Drug news, 30 October

October 30, 2010 by  
Filed under HEALTHCARE

New drugs, old drugs, tainted drugs, approved and disapprove drugs. Check out drug news round up this weekend.

FDA approves combination contraceptive containing a folate
A new contraceptive has been approved by the FDA in the American market. Beyaz, in tablet form, is a combi contraceptive containing estrogen/progestin that also contains a folate (levomefolate calcium 0.451 mg). Beyaz is indicated for:

Obesity drug lorcaserin rejected by FDA
On the other hand, the anti-obesity drug lorcaserin has been turned down by the US drug regulatory body. The FDA is demanding more data on the drug’s efficacy and safety. One preclinical study in rats also cause concern as it showed an increase in breast tumors. How this observation compares to the drug’s effects in humans needs to be clarified before the drug can be approved.

Aspirin paradox investigated in TIMI database
Does aspiring prevent or increase the risk for cardiac events? The role of aspirin in the management of acute coronary syndrome (ACS) was further investigated in order the clarify the so-called “aspirin paradox” which “despite the proven benefits of aspirin in the primary prevention, secondary prevention, and treatment of ACS, some studies have suggested that those already on aspirin before suffering an ACS have worse outcomes than those not having taken aspirin before the event.”

Data from the Thrombolysis in Myocardial Infarction (TIMI) trials were used with results showing that bad outcomes may present in 5% of cases, probably due to aspiring resistance.

GlaxoSmithKline settles bad drug case for $750M
Some more bad news for the British pharmaceutical company GlaxoSmithKline. It recently agreed to settle at a price of $750 million allegations related to the manufacture and marketing of contaminated drugs produce in their plant in Puerto Rico. The said plant violated good manufacturing practices, resulting in adulterated drugs, including Bactroban, Kytril and Paxil. Part of the settlement will go to a whistle blower, the company’s former global quality assurance manager who reported the violations to the US FDA. The manager repeated warned GSK of the violations but was fired instead.


Heart(y) news: clinical trial updates, Oct 29

October 29, 2010 by  
Filed under HEART AND STROKE

No firm conclusions about HDL cholesterol can be drawn from JUPITER sub-analysis
The JUPITER trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) investigated the efficacy of the anti-cholesterol drug rosuvastatin in preventing cardiovascular disease. Based on the JUPITER results, a paper has been published that claims that “a normal, healthy individual has level of low density lipoprotein (LDL), known as “bad cholesterol”, substantially lowered with a potent statin, then the level of HDL “good cholesterol” in that person no longer bears any relation to the remaining cardiovascular risk.”
However, the European Society of Cardiology (ESC) has expressed concerns about the paper’s claims and interpretations that might be easily misinterpreted as raising HDL levels having no beneficial cardiovascular effects.

RENEW: Intense diet/exercise improves weight, CV risk factors, in severely obese
More and more clinical trials on lifestyle-based interventions are being conducted. One such trial is the Re-Energize with Nutrition, Exercise and Weight Loss (RENEW) which studied the effect of intensive lifestyle interventions in the extremely obese. The results were very encouraging and will be discussed in detail in another post.

NIH blood pressure trial expands to include more older adults
The Systolic Blood Pressure Intervention Trial (SPRINT) trial is enrolling more elderly adults, e.g. an additional 1,750 study participants aged above 75. The trial is investigating how blood pressure range in is related to cardiovascular and kidney diseases, age-related cognitive decline, and dementia. According to Dr. Susan B. Shurin:

No large-scale clinical trial has examined the impact of aggressively lowering systolic blood pressure among older adults. The SPRINT study and the senior expansion address four of the 10 common causes of death and disability in adults over 75 years: heart disease, stroke, kidney failure, and dementia. The addition of these participants promises to provide useful scientific and public health information on a large and growing segment of the population.”

FDA stopped enrolment in TIDE trial
The enrolment for Thiazolidinedione Intervention with Vitamin D Evaluation (TIDE) trial which compared the cardiovascular effects of long-term treatment with rosiglitazone vs. pioglitazone was stopped in July by the US FDA in connection with safety issues regarding rosiglitazone (Avandia). After postmarketing data review, European drug authorities suspended rosiglitazone from the EU market. In the US, Avandia remains but increased warnings.

Liraglutide in nondiabetics: Weight and BP improve at two years in extension trial
Finally, a drug-based trial with encouraging results. The diabetes drug liraglutide (Victoza) seems to be also effective as a weight loss drug in non-diabetic patients. Furthermore, it is helps in blood pressure control. However, liraglutide still has to overcome the hurdle of strict regulations on cardiovascular safety so that it doesn’t go the way of sibutramine.


How to have a happy and healthy Halloween

October 28, 2010 by  
Filed under HEALTHCARE

Halloween is just around the corner. That is why I’ve brought you today a round-up of what I feel are useful tips for a healthy and safe Halloween.

Halloween candy: Facts and myths
There are fears that Halloween treats poisoned but this is highly unlikely, according to experts. Instead, what we should be scared off are the calories, the sugars and the transfats. Health and nutrition experts at the University of North Carolina explain the facts and myths about Halloween candies, covering the following claims:

Check it out so you will know “how to tell truth from fiction as you stay safe and well on Halloween.”

Trick-or-treaters’ Halloween candy often picked off by parents
How’s these for Halloween statistics:

With these figures in mind, health experts are hoping the everyone – adults and children alike – will be practicing moderation this coming Sunday.

