Archive for March, 2006
An FDA advisory panel debated the issue on whether a “black box†warning should be placed on drugs such as Ritalin, prescribed for hyperactivity and attention deficit disorder. Up to 3.3 million Americans under the age of 20 take ADHD medications such as Ritalin, Adderal and Straterra.
Psychiatrists urged the FDA to carefully consider a previous proposal to include the strongest warnings about heart attack, hallucinations and other potential risks. These adverse events believed to be associated with the drugs are seen in only a small numbers of patients.
Mental health advocates emphasized that leaving conditions untreated in children who need these medications could be equally as risky as the potential cardiovascular and psychiatric risks a few might encounter from their use. The likely outcome is that stronger wordings of potential adverse effects will be included, but a black box warning will be avoided.
Source Article
March 31st, 2006
For various reasons, women of African-American descent are more likely to die from breast cancer than their Caucasian counterparts. Recent findings published in the Journal of Clinical Oncology indicated that black women were nearly 20 percent more likely than white women to succumb to their disease. Researchers took into consideration variables such as socioeconomic status and disease stage.
Another study, conducted at Mount Sinai School of Medicine in New York, showed that women in minority groups – including Hispanics — were unlikely to receive complete follow-up treatment after breast cancer surgery. Treatments including radiation, chemotherapy or hormonal therapy are often given as an extra precaution against recurrence.
The two studies were controlled for socioeconomic differences, the presence of other illnesses, and whether or not a woman had health insurance. The likelihood of not getting the best adjuvant therapy (follow-up care) was 16 percent among white women, 23 percent for Hispanics and 34 percent for blacks.
Further investigation is needed as to the role of biologic, genetic, and socio-cultural factors in breast cancer mortality among minority women, especially among black women. Progress toward reducing racial disparities in cancer deaths can be made by providing equal opportunities for breast cancer treatment.
Breast cancer screening and early detection play a vital role in finding and treating the disease at its most curable stage. Minority women often do not seek treatment or have access to care until breast cancer is in advanced stages.
Source Article Â
March 31st, 2006
Most miscarriages occur during the first few weeks of pregnancy. Sometimes women aren’t even aware they were pregnant.
They may think they were having an unusually heavy menstrual period. The cause of miscarriage is often due to health problems with the mother or defects in the developing fetus.
In a small study of 61 married women aged 18-32 in rural Guatemala, researchers measured cortisol levels in the women’s urine three times a week.
Measurements of this hormone produced by stress began before the women got pregnant and continued for three weeks post pregnancy. Over a year, 16 of these women had 22 pregnancies, in which 9 of them resulted in live births and 13 resulted in miscarriages.
This study found that miscarriages were 2.7 times more likely among women with high cortisol levels. Ninety percent of the women with high cortisol experienced miscarriages in the first three weeks of their pregnancy. Only 33 percent of women with normal stress levels miscarried in the first three weeks.
Researchers are calling for bigger studies to determine whether maternal stress contributes to miscarriage. Cortisol in the urine could indicate that a woman’s body isn’t in the best condition to carry a child to term.
Source:Â WebMD. Inc.;Â (original article by Miranda Hitti and reviewed by Louise Chang, M.D.); 2/21/06; Dr. Dean Edell, San Francisco-KGO weekday broadcasts.
March 30th, 2006
More Americans than ever are turning to sleep medications to get through the night. Ads promising safe slumber with little or no side effects may be behind this new trend. Many of us lead stressful lives — at the office, in our long commutes, raising children, and caring for older parents. It may be next to impossible to tune it all out at night.
Health experts are concerned that these drugs may be over-prescribed. About 42 million prescriptions for sleeping pills were filled in 2005, up nearly 60 percent since 2000. At least 10 percent of U.S. adults complain of having trouble falling asleep or staying asleep throughout the night. Although the newer drugs may not carry the same risk of dependence as the older ones (usually barbiturates), there is concern that they can sometimes cause strange side effects.
Episodes of sleepwalking or short-term amnesia may be connected to their long term use. In taking sleeping pills, many experience continued sleepiness for several hours after awakening.
Among the most commonly prescribed sleep aids are Ambien and Lunesta. The drug Sonata is shorter acting and may work better for persons who have difficulty falling asleep but who are able to sleep through the night.
Some psychiatrists believe that difficulty sleeping can be a sign of multiple disorders. Among them might be anxiety and depression, problems which are not being addressed.
Developing sleep-promoting habits in the hours just prior to bedtime could solve your insomnia better than taking pills, in the long run. Suggested strategies: Use your bed only for sleep and for sex; take a warm shower to relax; don’t watch violent movies just before bedtime; don’t exercise in the late evening hours; drink a glass of warm milk; avoid caffeine in the evening; gently wind down your conversations; listen to a relaxation tape at bedtime; try to fall asleep in the same general time frame each night.
Labels on sleep medications warn that they should be used only when you can devote a full night to sleeping. If taken in the wee hours of the morning, these drugs could cause sleepiness when driving to work or school or even temporary memory loss.
Newer drugs, such as Rozerem, are coming on the market which may pose fewer long-term risks. This drug acts on the brain’s melatonin receptors, thought to play a role in sleeping and waking cycles.
