Archive for April, 2006
For the first time, a pharmaceutical company has produced a once-monthly injectable drug to treat dependence on alcohol. The FDA has approved Vivitrol, expected to be available to medical providers and their patients by late June. The injectable drug is nonaddictive and must be administered by a health professional.
Intended for alcohol-dependent patients in an outpatient setting, the injection is used in combination with counseling or group therapy. Vivitrol works best for patients who are not actively drinking when beginning the treatment.
A six-month study of Vivitrol was conducted with 624 patients who had typically spent 20 days a month drinking heavily – five or more drinks daily for men and four or more drinks a day for women. Participants were randomly assigned to get the monthly shot of Vivitrol or a similar shot as a placebo (no medication). All received psychosocial support.
Results for those receiving the new drug were dramatic, according to Dr. Michael Bohn, a board-certified addiction psychiatrist and one of the study researchers. For those who received Vivitrol instead of placebo, their rate of continued heavy drinking was 25% lower than in the control group.
All participants had been asked to abstain from alcohol for a week before receiving the first shot. Some complied and some did not. Patients who abstained for at least four days before getting an injection of Vivitrol were more likely to remain abstinent, or they drank much less than they had previously.
Two-thirds of those enrolled in the study based at a Wisconsin treatment center completed the six-month treatment regimen. All who did were allowed to stay on Vivitrol. Those who received only the placebo were offered the drug, and 85% of them accepted the new injectable drug.
The medication was well-tolerated by most patients taking part in the clinical trials. A few experienced mild nausea, vomiting, headache, fatigue, or reactions at the injection site. The once-a-month injection made compliance relatively easy.
The drug manufactures warned, however, that persons taking opiods or in acute opiod withdrawal should not take Vivitrol. In addition, the active ingredient, naltrexone, can cause liver damage if given in excessive doses.
Vivitrol works by binding to and blocking the opioid or pleasure-sensing receptors in the brain, thus removing or reducing the incentive to drink. Naltrexone has been successfully used in tablet forms by alcohol treatment programs for many years. However, Vivitrol is the only injectable drug given once per month to treat alcohol dependence.
About 18 million people in the U.S. are dependent on alcohol or drink excessively. More than 2 million of them receive treatment each year. Vivitrol offers new hope for a significant number of those seeking help from treatment programs for their alcohol addiction.
Sources: WebMD; FamilyDoctor.Org
April 28th, 2006
An international trial of a vaccine designed to prevent asthma from developing in young children is being tested in 200 babies and toddlers from the U.S. and Australia. The clinical trial could expand to Germany and Sweden, as well. All are receiving daily oral drops of common allergens over a one-year period.
All children receiving the oral vaccine are from families with a strong history of asthma or other allergies. They will be followed for three years to determine whether their immune system can be educated to prevent allergies that trigger asthma. The drops are similar to those used to treat patients with established allergies and are considered to be safe.
This first attempt to prevent young children from getting allergies is considered promising. If successful, children all over the world could benefit. Asthma can be a debilitating and life-threatening condition, and preventing it from developing early on would be a major breakthrough.
Source: ABC Online
April 24th, 2006
A nationwide, federally funded study involving 322 women having surgery for uterine prolapse showed conclusively that future bladder problems can be prevented with four additional stitches.
Uterine prolapse occurs when the uterus sags into the birth canal and causes pain. Frequent childbirths are generally a contributing factor. About 200,000 women have this condition corrected surgically each year.
The surgery itself can lead to bladder problems unless a second step, called the Burch procedure, is added. This procedure involves placing four permanent stitches (from the vagina to a pelvic ligament), forming a “hammock†that keeps urinary control muscle supported.
Women in the group that did not receive the extra stitches developed bladder control problems with greater frequency than those who did. Also known as “stress incontinence,†urine can leak when a woman coughs, sneezes or laughs hard.
The study showed that only 6% of women given the Burch procedure during uterine prolapse surgery developed urinary control symptoms three months later. Of those who didn’t receive the additional four stitches, 25% developed bothersome and embarrassing stress incontinence.
Because the benefits of the Burch procedure were so obvious, the study was stopped early. The technique was developed in the 1960s by Dr. John Burch, a Tennessee obstetrician. Other methods are also used to treat or prevent urinary leakage, but the study did not examine them.
This study demonstrated for the first time that an operation can actually prevent stress incontinence. Principal investigator Dr. Linda Brubaker of Loyola University pointed out that study findings are a big step forward in providing better solutions for these common women’s health problems.
