ErinPharm Gazette  December 2008
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Vitamins, supplements, blood tests
A review of December 2008. A selection of topics.
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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.

December 31, 2008        John L. Fahey           johnfahey@tds.net
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.
Read this article from Medscape
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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.
From National Geographic     
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.
From Nothing But Nets     
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.
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Trilipix has been approved. Now it is possible to take this medication with a statin to modulate HDL-cholesterol, LDL-cholesterol and triglycerides with two medications. Surgery on the elderly can have just as much benefit as surgery on younger patients. A link has been established between the herpes simplex virus and Alzheimer's disease. Colonoscopy needs to be done by experienced physicians for the best results at detecting pre-cancerous lesions. Poor sleep pattern is associated with coronary artery calcification. Coronary artery bypass grafting should only be done at tier 1 hospitals. The incidence and death rate from cancer is falling in the United States but rising in the poorer countries of the world. Gum disease has been related to atherosclerosis. Individual DNA gene sequencing is becoming a factor in deciding whether or not to dose a particular patient with a medication. 
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.
From Medscape   
To activate Medscape hyperlinks register with Medscape. Get direct access to authors, reports, and medical information and research publications  through the links.
To activate Medscape hyperlinks register with Medscape. Get direct access to authors, reports, and medical information and research publications  through the links.
To activate Medscape hyperlinks register with Medscape. Get direct access to authors, reports, and medical information and research publications  through the links.
Trilipix was approved by the FDA December 15, 2008. This is the first fibrate approved for use with diet and a statin intended to lower triglycerides and LDL-cholesterol and raise HDL-cholesterol. This delayed-release medication is an advance in modulating the reverse cholesterol transport system and a step forward in stopping plaque progression and assisting plaque regression with the objective of reaching vascular flow health. It is extremely promising, paticularly for men with HDL-cholesterol <40 mg/dL, that it has been reported 135 mg Trilipix with 10 mg Crestor daily had an increase in HDL-cholesterol of 20.3%, decrease of triglycerides by 47.1%, and an LDL-cholesterol decrease of 37.2%. In comparison Crestor alone raised HDL-cholesterol by 8.5% and lowered triglycerides by 24.4%. Increasing Crestor to 20 mg gave a 19.0% HDL-cholesterol increase, a 42.9% triglyceride decrease, and 38.8% LDL-cholesterol decrease. Similar results were obtained when Trilipix was studied with Lipitor or Zocor. It thus appears that there is little additional benefit to the larger statin dose. This is a significant step forward. The Abbott scientists are to be commended for their thoroughly rigorous clinical trials.
From US News 
From Abbott  
From Drugs.com 
From Reuters 
From Medscape   
There has been controversy from physicians and the general public alike about the advisability of surgery on the elderly and the debate has been driven by consideration of allocation of health resources and the capacity of the patient to endure and survive surgery. Some elderly, otherwise in good health, have ignored the debate and gone ahead anyway. Now geriatric surgeons are beginning to insist that treatment decisions cannot be made based on age alone and that ageism toward the elderly in medicine needs to catch up with social observations that certain elderly people show the vigor, vitality, and alertness of much younger people. Presentations at the November American Heart Association's annual conference In Miami Beach, Florida, made it clear that octogenarians who had bypass surgery had survival rates about the same as their peers who did not undergo surgery while patients 80 and older in three New England states survived operations for leaky aortic valves as well as their peers who did not need the repair. Planned joint replacements, and organ transplants, in those 65 and older are substantially increasing. Since Americans 85 and older are the fastest growing sector of the population and the number of centenarians is expected to rise from about 65,000 now to 208,000 by 2030 it is incumbent on us all to recognise this social change and not get in the way of patients who battle against the myopia of those who talk about allocation of resources and wish to restrict medical access to the elderly; an increasing sector of the population with accumulated wisdom and experience to pass on to younger generations.
From MSNBC   
Amid the growing number of clinical trials aimed at ameliorating or reversing Alzheimer's disease comes an exciting new development that the herpes simplex virus has been implicated in development of the disease. Although about 85% of us carry a latent infection of herpes simplex and most do not develop Alzheimer's disease, this physical link between herpes simplex virus and the major component of the amyloid plaques found in the brains of those with Alzheimer's disease is important. Past studies have also made this implication and agreement on the significance of the findings will not come until further investigations further define the link so that conclusions can be made. Though Dr. Elaine Bearer, senior research scientist and associate professor in Brown University's Department of Pathology and Laboratory Medicine, stress this should not cause alarm and conclusions can not yet be drawn, it could be the beginning of a breakthough in knowledge. Herpes simplex is treated with Acyclovir. Whether individuals at risk of Alzheimer's or those already with the disease should add this approved medication to a daily regimen will now be hotly debated.