For healthy pumpkin, squash the urge to turn it into pie
Last week, I baked a pumpkin pie for the first time for my family and they didn’t like it. Pumpkin pie as Americans know it – sweet and full of calories – is not something to be easily found in Europe. Because pumpkins are seldom eaten here sweet. We do eat lots of pumpkin soup as well as pureed pumpkin. But never tried nor heard of pumpkin pudding or pumpkin doughnuts before. This article in USA Today gives a couple of alternative, low-fat, low-calorie recipes for pumpkins.

Tips to Green Your Halloween
The Environmental Working Group (EWG) gives us some tips on how to celebrate Halloween safely and toxic-free.
In particular, EWG warns consumers about the potentially harmful products in face paints, hairsprays and costumes. It gives recommendation on more natural alternatives in terms of make ups, treats, decorations and food.

Halloween the Healthy Way
The Centers for Disease Control and Prevention (CDC) is also sharing with us special Halloween tips with the following take home message: “Don’t be tricked this Halloween. Make better lifestyle choices to keep you and your family safe and healthy.” For this purpose, CDC has Halloween health e-cards for you to use and share – in English and in Spanish. Check them out!


“Look Now: Facing Breast Cancer”: a photographic tribute to breast cancer survivors

October 28, 2010 by  
Filed under CANCER

What better way to end Pink October than to pay tribute to breast cancer survivors? Sycaruse University launched exactly such an event onWednesday, Oct 27. “Look Now: Facing Breast Cancer” is a photographic project that will feature a series of portraits of women who have faced, fought, and triumphed over the monster that is breast cancer. It aims “to bring awareness of the emotional and physical aspects of breast cancer.”

In our society, looks are very important. For women with breast cancer,  the loss of breasts and hair, physical attributes which make women attractive, is a big blow. This is what the artist will focus on.

Most projects on breast cancer survivorship focus on celebrities. The portraits that artist Angelika Rinnhofer created  and is planning to create would not be of the rich and famous but ordinary women like you and me. This week’s launch started with portraits of 3 central New Yorkers. The project will last for a year as the artist continues to create more portraits of more survivors of different ages, ethnicity and levels of surgery. The target is to have 20 to 25 double portraits, one with the survivor clothed, the other with the survivor nude in the upper torso.

One of the survivors already photographed is Goenka who stated:

“Breast cancer is a disease that sucks you in, chews you up and spits you out. Some women lose their breasts. Most lose their hair. And many lose their lives. But all those who survive lose their sense of themselves and never really feel whole again. I know this because I am a breast cancer survivor myself.”

Each portrait will tell a different story, yet with a common theme. Despite the uniqueness of each case, the portraits will depict the survivors “as vibrant and empowered” and despite undergoing surgery that might have led to loss of 1 or both breasts, are “still whole.”

Says the artist:

“Every case of breast cancer is a unique story that doesn’t just begin with the diagnosis and end with surgery or chemotherapy.”

What the project aims to do:

The project will culminate in an exhibition in Pink October 2011. A documentary film about the project is also being planned.


Expat Life and Alcohol

October 27, 2010 by  
Filed under ADDICTION

Being an expat and a trailing spouse is tough. I am one. That is why I fully understood what this woman has gone/is going through. And I admire her bravery for sharing her story…Thanks, B!

To all Recovering Moms in Switzerland, this is for you.

I love red wine.  The way it looks, smells, and tastes.  I love the way it brings people together with smiles, toasts, and pleasant wishes.  Alcohol….a source of celebration and happiness for many. Not for me.  Alcohol brings me physical pain (in the form of hangovers or unforced self-injuries),  guilt (from drinking again after vowing to stop), and shame (from having done or said something I regretted while drunk).  I also feel shame because I want to stop but can’t.  

I have chosen to remain anonymous because I am not yet ready to tell the world about my horrible and dangerous disease and we all know how small Switzerland is. I have only recently shared this with my immediate family and the only reason I did was because I had reached the point of either getting help or dying.  My daughters are still young so dying is not an option. They deserve better than this.  I did not bring them into this world to leave them motherless in a few years because of alcohol abuse.  I wanted to speak up because I know there are many of you out there who are in the same boat as I and are afraid to reach out and get help. If you think you have a problem you need to know that you are not alone.  There are many of “us” out there.   I didn’t have a problem back in college or graduate school. I partied like everyone else did, I didn’t drink everyday (nor alone), and I excelled academically.  Drinking was a social thing for me.  My problems came later on when life got more serious and settled (when I married and became a mother).  

