Wednesday, August 20, 2008

Hypothyroidism cause joint pain

The signs and symptoms of underactive thyroid (hypothyroidism) vary widely, depending on the severity of the hormone deficiency. For some people, low levels of thyroid hormone contribute to joint and muscle problems.

Specifically, hypothyroidism may lead to:

  • Muscle aches, tenderness and stiffness, especially in the shoulders and hips
  • Joint pain and stiffness
  • Swelling of the knee joint and small joints in the hands and feet
  • Carpal tunnel syndrome

Treatment of these joint and muscle problems is often directed at the underlying thyroid disorder. Thyroid hormone treatment often helps dramatically. Pain relievers may help, too.

Keep in mind that hypothyroidism can increase your risk of developing other autoimmune diseases, such as rheumatoid arthritis. If pain, stiffness and swelling don't improve after adequate thyroid treatment, consult your doctor. He or she may consider other possible causes of your joint pain.

Sunday, July 27, 2008

Transcranial magnetic stimulation

Transcranial magnetic stimulation is an experimental procedure that uses magnetic fields to stimulate nerve cells in the brain in the hope of improving chronic depression symptoms. Transcranial magnetic stimulation is one of the newer types of brain stimulation methods designed to treat depression when standard treatment hasn't worked.

There are different ways to perform transcranial magnetic stimulation. But in general, a large electromagnetic coil is placed against your scalp near your forehead. The electromagnet creates painless electric currents that stimulate nerve cells in the region of your brain involved in mood regulation and depression.

Depression is usually a very treatable condition. Often, standard treatment with antidepressant medications, psychotherapy or electroconvulsive therapy can help improve even severe cases of depression.

But if standard depression treatment doesn't work, all hope isn't lost. Researchers are studying brain stimulation as the newest frontier in depression treatment. Transcranial magnetic stimulation is one form of brain stimulation being tested as a possible treatment option. This procedure is still experimental and hasn't been approved by the Food and Drug Administration as a depression treatment.

Because it's experimental, transcranial magnetic stimulation isn't recommended as a first treatment option for depression. It's used only as a research tool and is generally available in the United States only through clinical trials. In countries where transcranial magnetic stimulation has been formally approved to treat depression, it's typically used only for people with depression that hasn't improved with standard treatments or for those who may be considering electroconvulsive therapy but want an alternative.

People who have long-standing depression or depression that hasn't improved with standard treatments may be eligible to participate in a clinical trial of transcranial magnetic stimulation. Talk to your doctor to see if it may be a good option for you. Transcranial magnetic stimulation may also be used experimentally in other mental health disorders, such as post-traumatic stress disorder, obsessive-compulsive disorder and bipolar disorder.

Transcranial magnetic stimulation is the least invasive of the brain stimulation procedures used for depression. It requires no surgery or implantation of electrodes or nerve stimulators. While it's considered generally safe, it's not without some risks.

Common side effects
Common side effects and adverse health problems associated with transcranial magnetic stimulation include, but may not be limited to:

  • Headache
  • Scalp discomfort at the site of stimulation
  • Tingling, spasms or twitching of facial muscles
  • Lightheadedness
  • Discomfort from noise during treatment

Uncommon side effects
In rare cases, transcranial magnetic stimulation may also cause more serious side effects, including:

  • Seizure
  • Mania
  • Hearing problems

Because transcranial magnetic stimulation involves changes in brain function, unknown long-term adverse health effects are possible. Some studies have shown structural changes in the brain after transcranial magnetic stimulation. The significance of these changes isn't yet known. Also, the long-term effects of exposure to the strong electromagnetic fields involved remain unknown.

Because transcranial magnetic stimulation is experimental, it's generally available only through participation in clinical trials. Before having the procedure, you may need to have a medical evaluation to make sure it's safe for you and a good option in your case. You may need a full physical and psychiatric evaluation. But because transcranial magnetic stimulation isn't invasive, doesn't require anesthesia and can be performed in a doctor's office, little other preparation is needed.

Transcranial magnetic stimulation is usually done on an outpatient basis in a doctor's office or clinic that's running a clinical trial for the procedure. There are different ways to perform the procedure. Techniques may change as more is learned about the most effective ways to use transcranial magnetic stimulation.

