.

Researchers reviewed available data on elective induction, in which women choose to have labor induced rather than requiring it for medical reasons. Most of the studies included women who were about one week past their due date.

The review results suggest that, compared with waiting, elective induction of labor at or after 41 weeks' gestation lowered Cesarean delivery risk by 22 percent. In addition, women whose labor was electively induced were half as likely to have meconium-stained amniotic fluid, which is a sign of fetal intrauterine stress.

The findings suggest that elective induction of labor may be safer than continuing pregnancy past 41 weeks, according to the researchers at Stanford University School of Medicine and University of California, San Francisco (UCSF). Their study appears in the Aug. 18 issue of the Annals of Internal Medicine.

"It appears there is misunderstanding regarding the association of increased Cesarean deliveries with elective induction of labor, a procedure which has been rising in frequency," review lead author Dr. Aaron Caughey, an associate professor of obstetrics, gynecology and reproductive sciences at UCSF, said in a Stanford University news release. "However, our findings need to be tempered with women's and physicians' expectations of choosing to induce labor."

The message for pregnant women is that labor induction can be done without increasing Cesarean risk if doctors give induction sufficient time to work, said co-author Dr. Douglas Owens, director of the Stanford-UCSF Evidence-based Practice Center.

"Women should talk with their physician about how they would handle induction and what their approach to the procedure would be," Owens said in the news release.

Induced Labor May Prevent Need for Cesarean Section

Inducing labor doesn't necessarily increase the risk of Cesarean section delivery, according to a study that challenges the widely held opinion.

Researchers reviewed available data on elective induction, in which women choose to have labor induced rather than requiring it for medical reasons. Most of the studies included women who were about one week past their due date.

The review results suggest that, compared with waiting, elective induction of labor at or after 41 weeks' gestation lowered Cesarean delivery risk by 22 percent. In addition, women whose labor was electively induced were half as likely to have meconium-stained amniotic fluid, which is a sign of fetal intrauterine stress.

The findings suggest that elective induction of labor may be safer than continuing pregnancy past 41 weeks, according to the researchers at Stanford University School of Medicine and University of California, San Francisco (UCSF). Their study appears in the Aug. 18 issue of the Annals of Internal Medicine.

"It appears there is misunderstanding regarding the association of increased Cesarean deliveries with elective induction of labor, a procedure which has been rising in frequency," review lead author Dr. Aaron Caughey, an associate professor of obstetrics, gynecology and reproductive sciences at UCSF, said in a Stanford University news release. "However, our findings need to be tempered with women's and physicians' expectations of choosing to induce labor."

The message for pregnant women is that labor induction can be done without increasing Cesarean risk if doctors give induction sufficient time to work, said co-author Dr. Douglas Owens, director of the Stanford-UCSF Evidence-based Practice Center.

"Women should talk with their physician about how they would handle induction and what their approach to the procedure would be," Owens said in the news release.

Tuesday, August 18, 2009

Gut Checks Carry More Weight


When big-bellied patients come through the door of George Griffing's medical office in Brentwood, Mo., he pulls out a measuring stick.

Griffing, a professor of internal medicine at Saint Louis University School of Medicine, has those patients lie flat on their backs on an exam table. Then he measures the height of their bulging midsection from table top to tummy top.

"I'd like to use a ruler, but with a lot of patients I have to use a yardstick," he says. "What we're really looking for is how much fat is in the abdomen and the liver. It's simple and accurate and reveals a lot of information."

Medical experts have long suspected that people with excess deep-belly fat are at an increased risk for cardiovascular disease and Type 2 diabetes, and ongoing research bolsters that belief.

Griffing believes that measuring abdominal height is more efficient and accurate at predicting the risks of diabetes and cardiovascular disease than more commonly used methods such as calculating body mass indexes or waist-to-hip ratios, or measuring the circumferences of patients' waists. Those all factor in subcutaneous fat on arms, legs and hips, which is not as bad for you as fat in the gut, Griffing says. Griffing says most studies have found that abdominal heights that measure more than 10 inches in women and more than 12 inches in men triple the chance of cardiovascular disease.

