Thursday, December 8, 2011
Some men can delay prostate cancer treatment: panel
Some men can delay prostate cancer treatment: panel
By Julie Steenhuysen
Dec 7, 2011
(Reuters) - Men with low-risk prostate cancer may wait to see if their disease progresses before treating it, an independent panel of experts convened by the U.S. National Institutes of Health (NIH) said on Wednesday.
The panel backed the so-called active monitoring approach to prostate cancer treatment as a way to help men avoid the potential health consequences of treatment, which include impotence and incontinence.
The NIH is considering dropping the name "cancer" from this very early stage of the disease because it may make it easier for men to accept that carefully monitoring for changes is a better approach for them than immediate treatment.
Prostate cancer is the most common non-skin cancer in men in the United States. Some 240,000 U.S. men will be diagnosed with prostate cancer this year, and about 33,000 will die of the disease. More than half of these cancers are confined to the prostate and unlikely to become life-threatening.
Even so, about 90 percent of men who are diagnosed with prostate cancer get immediate treatment, such as surgery or radiation therapy.
"It's clear that many men would benefit from delaying treatment," said Dr. Patricia Ganz, a cancer prevention expert at the University of California Los Angeles, who chaired the NIH's state-of-the-science panel on prostate cancer.
The problem, said Ganz, is there is no consensus on the best strategies for monitoring the progress of prostate cancer and what benchmarks should be used to determine when treatment is needed. The panel urged NIH for more research to clarify this matter.
Many doctors already use a variety of monitoring strategies for men whose low-grade prostate cancer was detected through PSA screening, a blood test that detects levels of a protein made in the prostate gland known as prostate-specific antigen.
Elevated levels of this protein can indicate prostate cancer, but it can be caused by other things as well..
Several studies have suggested many men are over-screened for prostate cancer, and this over-screening has in many cases caused more harm than good, leading men to chose a biopsy and treatment for a slow-growing cancer that may have never caused them harm during their lifetimes.
Alternative strategies for men with low-risk prostate cancer typically fall into two camps: observation with and without the intent to cure.
In the observation without intent to cure approach, sometimes called watchful waiting, doctors treat symptoms if they develop.
In observation with intent to cure, often called active surveillance, patients undergo frequent testing and are offered curative treatment if the cancer progresses.
Ganz said it is not yet clear which approach is best.
"Prostate cancer affects some 30-40 percent of men over the age of 50. Some of these men will benefit from immediate treatment, others will benefit from observation. We need to standardize definitions, group patients by their risks and conduct additional research to determine the best protocols for managing low-risk disease," she said in a statement.
(Editing by Todd Eastham)
Wednesday, December 7, 2011
Why Working the Night Shift May Boost Your Risk of Diabetes
Why Working the Night Shift May Boost Your Risk of Diabetes
By Alice Park
Time
December 7, 2011
The night shift isn't usually anyone's first choice, but in some professions — and in this economy — it can't be avoided. About 26% percent of the American workforce, including health-care workers and sanitation staff, clocks in after dark, and the schedule may be taking a toll on their health.
Past research has shown that working when you're supposed to be in bed disrupts your circadian rhythm, raising the risk of heart disease, obesity, ulcers and even depression. Now, reporting in the journal PLoS Medicine, scientists also find that rotating night-shift work can increase the risk of developing Type 2 diabetes. The backward schedule can mess with the body's ability to use insulin properly to break down sugars in the blood, according to Dr. Frank Hu, a professor of nutrition and epidemiology at Harvard School of Public Health.
In a study involving nearly 177,000 middle-aged women enrolled in two Nurses' Health Studies, women who worked rotating night shifts for 1 to 2 years increased their risk of developing diabetes by 5% over a 20-year follow-up period, compared with women who didn't get assigned these shifts. Women who kept up night work for 10 to 19 years increased their risk by 40%. Working on and off at night for more than 20 years boosted the risk of diabetes by 60%.
Certainly, body weight is part of the problem, since excess weight is a risk factor for diabetes. People who work at night may snack more when they should be sleeping — and our bodies are metabolically trained to slow down as the sun sets. So the calories we take in during the evening and night hours are less likely to get burned off efficiently, and more likely to be stored as fat.
It's not just night work that causes a problem. Simply not sleeping when you're supposed to, or not getting enough sleep, can also wreak havoc with your metabolism, by pushing up levels of the appetite-stimulating hormone ghrelin and suppressing the appetite-curbing hormone leptin. Our circadian clocks also regulate body weight indirectly, by controlling body temperature and blood glucose levels. "The bottom line is there are probably multiple mechanisms through which disrupted sleep patterns or long term rotating night shift work can influence the risk of Type 2 diabetes," says Hu.
The study focused on people who rotated night shift work, so they weren't working nights routinely, but perhaps once every few days or weeks. Hu says it's not clear whether those who regularly work at night (and therefore sleep during the day) can adjust their body clocks to avoid this increased risk of diabetes.
What intrigued Hu and his team the most was the cumulative effect that night work had on diabetes risk. The longer people worked irregular hours at night, the higher their risk of developing the disease. "It's something people should keep in mind," he says. "If they minimize or reduce the time they work on night shifts, they may be able to attenuate their risk."
That's an important lesson for those who have to work at night. They might not be able to avoid the late hours, but they should remember that sticking with a night shift schedule for too long can be harmful for their health. And because these individuals may be at higher risk of developing diabetes, they should pay more attention to things that can lower their risk, such as watching their diet, exercising and getting screened for the disease more regularly.
By Alice Park
Time
December 7, 2011
The night shift isn't usually anyone's first choice, but in some professions — and in this economy — it can't be avoided. About 26% percent of the American workforce, including health-care workers and sanitation staff, clocks in after dark, and the schedule may be taking a toll on their health.
Past research has shown that working when you're supposed to be in bed disrupts your circadian rhythm, raising the risk of heart disease, obesity, ulcers and even depression. Now, reporting in the journal PLoS Medicine, scientists also find that rotating night-shift work can increase the risk of developing Type 2 diabetes. The backward schedule can mess with the body's ability to use insulin properly to break down sugars in the blood, according to Dr. Frank Hu, a professor of nutrition and epidemiology at Harvard School of Public Health.
In a study involving nearly 177,000 middle-aged women enrolled in two Nurses' Health Studies, women who worked rotating night shifts for 1 to 2 years increased their risk of developing diabetes by 5% over a 20-year follow-up period, compared with women who didn't get assigned these shifts. Women who kept up night work for 10 to 19 years increased their risk by 40%. Working on and off at night for more than 20 years boosted the risk of diabetes by 60%.
Certainly, body weight is part of the problem, since excess weight is a risk factor for diabetes. People who work at night may snack more when they should be sleeping — and our bodies are metabolically trained to slow down as the sun sets. So the calories we take in during the evening and night hours are less likely to get burned off efficiently, and more likely to be stored as fat.
It's not just night work that causes a problem. Simply not sleeping when you're supposed to, or not getting enough sleep, can also wreak havoc with your metabolism, by pushing up levels of the appetite-stimulating hormone ghrelin and suppressing the appetite-curbing hormone leptin. Our circadian clocks also regulate body weight indirectly, by controlling body temperature and blood glucose levels. "The bottom line is there are probably multiple mechanisms through which disrupted sleep patterns or long term rotating night shift work can influence the risk of Type 2 diabetes," says Hu.
The study focused on people who rotated night shift work, so they weren't working nights routinely, but perhaps once every few days or weeks. Hu says it's not clear whether those who regularly work at night (and therefore sleep during the day) can adjust their body clocks to avoid this increased risk of diabetes.
What intrigued Hu and his team the most was the cumulative effect that night work had on diabetes risk. The longer people worked irregular hours at night, the higher their risk of developing the disease. "It's something people should keep in mind," he says. "If they minimize or reduce the time they work on night shifts, they may be able to attenuate their risk."
That's an important lesson for those who have to work at night. They might not be able to avoid the late hours, but they should remember that sticking with a night shift schedule for too long can be harmful for their health. And because these individuals may be at higher risk of developing diabetes, they should pay more attention to things that can lower their risk, such as watching their diet, exercising and getting screened for the disease more regularly.
Monday, November 28, 2011
A form of autism called regressive autism is linked to brain overgrowth in males
Larger brains linked with regressive autism
By Shari Roan
Los Angeles Times
November 28, 2011
Autism symptoms can appear in babies, however some children with the disorder develop normally until about age 2 when they suddenly regress. A new study has linked this second type of autism -- regressive autism -- with larger brain size in boys.
Other studies have suggested some association between overgrowth of the brain and autism. The new study, led by researchers at the UC Davis MIND Institute, demonstrates that there are multiple biological subtypes of autism including likely differences between males and females.
Researchers looked at 114 children with autism spectrum disorder between the ages of 2 and 4 and compared them with 66 healthy children of the same age. Of the 114 with the disorder, 54% had regressive autism and 46% had non-regressive autism.
Brain scans of the children showed that abnormal head growth and brain enlargement was identifiable in 22% of males with regressive autism compared with 5% of males with the non-regressive type. Girls with autism did not show brain enlargement. The data suggest that the abnormal brain growth occurred at around 4 to 6 months of age, much earlier than the symptoms of regression -- such as a decline in speech -- actually appear.
The study, published Monday in the Proceedings of the National Academy of Sciences, adds to a growing body of evidence showing autism likely has various biological underpinnings. Researchers are particularly interested in understanding the disorder in girls. "[I]t is likely that the pattern of pathology is different in females than in males," they wrote.
By Shari Roan
Los Angeles Times
November 28, 2011
Autism symptoms can appear in babies, however some children with the disorder develop normally until about age 2 when they suddenly regress. A new study has linked this second type of autism -- regressive autism -- with larger brain size in boys.
Other studies have suggested some association between overgrowth of the brain and autism. The new study, led by researchers at the UC Davis MIND Institute, demonstrates that there are multiple biological subtypes of autism including likely differences between males and females.
Researchers looked at 114 children with autism spectrum disorder between the ages of 2 and 4 and compared them with 66 healthy children of the same age. Of the 114 with the disorder, 54% had regressive autism and 46% had non-regressive autism.
Brain scans of the children showed that abnormal head growth and brain enlargement was identifiable in 22% of males with regressive autism compared with 5% of males with the non-regressive type. Girls with autism did not show brain enlargement. The data suggest that the abnormal brain growth occurred at around 4 to 6 months of age, much earlier than the symptoms of regression -- such as a decline in speech -- actually appear.
The study, published Monday in the Proceedings of the National Academy of Sciences, adds to a growing body of evidence showing autism likely has various biological underpinnings. Researchers are particularly interested in understanding the disorder in girls. "[I]t is likely that the pattern of pathology is different in females than in males," they wrote.
Thursday, November 10, 2011
Happiness linked to longer life
Happiness linked to longer life
By Amanda MacMillan
Health.com
October 31, 2011
A new study suggests that happiness in older people may lead to a longer life.
(Health.com) -- Being happy doesn't just improve the quality of your life. According to a new study, it may increase the quantity of your life as well.
Older people were up to 35% less likely to die during the five-year study if they reported feeling happy, excited, and content on a typical day. And this was true even though the researchers took factors such as chronic health problems, depression, and financial security out of the equation.
"We had expected that we might see a link between how happy people felt over the day and their future mortality, but we were struck by how strong the effect was," says Andrew Steptoe, Ph.D., the lead author of the study and a professor of psychology at University College London, in the United Kingdom.
Health.com: Boost your mood naturally
Previous studies on happiness and longevity have largely relied on the participants' ability to recall how they felt during a certain period of time in the past. These recollections aren't always accurate, though, and to get around this problem Steptoe and his colleagues asked more than 3,800 people to record their levels of happiness, anxiety, and other emotions at four specific times over the course of a single day.
The participants, who were between the ages of 52 and 79 when the study began, were divided into three groups according to how happy and positive they felt. Although the groups differed slightly on some measures (such as age, wealth, and smoking), they were comparable in terms of ethnic makeup, education, employment status, and overall health.
Five years later, 7% of people in the least happy group had died, compared with just 4% in the happiest group and 5% in the middle group.
When the researchers controlled for age, depression, chronic diseases, health behaviors (such as exercise and alcohol consumption), and socioeconomic factors, they found that the happiest and medium-happy people were 35% and 20% less likely to have died, respectively, than their gloomier counterparts.
Health.com: How to live to 100
It may seem far-fetched that a person's feelings on one particular day would be able to predict the likelihood of dying in the near future, but these emotional snapshots have proven to be a good indication of overall temperament in previous studies, says Sarah Pressman, Ph.D., a professor of psychology at the University of Kansas, in Lawrence.
"There is always room for error, of course; if I get a parking ticket or stub my toe on the way to the study, I'm not going to be particularly happy," says Pressman, who was not involved in the study but researches the impact of happiness on health. "But given that the study worked, it suggests that, on average, this day was fairly typical for the participants."
Unlike the happiness measures, depression symptoms were not associated with mortality rates once the researchers adjusted for overall health. According to the study, this finding suggests that the absence of happiness may be a more important measure of health in older people than the presence of negative emotions.
Health.com: The secrets to a super-happy winter
Positive emotions could contribute to better physical health in a number of ways. Regions of the brain involved in happiness are also involved in blood-vessel function and inflammation, for instance, and studies have shown that levels of the stress hormone cortisol tend to rise and fall with emotion.
The study doesn't prove that happiness (or unhappiness) directly affects lifespan, but the findings do imply that doctors and caregivers should pay close attention to the emotional well-being of older patients, the researchers say. "We would not advocate from this study that trying to be happier would have direct health benefits," Steptoe says.
However, this study and others like it should help establish happiness as a legitimate area of concern for health professionals, Pressman says. "There are still some people who see happiness as something fluffy and less scientific -- not something they should be worried about like, say, stress or depression," she says...
By Amanda MacMillan
Health.com
October 31, 2011
A new study suggests that happiness in older people may lead to a longer life.
(Health.com) -- Being happy doesn't just improve the quality of your life. According to a new study, it may increase the quantity of your life as well.
Older people were up to 35% less likely to die during the five-year study if they reported feeling happy, excited, and content on a typical day. And this was true even though the researchers took factors such as chronic health problems, depression, and financial security out of the equation.
"We had expected that we might see a link between how happy people felt over the day and their future mortality, but we were struck by how strong the effect was," says Andrew Steptoe, Ph.D., the lead author of the study and a professor of psychology at University College London, in the United Kingdom.
Health.com: Boost your mood naturally
Previous studies on happiness and longevity have largely relied on the participants' ability to recall how they felt during a certain period of time in the past. These recollections aren't always accurate, though, and to get around this problem Steptoe and his colleagues asked more than 3,800 people to record their levels of happiness, anxiety, and other emotions at four specific times over the course of a single day.
The participants, who were between the ages of 52 and 79 when the study began, were divided into three groups according to how happy and positive they felt. Although the groups differed slightly on some measures (such as age, wealth, and smoking), they were comparable in terms of ethnic makeup, education, employment status, and overall health.
Five years later, 7% of people in the least happy group had died, compared with just 4% in the happiest group and 5% in the middle group.
When the researchers controlled for age, depression, chronic diseases, health behaviors (such as exercise and alcohol consumption), and socioeconomic factors, they found that the happiest and medium-happy people were 35% and 20% less likely to have died, respectively, than their gloomier counterparts.
Health.com: How to live to 100
It may seem far-fetched that a person's feelings on one particular day would be able to predict the likelihood of dying in the near future, but these emotional snapshots have proven to be a good indication of overall temperament in previous studies, says Sarah Pressman, Ph.D., a professor of psychology at the University of Kansas, in Lawrence.
"There is always room for error, of course; if I get a parking ticket or stub my toe on the way to the study, I'm not going to be particularly happy," says Pressman, who was not involved in the study but researches the impact of happiness on health. "But given that the study worked, it suggests that, on average, this day was fairly typical for the participants."
Unlike the happiness measures, depression symptoms were not associated with mortality rates once the researchers adjusted for overall health. According to the study, this finding suggests that the absence of happiness may be a more important measure of health in older people than the presence of negative emotions.
Health.com: The secrets to a super-happy winter
Positive emotions could contribute to better physical health in a number of ways. Regions of the brain involved in happiness are also involved in blood-vessel function and inflammation, for instance, and studies have shown that levels of the stress hormone cortisol tend to rise and fall with emotion.
The study doesn't prove that happiness (or unhappiness) directly affects lifespan, but the findings do imply that doctors and caregivers should pay close attention to the emotional well-being of older patients, the researchers say. "We would not advocate from this study that trying to be happier would have direct health benefits," Steptoe says.
However, this study and others like it should help establish happiness as a legitimate area of concern for health professionals, Pressman says. "There are still some people who see happiness as something fluffy and less scientific -- not something they should be worried about like, say, stress or depression," she says...
Monday, October 24, 2011
BPA tied to behavior problems in girls: study
BPA tied to behavior problems in girls: study
By Genevra Pittman
Oct 24, 2011
(Reuters Health)
In a new study of Cincinnati-area kids, girls exposed to higher levels of bisphenol A before birth had more behavioral problems and were more anxious and over-active than those only exposed to small amounts of the chemical.
The finding doesn't prove that moms who have more contact with BPA, which is used to make plastics and found in some food packaging and canned goods, are putting their daughters at risk.
