Harbinger Rolled Mat

February 28, 2010 by  
Filed under HEALTHCARE

SHIPPING INCLUDED Lightweight, portable exercise mat. Size: 24″ wide by 72″ long. Exclusive 3/8″ thick Durafoam™ pad makes floor workouts more comfortable, while the double sided non-slip surface grips the floor to prevent injuries. Moisture resistant skin is easy to clean. Integrated strap makes carrying and storing easy.

Heart(y) News February 26: Non-heart drugs that can affect your heart

February 26, 2010 by  

Some noncardiovascular medications have the potential to affect cardiovascular function causing adverse effects that can potentially be life-threatening. The lesson learned from Vioxx was a hard one. That is why new drugs are thoroughly screened on cardiovascular safety.

Avandia (rosiglitazone): Ongoing Review of Cardiovascular Safety
One of the drugs most recently scrutinized is the antidiabetes drug Avandia (rosiglitazone). The US FDA recently issued a notification to healthcare professional and patients about ongoing reviews of clinical trial data. The data in question were primarily from the large, long-term RECORD trial. The US FDA expects to complete the review in the coming months and will publicly report the review results in July this year. In the meantime, the regulatory body recommends that doctors should follow closely the prescribing info, including the black boxed warning.

New senate report puts Avandia safety in spotlight again
The ongoing US FDA review is just one of Avandia’s manufacturer GlaxoSmithKline’s (GSK) problems. A new senate report accuses Avandia researchers for unethical conduct in relation to another clinical trial called Thiazolidinediones Intervention with Vitamin D EvaluationThiazolidinediones Intervention with Vitamin D Evaluation (TIDE). The TIDE study compared Avandia with the competitor drug pioglitazone. However, the report questions the safety, thus the ethical status of the trial.
This is not the first time that GSK is criticized about Avandia. In 2007, a study was published indicating cardiovascular safety issues in connection with the diabetic drug. Furthermore, some experts believe that the pharma company was aware about the safety issues but didn’t disclose it to the authorities. The company, however, denies the allegations

“The safety and effectiveness of Avandia is well characterized in the label approved by the FDA. Contrary to the assertions in the report… the scientific evidence simply does not establish that Avandia increases cardiovascular ischemic risk or causes myocardial ischemic events.”

Invirase (saquinavir): Ongoing safety review of clinical trial data
Another drug scrutinized for cardiovascular safety is the antiviral agent Invirase (saquinavir). Invirase is used in combination with another antiviral drug Norvir (ritonavir) in the treatment of HIV infection. The combination therapy, however, seems to have an adverse effect on the heart. According to the US FDA:

The data suggest that together the two drugs may affect the electrical activity of the heart, known as prolonged QT or PR intervals. A prolonged QT interval can increase the risk for a serious abnormal rhythm called torsades de pointes. A prolonged PR interval can cause the electrical signal responsible for generating a heart beat to slow or even stop, known as heart block.

The US FDA is also conducting a review of clinical trial data on Invirase.

Photo credit: stock.xchng

Think about rare diseases on February 28

February 26, 2010 by  
Filed under Featured, HEALTHCARE

One of the February events I forgot to mention earlier this month is the Rare Diseases Day which falls on February 28. You might have stumbled across these terms before: rare diseases, orphan diseases. Let’s see whether we can clarify these terms.

Rare diseases, also known as orphan diseases are diseases with very low prevalence. In the US, a disease is considered rare when prevalence in a population is fewer than 200,000 affected individuals. In Europe, rare diseases are those that affect five out of every 10,000 people. There are hundreds, even thousands of diseases and conditions considered “rare” but we seldom hear about them except perhaps when watching episodes of Dr. House.

Here’s some info from the Rare Diseases Day campaign:

Rare diseases are life-threatening or chronically debilitating diseases with a low prevalence and a high level of complexity. 6000 to 8000 rare diseases have been identified, affecting 30 million European citizens. Patients with very rare diseases and their families are particularly isolated and vulnerable. The life expectancy of rare disease patients is significantly reduced and many have disabilities that become a source of discrimination and reduce or destroy educational, professional or social opportunities.

Some of the more “well-known” rare diseases are the Guillain-Barre Syndrome (supposedly linked to certain vaccines), Huntington Disease (this is what Dr Remy Hadley – played by Olivia Wilde – has), and Reye Syndrome (associated with aspirin use in children). A comprehensive (though not complete) list of rare diseases can be found here.

Rare disease should not be confused with the term neglected diseases. Neglected diseases are not necessary rare, they just don’t get all the attention they deserve because most of these are tropical diseases highly prevalent in low-income countries of Asia, Africa, and Latin America. Even though they are prevalent, they, like rare diseases, are not considered worthy enough of the time, not the mention the financial investment, needed to develop vaccines and treatments. Example of neglected diseases are schistosomiasis, African Sleeping Sickness (African trypanosomiasis), and dengue fever.

Back to rare diseases, February 28 is chosen to mark Rare Diseases Day and this year’s theme is “Bridging Patients and Researchers.”

So why are rare diseases also called orphan diseases?

The rare disease patient is the orphan of health systems, often without diagnosis, without treatment, without research, therefore without reason to hope.”

