ErinPharm Gazette December 2006
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This documentation of events taking place on the medical frontiers leading to elimination of cardiovascular disease and cancer is sadly only applicable and available to those educated, aware, motivated, financially able, and living in the developed nations of the world. For the large majority of humankind death from these diseases will continue. By 2050 will we look back at a huge divide between us? Or will we have done everything we can to conquer disease, war, and poverty on a global scale? For the 9 billion of humankind expected then. We do have decisions to make beyond a personal healthy longevity.
It is now clear that vascular health is essential. Data collected on supercentenarians and those with 'longevity syndrome' who have fortunate genetics has led to the conceptual logic of lowering LDl-cholesterol levels and increasing HDL-cholesterol levels. As ongoing clinical studies reveal optimal target levels for blood lipids the demographic structure of society will begin to change. Stem cell research and conquest of cancer will bring wonders in the years to come.
A review of November and December 2006
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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, 2006 John L. Fahey johnfahey@tds.net
The Life Extension Foundation
Data collected so far on 32 supercentenarians aged 110 to 119 years is notable that these individuals have markedly delayed or even escape clinical expression of vascular disease up to the end of their remarkably long lives.
From WebMD
The safety and tolerability of taking Niaspan to increase HDL-cholesterol while also taking a statin to decrease LDL-cholesterol is reported by investigators in the NAUTILUS study group. This study was an open label, uncontrolled, phase IIIb clinical study. The study population of 588 men and women with low HDL-cholesterol levels had Niaspan added to existing medications for 15 weeks. The study, in Germany, excluded patients with significant vascular disease and uncontrolled diabetes. The focus of this publication is on changes in blood parameters and adverse events. Marked increases of HDL-cholesterol, >20%, were noted irrespective of statin intake.
Reported by Medscape
While Niaspan is now the leading candidate to raise HDL-cholesterol, the data from the frontier clinical trials from Pfizer's torcetrapib, terminated December 3, 2006, show that torcetrapib raised HDL-cholesterol by up to 54.5%.
With the conceptual logic of raising HDL-cholesterol now well established, interest is turning toward the quality and function of the heterogeneous particle assemblies we call HDL-cholesterol along with their varying levels of antioxidants or pro-oxidants modulating systemic inflammation. This article gives an excellent review of current and emerging therapies to raise and improve the protective effects of HDL-cholesterol.
From Medscape
Retrospective analyses have now shown that statin medication should not be discontinued in a patient hospitalized for an acute coronary event and benefit could result from increasing the statin medication.
From Medscape
Chemotherapy following lung cancer surgery has become a common practice in recent years. Now a new gene test has been developed to determine if a patient is at increased risk of relapse so that aggressive chemotherapy can be targeted to only those who need it.
From New Scientist
Dr. Gary Freedman, radiation oncologist at the Fox Chase Cancer Center, Philadelphia, has presented initial study data that delivering the same dose of current radiation therapy for breast cancer over four weeks rather than the seven weeks now used after lumpectomy has significant benefits with a lower rate of skin reactions and other side effects. Confirmation of this with a larger study will lead to a change in medical practice in radiation delivery for such patients.
From WebMD
Watch and listen to Dr. Barbara A. DeBuono in this video editorial as she explains the urgent need to bring health literacy to the American population. Make the Partnership for Clear Health Communication a web link for you to refer to frequently as this non-profit group of organizations builds awareness and advances solutions to improve health literacy.
From Medscape
An interesting study presented at the 2006 annual meeting of the American College of Rheumatology with the diabetic nerve pain and post shingles pain drug Lyrica showed extended pain relief for patients with fibromyalgia. Since there are no FDA approved medications for fibromyalgia Lyrica could now possibly be another 'off-label' medication fibromyalgia sufferers could consider.
From WebMD
In a very significant study of 35 patients with peripheral artery disease (PAD) at the Minnesota School of Nursing, presented at an American Heart Association 2006 Scientific Session by Dr. Diane Treat-Jacobson, it was found that upper arm exercise has a global effect in extending maximal walking distance until claudication occurs. Combination with treadmill exercise was additive, extending walking distance even further. These findings suggest that it is possible arm exercises may stimulate growth factors promoting growth of collateral blood vessels and improve endothelial function.