In general during transcranial magnetic stimulation, an electromagnetic coil is placed against your scalp on an area near your forehead, often on the left side. To produce the stimulating pulses, the electromagnetic coil is switched off and on repeatedly, sometimes up to 10 times a second. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. This process is repeated for the duration of the treatment session, which lasts about 30 to 40 minutes.

Although transcranial magnetic stimulation is generally painless, it may cause the muscles of your scalp or jaw to contract, which can be uncomfortable. Talk to your doctors about taking an over-the-counter pain reliever before the procedure if you're worried about discomfort. Also, wear earplugs during the procedure to reduce the risk of hearing problems.

It's not clear precisely how transcranial magnetic stimulation may help relieve symptoms of depression. Networks of brain regions may play a role in mood regulation. Stimulating the brain in these regions can change how the brain functions and may lead to mood improvement.

During transcranial magnetic stimulation, the magnetic pulses create painless electrical currents in your brain. These currents stimulate nerve cells in the region of your brain involved in mood regulation and depression. In some types of transcranial magnetic stimulation, brain activity is suppressed. In other types, brain activity is increased.

Researchers are still trying to determine the best dosage of stimulation and the best area of the brain to stimulate. The amount of stimulation can be changed depending on your symptoms and side effects.

Transcranial magnetic stimulation generally requires multiple treatment sessions. You may have the procedure every weekday for two weeks, for instance. After each treatment with transcranial magnetic stimulation, you can go about your normal daily activities.

If transcranial magnetic stimulation works, your depression symptoms will improve or go away completely. Improvement in your mood may last for days or weeks. Some research, however, shows a lack of dramatic improvement in depression symptoms. But as researchers learn more about different techniques, the number of stimulations required and the best sites on the brain to stimulate, the effectiveness of transcranial magnetic stimulation may improve over time.

Some research suggests that transcranial magnetic stimulation is less effective in certain situations, including:

  • Older age
  • Presence of psychosis
  • Depression that has lasted four or more years

It's not yet known if transcranial magnetic stimulation can be used to treat depression for the long term, or whether you can have periodic maintenance treatments to prevent depression symptoms from returning.

Wednesday, July 02, 2008

Coronary bypass surgery

Coronary bypass surgery is a procedure to allow blood to flow to your heart muscle despite blocked arteries. Coronary bypass surgery uses a healthy blood vessel taken from your leg, arm, chest or abdomen and connects it to the other arteries in your heart so that blood is bypassed around the diseased or blocked area. After a coronary bypass surgery, normal blood flow is restored. Coronary bypass surgery is just one option to treat heart disease.

Just like all the other organs in your body, your heart needs blood and oxygen to do its job. Coronary arteries snake across the surface of your heart, delivering a constant supply of blood and oxygen to the heart muscle. When one or more of these arteries become narrowed or blocked, blood and oxygen are reduced and heart muscle is damaged. Coronary bypass surgery can minimize this damage.

Although they rarely occur, the most common complications of coronary bypass surgery are:

  • Bleeding
  • Heart rhythm irregularities (arrhythmias)
  • Kidney failure
  • Infections of the chest wound
  • Memory loss or troubles with thinking clearly, which often go away within six to 12 months
  • Stroke

Your risk of developing these complications depends on your health before the surgery. Talk to your doctor to get a better idea of the likelihood of experiencing these risks.

If you're having a scheduled coronary bypass surgery, your risk of death is usually low, but still depends on your overall health. The risk is higher if the operation is done as an emergency or if you have other significant medical conditions such as emphysema, kidney disease, diabetes or peripheral vascular disease.

During the procedure
Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. On average, surgeons repair two to four coronary arteries. The number of bypasses required depends on the location and severity of blockages in your heart.

Most coronary bypass surgeries are done through a large incision in the chest while blood flow is diverted through a heart-lung machine (called on-pump coronary bypass surgery).

The surgeon makes an incision down the center of the chest, along the breastbone. The rib cage is spread open to expose the heart. After the chest is opened, the heart is temporarily stopped and a heart-lung machine takes over blood circulation to the body.

The surgeon takes a section of healthy blood vessel, often from inside the chest wall (the internal mammary artery) or from the lower leg, and attaches the ends above and below the blocked artery so that blood flow is diverted (bypassed) around the narrowed portion of the diseased artery.

