PlusDrugStore blog

February 28, 2007

Differences in outcomes of obese women and men undergoing primary total hip arthroplasty

Filed under: Health News — Daniel @ 4:44 pm

Obese patients tend to have a higher prevalence of total hip replacements due to a higher incidence of hip osteoarthritis. This is of particular concern in light of the trend in rising rates of obesity in developed countries.
A new study published in the March 2007 issue of Arthritis Care & Research evaluated the effects of obesity on complications and outcomes following total hip replacements and investigated whether the results differed in obese women and men.

Led by Anne Lebbeke, M.D., MSc, of the Geneva University Hospital in Geneva, Switzerland, researchers conducted a study of all patients who underwent total hip replacements between March 1996 and July 2005 at their hospital. Of the 2,495 hip replacements (some were bilateral), 589 were performed in obese patients, with a higher prevalence of obese males than females. Obesity was defined as a body mass index equal to or greater than 30 kg/m2. Researchers evaluated the incidence of infection, dislocation, and revision (redoing the replacement), as well as quality of life, satisfaction, and general health five years after undergoing a hip replacement.

The results showed that obesity was associated with a substantially higher risk for infection in women, led to more dislocations (with a greater increase in women), and resulted in more revisions due to septic loosening (caused by infection). After five years, outcomes for 635 hips in non-obese patients and 183 hips in obese patients were evaluated. Obese women, but not obese men, reported moderately lower functional outcomes and slightly less satisfaction, mostly due to a higher incidence of complications.

The risk factors for infection that are known to be more frequent in obese patients, such as longer operating time and diabetes, were not related to females in the study and do not explain why the women had poorer results. The researchers suggest that other reasons related to sex differences, such as body fat distribution and metabolic response, might be involved. They also note that the higher number of dislocations in obese women may be due to the lower peripheral muscle strength seen in this group of patients, while the lower functional outcomes may be due to additional factors such as a higher incidence of osteoarthritis.

Source : www.news-medical.net

Antioxidant supplements beta carotene, vitamin A and E may increase risk of death

Filed under: Health News — Daniel @ 4:41 pm

Many people take antioxidant supplements, believing they improve their health and prevent diseases. Whether these supplements are beneficial or harmful is uncertain, according to background information in the article.

Goran Bjelakovic, M.D., Dr.Med.Sci., of the Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark, and colleagues conducted an analysis of previous studies to examine the effects of antioxidant supplements (beta carotene, vitamins A and E, vitamin C [ascorbic acid], and selenium) on all-cause death of adults included in primary and secondary prevention trials. Using electronic databases and bibliographies, the researchers identified and included 68 randomized trials with 232,606 participants in the review and meta-analysis. The authors also classified the trials according to the risk of bias based on the quality of the methods used in the study, and stratified trials as “low-bias risk” (high quality) or “high-bias risk” (low quality).

In an analysis that pooled all low-bias risk and high bias risk trials, there was no significant association between antioxidant use and mortality. In 47 low-bias trials involving 180,938 participants, the antioxidant supplements were associated with a 5 percent increased risk of mortality. Among low-bias trials, use of beta carotene, vitamin A, and vitamin E was associated with 7 percent, 16 percent and 4 percent, respectively, increased risk of mortality, whereas there was no increased mortality risk associated with vitamin C or selenium use.

“Our systematic review contains a number of findings. Beta carotene, vitamin A, and vitamin E given singly or combined with other antioxidant supplements significantly increase mortality. There is no evidence that vitamin C may increase longevity. We lack evidence to refute a potential negative effect of vitamin C on survival. Selenium tended to reduce mortality, but we need more research on this question,” the authors write.

“Our findings contradict the findings of observational studies, claiming that antioxidants improve health. Considering that 10 percent to 20 percent of the adult population (80-160 million people) in North America and Europe may consume the assessed supplements, the public health consequences may be substantial. We are exposed to intense marketing with a contrary statement, which is also reflected by the high number of publications per included randomized trial found in the present review.”

“There are several possible explanations for the negative effect of antioxidant supplements on mortality. Although oxidative stress has a hypothesized role in the pathogenesis of many chronic diseases, it may be the consequence of pathological conditions. By eliminating free radicals from our organism, we interfere with some essential defensive mechanisms . Antioxidant supplements are synthetic and not subjected to the same rigorous toxicity studies as other pharmaceutical agents. Better understanding of mechanisms and actions of antioxidants in relation to a potential disease is needed,” the researchers conclude.

Source : www.news-medical.net

February 25, 2007

Daily Aspirin for Women?

