Bacon, sausage, and ham -- some of the most beloved foodstuffs on the planet --are once again being singled out as key culprits driving the association between meat consumption and the world's most common diseases.
In one of the largest studies to address this question, high consumption of processed meat by middle-aged adults was associated with a near doubling of the risk of all-cause mortality, compared with low consumption, over a mean of 12 years. Risk of cardiovascular death, after rigorous modeling, was increased by more than 70% among people eating more than 160 g/day, as compared with those eating 10 to 19.9 g/day. Risk of cancer deaths was also 43% higher among the highest consumers of processed meats.
"The clinical message, in our opinion, is that it's okay to eat some meat, but to limit consumption of processed meat: not every day and not in high amounts," lead author Dr Sabine Rohrmann (University of Zurich, Switzerland) told heartwire in an email.
EPIC Data
The new data come from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, involving 10 countries and almost half a million men and women. It was published online today inBMC Medicine.
Of note, say the authors, while a signal of increased mortality was seen among the highest consumers of red meat in general, the risk for red meat was much lower that that of processed meats and lost statistical significance after correction for measurement error. With the same adjustments and corrections, high processed-meat consumption was associated with an 18% greater risk of all-cause mortality.
As the authors point out, processed meats tend to contain more saturated fat than unprocessed meat (where the fat is often trimmed off), as well as more cholesterol and additives, often as part of the smoking or curing process. Some of these are believed to be carcinogenic or precursors to carcinogenic processes. "Another factor is the content of salt in processed-meat products, which is linked to hypertension, which is a CVD risk factor," Rohrmann told heartwire . "Heme iron is another mechanism, which links meat consumption to CVD risk, but that's not limited to processed meat."
Rohrmann and colleagues also point out that high consumption of processed meat typically went hand in hand with other unhealthy behaviors, including smoking, low physical-activity levels, and low consumption of fruits and vegetables.
"Overall, we estimate that 3% of premature deaths each year could be prevented if people ate less than 20 g of processed meat per day," Rohrmann commented in a press statement.
What about red meat?
Other studies have singled out processed meats as particularly hazardous to health. US analyses of meat consumption and mortality, drawing on data from two large, long-running US studies, have also documented the link between meat consumption and CVD and cancer deaths, but the stronger association seen with processed meats in this European cohort is somewhat at odds with the American data.
"Although we did not find a statistically significant association between unprocessed red-meat consumption and mortality in our studies, the two US studies did," Rohrmann said. "Therefore, we would not say that there is definitely no association [between red-meat consumption and CVD]. What I think our studies show is that it's okay to eat a moderate amount of meat--300 to 600 g per week as recommended by many nutrition societies--for intake of some important minerals and vitamins; however, a balanced vegetarian diet is, of course, okay as well."
Source: http://www.medscape.com/viewarticle/780412?nlid=29037_1301&src=wnl_edit_dail
Welcome to my collection of health articles. Most of them contain little nuggets of health wisdom that we can easily apply to our daily lives. As you can gather, I've been consuming all sorts of supplements over the years, most of them from iherb. They deliver on time (DHL), and prices are good. If you're a first-time buyer, use my code 'pot089' to enjoy up to $10 off.
Saturday, 9 March 2013
Friday, 1 March 2013
Acne: Bad and good bacteria identified
A genomic approach to comparing acne-ridden skin with clear human skin has revealed a bacterial strain that may protect against the disease. The work was published online February 28 in the Journal of Investigative Dermatology by Sorel Fitz-Gibbon, PhD, from the Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles, and colleagues.
Four of 5 people in the United States develop acne at some point. Although dermatologists no longer blame blemishes on too much chocolate or fatty foods, commonly prescribed acne drugs such as benzoyl peroxide, antibiotics, and isotretinoin (Accutane, Roche) have been used for decades, although they are not ideal. Antibiotics are usually ineffective in severe cases, and isotretinoin both has adverse effects and is teratogenic.
Propionibacterium acnes is a dominant skin commensal that colonizes pilosebaceous units, in which certain strains are hypothesized to stimulate development of acne vulgaris. The population sizes of the bacteria are similar among individuals, but the proportions of different strains vary between people prone to acne and people with clear skin. Similar to Staphylococcus aureus, only certain strains of the bacteria are pathogenic.