The best strategy, if possible, is to avoid taking pills to sleep each night. Reducing the stress in your life, developing good sleep preparation habits, or addressing any psychological problems with your doctor may be the wisest course.
Sources:Â New York Times (date?) (www.nytimes.com); Dr. Dean Edell, ABC daily broadcasts (www.healthcentral.com)Â
March 29th, 2006
A recent study tracking caffeine consumption of 150,000 women over a 12-year period found that coffee and tea did not cause hypertension (high blood pressure). But for reasons unknown, cola drinks — both sugared and diet colas — have been linked to this condition that can increase risks for heart disease. By cutting back on their intake of cola drinks, women may protect their teeth, gain less weight from “empty calories†and be kinder to their hearts.
The Johns Hopkins Medical Letter, Health After 50, February 2006 (Call 1-800-829-0422 for subscription inquiries.)Â Â Â Â
March 29th, 2006
Saw Palmetto, a popular herbal pill used by millions of American men for symptoms of prostate enlargement, was found to be ineffective in a year-long research study involving 225 men over age 49.
More than 2 million American men and many in Europe take the herb in an effort to ease their urinary symptoms — the frequent urge to go to the bathroom. In this new study, saw palmetto was no more effective than placebo pills (fake capsules). Findings were published in the New England Journal of Medicine (NEJM) in early February.
As men age, many develop benign (noncancerous) enlargement of the prostate, a walnut-sized gland that surrounds the urethra. The men recruited for this most recent study had moderate to severe symptoms. One group took 160 miligrams of saw palmetto twice a day.
Men in the second group swallowed a similar-looking, tasting and smelling dummy capsule. Participants in both groups filled out a symptoms survey and had urine flow measured. After a year, no significant difference was detected between the two groups, in symptom changes or other measurements.
An earlier, shorter study found that some men seemed to benefit from taking Saw Palmetto. Until this new research is confirmed by more studies, lead researcher Dr. Stephen Bent of San Francisco’s VA Medical Center advises that men who take the herb and feel it is helpful should probably keep using it.
Source: San Francisco Chronicle (2/9/06)Â www.sfgate/chronicle.com
Further Research:
What You Need to Know About Prostate Cancer
March 27th, 2006
New research has found women with higher natural estrogen levels may have a greater risk of stroke. High levels of estrogen are linked to obesity, which is also a factor in raising the odds of a stroke. The drug raloxifene (Evista) may guard women against this potential risk. The study led by Dr. Jennifer Lee of UCSF was presented this month at an American Stroke Association conference.
The four-year study involved 7,290 women – in which 4,843 took raloxifene and the others a dummy pill. Raloxifene is a designer estrogen that blocks that hormone’s action to the breast, for example, while providing beneficial effects to the bones.
The drug appeared to lower stroke risk in those with highest levels of a form of estrogen called estradiol, the most potent kind in estrogen circulating in the bloodstream. Women taking placebo pills had no detectable postmenopausal levels of estradiol at the study’s conclusion. Dr. Lee’s results factored in the women’s weights, their ages and other heart and stroke risk factors.
Dr. Lee estimates that if recent results prove true in additional studies, perhaps one stroke might be prevented for every 78 women given raloxifene. The drug is used to treat osteoporosis and also inhibit development or recurrence of estrogen-dependent breast cancers. Preliminary evidence suggests that taking hormones after menopause is especially risky for women with naturally high estradiol levels.
San Francisco Chronicle, 2/18/06 (Marilynn Marchione, Associated Press report)
March 27th, 2006
The majority of strokes occur because a clot restricts the flow of blood to an area of the brain, causing it to die. Persons who survive a severe stroke can linger for a decade or more with devastating physical and mental impairments. Strokes kill approximately 163,000 Americans annually and are a leading cause of long-term disability.
The costs of their care can quickly drain a family’s financial resources. Recognizing the symptoms of a stroke and getting appropriate treatment rapidly can determine the severity of the outcome. New treatments are offering hope for a full recovery within days or months.
In the past decade, the clot-buster TPA has been administered to dissolve brain clots. Originally used for heart attacks, TPA was shown to be also effective for strokes if given intravenously during the first three hours after onset of symptoms. It doesn’t always work for the patient and sometimes causes bleeding in the brain.
In 2005, a new stroke treatment – a corkscrew device to physically remove the clot – came into use for certain patients with major strokes. Now, an experimental treatment gives doctors even more options to help save lives and minimize the disabilities that strokes can produce.
Doctors involved in clinical studies are now delivering TPA precisely to the clot area and dripping the dissolving agent directly onto the blockage. Similar to angioplasty, in which a catheter is threaded through a vessel in the groin to the heart blockage, a tube is guided to the brain instead. TPA is delivered through a specialized tube to the clot, instead of making its way there through the bloodstream.
Many patients given this experimental treatment made stunning recoveries by the next day – often without the speech loss and paralysis that can result from stroke. One study found that after this novel treatment, 65 percent of patients were able to walk, talk and function normally after three months, compared to those given standard care.
