ErinPharm Gazette August 2008
Join the Life Extension Foundation
Vitamins, supplements, blood tests
A review of August 2008. A selection of topics.
This web page is one of a number of ErinPharm web pages designed by me as a synopsis of topics that interest me as well as being a quick reference page for my newsletter subscribers and myself. I have no affiliation of any kind to any pharmaceutical company or medical group. The opinions expressed are my own. I welcome communication and debate. I am an optimist. I look forward to the future with wonder.
Keep up to date with advances in the prevention, diagnosis, and treatment of colorectal cancer.
Know about the latest treatment guidelines for addiction.
Patients should know everything there is to know about Gastro-esophageal Reflux Disease (GERD)
Advances in lung cancer therapies are moving ahead. Keep up to date.
The first comprehensive map of Genomic copy number variations has been developed. Such copy numbers influence genetic diversity and susceptibility to disease.
The American Cancer Society is your main source of information in the ongoing battle against cancer.
Are you trying to lose weight and have been misled by the multi-billion dollar industry selling pills, potions, and 'magic cures'? You are not alone. A survey backed by a commercial drug company reports that approximately 70% of American dieters have tried scientifically unproven methods to lose weight. That's an astounding number of people who have tried dietary supplements in the form of pills and powders. About half of survey respondents incorrectly think supplements are approved by the federal Food and Drug Administration, while about two-thirds believe such products must carry warning labels for side effects. All that happens is maybe temporary loss of weight and the emptying of your pocket. Resist the temptation to believe in those seductive commercials. The only way you can lose weight and keep it off is by a commitment to a change in lifestyle. I recommend lifestyle changes.
Keep up to date with advances in the use of statins.
Report Adverse Drug Events. Help facilitate drug safety.
Have you done an act of kindness today? Have you sent 1.1 cups of food to an impoverished hungry person in the underdeveloped world just by clicking this link: http://www.thehungersite.com ? Sponsors will pay the cost. All you do is click and acknowledge you have visited the page. You can do it every day. As an introduction to the high quality of Life Extension Foundation vitamins and supplements readers of Erinpharm web pages can buy Coenzyme Q10 Ubiquinol, Omega-3 EPA/DHA fish oils, Vitamin D3, Folic Acid with Vitamin B12, Gamma E Tocopherol, Super Booster with Advanced K2 complex, and Super K with advanced K2 complex directly from Erinpharm as a low price single item: click here.
Readers of ErinPharm Gazettes are among those aware, motivated, and seeking to take advantage of knowledge generated on the expanding frontiers of medical/scientific research. It is important to recognise that while we are privileged to be part of this future coming rapidly toward us we also live on a planet where the majority of our fellow human beings suffer under a burden of disease overwhelming and horrifying. One such disease is malaria. It threatens half the world's population, will strike up to half a billion people this year, at least a million will die, most of them under age 5, the vast majority living in Africa.
YOU can make a difference. YOU can take the time to care. YOU can reach out to our distant cousins in our common human lineage. YOU can click this link and become part of.....NothingButNets....YOU can join the fight against malaria.
Coming on vacation from overseas? Taking out membership with the Life Extension Foundation means you can shop at the LEF Retail Store in Fort Lauderdale, Florida, and get blood drawn for a comprehensive test analysis the same day. No appointment for a blood draw is necessary. Just arrive before 2:00 pm.
As of March 31, 2008, Abbott Laboratories has already submitted an NDA (New Drug Application) to the US FDA for TriLipix as monotherapy and in combination with a statin.
Are you aging in a healthy manner?
Accumulating clinical trials are pointing out that most peole have a deficiency of Vitamin D3 circulating in their bloodstream. Evidence is presented that a ban on smoking in public places results in lower local hospital admissions. Research moves forward in using transcription factors to convert one type of cell into another. Intravenous vitamin C as an adjunct to cancer therapy is under investigation. The rising incidence of obesity among children with the resultant risk of future hypertension, diabetes, and cardiovascular disorders raises alarm among experts. The inequitable delivery of healthcare raises uncomfortable questions. Baby boomers are entering the above 65 bracket, 78 million starting to enter this section of the population by 2011.