If there are orphan diseases, there are also orphan drugs. Drugs for [rare] diseases and conditions are commonly referred to as “orphan drugs”.

According to the US Orphan Drug Act:

Thus the Orphan Drug Act is aimed to provide incentives to pharmaceutical companies to develop orphan drugs for rare diseases. Incentives include tax advantages, less strict regulations (e.g. fewer clinical trials since there isn’t often enough patients to test), and special considerations in patenting and licensing. Because of such incentives, orphan drug applications for approval have doubled in the last decade. According to the Tufts Center for the Study of Drug Development, the US FDA has granted orphan drug status to 425 experimental drugs between 2006 and 2008. From 2000 and 2002, it was only 208.

However, there are still many rare diseases without any cure. Thus, Rare Diseases Day aims to increase awareness about this issue. The main messages of the Rare Diseases Day campaign are:

Preventing Coronary Heart Disease: Prospects, Policies, and Politics

February 25, 2010 by  
Filed under HEALTHCARE

Heart disease is a leading cause of death among both men and women around the world. Preventing Coronary Heart Disease examines the statistics and focuses specifically on policies for the prevention of heart disease by the government, general practitioners, and concerned groups. Michael Calnan examines the feasibility and effectiveness of these health policies and the obstacles that may prevent their adoption.brDrawing mainly on the discipline of politics, sociology, and epidemiology, the author begins by examining the epidemiological case for prevention, and then analyzes the role of the government, and of doctors, concerned groups and the general public.brHeart disease is of major concern to all those working in health and related industries, as well as to individuals. This book is the first study of the policies of prevention of the disease and will be invaluable reading for students of health studies and social policy, as well as professionals working in health care.br

Pregnant and smoking? Read this!

February 25, 2010 by  

Pregnant, yet still smoking? Well, this latest report from the experts might motivate you to quit.

Swedish researchers compared the blood pressure of babies of moms show smoked during pregnancy, and babies of moms who did not. The results are really bad news for smoking moms and even worse news for their babies. Why bad news? Because these babies tend to suffer from a so-called circulatory dysfunction which results in abnormal control of the blood pressure during repositioning.

When we stand up, the heart rate normally increases, blood vessels constrict to keep the blood supply to the organs of the upper part of the body especially the brain and the heart, the blood pressure increases slightly.

In the first few months of their lives, babies are not able to change positions or sit/stand upright and have to be lifted for repositioning. During repositioning, the baby’s body, too, has to cope with the change in position with change in blood pressure.

The study involved 19 babies of non-smoking couples and 17 babies of moms who smoked 15 sticks of cigarettes per day on average. Both groups of babies were of normal weight at birth and were breastfed. A test for blood pressure control is by tilting the babies upright during sleep.

In this research, the babies were tilted up to an angle of 60 degrees and then returned to their lying position again. Blood pressure and heart rates were then measured during sleeping, during tilting, and after returning to the original lying position. The tilting test and the measurements were performed when the babies were aged 1 week, 3 months, and 1 year. The results of the study show:

  • Babies at age one week who were not exposed experience a 2% increase in blood pressure when tilted. At age one year, this increase in blood pressure is up to 10%, a normal increase correlated to the increase in size and mobility of the baby.
  • Babies who were exposed to tobacco in utero exhibit the opposite trend in blood pressure during tilting. A 10% increase was observed during the first week, which decreases down to 4% at age 12 months.
  • The researchers also observed that the heart rates of the exposed babies were abnormal and highly exaggerated in response to tilting at ages 3 months and one year.
  • When sleeping undisturbed, diastolic blood pressures of exposed babies were higher at 3 months, and the heart rates were 20% slower at 1 year compared to non-exposed babies.
  • When upright babies were returned abruptly to their lying position, blood pressure in non-exposed babies goes back to normal; blood pressure of tobacco-exposed babies goes up.

According to lead author Dr. Gary Cohen, senior research scientist in the Department of Women and Child Health at the Karolinska Institute in Stockholm, Sweden:

“Tobacco-exposed infants have a different profile. It’s surprising how early in life these functional abnormalities can be detected in the babies of smokers. The re-programming of the cardiovascular function is present at birth and is still present and even more dramatic at one year.”

In other words, the circulatory system of tobacco-exposed babies is not functioning properly and is hyperreactive in the first days of life, but becomes underreactive and less effective with time. The circulatory dysfunction and poor blood pressure control have some consequences later in life, including susceptibility to hypertension and other cardiovascular problems.

Is there such a thing a “too much exercise?”

February 25, 2010 by  
Filed under ARTHRITIS

With the increasing problems of obesity and cardiovascular diseases attributed to sedentary lifestyle, physical exercise has touted as the solution to lots of health problems. But can physical exercise also have some adverse effects on health? German and American researchers presented results at Radiological Society of North America (RSNA) in Chicago last year that indicated that high levels of physical activity can cause cartilage damage and lead to osteoarthritis.

According to Dr. Christoph Stehling, a researcher in the US and in Germany:

“Our data suggest that people with higher physical activity levels may be at greater risk for developing knee abnormalities and, thus, at higher risk for developing osteoarthritis.”