According to study leader Dr. Doojin Kim, one-fourth of 128 patients given this localized treatment at UCLA over ten years at UCLA showed dramatic improvement of stroke symptoms within a day of administering TPA with the drip method.
Ninety percent of them survived, compared with 74 percent of stroke patients receiving standard intravenous TPA. Not only did they survive, they had excellent final outcome. Bleeding in the brain was less common with the new approach.
In a second study, 73 patients with severe strokes first got intravenous TPA, followed by the dripped treatment if needed. Some also received ultrasound through the TPA tube to further break up the clot. Bleeding was a more common side effect, but the twice as many clots were dissolved.
The new dripping technique is suggested for patients under age 80 who suffer a major stroke. Using those criteria, doctors estimated that up to half of stroke patients might qualify for the procedure. Only about 30 percent of clots dissolve with intravenous TPA alone, according to Dr. Gergory Del Zoppo, a stroke expert from Scripps Research Institute in La Jolla, CA.
Now physicians must decide which individuals would do best with various clot-dissolving strategies instead of using the corkscrew type device to pull out the clot.
Both the dripping technique and the corkscrew device promise to give stroke patients another option if their initial treatment with intravenous TPA fails. Doctors involved with the new treatment strategies agree that relative risks and benefits of each need further study.
Sources:Â San Francisco Chronicle, 2/17/06 (original article by Marilynn Marchione, Associated Press wire service)
March 27th, 2006
Type 2 diabetes is rising so rapidly in young children that many will die younger than their parents. This alarming trend is directly related to the epidemic of overweight or obese children we are seeing in many schoolyards today. Inactivity, overeating, and indulging in foods high in fat and sugar content are major factors in this looming health crisis.
Alice Waters, owner of renowned Chez Panisse Restaurant and Café in Berkeley, California, is working with groups of schoolchildren in a concerted effort to reverse this trend.
“Universal physical education is a start, and it’s a shame that schools have been cutting back on recess and gym,†Waters says. “But in a country where 9 million children over age 6 are obese, we need the diet part of the equation.â€
Waters knows from experience that teaching children about food changes their lives. She helped to initiate the gardening and cooking program, the “Edible Schoolyard,†in Berkeley’s Public Schools. “Children’s eating habits stay with them for the rest of their lives,†Waters explains.
 “The best way to defeat the obesity epidemic is to teach children about food — and thereby prevent them from ever becoming obese.â€
Critical of the hamburgers, chicken nuggets and French fries that dominate school lunch programs, Waters also bemoans the fast disappearing shared family meal. Only a third of married couples with children report having dinner regularly together.
In schools without programs such as hers, it’s all too often that fresh fruit and salad get thrown out from cafeteria meals. Students frequently bring packaged junk food in their lunches or buy fast food after school.
Waters’ program began at Martin Luther King Jr. Middle School 10 years ago, with a kitchen classroom and a garden full of fruits, vegetables and herbs. The Edible Schoolyard has become a model for a district-wide school lunch program.
At King School today, 1,000 children now grow, prepare and share fresh food. In addition, teachers incorporate food-related activities into the math, science and history curriculum.
 “When a healthy lunch is part of a class that all children have to take, for credit – and when they can follow food from the garden to the kitchen to the table, doing much of the work themselves – something amazing happens.
Students want to taste everything. They get lured in by foods that are beautiful, that taste and smell good… When children grow and prepare good, healthy food themselves, they want to eat it, and what’s more, they like this way of learning.â€
Waters calls for a “delicious revolution†that will induce children in a pleasurable way to think critically about what they eat. She advocates food studies as part of a core curriculum for all students from kindergarten through high school.
“It will be costly,†she admits, “but if we don’t pay now, the health care bill later will be astronomical.â€
San Francisco Chronicle, 2/24/06; The New York Times; from an op-ed article by Alice Waters
March 26th, 2006
Califonia Deaths Investigated
In May, the FDA will hold a day-long scientific meeting to look into sudden deaths of four California women after taking abortion pill RU-486 in early pregnancy. A bacterial infection killed all four within days of their taking the pills — sold under brand name Mifeprex, and a follow-up drug called misoprostol. It is uncertain how each contracted the unusual infection and whether it was related to taking Mifeprex.
Dr. Marc Fischer, medical epidemiologist at the Center for Disease Control, will present at the workshop. His theory is that pregnancy or abortion could predispose a tiny number of women to acquire the bacteria that produce toxins in the lining of the blood vessels. The California women died from rapidly developing toxic shock brought on by the bacterium Clostridium sordellii.
Most abortion providers maintain that RU-486 is effective and safe when administered correctly and with careful patient monitoring and follow-up. More than 460,000 doses of Mifeprex have been sold in the U.S. to abortion providers since its approval. Half a million women in 35 countries have taken the abortion pill.
At the workshop, participants will develop a draft research agenda and put together recommendations for detecting the toxic condition. A panel of experts in immunology, epidemiology, and gynecological infections will present information at the investigatory meeting to determine whether RU-486 used in medical abortions needs further study.
Source:Â The Oakland Tribune, 2/15/06Â
(Contact Rebecca Vesely at rvesely@angnewspapers.com)
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March 26th, 2006
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