I love being a mom.  My kids are my reason for living.  I would do anything for them!  Unfortunately I started to drown in my home life.  Laundry, cooking, cleaning, diaper changing, driving….there was no escape from my housekeeping duties.  Life wasn’t perfect with my husband either at times and that didn’t help. Being a SAHM (stay at home mom) or dad can be very isolating and lonely. My drinking problem started a few years ago when I would have a drink or two on some evenings (usually red wine).  I especially loved doing this while I prepared dinner.  Nothing wrong with that right?  I deserved it!  A small token after doing so much during the day and being stressed out with the kids and all of the activities I had to deal with.     As time progressed so did my drinking.  I went from one to two glasses a couple of nights during the week to several nights per week.  My alcohol intake advanced as well. One/two glasses were not enough anymore.  I reached the point (this year) where I’d end up guzzling a whole bottle and hiding the evidence from my husband deep down in the garbage bag.  My social drinking also changed: I’d continue drinking at home alone (behind my husband’s back) after we would return from a restaurant or party.  Something else I started doing? I’d chug a glass of wine while no one was watching and drink a new glass pretending to be one of them.  Yes…I would pretend to be a responsible and controlled drinker.  
A couple of years ago I started to wonder if I had a drinking problem.  Naah!  If I had a problem somebody would have pointed it out already right?  I thought: “I’m responsible. I take care of my kids and pay our bills.  I make playdates and medical appointments on time.  I’m doing my job!  I also don’t look like an alcoholic. My face isn’t red and puffy and I’m not living out of a box under a bridge, dressed up in rags. I don’t have the “shakes” or need a drink first thing in the morning.  How can I be an alcoholic?”     Oh! How I fooled myself into thinking I was normal through all of these thoughts and rationalizations!  The truth came loud and clear a few weeks ago when I got very drunk at a birthday party. I don’t remember much about the night (just little bits and pieces).  Apparently I lost it and went crazy when we arrived home. I made my girls cry that night because I had threatened to leave Switzerland (I said I would go away and never come back).  My husband had to get away from me so he left the house. My daughters started to call daddy on the phone because they thought he was going to leave them too.    After a couple of hours I ended up passing out on the couch and waking up at 2am.  I knew I had done something very bad.  I didn’t remember anything specific but I had the flashback of my girls crying big fat tears and my heart sank.  I was not able to go back to sleep and was extremely anxious the rest of the early morning.  That is when I said “enough is enough”. I knew I didn’t want to keep doing this anymore. I knew I was slowly killing myself and needed help.  So I made the decision to tell my husband about my secret drinking life and problem. I had no choice. I had wanted to do this before but I was afraid because to say the words “I am an alcoholic” is a very scary thing.  I was terrified but it was “do” or “die”.  I decided to choose life and get better for me and my family.

I am very lucky to be where I am right now.  Alcoholism is a progressive disease and it can turn bad and ugly very quickly.  The lucky ones get help before they lose their job, spouse, family or cause a major tragedy (like Diane Schuler, the mother who killed eight people including herself and four children on a NY parkway in July).  I am very blessed to still have my life and the people I love in it.
I have been sober for a few weeks now and am seeing things more clearly than ever. I urge any parent (mom or dad) who is struggling with alcohol abuse to talk to someone and reach out for help. You are not alone!   If you would like to meet other moms going through the same struggles with alcohol abuse (or if you think you might have a problem and would like to explore it further) please join our
Recovering Moms in Switzerland” online group:   health.groups.yahoo.com/group/recovering_moms_Switzerland/     (you can join anonymously if you wish)


When Giants Walked the Earth; A Biography of Led Zeppelin

October 27, 2010 by  
Filed under HEALTHCARE

Veteran rock journalist Mick Wall unflinchingly tells the story of the band that pushed the envelope on both creativity and excess, even by rock ‘n’ roll standards. Led Zeppelin was the last great band of the 1960s and the first great band of the 1970s-and When Giants Walked the Earth is the full, enthralling story of Zep from the inside, written by a former associate of both Jimmy Page and Robert Plant. Rich and revealing, it bores into not only the disaster, addiction and death that haunted the band but also into the real relationship between Page and Plant, including how it was influenced by Page’s interest in the occult. Comprehensive and yet intimately detailed, When Giants Walked the Earth literally gets into the principals’ heads to bring to life both an unforgettable band and an unrepeatable slice of rock history.


Canada’s Heart & Stroke Foundation sends wake up call to the badly sleeping youth

October 27, 2010 by  
Filed under HEART AND STROKE

Canada’s foremost heart organization Heart and Stroke Foundation (HSF)  has issued a warning to the nation’s adolescents – your lifestyle threatens you with premature heart disease and stroke. HSF researcher Dr. Brian McCrindle cites poor sleep hygiene as the main risk factor.

“Sleep disorders in kids are on the increase. They are marching hand in hand with other increasing cardiovascular risk factors such as overweight and obesity, lack of physical activity, a poor diet, and high levels of unhealthy cholesterol.”

According Dr. McCrindle, disordered sleep in terms of duration, quality, and pattern is associated with increased body mass index (BMI), with subsequent increased risk for obesity and cholesterol levels. These findings are based on a survey of more than 1600 Canadian 9th graders aged 14 to 16. 22% of the young respondents admitted to having bad sleep patterns. 14% admitted they had problems staying awake at daytime 1 to 2 times a week and 5% even admits to having the similar episodes more than 3 times a week. The problems seem to be serious enough to induce 17% of these children to take sleep medications which may be prescription or over-the-counter.

Aside from the survey, the study participants also underwent evaluations for blood pressure, total blood cholesterol, and waist circumference measurement. Data analysis showed that poor sleeping habits are associated higher levels of blood pressure, BMI and other poor health conditions.

So what causes sleep disorders in these children? Studies have showed a link between poor sleep hygiene and physical inactivity and poor eating habits. Dr. McCrindle explains:

“It is a perfect example of harmful synergy at work. It’s like the chicken and egg conundrum: lack of physical activity and poor food choices negatively affect quality of sleep – and on the other hand, lack of sleep can lead to being too tired to exercise and not taking the time to eat properly.”