Additionally, there was no link between the amount of BPA measured in pregnant women's urine and boys' later behavioral problems -- or between levels of the chemical in kids themselves and their behavior.
Although almost all women and kids had traces of BPA in their urine, "The vast majority of our children were typically-developing children and didn't meet any clinical criteria for behavioral problems," said study author Joe Braun, from the Harvard School of Public Health in Boston.
"PRELIMINARY" ASSOCIATION
One researcher not involved in the study called the link between BPA and girls' behavior "very preliminary."
"Other groups are going to have to replicate these findings to be able to strengthen the implications of this particular study," said Dr. Amir Miodovnik, who studies children's environmental health at The Mount Sinai Medical Center in New York.
Braun and his colleagues took urine samples from 244 pregnant women living in and around Cincinnati twice during their pregnancies, and again right after they gave birth, and measured BPA concentrations.
After that, the researchers measured BPA levels in the children each year. At age three, parents filled out a survey on kids' anxiety, depression, aggression and hyperactivity, as well as any behavioral problems or trouble controlling their emotions.
Almost all women had BPA in their urine, at an average concentration of two micrograms per liter. For every 10-fold increase in that concentration during pregnancy, girls -- but not boys -- had significantly higher scores on tests of anxiety and depression and had worse behavioral and emotional control.
On the surveys, where a score of 50 represents an average kid, those increases were between nine and 12 points, "a fairly sizable effect" that parents would probably be able to notice, Braun said.
That was after the researchers took into account whether moms were depressed during pregnancy, as well as their race, income, education and marital status.
Miodovnik estimated that a score of about 65 on the tests "would be in the concerning range."
A higher BPA concentration in kids' urine at ages one, two and three wasn't linked to behavioral or emotional problems, the researchers reported in Pediatrics.
IS IT CAUSE-AND-EFFECT?
The findings don't prove that BPA exposure in the womb causes behavioral problems, Braun said.
"It might be that women who are consuming more processed and packaged foods and more canned foods are also consuming less nutrients that are important for brain development," for example, he told Reuters Health.
Still, "There's a growing body of evidence... that really seems to suggest what you're exposed to and what happens during gestation can set you up on your life course," Braun said.
"The brain begins developing from very, very early in pregnancy. Disruption in development could have lasting effects across childhood and the lifetime."
BPA is thought to be an "endocrine disruptor," a chemical that mimics or interferes with naturally occurring hormones in the body. Canada and the European Union ban its use in baby bottles.
Braun thinks the effect seen in the study was limited to girls because BPA may interfere with only certain hormones, and boys and girls get exposed to different levels of hormones as they're developing in-utero...
By Genevra Pittman
Oct 24, 2011
(Reuters Health)
In a new study of Cincinnati-area kids, girls exposed to higher levels of bisphenol A before birth had more behavioral problems and were more anxious and over-active than those only exposed to small amounts of the chemical.
The finding doesn't prove that moms who have more contact with BPA, which is used to make plastics and found in some food packaging and canned goods, are putting their daughters at risk.
Additionally, there was no link between the amount of BPA measured in pregnant women's urine and boys' later behavioral problems -- or between levels of the chemical in kids themselves and their behavior.
Although almost all women and kids had traces of BPA in their urine, "The vast majority of our children were typically-developing children and didn't meet any clinical criteria for behavioral problems," said study author Joe Braun, from the Harvard School of Public Health in Boston.
"PRELIMINARY" ASSOCIATION
One researcher not involved in the study called the link between BPA and girls' behavior "very preliminary."
"Other groups are going to have to replicate these findings to be able to strengthen the implications of this particular study," said Dr. Amir Miodovnik, who studies children's environmental health at The Mount Sinai Medical Center in New York.
Braun and his colleagues took urine samples from 244 pregnant women living in and around Cincinnati twice during their pregnancies, and again right after they gave birth, and measured BPA concentrations.
After that, the researchers measured BPA levels in the children each year. At age three, parents filled out a survey on kids' anxiety, depression, aggression and hyperactivity, as well as any behavioral problems or trouble controlling their emotions.
Almost all women had BPA in their urine, at an average concentration of two micrograms per liter. For every 10-fold increase in that concentration during pregnancy, girls -- but not boys -- had significantly higher scores on tests of anxiety and depression and had worse behavioral and emotional control.
On the surveys, where a score of 50 represents an average kid, those increases were between nine and 12 points, "a fairly sizable effect" that parents would probably be able to notice, Braun said.
That was after the researchers took into account whether moms were depressed during pregnancy, as well as their race, income, education and marital status.
Miodovnik estimated that a score of about 65 on the tests "would be in the concerning range."
A higher BPA concentration in kids' urine at ages one, two and three wasn't linked to behavioral or emotional problems, the researchers reported in Pediatrics.
IS IT CAUSE-AND-EFFECT?
The findings don't prove that BPA exposure in the womb causes behavioral problems, Braun said.
"It might be that women who are consuming more processed and packaged foods and more canned foods are also consuming less nutrients that are important for brain development," for example, he told Reuters Health.
Still, "There's a growing body of evidence... that really seems to suggest what you're exposed to and what happens during gestation can set you up on your life course," Braun said.
"The brain begins developing from very, very early in pregnancy. Disruption in development could have lasting effects across childhood and the lifetime."
BPA is thought to be an "endocrine disruptor," a chemical that mimics or interferes with naturally occurring hormones in the body. Canada and the European Union ban its use in baby bottles.
Braun thinks the effect seen in the study was limited to girls because BPA may interfere with only certain hormones, and boys and girls get exposed to different levels of hormones as they're developing in-utero...
Monday, September 5, 2011
Mental Illness Affects Half Of All Americans During Their Lifetime
Mental Illness Affects Half Of All Americans During Their Lifetime
http://www.medicalnewstoday.com/articles/233884.php
Medical News Today
05 Sep 2011
Approximately half of all American adults with suffer some kind of mental illness during their lifetime, a CDC reports announced. The authors stress the need for better surveillance in order to improve treatment and prevention.
Ileana Arias, Ph.D., principle deputy director of CDC, said:
"We know that mental illness is an important public health problem in itself and is also associated with chronic medical diseases such as cardiovascular disease, diabetes, obesity, and cancer. The report's findings indicate that we need to expand surveillance activities that monitor levels of mental illness in the United States in order to strengthen our prevention efforts."
According to a SAMHSA (Substance Abuse and Mental Health Services Administration) study carried out in 2009, 4.8% of America's adult population - 11 million people - had suffered a mental illness during the preceding twelve months. They define a mental illness as "a diagnosable mental disorder (that) has substantially interfered with, or limited one or more major life activities."
This study reports that over the previous twelve months, about 8.4 million American adults thought seriously about suicide, 2.2 made plans to end their lives, and about one million attempted to commit suicide.
SAMHSA administrator Pamela S. Hyde, said:
"This new CDC study combined with SAMHSA's latest surveillance data provides a powerful picture of the impact of mental illness on public health. People with mental disorders should seek help with the same urgency as any other health condition.
Treatment and support services are effective and people do recover."
Depression prevalence in the USA
The table below is from the 2006 Behavioral Risk Factor Surveillance System, which shows depression rates across the USA among adults aged 18+ years. Depression rates are higher in the southeastern states (data on Ohio, New York, Massachusetts, Illinois, Idaho, Colorado and Arizona refer to 2008):
Depression rates in the USA
Serious psychological distress prevalence in the USA
The table below is from the 2007 Behavioral Risk Factor Surveillance System. Serious psychological distress rates were generally higher in the southeastern states. The researchers defined serious psychological distress as a Kessler-6 score of thirteen or more:
http://www.medicalnewstoday.com/articles/233884.php
Medical News Today
05 Sep 2011
Approximately half of all American adults with suffer some kind of mental illness during their lifetime, a CDC reports announced. The authors stress the need for better surveillance in order to improve treatment and prevention.
Ileana Arias, Ph.D., principle deputy director of CDC, said:
"We know that mental illness is an important public health problem in itself and is also associated with chronic medical diseases such as cardiovascular disease, diabetes, obesity, and cancer. The report's findings indicate that we need to expand surveillance activities that monitor levels of mental illness in the United States in order to strengthen our prevention efforts."
According to a SAMHSA (Substance Abuse and Mental Health Services Administration) study carried out in 2009, 4.8% of America's adult population - 11 million people - had suffered a mental illness during the preceding twelve months. They define a mental illness as "a diagnosable mental disorder (that) has substantially interfered with, or limited one or more major life activities."
This study reports that over the previous twelve months, about 8.4 million American adults thought seriously about suicide, 2.2 made plans to end their lives, and about one million attempted to commit suicide.
SAMHSA administrator Pamela S. Hyde, said:
"This new CDC study combined with SAMHSA's latest surveillance data provides a powerful picture of the impact of mental illness on public health. People with mental disorders should seek help with the same urgency as any other health condition.
Treatment and support services are effective and people do recover."
Depression prevalence in the USA
The table below is from the 2006 Behavioral Risk Factor Surveillance System, which shows depression rates across the USA among adults aged 18+ years. Depression rates are higher in the southeastern states (data on Ohio, New York, Massachusetts, Illinois, Idaho, Colorado and Arizona refer to 2008):
Depression rates in the USA
Serious psychological distress prevalence in the USA
The table below is from the 2007 Behavioral Risk Factor Surveillance System. Serious psychological distress rates were generally higher in the southeastern states. The researchers defined serious psychological distress as a Kessler-6 score of thirteen or more:
Nearly 40 percent of Europeans suffer mental illness
Nearly 40 percent of Europeans suffer mental illness
By Kate Kelland
Sep 4, 2011
(Reuters) Europeans are plagued by mental and neurological illnesses, with almost 165 million people or 38 percent of the population suffering each year from a brain disorder such as depression, anxiety, insomnia or dementia, according to a large new study.
With only about a third of cases receiving the therapy or medication needed, mental illnesses cause a huge economic and social burden -- measured in the hundreds of billions of euros -- as sufferers become too unwell to work and personal relationships break down.
"Mental disorders have become Europe's largest health challenge of the 21st century," the study's authors said.
At the same time, some big drug companies are backing away from investment in research on how the brain works and affects behavior, putting the onus on governments and health charities to stump up funding for neuroscience.
"The immense treatment gap ... for mental disorders has to be closed," said Hans Ulrich Wittchen, director of the institute of clinical psychology and psychotherapy at Germany's Dresden University and the lead investigator on the European study.
"Those few receiving treatment do so with considerable delays of an average of several years and rarely with the appropriate, state-of-the-art therapies."
Wittchen led a three-year study covering 30 European countries -- the 27 European Union member states plus Switzerland, Iceland and Norway -- and a population of 514 million people.
A direct comparison of the prevalence of mental illnesses in other parts of the world was not available because different studies adopt varying parameters.
Wittchen's team looked at about 100 illnesses covering all major brain disorders from anxiety and depression to addiction to schizophrenia, as well as major neurological disorders including epilepsy, Parkinson's and multiple sclerosis.
The results, published by the European College of Neuropsychopharmacology (ENCP) on Monday, show an "exceedingly high burden" of mental health disorders and brain illnesses, he told reporters at a briefing in London.
Mental illnesses are a major cause of death, disability, and economic burden worldwide and the World Health Organization predicts that by 2020, depression will be the second leading contributor to the global burden of disease across all ages.
Wittchen said that in Europe, that grim future had arrived early, with diseases of the brain already the single largest contributor to the EU's burden of ill health.
The four most disabling conditions -- measured in terms of disability-adjusted life years or DALYs, a standard measure used to compare the impact of various diseases -- are depression, dementias such as Alzheimer's disease and vascular dementia, alcohol dependence and stroke.
The last major European study of brain disorders, which was published in 2005 and covered a smaller population of about 301 million people, found 27 percent of the EU adult population was suffering from mental illnesses...
By Kate Kelland
Sep 4, 2011
(Reuters) Europeans are plagued by mental and neurological illnesses, with almost 165 million people or 38 percent of the population suffering each year from a brain disorder such as depression, anxiety, insomnia or dementia, according to a large new study.
With only about a third of cases receiving the therapy or medication needed, mental illnesses cause a huge economic and social burden -- measured in the hundreds of billions of euros -- as sufferers become too unwell to work and personal relationships break down.
"Mental disorders have become Europe's largest health challenge of the 21st century," the study's authors said.
At the same time, some big drug companies are backing away from investment in research on how the brain works and affects behavior, putting the onus on governments and health charities to stump up funding for neuroscience.
"The immense treatment gap ... for mental disorders has to be closed," said Hans Ulrich Wittchen, director of the institute of clinical psychology and psychotherapy at Germany's Dresden University and the lead investigator on the European study.
"Those few receiving treatment do so with considerable delays of an average of several years and rarely with the appropriate, state-of-the-art therapies."
Wittchen led a three-year study covering 30 European countries -- the 27 European Union member states plus Switzerland, Iceland and Norway -- and a population of 514 million people.
A direct comparison of the prevalence of mental illnesses in other parts of the world was not available because different studies adopt varying parameters.
Wittchen's team looked at about 100 illnesses covering all major brain disorders from anxiety and depression to addiction to schizophrenia, as well as major neurological disorders including epilepsy, Parkinson's and multiple sclerosis.
The results, published by the European College of Neuropsychopharmacology (ENCP) on Monday, show an "exceedingly high burden" of mental health disorders and brain illnesses, he told reporters at a briefing in London.
Mental illnesses are a major cause of death, disability, and economic burden worldwide and the World Health Organization predicts that by 2020, depression will be the second leading contributor to the global burden of disease across all ages.
Wittchen said that in Europe, that grim future had arrived early, with diseases of the brain already the single largest contributor to the EU's burden of ill health.
The four most disabling conditions -- measured in terms of disability-adjusted life years or DALYs, a standard measure used to compare the impact of various diseases -- are depression, dementias such as Alzheimer's disease and vascular dementia, alcohol dependence and stroke.
The last major European study of brain disorders, which was published in 2005 and covered a smaller population of about 301 million people, found 27 percent of the EU adult population was suffering from mental illnesses...
Friday, September 2, 2011
Man Dies From Toothache, Couldn't Afford Meds
"He [Willis] might as well have been living in 1927..."
"Young people need access...I think the government should come up with a public option." Dr. Jorge Rodriguez
http://www.blogger.com/img/blank.gif
Man Dies From Toothache, Couldn't Afford Meds
By CARRIE GANN
ABC News Medical Unit
Sept. 2, 2011
A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.
According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.
When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.
The tooth infection spread, causing his brain to swell. He died Tuesday.
Calls to Willis' family were not immediately returned. University Hospital in Cincinnati, where Willis was admitted, did not comment, citing federal privacy laws.
"People don't realize that dental disease can cause serious illness," said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. "The problems are not just cosmetic. Many people die from dental disease."
Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.
PHOTO: X-rays of teeth
Getty Images
A Cincinnati man without insurance died from... View Full Size
Higher Risk of Death for the Uninsured Watch Video
Understand Your Health Care Coverage Watch Video
Survey: Health Insurance Premiums Jump Watch Video
"When people are unemployed or don't have insurance, where do they go? What do they do?" Silverstein said. "People end up dying, and these are the most treatable, preventable diseases in the world."
Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.
Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.
"People want to believe there's a safety net that catches all of these people, and there isn't," said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians. He noted that it is often young men who are the most likely to lack health coverage.
Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.
"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."...
"Young people need access...I think the government should come up with a public option." Dr. Jorge Rodriguez
http://www.blogger.com/img/blank.gif
Man Dies From Toothache, Couldn't Afford Meds
By CARRIE GANN
ABC News Medical Unit
Sept. 2, 2011
A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.
According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.
When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.
The tooth infection spread, causing his brain to swell. He died Tuesday.
Calls to Willis' family were not immediately returned. University Hospital in Cincinnati, where Willis was admitted, did not comment, citing federal privacy laws.
"People don't realize that dental disease can cause serious illness," said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. "The problems are not just cosmetic. Many people die from dental disease."
Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.
PHOTO: X-rays of teeth
Getty Images
A Cincinnati man without insurance died from... View Full Size
Higher Risk of Death for the Uninsured Watch Video
Understand Your Health Care Coverage Watch Video
Survey: Health Insurance Premiums Jump Watch Video
"When people are unemployed or don't have insurance, where do they go? What do they do?" Silverstein said. "People end up dying, and these are the most treatable, preventable diseases in the world."
Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.
Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.
"People want to believe there's a safety net that catches all of these people, and there isn't," said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians. He noted that it is often young men who are the most likely to lack health coverage.
Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.
"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."...
Thursday, September 1, 2011
Myth busted: Potatoes help fight BP sans weight gain
Myth busted: Potatoes help fight BP sans weight gain
Times of India
Sep 2, 2011
LONDON: Potatoes are generally discarded by most people as fatty food. But, a new study now claims that eating spuds daily can help lower your blood pressure; and moreover, there is also no weight gain involved. In the study, researchers fed 18 volunteers six to eight spuds twice a day.
Most of those taking part were overweight or obese and on pills to lower blood pressure. And, the spuds used were purple ones cooked unpeeled in a microwave. But researchers believe that redskin potatoes and white potatoes may have similar effects.
After a month, the upper of their blood pressure reading when blood is pumped with each beat of the heart, was down by 3.5%. Diastolic or the lower readings decreased by 4.3%. In addition, none of the volunteers put on any weight, the Daily Mail reported.