Osteoarthritis is the most common form of arthritis, affecting about 27 million people in the US. It is a degenerative joint disease that causes pain, swelling and stiffness.

The researchers looked at 236 study participants (100 men and 136 women) with ages ranging from 45 to 55. The participants were asked to complete the Physical Activity Scale for the Elderly (PASE) questionnaire and based on their PASE scores, were classified as low, middle-, and high-activity groups. A person of high activity level would typically engage in several hours of walking, sports or other types of exercise per week, as well as yard work and other household chores. The participants were then subjected to magnetic resonance imaging (MRI) that looked at musculoskeletal structures of the knee.

The study results revealed the following knee abnromalities in some of the participants:

  • meniscal lesions
  • cartilage lesions
  • bone marrow edema
  • ligament lesions

The frequency and degree of knee damage seems to be associated with the level of physical activity based on PASE scores.

Dr. Stehling continues to say

“The prevalence of the knee abnormalities increased with the level of physical activity… In addition, cartilage defects diagnosed in active people were more severe.”

In addition, certain activities, especially weight bearing activities such as walking or running cause more damage than other activities. The researchers do not necessarily advocate a sedentary lifestyle, which can be also detrimental to musculoskeletal health. Instead, they recommend non-weight bearing activities such as swimming and cycling. These activities are beneficial to cardiovascular health without causing cartilage damage.

The study authors concluded:

•High levels of physical activity may result in knee damage and eventually arthritis for middle-aged men and women.

•MRI showed evidence of knee abnormalities, including cartilage damage and ligament lesions, in active adults with no pain or other symptoms

How Alanis Morisette fights depression

February 24, 2010 by  
Filed under DEPRESSION

I love the music of Alanis Morisette. I saw her live in her Frankfurt concert years ago, and man, was I I love watching her perform on stage. She came a long, long way from the Canadian teen star (ala Britney Spears) to a serious recording artist whose soulful music and ironic (and sometime dark) lyrics remind one of Janis Joplin. She has four Grammys under her belt and sold millions of million worldwide. Yet, like many of us, Alanis, too, has had her ups and downs, from love affairs gone sour to eating disorders and bouts of depression. She probably reached her lowest point in 2007 after a major break up. During that time, Alanis thought food was the ultimate remedy to a broken heart. Expectedly, this lead to health problems, gain weight, low self-esteem, and –yes – more depressive symptoms.

Fortunately, after spending two years in the dumps, Alanis finally found the courage to make major lifestyle changes. She found redemption in a strict vegan diet, working out, and running.

In an interview with Runner’s World, Alanis says

“…running has made being depressed impossible. If I’m going through something emotional [I] just go outside for a run, and you can rest assured I’ll come back with clarity.”

Like most of us, Alanis knows it is easier said than done. I, too, find it hard to drag myself out of my warm bed to brave the cold winter weather for a jogging run.

[she forces herself to] “tie my laces, put on a tight bra and get out there like a little robot. The first 10 minutes are excruciating, but soon I get into the flow.”

Yes, self-discipline is necessary to keep on what one has started. And Alanis has proven she has the discipline and the will power to get up when she was down and move on. The results were astounding – weight loss, no depression, and another smashing hit album.

But Alanis didn’t just stop there. She continues to advocate a healthy lifestyle and she inspires others to do so. She has run several marathons for the benefit of not-for-profit organizations. Her decision to have a major lifestyle change paid off. She’s “back to what I was born to be, at my best. … I feel very alive. … I have no more aches and pains.”

Indeed, clinical evidence is accumulating that a healthy lifestyle is closely linked not only to good physical but also mental health. Depression is associated with genetic and environmental factors. While egentic factors are non-modifiable, environmental factors, mainly lifestyle factors are. Exercise and sunshine, for example, have been shown to relieve depressive symptoms with efficacy comparable to those of pharmacological agents or psychotherapy. From my point of view, that is a great (not to mention cheap) way of managing depression, with long-lasting benefits and no side effects.

And yes, bravo, Alanis!

Photo: wikicommmons

A heart story in the winter Olympics 2010

February 24, 2010 by  

For athletes, the ultimate dream is to compete in the Olympics. These people have to give up a lot and suffer through injuries in order to have a chance for glory.

Just a year ago, the Crawford sisters never thought they will make it to the Vancouver Winter Olympics 2010.

26-year old Chandra Crawford was an Olympic gold medallist. She won a gold medal in cross-country skiing 4 years ago in the Olympic games in the Turin 2006 games. However, she had ankle problems last year that almost cost her her spot in the Canadian Olympic team.

However, it was Chandra’s younger sister who had more problems. 21-year old Rosanna who is a biathlete, was diagnosed with atrial tachycardia, a heart condition that causes the heart to beat too fast. In Rosanna’s case, her heart would sometimes race more than twice faster than normal. “I had no energy. I couldn’t ski fast. All my limbs hurt,” said Rosanna.

Thus last year, Rosanna had to undergo an intervention to repair heart condition.

“They go into a vein in your thigh, up to your heart, and they find where you have bad nerves. I had a nerve that would just go in little loop and make my heart race. They had to cauterize the nerve, so they just burned it.”