Health experts are constantly warning adults about the perils of an unhealthy lifestyle. However, findings of recent studies that lifestyle change interventions should already start at childhood. HSF believes that by educating children on health and health risks, these problems may be prevented in adulthood. HSF spokesperson Dr. Beth Abramson appeals to parents and schools to help. Here’s how:

  • School: “One of the best ways to ensure kids get their 90 minutes of daily physical activity is a school environment which supports and promotes physical activity.”
  • Parents: Parents should serve as role models. Their lifestyle reflects on their children’s lifestyle.

Unfortunately, this problem is not unique to Canadian youths but is widespread in most developed countries. Thus, the warning should not only be to young Canadians but to all of us!


Breast Cancer Action Group launches Think Before You Pink blog

October 26, 2010 by  
Filed under CANCER

Pink October is coming to an end but the struggle against breast cancer goes on. The Breast Cancer Action (BCA) Group is one of the strongest group the cause and it recently launched the Think Before You Pink blog.

BCA is the first group to crack down on pinkwashing defined as:

“…sponsoring companies positioning themselves as leaders in the effort to eradicate breast cancer while engaging in practices that may contribute to rising rates of the disease.”

Can you imagine that BCA even took on the joint campaign “Buckets for the Cure” of Kentucky Fried Chicken (KFC) the breast cancer giant Susan Komen for the Cure. After all, KFC is not exactly the healthiest fare we should go for if we want to stop breast cancer.  According to BCA:

Considering that high-fat fast foods lead to obesity, and obesity is a known risk factor for all cancers, not only breast cancer, this is an especially tasteless campaign.”

BCA was also able to help convince Yoplait to go rBGH-free. rBGH is a growth hormone used in cows to enhance milk production. It is also suspected to cause cancer and other health conditions. Its latest campaign is to try to convince rBGH manufacturer Eli Lilly

The Think Before You Pink blog is specifically designed to inform consumers about companies who use the pink color and breast cancer to attract attention and market their products. I mean, some even contribute part of their sales to breast cancer research. However, BCA thinks it is not right to accept financial support from corporate sponsors whose products and services actually promote rather than fight breast cancer.

Here are some other examples of pink washing companies and campaigns:

  • Simple Green, whose cleaning products that carry the pink ribbon logo may actually contain carcinogens.
  • Lay’s, Frito’s, Cheeto’s, and chips etc. says “Together we can help beat breast cancer.” Definitely not by eating these products, right?
  • Cosmetic giant Estee Lauder is a big player in the breast cancer campaign but its products are not necessarily pink and may contain  potentially carcinogenic ingredients.

With the new blog, BCA aims to reach more people about pinkwashing. Battling Cancer is fully supporting BCA and its efforts in fighting pinkwashing.

So next time you think pink, remember these BCA mantras:

  • Action speaks louder than pink.
  • Think before you buy pink.

Hospitalizations for drug abuse is increasing among the elderly

October 26, 2010 by  
Filed under ADDICTION

Grandpa sniffing coke? Grandma gulping down cough syrup? Sounds ridiculous but it cna be true.

Drug abuse is not restricted only to the young. While young people are getting more and more into prescription drug abuse (see previous post on National Medicine Abuse Awareness Month), many of the older generation are still hooked on illicit drugs and trying out OTC drug abuse at the same time. In fact, a recent report by the Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ) shows that rate of hospitalization for drug-related conditions among Americans aged 45 years old and older is increasing.  The report cited three main types of drug-related conditions that led to hospitalizations in this age group:

But it is not only the middle-aged who are abusing substances. Even senior citizens above 65– our grandpas and grandmas- are also involved

The study revealed the following statistics:

The trend found by the AHRQ study was disturbing because it is assumed that adolescents who abuse drugs mature and outgrow the need to try to new and exciting things. And as they grow, they also become wiser and more sensible. Yet, the age distribution of drug abusers seems to be changing, with a tendency to increase with increasing age. The reasons  for this are not fully understood and need to be addressed by more studies.

It is, however, important to inform people that drug abuse is dangerous and can kill. AHRQ describes the most common drug-related conditions:

  • Drug-induced delirium or dementia can be caused by sleeping pills as well as drugs for urinary incontinence, nausea and other problems common in the elderly, but doctors sometimes cannot identify the cause.
  • Poisoning by pain medicines or other drugs containing codeine, meperidine or other opiates can be caused by accidental overdosing or the failure to recognize the drug’s active ingredient.

Has your baby been screened for hearing impairment?

October 25, 2010 by  
Filed under HEARING

Hearing impairment is something that is not easily discernible in adults, much more in babies and little children. Studies have shown that even the slightest hearing impairment can translate to behavioural and learning difficulties in children. Those who suffer from more serious hearing problems can face a lifetime of speech and language deficits, poor academic performance and social and psychological problems. This is because even though the child can hear, he or she is missing some details of what is going on the environment, but cannot understand what is going on. It is thus important that children be screened early in life for hearing problems.

Hearing impairments may be congenital or acquired. Thus, screening for hearing loss should start early, in fact, right after the delivery of the baby. This means that a baby is screened before it leaves the hospital or the maternity clinic.

The two most commonly used hearing screening procedures for babies are (source: American Speech-Language Hearing Association (ASLHA):

The initial result of the screening is “pass” or “fail”. Those who pass are considered free from hearing impairment till the next screening. Those who fail require an intensive evaluation by an expert such as an audiologist or an ear specialist. They will be closely monitored for progression of the impairment plus other auditory-related effects.