"Mention 'potato' and people think 'fattening, high carbs, empty calories'. We hope our research helps to remake potato's popular nutritional image," lead researcher Dr Joe Vinson of the University of Scranton in Pennsylvania was quoted as saying.
Times of India
Sep 2, 2011
LONDON: Potatoes are generally discarded by most people as fatty food. But, a new study now claims that eating spuds daily can help lower your blood pressure; and moreover, there is also no weight gain involved. In the study, researchers fed 18 volunteers six to eight spuds twice a day.
Most of those taking part were overweight or obese and on pills to lower blood pressure. And, the spuds used were purple ones cooked unpeeled in a microwave. But researchers believe that redskin potatoes and white potatoes may have similar effects.
After a month, the upper of their blood pressure reading when blood is pumped with each beat of the heart, was down by 3.5%. Diastolic or the lower readings decreased by 4.3%. In addition, none of the volunteers put on any weight, the Daily Mail reported.
"Mention 'potato' and people think 'fattening, high carbs, empty calories'. We hope our research helps to remake potato's popular nutritional image," lead researcher Dr Joe Vinson of the University of Scranton in Pennsylvania was quoted as saying.
>Special Report: A pinch of doubt over salt
Special Report: A pinch of doubt over salt
By Kate Kelland, Health and Science Correspondent
Sep 1, 2011
(Reuters) - In Britain it started with Sid, the "giant slug with a message", who slicked his way onto television screens back in 2004 as part of a government health campaign to warn people about the dangers of consuming too much salt. "Stay away from fast cars, loose women and SALT!" he screamed.
Sid's message -- that liberal sprinklings of sodium, the main component of salt, don't only kill slugs but humans too -- has now become conventional wisdom worldwide. High salt intake is linked to high blood pressure, or hypertension, a key risk factor for strokes, heart attacks and other cardiovascular diseases. Together those rank as the world's number one killers. The World Health Organization (WHO) puts cutting salt intake alongside quitting smoking as one of the top 10 "best buys" in public health...
But the findings that policy-makers have accepted as settled are not as clear-cut among scientists. A study in July by the much-respected Cochrane Library, which conducts meta-analyses of scientific data by grouping together the best studies on a subject and pooling the results, found no evidence that reducing salt intake cuts the risk of developing heart disease or dying before your time.
In that study Rod Taylor, a professor of health services research at Exeter University, analyzed seven randomized controlled trials covering more than 6,500 people and found that although cutting down did appear to lead to slight reductions in blood pressure, this did not translate into lower risk of heart disease or premature death.
In one group of people -- those with pre-existing heart conditions -- reducing salt was actually associated with an increase in the likelihood of premature death.
Taylor said he did not receive payment from, or have links to, the salt industry. His study was funded by a grant from the UK government's National Institute for Health Research.
Taylor's study came hot on the heels of another, by Belgian scientists, which was published in the Journal of the American Medical Association (JAMA). That found people who ate lots of salt were no more likely to get high blood pressure, and were statistically less likely to die of heart disease, than those with low salt intake.
The researchers used data from two different studies, involving a total of around 3,700 Europeans whose salt consumption was measured through urine samples. The scientists divided the participants into three groups with low, medium and high intake: those with the lowest salt intake had the highest rate of death from heart disease - at 4 percent. People who ate the most salt had the lowest death rate from heart disease, at less than 1 percent.
"One should be very careful in advocating generalized reduction in sodium intake in the population at large. There might be some benefits, but there might also be some adverse effects," says Jan Staessen, head of hypertension studies at the University of Leuven and the lead investigator on the Belgian study. "You have to ask, should public health policies be based on something which is still being debated? I don't think so."
Staessen told Reuters he had no financial conflicts of interest. His work was funded largely by grants from the European Union and European national governments.
WHO SAYS A TEASPOONFUL WILL DO?
Such studies are re-drawing the battle lines around salt. Foodmakers are starting to fight back against the low-salters. Campbell's is now putting more salt back into all 31 of its Select Harvest soups after consumers voted with their taste buds and stopped buying the reduced-salt version.
"One size doesn't fit all," says Juli Mandel Sloves, Campbell's senior manager for nutrition and wellness communications. "And what this research debate shows is exactly that. You can't make a recommendation based on the needs of only one part of the population. It's really important that we offer a variety of choices."
Other major food industry groups and manufacturers approached by Reuters, including Kellogg's and Pepsico, as well as the U.S. Grocery Manufacturers' Association, either declined to be interviewed or sent statements reiterating their commitment to reducing sodium levels in their foods, in line with government dietary recommendations.
But the powerful U.S. National Restaurant Association is questioning the accepted wisdom. "The science is very clear in showing that reducing sodium reduces blood pressure. There's no question about that. The controversy is around reducing cardiovascular disease and ... basically the risk of death. That's where the evidence is completely weak," says Joy Dubost, the NRA's Director of Nutrition and Healthy Living. In other words, cutting back on salt does reduce blood pressure, but it may not reduce the risk of dying early.
Michael Alderman, a blood pressure expert at Albert Einstein College of Medicine in the United States and editor of the American Journal of Hypertension, believes there's a sense that some scientists -- and most policymakers -- may have moved too early to target salt as the cause of the problem. "If we're doing something so dramatic to the diets of whole populations, there should be no argument. The evidence should be overwhelming, but it's not overwhelming at all," he said.
Of around a dozen scientists interviewed by Reuters for this story, about half shared this point of view; but since they included salt-reduction campaigners and salt industry representatives, that is not necessarily an indicator of the balance of opinions across the scientific community.
Alderman argues that in addition to changing blood pressure, cutting sodium can cause other physiological changes such as increased resistance to insulin -- which can set the stage for diabetes and increase the risk of death from heart disease. Too little sodium can also increase sympathetic nerve activity which raises the risk of heart attacks, and boost the secretion of aldosterone, a hormone produced by the adrenal gland that is bad for the cardiovascular system.
"What we have -- like almost all interventions in health and medicine -- is something that produces a multitude of different effects," said Alderman, who disclosed having taken one $750 payment more than a decade ago from the Salt Institute, but who said he has since had no financial help from the industry. Besides Alderman and Heagerty, none of the other academic scientists interviewed for this article have disclosed financial interests.
In a letter to the British government seen by Reuters, the UK's Salt Association -- which along with the Salt Institute has a vested interest in defending the salt industry -- cites the Cochrane and JAMA papers and demands an urgent review of the salt reduction strategy. It goes as far as to say: "People may actually be dying as a result of poorly founded advice."
IS SALT THE NEW TOBACCO?
That kind of talk exasperates the Wolfson Institute's MacGregor, one of the most vocal advocates of salt reduction anywhere. Along with Franco Cappuccio, head of the WHO's collaborating center for nutrition at Warwick University and Simon Capewell, a professor of clinical epidemiology at Liverpool University, McGregor argues that salt -- most of it hidden in processed and packaged foods -- is a huge problem.
It's perhaps an indication of his conviction that MacGregor equates the argument about salt to past rows over tobacco, even though unlike tobacco, salt is a fundamental nutritional requirement for humans to survive.
"We're in exactly the same position as we were with tobacco 20 or 30 years ago when people were still arguing about whether tobacco caused lung cancer or heart disease," MacGregor says. "It obviously did, there was no doubt about it -- and the only people arguing were people who had commercial interest."
WASH and its UK counterpart CASH (Consensus Action on Salt and Health), which is also chaired by MacGregor, are funded by donations from individuals and charities.
Cappuccio and Capewell point to scores of scientific analyses to make their point. A 2007 study predicted that reducing salt intake around the world by 15 percent could prevent almost 9 million deaths by 2015. Another study published in March 2010 found that cutting salt intake by 10 percent in the United States could prevent hundreds of thousands of heart attacks and strokes over decades and save the government $32 billion in healthcare costs.
In a recent British Medical Journal commentary, Capewell and Cappuccio cautioned: "Denial and procrastination will be costly in terms of both avoidable illness and expenses."
When confronted with the two most recent scientific studies suggesting the contrary, MacGregor dismissed them as flawed or paradoxical. "There is absolutely no evidence of any harm from reducing salt intake. Absolutely none," he said.
In the case of the Cochrane review, MacGregor set about re-crunching the numbers and swiftly published a fresh analysis of the data in a rival medical journal, The Lancet, which drew the opposite conclusion.
Taylor responded by saying MacGregor had taken two of the sets of data in the study -- one from people with normal blood pressure and one from people with hypertension - and grouped them together. This, he said, is like comparing apples and oranges, and breaks a central tenet of statistical analysis.
Manchester University's Tony Heagerty has a wry observation of this to-and-fro: "If you torture data long enough it will give you the answer you want."
ONE BIG EXPERIMENT
Much of the argument barely touches on the data -- descending instead into personal attacks and accusations of conflicts of interest. Scientists on both sides talk of being taunted by their rivals. Both Cappuccio, who advocates less salt, and Staessen, the hypertension expert who has found risks in salt reduction, say they have been victimized or intimidated after publishing papers in scientific journals.
Salt-reduction advocate MacGregor points at one of his main opponents across the Atlantic, Morton Satin, director of science and research at the U.S.-based Salt Institute, who says reducing salt across whole populations may do more harm than good. "Imagine he's wrong," MacGregor said. "That would mean he's responsible for millions of strokes worldwide. When he goes to sleep tonight, he might like to think about that."
Satin hits back that the whole situation has left science behind. "Passions overtake an objective view of science... and we can have an entire society being led to believe something that doesn't stack up."
There is one thing the two sides appear to agree on: the matter could be settled by a large-scale -- 20,000 to 30,000 people -- randomized clinical trial with half allocated to a high and half to a low salt diet. To be done properly, the main protagonists agree, such a trial would need to run for several years. The huge numbers are needed so that all other possible factors -- weight, age, fitness, quality of diet, and medical conditions -- are roughly equal in both groups.
But salt-reduction advocates MacGregor and Cappuccio say such a trial would be prohibitively expensive, unnecessary, and may even be unethical. Again they draw comparisons with smoking. Since, in their view, the harms of salt are indisputable, asking people to be kept on a high salt diet for the purposes of a medical experiment would be equivalent to forcing people to smoke.
Alderman is enraged by such suggestions. "Any medical ethicist would say that before you impose changes you have to make sure they are safe and beneficial. If the science is uncertain, then how can it be unethical to do the right studies to answer the scientific questions? If you're asking 300 million Americans and I don't know how many millions of other people around the world to change their diet so dramatically, you ought to have overwhelming evidence that it's a good idea and it's safe."
Until the row is settled, people's salt intake will probably be guided by personal taste.
(Edited by Simon Robinson, Michael Williams and Sara Ledwith)
By Kate Kelland, Health and Science Correspondent
Sep 1, 2011
(Reuters) - In Britain it started with Sid, the "giant slug with a message", who slicked his way onto television screens back in 2004 as part of a government health campaign to warn people about the dangers of consuming too much salt. "Stay away from fast cars, loose women and SALT!" he screamed.
Sid's message -- that liberal sprinklings of sodium, the main component of salt, don't only kill slugs but humans too -- has now become conventional wisdom worldwide. High salt intake is linked to high blood pressure, or hypertension, a key risk factor for strokes, heart attacks and other cardiovascular diseases. Together those rank as the world's number one killers. The World Health Organization (WHO) puts cutting salt intake alongside quitting smoking as one of the top 10 "best buys" in public health...
But the findings that policy-makers have accepted as settled are not as clear-cut among scientists. A study in July by the much-respected Cochrane Library, which conducts meta-analyses of scientific data by grouping together the best studies on a subject and pooling the results, found no evidence that reducing salt intake cuts the risk of developing heart disease or dying before your time.
In that study Rod Taylor, a professor of health services research at Exeter University, analyzed seven randomized controlled trials covering more than 6,500 people and found that although cutting down did appear to lead to slight reductions in blood pressure, this did not translate into lower risk of heart disease or premature death.
In one group of people -- those with pre-existing heart conditions -- reducing salt was actually associated with an increase in the likelihood of premature death.
Taylor said he did not receive payment from, or have links to, the salt industry. His study was funded by a grant from the UK government's National Institute for Health Research.
Taylor's study came hot on the heels of another, by Belgian scientists, which was published in the Journal of the American Medical Association (JAMA). That found people who ate lots of salt were no more likely to get high blood pressure, and were statistically less likely to die of heart disease, than those with low salt intake.
The researchers used data from two different studies, involving a total of around 3,700 Europeans whose salt consumption was measured through urine samples. The scientists divided the participants into three groups with low, medium and high intake: those with the lowest salt intake had the highest rate of death from heart disease - at 4 percent. People who ate the most salt had the lowest death rate from heart disease, at less than 1 percent.
"One should be very careful in advocating generalized reduction in sodium intake in the population at large. There might be some benefits, but there might also be some adverse effects," says Jan Staessen, head of hypertension studies at the University of Leuven and the lead investigator on the Belgian study. "You have to ask, should public health policies be based on something which is still being debated? I don't think so."
Staessen told Reuters he had no financial conflicts of interest. His work was funded largely by grants from the European Union and European national governments.
WHO SAYS A TEASPOONFUL WILL DO?
Such studies are re-drawing the battle lines around salt. Foodmakers are starting to fight back against the low-salters. Campbell's is now putting more salt back into all 31 of its Select Harvest soups after consumers voted with their taste buds and stopped buying the reduced-salt version.
"One size doesn't fit all," says Juli Mandel Sloves, Campbell's senior manager for nutrition and wellness communications. "And what this research debate shows is exactly that. You can't make a recommendation based on the needs of only one part of the population. It's really important that we offer a variety of choices."
Other major food industry groups and manufacturers approached by Reuters, including Kellogg's and Pepsico, as well as the U.S. Grocery Manufacturers' Association, either declined to be interviewed or sent statements reiterating their commitment to reducing sodium levels in their foods, in line with government dietary recommendations.
But the powerful U.S. National Restaurant Association is questioning the accepted wisdom. "The science is very clear in showing that reducing sodium reduces blood pressure. There's no question about that. The controversy is around reducing cardiovascular disease and ... basically the risk of death. That's where the evidence is completely weak," says Joy Dubost, the NRA's Director of Nutrition and Healthy Living. In other words, cutting back on salt does reduce blood pressure, but it may not reduce the risk of dying early.
Michael Alderman, a blood pressure expert at Albert Einstein College of Medicine in the United States and editor of the American Journal of Hypertension, believes there's a sense that some scientists -- and most policymakers -- may have moved too early to target salt as the cause of the problem. "If we're doing something so dramatic to the diets of whole populations, there should be no argument. The evidence should be overwhelming, but it's not overwhelming at all," he said.
Of around a dozen scientists interviewed by Reuters for this story, about half shared this point of view; but since they included salt-reduction campaigners and salt industry representatives, that is not necessarily an indicator of the balance of opinions across the scientific community.
Alderman argues that in addition to changing blood pressure, cutting sodium can cause other physiological changes such as increased resistance to insulin -- which can set the stage for diabetes and increase the risk of death from heart disease. Too little sodium can also increase sympathetic nerve activity which raises the risk of heart attacks, and boost the secretion of aldosterone, a hormone produced by the adrenal gland that is bad for the cardiovascular system.
"What we have -- like almost all interventions in health and medicine -- is something that produces a multitude of different effects," said Alderman, who disclosed having taken one $750 payment more than a decade ago from the Salt Institute, but who said he has since had no financial help from the industry. Besides Alderman and Heagerty, none of the other academic scientists interviewed for this article have disclosed financial interests.
In a letter to the British government seen by Reuters, the UK's Salt Association -- which along with the Salt Institute has a vested interest in defending the salt industry -- cites the Cochrane and JAMA papers and demands an urgent review of the salt reduction strategy. It goes as far as to say: "People may actually be dying as a result of poorly founded advice."
IS SALT THE NEW TOBACCO?
That kind of talk exasperates the Wolfson Institute's MacGregor, one of the most vocal advocates of salt reduction anywhere. Along with Franco Cappuccio, head of the WHO's collaborating center for nutrition at Warwick University and Simon Capewell, a professor of clinical epidemiology at Liverpool University, McGregor argues that salt -- most of it hidden in processed and packaged foods -- is a huge problem.
It's perhaps an indication of his conviction that MacGregor equates the argument about salt to past rows over tobacco, even though unlike tobacco, salt is a fundamental nutritional requirement for humans to survive.
"We're in exactly the same position as we were with tobacco 20 or 30 years ago when people were still arguing about whether tobacco caused lung cancer or heart disease," MacGregor says. "It obviously did, there was no doubt about it -- and the only people arguing were people who had commercial interest."
WASH and its UK counterpart CASH (Consensus Action on Salt and Health), which is also chaired by MacGregor, are funded by donations from individuals and charities.
Cappuccio and Capewell point to scores of scientific analyses to make their point. A 2007 study predicted that reducing salt intake around the world by 15 percent could prevent almost 9 million deaths by 2015. Another study published in March 2010 found that cutting salt intake by 10 percent in the United States could prevent hundreds of thousands of heart attacks and strokes over decades and save the government $32 billion in healthcare costs.
In a recent British Medical Journal commentary, Capewell and Cappuccio cautioned: "Denial and procrastination will be costly in terms of both avoidable illness and expenses."
When confronted with the two most recent scientific studies suggesting the contrary, MacGregor dismissed them as flawed or paradoxical. "There is absolutely no evidence of any harm from reducing salt intake. Absolutely none," he said.