There are other methods your surgeon may use if you're having coronary bypass surgery:

  • Off-pump or beating-heart surgery. This procedure allows surgery to be done on the still-beating heart using special equipment to stabilize or quiet the area of the heart the surgeon is working on. This type of surgery is challenging because the heart is still moving. Because of this, it's not an option for everyone. The long-term outcome of this type of procedure is not yet known, and there have been no proven benefits of this technique over standard coronary bypass using the heart-lung machine in the average patient.
  • Minimally invasive surgery. In this procedure, a surgeon performs coronary bypass through a smaller incision in the chest, often with the use of robotics and video imaging that help the surgeon operate in a small area. Variations of minimally invasive surgery may be called port-access or keyhole surgery.

Once you're anesthetized, a breathing tube is inserted through your mouth. This tube attaches to a ventilator, which breathes for you during and immediately after the surgery.

After the procedure
Coronary bypass surgery is a major operation. Expect to spend a day or two in the intensive care unit after coronary bypass surgery. Here, your heart, blood pressure, breathing and other vital signs will be continuously monitored. Your breathing tube will remain in your throat for a few hours after surgery, so you won't be able to speak. You can communicate with hand gestures and notes. The breathing tube will be removed as soon as you are awake and able to breathe on your own.

Barring any complications, you'll likely be discharged from the hospital within a week, although even after you've been released, you may find it difficult to perform everyday tasks, or even walk a short distance. If, after returning home, you experience any of the following signs or symptoms, call your doctor. They could be warning signs that your chest wound is infected:

  • A fever higher than 100.4 F (38 C)
  • Rapid heart rate
  • New or worsened pain around your chest wound
  • Reddening, bleeding, or other discharge from your chest wound

Expect a recovery period of about six to 12 weeks. In most cases, you can return to work, begin exercising, and resume sexual activity after six weeks, but make sure you have your doctor's OK before doing so.

After surgery, most people have improvement or complete relief of their symptoms and remain symptom-free for as long as 10 to 15 years. Over time, however, it's likely that other arteries or even the new graft used in the bypass will become clogged, requiring another bypass or angioplasty.

Although bypass surgery improves blood supply to the heart, it doesn't cure underlying coronary artery disease. Your results and long-term outcome will depend in part on following healthy lifestyle recommendations and taking your medication as directed. Healthy lifestyle recommendations include:

  • Stop smoking.
  • Follow a healthy-eating plan, such as the DASH diet.
  • Reduce cholesterol levels.
  • Maintain a healthy weight.
  • Control blood pressure.
  • Manage diabetes.
  • Exercise.

Saturday, June 21, 2008

Are high-protein diets generally considered safe

High-protein diets are generally well tolerated by healthy adults. But a dramatic increase in protein-rich foods may be dangerous for people with liver or kidney disease because they lack the ability to get rid of the waste products of protein metabolism.

Some protein is essential to human life. Protein is found in your bones, muscles, skin, organs, blood, hormones and enzymes.

Your body can't store excess protein. During digestion and metabolism, protein is broken down into amino acids — the building blocks of protein. Your body uses these amino acids to make enzymes and other proteins. But any "extra" amino acids are stripped of nitrogen. The non-nitrogen parts of amino acids are used for energy or converted into fat, and the remaining nitrogen is eventually excreted by your kidneys and liver. These waste products have been shown to cause kidney injury, and in the presence of liver disease, excess nitrogen can cause further problems. High-protein diets may also increase the risk of kidney stones and osteoporosis. If you have kidney or liver disease or any chronic health condition, talk to your doctor before starting a new diet.

For most healthy people, a short-term high-protein diet generally isn't harmful. However, if followed long term, high-protein diets may limit other healthy foods, such as whole grains, fruits and vegetables. In addition, many high-protein foods — such as meat, milk, cheese and eggs — are also high in fat and cholesterol, which can increase your risk of heart disease, stroke and other health problems. So choose your protein sources wisely. Good choices include fish, beans, lentils and low-fat dairy products.

Saturday, April 05, 2008

Japan to study safety of cloned animals for food

Japan will study the safety of cloned animals for food, after a report
concluded there is no biological difference in the meat and milk of cloned
and non-cloned cattle, officials said on Wednesday.

"The safety commission has been asked to deliberate on the matter," an
Agriculture Ministry official said.

It was not immediately clear how long it would take for the Food Safety
Commission, Japan's food safety watchdog which will be looking into the
issue, to reach a conclusion.