Filed under: Health News — Daniel @ 5:54 pm

“There is a perception that aspirin protects a woman’s heart the same as a man. But that is not the case,” Mosca says. “Women under 65 should not be using aspirin routinely to benefit their heart — unless they are at high risk of heart disease.”

For women under age 65, regular low-dose aspirin does reduce the risk of one kind of stroke. But aspirin also greatly increases a woman’s risk of serious bleeding. For many women, the benefit does not outweigh the risk.

“Women should consider aspirin for prevention of a certain type of stroke — ischemic stroke — but that choice needs to be very informed and based on an individual woman’s risk factors for stroke and risk of side effects,” Mosca says. “The additional benefit in women over 65 for heart attack prevention should be weighed into that decision.”

That said, women who already have heart disease benefit greatly from regular low-dose aspirin, says Alice Jacobs, MD, director of interventional cardiology at Boston Medical Center.

“For women with established heart disease, aspirin is mandatory on a daily basis,” Jacobs says.

The bottom line: Women should not take regular aspirin to prevent stroke or heart disease without discussing the issue with their doctors.

Source : www.webmd.com

Women’s Heart Guidelines

Filed under: Uncategorized — Daniel @ 5:52 pm

Women can prevent heart disease and stroke, show the latest guidelines from the American Heart Association.

Armed with new data — and encouraged by the fact that 60% of U.S. women now know that heart disease is their No. 1 health threat — the AHA has launched an ambitious prevention program.

The program is the work of an expert panel led by Lori Mosca, MD, MPH, director of preventive cardiology at New York-Presbyterian Hospital and of the Columbia University Center for Heart Disease Prevention.

“Women are still confused about cardiovascular disease prevention,” Mosca said at a news conference. “We hope to clear up some of this confusion. These new guidelines will help our patients … develop strategies to combat this leading killer.”

Cardiovascular disease refers to any disease that affects the heart and blood vessels, including stroke.

The AHA women’s heart disease prevention strategy has three main elements: living a healthy lifestyle, addressing major heart risk factors, and using appropriate medications.

Here’s the plan:

All women age 20 and older should see a doctor to find out their heart disease risk.
About one in 10 women will learn she is at “optimal risk,” meaning she’s currently at no real risk of heart disease. These women should continue their heart-healthy lifestyles.
Most women will be “at risk” — meaning they must start thinking about preventing heart disease and stroke. These women must stop smoking, adopt a heart-healthy diet, get at least 30 minutes a day of exercise, and watch their weight. With a doctor’s advice — and only with a doctor’s advice — some of these women may need blood pressure medications, cholesterol-lowering therapy, or regular aspirin.
Many women will be “high risk,” meaning they already have some condition that makes it particularly likely they will suffer heart disease or stroke. In addition to taking the measures advised for their “at risk” sisters, “high risk” women may need more aggressive medical treatments or rehab.
Depression is common in women with heart disease. All women with heart disease should be evaluated for depression.

Source : www.webmd.com

February 22, 2007

Male Factor : Food

Filed under: Health News — Daniel @ 2:58 pm

As many as 30 percent of people with eating disorders are men. It’s not often talked about, and many men find it hard, even impossible, to get help since many facilities only accept females.

His image is not what 16-year-old Mike wants to see when he looks in the mirror. He says, “There was this saying that I heard somewhere, and it goes, ‘Your eyes see what mine can’t see.’”

All Mike’s eyes saw was an overweight teenager staring back at him. That dissatisfaction led to anorexia and then bulimia. He would eat only 500 calories every other day and would jog about 75 miles every weekend. His weight log shows how he went from 180 pounds to 112.

Mike says, “I wanted to be as skinny as I possibly could because I just didn’t believe I was worth anything, and after being told that for about seven or eight years, you get used to it, and you believe it.” He believed it so much, he even tried to kill himself … Twice.

Roberto Olivardia, Ph.D., a psychologist from McLean Hospital in Boston, says there are differences in how men and women cope with eating disorders. “With women who struggle with an eating disorder, it doesn’t violate their femininity. It doesn’t violate their gender in any way, whereas for men, it does, so they often struggle with, well does this make me less of a man? Does this make me gay? What does it mean?”

There are other differences as well. Men are more likely to have been involved in sports and to have been obese in the past. And nearly 70 percent of men with eating disorders have other problems like drug or alcohol dependence, depression, or obsessive-compulsive disorder.

Olivia Beckman, M.D., an eating disorder specialist, says men are also treated differently — with a more straightforward approach. “Some of the therapy that is used in eating disorders is using a feminist approach, and that would turn off men, not only do they not want to come in, when they get in, we’re talking about squishy feelings that they would not want to discuss,” says Dr. Beckman, who is from Walden Behavioral Care in Waltham, Mass.