In the clinical report of the American Academy of Pediatrics (AAP) entitle “Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening”:

“… researchers have developed an algorithm to assist pediatricians determine the course of treatment when a hearing screening indicates hearing loss in children from infants to 18 years of age. Confirmed abnormal hearing test results require ongoing evaluation and intervention by a team of specialists including an audiologist, otolaryngologist, speech-language pathologists and teachers. At least one-third of children with hearing loss will also have a coexisting condition, so they should continue to be monitored for developmental and behavioral disorders and referred for additional evaluation when necessary.”


The why’s and must have’s of mountain hiking

October 25, 2010 by  
Filed under HEART AND STROKE

We like to go hiking as family – two adults and two 7-year old boys – but we are not unique. On our walks and hikes, we often meet other families, sometimes with kids younger than ours. In our last walk, for example, we encountered a couple with 4 kids all under the age of 6. The two eldest had to walk while the parents had to carry 1 kid each, the daddy carrying a toddler on a back carrier, the mommy a baby in a front kangaroo carrier. Periodically, the dad had to carry another child on his shoulders. Tough, but they seem to have it all under control and actually enjoying it. This scene of large families going walking or hiking is quite common in Switzerland. I must admit that the set-up is quite conducive to families.

WHY HIKE?

So why do Swiss people like to go hiking, even with their families?

It’s cheap. Hiking is the cheapest way to spend a day with the family. You can pack some sandwiches and have a picnic somewhere. Or you can carry you sausages and barbecue along the way. In many hiking trails are designated barbecue facilities complete with toilets and running water!

Many starting points are accessible by public transport. We usually go to the mountains with the train where all kids under 12 traveling with parents are practically free (except for an annual ticket of $20 per child, cheaper from the 3rd child on). Add to that a special train compartment for families complete with mini-jungle gym, slide and drawing corner. Now, who would prefer to squeeze into an automobile and drive somewhere?

It’s healthy. In a previous post, I expounded on the health benefits of walking and hiking. In short, these physical activities are good for the heart, the bones and muscles and the brain. Now, add to that the fresh air up there. We’ve been to several Swiss villages which are car-free, e.g. all cars should be parked down the valley, while the village itself is only accessible by cable cars or cogwheel trains. The only mode of transport up there is electric cars and buses. What an exhilarating and liberating experience to stay in a place which is almost traffic-free.

It’s beautiful. There is nothing more majestic than a landscape surrounded by mountain peaks. In one of our hikes earlier this month, we stood on point where we could see the mountains of 6 different countries: Switzerland, Germany, Austria, France, Lichtenstein, and Italy. In another place, we saw the very spring in the watershed that feeds all three major European river systems: the Rhine, the Danube, and the Rhone. These are unbeatable experiences.

But walking or hiking needs some preparations and precautions and over the years, I have learned a lot of things by experience which I’d like to share with you.

WHAT TO WEAR

Proper footwear. Footwear which is sturdy yet comfortable is a must for everybody including the kids. They need not be expensive but they should fit the season and the weather conditions.

Clothes. Clothes should be customized to the time of the year and the altitude. Not too warm or not too cold. One should not overestimate the temperatures in higher altitudes. It may be sunny up there but it is not necessarily that warm because of the winds. Take into account the wind chill factor. A windbreaker or rain jacket should always be on stand-by in case needed. Weather conditions can change drastically in the mountains.

WHAT TO BRING

Water. Drink plenty of fluids. Dehydration is dangerous!

Finger foods. Little tidbits are needed to boost your energy and those of your little ones. My favorites are granola or fruity snack bars, dried fruits such as bananas or apples or raisins, and nuts. These are small and light enough to fit in the pockets – and they are also healthy.

Band aids. Blisters can appear out of nowhere. Once, one of my boys got blisters from a well-worn shoes that were probably getting too small. Luckily I had band aids ready that got him through the hike. A small first aid kit can be very useful. I have a very compact one which I filled, in addition to band aids, a small tube of sunscreen, a small phial of hand disinfectant, a small pack of tissues, and my son’s inhaler.

Sun protection. The sun up there is bright and strong up there. Sunglasses, sun caps, and sunscreens are needed to protect you from the strong UV solar rays.

Phone. In cases of emergency, a phone is invaluable.

Plus: don’t forget to bring a smile and lots of enthusiasm – in case the going gets tough.


Understanding Arthritis Chart

October 24, 2010 by  
Filed under HEALTHCARE

Understanding Arthritis Chart


Heart(y) News, October 22: drugs for and against the heart

October 23, 2010 by  
Filed under HEART AND STROKE

A new drug that is good for the heart…

FDA approves dabigatran for stroke prevention, embolism, in AF patients
Good news for the German pharma Boehringer Ingelheim. The US FDA has recently approved its antithrombin dabigatran, marketed as Pradaxa for the US market. Pradaxa is indicated for the prevention of stroke and systemic embolism in patients with atrial fibrillation. The approval comes with a guide that details the risk of serious bleeding as side effect. Other side effects include gastrointestinal symptoms, dyspepsia, stomach pain, nausea, heartburn, and bloating.

Existing drugs that might be bad for the heart…

Abbott Laboratories agrees to withdraw its obesity drug Meridia
Abbott Laboratories is voluntarily withdrawing its obesity drug Meridia (sibutramine) from the U.S. market due to safety issues. This is following a request from the US FDA following a review of data from a clinical trial data that indicated an increased risk for heart attack and stroke.