The American Diabetes Association and the American Heart Association endorse using the midsection measuring technique. On its Web site, the American Diabetes Association calls it a simple, cheap and noninvasive tool but added that more research is needed.

Ibuprofen is best for kids with broken arms

Kids with a broken arm do better on a simple over-the-counter painkiller than on a more powerful prescription combination that includes a narcotic, a surprising study finds.

It tested ibuprofen, sold as Advil, Motrin and other brands, against acetaminophen plus codeine — a combo called Tylenol No. 3 that is also sold in generic form.

The children on ibuprofen did better, said the study leader, Dr. Amy Drendel of the Medical College of Wisconsin in suburban Milwaukee.

"They were more likely to play, they ate better and they had fewer adverse effects," she said.

Results were published online Tuesday by the Annals of Emergency Medicine. Experts praised the study as one of the few to compare medicines that have been long used in children based on how they work in adults.

"We want to start with what's effective and less likely to cause problems," and in this case, it turned out to be a cheap, over-the-counter drug, said Dr. Knox Todd, an emergency medicine pain researcher at Beth Israel Medical Center in New York and a member of the American Pain Society's board of directors.

The results do not mean that ibuprofen beats acetaminophen for everyday pain relief in children or anyone else, though. The study tested a specific use — pain in the first three days after a broken arm — and the acetaminophen was combined with the narcotic codeine, not tested alone.

Still, it shows the best way to treat a very common problem: As many as one out of five kids will break a bone before age 10 — often, an arm.

Researchers randomly assigned 336 children ages 4 to 18 to go home with liquid versions of either ibuprofen or the acetaminophen-codeine combo after being treated for a broken arm at Children's Hospital of Wisconsin. Neither the children, parents nor the doctors knew who received what treatment until the study ended.

Full results were available on 244 children. The portion who failed to get relief from their assigned medicine was roughly the same.

However, half of those on the combo medicine reported side effects — mostly nausea and drowsiness that can occur with narcotics like codeine — versus 30 percent of those given ibuprofen.

The ibuprofen users also had fewer problems eating, playing, going to school or sleeping. They and their parents reported more satisfaction with the treatment.

"A lot of emergency medicine physicians are afraid to give kids narcotics and a lot of parents are uncomfortable with narcotic medicine," so finding an effective alternative is good news, Drendel said.

The hospital and medical school paid for the study, and a hospital-related charity paid for $10 Toys R Us gift certificates for each participant.

The study has nothing to do with limits on Tylenol for adults that were recently proposed by an advisory panel to the federal Food and Drug Administration, said Todd, who is a member of that panel.

"Acetaminophen when taken as directed is a very safe drug. The problem is people taking too much," or its inclusion in drugs that people might not be aware of, he explained.

Monday, August 17, 2009

News Government considers herbal medicine ban


The government is considering measures that would effectively outlaw herbal medicine.

Such a move is likely to be welcomed by groups who campaign for evidence-based medicine. But others warned that prohibition could make it harder to regulate herbalists, by driving them underground.

The proposal came in a DoH consultation on plans to subject alternative medicine to professional regulation. Experts argue that this would offer cheaper and more effective protection of public safety than attempting to regulate individual remedies.

The consultation was expected to consider how to implement regulation. But instead it re-opens the question of whether statutory regulation is the best way to ensure public safety.

It offers alternatives including abolishing section 12 (1) of the 1968 Medicines Act, which allows herbalists to practice.

NHS Alliance chairman Dr Michael Dixon said that any move to regulate alternative medicines should be ‘totally pragmatic'. ‘The public are already seeing these practitioners,' he said. ‘We need to be assured that they are safe and know what they are doing within the modality of those treatments.'

Some health professionals want a tougher stance on herbal medicines, however.

Professor David Colquhoun, professor of pharmacology at University College London said: ‘Every other form of drug is tested for safety and efficacy. These guys have a complete loophole.'

He warned that many herbal medicines came in un-standardised doses, and statutory regulation would offer patients false reassurance that treatments were safe or effective and urged GPs to oppose it in the consultation, which runs until 2 November.

Sunday, August 16, 2009

Get your omega-3s – carefully

I am really confused about what fish to eat. I hear that fish is good for my health but that some types are healthier and others should be avoided because of contamination. Could you please clarify what fish I should and should not eat?