However, Rosanna didn’t give up on her dream of competing next to her big sister in the next Olympics. Six weeks after her heart intervention, she started training and then competing in biathlon in order to secure a place in the Canadian team. During the final qualifying race, her big sister Chandra was there to cheer her on, running alongside the race course and shouting words of encouragement to her little sister.

“She helped me ski as fast as I could. She was yelling and cheering. She kept telling me to put my head down, grit and my teeth and move as fast as I could.”

The sisters are now together as part of the Canadian Olympics team in Whistler.

This is definitely an Olympic heart story, an inspiring story about determination to overcome odds and sisterly love.

About atrial tachycardia

According to Medline Plus encyclopedia

The human heart gives off electrical impulses, or signals, which tell it to beat. Normally, these signals begin in an area of the upper right chamber called the sinoatrial node (sinus node or SA node). This node is considered the heart’s “natural pacemaker.” It helps control the heartbeat. When the heart detects a signal, it contracts (or beats). The normal heart rate in adults is about 60 to 100 beats per minute. The normal heart rate is faster in children.

In multifocal atrial tachycardia (MAT), multiple locations within the heart fire signals at the same time. Too many signals lead to a rapid heart rate — anywhere from 100 to 250 beats per minute. The rapid heart rate causes the heart to work too hard. If the heartbeat is very fast, the heart has less time to fill up with blood, so it doesn’t have the right amount of blood to pump to the brain and the rest of the body.

February diabetes updates

February 23, 2010 by  
Filed under DIABETES, Featured

Once again, I am bringing you the latest updates on diabetes.

Erectile dysfunction linked to diabetes
There are many factors that can affect sexual function. Certain metabolic diseases, for example. Several research studies have shown that erectile dysfunction is quite common men with Type 2 diabetes mellitus. Men with diabetes have 3 times the risk for erectile dysfunction compared to those without diabetes, with estimates of prevalence ranging from 20 to 85%.  A study by researchers in Cairo University looked at 100 patients aged 35 and 50 who were diagnosed with type 2 diabetes. The study participants were asked to fill out the International Index of Erectile Function questionnaire. Based on the answers to the questionnaires, results showed that 53% of patients have good sexual potency, 20% had fair (20%), and 26% had poor potency. Potency was inversely related to glycemic control, as measured by hemoglobin A1c (HbA1c) values.

Lung cancer not linked to diabetes
In another study, American researchers looked at the relationship between diabetes and pulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pneumonia and lung cancer. Data were taken from a very large database of electronic health record of 1,811,228 members of a health plan in California. Of these, about 4% have been diagnosed with diabetes. Data analyses showed that diabetes is associated with an increased risk for asthma, COPD, pulmonary fibrosis, and pneumonia but not for lung cancer.

Gum disease linked to diabetes
A study by researchers of New York University indicates gum disease could be linked to diabetes. Base on national data collected by the CDC, gum disease is also linked to cardiovascular and metabolic disorders such as excess weight and hypertension.

“More than 90 percent of people with gum disease would have been recommended by the American Diabetes Association for diabetes testing because of their risk factors.”

In fact, based on the study results, gum disease could be used as a disease marker that can sound the alarm for further testing for diabetes.

Rise in diabetes limb amputations
Amputations due complications from diabetes are becoming more and more common, according to a BBC report. According to the report, major diabetes-linked amputations increased by 43% between 1996 and 2005 whereas lower extremity (below ankle) amputations doubled.

Vision Loss in Diabetics Becoming Less Common
On the bright side, vision loss brought about by type 1 diabetes less common. Comparing its current incidence to that in the 1970s, the decrease is significantly difference. Researchers believe this might be due “to better blood sugar control and improved treatment of diabetes-related eye disorders.”

Soon: a vaccine against prostate cancer?

February 23, 2010 by  
Filed under CANCER

What does the small pox virus has to do with prostate cancer? Well, scientists are using relatives of the deadly virus to develop a vaccine that holds lots of promise for patients with advanced prostate cancer. The vaccine Prostvac-VF is still in the testing stage and is a ground-breaking project of BN ImmunoTherapeutics, a division of Danish biotech firm Bavarian Nordic.

In the clinical trial development program of Prostvac-VF, the vaccine the vaccine was tested in 125 male patients with advanced prostate cancer that was resistant to most cancer drugs. The study conducted with the help of researchers at the Dana-Farber Cancer Institute and Harvard Medical School in Boston.

The results of the trial was very promising, with patients treated with the vaccine having extended survival of 8 months or more compared to those who did not receive the vaccine. According to researcher Dr. Philip Kantoff:

The average survival for these men is two years…At three years, 30 percent of the men who got the vaccine were still alive.”

Prostvac is one of therapeutic vaccines currently in the development stage Therapeutic vaccines are used to treat diseases that have been diagnosed and are therefore different from prophylactic vaccines which prevent diseases.

Prostvac was developed from genetically-engineered cowpox virus and fowlpox viruses which are related to the small pox virus. The viruses were weakened and genetically engineered to carry irregular versions of the prostate specific antigen (PSA), which are produced only by prostate cells. In addition, the vaccine also induces the production of “three costimulatory molecules that spur the immune system to a more vigorous attack on tumor cells.”

