Food Bill Aims to Improve Safety

Data from the CDC indicates that 1 in 6 Americans catch some kid of food-borne disease each year. Approximately 48 million people are affected according to the FDA, resulting in hospitalization and death. This is why the US Food Safety Modernization Act (FSMA) which was signed by US President Obama in early January was welcomed by health authorities. “The Food Safety Modernization Act (FSMA) gives FDA a mandate to pursue a system that is based on science and addresses hazards from farm to table, putting greater emphasis on preventing food-borne illness.” One the provisions of FSMA is the requirement of companies to develop and implement a written food safety plan.

Message from the FDA Commissioner on FSMA

According to US FDA Commissioner Margaret Hamburg:

“The legislation significantly enhances FDA’s ability to oversee the millions of food products coming into the United States from other countries each year. Among the improvements is the requirement that importers verify the safety of food from their suppliers and the authority for the FDA to block foods from facilities or countries that refuse our inspection. FDA will also be working more closely with foreign governments and increasing its inspection of foreign food facilities. FDA’s new import tool kit will have a huge impact on food safety given that an estimated 15 percent of the U.S. food supply is imported, including 50 percent of fresh fruits, 20 percent of fresh vegetables and 80 percent of seafood.”

USDA and HHS Announce New Dietary Guidelines to Help Americans Make Healthier Food Choices and Confront Obesity Epidemic

The US Department of Health and Human Services (HHS) and Department of Agriculture announced the release of the 2010 Dietary Guidelines for Americans at the end of last month. The new guidelines give evidence-based nutritional recommendations “to promote health, reduce the risk of chronic diseases, and reduce the prevalence of overweight and obesity through improved nutrition and physical activity.” The guidelines include 23 Key Recommendations for everyone and 6 additional Key Recommendations for those with special needs. Some of these are:

• Enjoy your food, but eat less.
• Avoid oversized portions.
• Make half your plate fruits and vegetables.
• Switch to fat-free or low-fat (1%) milk.
• Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.
• Drink water instead of sugary drinks.

New Nutrition Standards in School Food Programs Proposed

Last week, the Obama administration proposed major changes to the Nutrition Standards in the National School Lunch and School Breakfast Programs. The new standards would be faithful to the recommendations of the 2010 Dietary Guidelines.
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Some bad news…

Breast Implants: FDA Review Indicates Possible Association With A Rare Cancer
Women who had breast implants have a small but still measurable increased risk for developing anaplastic large cell lymphoma (ALCL), a rare type of blood cancer, according to a recent announcement the US FDA. Women who had implants, even if they have no symptoms, should schedule follow-ups with their doctors. Women who are considering having implants should talk it over with their doctors to weigh the risks and benefits.

According to the Breast Cancer Action group (BCA), it has “long advocated that the FDA stop approving products for the marketplace before we fully understand their potential impact on human health. The fact that the risk was only revealed through postmarketing data, after the implants have been approved and implanted drives home the point of BCA.

Diabetes/Cardiovascular Risk with Prostate Cancer Drugs
The FDA has ordered an update of the labelling of gonadotropin-releasing hormone (GnRH) agonists, drugs used in the treatment of prostate cancer The new label should warn about “an increased risk of diabetes and certain cardiovascular diseases.”  GnRH agents are available in the market under the following brand and generic names:

• Lupron (leuprolide acetate)
• Zoladex (goserelin acetate)
• Trelstar (triptorelin pamoate)
• Viadur (leuprolide acetate)
• Eligard (leuprolide acetate).

Some good news…

New Drug Shows Promise Against Triple-Negative Breast Cancer
Iniparib is an experimental drug currently being tested in a Phase III clinical trial. The drug shows promise in treating triple-negative breast cancer which is an aggressive form of breast cancer. Data from a small Phase II trial showed that iniparib treatment can shrink tumors and prolong life. “Triple-negative breast cancer is difficult to treat because its tumor cells lack certain receptors that some common breast cancer treatments, such as tamoxifen and trastuzumab (Herceptin), target.”

No Increased Cancer Risk Seen in Stem Cell, Marrow Donors
Does donation of stem cell and bone marrow present a risk for the donors? A recent study should reassure people that this is not the case. A study collected data spanning “55,228 observation-years of health data on 12,559 donors of bone-marrow and/or peripheral blood stem cells (PBSC)” and looked especially at the incidence of common as well as rare cancers. The results found no evidence of increased risk associated with donation thereby indicating that bone marrow or PBSC donation are safe for donors.
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Some news updates on diabetes

The bad news

France: Diabetes Drug May Be Linked to 500 Deaths
The diabetes and weight—loss drug benflourex (Mediator) has been linked to about 500 deaths in France. The drug which has been in use since 1976 may have caused heart valve problems. Patients who were taking the drug are advised to get their valves checked.  “The European Medicines Agency pulled [the drug] from the market in 2009‚ saying it had little effect on diabetes and could lead to a thickening of the heart valves.”

AHA: Gene Therapy Fails to Prevent Limb Loss
An international Phase III trial investigating an angiogenic therapy that could prevent limb loss in patients with limb ischemia failed to demonstrate its efficacy. This is a big disappointment to healthcare professionals and patients alike. Critical limb ischemia is a common complication of diabetes, and can lead to gangrene of the extremities that necessitate amputation. “In the last three decades in the U.S., amputation rates for patients with critical limb ischemia have not changed, signaling the need to develop novel strategies for these patients.”