The researchers sequenced bacterial genomes to better define the genetic compositions of the P acne component of the skin microbiome in acne-marked vs healthy skin. The strategy revealed "a previously unreported portrait of the microbiota of pilosebaceous units at the bacterial strain level," the researchers write.
Dr. Fitz-Gibbon and colleagues applied over-the-counter pore-cleansing strips to the noses of 49 people with acne and 52 participants with clear skin, sampling P acnes in whiteheads or blackheads. The investigators typed bacterial strains according to 16S ribosomal DNA sequences (ribotypes), assigning each strain an acne index based on prevalence among patients with acne. This approach identified 11,009 ribotypes, but only a few were abundant in either patient group.
Genome sequencing was the next step. Team members from Washington University in St. Louis, Missouri, sequenced the genomes of 66 previously unreported P acnes strains from the samples and compared 71 bacterial genome types overall. Author Shuta Tomida, PhD, also from the Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, identified DNA differences among the strains.
Beneficial Bacteria
Three genomically identified strains are of potential clinical significance. Two strains were discovered in 1 of 5 volunteers with acne, but rarely in clear-skinned people. Conversely, a third bacterial strain appeared to be common in healthy skin yet was rare in skin with acne, suggesting a protective role.
The findings may have practical applications, the authors write, such as the development of a probiotic topical preparation to favor the protective bacterial strain or drugs to selectively target acne-related bacteria. A simple skin test might predict whether a person has an increased risk of developing aggressive acne.
Further studies might address identifying host factors that contribute to acne and matching microbiome subtypes with clinical subtypes of acne, such as cystic, pustular, or inflammatory acne.
"By combining a metagenomic study of the skin microbiome and genome sequencing of this major skin commensal, this study provides insight into potential bacterial genetic determinants in acne pathogenesis and emphasizes the importance of strain-level analysis of the human microbiome to understand the role of commensals in health and disease," the researchers conclude.
Source: http://www.medscape.com/viewarticle/780020?nlid=28944_1301&src=wnl_edit_dail
Four of 5 people in the United States develop acne at some point. Although dermatologists no longer blame blemishes on too much chocolate or fatty foods, commonly prescribed acne drugs such as benzoyl peroxide, antibiotics, and isotretinoin (Accutane, Roche) have been used for decades, although they are not ideal. Antibiotics are usually ineffective in severe cases, and isotretinoin both has adverse effects and is teratogenic.
Propionibacterium acnes is a dominant skin commensal that colonizes pilosebaceous units, in which certain strains are hypothesized to stimulate development of acne vulgaris. The population sizes of the bacteria are similar among individuals, but the proportions of different strains vary between people prone to acne and people with clear skin. Similar to Staphylococcus aureus, only certain strains of the bacteria are pathogenic.
The researchers sequenced bacterial genomes to better define the genetic compositions of the P acne component of the skin microbiome in acne-marked vs healthy skin. The strategy revealed "a previously unreported portrait of the microbiota of pilosebaceous units at the bacterial strain level," the researchers write.
Dr. Fitz-Gibbon and colleagues applied over-the-counter pore-cleansing strips to the noses of 49 people with acne and 52 participants with clear skin, sampling P acnes in whiteheads or blackheads. The investigators typed bacterial strains according to 16S ribosomal DNA sequences (ribotypes), assigning each strain an acne index based on prevalence among patients with acne. This approach identified 11,009 ribotypes, but only a few were abundant in either patient group.
Genome sequencing was the next step. Team members from Washington University in St. Louis, Missouri, sequenced the genomes of 66 previously unreported P acnes strains from the samples and compared 71 bacterial genome types overall. Author Shuta Tomida, PhD, also from the Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, identified DNA differences among the strains.
Beneficial Bacteria
Three genomically identified strains are of potential clinical significance. Two strains were discovered in 1 of 5 volunteers with acne, but rarely in clear-skinned people. Conversely, a third bacterial strain appeared to be common in healthy skin yet was rare in skin with acne, suggesting a protective role.