So, doctors focus more on thoughts rather than feelings. Dr. Beckman says finding the right therapist is also important. “I would recommend that they would either see a man, or someone that’s used to working with men to be able to help them best.”

Mike still struggles with his body image but considers himself “mostly recovered.” He says the best therapy came from writing a book about his disorder. He says: “I still have moments where I believe I’m not worth anything, and I still purge about once a week or so, but that’s better than six times a day, so I’m doing better. I’m on the road to recovery, but there’s still bumps along that road.”

Now, it’s up to Mike to smooth out those bumps any way that works for him. He wants to make a complete recovery and hopes to help other boys who suffer from eating disorders in the future.

Source : www.ivanhoe.com

All-Natural Menopause Relief

Filed under: Health News — Daniel @ 2:51 pm

SAN FRANCISCO (Ivanhoe Broadcast News) — Hot flashes, mood swings, even depression. Symptoms of menopause can be harsh. And since researchers found hormone replacement therapy (HRT) increases the risk of cancer, stroke and heart attack, women aren’t left with many options.

“What we’re looking for is a treatment that would work, and at the same time, be safe,” Deborah Grady, M.D., an epidemiologist at University of California, San Francisco Medical Center, tells Ivanhoe.

Now, UCSF researchers may have found one — a therapy called MF101.

“It’s a combination of Chinese herbs, 22 of them,” George Sawaya, M.D., in obstetrics and gynecology at UCSF Medical Center, tells Ivanhoe. “We don’t know exactly how MF101 works. As you can imagine, anything that’s an extract of 22 herbs, it’s very hard to pinpoint the exact mechanism of action.”

But in the first phase of the study, MF101 improved menopause symptoms by 30 percent. It appears safer than HRT because it doesn’t affect reproductive hormones or promote tumor growth — suggesting it will not increase the risk of cancer.

Forty-six-year-old Monique Louvigny is participating in the study. “I could obviously benefit from this, but also everybody else who is my age,” she says.

MF101 will have to undergo at least one other clinical trial before getting FDA approval for use by the public. The herbs have been used for thousands of years in Chinese medicine, but have never before been tested for safety or efficacy.

Source : www.ivanhoe.com

February 19, 2007

New York City to unveil official condom as part of HIV prevention efforts

Filed under: Health News — Daniel @ 10:59 am

New York City health officials on Wednesday are scheduled to unveil the city’s official condom as part of the New York City Department of Health and Mental Hygiene’s efforts to curb the spread of HIV and other sexually transmitted infections, the AP/Long Island Newsday reports (Kugler, AP/Long Island Newsday, 2/13).
The health department last month approved a $1.57 million contract to deliver more than 20 million Ansell Healthcare’s Lifestyle condoms and packets of lubricants to organizations and venues in the city to help curb the spread of HIV.

The health department will pay Ansell four cents per condom, putting the cost of the program at about $720,000 annually, according to health officials.

Officials are attempting to make the packaging for the condoms, which will be distributed by the city, more distinctive.

City officials said they hope the condom’s packaging will help them to better track the effectiveness of their distribution program (Kaiser Daily HIV/AIDS Report, 1/29).

According to the AP/Newsday, the condoms’ design is expected to be a subway theme with different colors for various train lines (AP/Long Island Newsday, 2/13).

Officials plan to track the progress of the program through an annual community health survey, which polls 10,000 city residents by telephone.

New York City currently distributes about 1.5 million condoms monthly, or about 18 million annually, at no cost to organizations, health clinics, advocacy groups, bars, restaurants, nail salons, nightclubs and prisons.

Organizations or venues can request an unlimited supply of condoms at no cost through an online ordering system set up by the city health department (Kaiser Daily HIV/AIDS Report, 1/29).

Volunteers are scheduled to hand out the no-cost condoms at the launch, which will take place at a Kenneth Cole store in Manhattan. The store also plans to unveil a T-shirt and boxer shorts as part of the campaign (AP/Long Island Newsday, 2/13).

U.K. should increase efforts to support health systems in developing countries

Filed under: Health News — Daniel @ 10:57 am

The United Kingdom should do more to help train and support health workers in developing countries in an effort to strengthen their health care infrastructures, Lord Nigel Crisp, former chief of the U.K. National Health Service, said in a report released on Tuesday, BBC News reports.
Unless their health systems are strengthened, developing countries will not be able to achieve the U.N. Millennium Development Goals related to controlling the spread of HIV/AIDS, tuberculosis and malaria, according to the government-commissioned report.