Personal note by ErinPharm's John Fahey: I discovered this myself last year by gardening two to three hours a day using a metal outdoor chair, sitting and standing when able, for three days to four days a week. My maximal walking distance approximately doubled. I also take lipitor (40mg), coenzyme Q10 (100mg) and 8 fluid ounces of pomegranate juice each day. After reading this paper I intend to double my outdoor work this Spring. Of course the advantage for me of this method over arm exercise/treadmill was the bounty of vegetables I got from my 1,000 square ft. vegetable garden.
From WebMD
High dose atorvastatin (lipitor) cuts stroke risk for patients with coronary artery disease. The findings indicate that lowering LDL-cholesterol substantially below 100 mg/dL greatly decreases the risk of ischemic stroke and other cerebrovascular events and does not increase the risk of hemorrhagic stroke. This study is an analysis of data from 10,001 patients in the multi-center TNT study who were randomized to receive 10 mg or 80 mg of atorvastatin a day for a median of 4.9 years
From Reuters
An important data finding for postmenopausal breast cancer survivors is that a switch to Arimidex after two to three years tamoxifen therapy is advisable. Patients who do the switch have a 29% lower risk of death, 41% higher chance of disease-free survival and 45% lower chance of any cancer relapse when compared to those who did not make the switch.
From WebMD
A new treatment for ischemic stroke may be on the horizon. Researchers at The University of Rochester Medical Center have gained funding for 78 patients at 5 medical centers with stroke onset within the prior six hours to be treated with activated protein C (APC). This is a safety study with outcome measures to be conducted over five years. The researchers point out that the only other current treatment for stroke, tPA, must be administered within three hours and that APC has the potential of extending this window up to eight hours.
From Medscape
In a fascinating research publication from Thomas Jefferson University, a team of scientists has identified a stretch of codons in the DACH1 subfamily of nuclear proteins, first identified in Drosophila as promoting differentiation of the Drosophila eye and limb, whimsically called the 'Dachshund gene', as a codon region that expresses protein which reverses cancer cells to normal cells.
From Reuters
There has been controversy among physicians on whether surgery is a valid option for a herniated disk. This controversy is not likely to be settled soon since this randomized trial with an observational cohort showed that patients had improved outcomes within two years whether treated surgically or nonsurgically.
From Medscape
A small amount of abdominal fat (15g) drawn from elderly patients undergoing vascular related surgery was found to be a source of stem cells as good as those drawn from young healthy subjects both in quantity and quality. The research team, at Thomas Jefferson University, led by Dr. Paul J. Muzio, found that the cells could be grown in large numbers. This development means that elderly patients are now candidates for vascular repair studies using autologous (their own) stem cells.
From WebMD
In a very encouraging development Dr. Alessandro Moretti and colleagues at Massachusetts General Hospital have presented evidence that only two progenitor stem cells begin the ultimate development into all the major cardiac cardiac tissues, including myocardium, Purkinje fibers, vascular endothelium, and smooth muscle. Further study of this in vitro work could well sweep away the old view that the various tissues of the heart are derived from distinct progenitor cells with different embryonic origins.
From Heartwire
In wondrous work described by Dr. Simon P. Hoerstrup of the University Hospital of Zurich, stem cells extracted from amniotic fluid were induced to grow on leaflet shaped biodegradable polymer scaffolds to produce fully functional human heart valves opening and closing like natural valves. Now that proof of concept has been accomplished studies can be planned for the newborn infants who need surgery for faulty heart valves. Since they are derived from the infants own cells it is expected they will not be rejected and will grow with the child.
From Reuters
In a fascinating prospective study of 7 million active-duty US military personnel researchers at the Harvard School of Public Health found that high circulating serum levels of vitamin D in healthy young white adults is linked to a significantly lower risk of multiple sclerosis, with a 62% reduction for those with the highest levels compared with those with the lowest. This was not found for African Americans who are already known to have a lower risk of multiple sclerosis than whites. Since more than half the whites in the United States have levels of 25-hydroxyvitamin D less than 70 nmol/L suggestions have been made that target levels of 90 to 100 nmol/L would be optimal for bone mineralization and fracture prevention.
From Medscape
The time is approaching for a comparison of intravenous tPA and intra-arterial tPA thrombolysis after stroke with publication of a report that long term benefit is provided to stroke patients receiving intra-arterial tPA thrombolysis.
From Reuters
From Medscape
Tremendous strides forward are being made in the treatment of breast cancer. Keep up to date on these advances. Medscape Breast Cancer Resource Center
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.
Leading expert Dr. Mark Freedman presents new perspectives on multiple sclerosis
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.
Canadian study reports relief from chronic pain for patients using marijuana
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.
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