"There is no prior case that we can compare it with," an official with the
commission said. He said the safety of cloned cattle and also pigs would be

Many Japanese consumers, notoriously sensitive to food safety, are likely to
oppose moves to introduce meat or milk from cloned animals into the human
food supply, however.

The farm ministry official said Japan has been breeding cloned cattle since
1998. As of September last year, a cumulative total 535 cloned cattle had
been bred in Japan, all for research purposes.

The United States is ahead of Japan as it has already made a final risk

The U.S. Food and Drug Administration ruled in January that food from cloned
cattle, hogs and goats and their offspring is as safe as other food, opening
the door to bringing the meat and milk from cloned animals into the food
supply chain.

Thursday, March 27, 2008

Preventing Alzheimer's - Exercise still best

A report last week from the Alzheimer's Association predicts that 10 million baby boomers will develop Alzheimer's disease in the United States — that translates to one out of every eight. For us "baby boomers," this is frightening to say the least.

There are new treatments on the horizon, but we all wonder whether or not they will be available in time for us or even our children. Let's keep hoping for a cure or prevention model by supporting research in whatever way we can. Meanwhile, studies continue to point to physical exercise as the most effective therapy today to prevent Alzheimer's.

Mounting evidence suggests that physical activity may have benefits beyond a healthy heart and body weight. Through the past several years, population studies have suggested that exercise which raises your heart rate for at least 30 minutes several times a week can lower your risk of Alzheimer's. Physical activity appears to inhibit Alzheimer's-like brain changes in mice, slowing the development of a key feature of the disease.

In one observational study, investigators looked at the relationship of physical activity and mental function in about 6,000 women age 65 and older, over an 8 year period. They found that the women who were more physically active were less likely to experience a decline in their mental function than inactive women.

Another compelling study, conducted by researchers at the University of Chicago, was highlighted on ABC News last week. The study used mice bred to develop Alzheimer's type plaque in the brain. In the study, some mice were allowed to exercise and others were not. The brains in the physically active mice had 50 to 80 percent less plaque than the brains of the sedentary mice and they (exercising mice) produced significantly more of an enzyme in the brain that prevents plaque.

Monday, March 17, 2008

Cancer detected earlier with new technique

Doctors may one day be able to detect early stages of colon cancer without a biopsy, using a new technique developed by researchers at the Stanford University School of Medicine.

This imaging technology is one of many new ways of detecting cancers in the body in real time, said Christopher Contag, PhD, associate professor of pediatrics and of microbiology and of immunology, who led the study. Contag said he hoped it might be one of the first to be used routinely for early detection of cancer.

"Detecting colon cancers is just the first step," said Contag. He predicted similar techniques will eventually be able to find a wide range of cancers, monitor cancer treatment, and deliver chemotherapies directly to cancerous cells in the colon, stomach, mouth and skin. The study will be published online March 16 in Nature Medicine.

Colon cancer is the third most common cancer in men and women, with about 150,000 people diagnosed each year. Although colonoscopy isn't perfect, it's currently the best way of finding colon cancers when they are still at the most treatable stage.

If doctors find suspicious growths during a routine colonoscopy, they take a sample, called a biopsy, and send it to a pathology lab to screen for cancer. That step takes time and not all people have ready access to a nearby pathologist. What's more, doctors biopsy only the cancers that form easily visible growths called polyps. Early stage cancers that remain flat aren't detected.

The trick to picking up cancer without a biopsy is to find a way of seeing which cells are cancerous while they are still in the body. That's what Contag and his group succeeded in doing.

The group found a short protein that sticks to colon cells in the early stages of cancer. Before screening a person, they spray that short protein attached to a fluorescent beacon into the colon. The protein then gloms on to any cancerous cells and creates an easily visible fluorescent patch. They then used a miniaturized microscope called Cellvizio GI, developed by Paris-based Mauna Kea Technologies and loaned to Contag, to peer inside the colon and look for those telltale spots.

Not only did the researchers see fluorescent patches, they could make out the individual cancerous cells. That fine resolution could allow doctors to pick up the earliest possible cancers. Contag said it could also become a useful research tool for studying the small number of cancer stem cells that are thought to establish the eventual tumor.

In the initial trial with 15 patients, the technique detected 82 percent of the polyps that were considered cancerous by a pathologist. Contag said the next step is to work with some of the additional small proteins they've found that also attach to cancerous cells. He thinks that a combination of those proteins will make the technique highly accurate.