The findings may have practical applications, the authors write, such as the development of a probiotic topical preparation to favor the protective bacterial strain or drugs to selectively target acne-related bacteria. A simple skin test might predict whether a person has an increased risk of developing aggressive acne.
Further studies might address identifying host factors that contribute to acne and matching microbiome subtypes with clinical subtypes of acne, such as cystic, pustular, or inflammatory acne.
"By combining a metagenomic study of the skin microbiome and genome sequencing of this major skin commensal, this study provides insight into potential bacterial genetic determinants in acne pathogenesis and emphasizes the importance of strain-level analysis of the human microbiome to understand the role of commensals in health and disease," the researchers conclude.
Source: http://www.medscape.com/viewarticle/780020?nlid=28944_1301&src=wnl_edit_dail
Global rise in diabetes linked to increase in dietary sugar
The increasing availability of sugary food and drink — independent of excess calories, excess weight, or a sedentary lifestyle — explains part of the rise in cases of type 2 diabetes worldwide, suggests a new study published online February 27 in PLoS ONE.
The authors, led by Sanjay Basu, MD, from the Department of Medicine, Stanford University, Palo Alto, California, examined a decade of cross-sectional data from 175 countries. They note that most of the worldwide rise in diabetes is thought to be type 2, linked to the metabolic syndrome, a cluster of factors including dyslipidemia, hypertension, and insulin resistance.
They report that for each added 150 calories of sugar available per person per day — equivalent to one 12-oz can of soda — the prevalence of type 2 diabetes increased by about 1% (P < .001), after they controlled for factors such as food types, total calories, overweight and obesity rates, aging, urbanization, income, and time.
Sugar Alone Explains 25% of Increase in Diabetes
It is important to identify risk factors for type 2 diabetes, since nearly 1 in 10 adults worldwide has the condition, and the rates are increasing. "If obesity is a primary driver of diabetes, then measures to reduce calorie consumption and increase physical activity should be prioritized," Basu and colleagues write. "However, if added sugar consumption is a primary driver, then public health policies to reduce sugar consumption warrant investigation as diabetes-prevention proposals — especially for developing countries, where diabetes rates are rising dramatically, irrespective of obesity."
They give examples of several countries with high diabetes prevalence rates but low obesity rates, including the Philippines, Romania, France, Bangladesh, and Georgia.
To determine whether sugar in a country's food supply predicts subsequent spikes in diabetes rates, the researchers used a regression model to correlate the prevalence of diabetes from 2000 to 2010 in adults aged 20 to 79 living in 175 countries with the availability of sugar in a country's food supply.
They found that during this decade, the prevalence of worldwide diabetes rose by about 27%, with one quarter of this increase explained by an increase in the availability of sugary foods. No other food category had any significant effect on diabetes prevalence.
Rates of diabetes increased in a dose-dependent manner the longer a population was exposed to excess sugar and the greater the amount of available sugar in the food supply. Each extra year of living where sugary foods were widely available was linked with an increase in diabetes prevalence of 0.053% (P < .05).
The reverse was also true. Following periods of scarce sugar (typically due to changes in trade agreements), the prevalence of diabetes decreased by 0.074% (P< .05), after correction for confounding variables.
Although their findings were robust, the study was not designed to establish a causal link between sugar intake and subsequent diabetes diagnosis, the authors admit. Prospective longitudinal cohort studies in international settings, which are now under way, should shed more light on this link.
The authors, led by Sanjay Basu, MD, from the Department of Medicine, Stanford University, Palo Alto, California, examined a decade of cross-sectional data from 175 countries. They note that most of the worldwide rise in diabetes is thought to be type 2, linked to the metabolic syndrome, a cluster of factors including dyslipidemia, hypertension, and insulin resistance.
They report that for each added 150 calories of sugar available per person per day — equivalent to one 12-oz can of soda — the prevalence of type 2 diabetes increased by about 1% (P < .001), after they controlled for factors such as food types, total calories, overweight and obesity rates, aging, urbanization, income, and time.
