Political reporters know they need to follow the money to get the story. It turns out that doctors and medical reporters should, too. Investigators analyzed the outcomes of more than 500 drug trials. Studies funded by the federal government showed benefit about half the time. Those sponsored by the pharmaceutical industry demonstrated a positive response to the drug 85 percent of the time. Studies supported by drug company money were published less often than government funded trials. The investigators speculate that bias can be introduced in subtle ways including the design of the study, the selection of subjects, and the analysis of data.
Thursday, August 26, 2010
Healthy Heart Boosts Brain
Exercise has been shown to be good for the heart and also the brain. Now researchers may have come up with a possible explanation. They measured something called cardiac index, which is a marker for how much blood the heart pumps relative to body size. People with a lower cardiac index score also had demonstrable brain shrinkage. Roughly 1500 people were studied. The relationship was seen even for people in their thirties with no obvious heart disease. The investigators were quick to point out that smaller brain volume was not necessarily linked to cognitive decline, but it is associated with aging. They hypothesize that the pumping power of the heart could influence the amount of blood, oxygen and nutrients that get to brain cells.
Can Resveratrol Reverse Inflammation?
A dietary supplement that is gaining in popularity has new evidence to support its potential benefits. Resveratrol is a compound found in many plants, but peanut and grape skins are particularly rich in this antioxidant. In a small placebo-controlled study, 40 mg of resveratrol daily for six weeks significantly reduced the levels of several markers for inflammation. A number of chronic diseases have been linked to inflammation, including diabetes and heart disease. It is still too early to conclude that resveratrol could prevent these conditions, but the evidence is tantalizing.
[Journal of Clinical Endocrinology & Metabolism, online June 9, 2010]
Health Hazards from Dietary Supplements
Some ingredients in dietary supplements may pose health hazards. That's the conclusion of a review by Consumer Reports working in collaboration with the Natural Medicines Comprehensive Database. The so-called "dirty dozen" include herbs and minerals. For example, bitter orange has replaced a banned herb called ephedra in many natural weight loss and energy supplements. But bitter orange may itself be associated with heart rhythm problems, heart attacks and strokes, the same sorts of cardiovascular problems that got ephedra banned. Another perennial problem is the herb comfrey, which is popular for a range of problems such as cough, joint pain and excessive menstrual flow. But comfrey can damage the liver when taken internally. Some of the other herbs to be wary of include coltsfoot, lobelia and yohimbe.
Nitrates and Bladder Cancer
Common ingredients in processed meat like salami, bologna, hot dogs and ham may increase the risk of bladder cancer. Nitrates and nitrites are frequently used to preserve lunch meats and hot dogs. They also add the familiar pink color and add to the flavor of such foods. But researchers have raised concerns about the safety of such compounds for decades. A joint National Institutes of Health-AARP study of more than 300,000 older Americans lasted seven years. The investigators found that those people who consumed the most dietary nitrite in processed red meat were 30 percent more likely to be diagnosed with bladder cancer than those who ate the least. Beef, chicken and turkey were not linked to a higher risk of bladder cancer.
Will SAMe Combat Depression?
A dietary supplement called SAMe, also known as S-Adenosyl Methionine, may be helpful against resistant depression. SAMe is available without prescription and has long been used to relieve arthritis pain and ease depressive symptoms, but there has been little research. The most recent study recruited people with major depression who had not gotten better on standard antidepressant medications. They were randomly assigned to add either SAMe or placebo to their existing drug regimen. After six weeks, measures of depression showed that more of the subjects taking SAMe had improved. No serious side effects were detected. The researchers call for larger, longer studies to confirm their preliminary findings.
[American Journal of Psychiatry, published online July 1, 2010]
Acetaminophen Use and Asthma
Acetaminophen is one of the most popular pain relievers in the pharmacy. It is considered very safe, especially for babies and children. A new study suggests, however, that acetaminophen may be contributing to wheezing and asthma in children and adolescents. This epidemiological research is not the first to link acetaminophen use to a greater risk of asthma. Perhaps this latest research will encourage pediatricians and parents to be more cautious in using this common painkiller and fever reducer.
[American Journal of Respiratory and Critical Care Medicine, online August 13, 2010]
New Morning-After Pill Approved
The FDA has just approved a new contraceptive. This so-called morning-after pill called Ella is effective for five days after intercourse. Unlike Plan B, the first emergency contraceptive marketed in the U. S., Ella does not contain hormones. Instead, it prevents pregnancy by blocking the effects of progesterone. Ella will be available only by prescription. Side effects may include abdominal pain, headache, fatigue, menstrual discomfort, nausea or dizziness. It has been used in Europe for more than a year.
Calcium Supplements Fail to Protect Pregnant Women from Bone Loss
Calcium supplements did not protect pregnant women from bone loss. This new study comes on the heels of a controversial analysis showing that calcium pills increased the risk of heart attacks among older people. Although the evidence that calcium supplementation strengthens bones is modest, tens of millions of women have been popping down calcium in the belief that it would protect them against osteoporosis without negative consequences. The recent analysis in the journal BMJ suggests that assumption may not be valid.