The good news

Italy Carries Out First Hi-Tech Pancreas Transplant
Italian doctors performed the first robotically assisted transplant of the pancreas. The patient was a 43-year old type 1 diabetes woman who already had a kidney transplant. Conventional pancreatic transplant is very invasive. This revolutionary operation took 3 hours and was minimally invasive, performed through three small holes and a seven-centimeter incision. The operation was performed with the assistance of the Da Vinci SHDI robot. According to Dr. Ugo Boggi, head of the surgical team:

“This will put an end to the decades-old dilemma of whether it’s possible to do pancreatic transplants because the operation is so invasive when done in the traditional way.”

Smart Phone “APP” Helps Doctors Control Patients’ Diabetes
Doctors and other health professionals can have access to the new Johns Hopkins guide to diabetes on their iPhone, blackberry, and other smart phones. The POC-IT Diabetes Guide is easy to use and would help doctors especially during patient visits, to make clinical decisions. According to Dr. Rita Rastogi Kalyani, an assistant professor of medicine in the Division of Endocrinology at the Johns Hopkins University School of Medicine and the guide’s managing editor:

 “It offers almost instant, at-a-glance access to the latest consensus guidelines and expert opinions on a broad spectrum of topics in diabetes care. Hopkins’ mission is to share its knowledge with the world and this is a practical way to do that.”

Upcoming diabetes events:

Annual International Conference on Endocrinology, Diabetes, Metabolism-Research and Therapy
Dates: December 13-14, 2010 Venue: Santa Clara, California, USA

 Diabetes and Obesity Drug Discovery & Therapy, 3rd International Conference on Drug Discovery and Therapy, February 7 – 10, 2011, Dubai, UAE.

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.

Today, I am bringing you the latest research updates on drugs for obesity. Unfortunately, it is not all good news.

New research finds no evidence that popular slimming supplements facilitate weight loss
German researchers who evaluated the effectiveness of a broad selection of popular slimming supplements arrived at the disappointing conclusion that none of them helps with losing weight any more than placebo. They presented their results at the International Congress on Obesity in Stockholm, Sweden last month.

According to study leader Dr. Thomas Ellrott, head of the Institute for Nutrition and Psychology at the University of Göttingen Medical School, Germany:

“There are scores of slimming supplements out there claiming weight-loss effects through all sorts of mechanisms of action. We have so-called fat magnets, mobilizers and dissolvers, as well as appetite tamers, metabolism boosters, carb blockers and so on. The market for these is huge, but unlike for regulated drugs, effectiveness does not have to be proven for these to be sold. Few of these supplements have been submitted to clinical trials and the landscape of products is always changing, so we need to put them through rigorous scientific evaluation to determine whether they have any benefit.”

Anti-obesity drugs unlikely to provide lasting benefit according to scientists
Even clinically tested drugs prescribed for obesity cannot provide long-lasting benefits for those with weight problems, according to British scientists. These drugs “fail to provide lasting benefits for health and wellbeing because they tackle the biological consequences of obesity, and not the important psychological causes of overconsumption and weight gain.”

Rise in weight-loss drugs prescribed to combat childhood obesity
The number of young people prescribed anti-obesity drugs has increased 15-fold since 1999, according to a 2009 report. Most of these drugs have not been approved for use in patients under 18, yet are commonly prescribed “off-licence”, according to a British study. Most of these young people, however, stop taking the medications before effects can be measured.

According to study author Dr. Russel Viner of General and Adolescent Paediatrics Unit at University College London:

‘It’s possible that the drugs are being given inappropriately, or that they have excessive side effects that make young people discontinue their use. On the other hand they could be expecting the drugs to deliver a miracle ‘quick fix’ and stop using them when sudden, rapid weight loss does not occur.”

Experimental obesity drug avoids brain effects that troubled predecessors
On a more positive note, Danish researchers report about a promising new obesity drug that seems to have less psychological effects. The anti-obesity drug rimonabant was withdrawn from the market due to strong psychiatric effects that may have been linked to suicide. The new drug is a CB1 receptor blocker like rimonabant but of the second generation and was designed to target peripheral tissues only and thus does not affect the brain. So far, the drug has only been tested in animals but the results show a lot of promise.

Isn’t it annoying when one gets sick or catches a bug while on vacation? Check out some examples below.

WHO Recommendations for the Post-pandemic Period
Travelers need not be too concerned anymore about the pandemic H1N1 swine flu although the threat is not yet over. The World Health Organization (WHO) has declared this week that the H1N1 pandemic is over although the H1N1 (2009) virus is expected to continue to circulate as a seasonal virus for some years to come. We are now in the so-called post-pandemic period, for which WHO issued guidance on “recommended activities during the post-pandemic period, including advice on epidemiological and virological monitoring, vaccination, and the clinical management of cases.”
As of August 1, 2010, more than 18,449 laboratory confirmed deaths in more 214 countries and overseas territories or communities have been attributed to the pandemic influenza H1N1 2009.

Don’t bring home malaria
Vacations in tropical countries are great but health experts warn about bringing home the wring souvenirs such as tropical diseases. There is the well-publicized case of British pop star Cheryl Cole who caught the tropical disease in Tanzania. Malaria is common in many parts of Asia and Africa. According to Dr. David Townes of the University of Washington: “It is important to consider not only destination, but specific itinerary, type of travel, activities, and accommodations.”
Check out the traveller’s tips of the Centers for Disease Control and Prevention (CDC) on malaria and other tropical diseases.