Sugar Alone Explains 25% of Increase in Diabetes
It is important to identify risk factors for type 2 diabetes, since nearly 1 in 10 adults worldwide has the condition, and the rates are increasing. "If obesity is a primary driver of diabetes, then measures to reduce calorie consumption and increase physical activity should be prioritized," Basu and colleagues write. "However, if added sugar consumption is a primary driver, then public health policies to reduce sugar consumption warrant investigation as diabetes-prevention proposals — especially for developing countries, where diabetes rates are rising dramatically, irrespective of obesity."
They give examples of several countries with high diabetes prevalence rates but low obesity rates, including the Philippines, Romania, France, Bangladesh, and Georgia.
To determine whether sugar in a country's food supply predicts subsequent spikes in diabetes rates, the researchers used a regression model to correlate the prevalence of diabetes from 2000 to 2010 in adults aged 20 to 79 living in 175 countries with the availability of sugar in a country's food supply.
They found that during this decade, the prevalence of worldwide diabetes rose by about 27%, with one quarter of this increase explained by an increase in the availability of sugary foods. No other food category had any significant effect on diabetes prevalence.
Rates of diabetes increased in a dose-dependent manner the longer a population was exposed to excess sugar and the greater the amount of available sugar in the food supply. Each extra year of living where sugary foods were widely available was linked with an increase in diabetes prevalence of 0.053% (P < .05).
The reverse was also true. Following periods of scarce sugar (typically due to changes in trade agreements), the prevalence of diabetes decreased by 0.074% (P< .05), after correction for confounding variables.
Although their findings were robust, the study was not designed to establish a causal link between sugar intake and subsequent diabetes diagnosis, the authors admit. Prospective longitudinal cohort studies in international settings, which are now under way, should shed more light on this link.
Source: http://www.medscape.com/viewarticle/779985?nlid=28944_1301&src=wnl_edit_dail&pa=PCYXhnapQ2wZF1d7JGcwb4Ym85nElZ8ukcKRvE7ifDe0gl7tve%2FFWz1pQS47LFuU43mU9jD%2B1DtnxY47OmyybA%3D%3D
Thursday, 21 February 2013
High calcium intake with supplements unhealthy for women
Too much of a good thing may be just that: too much. That is the conclusion of yet another study, this time a prospective, longitudinal, population-based cohort of Swedish women, looking at calcium intake and cardiovascular mortality.
In this study, high rates of calcium intake were associated with higher all-cause and cardiovascular death rates but not with deaths from stroke, Karl Michaëlsson, MD, PhD, professor in medical epidemiology and senior consultant in orthopedic surgery at Uppsala University in Sweden, and colleagues report in an article published online February 13 in BMJ.
The study is the latest in a series of contentious analyses linking calcium intake and cardiovascular events. Earlier this month, a National Institutes of Health–sponsored study suggested that a high intake of supplemental calcium increased the risk for cardiovascular disease (CVD) death in men, but not women.
However, a commentator notes that the study results suggest that supplements, rather than the intake level, are the problem.
The Swedish mammography cohort, established between 1987 and 1990, followed up 61,433 women born between 1914 and 1948 for a median of 19 years and used registry data to determine outcomes. During that period, there were 11,944 deaths from all causes, of which 3862 were from CVD, 1932 from ischemic heart disease, and 1100 from stroke.
Dietary assessments from food frequency questionnaires at baseline and in 1997 were available for 38,984 women, from which the researchers estimated intakes of dietary and supplemental calcium.
The highest intakes of calcium (>1400 mg/day) were associated with higher all-cause risk for death (after adjustment for age, total energy, vitamin D, and calcium supplement intake, as well as other dietary, physical, and demographic factors) as compared with intakes of 600 to 1000 mg/day (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.17 - 1.67).
Disease-specific mortality risks were elevated for CVD (HR, 1.49; 95% CI, 1.09 - 2.02) and for ischemic heart disease (HR, 2.14; 95% CI, 1.48 - 3.09) at daily calcium intakes above 1400 mg. At calcium intakes less than 600 mg/day, these same mortality risks were also elevated. None of these patterns was apparent for mortality from stroke.
In an email exchange with Medscape Medical News, Dr. Michaëlsson said the association of calcium intake and all-cause and cardiovascular mortality "was especially strong if a high dietary intake of calcium was combined with calcium supplements."