In the case of the Cochrane review, MacGregor set about re-crunching the numbers and swiftly published a fresh analysis of the data in a rival medical journal, The Lancet, which drew the opposite conclusion.
Taylor responded by saying MacGregor had taken two of the sets of data in the study -- one from people with normal blood pressure and one from people with hypertension - and grouped them together. This, he said, is like comparing apples and oranges, and breaks a central tenet of statistical analysis.
Manchester University's Tony Heagerty has a wry observation of this to-and-fro: "If you torture data long enough it will give you the answer you want."
ONE BIG EXPERIMENT
Much of the argument barely touches on the data -- descending instead into personal attacks and accusations of conflicts of interest. Scientists on both sides talk of being taunted by their rivals. Both Cappuccio, who advocates less salt, and Staessen, the hypertension expert who has found risks in salt reduction, say they have been victimized or intimidated after publishing papers in scientific journals.
Salt-reduction advocate MacGregor points at one of his main opponents across the Atlantic, Morton Satin, director of science and research at the U.S.-based Salt Institute, who says reducing salt across whole populations may do more harm than good. "Imagine he's wrong," MacGregor said. "That would mean he's responsible for millions of strokes worldwide. When he goes to sleep tonight, he might like to think about that."
Satin hits back that the whole situation has left science behind. "Passions overtake an objective view of science... and we can have an entire society being led to believe something that doesn't stack up."
There is one thing the two sides appear to agree on: the matter could be settled by a large-scale -- 20,000 to 30,000 people -- randomized clinical trial with half allocated to a high and half to a low salt diet. To be done properly, the main protagonists agree, such a trial would need to run for several years. The huge numbers are needed so that all other possible factors -- weight, age, fitness, quality of diet, and medical conditions -- are roughly equal in both groups.
But salt-reduction advocates MacGregor and Cappuccio say such a trial would be prohibitively expensive, unnecessary, and may even be unethical. Again they draw comparisons with smoking. Since, in their view, the harms of salt are indisputable, asking people to be kept on a high salt diet for the purposes of a medical experiment would be equivalent to forcing people to smoke.
Alderman is enraged by such suggestions. "Any medical ethicist would say that before you impose changes you have to make sure they are safe and beneficial. If the science is uncertain, then how can it be unethical to do the right studies to answer the scientific questions? If you're asking 300 million Americans and I don't know how many millions of other people around the world to change their diet so dramatically, you ought to have overwhelming evidence that it's a good idea and it's safe."
Until the row is settled, people's salt intake will probably be guided by personal taste.
(Edited by Simon Robinson, Michael Williams and Sara Ledwith)
Monday, August 29, 2011
Military suicides linked to low Omega-3 levels
Military suicides linked to low Omega-3 levels
August 24, 2011
By Melissa Healy
The Los Angeles Times/For the Booster Shots blog
In a finding suggesting powerful psychiatric benefits for a component of fish oil, a study published Wednesday has linked military suicides to low levels of docosahexaenoic acid and found that service personnel with higher levels of DHA in their blood were less likely to take their own lives.
The study, published this week in the Journal of Clinical Psychiatry, looked back at the medical records of 800 U.S. servicemen and women who took their own lives between 2002 and 2008, and compared them with the records of 800 service personnel -- matched for age, gender and rank -- who had no history of suicide attempts.
August 24, 2011
By Melissa Healy
The Los Angeles Times/For the Booster Shots blog
In a finding suggesting powerful psychiatric benefits for a component of fish oil, a study published Wednesday has linked military suicides to low levels of docosahexaenoic acid and found that service personnel with higher levels of DHA in their blood were less likely to take their own lives.
The study, published this week in the Journal of Clinical Psychiatry, looked back at the medical records of 800 U.S. servicemen and women who took their own lives between 2002 and 2008, and compared them with the records of 800 service personnel -- matched for age, gender and rank -- who had no history of suicide attempts.
Tuesday, August 23, 2011
Osteoporosis drugs may stave off cancer
Bone drug tied to lower colon cancer risk
By Frederik Joelving
Aug 22, 2011
Reuters
A new study adds to evidence that bone drugs may play a role in suppressing cancer development, although there is still no proof that taking the medications would stave off malignancies.
The drugs, called bisphosphonates, have generated both good and bad headlines recently. Some work has linked them to fewer cases of cancer, while other research has found an increased risk of certain thigh fractures and serious jaw problems among women who take the drugs to treat the bone-thinning disease osteoporosis.
Bone drugs on the market include Merck's Fosamax, Roche's Boniva, Novartis's Reclast and Warner Chilcott's Actonel.
In the new study, researchers found that women on Actonel were only half as likely to be diagnosed with colon cancer as those who'd gotten just one prescription for the drug or none at all.
"At this point, I think people who are already taking the drug can be reassured," Dr. Harminder Singh, who worked on the study, told Reuters Health.
But he added that it's too soon to think about taking Actonel to prevent cancer.
"For people to start taking it, there are a few other things that need to be worked out -- the cost and the side effects," said Singh, of the University of Manitoba in Canada.
According to the American Cancer Society, one in 19 men develops colorectal cancer at some point, and slightly fewer women do. The disease is the third leading cause of cancer deaths in the U.S.
An Israeli study published earlier this year found a link between bisphosphonates and a lower risk of colon cancer among women, but it wasn't clear how to explain that result. It could be that the drugs have protective effects, or it could be that women taking them are healthier overall.
In contrast to the Israeli work, Singh's study, which is published in the journal Cancer, takes into account how often people see their doctors -- one factor that might muddy any differences found between those who take bone drugs and those who don't.
The research team tapped into data from a cancer registry in Manitoba, comparing colon cancer patients to people without the disease, but of the same age and sex.
About 1.1 percent (264) of the nearly 25,000 women in the comparison group had been given Actonel by their doctor, while only 0.6 percent (15) of 2,493 women with colon cancer had gotten the drug.
One way to interpret those findings is to chalk the difference up to a protective effect of Actonel. Indeed, women on that medication had 45 percent lower odds of having colon cancer than those who didn't take it.
But with a study design where you only observe patients, you can't ever be certain why some fare better than others, Singh cautioned.
"The ultimate proof of these agents would be a randomized controlled trial," he explained.
What's more, the researchers didn't have enough data to see if the findings would hold up for men, and they didn't find any reliable effects for the other bone drugs.
Even if Actonel did afford some protection against tumors, it's not cheap and its long-term side effects are not well known. The U.S. Food and Drug Administration is currently reviewing evidence suggesting bone drugs might raise the risk of esophageal cancer.
A month's supply of Actonel generally costs over $100.
So far, quitting smoking is one of the only things that experts agree will lower the risk of cancer. For colon cancer in particular, the U.S. Preventive Services Task Force, a federally supported expert panel, advises screening all people between 50 and 75 using stool tests, sigmoidoscopy or colonoscopy.
By Frederik Joelving
Aug 22, 2011
Reuters
A new study adds to evidence that bone drugs may play a role in suppressing cancer development, although there is still no proof that taking the medications would stave off malignancies.
The drugs, called bisphosphonates, have generated both good and bad headlines recently. Some work has linked them to fewer cases of cancer, while other research has found an increased risk of certain thigh fractures and serious jaw problems among women who take the drugs to treat the bone-thinning disease osteoporosis.
Bone drugs on the market include Merck's Fosamax, Roche's Boniva, Novartis's Reclast and Warner Chilcott's Actonel.
In the new study, researchers found that women on Actonel were only half as likely to be diagnosed with colon cancer as those who'd gotten just one prescription for the drug or none at all.
"At this point, I think people who are already taking the drug can be reassured," Dr. Harminder Singh, who worked on the study, told Reuters Health.
But he added that it's too soon to think about taking Actonel to prevent cancer.
"For people to start taking it, there are a few other things that need to be worked out -- the cost and the side effects," said Singh, of the University of Manitoba in Canada.
According to the American Cancer Society, one in 19 men develops colorectal cancer at some point, and slightly fewer women do. The disease is the third leading cause of cancer deaths in the U.S.
An Israeli study published earlier this year found a link between bisphosphonates and a lower risk of colon cancer among women, but it wasn't clear how to explain that result. It could be that the drugs have protective effects, or it could be that women taking them are healthier overall.
In contrast to the Israeli work, Singh's study, which is published in the journal Cancer, takes into account how often people see their doctors -- one factor that might muddy any differences found between those who take bone drugs and those who don't.
The research team tapped into data from a cancer registry in Manitoba, comparing colon cancer patients to people without the disease, but of the same age and sex.
About 1.1 percent (264) of the nearly 25,000 women in the comparison group had been given Actonel by their doctor, while only 0.6 percent (15) of 2,493 women with colon cancer had gotten the drug.
One way to interpret those findings is to chalk the difference up to a protective effect of Actonel. Indeed, women on that medication had 45 percent lower odds of having colon cancer than those who didn't take it.
But with a study design where you only observe patients, you can't ever be certain why some fare better than others, Singh cautioned.
"The ultimate proof of these agents would be a randomized controlled trial," he explained.
What's more, the researchers didn't have enough data to see if the findings would hold up for men, and they didn't find any reliable effects for the other bone drugs.
Even if Actonel did afford some protection against tumors, it's not cheap and its long-term side effects are not well known. The U.S. Food and Drug Administration is currently reviewing evidence suggesting bone drugs might raise the risk of esophageal cancer.
A month's supply of Actonel generally costs over $100.
So far, quitting smoking is one of the only things that experts agree will lower the risk of cancer. For colon cancer in particular, the U.S. Preventive Services Task Force, a federally supported expert panel, advises screening all people between 50 and 75 using stool tests, sigmoidoscopy or colonoscopy.
Thursday, August 11, 2011
Can vitamins help boost your memory?
Can vitamins help boost your memory?
By Genevra Pittman
Jul 28, 2011
(Reuters Health)
Adults who took vitamin and mineral supplements for almost a decade performed better on one type of memory test than those who didn't take the supplements, according to a new study from France.
The researchers say the findings suggest that getting enough nutrients could aid thinking and memory skills as people get older. But further studies are needed to confirm the results, they add.
The effect was "nothing wild that you'd say, 'Everybody should take these,'" said Geraldine McNeill, a nutritionist at the University of Aberdeen in the UK.
But McNeill, who wasn't involved in the new study, said some people -- especially those who are deficient in vitamins and minerals -- might get a memory benefit from boosting the nutrients in their diet.
Emmanuelle Kesse-Guyot of the University of Paris XIII in France and colleagues write that the link between a higher intake of some nutrients and thinking and memory skills has been shown before in so-called observational studies. But those studies can't get at a cause-and-effect relationship.
"The question is, does the cognitive performance depend on the diet, or does the diet depend on the cognitive performance?" McNeill told Reuters Health. It's possible that people who have better thinking and memory skills might pay closer attention to what they're eating, she explained.
To try to get a clearer picture of the association, Kesse-Guyot and her colleagues conducted a study of close to 4,500 French men and women.
In 1994, when the study participants were 45 to 60 years old, researchers split them randomly into two groups. Half of them took a daily supplement that included vitamins C and E, selenium, zinc, and beta-carotene for eight years. The others took a nutrient-free placebo pill each day.
None of the participants knew whether they were taking the vitamin or the sham pills.
When the eight years were up, researchers stopped giving participants their assigned pills, and they could choose on their own whether or not to take vitamin supplements.
Six years after that, the investigators brought them back to the lab for a round of memory tests.
The tests included word and number problems to measure different types of memory and "mental flexibility."
While the supplement and placebo groups performed similarly on most tests, the nutrient-boosted participants beat their peers on one test of long-term memory in which participants had to recall words in different categories.
"Our results have to be considered carefully," the authors wrote in the American Journal of Clinical Nutrition. Because they did several tests, it's more likely that the one difference they found was due to chance.
Still, they added, the "findings support a beneficial effect of a well-balanced intake of antioxidant nutrients at nutritional doses for maintaining cognitive performance, especially verbal memory."
McNeill said that most people could probably get the vitamin and nutrient doses used in the study through tweaks in their diet -- for example, drinking fruit juice to get Vitamin C and using plant oil, which is a good source of Vitamin E.
"Taking supplements for me is a last resort," she said.
Barbara Shukitt-Hale, a nutrition researcher at Tufts University in Boston, said it's important for people to know that boosting brainpower requires more than just taking a vitamin pill every day.
"Vitamins and minerals are important for memory, but they're not the only thing that's important," she told Reuters Health. "The most important thing is eating a healthy diet, being active, and keeping your brain sharp."
By Genevra Pittman
Jul 28, 2011
(Reuters Health)
Adults who took vitamin and mineral supplements for almost a decade performed better on one type of memory test than those who didn't take the supplements, according to a new study from France.
The researchers say the findings suggest that getting enough nutrients could aid thinking and memory skills as people get older. But further studies are needed to confirm the results, they add.
The effect was "nothing wild that you'd say, 'Everybody should take these,'" said Geraldine McNeill, a nutritionist at the University of Aberdeen in the UK.
But McNeill, who wasn't involved in the new study, said some people -- especially those who are deficient in vitamins and minerals -- might get a memory benefit from boosting the nutrients in their diet.
Emmanuelle Kesse-Guyot of the University of Paris XIII in France and colleagues write that the link between a higher intake of some nutrients and thinking and memory skills has been shown before in so-called observational studies. But those studies can't get at a cause-and-effect relationship.
"The question is, does the cognitive performance depend on the diet, or does the diet depend on the cognitive performance?" McNeill told Reuters Health. It's possible that people who have better thinking and memory skills might pay closer attention to what they're eating, she explained.
To try to get a clearer picture of the association, Kesse-Guyot and her colleagues conducted a study of close to 4,500 French men and women.
In 1994, when the study participants were 45 to 60 years old, researchers split them randomly into two groups. Half of them took a daily supplement that included vitamins C and E, selenium, zinc, and beta-carotene for eight years. The others took a nutrient-free placebo pill each day.
None of the participants knew whether they were taking the vitamin or the sham pills.
When the eight years were up, researchers stopped giving participants their assigned pills, and they could choose on their own whether or not to take vitamin supplements.
Six years after that, the investigators brought them back to the lab for a round of memory tests.
The tests included word and number problems to measure different types of memory and "mental flexibility."
While the supplement and placebo groups performed similarly on most tests, the nutrient-boosted participants beat their peers on one test of long-term memory in which participants had to recall words in different categories.
"Our results have to be considered carefully," the authors wrote in the American Journal of Clinical Nutrition. Because they did several tests, it's more likely that the one difference they found was due to chance.
Still, they added, the "findings support a beneficial effect of a well-balanced intake of antioxidant nutrients at nutritional doses for maintaining cognitive performance, especially verbal memory."
McNeill said that most people could probably get the vitamin and nutrient doses used in the study through tweaks in their diet -- for example, drinking fruit juice to get Vitamin C and using plant oil, which is a good source of Vitamin E.
"Taking supplements for me is a last resort," she said.
Barbara Shukitt-Hale, a nutrition researcher at Tufts University in Boston, said it's important for people to know that boosting brainpower requires more than just taking a vitamin pill every day.
"Vitamins and minerals are important for memory, but they're not the only thing that's important," she told Reuters Health. "The most important thing is eating a healthy diet, being active, and keeping your brain sharp."
Tuesday, July 26, 2011
One Third of Bottled Water Contain Contaminants
One Third of Bottled Water Contain Contaminants
Apr 26, 2011
Environmentalists and EBMUD push for more disclosure
Sacramento - Saying consumers should know what they're drinking, environmentalists and the East Bay Municipal Utility District want bottled water to follow the same disclosure rules as tap water.
Makers of bottled water, which include Pepsi and Coca-Cola, say there is already plenty of disclosure about their water's contents.
Advocates of two bills introduced in the Legislature say there isn't nearly enough.
"People tout bottled water as this pure substance that's trickling from clear mountain springs when, in fact, that may not be the case," said Assemblywoman Ellen Corbett, D-San Leandro, author of one of the bills.
"When I pick up bottled water, I want to know it truly is something that's good for me and better for me than drinking something else," Corbett said.
Nearly 70 percent of Californians drink bottled water, which nationwide is a $6 billion industry. And by the end of this year, bottled water will have moved past milk, coffee and beer to become the second most popular beverage behind soft drinks, according to the Beverage Marketing Corp.
Bottle vs Tap
Bottled water's popularity is fuelled in part by suspicions over the quality of tap water.
But Corbett and the backers of her bill say drink no way of knowing whether bottled water is better or worse.
Unlike tap water, bottled water is considered a food product and is subject to the same sanitation and preparation requirements as other food stuffs.
Although often advertising themselves as superior to tap water, bottlers are required in most cases only to meet the same quality standards as tap water.
Of the hundreds of contaminants state and federal regulators measure, bottled water is subject to a higher standard for only two, according to Randy Kanouse, EBMUD's Sacramento lobbyist.
Bottlers don't have to create a "consumer confidence" report each year like water agencies do. The reports tell customers what's in their water. It details levels of contaminants, if any, like lead, aluminium, arsenic and salt.
Corbett's bill, AB83, and a companion bill, SB50, by Sen. Byron Sher, D- Palo Alto, would impose the same reporting requirement on bottlers.
Bottling plants and water vending machines would be subject to annual inspections. Bottlers, vending machine owners and water haulers would pay an $86 fee to cover the costs of the inspections.