Once the screen is ready for widespread use, Contag said it could bring accurate cancer detection to people in remote locations who otherwise don't have access to pathology labs. "A doctor could send a video in real time via the Internet to someone trained to analyze the living cell images," Contag said. This could help people begin the appropriate therapy when the cancer is still at an early stage.

Contag thinks this technique, developed in part through the cancer imaging program at the Stanford Cancer Center, could also be adapted to detect cancers in the mouth, esophagus and stomach. In addition, real-time screening could be used as a way of assessing whether a chemotherapy regimen is working. Contag said that if a tumor responds to a given chemotherapy, changes in the cells might be visible immediately. That response could allow doctors to switch patients to a new, more effective treatment if the first one results in no improvement. Currently people go through several rounds of chemotherapy before the first screen to find out if the treatment is working, a delay that prevents people from moving on to an effective treatment as soon as possible.

Tuesday, March 11, 2008

Drinking may raise the risk of breast cancer

Even moderate drinking may raise the risk of breast cancer among postmenopausal women on hormone replacement therapy, new research suggests.

A number of studies have linked regular drinking to a higher risk of breast cancer; it's thought that the risk reflects the effects of alcohol on women's levels of estrogen and other hormones. Similarly, hormone replacement therapy (HRT) after menopause has been shown to raise the risk of breast cancer.

The new findings, reported in the International Journal of Cancer, suggest that alcohol and HRT may combine to further boost the odds of developing the disease.

Among the more than 5,000 Danish women researchers followed, those who were on HRT and averaged one or two drinks per day had a three-fold higher risk of breast cancer than women who neither drank nor took hormones.

Women who had more than two drinks per day had a nearly five-times higher risk of the disease.

In contrast, drinking habits were not related to breast cancer risk among women who did not use HRT, according to Drs. Naja Rod Nielsen and Morten Gronbaek of the Danish National Institute of Public Health, Copenhagen.

The findings, according to the researchers, raise the possibility that drinking affects postmenopausal breast cancer risk differently depending on women's hormone use. However, more studies are needed to confirm the interaction between alcohol and hormones, they write.

The findings come from two decades' worth of data on 5,035 postmenopausal women who were surveyed about their drinking habits and hormone use at the beginning of the study. Over the next 20 years, 267 women developed breast cancer.

Overall, regular drinking was linked to a slightly higher risk of the disease. But when the researchers considered hormone use, drinking affected breast cancer risk only among women who were on HRT at the outset.

In one previous study of postmenopausal women taking oral estrogen, those who drank were found to have estrogen levels that were three times higher than those of non-drinkers, Nielsen and Gronbaek note.

This may be one explanation for the higher breast cancer risk seen in this study, they write.

If further research confirms the findings, they conclude, there should be an impact on both HRT use and recommendations for "sensible drinking limits" among postmenopausal women.

Friday, March 07, 2008

Breast cancer patients can be treated safely

A new pilot study by investigators at Memorial Sloan-Kettering Cancer Center (MSKCC) found that breast cancer patients can be treated safely with a “dose-dense” regimen of standard chemotherapy agents and the antibody trastuzumab (Herceptin®), a drug that has previously been shown to cause cardiac toxicity. While previous reports evaluating the cardiac effects of breast cancer treatments including trastuzumab and anthracyclines have shown an acceptable safety margin, the new study demonstrates an even lower risk of cardiac toxicity when standard doses of these drugs are administered more frequently over time – a treatment plan called “dose-dense,” which has previously been shown to be a more effective anti-cancer approach.

The researchers used a dose-dense regimen of doxorubicin (Adriamycin®) and cyclophosphamide (Cytoxan® or Neosar®) followed by paclitaxel (Taxol®) and found that the regimen – when given every two weeks instead of three – pairs safely with trastuzumab, a drug that is used to treat breast cancer in women whose tumors contain the protein receptor called HER2.

According to the findings, only 1.4 percent (one patient) of the 70 early-stage breast cancer patients treated with this regimen experienced congestive heart failure after 28 months of follow-up. This rate of cardiac toxicity is lower than the 4 percent threshold that is generally considered acceptable, and still lower than what was found in larger, previously published trials evaluating conventionally scheduled treatment with the use of trastuzumab.

The study’s authors concluded that this dose-dense regimen combined with trastuzumab is a safe and effective way to treat women with early-stage HER2-positive breast cancer in the adjuvant setting and there is no need to forgo the use of this regimen because trastuzumab is also being administered.