Women with the highest intake of calcium (>1400 mg/day) and who used supplement tablets had an all-cause risk for death 2.5 times higher than women who had similar total intakes but were not taking a supplement.
The authors explain that serum calcium levels "are under tight homeostatic control" and do not normally correlate with the amount of calcium intake. However, low or very high intakes override this control, "causing changes in blood levels of calcium or calciotropic hormones."
Complex Study Results; Weak Findings?
Dr. Michaëlsson also noted that some previous studies have shown a similar relationship between calcium supplements and a higher risk for CVD but were not powered to look at mortality and did not assess the amount of dietary intake of calcium.
He advised that one should not make recommendations on the basis of a single study, but emerging evidence suggests caution about high calcium intake. He also noted that a meta-analysis of randomized trials has shown that calcium supplementation actually increased the rate of hip fracture. "My present recommendation is to avoid calcium supplement use if you have a normal varied diet," he said.
Commenting to Medscape Medical News by email, John Cleland, MD PhD, professor of cardiology at Hull York Medical School in Kingston-upon-Hull, United Kingdom, called the study results "extremely complex...with rather weak findings." He pointed out that in the study there were few patients or events in the group with high calcium intake (n = 1241; 2%), and the events were confined to those women taking supplements (total events, n = 23, of which 16 occurred among women taking any form of calcium supplement).
Women with calcium intakes greater than 1400 mg/day who were taking calcium tablets had an adjusted all-cause mortality rate of 2.57 (95% CI, 1.19 - 5.55) compared with 1.17 (95% CI, 0.97 - 1.41) among women who had similar daily intakes but were not taking supplements. "So, it's not the diet but the pills that are the problem," Dr. Cleland concluded, which is essentially in agreement with what Dr. Michaëlsson said.
Dr. Cleland raised the issues of what else may have been in the calcium pills and why the women were taking them; for example, if they had chronic kidney disease or osteoporosis. He said the article did not provide such information but just referred to a previous paper.
He also pointed out that calcium tablets "have not been shown to reduce fracture rates or improve any other patient outcome that I know of." He recommended that people stop taking calcium supplements "until efficacy/safety is shown," and that this advice "should definitely include those taking them for osteoporosis and should perhaps include those taking them for [chronic kidney disease]." His recommendation? "Having a healthy balanced diet and avoiding water filters that reduce calcium in drinking water is probably best."
Source: http://www.medscape.com/viewarticle/779541?nlid=28503_1301&src=wnl_edit_dail
In this study, high rates of calcium intake were associated with higher all-cause and cardiovascular death rates but not with deaths from stroke, Karl Michaëlsson, MD, PhD, professor in medical epidemiology and senior consultant in orthopedic surgery at Uppsala University in Sweden, and colleagues report in an article published online February 13 in BMJ.
The study is the latest in a series of contentious analyses linking calcium intake and cardiovascular events. Earlier this month, a National Institutes of Health–sponsored study suggested that a high intake of supplemental calcium increased the risk for cardiovascular disease (CVD) death in men, but not women.
However, a commentator notes that the study results suggest that supplements, rather than the intake level, are the problem.
The Swedish mammography cohort, established between 1987 and 1990, followed up 61,433 women born between 1914 and 1948 for a median of 19 years and used registry data to determine outcomes. During that period, there were 11,944 deaths from all causes, of which 3862 were from CVD, 1932 from ischemic heart disease, and 1100 from stroke.
Dietary assessments from food frequency questionnaires at baseline and in 1997 were available for 38,984 women, from which the researchers estimated intakes of dietary and supplemental calcium.
The highest intakes of calcium (>1400 mg/day) were associated with higher all-cause risk for death (after adjustment for age, total energy, vitamin D, and calcium supplement intake, as well as other dietary, physical, and demographic factors) as compared with intakes of 600 to 1000 mg/day (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.17 - 1.67).