The results of the study have been published in the Journal of Clinical Oncology. The authors concluded that immunotherapy with Prostvac-VF was well tolerated and associated with a 44% reduction in the death rate and an 8.5-month improvement in median overall survival rate in patients with metastatic castration-resistant prostate cancer. However, larger studies needed to confirm these findings.

Dr. Kantoff continues:

“Although this study is relatively small, it offers encouraging evidence of a clinically meaningful benefit from this vaccine approach.”

A trial that intends to include about 600 patients is in the planning.

There is a large economic potential for an effective prostate vaccine. Prostate cancer is a leading cause of mortality among American men, ranking second only to lung cancer as cancer killer. 2009 statistics from the American Cancer Society give 192,000 diagnosed cases 27,000 deaths. Financial analysts foresee a billion-dollar market for such a vaccine.

Current Therapy of Infertility

February 22, 2010 by  
Filed under HEALTHCARE

Current Therapy of Infertility

Beware of radiation overdose

February 22, 2010 by  
Filed under CANCER

First of all, this is not meant to scare you. This is simply to make you aware. Through the use of radiation, imaging techniques have greatly helped diagnostic medicine in saving lives. Through radiotherapy, cancer patients have gotten a new lease in life. But let’s face it. Despite its benefits, radiation especially ionizing radiation has its share of risks. Radiation can affect the cells, tissues and organs to cause cell damage and death that may be irreversible.

In a previous post, I have cited recent studies which lament lack of regulations of the use of imaging techniques, especially computer tomography (CT) scans.

This lack of proper regulations has led to several tragic accidents, that is, radiation overdoses. I describe these cases below.

Radiation overdose through CT scan

In October 2009, the New York Times reported two cases in California.

Case 1: This involved the well-known Cedars-Sinai Medical Center in Los Angeles. The hospital reported that it is possible that as many as 206 patients (median age 70 years) who underwent a CT brain perfusion scans were exposed to radiation up to 8 times more than the normal dose. The patients were suspected to have had a stroke and this type of diagnostic procedure can determine the presence of blood flow problems in the brain. Upon discovering the mistake, the hospital immediately alerted the health authorities. The US FDA then in turn alerted other clinics using this type of CT procedure.

Case 2: This case is so tragic because it involved a 2 ½-year-old boy evaluated at Mad River Community Hospital in Arcata. The child was subjected to over an hour of CT scan, a procedure which should normally take a few minutes. The hospital did not report the incident to the health authorities. The most difficult part of such cases is the fact that the damage, which may range from cataract to cancer, will only come out in years or even decades. And this kid still has whole life before him.

According to USCF researchers who evaluated CT scan safety:

“…Our results highlight the need for greater standardization because this is a medical safety issue.”7

Radiotherapy overdose

Radiation is used as therapy for many conditions, including cancer. Unfortunately, overdoses in radiotherapy also happen. Last month, the New York Times published a report about cases of radiation therapy that proved more fatal than the diseases they are supposed to cure.

Case 1: One case was 43-year old Sparks who was treated for tongue cancer. Unfortunately, due to computer error, the linear accelerator blasted high-energy radiation to his brain and neck for 3 consecutive days.

Case 2: In another case, a 32-year old breast cancer patient was subjected to radiation 3 times the prescribe dose – for 27 days. The accelerator used had a missing filter which the operators never noticed. The radiation overdose burned a hole into her chest. The report continued to explain that while the latest in radiation technology helps to diagnose tumors more swiftly and precisely, it has also become so complex that there is a lot of room for error that includes “software flaws, faulty programming, poor safety procedures or inadequate staffing and training.” Furthermore, there is no regulatory agency overseeing the use of medical radiation and there are no guidelines about reporting accidents and medical errors involving radiation. A search of records showed that some hospitals never report radiation-related errors. Some errors go on for months, up to a year being discovered, thus affecting a large number of patients.

Health experts are calling for more regulations about radiation use in medicine whether as a diagnostic or as a therapeutic tool.

To be fair, some hospitals are trying to do the right thing by informing patients of the risks, and reporting errors.

In the case of Cedars Sinai, they reported the cases and admitted that their flawed procedures might be responsible for the overdoses. However, its chief executive, Thomas M. Priselac, said the manufacturer could help to prevent future errors by improving its internal settings and by installing more safeguards.

The Henry Ford Health System issued a statement to inform their patients of potential risks. Furthermore, the recommend patients to ask questions before a CT scan that would include:

Chorioamnionitis, preterm birth, and asthma

February 22, 2010 by  
Filed under ASTHMA

Is asthma predetermined in the womb? The results of a recent study point to this. Chorioamnionitis is an infection of the uterine cavity caused by bacteria. When chorioamnionitis occurs together with premature delivery, which is very likely, the risk for asthma in the infant increases dramatically. And the risk increases even more among in children of certain ethnic groups. African American babies for example, have double the risk than other ethnicities, according to a report in the LA Times.