There is a shortage of 4.3 million health workers worldwide, BBC News reports (BBC News, 2/13).

The report calls for NHS to establish a scholarship program that would help train health workers in developing countries.

In addition, the report recommends new arrangements to support health workers who volunteer to work in developing countries to ensure that they are able to return to their jobs with no break in pension contributions (Press Association/Guardian, 2/13).

Crisp also calls for the creation of a Web site, called the Global Health Exchange, on which developing countries can advertise their resource needs. In addition, NHS hospitals can offer redundant equipment through the Web site, and health workers can offer volunteer services, the report says.

The report also calls for a Global Health Partnership Center to act as a single informational resource for individuals and organizations seeking to help global health systems (BBC News, 2/13).

Secretary of State for International Development Hilary Benn and Secretary of State for Health Patricia Hewitt welcomed the report and announced about $1.9 million over two years for the Global Health Workforce Alliance to help find solutions to health worker shortages in developing countries (Department of Health release/eGov Monitor, 2/13).

February 16, 2007

Human Skin Has Many More Types Of Bacteria Than Previously Thought

Filed under: Health News — Daniel @ 2:19 pm

It appears that the skin, the largest organ in our body, is a kind of zoo and some of the inhabitants are quite novel, according to a new study. Researchers found evidence for 182 species of bacteria in skin samples. Eight percent were unknown species that had never before been described.

It is the first study to identify the composition of bacterial populations on the skin using a powerful molecular method. Not only were the bacteria more diverse than previously estimated, but some of them had not been found before, says Martin J. Blaser, M.D., Frederick King Professor and Chair of the Department of Medicine and Professor of Microbiology at NYU School of Medicine, one of the authors of the study.

“The skin is home to a virtual zoo of bacteria,” he says. This study is published February 5, 2007, in the online edition of the Proceedings of the National Academy of Sciences.

The researchers analyzed the bacteria on the forearms of six healthy subjects; three men and three women. “This is essentially the first molecular study of the skin,” says Dr. Blaser. The skin has been, he says, terra incognita, an unknown world that he and his colleagues have set out to understand much like explorers.

“There are probably fewer than ten labs in the U.S. looking at this question,” says Dr. Blaser. “It is very intensive work,” he adds. Zhan Gao, M.D., senior research scientist in Dr. Blaser’s lab, led the research, which took more than three years to complete.

Some of the bacteria on the skin appear to be more or less permanent residents; others are transient, according to the study.

This research is part of an emerging effort to study human microbial ecology. Dr. Blaser’s laboratory has previously examined the bacterial population in the stomach and the esophagus. “Many of the bacteria of the human body are still unknown,” he says. “We all live with bacteria all our lives and occasionally we smile, so they’re not that bad for us.”

The most numerous cells in our body are microbial – they outnumber our cells 10 to 1. The body has microbes native to the body, including the skin, and these populations change according to how we live, he says. “Ultimately what we want to do is compare disease and health,” says Dr. Blaser. Keeping bacterial populations in our body stable may be part of staying healthy, he says.

In the new study, the researchers took swabs from the inner right and left forearms of six individuals picking the region halfway between the wrist and the elbow for its convenience. “It’s not where they wash their hands,” explains Dr. Blaser. “And they don’t have to undress.” The researchers wanted to be able to compare two similar parts of the body. Because they also wanted to study change over time, they took swabs from four of the individuals 8 to10 months after the first test.

Roughly half, or 54.4%, of the bacteria identified in the samples represented the genera Propionibacteria, Corynebacteria, Staphylococcus and Streptococcus, which have long been considered more or less permanent residents in human skin.

The six individuals differed markedly in the overall composition of the bacterial populations on their skin. They only had four species of bacteria in common: Propionibacterium acnes, Corynebacterium tuberculostearicum, Streptococcus mitis, and Finegoldia AB109769. “This is a surprise,” says Dr. Gao. “But many things affecting the skin affect bacteria, such as the weather, exposure to light, and cosmetics use.”

Almost three-quarters, or 71.4%, of the total number of bacterial species were unique to individual subjects, suggesting that the skin surface is highly diversified in terms of the bacteria it harbors, according to the study.

Three bacterial species were only found in the male subjects: Propionibacterium granulosum, Corynebacterium singulare, and Corynebacterium appendixes. While the sample is too small to draw conclusions, the scientists believe that women and men may harbor some different bacterial species on their skin.

In each individual, the bacterial populations varied over time while revealing a core set of bacteria for each individual. “The predominant bacteria don’t change much,” says Dr. Gao. “But the more transient bacteria did change over time,” she says.