As reports accumulate and medical attention is turning toward observations that the majority of the world population is deficient in blood levels of Vitamin D3, inadequately compensated for with diet and exposure to sunshine, national media joins medical professionals in urging that supplementation with Vitamin D3 should start in infancy. This article from the New York Times by Roni Caryn Rabin points out that we have neglected knowledge more than a century old that Vitamin D3 deficiency is linked to rickets, diabetes, cancer, osteoporosis, and an increased incidence of other diseases. Our human lineage received a daily dose of Vitamin D3 from exposure of skin to equatorial sunshine. Clothing and migration to temperate zones along with less than daily exposure to sufficient sunshine was recognised to be the cause of Vitamin D3 deficiency many decades ago and led to the mandated fortification of milk. That has not been sufficient and it is now clear that almost all individuals are at an increased risk of cancers, cardiovascular disease and other disorders because of our lack of attention to knowledge we have had since the early 1900s. Vitamin D3 supplements are inexpensive, easy to take, and should be an addition to nutrition for us all.
Arterial health can also be damaged by hypertension (high blood pressure). It is a condition often undiagnosed or ignored in and by the general population. It is a 'silent killer' since it can exist in an individual unaware of their high blood pressure for many years insidiously and incrementally damaging the blood circulation system prior to a catastrophic cardiovascular incident. The current impetus toward having households add a home blood pressure monitor to gauge the daily blood pressure status of those with hypertension could well raise the profile of the importance of regular blood pressure monitoring. ErinPharm recommends the Omron brand of blood pressure monitor as being inexpensive and easy to use. New data revealed May 2008 confirm that hypertension control in the general population appears to be better in the United States than in Europe though diabetics are ill served by the latest US guidelines and only about half of US patients achieve a blood pressure objective. This data comes from a comprehensive multi-country survey by investigators led by Dr. Y. Richard Wang, of Temple University and University of Pennysylvania, in which a total of 21,053 patients with a primary or secondary diagnosis of hypertension in six countries were evaluated. These patients had visited 1,284 primary care physicians and 291 cardiologists. With a definition of control as a blood pressure less than 140/90 mm Hg it was found that 53% of US patients reached that objective compared to 27% to 40% of Europeans. In Canada new guidelines for hypertension management were released to the public in January 2007 and stressed the importance of recognizing "high normal" blood pressure, i.e. 130-139/85-89 mm Hg, and the warning that more than half of such individuals will develop hypertension within four years if they do not make lifestyle changes. The point is also made that for individuals who do not follow a healthy lifestyle more than 90% will develop hypertension. Since guidelines, medications, and lifestyle changes can and will bring blood pressure to a healthy level over a time period of up to six weeks there is a need to overcome this societal inertia on the part of health care professionals and the general population to not actively seek blood pressure normalization. Yes, it does take significant effort at times, needs ongoing attention, requires a personal commitment on the part of the patient BUT it will result in a healthier way of life with a much reduced risk of heart attack or stroke. The next few years will see the launch of a number of new antihypertensive drugs and combination 'polypills'. In India a 'polypill' with two antihypertensives, aspirin, and a statin is expected to gain acceptance. The years to come will see major advances in this combined approach to arterial health.
Changing social attitudes toward smoking in public places in Scotland, and legislation to prevent it, has led to a significant decrease in admissions to Scottish hospitals for acute coronary syndromes since a ban went into effect. This data, published in the July 31 issue of the New England Journal of Medicine, by lead investigator Dr. Jill Pell, of the University of Glasgow, gives a solid foundation to efforts to restrict exposure of non-smokers to cigarette smoke. That there has been found to be a reduction of 14% in admissions for smokers, 19% reduction in admissions for former smokers, and a 21% reduction in admissions for those who never smoked surely provides reason to more vigorously follow the Scottish example; lowering acute coronary syndrome events among the general population, lowering the burden on our hospitals and reducing the total healthcare costs in our national economy.