Fish is a natural source of omega-3 fatty acids, which are thought to have numerous health benefits, including reducing inflammation and the risk of heart disease.

Omega-3 fatty acids may also reduce arthritis, decrease triglycerides, reduce blood clotting and reduce the risk of sudden cardiac death.

Since fish can be good for your health, it is recommended that a person eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish. But which fish should you eat?

To make it easy for you, here are some quick and easy "healthy fish basics":

1. Choose fish that is high in the omega-3s, or the "good fats." Fatty fish from the sea, including salmon, herring, and to a lesser extent tuna, are high in omega-3s. Most freshwater fish have less omega-3 fatty acid than do fatty fish from the ocean.

2. Eat less of the fish that are high in omega-6 fatty acids. Some fish, especially farmed fish like tilapia and catfish, contain more omega-6 than omega-3 fatty acids. This is because farmed fish are often raised on corn-based diets, leading to higher levels of omega-6 and arachidonic acid in their tissues. Arachidonic acid in particular can contribute to inflammation and plaque buildup in your arteries.

3. Avoid contaminated fish: Five primary contaminants are mercury, PCBs, chlordane, dioxin and DDT. Contamination levels increase as they move up the food chain, so remember that the top predators in a food chain – such as largemouth bass or walleye – may have very high levels of chemical contamination. Pregnant and nursing women, as well as children, should especially avoid highly contaminated fish.

Some of the most commonly consumed fish that are low in mercury are shrimp, canned light tuna, salmon and pollock. Conversely, the Food and Drug Administration cautions against eating shark, swordfish, king mackerel or tilefish because they contain high levels of mercury.

4. Think sustainable.

For a complete listing, go to www.montereybay aquarium.org.

And finally, if you are a vegetarian, non-fish food options that contain omega-3 fatty acids include flaxseed, flaxseed oil, walnuts, canola oil, soybeans and soybean oil.

Saturday, August 15, 2009

Brazil bans flu medicine ads

Brazil on Friday imposed a temporary ban on all flu medicine advertisements in an effort to reduce self-medication that may disguise A/H1N1 symptoms.

The ban applies to advertisements for aspirin-based medicine and over-the-counter remedies for flu symptoms on all mass media, including the Internet, said the National Health Surveillance Agency (Anvisa).

The measure aims at reducing the self-medication, which may cause errors in the diagnosis of the A/H1N1 flu, leading to more severe cases of the disease, the Anvisa said.

The Brazilian health ministry said that 77 percent of flu cases in the country were A/H1N1 and the number was rising sharply.

Brazil has registered 277 deaths from the disease, the third largest number of A/H1N1 deaths after the United States and Argentina.

Brazil are taking other measures to contain the spread of the A/H1N1virus, such as postponing poliomyelitis immunizations scheduled for Aug. 22 to avoid crowding in hospitals that could lead to more infections.

Classes remain suspended in many schools and universities in the country. Students will have to miss nearly a month of school before most schools resume classes in late August or early September.

Latest data released by the health ministry this week said that there are 3,642 confirmed cases of A/H1N1 flu in Brazil.

However, the ministry noted that the number may grow bigger, as more tests for the disease are underway.

Friday, August 14, 2009

What is alternative medicine?

Acupuncture, chiropractic, naturopathy, homeopathy, diet and supplements all come to mind when you think of alternative medicine.

But, alternative medicine is more than the sum of all the non-medical treatments out there. It is a completely different attitude about health care. Instead of looking for what's wrong, alternative medicine looks for what's right. The focus is on health rather than disease.

When you go to a medical doctor, you may be tested for several possible diseases depending upon your symptoms. An MD is trained to diagnose, before he or she can treat you.

Go to an alternative doctor, and diagnosis is secondary. In fact, alternative practitioners can usually treat without a diagnosis. Unlike surgery and medication, alternative treatments are generally healthful and without risk to the patient.

If this sounds like snake oil to you, you might want to read Never Be Sick Again by San Rafael author Raymond Francis.

A chemist and a graduate of MIT, Raymond Francis was not motivated to take control of his health until he became seriously ill, and near death, at age 48.