Source: Associated Press
April 20th, 2006
A new study is assessing whether back and neck pain from degenerative disk disease can be helped using fish oil supplements. The supplements containing omega-3 fatty acids might be a safer treatment than nonsteroidal anti-inflammatory drugs (NSAIDs) for some individuals with nonsurgical back or neck pain.
Researchers are Joseph Maroon, MD, and Jeffrey Bost, PAC, whose study at the University of Pittsburgh Medical Center’s neurological surgery department was published in the medical journal Surgical Neurology.
One in four U.S. adults will be affected by degenerative disc disease at some time in their lives. This condition in which shock-absorbing disks in the spine wear down is one of the largest causes of pain and disability in this country.
Although NSAIDs and Cox-2 inhibitors are potent painkillers, their long-term use can lead to stomach ulcers or increased risk of heart attack or stroke. The Cox-2 inhibitors Vioxx and Bextra were removed from the market in 2004 and 2005 due to suspected heart risks.
Researchers studied 250 people seen by a neurosurgeon for nonsurgical neck or back pain. Patients were asked to take daily fish oil supplements while gradually phasing off their NSAIDs over a two week period.
Patients initially took 2.4 grams of omega-3 EFAs, after which most cut their dose to 1.2 grams daily of fish oil supplements. After taking fish oil for 75 days, patients returned surveys. Three-quarters of them reported taking 1.2 grams daily of omega-three EFAs, while the rest took 2.4 grams daily. More than half had stopped taking any NSAIDs for pain (59%).
Study finding showed the following:
• 60% of patients noted overall improvement in their pain
• 60% specifically reported less joint pain
• 80% were satisfied with their improvement
• 85% noted they would keep taking fish oil supplements
Researchers understand that patient expectations of pain relief (placebo effect) may have played a role in their reported results. However, past research on arthritis has also shown less inflammation and joint pain with omega-3 EFAs.
Maroon and Bost have called for additional appropriately designed studies to confirm the effectiveness of omega-3 EFAs for spine-related pain.
Source: WebMD
April 19th, 2006
Today I visited WebMD Health and a message board post titled “Long Days of Fibro Pain:  What do you all do?” spoke to my heart. I can completely sympathize with what the writer is enduring in pain, disability, feelings of loneliness, and isolation. “Worthless, hopeless, friendless†are words that describe exactly how I have felt so many times over the past 14 years since my back injury.
Like Mindy, I have been diagnosed with fibromyalgia and chronic pain. I also have osteoarthritis, mild scoliosis, and degenerative disk disease. You name it. I’m osteopenic in my lumbar spine, had a knee replacement for an old ski injury, and I’m a breast cancer survivor of 17 years.
Before my health problems began, I was a vibrant PR professional working in a hospital setting as director of public relations and marketing. I was outgoing, had many friends, traveled frequently, went to concerts, plays, movies, enjoyed eating meals out, and I could keep up with activities of my two children – now in their 30s. Then, at age 52, just three months after my second marriage, I ruptured a disk at L5-S1. Two disks above that level are also deteriorating.
I was told I was not a candidate for surgery – just learn to live with it. I have been through two pain management programs, extensive physical therapy, biofeedback, counseling, and I’m on a lot of different medications. I was turned down for Social Security Disability twice and gave up. They told me I was still “walking around.†My marriage broke up after two years, due to my greatly changed condition. My husband could not cope with a woman he called “an old woman and an invalid.†So, I left him under duress. Talk about feeling worthless!
Fortunately, I still had my rented out home to move back to, where I slowly began my own business as a writing consultant for various health care providers. Within two months of my back injury, I had been laid off from work. I couldn’t have continued to work full-time and commute as I had previously done, anyway.
I knew I must find something I could do part-time, at my own pace. I began working as a healthcare contract writer from home. Gradually, I built up my clients and the hours I was able to work. Now almost retired, I continue to pace myself through each day.
Usually, I try to walk about a mile and a half about mid-morning. I also do a moderate series of stretching and strengthening exercises in the evening. After exercising, my tolerance for sitting at the computer usually improves. I sometimes set a timer to remind me to get up and stretch. In the beginning, I had two computers, one where I could stand to input copy, and one for sitting, to vary my position all day.
Of course, I have to lie down frequently or sit back in my recliner. I use a back support pad whenever I’m on the go, and I keep grabber devices handy to keep from bending and stooping. I often choose a restaurant based on the comfort of their seating. I’m tall, so I modified a good deal of my living and working environment to avoid stooping. I bought a refrigerator with the freezer portion on the bottom, as I don’t use it as much. I also have a shower stall with a built-in seat.