From Live Science
From ScienceDaily  (1)   From ScienceDaily  (2)
From MedicalNewsToday   
From Brown University  
For those over 50 a precautionary colonoscopy has become almost a rite of passage, since detection and removal of pre-cancerous polyps can avert the risk of getting colon cancer. Now a troubling report in the Annals of Internal Medicine has revealed that complacency about this procedure is not justified. It is less effective than formerly believed and can miss some cancers. Since it is still a highly effective detection technique this report is reason for the patient to more thoroughly seek a highly qualified gastroenterologist, to more completely prepare and clean their colon before the colonoscopy, and that a discussion with the gastroenterologist about a possible finding of flat, indented, or serrated lesions and his/her assurance that they are up-to-date on the latest findings and and have done retraining is appropriate.
From the New York Times  
Colonoscopy - from the Mayo Clinic  
An interesting study, published in the Journal of the American Medical Association, pointed out that of 495 study participants, aged 35 to 47, with no evidence of coronary artery calcification at the beginning of the study, those who were sleeping less than five hours a night had developed coronary calcification five years later among 27% of them, while those who were sleeping seven hours or more a night showed only 6% of paticipants with coronary artery calcification five years later. The senior author of the study, Dr. Diane S. Lauderdale, Associate Professor of Health Studies at the University of Chicago Medical Center, cautioned that this does not prove a cause and effect relationship. This does however support previous studies indicating that people who sleep less are at greater risk of heart disease and death. It could be that this data is indirectly related to the stress level and sleeping blood pressure of those sleeping less and consequently developing coronary artery calcification.
From the New York Times   
In a chilling study reported in the November 24, 2008, issue of the Archives of Internal Medicine, by. Dr. Steven D. Culler and colleagues at Emory University, Atlanta, we learn there are stunning differences, particularly by gender, in risk-adjusted death rates for patients undergoing coronary artery bypass grafting (CABG) surgery when comparing the best (tier 1) hospitals with the worst (tier 4) hospitals. Dr. Culler's statement is: "75% of the observed deaths of either male or female Medicare beneficaries treated in tier 4 hospitals could be avoided if tier 4 hospitals improved their performance to the average performance of top tier hospitals." This is a staggering observation. This is a huge difference. Clearly any reader of this information will take the steps necessary to ensure that only a tier 1 hospital should be chosen for this extremely invasive surgery to be performed on themselves, family, friends, and colleagues.
From TheHeart.org    
From Medscape HeartWire     
ErinPharm applauds and honors 20 doctors and dozens of teachers who graduated this month from University in Mogadishu, Somalia. In the first graduation there in almost two decades these outstanding young men and women have endured privation, the killing of classmates, gunfire, constant insecurity and the horror that is a continuing background they must struggle against. The president of Benadir University, Mohamed Maalim Muse, has announced his pride in these graduates. ErinPharm strongly and vigorously adds our pride to his. It is an event for tears of compassion and joy.
From the BBC  
From Medscape Reuters  
The closing months of this year mark the welcome report that the incidence and death rates for all cancers combined have decreased significantly for both men and women in the United States. The Annual Report to the Nation on the Status of Cancer is a combined report by the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries. A continuing decline is not guaranteed. It is time to take this data and substantially increase screening prevention and treatment, increase public education on risk reduction information, and strengthen tobacco-control programs.
From Medscape   
Yet despite the report that cancer incidence and death rates for the United States are in decline the same is not true of the rest of the world. In a new edition of the World Cancer Report from the International Agency for Research on Cancer comes the disappointing news that low- and middle-income countries will feel the impact of a higher incidence of cancer and cancer death rates with a projection that cancer will become the leading cause of death worldwide by 2010.
From ScienceDaily   
From Medscape  
There has been a belief for some years that gum disease is a contributory factor in the development of atherosclerosis, possibly due to the bacterium Porphyromonas gingivalis. Now a seminal study by Dr. Mario Clerici, of the University of Milan, Italy, has placed a foundation to that belief in a small study with 35 healthy volunteer patients who had improvement of endothelial dysfunction and significant reduction of carotid intima media thickness after dental treatment. Further studies of this finding with randomized clinical trials are planned. In the meantime...go visit your dentist.
From MedicalNewsToday 
From Medscape  
As this year of 2008 ends and 2009 begins the concept of genome based medicine is beginning to make inroads into the national consciousness. Until recent technological advances making DNA mapping for individuals possible the broad thrust of pharmaceutical research has been based on populations of patients and comparison of sub-groups has been the best that could be done. However human beings have a range of DNA variability and so therefore can have a range of sensitivity to a particular medication. These facts are well known to medical professionals and the adjustment of drug dosing and scheduling are a constant concern for physicians. But now the cost of gene sequencing is rapidly falling and astute physicians are taking advantage of this new approach, being able to treat patients as the unique DNA person they are and not just as an average member of a population. This is not a dramatic shift in focus and will enter the practice of medicine slowly as the means, technology, and information becomes available in years to come. But it has begun, and it will grow, and will change the focus of medical therapies.
From the New York Times  
From Chemical & Engineering News   
Current genetic testing