ErinPharm Gazette March 2007
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The most significant developments of note this month have been the publication of research papers that signal a shift away from surgical options for coronary artery and carotid artery disease toward medications that include statins and other drugs to stop and even reverse the growth of arterial plaque. Advances in the study of the composition of atherosclerotic plaque and technological advances in visualization of plaque are adding momentum to the objectives of a continuing reduction in heart attack and stroke in the general population. In the meantime a shift in thinking is taking place in approaches to eliminating cancer, while treatments for cancers of various kinds continue to advance on a broad frontier. Attention is turning to neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease and thus emphasis on public health measures to educate and assist the older members of society on ways to use medical discovery to maintain and improve optimal health. In reading this appreciate your good fortune in having the opportunity to plan for a future of optimal healthy longevity. You are a member of a privileged section of humankind. The majority of our fellow human beings lack adequate health care, suffer from diseases such as AIDS, malaria, and tuberculosis and have the poverty of diminished expectations.
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.
The Life Extension Foundation
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 Gastroesophageal Reflux Disease (GERD)
Advances in lung cancer therapies are moving ahead. Keep up to date.
University of Kansas research scientist, Dr. Ann Manzardo, is exploring the link between thiamine deficiency and a genetic predisposition to alcoholism.
Treatment of chronic pain patients with opioids causes serious problems for primary care physicians.
The first comprehensive map of Genomic copy number variations has been developed. Such copy numbers influence genetic diversity and susceptibility to disease.
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.
The American Cancer Society is your main source of information in the ongoing battle against cancer.
A longitudinal cohort study from a western health U.S. health plan with approximately 8 million covered members showed that, for patients newly initiated to a statin, crestor (rosuvastatin, 11 mg/day) was more effective than lipitor (atorvastatin, 15 mg/day) in achieving LDL-cholesterol objectives.
In a shift of thinking about approaches to the elimination of cancer, researchers are now beginning to recognise that many cancers arise from rare self-renewing cancer stem cells that are biologically distinct from their more numerous differentiated progeny. Dr. Richard Jones of the Johns Hopkins Kimmel Cancer Center in Baltimore, Maryland, has pointed out that, despite dramatic responses in current anticancer therapies, long term remissions will come from targeting these cancer stem cells. Clinical trials are under way at Johns Hopkins to test novel therapies such as monoclonal antibodies to target cancer stem cells.
There is still significant room for improvement in the health conditions of older Americans over 65, using Medicare preventive services, starting exercise programs, eating more fruits and vegetables.
Physicians are urged to consider statin therapy in patients even with a moderate cardiovascular risk.
Progress toward a breath test for very early lung cancer, though not yet ready for clinical use, indicates that a new tool for early detection is on the horizen in the next few years.
Dr. Francis Berthod at the University of Laval in Quebec and his colleagues have succeeded in producing mature neurons from human adult skin-derived precursor cells. This is now a source of neurons to treat various degenerative diseases and could serve a number of therapeutic applications.
In two recent issues of the Journal of American College of Cardiology it has been pointed out that the conventional diagnostic gold standard of stress-testing and coronary angiograms for detecting coronary stenosis may now be seen to be outdated. Dr. Amal Mattu at the University of Maryland has pointed out that as new technology develops it is the composition of the plaque and thus 'plaque vulnerability' that is the determining factor in whether a heart attack is likely to occur or not.
As new technology of cardiac imaging of coronary arteries using 64-slice CT scanners is reaching hospitals there is a need to educate and train radiologists in this methodology.
In a stunning development with a wide ranging impact research has shown that a majority of angioplasties and stenting for heart pain in non-emergency situations is of little or no value to the patient. It has been shown that treatment with medications (statins, aspirin, nitrates, ACE inhibitors, beta blockers, calcium channel blockers) and counselling on healthy lifestyles - diet, exercise, and stopping smoking, are just as effective in thwarting a potential future heart attack and there is no harm in starting with such a modality and waiting to give such drugs time to work. After an average of 4.5 years angioplasty or medication showed similar rates of heart attack, hospitalization and death with neither treatment proving any better for subgroups such as smokers, diabetics, older, or sicker people. Dr. Steven Nissen of the Cleveland Clinic is quoted as saying: "You are not putting yourself at risk of heart attack or death if you defer." Only one third of people treated with drugs ultimately needed angioplasty or a bypass. This research will be in the April 12 issue of the New England Journal of Medicine. Dr. William Boden of Buffalo General Hospital led the research.
Note from ErinPharm's John L. Fahey, Ph.D.: The above study adds further weight to a lifestyle aimed at achieving vascular health throughout the entire vascular system, thus also averting or ameliorating the harm of peripheral artery disease and potential stroke. The medications listed above - with the objective of reaching a healthy lipid profile using bloodwork taken often - , good nutrition, frequent upper and lower body exercise, complete avoidance of the oxidation effects of smoke, tobacco or otherwise, omega-3 fish oils to lower triglyceride levels and C-reactive protein levels (routine in European medical practice), and daily consumption of about 8 oz of pomegranate juice. That last because studies have shown consumption of that amount significantly reduces carotid artery plaque and it is reasonable to suggest that such an effect could well extend throughout the entire vascular system.
Dr. Frank Veith of the Cleveland Clinic, has suggested that for asymptomatic carotid stenoses widespread screening for potential patients suitable for surgery in the population, in light of current medical therapies, is not justified. He points out that statins and anti-platelet agents could well carry lower risks than carotid endarterectomy or carotid stenting (with their attendant procedural risks) and this should be studied further.
In the first study to examine the calcification content of carotid artery plaque, investigators at the University of Virginia Health System, led by Dr. Kiran Nandalur, have shown that heavily calcified plaque is less likely to be the cause of stroke.
Dr. Ashutosh Tewari and associates at New York Presbyterian Hospital, Weill Medical College of Cornell University, have shown that even patients with the most aggressive non-metastatic prostate cancers, if treated with prostatectomy or radiation treatment, can live for more than 14 years and are potentially curable, thus finally ending the concept of 'watchful waiting'.
Patients with Parkinson's disease need to have an ongoing collaborative interaction with a physician who is well versed in the multiple complexities of treatment with the many different modalities used to combat the progress of the disease.
CELL GENESYS is well ahead in developing a vaccine for use in patients with advanced prostate cancer.
Experiments in mice have shown the possibility of developing a DNA vaccine to provide a preventative and restorative treatment for Alzheimer's disease. This is just a beginning but shows promise.