Never Be Sick Again is a great introduction to the non-medical approach to health. Francis describes his own transformational journey, and invites the rest of us to follow.

So, curl up with this good book, and discover the world of alternative medicine. And never be sick again.

6 hours of sleep? It's not enough

Scientists have good and bad news for hard-driving people who boast they need only six hours of sleep a night.

The good news is a few may be right: Researchers at the University of California-San Francisco have identified a family with a genetic mutation that causes members to require only six hours sleep a night. The bad news? The gene is vanishingly rare in humans, found in less than 3% of people.

So almost everyone who says he needs only six hours' sleep is kidding himself. And the consequences of chronic sleep deprivation are serious, says Clete Kushida, president of the American Academy of Sleep Medicine and director of Stanford University's Sleep Medicine Center. Sleep deprivation has been linked to an increase in motor vehicle accidents, deficiencies in short-term memory, focus and attention. It's also tied to depressed mood and a decrease in the ability to control appetite.

The family members — a mother and daughter with the gene mutation — were discovered by researchers at UCSF studying circadian rhythms, the waxing and waning biochemical cycles that govern sleep, hunger and activity. Neither woman needed more than six to 6½ hours of sleep a night, and yet both were well-rested, healthy and energetic.

"One of them is over 70, always traveling internationally and extremely active. She dances three or four nights a week," says Ying-Hui Fu, a professor of neurology at UCSF.

When scientists examined the pair's DNA, they found a mutation in a gene called DEC2, which governs cell production and circadian rhythm.

The mutation seems to result in people who need much less than the normal eight to 8½ hours that most humans require for well-rested functioning, according to the paper, which is published in today's edition of the journal Science. The research by Fu and her colleagues determined that humans and mice that carry the mutation get more intense sleep, as measured by slow-wave electrical activity in the brain, and so they need less of it.

But Fu estimates that only about 3% of the population is likely to have this gene and cautions that most people who habitually get less than eight hours sleep a night are only building up a large, and dangerous, sleep debt.

Fu says her lab is investigating whether it might be possible to mimic the effects of the gene with therapeutic compounds, but she cautions the research is only at the very beginning. For now, the only real answer to true productivity is to sleep as much as your body needs, she says.

Can regenerative medicine defeat aging?

The relevance of nearly all biogerontology research to combating aging is restricted to the potential for slowing down the accumulation of molecular and cellular damage that eventually leads to age-related ill-health. Meanwhile, regenerative medicine has been progressing rapidly and is nearing clinical applicability to a wide range of specific conditions. My view is that we are approaching the point where regenerative medicine can be used against aging. This would entail not retarding but actually reversing the accumulation of damage. If successful, this would obviously be a far more valuable technology than mere slowing of aging. However, in order to be successful it must be comprehensive, and some aspects of aging may seem impossible to address in this way. In fact, however, it seems that all types of molecular and cellular damage which contribute to age-related ill-health are realistic targets of regenerative interventions.

The human body is, ultimately, a machine - an astronomically complex machine, of whose workings we remain pitifully ignorant - but still a machine. Like any machine, it accumulates ‘damage’ as a side-effect of its normal operation: molecular and cellular changes that occur throughout life are initially harmless, but eventually (when too abundant) increasingly impede the normal operation of the machine and eventually cause it to fail altogether. Conceptually, there are three strategies to postpone a machine’s demise beyond its ‘warranty period’. First, we can treat it really well throughout its life, thereby slowing down the accumulation of damage: but that can never stop the accumulation altogether, because to do so would require not operating the machine at all, and anyway it cannot address damage that has already occurred. Alternatively, we can combat the late-life symptoms, the dysfunction that eventually emerges: but that too is only a short-term approach, because the underlying damage that causes the dysfunction is still accumulating and making the dysfunction harder and harder to address. This is why the way in which machines that people love are in fact kept in good shape is the third strategy: repair and maintenance, in which we let the damage be created, but repair it before it becomes so severe as to cause dysfunction. In the case of the human body, this means using regenerative medicine against aging.

So… can it work? Are all the types of damage that contributed to age-related ill-health amenable to repair?