Bottlers say the bills aren't needed.
"There are already comprehensive, stringent regulations in place at the federal level for quality labeling," said Stephen Kay, a spokesman for the International Bottled Water Association. "These two proposed bills are proscriptive and redundant."
Kay also cited a bill signed last year that requires bottlers to include an 800 number, Web site or address on their labels so consumers can get more information.
But Adrianna Quintero, a lobbyist for the Natural Resources Defence Council,
says knowing the nutritional facts about water is not enough.
"It's pointless to tell me water has zero calories and zero carbohydrates," Quintero said. "Is there arsenic, nitrates, microbiologic contaminants, perchlorate? If these bottlers are doing the right thing, they shouldn't have a problem telling me about it."
The Food and Drug Administration needs to tightened its regulations on bottled water after a four-year study by the NRDC found that of 103 brands surveyed, one- third contained levels of contamination.
The NRDC found the contents of one bottle, labeled "Spring Water," actually came from an industrial parking lot next to a hazardous waste site.
The FDA now insists that bottled water actually come from a spring if the bottler claims it does.
Bottled water sales have been growing at roughly 10 percent each year through the 1990s.
California is by far the biggest guzzler of bottled water, representing about 24 percent of the national market -- twice the consumption level of any other state.
It's attracted the interest of some of the country's biggest beverage sellers like Pepsi, which created Aquafina bottled water. Coca-Cola created Dasani.
Nestle Waters of North America owns Arrowhead, Calistoga, Poland Spring, Perrier, S. Pellegrino and Vittel.
But water districts like EBMUD aren't worried.
"Bottled water doesn't cut into our market share," said Kanouse. "It's kind of like conservation -- it relieves a small amount of the demand we have."
Written by Greg Lucas, Sacramento Bureau Chief
Apr 26, 2011
Environmentalists and EBMUD push for more disclosure
Sacramento - Saying consumers should know what they're drinking, environmentalists and the East Bay Municipal Utility District want bottled water to follow the same disclosure rules as tap water.
Makers of bottled water, which include Pepsi and Coca-Cola, say there is already plenty of disclosure about their water's contents.
Advocates of two bills introduced in the Legislature say there isn't nearly enough.
"People tout bottled water as this pure substance that's trickling from clear mountain springs when, in fact, that may not be the case," said Assemblywoman Ellen Corbett, D-San Leandro, author of one of the bills.
"When I pick up bottled water, I want to know it truly is something that's good for me and better for me than drinking something else," Corbett said.
Nearly 70 percent of Californians drink bottled water, which nationwide is a $6 billion industry. And by the end of this year, bottled water will have moved past milk, coffee and beer to become the second most popular beverage behind soft drinks, according to the Beverage Marketing Corp.
Bottle vs Tap
Bottled water's popularity is fuelled in part by suspicions over the quality of tap water.
But Corbett and the backers of her bill say drink no way of knowing whether bottled water is better or worse.
Unlike tap water, bottled water is considered a food product and is subject to the same sanitation and preparation requirements as other food stuffs.
Although often advertising themselves as superior to tap water, bottlers are required in most cases only to meet the same quality standards as tap water.
Of the hundreds of contaminants state and federal regulators measure, bottled water is subject to a higher standard for only two, according to Randy Kanouse, EBMUD's Sacramento lobbyist.
Bottlers don't have to create a "consumer confidence" report each year like water agencies do. The reports tell customers what's in their water. It details levels of contaminants, if any, like lead, aluminium, arsenic and salt.
Corbett's bill, AB83, and a companion bill, SB50, by Sen. Byron Sher, D- Palo Alto, would impose the same reporting requirement on bottlers.
Bottling plants and water vending machines would be subject to annual inspections. Bottlers, vending machine owners and water haulers would pay an $86 fee to cover the costs of the inspections.
Bottlers say the bills aren't needed.
"There are already comprehensive, stringent regulations in place at the federal level for quality labeling," said Stephen Kay, a spokesman for the International Bottled Water Association. "These two proposed bills are proscriptive and redundant."
Kay also cited a bill signed last year that requires bottlers to include an 800 number, Web site or address on their labels so consumers can get more information.
But Adrianna Quintero, a lobbyist for the Natural Resources Defence Council,
says knowing the nutritional facts about water is not enough.
"It's pointless to tell me water has zero calories and zero carbohydrates," Quintero said. "Is there arsenic, nitrates, microbiologic contaminants, perchlorate? If these bottlers are doing the right thing, they shouldn't have a problem telling me about it."
The Food and Drug Administration needs to tightened its regulations on bottled water after a four-year study by the NRDC found that of 103 brands surveyed, one- third contained levels of contamination.
The NRDC found the contents of one bottle, labeled "Spring Water," actually came from an industrial parking lot next to a hazardous waste site.
The FDA now insists that bottled water actually come from a spring if the bottler claims it does.
Bottled water sales have been growing at roughly 10 percent each year through the 1990s.
California is by far the biggest guzzler of bottled water, representing about 24 percent of the national market -- twice the consumption level of any other state.
It's attracted the interest of some of the country's biggest beverage sellers like Pepsi, which created Aquafina bottled water. Coca-Cola created Dasani.
Nestle Waters of North America owns Arrowhead, Calistoga, Poland Spring, Perrier, S. Pellegrino and Vittel.
But water districts like EBMUD aren't worried.
"Bottled water doesn't cut into our market share," said Kanouse. "It's kind of like conservation -- it relieves a small amount of the demand we have."
Written by Greg Lucas, Sacramento Bureau Chief
Parents' stress tied to pollution's effect on kids
Parents' stress tied to pollution's effect on kids
By Kerry Grens
Reuters
Jul 22, 2011
(Reuters Health) - Children living in high-stress households are more vulnerable to lung damage from traffic pollution than children whose parents are less stressed out, according to the results of a new study.
"It makes sense," said Dr. Jane Clougherty from the University of Pittsburgh, who was not involved in this study. "The bodily wear and tear induced by...stress could make the individual more susceptible to the effects of traffic-related air pollution."
The researchers took measurements of several indicators of lung function in nearly 1,400 children living in southern California.
They also predicted the amount of traffic pollutants the children were exposed to by sampling almost 1,000 different sites around the area. In particular the researchers were looking for nitrogen oxides, which are formed when fuel is burned. Nitrogen oxides can damage lung tissue and make asthma worse, they explain in an article in the American Journal of Respiratory and Critical Care Medicine.
Six years earlier, the children's parents had filled out a questionnaire about their level of stress. The questions asked how often they felt able to handle personal problems or felt in control, for instance.
Air pollution levels varied widely depending on where the children lived, from six parts per billion of nitrogen oxides to 101 parts per billion.
For kids from high-stress homes, when the average amount of nitrogen oxides in the air went up by 22 parts per billion, their lung function got roughly five percent worse.
That same increase in pollutants around a child whose parents had a low level of stress made no difference to their lung function, however.
Dr. Talat Islam from the University of Southern California, the lead author of the study, said he expected that stress would lead to a bigger effect of pollution on kids, but he was surprised that increased air pollution had no effect on the kids from low-stress homes.
"We see the whole effect of traffic-related air pollution in those children who were exposed to higher stress," Islam told Reuters Health.
Islam's group did not test whether that decrease in lung function among these children had any effect on their health or comfort.
An earlier study by some of the same researchers found that children exposed to traffic-related air pollution and a high-stress home were 51 percent more likely to develop asthma than children exposed to the same pollutants, but in a low-stress environment (see Reuters Health report, July 21, 2009).
It's not clear what might underlie the links between pollution, a stressful household, and lung function, but Islam said that stress and pollutants are both tied to inflammation and tissue damage.
Clougherty said it's important for parents to consider -- if they have a choice -- their children's exposure to traffic and air pollution when deciding where to live, play and go to school.
But as the results indicate, she added, "the social environment might be equally, if not more, important to the child's health overall."
SOURCE: American Journal of Respiratory and Critical Care Medicine, online June 23, 2011.
By Kerry Grens
Reuters
Jul 22, 2011
(Reuters Health) - Children living in high-stress households are more vulnerable to lung damage from traffic pollution than children whose parents are less stressed out, according to the results of a new study.
"It makes sense," said Dr. Jane Clougherty from the University of Pittsburgh, who was not involved in this study. "The bodily wear and tear induced by...stress could make the individual more susceptible to the effects of traffic-related air pollution."
The researchers took measurements of several indicators of lung function in nearly 1,400 children living in southern California.
They also predicted the amount of traffic pollutants the children were exposed to by sampling almost 1,000 different sites around the area. In particular the researchers were looking for nitrogen oxides, which are formed when fuel is burned. Nitrogen oxides can damage lung tissue and make asthma worse, they explain in an article in the American Journal of Respiratory and Critical Care Medicine.
Six years earlier, the children's parents had filled out a questionnaire about their level of stress. The questions asked how often they felt able to handle personal problems or felt in control, for instance.
Air pollution levels varied widely depending on where the children lived, from six parts per billion of nitrogen oxides to 101 parts per billion.
For kids from high-stress homes, when the average amount of nitrogen oxides in the air went up by 22 parts per billion, their lung function got roughly five percent worse.
That same increase in pollutants around a child whose parents had a low level of stress made no difference to their lung function, however.
Dr. Talat Islam from the University of Southern California, the lead author of the study, said he expected that stress would lead to a bigger effect of pollution on kids, but he was surprised that increased air pollution had no effect on the kids from low-stress homes.
"We see the whole effect of traffic-related air pollution in those children who were exposed to higher stress," Islam told Reuters Health.
Islam's group did not test whether that decrease in lung function among these children had any effect on their health or comfort.
An earlier study by some of the same researchers found that children exposed to traffic-related air pollution and a high-stress home were 51 percent more likely to develop asthma than children exposed to the same pollutants, but in a low-stress environment (see Reuters Health report, July 21, 2009).
It's not clear what might underlie the links between pollution, a stressful household, and lung function, but Islam said that stress and pollutants are both tied to inflammation and tissue damage.
Clougherty said it's important for parents to consider -- if they have a choice -- their children's exposure to traffic and air pollution when deciding where to live, play and go to school.
But as the results indicate, she added, "the social environment might be equally, if not more, important to the child's health overall."
SOURCE: American Journal of Respiratory and Critical Care Medicine, online June 23, 2011.
Thursday, July 14, 2011
Asthma study reveals the power of the placebo effect
Asthma study reveals the power of the placebo effect
In a new study, the placebo effect was so strong that asthma patients couldn't tell whether the inhaler they used had actual medicine in it.
By Karen Kaplan
Los Angeles Times
July 13, 2011
The placebo effect is alive and well, at least for patients with acute asthma.
That’s the finding of a pilot study funded by the National Center for Complementary and Alternative Medicine -- part of the National Institutes of Health -- and published in Thursday’s edition of the New England Journal of Medicine.
Researchers from Harvard Medical School and colleagues decided to test the placebo effect in asthma patients because it’s easy to assess their physical improvement (as measured by lung function tests) in a short period of time.
They recruited 39 patients who cycled among four treatment options over 12 visits. In some cases they got albuterol -- a bona fide asthma treatment -- through an inhaler, and sometimes they used an inhaler with no medicine, though the subjects didn’t know which was which. Other times, they were given sham acupuncture treatment (but told it was real), and on some visits there was no treatment at all.
Patients said their symptoms improved by 21% on the occasions when they got no treatment. But when they thought they were getting some kind of treatment, they said their symptoms improved much more -- by 50% when they got the albuterol, by 45% when they had the placebo inhaler, and by 46% with the sham acupuncture. (There was no statistically significant difference among those three outcomes.)
Did they really get that much better? When they had the albuterol, patients’ maximum forced expiratory volume in 1 second (a measure of lung function) improved by 20%. But in all three other cases, lung function improved by only 7.1% to 7.5%.
The results demonstrate that the placebo effect is powerful, the researchers said. When it came to patients’ assessments of the treatments, “the placebo effects were equivalent to the drug effect,” they wrote.
These results also suggest that patients can’t be relied upon to make accurate reports of whether their symptoms are getting better. In this study, patients couldn’t tell when the albuterol was making a real difference. In fact, any time they got something that looked like a “treatment,” they reported roughly the same degree of improvement, the researchers said.
“Even though there was a large, objective drug effect ... that was nearly three times the effect of the two placebos and the no-intervention control ,” they wrote, “patients could not reliably detect the difference between this robust effect of the active drug and the effects of inhaled placebo and sham acupuncture.”
A summary of the study is available here.
In a new study, the placebo effect was so strong that asthma patients couldn't tell whether the inhaler they used had actual medicine in it.
By Karen Kaplan
Los Angeles Times
July 13, 2011
The placebo effect is alive and well, at least for patients with acute asthma.
That’s the finding of a pilot study funded by the National Center for Complementary and Alternative Medicine -- part of the National Institutes of Health -- and published in Thursday’s edition of the New England Journal of Medicine.
Researchers from Harvard Medical School and colleagues decided to test the placebo effect in asthma patients because it’s easy to assess their physical improvement (as measured by lung function tests) in a short period of time.
They recruited 39 patients who cycled among four treatment options over 12 visits. In some cases they got albuterol -- a bona fide asthma treatment -- through an inhaler, and sometimes they used an inhaler with no medicine, though the subjects didn’t know which was which. Other times, they were given sham acupuncture treatment (but told it was real), and on some visits there was no treatment at all.
Patients said their symptoms improved by 21% on the occasions when they got no treatment. But when they thought they were getting some kind of treatment, they said their symptoms improved much more -- by 50% when they got the albuterol, by 45% when they had the placebo inhaler, and by 46% with the sham acupuncture. (There was no statistically significant difference among those three outcomes.)
Did they really get that much better? When they had the albuterol, patients’ maximum forced expiratory volume in 1 second (a measure of lung function) improved by 20%. But in all three other cases, lung function improved by only 7.1% to 7.5%.
The results demonstrate that the placebo effect is powerful, the researchers said. When it came to patients’ assessments of the treatments, “the placebo effects were equivalent to the drug effect,” they wrote.
These results also suggest that patients can’t be relied upon to make accurate reports of whether their symptoms are getting better. In this study, patients couldn’t tell when the albuterol was making a real difference. In fact, any time they got something that looked like a “treatment,” they reported roughly the same degree of improvement, the researchers said.
“Even though there was a large, objective drug effect ... that was nearly three times the effect of the two placebos and the no-intervention control ,” they wrote, “patients could not reliably detect the difference between this robust effect of the active drug and the effects of inhaled placebo and sham acupuncture.”
A summary of the study is available here.
Tuesday, July 12, 2011
High salt + low potassium = early death: study
High salt + low potassium = early death: study
By Julie Steenhuysen
Jul 11, 2011
(Reuters)
Put down the salt shakers. Eating too much salt and too little potassium can increase the risk of death, U.S. government researchers said on Monday.
The findings from a team at the U.S. Centers for Disease Control and Prevention are a counterpoint to a fiercely-debated study released last week that found no evidence that making small cuts in salt intake lowers the risk of heart disease and premature death.
"Salt is still bad for you," said Dr. Thomas Farley, Health Commissioner for New York City, which is leading a campaign to reduce salt in restaurant and packaged foods by 25 percent over five years.
Most health experts agree with Farley that consuming too much salt is not good for you and that cutting salt intake can reduce high blood pressure, which raises the risk of heart attack and stroke. Salt intake has been rising since the 1970s, with Americans consuming about twice the recommended daily limit.
The CDC study, published in the Archives of Internal Medicine, specifically focused on growing research that shows a diet high in salt and low in potassium is especially risky.
Farley, who wrote an editorial on the CDC study, said it is one of the best yet looking at the long-term effects of eating too much salt.
"It is entirely consistent with what we've said all along about sodium intake," Farley said in a telephone interview.
For the study, researchers looked at the long-term effects of sodium and potassium intake as part of a 15-year study of more than 12,000 people.
By the end of the study period, 2,270 of the study participants had died; 825 of these deaths were from heart disease and 433 were from blood clots and strokes.
POTASSIUM IS KEY
They found that people who had a high salt intake and a low potassium intake were most at risk.
"People who ate a diet high in sodium and low in potassium had a 50 percent increased risk of death from any cause, and about twice the risk of death -- or a 200 percent increase -- from a heart attack," said Dr. Elena Kuklina of the CDC who helped lead the study.
She said consumers need to increase the levels of potassium in their diet by adding more servings of fresh fruits and vegetables, such as spinach, grapes, carrots, sweet potatoes, and low fat milk and yogurt.
The Salt Institute, an industry group, challenged the findings, pointing out that the CDC study found that the link between salt intake and heart disease was statistically insignificant.
"This is a highly flawed publication that reveals more about the anti-salt agenda being pursued by the CDC than about any relationship between salt and health," said Mort Satin, the Salt Institute's Director of Science and Research.
"The only significance is between low potassium and mortality," Satin said in a statement.
Dr. Robert Briss, director of the National Center for Chronic Disease Prevention and Health Promotion at the CDC, said the findings support the general weight of evidence and suggests that higher doses of sodium are linked with poor health consequences.
And it suggests "that higher potassium may be better for you," Briss said in a telephone interview.
"About 90 percent of Americans consume more sodium than is recommended. This impacts their blood pressure," Briss said.