A hep shot
Hepatitis diseases are infections of the liver. There are many types of hepatitis. Perhaps the most common and easily contracted, yet the easiest to prevent and treat is hepatitis A. Travellers are especially at risk of catching this viral infection due to contaminated food and drinks. The hepatitis A vaccine has been available since the mid-1990s and can be given starting at 12 months of age but should be renewed periodically. According to Trudy Murphy of the CDC:

“The vaccine is also recommended for people who are most at risk of having the infection, including travelers and people who have liver disease or clotting disorders.”

Kids and ruptured appendixes
Friends of ours had to cut short their summer vacation when their daughter had appendicitis. Fortunately, it wasn’t ruptured. Although people may take appendicitis for granted, a ruptured appendix can be dangerous, as it can lead to life-threatening sepsis. Apparently, children are more likely to have ruptured appendixes than adults, and African-American, followed by Hispanic children are more susceptible than white children, according to researchers at the Agency for Healthcare Research and Quality (AHRQ). There are other factors involved aside from ethnicity, says AHRQ researcher Karen Ho:

“Poverty also plays a role. Children living in poor communities were 26 percent more likely to be hospitalized for this condition than those living in higher-income communities.”

Hydrogels, dissolvable patches, and imaging techniques: today I bring you the latest medical innovations.

Gel targets prostate cancer
Japanese researchers at Kyoto University have developed a supramolecular hydrogel capsule that can seek out and recognize out prostate cancer cells and releases its contents directly into the diseased cells. “The mechanically tough hydrogel made using a glycolipid mimic forms a stable capsule in both aqueous and cellular media. PSA is small enough to diffuse into the hydrogel where it cleaves a prostate cancer targeting compound and a fluorescent biomarker that is co-assembled in the hydrogel, allowing imaging of both PSA activity and prostate cancer cells.”
The hydrogel could help provide a more accurate way of detecting prostate cancer.

Researchers develop a dissolvable needle-free Nanopatch for vaccine delivery
University of Queensland researchers has developed a vaccine delivery method that is not only needle-free and pain-free method but also now dissolvable. This new innovation called Nanopatch totally eliminates the need of needle-stick injury. The use of needles presents risks not only to patients but also to health care workers in the form of injuries, infections, and transmission of infectious diseases. Here is how Nanopatch works:

“The Nanopatch is smaller than a postage stamp and is packed with thousands of tiny projections – invisible to the human eye – now dried to include the vaccine itself together with biocompatible excipients.
When the patch is placed against the skin, these projections push through the outer skin layer and deliver the biomolecules to the target cells.
When dry, the device is stable and strong. When the Nanopatch is applied to the skin, the projections immediately become wet, dissolving within minutes.”

The sound of melanoma can help doctors find cancer (w/ Video)
Can we hear the sound of cancer? American researchers at the University of Missouri said they can. Using photoacoustics or a laser-induced ultrasound, they locate the general area of the lymph node where melanoma cells could have spread, thus enabling them to identify the stage of melanoma with more accuracy. Lead researcher Dr. John Viator describes how it works:

“It’s very similar to identifying a prize inside a cake. Instead of looking through the entire cake, we can use our ultrasound to pinpoint a slice or two that might contain the ‘prize.’ In the case of the lymph nodes, when you get a signal, this alerts the pathologist that this is an area of the node that might contain cancer cells. At that point, a pathologist would be able to narrow down the search, saving time and money.”

New Microscope Lets Scientists Make Movies of Early Animal Development
A new microscopic imaging method is enabling scientists to closely follow the development of embryos while inside an animal, say from cell 0 to 20,000 – in video! The potential use of this technology in medicine is enormous. According to researcher Dr. Philipp Keller:
“It is really amazing to have a tool that captures the development of an entire animal with single cell resolution. This finally allows us to study, and hopefully eventually understand, this complex biological system on a truly quantitative level.”

The obesity epidemic knows no boundaries as shown in the news updates below.

Obesity in America
Nearly 90 percent of American adults will be overweight or obese by 2030, according to the Agency for Healthcare Research and Quality (AHRQ). More about this is presented in a series of radio podcasts as part of AHRQ’s public service news Healthcare 411:

• Rising Health Care Costs Related to Obesity
• Staying Healthy: Losing Weight
• Obesity – Prevention and Treatment

Mexico to ban junk food from schools to fight fat
Mexico is another country struggling with rising obesity rates. The battle against obesity is currently being fought in the schoolyard where traditional Mexican treats are being scrutinized for nutritional value. Some of the banned foodstuffs are:

• salted tamarind candy
• pork rinds
• atole (the thick and sweet cornstarch-based beverage served piping hot in the morning)
• tortas (overstuffed, greasy, meat-packed sandwiches)

These drastic measures are justified since according to Mexican President Felipe Calderon “Unfortunately, we are the country with the biggest problem of childhood obesity in the entire world.”

States requiring PE, but amount varies
More and more American states are making physical education (PE) obligatory in elementary, middle and high schools. However, the guidelines seem to have too many loopholes in terms of quantity and timing of PE.

