ErinPharm Gazette March 2008
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Advances in imaging arterial plaque now can give us a visualization of plaque morphology. Gene-typing is a sign of the beginning of patient-specific medicine. The importance of recognising that commercial vitamin E is not all the same; that the gamma-tocopherol component of vitamin E is the clinically important component.
Fibromyalgia is not an inflammation process but a disorder of central pain processing. Preliminary studies indicate that post-stroke patients should have immediate treatment for hypertension when it occurs and that statin therapy should be continued even if necessary to deliver it by nasogastric tube. Stroke statistics comparing US and European patients. Malaria can be placed into retreat. The importance of taking omega-3 (EPA/DHA) fish oils for cardioprotection. Gardasil is shown to be safe but adult immunizations have an alarming low rate of application.
A review of March 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.
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 Gastro-esophageal 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.
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.
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Keep up to date with advances in the use of statins.
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Examination of coronary plaque occlusion is currently done by means of angiography. However, in this fascinating article by Dr. Andreas König and colleagues, published in Nature Clinical Practice Cardiovascular Medicine, coronary artery disease is yielding to more sophisticated technology with coronary plaque classification by intravascular ultrasonography radiofrequency analysis (IVUS). This tomographic imaging tool can visualize coronary atherosclerosis in vivo identifying plaque area, plaque distribution, lesion length, and effect on the artery wall, demonstrating the discrepancies between the extent of atherosclerosis seen by conventional coronary angiography and the actual extent of atherosclerotic disease. This detailed quantitative assessment of plaque will provide patient-specific analysis of plaque morphology and is destined to become the tool to measure regression of atherosclerotic plaque as current trials with CETP inhibitors and other molecules under investigation produce clinically relevant and applicable data.
As an example of the changing face of medicine with the availability to gene-type the patient this article about work by Dr. Andrew Levy of Technion-Israel Institute of Technology about vitamin E supplementation reducing cardiovascular events in middle-age patients with type 2 diabetes and the haptoglobin (Hp) 2-2 genotype is a sign of patient-specific medicine based on the patient's genetics. As Dr. Levy points out, about 2-3% of the general population carry the Hp 2 allele protein which affords inferior antioxidant protection.
It is important to recognise that it is the gamma-tocopherol found in natural vitamin E that is the critically important component of vitamin E and not the alpha-tocopherol found, sadly, in many commercial forms of vitamin E sold in the marketplace.
Fibromyalgia is a source of pain and distress to many patients, and not least among the distress is the apparent inability of some physicians to either resolve the problem or even in some cases to recognise it as a true condition. With this insightful video editorial from Dr. George Griffing, Professor of Medicine at St. Louis University, fibromyalgia patients can gain a rational perspective. He points out that fibromyalgia in the past has been mistaken as an inflammatory process and consequently treatment failure when treating for inflammation is not suprising. He points out that evidence indicates fibromyalgia is a neurologic disorder of central pain processing in which fibromyalgia patients experience pain differently and have lower pain thresholds compared to others. He points out that pharmaceutical companies seem to recognise that fact and have a focus on therapies appropriate to central pain processing with Lyrica (pregabalin) the first and only medication approved by the FDA.
A controlled randomized study published in Neurology 2007; 69(9):904-910, by Drs. Blanco, Nombela, Castellanos et al., titled 'statin treatment withdrawal in ischemic stroke' makes it clear that even when an acute stroke patient is unable to swallow, statin therapy should be continued even if it has to be delivered by nasogastric tube administration. In their study on 89 patients randomized to continued statin or no statin for three days after acute stroke the troubling finding revealed significantly higher rates of early neurologic deterioration and a 4-fold higher increased risk of death or dependency after three months in those patients in which statin was not administered for three days after acute stroke.
American men have a 61% higher odds of having a stroke than European men. Women in the United States have a 2-fold higher risk of stroke then European women. This study, presented by Dr. Mauricio Avendano, from the Erasmus Medical Center In Rotterdam, the Netherlands, at the American Stroke Association (ASA) International Stroke Conference 2008, does not clarify whether the difference in stroke prevalence rates are a reflection of better stroke prevention in Europe or better stroke treatment in the United States but it does highlight the need in the United States to intensify risk-factor control and address the issue of healthcare provision to the estimated 48 to 60 million Americans who are uninsured and thus do not have ready access to the treatment focus of the US healthcare system which they would have in the European preventive orientation system.