"Most of that sodium is not related to the salt shaker but it is in foods and especially processed and restaurant foods that we buy and order from restaurants. Consumers, even motivated ones, don't have as much choice as they could," he said.
Kuklina said potassium often counteracts the effects of salt in the diet. This equilibrium is affected when people eat highly processed foods, which tend to increase sodium levels and decrease potassium content.
"If sodium increases your high blood pressure, potassium decreases it. If sodium retains water, potassium helps you get rid of it," she said.
Instead of focusing only on salt, Kuklina said researchers should focus on the balance between potassium and salt.
"We need to strive to do both -- decrease your sodium intake and increase your potassium intake," she said.
By Julie Steenhuysen
Jul 11, 2011
(Reuters)
Put down the salt shakers. Eating too much salt and too little potassium can increase the risk of death, U.S. government researchers said on Monday.
The findings from a team at the U.S. Centers for Disease Control and Prevention are a counterpoint to a fiercely-debated study released last week that found no evidence that making small cuts in salt intake lowers the risk of heart disease and premature death.
"Salt is still bad for you," said Dr. Thomas Farley, Health Commissioner for New York City, which is leading a campaign to reduce salt in restaurant and packaged foods by 25 percent over five years.
Most health experts agree with Farley that consuming too much salt is not good for you and that cutting salt intake can reduce high blood pressure, which raises the risk of heart attack and stroke. Salt intake has been rising since the 1970s, with Americans consuming about twice the recommended daily limit.
The CDC study, published in the Archives of Internal Medicine, specifically focused on growing research that shows a diet high in salt and low in potassium is especially risky.
Farley, who wrote an editorial on the CDC study, said it is one of the best yet looking at the long-term effects of eating too much salt.
"It is entirely consistent with what we've said all along about sodium intake," Farley said in a telephone interview.
For the study, researchers looked at the long-term effects of sodium and potassium intake as part of a 15-year study of more than 12,000 people.
By the end of the study period, 2,270 of the study participants had died; 825 of these deaths were from heart disease and 433 were from blood clots and strokes.
POTASSIUM IS KEY
They found that people who had a high salt intake and a low potassium intake were most at risk.
"People who ate a diet high in sodium and low in potassium had a 50 percent increased risk of death from any cause, and about twice the risk of death -- or a 200 percent increase -- from a heart attack," said Dr. Elena Kuklina of the CDC who helped lead the study.
She said consumers need to increase the levels of potassium in their diet by adding more servings of fresh fruits and vegetables, such as spinach, grapes, carrots, sweet potatoes, and low fat milk and yogurt.
The Salt Institute, an industry group, challenged the findings, pointing out that the CDC study found that the link between salt intake and heart disease was statistically insignificant.
"This is a highly flawed publication that reveals more about the anti-salt agenda being pursued by the CDC than about any relationship between salt and health," said Mort Satin, the Salt Institute's Director of Science and Research.
"The only significance is between low potassium and mortality," Satin said in a statement.
Dr. Robert Briss, director of the National Center for Chronic Disease Prevention and Health Promotion at the CDC, said the findings support the general weight of evidence and suggests that higher doses of sodium are linked with poor health consequences.
And it suggests "that higher potassium may be better for you," Briss said in a telephone interview.
"About 90 percent of Americans consume more sodium than is recommended. This impacts their blood pressure," Briss said.
"Most of that sodium is not related to the salt shaker but it is in foods and especially processed and restaurant foods that we buy and order from restaurants. Consumers, even motivated ones, don't have as much choice as they could," he said.
Kuklina said potassium often counteracts the effects of salt in the diet. This equilibrium is affected when people eat highly processed foods, which tend to increase sodium levels and decrease potassium content.
"If sodium increases your high blood pressure, potassium decreases it. If sodium retains water, potassium helps you get rid of it," she said.
Instead of focusing only on salt, Kuklina said researchers should focus on the balance between potassium and salt.
"We need to strive to do both -- decrease your sodium intake and increase your potassium intake," she said.
Doctors overuse stents, despite guidelines
Doctors overuse heart treatment, despite guidelines
By Frederik Joelving
Jul 11, 2011
(Reuters Health) - The controversial use of stents days after a heart athttp://www.blogger.com/img/blank.giftack has continued unabated in the United States, even after a landmark study and new guidelines said the pricey therapy does not help patients.
Just over half of patients who have survived at least 24 hours after a heart attack will have a stent -- a small metal mesh tube -- placed to open a blocked coronary artery, and that rate has not changed from 2005 through 2008.
The findings add to concerns about overuse of the heart devices, made by companies such as Boston Scientific, Abbott Laboratories, Medtronic Inc and Johnson & Johnson.
Stenting procedures cost the United States about $12 billion every year, and researchers say it is time doctors take responsibility for the nation's spiraling health costs.
"I think physicians have to rise to the challenge," said Dr. Judith Hochman, a cardiologist at New York University, who led the new work.
In 2006, Hochman published a study known as the Occluded Artery Trial showing that stents did not prevent any deaths or new heart attacks compared with drugs alone when inserted more than 24 hours after a heart attack into a totally blocked artery.
While the people who got stents did not experience any more side effects, the devices did rack up an extra $7,000 in net cost per person after two years, Hochman later found.
"After a day or so, whatever damage is going to be done was done already," she told Reuters Health. "The message is to seek medical care soon after a heart attack, and that is when stenting really helps."
Hochman's results became part of revised guidelines from the American Heart Association and other groups in 2007, which recommend against using stents more than 24 hours after a heart attack in stable patients.
Her new study, published in the Archives of Internal Medicine (bit.ly/7qXyI), is based on nearly 29,000 patients seen at 896 U.S. hospitals.
It shows that neither the 2006 trial nor the revised guidelines had a noticeable effect on stent use.
"Overall there was no change in practice," Hochman said. "I expected to see a change, so it was a big surprise and a disappointment."
600,000 STENTS A YEAR
Hochman's findings apply to about 100,000 Americans a year, suggesting that about 50,000 people are having the $20,000 procedure done unnecessarily every year.
That is in addition to thousands of stents inserted outside the context of emergencies such as a heart attack, according to a study from last week showing at least one in 12 of those procedures probably leads to more harm than benefit.
Each year in the United States, about 600,000 stents are inserted into ailing hearts where they prop open blocked arteries.
The stenting procedure, called percutaneous coronary intervention, or PCI, carries risks of complications like major bleeding or tears in the heart. After leaving the hospital, people also need to take clot-busting medications, which further increase the chance of bleeds.
Studies have found that many doctors rush to do PCI before using medications that might help stable patients just as well.
In an editorial, Dr. Mauro Moscucci of the University of Miami said Hochman's study had inadequate information about the severity of heart attacks, which might have justified the use of stenting in some cases.
Still, he said, it would have been reasonable to expect a reduction in the frequency of late stenting.
"While the debate on health care reform is ongoing, health care expenditures in the United States are continuing to escalate," Moscucci said.
"Thus we must heed the call to professional responsibility aimed at the elimination of tests and treatments that do not result in any benefit for our patients, and for which the net effect will be added costs, waste, and possible harm."
Another study in the same journal, published Monday along with Hochman's report, shows it is not uncommon to see new and better research challenge established conventions and treatments.
In that study, as many as 16 of the reports that appeared in 2009 in the New England Journal of Medicine, a leading medical publication, contradicted current practice.
But according to Hochman, getting doctors to drop a new treatment may be harder than getting them to take it up -- whether that's due to strongly held beliefs about its effectiveness, worries about medical liability or losing money, or patient expectations...
By Frederik Joelving
Jul 11, 2011
(Reuters Health) - The controversial use of stents days after a heart athttp://www.blogger.com/img/blank.giftack has continued unabated in the United States, even after a landmark study and new guidelines said the pricey therapy does not help patients.
Just over half of patients who have survived at least 24 hours after a heart attack will have a stent -- a small metal mesh tube -- placed to open a blocked coronary artery, and that rate has not changed from 2005 through 2008.
The findings add to concerns about overuse of the heart devices, made by companies such as Boston Scientific, Abbott Laboratories, Medtronic Inc and Johnson & Johnson.
Stenting procedures cost the United States about $12 billion every year, and researchers say it is time doctors take responsibility for the nation's spiraling health costs.
"I think physicians have to rise to the challenge," said Dr. Judith Hochman, a cardiologist at New York University, who led the new work.
In 2006, Hochman published a study known as the Occluded Artery Trial showing that stents did not prevent any deaths or new heart attacks compared with drugs alone when inserted more than 24 hours after a heart attack into a totally blocked artery.
While the people who got stents did not experience any more side effects, the devices did rack up an extra $7,000 in net cost per person after two years, Hochman later found.
"After a day or so, whatever damage is going to be done was done already," she told Reuters Health. "The message is to seek medical care soon after a heart attack, and that is when stenting really helps."
Hochman's results became part of revised guidelines from the American Heart Association and other groups in 2007, which recommend against using stents more than 24 hours after a heart attack in stable patients.
Her new study, published in the Archives of Internal Medicine (bit.ly/7qXyI), is based on nearly 29,000 patients seen at 896 U.S. hospitals.
It shows that neither the 2006 trial nor the revised guidelines had a noticeable effect on stent use.
"Overall there was no change in practice," Hochman said. "I expected to see a change, so it was a big surprise and a disappointment."
600,000 STENTS A YEAR
Hochman's findings apply to about 100,000 Americans a year, suggesting that about 50,000 people are having the $20,000 procedure done unnecessarily every year.
That is in addition to thousands of stents inserted outside the context of emergencies such as a heart attack, according to a study from last week showing at least one in 12 of those procedures probably leads to more harm than benefit.
Each year in the United States, about 600,000 stents are inserted into ailing hearts where they prop open blocked arteries.
The stenting procedure, called percutaneous coronary intervention, or PCI, carries risks of complications like major bleeding or tears in the heart. After leaving the hospital, people also need to take clot-busting medications, which further increase the chance of bleeds.
Studies have found that many doctors rush to do PCI before using medications that might help stable patients just as well.
In an editorial, Dr. Mauro Moscucci of the University of Miami said Hochman's study had inadequate information about the severity of heart attacks, which might have justified the use of stenting in some cases.
Still, he said, it would have been reasonable to expect a reduction in the frequency of late stenting.
"While the debate on health care reform is ongoing, health care expenditures in the United States are continuing to escalate," Moscucci said.
"Thus we must heed the call to professional responsibility aimed at the elimination of tests and treatments that do not result in any benefit for our patients, and for which the net effect will be added costs, waste, and possible harm."
Another study in the same journal, published Monday along with Hochman's report, shows it is not uncommon to see new and better research challenge established conventions and treatments.
In that study, as many as 16 of the reports that appeared in 2009 in the New England Journal of Medicine, a leading medical publication, contradicted current practice.
But according to Hochman, getting doctors to drop a new treatment may be harder than getting them to take it up -- whether that's due to strongly held beliefs about its effectiveness, worries about medical liability or losing money, or patient expectations...
Sunday, July 10, 2011
When Nurses Make Mistakes
And then this doctor said something that made a huge difference to me, and it’s a sentiment I think about often. “A situation like this can build trust, Theresa,’’ he told me, “because the patient knows we’re being honest.”
July 6, 2011, When Nurses Make Mistakes
By THERESA BROWN, R.N.
New York Times
This year, a Seattle nurse named Kim Hiatt committed suicide. Ms. Hiatt’s death came nearly seven months after she had given an unintended overdose to an infant heart patient, a medical error that was said to have contributed to the child’s death days later.
Ms. Hiatt had been a nurse for 27 years and had often cared for the 8-month-old girl during the child’s stay in the pediatric intensive care unit of her hospital. She had probably drawn up the right dose of the drug hundreds of times in her career. But once, she made a life-changing error. A baby died, and she was suspended, then fired from a profession she loved. And now she’s dead.
July 6, 2011, When Nurses Make Mistakes
By THERESA BROWN, R.N.
New York Times
This year, a Seattle nurse named Kim Hiatt committed suicide. Ms. Hiatt’s death came nearly seven months after she had given an unintended overdose to an infant heart patient, a medical error that was said to have contributed to the child’s death days later.
Ms. Hiatt had been a nurse for 27 years and had often cared for the 8-month-old girl during the child’s stay in the pediatric intensive care unit of her hospital. She had probably drawn up the right dose of the drug hundreds of times in her career. But once, she made a life-changing error. A baby died, and she was suspended, then fired from a profession she loved. And now she’s dead.
Saturday, July 9, 2011
Naturopath Sentenced For Injecting Teen With Hydrogen Peroxide
Naturopath Sentenced For Injecting Teen With Hydrogen Peroxide
O'Connell To Spend 13 Years In Prison
March 27, 2006
GOLDEN, Colo. -- The so-called holistic doctor who pleaded guilty in the death of a patient was sentenced Monday to 13 years in prison after a judge told him he had shown no remorse over the death of a 19-year-old cancer victim he was treating.
http://www.blogger.com/img/blank.gif
Brian O'Connell admitted last month to criminally negligent homicide for injecting 19-year-old Sean Flanagan with hydrogen peroxide. Flanagan suffered from Ewing's Sarcoma, a form of cancer, and had tried chemotherapy and radiation treatment to no avail.
Flanagan's family sent him to O'Connell, who practices using natural remedies. However, the family said that Flanagan died prematurely in 2003 because of O'Connell's treatments.
In court on Monday, O'Connell asked Jefferson County District Judge Margie Enquist for leniency, saying he didn't know what he was doing was wrong. He said he had changed and regretted Flanagan's death.
Enquist told O'Connell she didn't believe him, and sentenced him to just two years less than the maximum.
"You stand here today without remorse, without regret, and denying what you pled guilty to, and you still call yourself a victim," she said.
Flanagan's parents, Laura and David Flanagan, said the sentence was fair.
O'Connell showed no emotion when Enquist announced the sentence, but his wife, seated in the front row of the gallery, wept.
Defense attorney Richard Jaffe said no appeal was likely, but he said people who would have sought care from O'Connell were also victims.
"There are victims on the other side too that can't get treatment now," he said.
Jaffe presented about a dozen witnesses during the sentencing hearing who said O'Connell helped them fight conditions that did not respond to traditional medicine.
In February, O'Connell also admitted guilt to theft, perjury, criminally negligent homicide, illegal practice of medicine and third-degree assault.
O'Connell was in charge of Mountain Area Naturopathic Associates in Wheat Ridge. In his office he displayed numerous degrees and certifications claiming he was doctor and a naturopath. The Colorado Medical Board found that he had no license to practice medicine in Colorado and was not certified as any kind of health care worker.
O'Connell was treating Flanagan with a procedure known as ultraviolet blood irradiation, where his blood was removed from the body, passed under an ultraviolet light and then returned to the body. When he didn't respond well to that, O'Connell then treated Flanagan by injecting his blood with hydrogen peroxide. The next day he died.
Prosecutors argued that Flanagan's cause of death was listed as probable complications from the hydrogen peroxide treatment.
O'Connell also injected this hydrogen peroxide solution into a 17-year-old girl, which caused her to go into cardiac arrest...
O'Connell To Spend 13 Years In Prison
March 27, 2006
GOLDEN, Colo. -- The so-called holistic doctor who pleaded guilty in the death of a patient was sentenced Monday to 13 years in prison after a judge told him he had shown no remorse over the death of a 19-year-old cancer victim he was treating.
http://www.blogger.com/img/blank.gif
Brian O'Connell admitted last month to criminally negligent homicide for injecting 19-year-old Sean Flanagan with hydrogen peroxide. Flanagan suffered from Ewing's Sarcoma, a form of cancer, and had tried chemotherapy and radiation treatment to no avail.
Flanagan's family sent him to O'Connell, who practices using natural remedies. However, the family said that Flanagan died prematurely in 2003 because of O'Connell's treatments.
In court on Monday, O'Connell asked Jefferson County District Judge Margie Enquist for leniency, saying he didn't know what he was doing was wrong. He said he had changed and regretted Flanagan's death.
Enquist told O'Connell she didn't believe him, and sentenced him to just two years less than the maximum.
"You stand here today without remorse, without regret, and denying what you pled guilty to, and you still call yourself a victim," she said.
Flanagan's parents, Laura and David Flanagan, said the sentence was fair.
O'Connell showed no emotion when Enquist announced the sentence, but his wife, seated in the front row of the gallery, wept.
Defense attorney Richard Jaffe said no appeal was likely, but he said people who would have sought care from O'Connell were also victims.
"There are victims on the other side too that can't get treatment now," he said.
Jaffe presented about a dozen witnesses during the sentencing hearing who said O'Connell helped them fight conditions that did not respond to traditional medicine.
In February, O'Connell also admitted guilt to theft, perjury, criminally negligent homicide, illegal practice of medicine and third-degree assault.
O'Connell was in charge of Mountain Area Naturopathic Associates in Wheat Ridge. In his office he displayed numerous degrees and certifications claiming he was doctor and a naturopath. The Colorado Medical Board found that he had no license to practice medicine in Colorado and was not certified as any kind of health care worker.
O'Connell was treating Flanagan with a procedure known as ultraviolet blood irradiation, where his blood was removed from the body, passed under an ultraviolet light and then returned to the body. When he didn't respond well to that, O'Connell then treated Flanagan by injecting his blood with hydrogen peroxide. The next day he died.
Prosecutors argued that Flanagan's cause of death was listed as probable complications from the hydrogen peroxide treatment.