People go in for traditional medicines

With no preventive medicines available for swine flu in modern medicine, people are increasingly turning towards the traditional systems of medicines like Ayurveda and homeopathy.

The homeopathic medicine Influnzenium 200 is in great demand these days. A repesentative of Dr Reckweg Clinic in the city said “the medicine has become the most sought after these days after the swine flu menace spread. Earlier, nobody asked for it even once in a day.” Stocks are fast selling out and we have ordered fresh stocks, said a homeopathic medicine shop owner.

Homeopath Tareshwar Jain says swine flu is an influenza-like illness where primary symptoms are very much similar to those of influenza. Thus, one can take Influnzenium 200 as a preventive medicine. However, consulting a doctor will be advisable before self-medication.

Dr Mahesh Sharma, director of the National Institute of Ayurveda, says there is both preventive and curative medicines in traditional medicine. He says as a preventive measure care has to be taken on maintaining cleanliness and proper diet.

He said an OPD will soon start functioning at the institute from next Monday offering free medicines and guidance. “We can treat people with initial symptoms. However, in advanced and complicated cases with symptoms of diarrhoea and bleeding, it is advisable to approach a specialised hospital, “he added.

He says application of either mustard or sesame oil in the nostrils to get relief from cold, besides swallowing two to three tulsi leaves (with out chewing), also help to increase immunity against the virus.

Dr Sharma suggests taking a dose of the boiled water of a teaspoon of turmeric (haldi) black pepper, tulsi leaves, and jeera could be of great help in curing the the respiratory system and immune system from all kinds viral infections and cure for the common cough and cold.

However he suggests “it is better to avoid butter milk (chach) and curd (dahi) during this period. People are advised to take proper diet and those who suffer from constipation should take some remedy as it increases the chances of infection.”

Wednesday, August 12, 2009

New diabetes-related medicines being tested on patients

Four novel approaches to treat type 2 diabetes were discussed at the recent 69th Scientific Sessions of the American Diabetes Association.

All are in stage 3 clinical research trials right now. In other words, real patients are using these new treatments and their progress is being recorded and analyzed.

One treatment of great interest to anyone with diabetes is the possibility of taking insulin by mouth. New approaches have been developed to make this a reality. Until now, any insulin swallowed is damaged by the stomach acids. New discoveries allow the tissues inside the cheek to absorb insulin.

Another new category of anti-diabetic medicines called SGLT-2 inhibitors have been found to reduce blood sugars without the use of insulin. These drugs make the kidneys spill sugar into the urine. This has two potentially beneficial effects. First, it lowers blood sugar levels by helping the body eliminate high sugars faster. Second, the extra calories the sugar represents are lost. This helps the diabetic lose weight. Side effects seem to be minimal. Studies are under way to prove their value and effectiveness.

There is good evidence that the insulin-producing cells of the body are damaged and destroyed by inflammation in type 2 diabetics. That puts it in a similar category with other inflammatory diseases such as rheumatoid arthritis and gout. One new agent being investigated is called interleukin-2 (IL-2) beta receptor antagonist. Studies have shown the receptor plays a significant role in the death of the insulin producing cells. If this killer agent could be blocked, then insulin production would be preserved. Diabetes would be slowed or maybe even stopped.

Another anti-inflammatory agent being studied is Salsalate. Not only might this medication, which is chemically similar to aspirin, be helpful in preventing type 2 diabetes, but it also could protect against the damage to blood vessels so commonly seen in all diabetics. Salsalate is known to slow down overactive inflammatory pathways in type 2 diabetics. There is now good evidence that inflammation of blood vessels is closely associated with insulin resistance and impaired insulin secretion.

None of these medicines will be on shelves anytime soon. It’s important to study new medications for side effects and prove their value. Next, the FDA would need to evaluate these drugs and that process can take time before formal approval. Finally, like any other new medicines, don’t expect them to be inexpensive or covered by your health insurance.

As exciting as any new medicine may seem, the best management for any type of diabetes is carefully balancing food eaten, regular activity, and medications (only if needed). The Diabetes Prevention Program proved more than a decade ago that regular daily exercise combined with improved eating habits aimed at lowering weight by just 7 percent prevents diabetes better than any known medicine.