A report released Tuesday by the American Heart Association and the National Association for Sport and Physical Education said exercise for schoolchildren is also threatened by a rising number of waivers and exemptions from PE in school districts around the country.
Nancy Brown, CEO of the heart association, said the group is pleased that more states are requiring physical education but is also concerned that the requirements don’t have more teeth.

Scottish people ‘living dangerously’
By dangerous living here is not meant risk-taking behaviors like performing dangerous sports or engaging in violent crime. The study is referring to the fact that almost the entire Scottish population (97.5%) has multiple behavioral risk factors for cardiovascular disease and other chronic conditions. [They] are likely to be either cigarette smokers, heavy drinkers, physically inactive, overweight or have a poor diet.

Genetic basis for health benefits of the ‘Mediterranean diet’
Does Mediterranean diet really help in reducing weight and keeping your heart healthy? Researchers report that phenolic compounds found virgin olive oil repress genes that are pro-inflammatory. Once these genes are repressed, the immune system cells shift to a “less deleterious inflammatory profile.” The researchers report that:

“These findings strengthen the relationship between inflammation, obesity and diet and provide evidence at the most basic level of healthy effects derived from virgin olive oil consumption in humans. It will be interesting to evaluate whether particular phenolic compounds carry these effects, or if they are the consequence of a synergic effect of the total phenolic fraction”.

Today I am bringing you the latest research updates on diabetes: how cancer, loss weight and environmental factors are linked to diabetes

Increased cancer risk of people with type 2 diabetes
What do cancer and diabetes have in common? Researchers report that people with type 2 diabetes mellitus (T2DM) have an increased risk for certain types of cancer. The study looked at 125,126 Swedish patients with T2DM and the incidence of cancer in this group of patients. The results indicate that patients with T2DM have increased risk for developing 24 types of cancer. These patients have double the risk for cancers of kidneys, thyroid, esophagus, small intestine and nervous system, and 4.5 times the risk for cancers of the liver cell and the pancreas compared to the general population. However, the risk for prostate cancer is much lower. The increased rates cannot be attributed to early detection of cancer as a result of close and routine monitoring of T2DM patients compared to the general population. The mechanisms linking the two diseases are not so clear. Two possibilities are: 1) they have the same risk factors 2) T2DM causes “processes in the body which promote the onset or growth of cancer.”

New study finds attending Weight Watchers meetings helps reduce the risk for type 2 diabetes
Weight loss programs such as Weight Watchers are beneficial for those with pre-diabetes and help reduce the risk of developing full-blown T2DM. Researchers report that those who participated in such program have, after 6 months, lost some weight but also improved glycemic parameters such as fasting blood glucose and insulin levels. There are many such programs out there but Weight Watchers are the best-known and most popular. The program includes education on a lower calorie diet (a food plan), exercise (an activity plan) and weekly group support sessions. Success is especially evident among those who attend the most sessions. According to study author Dr. Kathleen Melanson:

“We know that previous research programs have successfully reduced diabetes risk using intensive lifestyle treatment. But what we didn’t know is that a program that costs appreciably much less than specially-designed diabetes prevention programs would have a profound impact on the same risk factors for type 2 diabetes. These findings could have important public health potential.”

New associations between diabetes, environmental factors found by novel Stanford analytic technique
Finally, Stanford researchers report new evidence that indicates a link between environmental factors and diabetes. Diabetes has been linked to genetic and lifestyle risk factors but this latest report says that environmental factors should also be taken into consideration. Whereas environmental factors have been closely linked to diseases such as cancer and asthma, very few studies have demonstrated this in the case of diabetes. Some of the environmental cues for diabetes are exposure to pesticides and other organic compounds as well as consumption of a certain type of vitamin E called gamma-tocopherol.

April 7 is World Health Day!

We’ll keep you posted of events planned for that day in the upcoming posts. In the meantime, here is your heart(y) news for this weekend. Apologies for the delay!

Controversial ezetimibe trial’s completion expected in June 2013
IMPROVE-IT is short for Improved Reduction of Outcomes: Vytorin Efficacy International Trial, which is a study testing the rather controversial anti-cholesterol drug Vytorin (ezetimibe). IMPROVE-IT is testing the efficacy and safety of ezetimibe as add-on to statin therapy and is expected to be finished in June 2013. An estimated 18,000 patients are expected to be enrolled in the trial by June 2010.

Boston Scientific Recall Under Investigation
The medical device manufacturer Boston Scientific is being investigated by the US Department of Justice and the Securities and Exchange Commission (SEC) in connection with the recent recall of implantable cardioverter defibrillators (ICDs), according to the Wall Street Journal. The ICD recall was initiated in March when it was discovered that manufacturing changes implemented haven’t been approved by regulators.

UK NICE reverses decision on dronedarone for AF
The National Institute for Clinical Excellence (NICE) in the UK decide to give dronedarone (Multaq) a go in the treatment of atrial fibrillation. A new draft guidance issued end of March “recommends limited use of the drug as a second-line treatment in patients with additional cardiovascular risk factors whose AF has not been controlled by first-line therapy (usually including beta blockers).” An earlier guidance did not recommend Multaq’s use of atrial fibrillation. The change is due to the fact that although NICE is not convinced that Multaq is more effective than other antiarrhythmic drugs, it has fewer long-term side effects that can impact quality of life.