O'Connell also injected this hydrogen peroxide solution into a 17-year-old girl, which caused her to go into cardiac arrest...
Wednesday, July 6, 2011
The hygiene hypothesis
The hygiene hypothesis
It suggests lack of early exposure to infectious agents can suppress development of the immune system
By Dr. Richard L. Gallo
Jan. 31, 2011
In 1998, researchers at the University of Georgia published a paperhttp://www.blogger.com/img/blank.gif that estimated about 5 million trillion bacterial cells reside on Earth. That’s a 5 with 30 zeros. That’s a lot of bacteria. Indeed, if each individual bacterium were a penny piled atop one another, it would take a trillion light-years to reach the end of the stack, which is far beyond the observable universe.
Some of these bacteria, Louis Pasteur and others duly discovered, cause disease, and so contemporary humans have long been urged, explicitly and otherwise, to fight back: Wash often. Stay clean. And don’t skimp on those alcohol-based hand-sanitizing gels, foams and lotions that reportedly kill 99 percent of all germs. Odds are there’s a dispenser near you right now.
But is cleanliness really next to goodliness?
Maybe not. There is compelling, growing evidence that being too clean might actually be bad for your health; that it results in increased sickness and the development of chronic immunological ailments that might not occur if we all dialed back on the Dial and dispensers.
This thinking is encapsulated in an idea called “the hygiene hypothesis,” which first emerged in the late-1980s. The hypothesis suggests that a lack of early childhood exposure to infectious agents and microorganisms (not just bacteria, but viruses and fungi, too) suppresses natural development of the immune system, resulting in increased susceptibility to infection and disease.
The hypothesis has been used to help explain why allergies like hay fever are less common in children from large families, even though presumably these kids are exposed to more infectious agents than those in smaller families. Epidemiologists have also noted that ailments like asthma and eczema (a kind of skin inflammation) are more prevalent in industrialized countries where personal cleanliness is emphasized.
Though not conclusively proved, the hypothesis makes sense — at least as part of a larger explanation. Let’s look at the science.
One’s a crowd
If the world is fraught with bacteria, so too are you. Based solely on the average number of cells in a typical human being, we’re all more inhuman than human. Bacterial cells outnumber human cells 10 to 1. Your gut, for example, is a well-known bacterial repository, home to hundreds of trillions of individual microbes (somewhere between 300 and 1,000 species), many of which beneficially assist in necessary functions like digestion and immune response. Plus, they take up space that might otherwise be occupied by nastier, disease-causing pathogens.
Your skin is similarly populated. Recent studies have identified hundreds of species, many previously unknown. One estimate calculates the total number of skin-based bacteria on the average person at roughly 1,000,000,000,000. These bacteria live in colonies, each favoring a different environmental niche. The bacteria that prefer the crook of your elbow, for example, are different from those homesteading your forearm.
Swathed in our cloaks of microbial invisibility, some questions are nonetheless obvious: How do skin bacteria survive our constant assaults with soaps and antibiotics? And why don’t they make us sick more often?
In research published this year and last, my colleagues and I uncovered some of the answers. Our skin hums with constant communication and interaction between commensal or benign bacteria and skin cells. Certain species of superabundant Staphylococcus bacteria, for example, produce a molecule that inhibits the inflammation response (heat, redness, swelling) generated when you injure your skin. That’s a good thing. Some inflammation is vital to healing, but too much can be worse than the infection.
Why do Staphylococci do this? It’s hard to know for sure, but one possibility is that it’s an evolutionary adaptation, a neat trick bacteria have developed to reduce the chances that an inflammatory response will kill them. Another possibility is that we have evolved together and count on these bacteria to help us control the skin response. In return for this microbial good deed, we reward specific bacteria with a comfortable place to live.
Recently, we discovered that a specific type of Staphylococci — Staphylococcus epidermidis, the most common bacterial species cultured from human skin — produces antimicrobial molecules that kill some other kinds of bacteria, including its cousin, S. aureus, a more problematic bug that causes everything from pimples and boils to deadly pneumonia, meningitis and sepsis.
S. epidermidis not only makes antimicrobials, it also instructs human skin cells to make natural antimicrobials of their own, thus serving as both warning system and mentor. The result is a balanced relationship that benefits both human hosts and our commensal bacterial buddies.
Scorched skin policy
Overuse of antibiotic soaps and hand sanitizers upsets this happy homeostasis by essentially killing all bacteria, good and bad. The consequence of this scorched skin policy is that we kill the germs that sometimes contaminate our skin and make disease transmission more difficult, but also reduce the effectiveness of our skin’s antimicrobial defenses.
Wiping out all microbes means your skin is wide open to recolonization by all comers — commensals and pathogens. It may be a tossup which returns first and faster. Excessive cleanliness also removes natural oils that help keep skin supple and intact. Dry skin is more prone to cracking, which provides new entry points for bacteria and other agents. Some bacterial species that are harmless resting atop your skin are troublemakers inside it.
Of course, no one’s suggesting we abandon antimicrobial soaps, gels and lotions. In some situations and circumstances, such as hospitals and health care, they are essential. Every effort must be made to reduce exposure to pathogens. More broadly, people should continue to wash their hands regularly and diligently. (There’s an ongoing debate about whether daily washing beyond the wrists is necessary, but that’s a different story.)
As always, nature suggests a solution, albeit one that first requires us to more fully understand the complicated relationships between microbes and our health. Rather than regularly render our skin a sort of microbial dead zone, we could develop soaps and sanitizers that are more discriminating or which include ingredients that promote the return of bacteria like S. epidermidis or deter the development of conditions like eczema. We do a little bit of that now with soaps and lotions that contain compounds designed to help skin retain its oils and moisture.
Someday you might slather up with something that selectively kills and fertilizes, encouraging certain microbial species to take root and call you home, thus restoring balance to our natural ecology.
Richard L. Gallo, M.D., Ph.D., is a professor of medicine and pediatrics and chief of UC San Diego’s Division of Dermatology and the dermatology section of the Veterans Affairs San Diego Healthcare System.
It suggests lack of early exposure to infectious agents can suppress development of the immune system
By Dr. Richard L. Gallo
Jan. 31, 2011
In 1998, researchers at the University of Georgia published a paperhttp://www.blogger.com/img/blank.gif that estimated about 5 million trillion bacterial cells reside on Earth. That’s a 5 with 30 zeros. That’s a lot of bacteria. Indeed, if each individual bacterium were a penny piled atop one another, it would take a trillion light-years to reach the end of the stack, which is far beyond the observable universe.
Some of these bacteria, Louis Pasteur and others duly discovered, cause disease, and so contemporary humans have long been urged, explicitly and otherwise, to fight back: Wash often. Stay clean. And don’t skimp on those alcohol-based hand-sanitizing gels, foams and lotions that reportedly kill 99 percent of all germs. Odds are there’s a dispenser near you right now.
But is cleanliness really next to goodliness?
Maybe not. There is compelling, growing evidence that being too clean might actually be bad for your health; that it results in increased sickness and the development of chronic immunological ailments that might not occur if we all dialed back on the Dial and dispensers.
This thinking is encapsulated in an idea called “the hygiene hypothesis,” which first emerged in the late-1980s. The hypothesis suggests that a lack of early childhood exposure to infectious agents and microorganisms (not just bacteria, but viruses and fungi, too) suppresses natural development of the immune system, resulting in increased susceptibility to infection and disease.
The hypothesis has been used to help explain why allergies like hay fever are less common in children from large families, even though presumably these kids are exposed to more infectious agents than those in smaller families. Epidemiologists have also noted that ailments like asthma and eczema (a kind of skin inflammation) are more prevalent in industrialized countries where personal cleanliness is emphasized.
Though not conclusively proved, the hypothesis makes sense — at least as part of a larger explanation. Let’s look at the science.
One’s a crowd
If the world is fraught with bacteria, so too are you. Based solely on the average number of cells in a typical human being, we’re all more inhuman than human. Bacterial cells outnumber human cells 10 to 1. Your gut, for example, is a well-known bacterial repository, home to hundreds of trillions of individual microbes (somewhere between 300 and 1,000 species), many of which beneficially assist in necessary functions like digestion and immune response. Plus, they take up space that might otherwise be occupied by nastier, disease-causing pathogens.
Your skin is similarly populated. Recent studies have identified hundreds of species, many previously unknown. One estimate calculates the total number of skin-based bacteria on the average person at roughly 1,000,000,000,000. These bacteria live in colonies, each favoring a different environmental niche. The bacteria that prefer the crook of your elbow, for example, are different from those homesteading your forearm.
Swathed in our cloaks of microbial invisibility, some questions are nonetheless obvious: How do skin bacteria survive our constant assaults with soaps and antibiotics? And why don’t they make us sick more often?
In research published this year and last, my colleagues and I uncovered some of the answers. Our skin hums with constant communication and interaction between commensal or benign bacteria and skin cells. Certain species of superabundant Staphylococcus bacteria, for example, produce a molecule that inhibits the inflammation response (heat, redness, swelling) generated when you injure your skin. That’s a good thing. Some inflammation is vital to healing, but too much can be worse than the infection.
Why do Staphylococci do this? It’s hard to know for sure, but one possibility is that it’s an evolutionary adaptation, a neat trick bacteria have developed to reduce the chances that an inflammatory response will kill them. Another possibility is that we have evolved together and count on these bacteria to help us control the skin response. In return for this microbial good deed, we reward specific bacteria with a comfortable place to live.
Recently, we discovered that a specific type of Staphylococci — Staphylococcus epidermidis, the most common bacterial species cultured from human skin — produces antimicrobial molecules that kill some other kinds of bacteria, including its cousin, S. aureus, a more problematic bug that causes everything from pimples and boils to deadly pneumonia, meningitis and sepsis.
S. epidermidis not only makes antimicrobials, it also instructs human skin cells to make natural antimicrobials of their own, thus serving as both warning system and mentor. The result is a balanced relationship that benefits both human hosts and our commensal bacterial buddies.
Scorched skin policy
Overuse of antibiotic soaps and hand sanitizers upsets this happy homeostasis by essentially killing all bacteria, good and bad. The consequence of this scorched skin policy is that we kill the germs that sometimes contaminate our skin and make disease transmission more difficult, but also reduce the effectiveness of our skin’s antimicrobial defenses.
Wiping out all microbes means your skin is wide open to recolonization by all comers — commensals and pathogens. It may be a tossup which returns first and faster. Excessive cleanliness also removes natural oils that help keep skin supple and intact. Dry skin is more prone to cracking, which provides new entry points for bacteria and other agents. Some bacterial species that are harmless resting atop your skin are troublemakers inside it.
Of course, no one’s suggesting we abandon antimicrobial soaps, gels and lotions. In some situations and circumstances, such as hospitals and health care, they are essential. Every effort must be made to reduce exposure to pathogens. More broadly, people should continue to wash their hands regularly and diligently. (There’s an ongoing debate about whether daily washing beyond the wrists is necessary, but that’s a different story.)
As always, nature suggests a solution, albeit one that first requires us to more fully understand the complicated relationships between microbes and our health. Rather than regularly render our skin a sort of microbial dead zone, we could develop soaps and sanitizers that are more discriminating or which include ingredients that promote the return of bacteria like S. epidermidis or deter the development of conditions like eczema. We do a little bit of that now with soaps and lotions that contain compounds designed to help skin retain its oils and moisture.
Someday you might slather up with something that selectively kills and fertilizes, encouraging certain microbial species to take root and call you home, thus restoring balance to our natural ecology.
Richard L. Gallo, M.D., Ph.D., is a professor of medicine and pediatrics and chief of UC San Diego’s Division of Dermatology and the dermatology section of the Veterans Affairs San Diego Healthcare System.
Thursday, May 5, 2011
New drugs often marketed ahead of crucial data
Data that could save money and help doctors make smarter treatment decisions are often unavailable at the time new medicines hit the market, according to U.S. researchers.
New drugs often marketed ahead of crucial data
By Frederik Joelving
May 4, 2011
NEW YORK (Reuters Health) - Data that could save money and help doctors make smarter treatment decisions are often unavailable at the time new medicines hit the market, according to U.S. researchers.
In a study out Tuesday, they found nearly a third of new drug approvals from the Food and Drug Administration included no data on how well the medications compare with existing alternatives.
"Even when these things are accessible, it's hugely time-consuming to go through it," said Joshua Gagne, a pharmacist at Harvard Medical School in Boston.
That leaves insurers and healthcare providers at a loss when trying to find the best and cheapest drugs for their patients, Gagne, who led the new work, told Reuters Health.
In 2009, Congress earmarked $1.1 billion to support drug comparison research, which would help doctors choose between various drugs.
But that information is unlikely to appear until years after new medicines reach the market, because drugmakers only need to show their products work better than a sugar pill -- not how they compare to existing treatments.
"There is a gap between the time the drug hits the market and the time this information is generated," Gagne said.
With his colleagues, he went through public FDA data for 197 drugs approved between 2000 and 2010.
After excluding medications for diseases with no alternative treatments, 70 percent of the FDA approval packages contained some data on how the new products compared to existing ones.
Experts who spoke with Reuters Health were split in their reaction to the new study, published in the Journal of the American Medical Association.
Dr. Robert Temple, who directs FDA's Office of Medical Policy at the Center for Drug Evaluation and Research, said he was surprised by how many drugmakers had provided some comparative data, despite not being required to do so.
"Considering that there is absolutely no requirement, it is pretty impressive," he said in a phone interview.
Another expert took the opposite view.
"A third of new drugs that are approved have no comparative data at all," said Dr. Alec B. O'Connor of the University of Rochester School of Medicine and Dentistry in New York. "I think we'd all say that is sad."
He said he believes new drugs should always be tested against those already approved to treat a given disease.
In an earlier study, O'Connor had tried to compare the cost-effectiveness of different painkillers. But that turned out to be next to impossible, because almost no researchers had tested the drugs head-to-head.
"When a new drug becomes available, if it's not compared with a drug we already use, we don't know if it is better or worse -- we're just guessing. If you're a patient, I don't think you would want your doctor to be guessing," he told Reuters Health.
"You could save a lot of money if you had better comparative data at the time of approval," he added. "It's a win-win for patients, for doctors and for societal costs."
Meanwhile, Gagne and his team say the comparative FDA data, when it exists, should be made more accessible.
But according to an e-mail from Temple, of the FDA, that is not without problems.
"Comparative data are often too limited to allow a firm conclusion about comparative effectiveness (the size of studies that would be needed to rule out a small difference is usually daunting)," he told Reuters Health. "FDA would not want to suggest that a small study showing no difference between two treatments 'proves' equivalence, when the data fall well short of such proof."
SOURCE: bit.ly/j8dJ7p Journal of the American Medical Association, May 4, 2011.
New drugs often marketed ahead of crucial data
By Frederik Joelving
May 4, 2011
NEW YORK (Reuters Health) - Data that could save money and help doctors make smarter treatment decisions are often unavailable at the time new medicines hit the market, according to U.S. researchers.
In a study out Tuesday, they found nearly a third of new drug approvals from the Food and Drug Administration included no data on how well the medications compare with existing alternatives.
"Even when these things are accessible, it's hugely time-consuming to go through it," said Joshua Gagne, a pharmacist at Harvard Medical School in Boston.
That leaves insurers and healthcare providers at a loss when trying to find the best and cheapest drugs for their patients, Gagne, who led the new work, told Reuters Health.
In 2009, Congress earmarked $1.1 billion to support drug comparison research, which would help doctors choose between various drugs.
But that information is unlikely to appear until years after new medicines reach the market, because drugmakers only need to show their products work better than a sugar pill -- not how they compare to existing treatments.
"There is a gap between the time the drug hits the market and the time this information is generated," Gagne said.
With his colleagues, he went through public FDA data for 197 drugs approved between 2000 and 2010.
After excluding medications for diseases with no alternative treatments, 70 percent of the FDA approval packages contained some data on how the new products compared to existing ones.
Experts who spoke with Reuters Health were split in their reaction to the new study, published in the Journal of the American Medical Association.
Dr. Robert Temple, who directs FDA's Office of Medical Policy at the Center for Drug Evaluation and Research, said he was surprised by how many drugmakers had provided some comparative data, despite not being required to do so.
"Considering that there is absolutely no requirement, it is pretty impressive," he said in a phone interview.
Another expert took the opposite view.
"A third of new drugs that are approved have no comparative data at all," said Dr. Alec B. O'Connor of the University of Rochester School of Medicine and Dentistry in New York. "I think we'd all say that is sad."
He said he believes new drugs should always be tested against those already approved to treat a given disease.
In an earlier study, O'Connor had tried to compare the cost-effectiveness of different painkillers. But that turned out to be next to impossible, because almost no researchers had tested the drugs head-to-head.
"When a new drug becomes available, if it's not compared with a drug we already use, we don't know if it is better or worse -- we're just guessing. If you're a patient, I don't think you would want your doctor to be guessing," he told Reuters Health.
"You could save a lot of money if you had better comparative data at the time of approval," he added. "It's a win-win for patients, for doctors and for societal costs."
Meanwhile, Gagne and his team say the comparative FDA data, when it exists, should be made more accessible.
But according to an e-mail from Temple, of the FDA, that is not without problems.
"Comparative data are often too limited to allow a firm conclusion about comparative effectiveness (the size of studies that would be needed to rule out a small difference is usually daunting)," he told Reuters Health. "FDA would not want to suggest that a small study showing no difference between two treatments 'proves' equivalence, when the data fall well short of such proof."