Disease-specific mortality risks were elevated for CVD (HR, 1.49; 95% CI, 1.09 - 2.02) and for ischemic heart disease (HR, 2.14; 95% CI, 1.48 - 3.09) at daily calcium intakes above 1400 mg. At calcium intakes less than 600 mg/day, these same mortality risks were also elevated. None of these patterns was apparent for mortality from stroke.
In an email exchange with Medscape Medical News, Dr. Michaëlsson said the association of calcium intake and all-cause and cardiovascular mortality "was especially strong if a high dietary intake of calcium was combined with calcium supplements."
Women with the highest intake of calcium (>1400 mg/day) and who used supplement tablets had an all-cause risk for death 2.5 times higher than women who had similar total intakes but were not taking a supplement.
The authors explain that serum calcium levels "are under tight homeostatic control" and do not normally correlate with the amount of calcium intake. However, low or very high intakes override this control, "causing changes in blood levels of calcium or calciotropic hormones."
Complex Study Results; Weak Findings?
Dr. Michaëlsson also noted that some previous studies have shown a similar relationship between calcium supplements and a higher risk for CVD but were not powered to look at mortality and did not assess the amount of dietary intake of calcium.
He advised that one should not make recommendations on the basis of a single study, but emerging evidence suggests caution about high calcium intake. He also noted that a meta-analysis of randomized trials has shown that calcium supplementation actually increased the rate of hip fracture. "My present recommendation is to avoid calcium supplement use if you have a normal varied diet," he said.
Commenting to Medscape Medical News by email, John Cleland, MD PhD, professor of cardiology at Hull York Medical School in Kingston-upon-Hull, United Kingdom, called the study results "extremely complex...with rather weak findings." He pointed out that in the study there were few patients or events in the group with high calcium intake (n = 1241; 2%), and the events were confined to those women taking supplements (total events, n = 23, of which 16 occurred among women taking any form of calcium supplement).
Women with calcium intakes greater than 1400 mg/day who were taking calcium tablets had an adjusted all-cause mortality rate of 2.57 (95% CI, 1.19 - 5.55) compared with 1.17 (95% CI, 0.97 - 1.41) among women who had similar daily intakes but were not taking supplements. "So, it's not the diet but the pills that are the problem," Dr. Cleland concluded, which is essentially in agreement with what Dr. Michaëlsson said.
Dr. Cleland raised the issues of what else may have been in the calcium pills and why the women were taking them; for example, if they had chronic kidney disease or osteoporosis. He said the article did not provide such information but just referred to a previous paper.
He also pointed out that calcium tablets "have not been shown to reduce fracture rates or improve any other patient outcome that I know of." He recommended that people stop taking calcium supplements "until efficacy/safety is shown," and that this advice "should definitely include those taking them for osteoporosis and should perhaps include those taking them for [chronic kidney disease]." His recommendation? "Having a healthy balanced diet and avoiding water filters that reduce calcium in drinking water is probably best."
Source: http://www.medscape.com/viewarticle/779541?nlid=28503_1301&src=wnl_edit_dail
Wednesday, 20 February 2013
Saffron for macular degeneration
Age-related macular degeneration (ARMD) is the primary cause of older age onset partial or sometimes total blindness. Although most common in adults over 50, macular degeneration can occur at any age, though rarely among those under 50.
Macular degeneration mostly affects central vision, forcing people to rely more on less distinct peripheral vision to recognize objects and faces. The macula occupies a small portion of the retina in the back of the eye.
Though small, the macula is the most light sensitive area of the retina, and it permits detailed focus of objects located centrally in the field of vision. There are two classifications of macular degeneration: Dry and wet.
Dry macular degeneration is the most common and least severe. Diminished central vision clarity occurs gradually. It's called dry because there is no capillary leakage in that region of the eye. Wet macular degeneration does involve retina capillary leakage. It's symptoms are usually more severe and worsen rapidly.
Thus far, ophthalmology has little to offer as a remedy for macular degeneration. But ophthalmologists do recommend taking leutin and astaxanthin to slow ARMD's progress or possibly reverse it slightly.
However, recent human clinical research in Italy and Australia has discovered a non-pharmaceutical approach that proved efficacious for improving eyesight with macular degeneration sufferers safely. It is a little pricey though. It's the spice known as saffron.