Top 10 Choirs of the Most Powerful Voices Competition Selected
As part of the American Stroke Association’s Power to End  Stroke campaign, this online singing competition is aimed to educate people about stroke. You have the chance to cast your vote and choose your favorite out of the top 10 until April 6. The winning choirs will perform at the Power Awards Show in New York City on May 7. The association hosts the annual event to honor people who increase stroke awareness among African Americans. In addition, one of the two choirs will be chosen by EMI Gospel as a grand prize winner and will receive a professional coaching session from a national EMI Gospel artist.

Cleveland Clinic Health Chats

April 5: Reduce Your Risk Factors for Cardiovascular Disease with Dr. David Frid

April 13: Percutaneous Treatments for Valve Disease with Dr. Murat Tuzcu

April 21: Stress, Depression, and Heart Disease with Dr. Leopoldo Pozuelo

Photo credit: stock.xchng

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.”

Go Red Today
Don’t forget to wear something red today. Today, Friday, February 5 is National Wear Red Day in the US. And while at it, check out The Heart Truth Campaign and events for the American Heart Month.

AHRQ and American College of Cardiology Collaborate on Study of Implantable Cardioverter Defibrillators
The Agency for Healthcare Research and Quality (AHRQ) and the American College of Cardiology (ACC) will work together with the National Heart, Lung, and Blood Institute to study the long-term benefits and risks of implantable cardioverter defibrillators (ICDs) in patients at risk for ventricular fibrillation.
According to AHRQ Director Dr. Carolyn M. Clancy

“This study will provide critically important data from the real world of everyday medicine to inform discussions about the long-term benefits of ICD use. This study is an excellent example of how government and the private sector can work together to advance research and improve the quality and safety of health care services.”

HHS Secretary and Surgeon General Join First Lady to Announce Plans to Combat Overweight and Obesity and Support Healthy Choices
Three powerful ladies lead the fight against obesity. First Lady Michelle Obama, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and U.S. Surgeon General Regina Benjamin announced last week the plans to launch a major campaign against childhood obesity in the US. The First Lady says:

“The surge in obesity in this country is nothing short of a public health crisis that is threatening our children, our families, and our future. In fact, the health consequences are so severe that medical experts have warned that our children could be on track to live shorter lives than their parents.  The paper released today is an incredibly important step in directing the Nation’s attention to solving the obesity epidemic and we do not have a moment to waste.”

Panel to FDA: Nebivolol shouldn’t be approved for chronic heart failure
An FDA advisory panel recommends against the approval of nebivolol for the treatment of heart failure. Nebivolol has been approved for hypertension and its manufacturers have applied for extending the drug’s indication to chronic heart failure in the US. The panel’s vote against the approval was unanimous. The drug’s supporters pointed out that nebivolol is already approved for heart failure treatment in more than 70 countries. The US panel, however, was not fully convinced by the data presented to support the application.

New software provides 3-D views of arteries in catheterization lab
A new technology is being tested that would allow doctor to view 3-dimensional images of the heart arteries during a cardiac catheterization procedure. According to study investigator Dr. John D. Carroll

“Coronary interventions may be improved by having a realistic, 3-D image of the coronary artery tree… This [the study] is the first in-human use. The next step is to test it in multiple centers around the world. In addition, we’ll formally test it to see the impact on clinical care. The bottom line is that this is very exciting technology that holds great promise.”

Photo credit: stock.xchng

A multidisciplinary approach to multiple sclerosis is necessary to preserve and even improve the overall quality of life of multiple sclerosis patients. This is the message of a recent review at Medscape.

Multiple sclerosis (MS), a chronic heterogeneous disease with variable course, often imposes a substantial burden on the community, family, and individual, with notable negative effects on patient function and quality-of-life.

Multiple sclerosis causes pain, physical impairment and disability but the effects even go deeper  down to psychosocial and neuropsychological problems. Thus, traditional approaches that address only the physical impairment is not effective in improving the quality of life of the patients. Here are some ways to help improve the quality life of multiple sclerosis patients, ways which go beyond standard care:

Fatigue. Fatigue is part of the daily life of an MS patient. It may be caused by the disease itself but may also be due to sleeping problems. There pharmacological approaches to managing insomnia but there are also non-pharmacological approaches such as:

• Regular exercise
• Energy conservation strategies
• Lifestyle modification

Depression. Many patients with MS suffer from depressive symptoms, which can also be linked to fatigue and insomnia. Pharmacologic  therapy using  anti-depressants is possible. Examples of nonpharmacologic approaches are cognitive-behavior therapy and group psychotherapy. However, physical therapy and exercise are also known to reduce depressive symptoms. A combination of pharmacologic and nonpharmacologic therapy may also be beneficial.

Cognitive dysfunction. Loss of memory and disorientation are some of the cognitive effects of MS. There are no approved drugs for the treatment of cognitive dysfunction associated with MS. However, there are a lot of nonpharmacologic interventions including

• cognitive rehabilitation
• counseling
• education
• lifestyle changes
• compensation strategies ,e.g. taking notes, making lists, and improved organization

Bladder and bowel dysfunction. Bladder problems, even incontinence are common about MS patients. So are diarrhea and constipation. Drugs are most commonly used to manage these symptoms but proper diet and a regular daily bowel output routine may also be helpful.

Pain. The pain that MS patients suffer from may or may be due to MS, or may be an effect of MS treatment. Pain is also linked to lack of sleep and fatigue. Medications to manage pain and spasms are usually prescribed.

Finally, MS patients need a strong support group or network, family and friends who will always be there for them.