Let us take a look at some statistics from the report:

  • About 8% of pregnancies are affected by chorioamnionitis.
  • About 14% of American children are afflicted with asthma.
  • About 50% of asthma cases are hereditary.
  • African Americans have 25% higher incidence of asthma compared to other ethnic groups.

The study used data from the Kaiser Permanente Southern California (KPSC) Matched Perinatal records of 510,216 singleton infants born between 1991 and 2007. The aim of the study was to examine the association between chorioamnionitis and childhood asthma based on gestational age at birth and race/ethnicity.

The results indicate that the combination of premature birth and chorioamnionitis greatly determines asthma development as children grow older. African American children have 98% higher risk of developing asthma before age 8 years. In Latin American children, the risk is 70% higher, and it is 66% higher among whites. No increased risk was found in Asian or Pacific Islander children. No increased risk was also found among kids who were born at full term.

About chorioamnionitis:

Maternal chorioamnionitis or simply chorioamnionitis is characterized by inflammation of the chorion and the amnion, the membranes that surround the fetus. Chorioamnionitis usually is associated with a bacterial infection. This may be due to bacteria ascending from the mother’s genital tract into the uterus to infect the membranes and the amniotic fluid (source Medicine.net).

There is indication that a large proportion of preterm births is directly or indirectly linked to some form of infection, including chorioamnionitis. Signs of placental inflammation have been observed in 42% of infants with extremely low birth weight infants.

The incidence of chorioamnionitis is difficult to determine but it is known to be higher in underdeveloped countries than in developed countries. Its occurrence declines as pregnancy advances toward term gestation. It is also estimated that 40 to 60% of all preterm births are associated with some kind of infection, including chorioamnionitis. The risk of chorioamnionitis depends on health conditions and behaviours but also on gestational age and socioeconomic factors such as economic status, and ethnicity.

Heiress of All the Ages: Sex and Sentiment in the Genteel Tradition

February 20, 2010 by  
Filed under HEALTHCARE

DIVpiHeiress of All the Ages/iwas first published in 1959. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions./ppIn a provocative study of American literature, Professor Wasserstrom reappraises the genteel tradition and its place in social and intellectual history. He shows that our image of this tradition has been inadequate, that most of our writers and critics have failed to recognize its profound effects./ppBasing his discussion primarily on a study of the major novelists of the period from 1830 to the present, the author examines the role of women in fiction and defines some of our national attitudes toward love. He discusses especially the world of Henry James (from whose phrase heir of all the ages the title of this book is derived), William Dean Howells, Nathaniel Hawthorne, James Fenimore Cooper, Edith Wharton, and Robert Penn Warren. He also considers such well known novelists of their day as Bret Harte, Edgar Fawcett, Robert Herrick, Henry B. Fuller, Hamlin Garland, and Gertrude Atherton. In addition, his study is based on source material of the period: diaries, recipe books, family magazines, early issues of sociology and psychology journals, and travel books./ppThis book will interest not only students of literature and history but also those in the general field of American civilization and sociologists and psychologists concerned with the relation of American literature to our mores./p/DivDIVWilliam Wasserstron was an assistant professor of English at the University of Rochester and also taught at Adelphi and Swarthmore Colleges. His work has appeared in such magazines as Psychoanalysis, American Quarterly, and Yale Review./divDIVMinnesota Archive Editions uses digital technology to make long-unavailable books once again accessible to scholars, students, researchers, and general read@O€

Heart(y) News, February 19

February 19, 2010 by  

Texas Children’s discharges history-making patient
Sixteen-year-old Francesco “Frank” De Santiago is finally going home from the hospital, thus making history. He was the first pediatric patient to be discharged last October after receiving an implanted mechanical heart pump, or ventricular assist device (VAD). The VAD is a bridging device implanted in patients waiting for a heart donor. Other pediatric patients with VAD have to stay at the hospital until a matching heart donor is found. Frank finally received a donor heart on January 29 after a 9-nine operation

According to Dr. David L.D. Morales, pediatric cardiovascular surgeon at Texas Children’s Heart Center who implanted Frank’s device last May and performed his recent heart transplant.
“Frank’s surgery went extremely well; he was a much better candidate for a heart transplant now than eight months ago when his heart was failing. The device improved his physical health and allowed him be discharged so he could enjoy some normal teen activity during the wait for a donor heart. Texas Children’s is leading the way in using five different types of VAD technology to help pediatric patients enhance their quality of life and outlook so they are better prepared for their transplant surgery.”

Statement of Health and Human Services Secretary Kathleen Sebelius on American Heart Month, February 2010
The American Heart Month is soon coming to an end but the we hope that the lessons learned have long-lasting effects. Here is part of HHS Secretary Kathleen Sebelius’ statement:
American Heart Month is a time to spread awareness of the dangers of heart disease and stroke, and recommit to strengthening prevention, improving treatments, and helping all Americans live longer, healthier lives… This American Heart Month, talk with your doctor about your personal risk for heart disease and the steps to take to lower it.  By encouraging all Americans to adopt a healthy lifestyle, we can reduce the threat of heart disease and become a healthier country.”