A randomized pilot study indicates that blood pressure lowering in the more than half of patients who become hypertensive immediately following acute stroke reduces 3-month mortality without serious side effects or increasing stroke severity. This CHIPPS study (Control of Hypertension and Hypotension Immediately Post Stroke) on 179 randomized patients found that patients in the placebo group were more likely to die within 3 months after stroke compared with those on active treatment. The principal investigator, Dr. John Potter, of the University of East Anglia in the United Kingdom, said at a press conference that these benefits need to be replicated in a much larger Phase III study. To treat or not to treat is at the moment a 'gamble' and left to the discretion of the individual physician. A larger study is urgently needed to determine if this pilot study gives us reason to always treat.
In a most welcome and very suprising finding researchers have produced a new global malaria map showing that nearly half the 2.37 billion people at risk from the mosquito-bourne disease live in areas where the disease is hanging on by a thread and could be wiped out there by concerted action with tools such as insecticide treated bed-nets already available. Developing a strong international will to do so will provide impetus to attack malaria in a smaller geographic area and then on to complete elimination of this scourge of humankind.
The American Heart Association (AHA) has endorsed the use of omega-3 fatty acids (EPA/DHA) for secondary prevention of cardiovascular events in people with documented coronary artery disease. This is the first time the AHA has recommended a nutritional supplement for such protection and follows a growing and large body of evidence supporting the cardiovascular benefits and triglyceride lowering benefits of omega-3 fatty acids. Based on large controlled trials in which 32,000 patients were randomized to omega-3 fatty acids or a control regimen the patients randomized to omega-3 fatty acids had a 19% to 45% reduction in cardiovascular events compared to the control group. Building up to approximately one (1) gram a day of EPA/DHA is advised and for patients with severely elevated triglyceride levels (>500 mg/dL) building up to consumption of three (3) to four (4) grams a day of EPA/DHA can lower triglyceride levels by as much as 45%. When used in conjunction with statin therapy further reductions in triglyceride levels can be obtained. This article describes the amounts of EPA/DHA fish oil capsules that should be taken for various levels of protection, up to the 3 to 4 gram level (5 to 7 capsules/day for most commercially available fish oil capsules) and points out that consumption can be taken at any time in full or divided doses without interaction with other medications.
Erinpharm note: the Super Omega-3 EPA/DHA capsules sold by the Life Extension Foundation (triple distilled and from sustainable fisheries) contain 350mg EPA/250 mg DHA per one gram fish oil concentrate capsule. As a courtesy to readers of this page, and an introduction to the Life Extension Foundation, I am distributing LEF Super Omega-3 EPA/DHA with sesame lignans and olive fruit extract, 120 capsules, Catalog Number 00982 (click LEF logo above for full details on this important supplement) for $17.00 plus $3.00 shipping charge. This is a single item offer; USA and Canada only.
Dr. John Iskandar, acting director of the Immunization Safety Office, Centers for Disease Control and Prevention in Atlanta, Georgia, reported at the International Conference on Emerging Infectious Diseases 2008 that the quadrivalent human papillomavirus (HPV) vaccine Gardasil seems to be safe after reviewing 30,000 prelicensure and 12.4 million postlicensure doses.
It is alarming that American adults are receiving immunizations at very low rates. The National Foundation for Infectious Diseases held a Washington, D.C., news conference on the issue, releasing survey findings that a lack of awareness and apathy are presenting serious obstacles to heading off preventable diseases. The Centers for Disease Control (CDC) has released data that by January 2008 some adult immunization rates barely passed the 2% mark. The CDC survey found that only 2.1% of American adults aged 18 to 64 are vaccinated against tetanus, diphtheria and whooping cough and only 1.9% of adults aged 60 and older are immunized against shingles. The great advances in prevention that have been made in the past few years have not translated into public awareness and acceptance. These vaccines have the potential to save thousands of lives each year. Health care providers must urge adults to become vaccinated against these diseases with the same vigor we direct to immunizations for children.
Dare we use the word: gluttony? And yet since this is a weighty matter amid a global epidemic of overweight and obesity maybe it is time to become provocative and attract attention to the Americanization of food choices and portion sizes. This article, from Dr. Martin Donohoe, posted in Medscape March 19, 2008, calls on us all to make this health problem a central part of our lives. Read this article. Copy and share it with others. We can all play a part in making a daily difference.
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.