Photo credit: stock.xchng

Researchers find human protein that prevents H1N1 influenza infection
A light at the end of the flu tunnel? Researchers at the Howard Hughes Medical Institute may just have found a way to prevent H1N1 flu infection. They identified a naturally occurring human protein that blocks the replication of the H1N1 flu virus. But it doesn’t even stop there. The same protein also blocks other disease-causing viruses, including the deadly West Nile virus and the dengue fever virus. The protein is a member of the Inducible Transmembrane (IFITM) protein family.

The unexpected discovery could lead to the development of more effective antiviral drugs, including prophylactic drugs that could be used to slow influenza transmission.

1 dose of H1N1 vaccine may provide sufficient protection for infants and children
Here’s another piece of good news. One dose of the vaccine may actually be enough for protecting infants and very young children from the H1N1 flu, according to a recent study by Australian researchers at the University of Melbourne. The current guidelines of the Advisory Committee on Immunization Practices require two doses of the vaccine for children under 9 years old.

The authors state:

“Our findings suggest that a single dose 15-microgram dose vaccine regimen may be effective and well tolerated in children, and may have positive implications for disease protection and reduced transmission of pandemic H1N1 in the wider population.”

2/3 of Australians unlikely to get vaccinated against swine flu
However, it’s not all good news from down under. Skepticism about the H1N1 flu vaccine has spread to the southern hemisphere. According to Research Australia, a survey revealed that about 65% of the population are unlikely to get vaccinated against the swine flu in the coming year. This unwillingness to get vaccinated among Australians is causing concerns among health officials who are bracing for a major outbreak in the coming winter months. Even among people with high risk profile, the rate of vaccination is rather low.

The poll found that, in terms of people at higher risk, only 33 per cent with asthma or lung disease, 45 per cent with diabetes, 28 per cent with reduced immunity, and 40 per cent with heart disease had been vaccinated.

FDA Approves High Dose Seasonal Influenza Vaccine for People Ages 65 and Older
It’s not only the H1N1 flu that’s causing frenzy in the pharma industry. The US FDA approved last week the high dose seasonal flu vaccine called Fluzone High-Dose. The shot is an inactivated influenza virus vaccine indicated for people ages 65 years and older to prevent disease caused by influenza virus subtypes A and B.

It’s been a while since I brought you some news updates from the flu front. Here’s one just before the end of the year.

Voluntary Non-Safety-Related Recall of Specific Lots of Nasal Spray Vaccine for 2009 H1N1 Influenza
There has been a voluntary recall of specific lots of the nasal spray vaccine for H1N1. However, the CDC emphasizes that teh recall has nothing to do with unwanted side effect but is part of a routine quality assurance checks, especially for stability and shelf-life.

A pre-Christmas round up of health care news for you…

HHS Announces $27 Million from Recovery Act to Help Older Americans Fight Chronic Disease
The US Department of Health and Human Services (HHS) is allocating $27 million to help the elderly improve their health, thereby reducing health care costs. The funds are made possible through the American Recovery and Reinvestment Act.

According to HHS Secretary Kathleen Sebelius

“This program is about getting money to communities to help seniors manage chronic conditions that threaten their ability to remain in their own homes. Through HHS’ national aging-services network which reaches into nearly every community in America, we are helping people living with chronic conditions and others better manage their own health,”

FDA Expands Presence Outside U.S. with Opening of Mexico City Post
The US FDA has recently opened a post in Mexico City. This is to facilitate cooperation with the body’s regulatory partners overseas, a move that is important in ensuring food and medical product safety in the US. According to FDA Commissioner Dr. Margaret A. Hamburg

“The opening of this office represents an important step as we re-design our product safety strategy. We, like our partners in the Mexican Government, realize that prevention is the key. For example, more than a third of the fresh fruits and vegetables we eat come from Mexico as do a large amount of our medical devices. Having FDA experts located permanently there will be mutually beneficial to both our countries and respective citizens.

US National Survey Tracks Rates of Common Mental Disorders Among American Youth
A survey partially sponsored by the US National Institute of Mental Health (NIMH) on the prevalence of common mental disorders revealed that only about 50% of children and adolescents in the US who are suffering from some kind of mental disorders receive professional help. The specific disorders surveyed were:

• •8.6 percent had ADHD, with males more likely than females to have the disorder;
• •3.7 percent had depression, with females more likely than males to have the disorder;
• •2.1 percent had conduct disorder;
• •0.7 percent had an anxiety disorder (GAD or panic disorder);
• •0.1 percent had an eating disorder (anorexia or bulimia).

The good news is that except for ADHD, these prevalence rates are lower than previously reported. The bad news is that only 32% of young people with anxiety disorder consulted a mental health specialist. This is especially true among African-Americans and Mexican-Americans compared to the white.

Interactive Timeline on H1N1: The Year in Review
US health officials give a summary of events surrounding the H1N1 2009 outbreak and discuss the next phase of the response to the pandemic at www.flu.gov

It’s been a while since I brought you some flu updates… Here are your updates for this weekend.