NHLBI Funds Preclinical Tests on Devices for Infants and Children with Congenital Heart Defects
Each year, about 1,800 infants in the US die due to congenital heart defects. Many others suffer from heart diseases including heart failure. The US National Heart, Lung, and Blood Institute (NHLBI) has recently awarded four contracts totaling $23.6 million for preclinical testing of devices to help children born with congenital heart defects The program is called Pumps for Kids, Infants, and Neonates (PumpKIN) and is planned for 4 years. The contractors are researchers in University of Pittsburgh, Ension, Inc., University of Maryland, and Jarvik Heart, Inc.

According paediatrician Dr. Susan B. Shurin, NHLBI Acting Director

“This research seeks to develop technologies to expand life-saving options for infants and children born with congenital heart defects or those who develop heart failure. The NHLBI is committed to saving the lives of our youngest patients. Well-designed circulatory support devices are expected to substantially improve the outcomes of the infants and young children who need them as they seek to recover or wait to receive a heart transplant.”

Cancer in the headlines, Feb 19

February 19, 2010 by  
Filed under CANCER

FDA Cancer Drug Approval Rate Highlighted in JNCI
A review in the Journal of the National Cancer Institute gives positive feedback on US FDA’s rate of cancer drug approval. Between July 2005 and end of 2007, the regulatory body Office of Oncology Drug Products approved more than 50 new indications in oncology as well as hematology drugs and biologics. In addition, the review reports:

FDA Approves Rituxan to Treat Chronic Lymphocytic Leukemia
One of the latest approved cancer drug is Rituxan (rituximab), indicated for the treatment of chronic lymphocytic leukemia (CLL). CLL is a slowly progressing cancer of the blood and bone marrow primarily affecting people older than 50. It arises from a group of white blood cells known as B-cells—part of the body’s immune system. About 16,000 people in the US are diagnosed with CLL each year, resulting in 4,400 deaths. Rituxan is indicated for patients for chemotherapy-naive as well as chemotherapy-experienced patients not responding to ongoing therapy. Rituxan is administered in combination with two other chemotherapy drugs, fludarabine and cyclophosphamide.

According to Dr. Richard Pazdur, director of the Office of Oncology Drug Products in the FDA’s Center for Drug Evaluation and Research

“Rituxan is the third drug approved for the treatment of CLL since 2008 and underscores FDA’s commitment to expediting the development and approval of drugs for patients with serious and life-threatening diseases.”

Merck: Studies boost Gardasil for new uses
The HPV vaccine Gardasil is effective against other conditions, according to its manufacturer Merck. Gardasil was initially approved for prevention of cervical cancer in females from age 9 to 26. Last year, it was approved for the prevention of genital warts in males aged 9 to 26. New studies indicate that the vaccine is also effective in preventing cervical cancer and genital warts in older women (up to 45 years) and anal cancer in men. Merck is applying for approval for these new indications.

Wishing you all a relaxing weekend!

Statins and diabetes

February 18, 2010 by  

Some antidiabetes drugs are said to increase risk for cardiovascular disease. Can it also be true the other way around? That is what the JUPITER (short for Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study reported – that some statins may increase the risk for type 2 diabetes. Statins are cholesterol-lowering drugs commonly prescribed for those who are a t risk for cardiovascular events.

A more recent meta-analysis conducted by researchers at the University of Glasgow showed that indeed, statin users may be at risk for developing diabetes mellitus. However, it should be emphasized that the increase in risk is very slight, and doesn’t really outweigh the benefits of statins.

According to study investigator Dr David Preiss

“We found that there was indeed a risk of diabetes, about 9%, but it isn’t a worrying increase as had been suggested by other studies. Then again, it wasn’t a completely flat result. We did see something. Our message would be that people on statins should be those we think are at moderate to high cardiovascular risk in the future. If you look at that group of patients, then what we really want to see come out of the study is a reassuring message, because there is little question that the protective effects in reducing heart attacks, strokes, and so on heavily outweigh this risk of developing diabetes.”

Health experts who were not part of the study are appreciative of how the authors carefully worded their findings so as not to create panic among statin users. They are that the media would the same and be objective about what they report. Statins are the bestsellers of many pharmaceutical firms so it’s no wonder that statin-bashing is a favorite pastime of many.

According to Dr Richard Karas of Tufts Medical Center in Boston who was involved in the meta-analysis study:

“This is another opportunity for the media to really scare the pants off people, and I think their findings are very carefully worded—there is a statistically significant but slight increase in the risk of diabetes. It’s a provocative finding, but it’s also of modest strength because it’s information culled from studies not designed to answer this question.”

Statins are drugs designed to lower LDL-cholesterol, thereby reducing the risk for heart attacks and stroke. The majority of experts agree that the benefits of statins exceed the slight risk of diabetes. Clinicians are advised not to drastically change clinical practice based on these findings alone.

Tick tock goes the male biological clock

February 18, 2010 by  

Tick tock tick tock. As soon we women reach the age of 30, we hear the biological ticking away as we try to hold on to our fertility just for another while. But what about men? Don’t they have a biological clock to listen to?