SOURCE: bit.ly/j8dJ7p Journal of the American Medical Association, May 4, 2011.
Friday, April 29, 2011
$50 eye drug found equal to $2,000 dose
$50 eye drug found equal to $2,000 dose
Study may alter patient choices
By Deborah Kotz
Boston Globe
April 29, 2011
An expensive eye injection that’s approved to treat macular degeneration — the most common cause of age-related blindness — works no better than a much cheaper drug at preventing vision loss. That’s the finding of a long-awaited study published online yesterday by the New England Journal of Medicine.
The study, involving more than 1,200 patients with the “wet’’ form of macular degeneration, found no difference between those who were randomly treated for one year with the more expensive drug Lucentis — which costs about $2,000 a dose — and the cheaper drug Avastin, which costs $50.
“Lucentis and Avastin were equivalent for visual acuity,’’ said study leader Dr. Daniel Martin, chair of ophthalmology at the Cleveland Clinic Cole Eye Institute during a press conference. “When we looked at the number of letters gained or lost on an eye chart, the lost or gained lines of vision, the two drugs are virtually identical.’’
For about five years, doctors have been treating most macular degeneration patients “off-label’’ with Avastin (bevacizumab), which is primarily a cancer treatment, since it’s chemically similar to Lucentis (ranibizumab). (They use a fraction of the dose given cancer patients.) But there was always uncertainty as to whether it was just as safe and effective. Experts say the new study indicates that it is...
Study may alter patient choices
By Deborah Kotz
Boston Globe
April 29, 2011
An expensive eye injection that’s approved to treat macular degeneration — the most common cause of age-related blindness — works no better than a much cheaper drug at preventing vision loss. That’s the finding of a long-awaited study published online yesterday by the New England Journal of Medicine.
The study, involving more than 1,200 patients with the “wet’’ form of macular degeneration, found no difference between those who were randomly treated for one year with the more expensive drug Lucentis — which costs about $2,000 a dose — and the cheaper drug Avastin, which costs $50.
“Lucentis and Avastin were equivalent for visual acuity,’’ said study leader Dr. Daniel Martin, chair of ophthalmology at the Cleveland Clinic Cole Eye Institute during a press conference. “When we looked at the number of letters gained or lost on an eye chart, the lost or gained lines of vision, the two drugs are virtually identical.’’
For about five years, doctors have been treating most macular degeneration patients “off-label’’ with Avastin (bevacizumab), which is primarily a cancer treatment, since it’s chemically similar to Lucentis (ranibizumab). (They use a fraction of the dose given cancer patients.) But there was always uncertainty as to whether it was just as safe and effective. Experts say the new study indicates that it is...
Monday, April 18, 2011
ACS President Resigns Over Controversial Editorial
ACS President Resigns Over Controversial Editorial
By Emily P. Walker
MedPage Today
April 18, 2011
The president-elect of the American College of Surgeons has resigned in light of backlash over an editorial he penned on the mood-enhancing effects semen has on women,
The ACS announced the resignation of Lazar Greenfield, MD, in an email sent to its members on Sunday.
In the article, Greenfield, an emeritus professor of surgery at the University of Michigan, cited research from the Archives of Sexual Behavior and wrote, "Female college students having unprotected sex were significantly less depressed than were those whose partners used condoms."
The article offended many in the surgeons' group, and some said it was sexist and perpetuates the boys club mentality of surgery.
Greenfield expressed his "deep regret" and then his resignation to the group's Board of Regents, which met Sunday to consider the status of the 78-year-old surgeon.
Writing in the Valentine's Day editorial, which was published in Surgery News -- and has since been retracted -- Greenfield discussed research that suggests semen includes mood enhancers including oxytocin and serotonin (and a sleep enhancer, melatonin).
He concluded: "So there's a deeper bond between men and women than St. Valentine would have suspected, and now we know there's a better gift for that day than chocolates."
The ACS received "numerous communications from the surgical community about the editorial," wrote the group's president, L. D. Britt, MD, along with Carlos Pellegrini, MD, chairman of the Board of Regents, and David Hoyt, MD, executive director.
At least one female ACS member, Colleen Brophy, MD, a professor of surgery at Vanderbilt University, resigned from the ACS over the editorial.
Writing in a letter to the Board, Brophy said the editorial is "just a symptom of a bigger issue," and that that college needs to be more transparent in choosing its leaders and conducting business.
"The fact that Dr. Greenfield apologized for me, for my 'taking offense' to his op ed without any insight into the implications that a physician leader advocated for unprotected sex, disturbs me," she wrote.
In a brief email to MedPage Today, Greenfield dismissed the claim that his editorial pointed to a larger sexist culture in surgery.
ACS officials acknowledged the contributions of Greenfield, including his invention of the "Greenfield Filter" a device placed in the inferior vena cava of patients who are particularly vulnerable to pulmonary embolism, to prevent venous emboli from entering the pulmonary circulation.
"We wish to honor Dr. Greenfield and celebrate his inestimable contributions to the College and the surgical community," the ACS officials wrote. "We also know that at this critical juncture for surgery and health care in America, it is important that the American College of Surgeons not be distracted by any issues that would diminish its focus on improving care of the surgical patient."
The group announced it would appoint a woman, Patricia Numann, MD, a retired surgeon from SUNY Upstate Medical Center, as the next president-elect...
By Emily P. Walker
MedPage Today
April 18, 2011
The president-elect of the American College of Surgeons has resigned in light of backlash over an editorial he penned on the mood-enhancing effects semen has on women,
The ACS announced the resignation of Lazar Greenfield, MD, in an email sent to its members on Sunday.
In the article, Greenfield, an emeritus professor of surgery at the University of Michigan, cited research from the Archives of Sexual Behavior and wrote, "Female college students having unprotected sex were significantly less depressed than were those whose partners used condoms."
The article offended many in the surgeons' group, and some said it was sexist and perpetuates the boys club mentality of surgery.
Greenfield expressed his "deep regret" and then his resignation to the group's Board of Regents, which met Sunday to consider the status of the 78-year-old surgeon.
Writing in the Valentine's Day editorial, which was published in Surgery News -- and has since been retracted -- Greenfield discussed research that suggests semen includes mood enhancers including oxytocin and serotonin (and a sleep enhancer, melatonin).
He concluded: "So there's a deeper bond between men and women than St. Valentine would have suspected, and now we know there's a better gift for that day than chocolates."
The ACS received "numerous communications from the surgical community about the editorial," wrote the group's president, L. D. Britt, MD, along with Carlos Pellegrini, MD, chairman of the Board of Regents, and David Hoyt, MD, executive director.
At least one female ACS member, Colleen Brophy, MD, a professor of surgery at Vanderbilt University, resigned from the ACS over the editorial.
Writing in a letter to the Board, Brophy said the editorial is "just a symptom of a bigger issue," and that that college needs to be more transparent in choosing its leaders and conducting business.
"The fact that Dr. Greenfield apologized for me, for my 'taking offense' to his op ed without any insight into the implications that a physician leader advocated for unprotected sex, disturbs me," she wrote.
In a brief email to MedPage Today, Greenfield dismissed the claim that his editorial pointed to a larger sexist culture in surgery.
ACS officials acknowledged the contributions of Greenfield, including his invention of the "Greenfield Filter" a device placed in the inferior vena cava of patients who are particularly vulnerable to pulmonary embolism, to prevent venous emboli from entering the pulmonary circulation.
"We wish to honor Dr. Greenfield and celebrate his inestimable contributions to the College and the surgical community," the ACS officials wrote. "We also know that at this critical juncture for surgery and health care in America, it is important that the American College of Surgeons not be distracted by any issues that would diminish its focus on improving care of the surgical patient."
The group announced it would appoint a woman, Patricia Numann, MD, a retired surgeon from SUNY Upstate Medical Center, as the next president-elect...
Wednesday, April 6, 2011
U.S. researchers develop new drug shrinking cancer in animals
U.S. researchers develop new drug shrinking cancer in animals
2011 April 07
xinhuanet.com
A study led by researchers at the University of Michigan (U-M) showed in animal studies that new cancer drug compounds they developed shrank tumors, with few side effects.
The study, done in two mouse models of human cancer, looked at two compounds designed to activate a protein that kills cancer cells. The protein, p53, is inactivated in a significant number of human cancers. In some cases, it is because another protein, MDM2, binds to p53 and blocks its tumor suppresser function. This allows the tumor to grow unchecked. The new compounds block MDM2 from binding to p53, consequently activating p53.
"For the first time, we showed that activation of p53 by our highly potent and optimized MDM2 inhibitors can achieve complete tumor regression in a mouse model of human cancer," says lead study author Shaomeng Wang, director of the Cancer Drug Discovery Program at the U-M Comprehensive Cancer Center.
Wang presented the study Wednesday at the American Association for Cancer Research 102nd annual meeting.
Many traditional cancer drugs also activate p53 but they do so by causing DNA damage in both tumor cells and normal cells, causing side effects. These new MDM2 inhibitors activate p53 while avoiding the DNA damage common with other drugs. In this study, which was done in collaboration with Ascenta Therapeutics and Sanonfi-Aventis, researchers showed that these new drugs shrank tumors without significant side effects.
Because p53 is involved in all types of human cancer, the new drug has potential to be used in multiple types of cancer. Further, the researchers also identified certain markers in tumors that predict which ones will be particularly sensitive to the MDM2 inhibitor, which would allow physicians to target the drug only to patients most likely to benefit.
2011 April 07
xinhuanet.com
A study led by researchers at the University of Michigan (U-M) showed in animal studies that new cancer drug compounds they developed shrank tumors, with few side effects.
The study, done in two mouse models of human cancer, looked at two compounds designed to activate a protein that kills cancer cells. The protein, p53, is inactivated in a significant number of human cancers. In some cases, it is because another protein, MDM2, binds to p53 and blocks its tumor suppresser function. This allows the tumor to grow unchecked. The new compounds block MDM2 from binding to p53, consequently activating p53.
"For the first time, we showed that activation of p53 by our highly potent and optimized MDM2 inhibitors can achieve complete tumor regression in a mouse model of human cancer," says lead study author Shaomeng Wang, director of the Cancer Drug Discovery Program at the U-M Comprehensive Cancer Center.
Wang presented the study Wednesday at the American Association for Cancer Research 102nd annual meeting.
Many traditional cancer drugs also activate p53 but they do so by causing DNA damage in both tumor cells and normal cells, causing side effects. These new MDM2 inhibitors activate p53 while avoiding the DNA damage common with other drugs. In this study, which was done in collaboration with Ascenta Therapeutics and Sanonfi-Aventis, researchers showed that these new drugs shrank tumors without significant side effects.
Because p53 is involved in all types of human cancer, the new drug has potential to be used in multiple types of cancer. Further, the researchers also identified certain markers in tumors that predict which ones will be particularly sensitive to the MDM2 inhibitor, which would allow physicians to target the drug only to patients most likely to benefit.
Friday, March 25, 2011
Social Networks Prevent Dementia in Women
June 6, 2008
Social Networks Prevent Dementia in Women, Kaiser Permanente Study Finds
Kaiser Permanente press release
A strong social network of family and friends is associated with a lower risk of dementia, says a Kaiser Permanente study published in the July issue of the American Journal of Public Health. This is the latest in a series of studies that Kaiser Permanente is conducting on the causes and prevention of dementia.
The five-year study from the Kaiser Permanente Southern California Department of Research & Evaluation followed 2,249 women 78 years or older who had not been diagnosed with dementia and found that women with large social networks were about 26 percent less likely to develop dementia when compared to those women with smaller networks.
"There are a variety of ways that a large social network can facilitate cognitive health but the possible influence on the brain is indirect and largely unknown. Future studies will need to examine which specific aspects of social network are associated with dementia risk. We also need to identify and describe what synthetic social networks may be created that serve to augment or substitute social networks for the elderly who are more socially isolated." said Dr. Valerie Crooks, lead author and research scientist at Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena.
"This well done study significantly adds to the growing body of information that lifestyle, cognitive activity and social connectivity appear to reduce the risk of dementia and help maintain a healthy brain and my advice to older adults is to maintain and even increase their social ties", said Dr. Richard Della Penna, medical director, Kaiser Permanente Aging Network and national Elder Care Clinical Lead for the Care Management Institute.
As many as 5 million Americans are living with Alzheimer's disease, the most common form of dementia. This study provides longitudinal evidence that having larger social networks does have a protective association on the development of dementia in very elderly women.
"The Alzheimer's Association supports the adoption of a brain-healthy lifestyle and encourages all people to remain mentally, socially and physically engaged," said William Thies, PhD, vice president of Medical and Scientific Relations at the Alzheimer's Association. "There is a growing body of scientific evidence that suggests staying socially active, in combination with other activities like managing medical risks, exercising and maintaining a healthy diet, may reduce the risk of Alzheimer's or other dementia."
This study was funded by the National Institute on Aging.
Social Networks Prevent Dementia in Women, Kaiser Permanente Study Finds
Kaiser Permanente press release
A strong social network of family and friends is associated with a lower risk of dementia, says a Kaiser Permanente study published in the July issue of the American Journal of Public Health. This is the latest in a series of studies that Kaiser Permanente is conducting on the causes and prevention of dementia.
The five-year study from the Kaiser Permanente Southern California Department of Research & Evaluation followed 2,249 women 78 years or older who had not been diagnosed with dementia and found that women with large social networks were about 26 percent less likely to develop dementia when compared to those women with smaller networks.
"There are a variety of ways that a large social network can facilitate cognitive health but the possible influence on the brain is indirect and largely unknown. Future studies will need to examine which specific aspects of social network are associated with dementia risk. We also need to identify and describe what synthetic social networks may be created that serve to augment or substitute social networks for the elderly who are more socially isolated." said Dr. Valerie Crooks, lead author and research scientist at Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena.
"This well done study significantly adds to the growing body of information that lifestyle, cognitive activity and social connectivity appear to reduce the risk of dementia and help maintain a healthy brain and my advice to older adults is to maintain and even increase their social ties", said Dr. Richard Della Penna, medical director, Kaiser Permanente Aging Network and national Elder Care Clinical Lead for the Care Management Institute.
As many as 5 million Americans are living with Alzheimer's disease, the most common form of dementia. This study provides longitudinal evidence that having larger social networks does have a protective association on the development of dementia in very elderly women.
"The Alzheimer's Association supports the adoption of a brain-healthy lifestyle and encourages all people to remain mentally, socially and physically engaged," said William Thies, PhD, vice president of Medical and Scientific Relations at the Alzheimer's Association. "There is a growing body of scientific evidence that suggests staying socially active, in combination with other activities like managing medical risks, exercising and maintaining a healthy diet, may reduce the risk of Alzheimer's or other dementia."
This study was funded by the National Institute on Aging.
Sunday, January 23, 2011
Brian Billbray spreads false allegations about Obama's health reform
Fact Check: Doctor Approval Needed for NyQuil?
Voice of San Diego
January 5, 2011
by Keegan Kyle
"Another example of unintended, and somewhat ridiculous, consequences in PPACA (the health care reform act) can be found in a provision that requires individuals to obtain a doctor's prescription before using their own money to purchase over-the-counter medications like aspirin or NyQuil," U.S. Rep. Brian Bilbray, R-Calif., wrote in an op-ed published by the Union-Tribune on Dec. 17.
Determination: False
Analysis: Part of the landmark health care legislation passed by Congress last year changed how millions of people can receive discounted medical supplies. In the editorial, Bilbray derided the change as another example of failed legislation and advocated for an overhaul.
But his example isn't accurate.
Some employer-provided health care plans, such as flexible spending accounts or health savings accounts, provide a tax break and reimburse recipients for the cost of their medical supplies, which may include over-the-counter medication like aspirin or NyQuil. Under the new legislation, those people must first get a prescription for over-the-counter medication in order to get the tax break and reimbursement. Without a prescription, they can't benefit from their health care plan's discounted price.
However, contrary to Bilbray's statement, the legislation doesn't stop people from buying over-the-counter medication without a prescription. They'll just have to pay the full retail price and any accompanying taxes...
Voice of San Diego
January 5, 2011
by Keegan Kyle
"Another example of unintended, and somewhat ridiculous, consequences in PPACA (the health care reform act) can be found in a provision that requires individuals to obtain a doctor's prescription before using their own money to purchase over-the-counter medications like aspirin or NyQuil," U.S. Rep. Brian Bilbray, R-Calif., wrote in an op-ed published by the Union-Tribune on Dec. 17.
Determination: False
Analysis: Part of the landmark health care legislation passed by Congress last year changed how millions of people can receive discounted medical supplies. In the editorial, Bilbray derided the change as another example of failed legislation and advocated for an overhaul.
But his example isn't accurate.
Some employer-provided health care plans, such as flexible spending accounts or health savings accounts, provide a tax break and reimburse recipients for the cost of their medical supplies, which may include over-the-counter medication like aspirin or NyQuil. Under the new legislation, those people must first get a prescription for over-the-counter medication in order to get the tax break and reimbursement. Without a prescription, they can't benefit from their health care plan's discounted price.
However, contrary to Bilbray's statement, the legislation doesn't stop people from buying over-the-counter medication without a prescription. They'll just have to pay the full retail price and any accompanying taxes...
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