CDC: Swine flu less widespread, down to 32 states
Finally, some good news about the flu swine from the Centers of Disease Prevention and Control (CDC). It seems to be on the wane in the US. Infection was widespread in 48 states in October and in 43 states in early November. As of November 21, it was down to 32 states. Unfortunately, the number of deaths especially among children does not seem to be waning. There were 27 new lab-confirmed H1N1 deaths in the under 18 year olds on that week, the highest weekly toll so far. There are reports that the H1N1 flu activity in Canada is also easing. In most parts of Europe, the epidemic is just reaching its peak. Health officials at the CDC, however warns that it may not be over yet. They expect to see another peak right after the Christmas holidays when children go back to school.

H1N1 activity waxes, wanes: WHO
In fact, flu expert at the World Health Organization (WHO) Keiji Fukuda believes we may not be out of the wood yet. Reports show that the flu is peaking, even waning in some areas. “I think it’s a little bit early to begin those discussions now because we are still in a period where some countries are still increasing in terms of infections, even though in some countries, such as the United States and Canada, it looks like infections and cases are going down.”

FDA Approves Additional Vaccine for 2009 H1N1 Influenza Virus
The US FDA approved another vaccine against the H1N1 flu in November. This was the 5^th vaccine to be approved in the US and is manufactured by ID Biomedical Corp. of Quebec, Canada, owned by GlaxoSmithKline PLC (GSK).

WHO approves Glaxo’s swine flu shot
The World Health Organization (WHO) has also certified one of GSK’s flu vaccine made in Canada for distribution in 95low-income countries. This vaccine contains an adjuvant which will boost the immune system.
A batch of the same vaccine was withdrawn last month due to the high incidence of allergic reactions.

Flu.gov on Twitter
To spread the flu news faster that the flu bug is spreading, health authorities in the US is using social media particularly twitter.  The FluGov twitter bio says “One-stop access to U.S. Government H1N1, avian and pandemic flu information.”  Check out the latest webcast in a briefing by CDC director Dr. Thomas Frieden.

WHO: Clinical Management of Human Infection with Pandemic (H1N1) 2009: Revised Guidance
WHO also issued a revision of the H1N1 flu guidelines which included

• risk factors for severe disease
• signs and symptoms of progressive disease
• diagnosis
• treatment, both outpatient and in hospitals, and
• clinical care for resource-poor settings.

Photo credit:stock.xchng

Today, I am bring some diabetes updates on what increases or decreases our chances to develop diabetes.

Heading off diabetes
Researcher David Nathan of Massachusetts General Hospital Believes people can prevent getting diabetes even if they are at high risk. And he has 10 years’ worth of data to prove it at the Diabetes Prevention Program Outcomes Study. Here are Dr. Nathan’s trips to head off diabetes:

• A brisk 30-minute walk once a day or equivalent
• Proper eating,
• Kept off a crucial 5 pounds over those 10 years

The results: lower your risk by a third!

“We can actually push back, delay or prevent the development of diabetes in a substantial fraction of people over a long period of time. That means almost certainly that they will be healthier”, say Dr. Nathan.

Statin Drugs Might Slightly Boost Diabetes Risk
Statins do not lower diabetes risk. In fact, it can actually elevate the risks, albeit modestly. This is the result of a latest study by researchers at the Einstein College of Medicine, New York. Statins are cholesterol-lowering drugs that are commonly used in patients with cardiovascular conditions. However, its role in diabetes prevention has always been an issue of controversy. According to lead study investigator Dr. Swapnil

“Contrary to our expectation, we did not find any benefit of statins on diabetes risk. In fact, there is a suggestion that statins may be associated with increased risk — which needs to be explored further.”

Fish vs Shell fish in diabetes risk study
There is fish and there is fish. Some types can lower your risk for type 2 diabetes; some have the opposite effect. A British study reports that incorporating more white and oily fish in the diet lowers type 2 diabetes risk by 25%. However, one should take care about eating shellfish – e.g. mussels, oysters, crabs, and prawn. These seafoods actually elevate your diabetes risk by a whopping 36%! But is it really the shellfish? The researchers do not rule out that cooking and preparation methods can play a role in making these seafoods unhealthy. In the UK, for example, shellfish is usually fried in oil and served with sauces which are high in cholesterol. Fish that is good for the health should be eaten steamed, baked, of broiled with low fat sauces. Example of these fishes are:

• White fish: cod, haddock, sole, and halibut
• Oily fish: mackerel, kippers, tuna, and salmon,

The feasting season (Thanksgiving and Christmas) is just around the corner. Let’s take some time to update on weight gain and obesity.

Obesity causes 100,000 U.S. cancer cases
Obesity can cause cancer, according to researchers. As estimated 100,000 cases of cancer related to obesity are reported in the US each year and the numbers are expected to rise as the obesity problems worsen. The types of cancer caused by excessive fat include endometrial and esophageal cancer.

Some obese people perceive body size as OK, dismiss need to lose weight
Can we judge our weight properly? It seems that people who are overweight tend to perceive their body size wrongly – thus, leading to the belief that losing weight is not necessary. This was according to a research presented at the research presented at the American Heart Association’s (AHA) Scientific Sessions 2009 in Orlando, Florida. I will discuss the report more in detail in an upcoming post.

At last, a chocolate that makes you LOSE weight (if you don’t mind the green tinge)
It looks like chocolate with a greenish tinge and it’s yummy like chocolate but it’s not fattening like chocolate. It is called Lola, manufactured by the Spanish food maker Cocoa Bio and it supposedly helps you lose weight. The manufacturers claim that they have specially added amino acids into the chocolates that stimulate production of hormones which suppresses appetites. By simply popping one or two of these goodies in your mouth about an hour meal mealtime, you will feel pleasantly full. Truly good news for chocoholics, except for the steep price – £5 for a box of 5. Oh, and the green tinge? It’s from the algae Spirulina added as dietary supplement.