According to Dr. John Jenkins, director of the Office of New Drugs in the FDA’s Center for Drug Evaluation and Research (CDER):

“Meridia’s continued availability is not justified when you compare the very modest weight loss that people achieve on this drug to their risk of heart attack or stroke. Physicians are advised to stop prescribing Meridia to their patients and patients should stop taking this medication. Patients should talk to their health care provider about alternative weight loss and weight loss maintenance programs.”

Invirase (saquinavir): Label Change – Risk of Abnormal Heart Rhythm
Safety warning on the antiviral drug Invirase (saquinavir): risk for arrhythmia (abnormal heart rhythms) due to changes in the electrical activity of the heart when used with Norvir (ritonavir), another antiviral medication. Both drugs are used to treat HIV infection. The warning has been added to the label of Invirase.

FDA: Include warnings on risk for class of prostate cancer drugs
Safety issues are also facing gonadotropin-releasing hormone (GnRH) agonists, a class of drugs primarily used to treat men with prostate cancer. Warnings are added to the labels concerning potential risk of heart disease and diabetes for those taking these medications. GnRH agonists are marketed in the US under the following brand names: Eligard, Lupron, Synarel, Trelstar, Vantas, Viadur, and Zoladex but are also available in generic form.


Breast Cancer In Pets

October 22, 2010 by  
Filed under CANCER

While everyone is sporting pink ribbons this month in honor of breast cancer awareness, many people don’t realize that important member of our families can also suffer from the disease. Our pets. Mammary gland tumors are common in dogs and cats, especially those that aren’t spayed or were spayed late in age.

Owners can reduce the chance of breast cancer in their pets to nearly zero by simply having them spayed before the first heat.

Mammary exams and early detection are key for them just as they are for humans.

The fact sheet below details how mammary cancer effects dogs and cats in different ways, compliments of PurinaCare Insurance Services Inc.

BREAST CANCER IN PETS FACT SHEET

Many people don’t realize that pets can also suffer from breast cancer. Mammary gland tumors are common in dogs and cats, especially those that aren’t spayed or were spayed late in age.

Mammary exams for pets are important and early detection is key. Once your dog or cat is five years old, perform a mammary exam monthly. Gently feel the tissue under and around each nipple, “rolling” the tissue between your fingers. If you feel even a tiny lump, bring your pet to the veterinarian.

Dogs:

• 25% (1 in 4) of un-spayed female dogs will get mammary cancer
• Most common in older female dogs
• Less than 50 percent of canine mammary tumors are malignant
• Spaying a dog before their first heat will reduce the chance of breast cancer to almost zero.
• Most “at-risk” breeds: poodle, Brittany spaniel, English setter, pointer, fox terrier, cocker spaniel, Boston terrier
• Diagnosis: affected area will be red, swollen, feverish, and painful to the touch
• Early detection/prompt treatment can successfully treat even serious tumors. Look for small, firm pea-sized lumps in the breast tissue.
• Surgical removal is the first treatment method and chemo is sometimes a secondary treatment, depending on the severity of the tumor

Cats:

• Less common in cats than dogs, 1/4000 will have mammary cancer
• Early spaying is the best prevention and also if a cat has had kittens they’re less likely to get it
• Around 90 percent of feline mammary tumors are malignant
• Siamese cats and cats over the age of 10 are the most prone to mammary cancer
• Diagnosis: affected area will be painful to the touch, swollen, infected, and the cat may have a fever
• Surgical removal of the tumor and aggressive chemo is the recommended treatment, however mammary cancer is usually fatal in cats

THE MOST IMPORTANT PREVENTION MEASURE A PET OWNER CAN TAKE:

Spaying before the first heat can reduce the chance of breast cancer to nearly zero. That simple decision can save a pet’s life.

About PurinaCare Insurance Services Inc.

PurinaCare Insurance Services Inc., a wholly-owned subsidiary of Nestlé Purina PetCare Company, is dedicated to providing pet owners with a Lifetime of Care® for their dogs and cats. PurinaCare® pet health insurance is offered to dog and cat owners in all 50 states and the District of Columbia. PurinaCare is committed to promoting responsible pet care, providing humane education, supporting community pet involvement, and fostering the positive bond between people and their pets. PurinaCare pet health insurance is underwritten by Central States Indemnity Co. of Omaha, a subsidiary of Berkshire Hathaway Inc. PurinaCare pet health insurance is also offered as a direct benefit to select employees and associations nationwide and its high-deductible policies have earned the AAHA Seal of Acceptance. For more information about PurinaCare pet health insurance, call 877-8-PURINA or visit www.purinacare.com


Medical innovations, October 22

October 22, 2010 by  
Filed under HEALTHCARE, HEART AND STROKE

Bionic legs, long-lasting artificial hearts, and gene X-rays. These are just some of the latest medical innovations we are bringing you this week.

Italian Man Surpasses 1,000 Days of Support with an Artificial Heart
A 54-year-old man was the first in Italy to receive SynCardia’s Total Artificial Heart while waiting for a matching donor. He was also the first to surpass 1000 days on the device while enjoying a normal life at home. He walks 10 km and works out at home for 30 minutes each day. The artificial heart is powered by a The Freedom™ portable driver approved for commercial use in Europe and but is still undergoing an FDA-approved Investigational Device Exemption (IDE) clinical study in the U.S.