Sunday, March 02, 2008

Pregnancy weight gain

Why do we care so much about pregnancy weight gain? The research on this subject is pretty clear. The incidence of pregnancy complications is higher in the upper and lower extremes of weight gain. Generally your health care provider will give you an idea of the amount of weight gain that is optimum for you and your baby.

So, what do you do the month you get on the scale and you find you gained 8 pounds? First, forgive yourself. Secondly, remember that the 8 pounds is history now. Look at the past weeks and see if you can pinpoint any major contributing factors to your pregnancy weight gain. Once you recognize possible causes you can find ways to deal with them.

If you find you are having real problems getting a handle on your pregnancy weight gain, see if there is a nutritionist or dietitian available for you to talk to about the problem. Enjoy your food. Your weight gain is one part of your pregnancy. Don't let the scale ruin your joy and enjoyment of this pregnancy.

There are women on the other side of the needle of the scale. You get on the scale thinking you'll have gained at least 3 pounds and instead you lost a pound or gained 1/2 a pound. My advice is the same. What can you learn from it looking back on your eating habits? Sometimes just changing to a healthier diet can cause a loss.

Thursday, February 14, 2008

Cancer drug Rituxan slows multiple sclerosis progression

Two infusions of the cancer drug Rituxan given two weeks apart slowed the progression of multiple sclerosis for nearly a year, researchers reported on Wednesday.
Multiple sclerosis, which affects as many as 350,000 people in the United States and 2 million worldwide, is apparently caused when the immune system attacks and breaks down the insulation surrounding cells that make up the brain and spinal cord.

MS symptoms may include blurred vision, loss of balance, poor coordination, extreme fatigue, paralysis and blindness. There is no cure.

Although no head-to-head comparison has been done, Hauser said Rituxan appears to work better than existing therapies.

His team tested patients with the relapsing-remitting form of the disease, in which symptoms wax and wane over many years, making it difficult to gauge whether a treatment is really working. They make up about half the patients with MS.

To assess the progress of the Rituxan treatments, they used magnetic resonance imaging, or MRI, scans to see damage to the nervous system.
The number of lesions they could see dropped immediately after the two shots.

Within 12 weeks, there were almost no old or new lesions, while the number of lesions on volunteers who received placebo shots tended to stay the same or increase in number.

But the drug was not as good at preventing relapses.

After 48 weeks, 20 percent of the 69 Rituxan recipients had suffered a relapse. That was still much better than the 35 patients who got placebo injections and had a relapse rate of 40 percent.

Monday, February 04, 2008

Antiepileptic drugs may boost the risk of suicide

Commonly used antiepileptic drugs may boost the risk of suicide among patients who use them.
A review of 199 studies comparing 11 of these drugs to placebos found that patients taking the drugs had about twice the risk of suicidal behavior compared with patients taking a placebo. In fact, of the almost 44,000 patients in the studies, four people taking antiepileptic drugs committed suicide while none of the patients receiving a placebo did.
Currently, some of drug labels do list suicide or suicidal behavior as a side effect, but others don't.
The drugs included in the warning are: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR), Felbamate (marketed as Felbatol), Gabapentin (marketed as Neurontin), Lamotrigine (marketed as Lamictal), Levetiracetam (marketed as Keppra), Oxcarbazepine (marketed as Trileptal), Pregabalin (marketed as Lyrica), Tiagabine (marketed as Gabitril), Topiramate (marketed as Topamax), Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) and Zonisamide (marketed as Zonegran). Some of these drugs are also available as generics.

The 11 drugs listed above were included in the studies the FDA analyzed. However, the agency expects that the increased risk of suicidality is present in all antiepileptic drugs and so the labeling changes will be applied to all drugs in the class.

As of now, the FDA is advising patients not to make any changes in their medication without talking to their doctor.

Tuesday, January 15, 2008

U.S. government - meat and milk from cloned animals safe

The U.S. government ruled on Tuesday that meat and milk from cloned animals and their offspring is as safe as other food, but pressed firms that produce clones to hold off on bringing them into the food supply.
The FDA said it did not have enough information to make an assertion about cloned sheep.
The ruling was the latest twist after years of debate over the reproductive technology, which advocates say will provide consumers with top-quality food by replicating prized animals that can breed highly productive offspring.