I am now blessed to have a man in my life who understands my disabilities and helps to take care of me. He accepts me for who I am and I never feel put down by him because I can’t do much. I don’t have as many friends, but I do go for lunch with various girlfriends, those who have stuck with me through my trials, about once a month. I write poetry and I’m working on my life story. I joined a women’s group at church where I read from my autobiography every other week. It’s a great bunch of women who understand when I have to stand to stretch mid-way through our meeting.
I have also scanned and retouched many old family portraits and organized them into binders. Photography has always been a passion for me, and I’m grateful that I can continue that hobby. I’m thinking about painting with acrylics again, something I enjoyed in my 30s.
My male friend and I do a lot of listening to classical music and watching movies on DVD. He also reads to me. My trips by plane are generally short, and I stand up and stretch when I need to. If I’m traveling alone, I swallow my pride and get wheelchair assistance, as I can’t lift a suitcase.
Recently, I had another adjustment to make. My last corporate client told me he was retiring following a hospital merger. Although I am now Medicare age, I wasn’t ready to quit working or feeling like I was doing something constructive. Many former nurses and PR professionals in a hospital setting like me still have a desire to interact with people and feel like they might be making a difference in someone else’s life.
Today, the Internet provides wonderful networking opportunities and support systems for persons facing physical challenges. This Blog is still in its early stages, but I am enjoying summarizing new developments and trends in the health care field. I feel like I am keeping my mind active and possibly helping others to find solutions to their health care issues. I continue to do what I can on good days and rest when I’m having a bad flareup.
My best advice to you is NEVER GIVE UP. Find a way to do at least a portion of what you love. The friends that remain are TRUE friends. Find ways to show them how much it means to have them in your life.
April 18th, 2006
After looking into the recent deaths of two U.S. women following their use of the abortion pill RU-486 (Mifeprex), the U.S. Food and Drug Administration (FDA) ruled out medical abortion as the cause of one death. The second case is still under investigation.Â
The two deaths in March brought the total to six U.S. women and one Canadian woman whose deaths may have been related to taking Mifeprex and the follow-up drug Misoprostol two days later.
About 560,000 women have taken the pills since their approval in September 2000 for ending a pregnancy of less than 50 days. In most cases, the second drug was taken by mouth; however, some women were advised to insert Misoprostol vaginally. A very small number of these women developed serious or fatal infections.
The FDA will hold a public hearing in Atlanta in May to address the growing number of infections from bacteria called Clostridium sordelli.
There is increasing political momentum in the U.S. House of Representatives in support of Hollys Law, a bill calling for withdrawal of RU-486 from the market.
Sources: Yahoo!News; Oakland Tribune, April 11, 2006,AP story, reporter Andrew Bridges
Related Article: Two More Women Die After Taking Abortion Pill RU-486
April 17th, 2006
A new cancer vaccine still in the experimental stages appears to provide protection against several strains of cervical cancer for up to five years. Results of a study of 1,100 women to test the efficacy of the vaccine Cervarix were published in the April 6 issue of The Lancet.
At 4.5 years, the vaccine was still protecting all women who received the vaccine, according to study author Dr. Diane Harper. Cervarix is designed to protect against human papilloma virus (HPV) types 16 and 18, responsible for about 70 percent of cervical cancers.
The vaccine seems to offer similar protection against HPV types 45 and 31, which can also trigger cervical cancer, the second most common malignant disease in women worldwide. Spread by sexual contact, human papilloma viruses are the main cause of cervical cancer.
Women taking part in the study received either three doses of Cervarix or a placebo. Those who got the vaccine had no more long-term side effects than those getting the placebo injection.
Cervarix is yet to be approved for general use on the market. Preliminary results show from antibody levels tested that protection remains unchanged nearly five years later. Further investigation of the new vaccine will take place before the vaccine is approved for widespread use.  Â
A similar vaccine called Gardasil is awaiting approval by the U.S. Food and Drug Administration (FDA). Gardasil is thought to protect against HPV 16 and 18 as well as HPV 6 and 11, which account for about 90% of genital warts.
Gardasil could be on the market later this year and would likely be given to women in their late teens or early 20s. Cervical cancer is often diagnosed at a younger age than any other cancers.
Source:Â MedicineNet.com
Also see the latest news and discoveries for GardasilÂ
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April 17th, 2006
Men who undergo a vasectomy cannot assume they are immediately sterile. After a doctor severs the vas deferens, the sperm-carrying tubes, a man and his partner should use another form of birth control until follow-up tests confirm the success of the operation.
Usually, doctors ask the patient to submit sperm samples two months post- vasectomy and another after the third month. When two consecutive samples are negative, the surgery is considered a success.