The latest challenge to calcium's benefits comes from the Gambia. Researchers randomly assigned women to take either 1500 mg of calcium carbonate or a placebo daily during pregnancy. The supplements were continued up to delivery. These women normally had low levels of calcium in their diets, so the scientists expected that the supplements would protect them from bone loss. Pregnancy puts extra demands on calcium stores to help build new bones in the baby. Contrary to expectation, however, the women who got extra calcium had lower bone mineral content than those on placebo. The investigators speculate that calcium pills disrupted normal adaptation to pregnancy and nursing.
Unorthodox Cancer Treatments
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Research in rodents and test tubes has turned up many compounds that are active against cancer cells. But relatively few of these have been developed into cancer treatments. The established ways of treating cancer, such as chemotherapy and radiation, are often toxic and usually very expensive. Worse, they don't always work. What other therapies already available on drugstore shelves show promise for treating cancer? How can we utilize the body's own defense, the immune system, to fight cancer? This is the third in our three-part series on unconventional approaches to cancer.
Guests: Vikas Sukhatme, MD, PhD, oncology researcher and Professor of Medicine at Harvard University Medical School. He is co-founder of Global Cures.
Vidula Sukhatme, MA, MS, is co-founder and CEO of Global Cures. The photo is of Vidula Sukhatme.
Coley's Toxin, Cancer and Immunology Archive
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Click the arrow to play audio file:
click here if you cannot view audio player: MatzingerFull.mp3
Beyond the Podcast: listen to an additional interview with our guest:
click here if you cannot view audio player: MatzingerFull.mp3
Dr. William Coley was a cancer surgeon at the turn of the 20th century. In an effort to improve the treatment he could offer his patients, he created a toxin that made them really sick. If they recovered from their fever, however, they were often cured of their sarcomas.
A century later, cancer researchers are taking a new look at Coley's toxin and how it might help us understand spontaneous remissions and the role of the immune system. In exploring this topic, we encounter an innovative immunologist who has developed a new paradigm for how the immune system works.
Guest: Uwe Hobohm, PhD, is a cell biologist and Professor of Bioinformatics at the University of Applied Sciences in Giessen, Germany. He has worked at the European Molecular Biology Laboratory in Heidelberg and at F. Hoffmann-La Roche in Basel. He is the author of Healing Heat: An Essay on Cancer Immune Defence.
http://bioinfo.tg.fh-giessen.de/pamp-cancer/
Polly Matzinger, PhD, is an ex-Playboy bunny turned scientist. At the National Institute of Allergy and Infectious Diseases, she is section head of the Ghost Lab, more formally known as the section on T cell tolerance and memory of the Laboratory of Cellular and Molecular Immunology. In her private life, she trains award-winning sheep dogs. The photo is of Polly and her dog Annie.
Improving Patient Safety
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Ten years ago, the Institute of Medicine shocked the medical establishment when it published To Err Is Human. The experts of the IOM estimated that nearly 100,000 Americans died of medical errors in hospitals every year. More studies of the problem have revealed that this may be only the tip of the iceberg.
Efforts to improve patient safety have had some effect. One doctor developed a checklist to reduce the risk of certain hospital-acquired infections. Find out about how he came up with the checklist and how his campaign to make hospitals safer is being waged.
Guest: Peter Pronovost, MD, PhD, is a professor at Johns Hopkins School of Medicine. He directs the Quality and Safety Research Group and serves as medical director for the Center for Innovation in Quality Care. Dr. Pronovost was named one of Time Magazine's 100 most influential people in 2008 and was the recipient of a MacArthur genius grant in 2009. Together with Eric Vohr, he has written Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Change Healthcare from the Inside Out. He is also the author of a recent article in the Journal of the American Medical Association.
Dealing with Dizziness
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As many as 7 million people each year have dizziness or vertigo so severe it drives them to seek medical care. But although the symptom of dizziness is common, finding the cause and the proper treatment is complicated. We learn how balance disorders are best approached.
Guest: David M. Kaylie, MD, MS, is Associate Professor in the Division of Otolaryngology--Head and Neck Surgery at Duke University Medical Center.
Cancer and the Immune System
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Bonus Interview:
Dr. Jon Serody describes his work with cancer vaccines and how they may trigger the immune system to fight cancer.
click here if you cannot view audio player: SerodyColey.mp3
Bonus Interview:
Don MacAdam discusses Dr. Coley's success treating cancer. He describes his company's efforts to make Coley's fluid available.
click here if you cannot view audio player: MacAdamColeyExtended.mp3
More than 100 years ago, a New York surgeon named William Coley developed an unusual cancer treatment that produced a high fever in his patients. Although the treatment was unconventional, it turned out to be successful surprisingly often. Should Coley's treatment be revived today? How else might we jump-start the immune system? Find out about the hope for vaccine treatments for cancer, as well as the status of Coley's fluid. This is the second in a three-part series on unconventional approaches to cancer.
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