Secondhand smoke exposure worse for toddlers, obese children
We know that secondhand smoke is bad for the health. The latest findings, however, indicate that some are more endangered than others. In this study presented at the AHA’s Scientific Sessions 2009, researchers report that exposure to secondhand smoke has the greatest impact on those who are young and those who are obese.

Relation between socioeconomic status and body mass index: evidence of an indirect path via television use
German researchers investigated how body mass index (BMI) is related to socioeconomic status and television (TV) and video game use. They conducted the investigations in German and American children. The results showed that low socioeconomic status is related to high BMI. This in turn is related to media, particular TV use. Children of low socioeconomic status tend to watch more TV and have higher BMI. The presence of TV in the children’s bedrooms is especially an important contributing factor whereas video game use is not.

Some important healthcare updates for this weekend…

AMA, AARP back House bill on health care reform
The healthcare reform efforts of President Barack Obama gets a much needed boost from the American Medical Association (AMA), the American Cancer Society Cancer Action Network, and the power senior citizen’s group American Association of Retired Persons (AARP). AARP is especially a powerful ally as it represents more than 40 million Americans older than 50, a force to be reckon with in today’s aging population. According to an AARP spokesperson:

“We can say with confidence that it meets our priorities for protecting Medicare, providing more affordable insurance for 50- to 64-year-olds and reforming our health care system.”

The US Congress is expected to make a decision about the health bill this weekend. The new health care bill will provide health care coverage for everybody.

Immunity Claims Coming Off Cereal Boxes: Kellogg
Kellogg’s new slogan on their cereal boxes “Helping to support your family’s immunity” has been strongly criticized and viewed by many as a marketing ploy that takes advantage of the H1N1 flu scare.
The city of San Francisco wrote a letter to the cereal company and the US FDA requesting evidence of the immunity claims, suggesting Kellogg “may mislead parents at a time when they are increasingly worried about the spread of the H1N1 virus.”
Kellogg has now announced they will remove the offending slogan but will continue to add extra oxidants to their cereals, on which they based their original claims.

FDA Unveils Safe Use Initiative that Targets Preventable Harm from Medication Use
The US FDA launched the Safe Use Initiative earlier this week, “a program aimed at reducing the likelihood of preventable harm from medication use.” Millions of people suffer from adverse drug reactions every year due to inappropriate use that may be accidental or intentional.  Accidental adverse drug reactions are common in children where medication abuse among teenagers is on the rise. According to FDA Commissioner Dr. Margaret A. Hamburg

“Too many people suffer unnecessary injuries from avoidable medication misuse, errors and other problems. The FDA is launching the Safe Use Initiative to develop targeted solutions for reducing these injuries.”

Doctor sentenced for writing prescriptions over the internet for people whom he had never met or examined
A Virginia doctor wrote prescriptions online for people he never met, much less examined. He wrote up to 100,000 prescriptions over the Internet and got paid by online pharmacies, income which he failed to declare. He was convicted and sentenced to one year and a day in prison and would most probably lose his medical license.

Photo credit: stock, xchng

Obama declares swine flu a national emergency

US President Barack Obama has declared the swine flu epidemic a national emergency. The declaration will make it easier for U.S. medical facilities to handle a surge in flu patients by allowing the waiver of some requirements of Medicare, Medicaid and other federal health insurance programs as needed.

Swine flu vaccine met with a big dose of skepticism

Not everyone welcomes the H1N1 vaccine with open arms. Many people are sceptical about the efficacy and safety of the vaccine and the skeptics, including some healthcare professionals who are opposed to the mandatory vaccinations in their line of work. A September survey by Consumer Reports revealed that

• 51% of parents are agreeable to giving the shorts to their kids.
• 40% of adults are certain they will get the shots.

NYC Schools to Start Offering Swine Flu Shots

Meanwhile, New York City is not seemed to be fazed by the scepticism surrounding the H1N1 vaccine. The city will start offering flu shots or nasal sprays at the public primary schools this week. Private schools are also welcome to participate. Older kids in middle and high schools will have to wait till November or December for vaccination. School nurses will administer the vaccine.

H1N1 in turkeys poses ‘minimal’ human risk: official

With Thanksgiving and Christmas just around the corner, many people are already planning the holiday menus. However, there are concerns over about the safety of the turkey that will end up on the family table. In Canada, there was a reported incident of a swine flu outbreak in Ontario, CBC Canada reports. Health officials however, declared that the birds in the said farm were not meant for eating but only for egg production and there poses “minimal” risk to humans.

Doctors Told to Give Flu Medicine Promptly

US health officials warned doctors not to wait for the results of flu tests before prescribing flu medications. The lab tests would take time and people with high risk factors, e.g. children under 2, pregnant women, and those with underlying condition such as asthma, diabetes, or heart disease should be treated promptly.

Get H1N1 vaccine: health minister

Country leaders are urging their people to get the vaccine. And to set a good example, many heads of states and other leaders have got the vaccine. Canada’s health ministers Leona Aglukkaq is appealing to the public, especially those who are at high risk, to accept the vaccine. Canada is said to have entered the 2^nd wave of H1N1 infections.