ErinPharm Gazette  November 2008
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Vitamins, supplements, blood tests
A review of November 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.

November 30, 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.
LEF Retail Store 
*****Note******
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.
Abbott press release
Google
America's best hospitals
US News and World Report
Urinary tract infections, in both women and men, occur for up to 50% of the population at least once in a lifetime. Forskolin with antibiotics is a treatment for those with severe, recurrent infection. Testing for C-reactive protein levels is as important as LDL-cholesterol levels in deciding whether a person is at risk of cardiovascular disease. Drinking 'black' tea is good for you. The 1,000 Genome Project is well under way. 'Dr. Rob' and Musings of a Distractable Mind give a light-hearted look at medicine. A review on HDL-cholesterol replacement adds a counterpoint to current Phase 3 cholesteryl ester protein inhibition studies to elevate HDL-cholesterol. A pioneering triumph in organ transplant with a 'clean' donor scaffold seeded with the patient's own mature stem cells is reported with a successful trachea transplant. Have you visited TheHungerSite today?
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.
More than 50% of women experience a urinary tract infection during their lifetime. This dry fact does not convey the agonizing pain the patient experiences nor the fact that it is not uncommon for the infection to re-occur even after antibiotic treatment. Dr. David Rahn, in the Division of Female Pelvic Medicine and Reconstructive Surgery, at the University of Texas Southwestern Medical Center in Dallas, published an excellent review of the 'Best Practices to Treat Urinary Tract Infections' in the October issue of Urologic Nursing. He gives a detailed explanation of the rigorous treatment for complicated or recurrent infections, in which repeating, relapsing, infection can progress to more serious complications.
From Medscape  

ErinPharm note: Similar complicated urinary tract infections occur also in men. Acute prostatitis causes great pain and is sometimes difficult to clear. This is a case where conventional western medicine and Chinese herbal medicine can combine to produce a cure when neither approach is effective. Antibiotics and Forskolin are reported to combine together with significant benefit.

Duke University report on Forskolin with antibiotics for urinary tract infection.
A dramatic shift in thinking about primary prevention of cardiovascular disease mortality accompanied the report of the JUPITER trial (Justification for the use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) at the November 9 opening of the American Heart Association 2008 Scientific Sessions in New Orleans. It brings evaluation of a patient's C-reactive protein level as well as LDL-cholesterol level into prominent focus. Effectively it was found that even healthy patients with a low LDL-cholesterol level but a high C-reactive protein level will cut their risk of cardiovascular disease mortality by almost half by taking a statin. This benefit extended to all sub-groups. Presented by Dr. Paul Ridker, Brigham and Women's Hospital, Boston, Massachusetts, this presentation evoked the following response by Dr. Steven Nissen, of the Cleveland Clinic, Ohio: '...despite what the guidelines state (about LDL-cholesterol levels), when I know a patient has an elevated C-reactive protein level, I know treating him with intensive statin therapy is going to cut his risk of cardiovascular morbidity and mortality in half.' Clearly physicians need to rethink how they think about seemingly low-risk patients and routinely add a high sensity C-reactive protein test (hsCRP) to the lipid panels they already do.
Editorial - New England Journal of Medicine  
C-reactive protein 
From Medscape 

ErinPharm note: Though the JUPITER trial has now established that an elevated C-reactive protein level can double cardiovascular disease mortality that does not mean a healthy person with an elevated C-reactive protein level should immediately start taking a statin. Finding out why the C-reactive protein level is elevated in the first place and exploring other known, less extreme, ways of reducing C-reactive protein such as omega-3 fish oils and Vitamin D3 first would be a prudent strategy.
Vitamin D3 
Drinking tea is good for you. We all know that. However the enthusiasts promoting 'green tea' have neglected to point out that the regular 'black' tea consumed by 72% of the world's tea drinkers has the same benefits. Now an observational study of community-dwelling Chinese patients from Singapore 55 years of age and older, reported in the July issue of the American Journal of Clinical Nutrition, redresses that balance. The study, by Dr. Tze-Pin Ng and colleagues, at the University of Singapore, on 2,501 particants, established that drinking 'black' tea and 'oolong' tea is associated with prominent effects of lower risks of cognitive impairment and decline.
From Medscape  
To activate Medscape hyperlinks register with Medscape. Get direct access to authors, reports, and medical information and research publications  through the links.
The 1,000 Genomes Project is now well under way. This year has seen the beginning of a grand and ambitious search for a medically useful map of human genetic variation. The intent is to quickly make the accumulating data available worldwide through public databases. Remarkable advances in sequencing, population genomics, and computer bioinformatics over the last two years have made it possible to open this window on determining the human genetic susceptibility to disease. Sequencing companies 454 Life Sciences, Applied Biosystems, and Illumina Inc. are part of this work. Though not widely acknowledged in the news media this drama is taking place with thousands of young scientists seeing the unfolding of human destiny before their eyes every day; surely as inspiring as the speculations of futurists and science fiction writers in years past. Talk is of the possibility of a $1,000 genome, inscribed on CD discs, available for anyone who donates their DNA sample becoming reality in the years to come. In the decades ahead of us this foundation work will lead to fundamental insights and cures for human diseases as well as providing a blueprint for our understanding of what it is that makes us human, makes us able to determine our own destiny. 
454 Life Sciences   
Applied Biosystems 
Illumina 
Celera    
ErinPharm applauds 'Dr. Rob', a practicing primary care physician in the Southeastern US, for his light-hearted web site Musings of a Distractable Mind.
A fascinating review of HDL-cholesterol replacement therapies by Dr. Alan T. Remaley, Dr. Marcelo Amar, and Dr. Dmitri Sviridov, from the National Institutes of Health, make it clear that these approaches are as yet completed only for early stage clinical trials. Although they show great promise in establishing a regimen to promote arterial plaque regression the parallel clinical trials on CETP (cholesteryl ester transfer protein) inhibitors are further ahead into Phase 3 trials and so the race to find effective methods of elevating HDL-cholesterol sufficient to modulate the cholesterol transport system to place arterial plaque into regression is still in progress.
From Medscape   
Claudia Castillo, is a pioneer in the new world of generating replacement organs from the person's mature stem cells seeded onto a donor scaffold 'cleaned' of its original cells. She received a trachea transplant which, in being comprised of her own cellular tissue, is completely compatible and will not provoke an immune response. The dedicated teams of medical experts who saw this through to a successful conclusion are to be praised and commended for their work. It opens an exciting window into future organ transplants made from the person's own mature stem cells seeded onto a suitable compatible scaffold.
From Reuters   
A startling report on a mammography study from Norway reveals that it's possible up to 22% of breast cancers may undergo spontaneous regression without treatment. Although the medical literature does report that cancer remission does occur there has been no measure of incidence and this study reports an incidence of a magnitude no reasonable clinician would have imagined. Much more investigation must be done.
From Medscape  
From the NHS