In a fascinating example of the pace of research exploring methods of generating a person's own cell tissue of various types, up to now with a focus on stem cells and reversing mature cells to an embryonic state, research moves forward as a research group at Harvard reports that they have converted pancreatic cells from non-insulin producing to insulin producing in mice using a set of three transcription factors, correcting the deficiency in diabetic mice. Thus the pioneering work by Dr. Shinya Yamanaka showing that transcription factors can return a mature cell to an embryonic state has now led to this remarkable work by Dr. Qiao Zhou and Dr. Douglas Melton. Since last month Dr. Patrick Scale and Dr. Bruce Spiegelman, at the Dana-Farber Cancer Institute in Boston, showed that a single transcription factor can change white fat cells to brown fat cells another conceptual barrier falls; it may indeed be possible to convert one kind of cell into another using transcription factors. As yet in early research stages this is a new scientific methodology in the making. There is reason to believe that research laboratories worldwide are rapidly building on the original discoveries by Dr. Yamanaka. There are wonders ahead.
Scientists are fully aware of the need to determine whether people already with a disease condition have cell tissue that can be reversed to a useful therapeutic cell type. Dr. Kevin Eggan and his colleagues, at Harvard University and Columbia University, have addressed this issue and report in the online issue of ScienceExpressJuly 31 that they have successfully generated pluripotent stem cells from skin cells of an 82 year old patient with amyotropic lateral sclerosis and produced motor neurons and glia. These results indicate there is a vast geographic landscape of research yet to be explored with horizens yet to be crossed by researchers. Encourage the young to turn their studies toward objectives in which they can participate in these magnificent years ahead.
The rising incidence of obesity in children and the consequent raised risk of diabetes, hypertension, and cardiovascular disorders is causing alarm among medical professionals. The American Academy of Pediatrics has issued a new clinical report on lipid screening and cardiovascular health, with co-authors Dr. Stephen Daniels of the University of Colorado School of Medicine, Dr. Frank Greer of the University of Wisconsin Medical School, and the Committee on Nutrition, giving a detailed reemphasis on the need for dyslipidemia screening in children and encouragement of sensible dietary guidelines and increasing physical activity.
Low-carb diets to lose weight were advised by the American Diabetes Association in January 2008. Dr. Iris Shai and colleagues, at Ben-Gurion University of the Negev, Beer-Sheva, Israel, have now published the results of the Dietary Intervention Randomized Controlled Trial (DIRECT) in the July 17, 2008, issue of the New England Journal of Medicine, which indicate that low-carb and Mediterranean diets beat low-fat diets for weight loss and lipid changes at two years for most people. This article raises a number of comments and issues that continue the debate on choosing optimal nutrition dietary habits.
Advocates of intravenous Vitamin C as an adjunct to the treatment of cancer during the periods when radiation and chemotherapy are not being done will find encouragement from a report in the August 4th Early Edition of the Proceedings of the National Academy of Sciences, by Dr. Mark Levine and colleagues, at the National Institute of Health in Bethesda, Maryland, that intravenous Vitamin C significantly slowed the growth of glioblastoma, ovarian cancer, and pancreatic cancer, in mice with the pharmacologic level used cytotoxic to the cancer but not to normal cells. The report also says that administration of intravenous Vitamin C to humans achieved concentration levels corresponding to the efficaceous levels in mice.
The health benefit of statins in reducing LDL-cholesterol and lowering C-reactive protein levels are well established. In this excellent review by Dr. Manuel Rodriguez-Yáňez and colleagues published in Therapeutic Advances in Cardiovascular Disease we learn of the important role statins have in neurorepair mechanisms, promoting angiogenesis, endogenous cell proliferation, neurogenesis, and new synapse formation. These mechanisms are of importance in having a neuroprotective effect during the acute phase of a stroke.
There are signs that the public, and medical professionals, are ready to address the inequity in health delivery to the population of the United States. In this video editorial by Dr. Quentin Young, National Coordinator, Physicians for a National Health Program, we learn that this year has seen a huge shift in public positions and a corresponding endorsement by medical societies that the time has come for a National Health Care System to cover all Americans. The time is now to remove the shame of inadequate health care delivery to our population.