“What that suggests,” adds Dr. Blaser, “is that there is a scaffold of bacteria present in everybody’s skin. Some stay and others come and go.”

Finding the method

To obtain a sample Dr. Gao rubbed a swab on each individual’s forearms. “We didn’t tell them to be particularly clean, we just made sure they didn’t take antibiotics up to one month prior to the test,” Dr. Gao explains. She chose three men and three women to have a balance of genders. She set up a clean room so the samples didn’t risk contamination.

Traditionally, bacteria are cultured in the lab in petri dishes, which contain a medium to grow bacteria. But the method leads to inaccuracies, she explains, because only a fraction of bacteria in a sample grow in that medium. So the team used a powerful molecular method that involved extracting a subunit of genetic material called 16S ribosomal DNA from the samples. “It is kind of a common currency, it’s a conserved gene,” says Dr. Blaser. Another advantage is that there is a large database of 16S ribosomal DNA available to scientists.

The ambitious task for this study was to gather samples, prepare them, amplify the bacteria creating colonies of each single species of bacteria present in the skin samples. Then Dr. Gao used established tools – primers – to pick out the species-specific genetic regions in the bacteria. After sequencing those regions, the 16S ribosomal DNA (rDNA) in each colony, she consulted 16S rDNA databases to determine the bacterial species present in each sample. Many bacteria in the database only exist as sequences and have nether been named or extensively studied. Those are termed SLOTUs, or species-level taxonomic units.

Taxonomy and the study results

To distinguish organisms from one another, biologists group and categorize them. Species or SLOTUs are small categories. There are larger groupings such as genera and phyla. Humans, for example, belong to the phylum chordata, the genus Homo and the species Homo sapiens.

The molecular method used in this study revealed differences between the bacterial populations in individuals. Other methods had previously not shown those differences.

The team found a total of 182 species or SLOTUs and 91 genera of bacteria in the skin samples.

The samples yielded mainly three phyla of bacteria: Actinobacteria, Firmicutes, and Proteobacteria. Ninety-four point six percent of the bacteria were in these phyla. These phyla were found in all six tested individuals. When compared with earlier studies, the researchers found that these three phyla are also dominant in the esophagus and the stomach. In terms of bacterial species, however, the insides of the body, for example the stomach, and the exterior of the body, the skin, show vast differences in bacterial populations.

Skin condition can change markedly due to a variety of factors such as climate, diet, personal hygiene, and disease. But skin is never devoid of bacteria, particularly its more permanent residents. That is not bad news, after all, in healthy individuals these bacteria are not pathogens. “Without good bacteria, the body could not survive,” says Dr. Gao.

The next step for the research team is to look at diseased skin. “We plan to ask the question: Are the microbes in diseased skin, in certain diseases like psoriasis or eczema, different than the microbes in normal skin?” says Dr. Blaser.

FDA Clears First Of Its Kind Suture Made

Filed under: Health News — Daniel @ 2:16 pm

The U.S. Food and Drug Administration (FDA) today announced it has cleared for marketing in the U.S. the TephaFLEX Absorbable Suture- the first absorbable polymer suture made from material isolated from bacteria modified by recombinant DNA technology.

Recombinant DNA technology uses living organisms to create chemicals that may be more difficult to produce under standard industrial methods.

“The TephaFLEX Absorbable Suture is made from material that uses the latest DNA technology,” said Daniel Schultz, M.D., director, Center for Devices and Radiological Health, FDA. “This approach could have broader applications for medical devices that use this novel manufacturing technology.”

FDA based its decision on the company’s laboratory and animal testing that examined chemical composition, biological safety and mechanical performance of the polymeric suture. The company provided data to show that the suture could be manufactured in a consistent and safe manner.

FDA reviewed safety and effectiveness information for the device under the de novo petition process. De novo petitions were added under the Food and Drug Administration Modernization Act of 1997 to find a way for novel but less risky products to get to market. As a result of its review, FDA determined that products of this type will be regulated as class II (moderate-risk) devices.

The device is contraindicated in patients allergic to the cells or the growth media used to produce the absorbable polymeric material.

Doctors use sutures in patients to hold soft tissue together while the tissue heals from a deep cut or surgical incision. Absorbable sutures are made of materials that break down in the body after a short period of time.

TephaFLEX Absorbable Suture is manufactured by Tepha, Inc., of Cambridge, Mass.

FDA’s regulation of all medical devices is risk-based, with devices classified into low-risk (class I), moderate-risk (class II) or high-risk (class III) categories. The FDA regulatory program for medical devices is comprehensive and includes requirements for registration and listing of products, premarket evaluation, high-quality production using good manufacturing practices and post-market reporting of adverse events.

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