The cloning industry, made up so far of only a handful of firms, expects that it will be the offspring of cloned animals, not the costly clones themselves, that would eventually provide meat or milk to U.S. consumers.

Some dairy firms oppose cloning, betting that consumers will shun goods they see linked to cloning technology.

Others believe that more investigation is needed before concluding that cloning is safe -- especially after a year in which consumer confidence was marred by numerous food scares -- or oppose it on moral or religious grounds.

Saturday, January 12, 2008

Way to reduce the amount of bad cholesterol

Researchers at the University of Alberta, have found a way to reduce the amount of bad cholesterol and fatty acids that end up in the blood from food the body metabolizes, a key discovery that could lead to new drugs to treat and reverse the effects of Type 2 diabetes and heart disease related to obesity.

In a series of recently published articles,* Dr. Richard Lehner and his colleagues report they successfully decreased the level of LDL (low-density lipids) – the so-called bad cholesterol – and triglycerides in the blood of mice and hamsters by manipulating a particular enzyme.

It’s well-known that eating too much fat and sugar and too little exercise will make you fat, and that obesity often leads to diabetes and heart disease. Lehner’s group studied the mechanisms behind this.

“We established the proof of principle of how these metabolic pathways work,” he says. “We discovered the activity of an enzyme that releases fatty acids from fat cells and the liver into the blood and how to inhibit this from happening.”

Drugs called statins are used to lower LDL levels in patients, but do not treat obesity. What makes the U of A researchers’ findings noteworthy is their discovery of how to inhibit LDL and triglycerides, which are another form of fat in the blood and a leading risk in obesity-related Type 2 diabetes as well as heart disease.

Lehner is director of the Group on Molecular and Cell Biology of Lipids in the U of A’s Faculty of Medicine and Dentistry. The research is being supported by the Canadian Institutes of Health Research and the Heart and Stroke Foundation.

“There is a substantial pharmacological interest in the enzymes that control TG (triglycerides – fatty acids) and cholesterol metabolism in tissues,” he says.

This unique discovery is an important scientific breakthrough, but one that requires further testing.

Tuesday, January 08, 2008

Treating some kidney cancers

A new study suggests that removing the entire kidney from younger patients with small kidney tumors may lead to decreased overall survival compared with an operation that removes the tumor but leaves the kidney intact.

Radical nephrectomy is a surgical procedure to remove the entire kidney along with the adrenal gland that sits a top the kidney and adjacent lymph nodes. In a partial nephrectomy, only the tumor is removed, sparing the surrounding normal kidney tissue.

Recent evidence suggests that there is a graded impact on survival based on declining overall kidney function. So as kidney function declines, the risk of heart attacks and heart-related events goes up, and consequently the risk of death from these events goes up.

In this retrospective study, the research team reviewed the cases of 648 patients who underwent either a partial or radical nephrectomy for a kidney tumor 4 centimeters or smaller. In the 327 patients younger than 65 years of age, radical nephrectomy was significantly associated with death from any cause when compared with partial nephrectomy. Ten-year overall survival rates were 82 percent for patients treated with a radical nephrectomy and 93 percent for patients treated with a partial nephrectomy.

Urologic surgeons need to consider long-term health consequences for patients with small renal mass undergoing complete nephrectomy.

Less than 25 percent of patients who are treated surgically for small kidney tumors undergo a partial nephrectomy in the United States. The fact that this is being performed in less than a quarter of cases raises a quality of care concern, more study is needed.

Thursday, January 03, 2008

Cancer drug sunitinib (Sutent) can cause high blood pressure

New anti-cancer drug sunitinib (Sutent) can cause high blood pressure in patients with kidney cancer
Sunitinib works by blocking the activity of vascular endothelial growth factor (VEGF). Besides sunitinib, other so-called VEGF inhibitors have been developed, including bevacizumab (Avastin). Although these drugs are promising in fighting several types of cancer, they are associated with side effects, including high blood pressure, bleeding, gastrointestinal perforation, wound-healing complications and clotting.

The finding echoes the results of a study published last month that found the drug increased blood pressure and the risk of heart failure among patients with stomach cancer.

For the study were used home blood pressure monitoring, with the results sent automatically by telephone to the hospital. They found an immediate and marked increase in blood pressure in 14 patients with kidney cancer who were treated with 50 milligrams of sunitinib a day for four weeks.

In a statement released in December , sunitinib's maker, Pfizer Inc., agreed that these heart risks do exist.