The recommendation by the US Preventive Services Task Force that men over 75 should no longer have PSA screening for prostate cancer has generated a storm of controversy. However, after reading these guidelines, published in the Annals of Internal Medicine, rational and discerning physicians are well aware that this numerical cutoff is a clumsy attempt to regulate physician decisions and will do little to change their present practice; making PSA screening in older men a decision based upon assessment of potential longevity. After all, for those who intend to live well beyond a century, these recommendations are at most a commentary on societal norms.
In a fascinating development Dr. Emmanuel Skordalakes and colleagues, at the Wistar Institute, have deciphered the structure of the active region of telomerase. This remarkable achievement, published August 31 in Nature, opens the way to fully explore the way in which telomerase adds telomere repeats to the ends of chromosomes thereby maintaining genetic integrity during cell division. Loss of repeats is believed to be one of the primary causes of aging. It also will add to efforts to defeat cancer since the telomerase function in cancer cells is permanently turned on thus leading to proliferation of cancerous cells. This is landmark information. A new horizen has been crossed.
In one of the largest studies of its kind, 13,000 people followed for eight years, Dr. Michal Melamed and colleagues, of the Albert Einstein College of Medicine, reported August 11/25, 2008 in the Archives of Internal Medicine, that low levels of Vitamin D seem to be linked to an increased risk of death with a 29% risk of all cause mortality. They urge increased consumption of milk and oily fish. They did note in a female subgroup that very high levels of Vitamin D could be detrimental. This study adds to the growing body of evidence that a prudent person should add 1,000 IU of Vitamin D3 to their daily nutrition. It also validates measuring blood levels of Vitamin D3 in regular blood panels.
A report in the August 11, 2008, online first issue of Circulation by Dr. Stephanie Chiuve, from the Harvard School of Public Health, incontrovertibly provides solid evidence that a healthy lifestyle combining not smoking, a healthy weight, a healthful diet including moderate alcohol usage, and daily exercise reduces the risk of ischemic stroke by up to 80% in both women and men. The database for this report included 71,243 women and 43,685 men from cohort studies.
The baby boom generation of 78 million adults will begin to turn 65 in 2011 and there will not be enough doctors, nurses, and other caregivers to cope with this surge in numbers. In this video editorial by Dr. Harvey Fineberg, President of the Institute of Medicine, we are warned of the needs ahead. In these coming decades, with an increasing rate of longevity and newer medical techniques to extend meaningful healthy life the Institute of Medicine's report Retooling for an Aging America: Building the Healthcare Workforce is a welcome reminder that the problems ahead are being addressed.
ErinPharm comment: For the healthy and vigorous baby boomer the term Aging is really not polite - how about gaining Oldness - and Wisdom. Over a century is the new objective! Baby boomers returning to the workforce is another issue yet to be tackled.
Good news for heavily treatment experienced HIV patients was announced by Dr. Yazdan Yazdanpanah at the XVII International AIDS Conference in Mexico City August 11. Dr. Yazdanpanah, at the Tourcoing Hospital in France, reported that the TRIO study, in which 3 recently approved drugs, raltegravir + etravirine + darunavir/ritonavir, when added to existing background therapy reduced viral load to undetectable levels in 90% of the 103 patients enrolled at an interim analysis point of 24 weeks. The study will extend to at least 96 weeks.
ErinPharm comment: As one of the earliest clinical trial directors in the dark early days of the first clinical trials this is satisfying news indeed. Let us not forget now the millions of patients in the underveloped regions of the world that do not have access to these drugs. Let us think ahead, and plan, and have compassion.... John Fahey.
It is troubling that, despite the wealth of accumulated clinical trials, only 37% of US adults with cardiovascular disease are at the recommended LDL-cholesterol levels and only 17% are at the recommended levels for all lipids. As a comparison for those without cardiovascular disease 85% are at an appropriate LDL-cholesterol level but only 67% are at recommended levels for all lipids.
A thought provoking article in Medscape Medical News points out evidence that lower levels of LDL-cholesterol can be associated with increased risk of cancer but that in patients treated with a statin this relationship is not related to the statin. There is some speculation that low level LDL-cholesterol levels may be the result of undetected cancer years before clinical evidence appears.
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