Bionic Legs Allow Paraplegics to Get Up and Walk
Initially based on military technology, eLEGS is now geared for consumers. The bionic legs were developed by Berkeley Bionics and can help paraplegic get rid of their wheel chairs and walk.

eLEGS is the latest in a line of “human augmentation robotics systems” that Berkeley Bionics has created with the Robotics and Human Engineering Laboratory at the University of California, Berkeley. It was based on another system called HULC, for the Human Universal Load Carrier, a robotics system licensed to Lockheed Martin that was made for the military to help soldiers carry heavy packs across extreme terrain without risking injury.

The eLEGS device consists of a backpack that holds the battery, and metal leg casings that are secured around a person’s clothed body with velcro straps. A mixture of sensors and robotics creates a natural-seeming gait that can speed up to an excess of 2 miles per hour.

An X-ray for your genes
Researchers at the Tel Aviv University’s Sackler Faculty of Medicine is taking a big step towards personalized medicine. Using a deep sequencer, a machine that reads the human genome and its expression, doctors can more or less predict how a patient reacts to medications. Somewhat like an “X-ray for our genes”, the method enables researchers to look “at how the genetic expression of small regulatory genes, called microRNAs, affects the way a patient reacts to medication. This could mean fewer deaths from adverse drug effects and novel and safe uses for existing medications. “

Long-lasting mechanical heart implanted for the first time in Canada in heart-failure patient
A 61-year old woman was the first in Canada to receive the ventricular assist device (LVAD) for advanced heart failure. The device is called DuraHeart and “is designed for long-term cardiac support and reduces the risk of complications including strokes, infection and device failure – all of which can happen in mechanical heart devices. The device’s central pump is powered by magnetic levitation technology, which means its moving parts are held in place with magnets instead of bearings, eliminating wear and tear on the device. This technology enables blood to flow through the pump smoothly, which extends the life of the device and the life of the patient.”


Water and Vegetable Diet in Consumption, Scrofula, Cancer, Asthma, and Other Chronic Diseases

October 21, 2010 by  
Filed under HEALTHCARE

Water and Vegetable Diet in Consumption, Scrofula, Cancer, Asthma, and Other Chronic Diseases


Healthcare Payment Systems: An Introduction

October 21, 2010 by  
Filed under HEALTHCARE

Healthcare Payment Systems: An Introduction


Male breast cancer: risks and perceptions of family members

October 21, 2010 by  
Filed under CANCER

In another tribute to Breast Cancer Awareness Month, we tackle a type of breast cancer that is rare but equally dangerous – male breast cancer.

Men do get breast cancer, too. Male breast cancer may be rare but having a male relative diagnosed with breast cancer may present similaror even higher chances of developing the disease than having a female relative with breast cancer. Yet, perceptions and behavior of family member of cancer patients based on the gender of the diagnosed family member vary a lot. This is a according to a study by researchers at Multidisciplinary Breast Care Program at the James Graham Brown Cancer Center.

Typically, people with male relatives with breast cancer perceive their risk to be higher than those whose familial history of breast cancer is restricted to females. This is in most cases right. Yet, despite this perception, these people are less likely to take action to find out more about their genetic predisposition such as seek genetic counseling or undergo genetic testing.

The study results were based on data from “2,429 individuals with a first-degree relative – a parent, sibling or child – with breast cancer. The data were separated into two groups – those with a first-degree male relative with breast cancer, and those with a first-degree female relative with breast cancer. Data about perceived risk of inheriting genetic disease, genetic counseling and genetic testing were collected and compared between the two groups.”

The actual figures found by the study comparing the 2 groups (male relative vs. female relative) are as follows:

  • Perception of risk of developing breast cancer:  more than 60% vs. 46%
  • Awareness of genetic testing for breast cancer gene mutations: 38.4% vs. more than 50%
  • Discussion about genetic risk with health care provider: none vs. 13%

This discrepancy between risk perception and actual action may be due to many factors, such as:

  • Breast cancer in males is rather rare, accounting for only about 1% of all cases of breast cancer.
  • People are not well-informed about breast cancer genetic testing.
  • Doctors may fail to ask the right questions that would make patients reveal significant information.

The study authors wrote:

“Our findings speak to a real communication issue in health care. Patients need to be made aware of the risk posed by having one or more first-degree relatives who have had breast cancer, and physicians need to be meticulous in taking family histories and discussing risk with the patients they see.”
Patients need to be educated about their risks and what to look for, and on the flip side, doctors need to be sure they are taking complete family histories and referring patients for genetic evaluation if any red flags are raised.”


October is Dental Hygiene Month in the US

October 21, 2010 by  
Filed under HEALTHCARE, HEART AND STROKE

I am not one of those who are scared of dentists. In fact, I was more scared of the cost. You see, unlike in many European countries, dental care, even the most basic, is not covered by health insurance in Switzerland where I now live.

Thus, since we moved to Switzerland 4 years ago, I had my dental services done in Asia when every time I visit my family there. Asia, in fact, is very popular among “medical tourists” in terms of dental care.

Then a couple of weeks ago, I had pain in my teeth and gums that barely allowed me to eat. I hoped that the pain will go away but after 2 weeks on pain and discomfort, I finally decided to visit the dentist.

Now, let me tell you, dental care in Switzerland is the most expensive in the world. But it is also arguably the best in the world.

So I went to the dentist and I was told that the problem is not my teeth – no holes or caries anywhere – but my gums. Specifically the tartar or calculus that accumulated under my gums caused the problem.