I mean, look at the following oldies celebrity dads who fathered kids beyond their 60th birthday:

  • David Letterman, at age 61
  • Donald Trump, 62
  • Sylvester Stallone, 62
  • Rod Stewart, 63
  • Michael Douglas, 64
  • Mick Jagger, 65
  • Hugh Hefner, 65
  • Paul McCartney, 66
  • Clint Eastwood 66.
  • Sir Michael John Gambon, 68
  • Woody Allen, 73
  • Charlie Chaplin, 73
  • Larry King, 75
  • Anthony Quinn, 81

Surely for men, age doesn’t matter for fertility.

However, there is increasing evidence that this is not the case, and that men too, should listen to the ticking clock starting at midlife. Researchers report that the sperm quality of men decreases with age, and that fertility starts to wane when they reach the 30s, and plummets when they reach their 40s. During the time, the overall chance of fathering a child drastically decreases. And if a pregnancy is ever achieved, the likelihood of miscarriage is increased. In addition, the resulting offspring would have a higher likelihood to suffer from genetically related disorders such as autism, schizophrenia, autism and low IQ. This is according to a study by researchers at the Eylau Centre for Assisted Reproduction in Paris, France who looked at more than 1,200 couples.

So what’s reason behind the male biological clock?

Researchers think it is due to some kind of “sperm decay” which is characterized by DNA damage and abnormalities. Men start producing sperms at puberty at a rate of 100 million new sperms per day. During the process, DNA is copied and duplication from one sperm to another. During the countless sperm-copying processes, mistakes occur and DNA mutations happen. These errors accumulate with age, leading to decreasing sperm quality.

According to fertility specialist Dr. Carl Herbert

“These subtle copying defects cause a long list of diseases in the children of older fathers. Lesch Nyhan syndrome, polycystic kidney disease and hemophilia A are among the most well known. For fathers over age 40, the risk of having a child with a disease-causing mutation is similar to the risk the mother has for a child with Down syndrome.”

Aside from age, other health factors, including body weight and diabetes, can also adversely affect sperm quality.

According to Dr. Harry Fisch, urologist at Columbia University, and author of the book The Male Biological Clock

“…couples are waiting longer to have children, and advances in reproductive technology are allowing older men and women to consider having children. The lack of appreciation among both medical professionals and the lay public for the reality of a male biological clock makes these trends worrisome.”

He further advises older dads to “have a thorough history and physical examination focused on their sexual and reproductive capacity. Such examination should entail disclosure of any sexual dysfunction and the use of medications, drugs, or lifestyle factors that might impair fertility or sexual response.”

Cure Your Allergies…And Live Your Life

February 17, 2010 by  
Filed under HEALTHCARE

Cure Your Allergies…And Live Your Life

What’s new in pain management

February 17, 2010 by  
Filed under HEALTHCARE

Many of us have to face pain every day, from mild headaches, to debilitating pain of chronic diseases. Today I bring you some news update in pain management.

FDA Approves Morphine Sulfate Oral Solution for Relief of Acute and Chronic Pain
The US FDA approved last month an oral form of morphine for the management of moderate to severe, acute and chronic pain in patients who are opioid-tolerant.  This pain management strategy has already been commonly used in the past even prior to the approval. In order to minimize the risk for abuse, misuse, and overdose, the US FDA decided to work the manufacturers, patient organizations and prescribers to better regulate the product and ensure its quality, as part of the so-called unapproved drugs initiative.
“An important goal of the unapproved drugs initiative is to make sure that marketed drugs meet current FDA standards,” said Douglas Throckmorton, M.D., deputy director for the FDA’s Center for Drug Evaluation and Research. “Our action today reflects a careful balance between ensuring patient access to necessary medicines, while making sure companies comply with the law.”

Botulinum toxin injection may help prevent some types of migraine pain
Botox is not just for taking the wrinkles away. It may also be able to ease the headaches away, according to researchers. A study reports that the botulinum toxin is associated with reduced frequency of migraines, the kind called ocular headaches, described as “crushing, vice like or eye-popping” pain.
“These preliminary data are intriguing, and our results provide support for the hypothesis that patients with migraine that is characterized by imploding and ocular headaches are more responsive to botulinum toxin type A than those with migraine characterized by exploding headaches. Our findings invite consideration of using botulinum toxin type A injections to prevent migraine headaches and may promote the role of the dermatologist in the treatment of patients with migraine. However, well-controlled trials need to be conducted to confirm these findings.”

Anesthetic approach stops pain without affecting motor function
Anesthetics work by inducing a nerve block that eliminates sensation of pain. However, a long-lasting never block adversely affects motor functioning. Researchers at Children’s Hospital Boston are testing a substance that might potentially be the ideal anesthetic that stops the pain without affecting motor function. So far, the substance has shown promise in rats. Anesthetics without motor function effect can be very useful, for example, ”a  local anesthetic for childbirth that would block pain without interfering with the mother’s ability to push, or for musculoskeletal disorders in which it is important to maintain mobility.”

Taking the pain out of injections
Finally, there is the pain that comes with injections. The jab pain may not be that painful for adults but can be traumatic for children. If needle pain and fear are not properly managed, it can turn into a phobia that will track through to adulthood, and well, present some health care problems in the future. Get here some tips on how to take the “ouch” out of children’s injections.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.