A study of 436 men who received vasectomies at the Cleveland Clinic showed that a quarter of the men didn’t submit a sperm sample at two months, and only 21% bothered to return for the second follow-up.
Three months after vasectomy, when just half of the total patients returned to give samples, 9% of the tests still contained sperm. The residual sperm were usually in low numbers and nonmotile (unable to move on their own).
Three men with sperm-free samples at two-month intervals showed a trace of them remaining at the three-month check. All three had sperm-free samples by four and five months following their vasectomy.
In patients who followed the instructions of their doctor for return checks, vasectomy was eventually judged successful in all but one. Those who didn’t return for testing could potentially still get their partner pregnant.
According to Dr. Nivedita Dhar, a researcher at the Cleveland Clinic, it is impossible to know if and when the sterilization surgery is successful if patients do not submit semen samples as directed.
It is important to note that vasectomy does not affect a man’s orgasm or ejaculation, and it doesn’t prevent sexually transmitted diseases.
Source:Â WebMDÂ
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April 12th, 2006
Recent evidence shows that being overweight in one’s 40s contributes to Alzheimer’s disease and similar brain dementias later in life. Other contributing factors are diabetes and cardiovascular disease, but fat itself appears to play an important role in brain impairment.
This new evidence concerning obesity and brain function was presented in April at the American Academy of Neurology in San Diego, CA. Study author Rachel A. Whitmer, a research scientist at Kaiser Permanente of Northern California, reported on her findings as part of a larger study of 9,000 Kaiser patients who were followed for 30 years.
Study participants submitted to measurements of thickness of skin folds both below the shoulder and at the back of the upper arm. Individuals with the thickest shoulder measurements were found to be almost three times as likely to develop Alzheimer’s disease as those who had less thickness in these areas.
Maria Carrillo of the Alzheimer’s Association suggested that overweight people are often more sedentary. As a result, their arteries can become clogged and restrict blood flow. Healthy eating and exercise can contribute to healthy brain functioning, she indicated.
In 2006, 4.5 million Americans have been diagnosed with Alzheimer’s disease. Risk rises as people age. By 2050, with longevity increasing, the number is expected to increase to 16 million persons with the brain disease.
Sources:Â MedicineNet.com; Division of Research, Kaiser Permanente of Northern CaliforniaÂ
April 11th, 2006
After taking abortion pill RU-486, two more women died in March — one in the U.S. and one in Canada. These recent deaths raise the total to seven women. Used for more than 560,000 abortions in this country, the abortion pill still carries a small risk, affecting slightly over one in 100,000 women. In comparison, the risk of death associated with surgical abortion is only a tenth of the risk of pill-induced abortion, or one in a million.
RU-486 is administered at various abortion clinics. Women are instructed to take another drug, misoprostol, two to three days later. After taking scheduled doses of both drugs, women generally have a miscarriage that takes place at home. Some find the medical abortion preferable or more “natural†than surgery. Â
The first five women are known to have died from infection with the bacterium Clostridium sordellii. FDA officials dispute any definitive link between the infections and RU-486 or that women taking abortion pills are more at risk for infection than women who undergo surgical abortion. Dr. Phillip Stubblefield, a professor of obstetrics and gynecology at Boston University, points out that miscarriage, either natural or induced, can lead to infections.
Dr. Vanessa Cullins of Planned Parenthood Federation of America maintains that both surgical and medication abortion are extremely safe and effective. It is possible that the method of administering the second drug may have been responsible for the infections.
Planned Parenthood and some other U.S. abortion providers had begun instructing women to insert misoprostol vaginally two to three days after taking Mifeprex (RU-486) by mouth. The first five women who died had all inserted the second drug vaginally. In so doing, they may have accidentally introduced bacteria from skin near the anus, and once inside the vaginal canal, the pathogen flourished. In France, where no deaths have been reported, oral administration of both drugs is the standard procedure. Planned Parenthood has announced they are now prescribing misoprostol orally only.
Some physicians have expressed alarm at the seven deaths and are now performing only surgical abortions. Other doctors emphasize that Mifeprex is the only option for women in some isolated rural areas, but advise that patients who have a choice should be steered toward surgical abortions. These physicians are not calling for withdrawal of RU-486 from the market.
Apart from the seven deaths, other effects have been known to occur from medical abortions. In a 1999 study of 377 women, a significant number of those who took the pills to abort had higher levels of pain, nausea, vomiting and problem bleeding than patients who had surgical abortions. In addition, pill-based abortions may be more likely to fail than surgical ones, in which case a surgical follow-up is required.
Source: NY Times
Related Article: Update on Deaths in Women Taking Abortion Pill RU-486
April 10th, 2006
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