MedicineNet defines tartar as:

“… is the hardened product of longstanding plaque accumulating minerals from the saliva and foods. Plaque is the soft accumulation of food debris and bacteria around teeth. These bacteria feed on left over food in the mouth to excrete toxins that irritate the gums and dissolve the bone. Plaque can be removed by proper brushing and flossing at home. Tartar can become as hard as a rock and then can require a dentist or dental hygienist with special tools to remove it. Dental plaque and tartar cause inflammation of the bone surrounding the teeth referred to as “periodontia.”

So what I had was gingivitis, inflammation or infection of the gums. And I am not careful, it can progress to periodontitis when the infection spreads from the gums to the ligaments and bone that support the teeth.

So I did a bit of research into the topic, well-timed since it is Dental Hygiene Month in the US.

And here are some reasons why we should take dental hygiene seriously:

  • Periodontitis can cause tooth loss, especially among adults.
  • Periodontitis increase the risk for heart disease and other serious health problems.

According to Mayo Clinic experts:

“…bacteria may travel to the arteries in your heart. There, they can trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.”

Tartar may  accumulate on the tooth crown (supra-gingival) and on the root of the tooth under the gums (sub-gingival calculus). Mine were most the latter, which is the most difficult to remove.

So how is tartar removed?

Treatment options are:

A non surgical approach is when access to the root surfaces is via the sulci or periodontal pockets.

A surgical approach is when full thickness tissue flaps are reflected to expose the root surfaces and gain direct access to them.

The efficacy of subgingival plaque and calculus removal utilizing a non surgical approach is limited. Pockets up to 5mm may be adequately debrided using a closed approach, but deeper pockets often will require an open or surgical approach.

I am scheduled next week for a periodontal debridement.

And I have learned my lesson: don’t go for cheap dental hygiene options.


Is there such a thing as the ideal diabetic diet?

October 20, 2010 by  
Filed under DIABETES

Scientific evidence is piling up showing that lifestyle interventions, especially dietary interventions, may be more effective than drugs when it comes to the management of certain chronic diseases. This is especially true in the case of diabetes. The only problem is, which diet?

Unfortunately, experts cannot agree as to which diet is best for those with diabetes. This is the day and age of food customized to individual dietary requirements. Let us take a look at what is out there:

The Atkins diet

So what is the Atkins diet i? It is basically a low-carbohydrate diet which supposedly makes you lose weight without making you hungry. WebMD describes how it works:

“By restricting carbohydrates drastically to a mere fraction of that found in the typical American diet, the body goes into a state of ketosis, which means it burns its own fat for fuel. A person in ketosis is getting energy from ketones, little carbon fragments that are the fuel created by the breakdown of fat stores. When the body is in ketosis, you tend to feel less hungry, and thus you’re likely to eat less than you might otherwise. However, ketosis can also cause a variety of unpleasant effects (such as unusual breath odor and constipation) in a small number of people…As a result, your body changes from a carbohydrate-burning engine into a fat-burning engine. So instead of relying on the carbohydrate-rich items you might typically consume for energy, and leaving your fat stores just where they were before (alas, the hips, belly, and thunder thighs are popular fat-gathering spots), your fat stores become a primary energy source. The purported result: weight loss.

Although originally thought out for weight loss, Dr Eric C Westman of Duke University in Durham, NC advocates the Atkins diet for the management of diabetes based on his talk at the European Association for the Study of Diabetes (EASD) conference last month. After all, “years before medications were available to treat diabetes, a low-carbohydrate diet was used as the primary treatment of diabetes mellitus.

Westman is a co-author of the latest book on Atkins diet “New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great.”and is a consultant at Atkins Nutritionals.

Some of the experts’ comments on the Atkins diet are:

According to Dr Robert Eckel of the University of Colorado School of Medicine, Denver, also a spokesperson on nutritional issues for the American Heart Association (AHA):

“It’s a terrible diet to be on; 24% of the calories are from saturated fats. I would never prescribe an Atkins diet to a person with type 1 or type 2 diabetes.”

Other experts, however, believe that the Atkins diet may be “too restrictive for people to stay on long term and potentially unsafe” for diabetics.

The South Beach diet

The South Beach diet is very similar to Atkins but is less restrictive because it allows “good carbs.” South Beach, too, doesn’t let you go hungry.

Again, we rely on WebMD experts to give us an overview on the South Beach diet.

Fats. The South Beach Diet bans unhealthy fats but strongly promotes healthy ones.

Carbs. The South Beach Diet doesn’t count grams of carbs. The Atkins diet seeks to change a person from a sugar-burning machine into a fat-burning machine. The South Beach diet looks at how much sugar is in a carb. Low-sugar carbs — those with a low glycemic index (they don’t cause the blood sugar levels to rise and fall as quickly) — are good (this point may sound very familiar to fans of the Sugar Busters diet).”

Of course there are other diets out there but these two are currently in the limelight in connection with diabetes.

The American Diabetes Assocition (ADA) currently does not recommend the Atkins-type diet for diabetics. In fact, ADA spokesperson Stephanie A Dunbar, director of nutrition and medical affairs for the AD thinks it is at this point difficult to make dietary recommendations for people with diabetes because “there are no long-term data comparing the different diets in diabetes management… I don’t think there is one particular diet that is going to work for every person. Our real recommendation for people with diabetes is that they need to have an individualized approach to meal planning, whether they need to go to 35%, 40%, or 45% of calories from carbohydrates, that needs to be individualized.”

This is the day and age of food customized to individual dietary requirements. So when do we get the ideal diabetic diet?

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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.