Saffron is pricier than most other spices because the bulbs must be planted by hand, and the three crimson stigmas or saffron threads have to also be plucked out of each flower by hand.
The Australian clinical trial
Macular degeneration mostly affects central vision, forcing people to rely more on less distinct peripheral vision to recognize objects and faces. The macula occupies a small portion of the retina in the back of the eye.
Though small, the macula is the most light sensitive area of the retina, and it permits detailed focus of objects located centrally in the field of vision. There are two classifications of macular degeneration: Dry and wet.
Dry macular degeneration is the most common and least severe. Diminished central vision clarity occurs gradually. It's called dry because there is no capillary leakage in that region of the eye. Wet macular degeneration does involve retina capillary leakage. It's symptoms are usually more severe and worsen rapidly.
Thus far, ophthalmology has little to offer as a remedy for macular degeneration. But ophthalmologists do recommend taking leutin and astaxanthin to slow ARMD's progress or possibly reverse it slightly.
However, recent human clinical research in Italy and Australia has discovered a non-pharmaceutical approach that proved efficacious for improving eyesight with macular degeneration sufferers safely. It is a little pricey though. It's the spice known as saffron.
Saffron is pricier than most other spices because the bulbs must be planted by hand, and the three crimson stigmas or saffron threads have to also be plucked out of each flower by hand.
The Australian clinical trial
The Australian human study was conducted by Sydney University Professor of Neurology Jonathan Stone. Both this study and the Italian research were similar in scope and dosage. And both conducted a more humane approach to double blind placebo studies with a non-toxic remedy than normally.
The study involved 25 macular degeneration sufferers. Instead of depriving a placebo group from a product that could do something for their ailment, the study switched placebo subjects with saffron subjects half-way through the trial unbeknownst to all involved. The daily dosage was 20 mg of saffron.
The whole study was six months long, so each side of the 25 double blind subjects had three months of improved vision with three months of impaired vision. All 25 were tested for neuron electrical conductivity in the macula and retina, and 23 showed significant improvement. Those 23 also reported they could see much better.
Visual improvement began after only two weeks on saffron. When the saffron group was put onto placebos, they complained that their improved eyesight had begun diminishing again. Conversely, those on placebos for the first half of the trial began seeing better after three months of no improvement.
Professor Stone projects that after a year or more ingesting only 20 mg (milligrams) of saffron daily, vision improvements should stabilize without requiring more saffron dosing.
Stone doesn't know exactly how or why, but he became aware that saffron influences the neuron's genetic code to restore its capacity for healing and protecting neuron cells. Neurons are responsible for transmitting electrical signals or impulses throughout the nervous system.
Professor Stone is looking forward to completing animal studies with saffron for other neurological issues like Parkinson's and Alzheimer's. Then those would go into human clinical trials also.
His results, combined with the Italian study, impressed Professor Stone enough to create his own line of saffron capsules for the market. He qualified it as a safe nutraceutical that shouldn't require any more testing for FDA approval.
Source: http://www.naturalnews.com/039150_saffron_macular_degeneration_cure.html#ixzz2LPB2RnFa
The study involved 25 macular degeneration sufferers. Instead of depriving a placebo group from a product that could do something for their ailment, the study switched placebo subjects with saffron subjects half-way through the trial unbeknownst to all involved. The daily dosage was 20 mg of saffron.
The whole study was six months long, so each side of the 25 double blind subjects had three months of improved vision with three months of impaired vision. All 25 were tested for neuron electrical conductivity in the macula and retina, and 23 showed significant improvement. Those 23 also reported they could see much better.
Visual improvement began after only two weeks on saffron. When the saffron group was put onto placebos, they complained that their improved eyesight had begun diminishing again. Conversely, those on placebos for the first half of the trial began seeing better after three months of no improvement.
Professor Stone projects that after a year or more ingesting only 20 mg (milligrams) of saffron daily, vision improvements should stabilize without requiring more saffron dosing.
Stone doesn't know exactly how or why, but he became aware that saffron influences the neuron's genetic code to restore its capacity for healing and protecting neuron cells. Neurons are responsible for transmitting electrical signals or impulses throughout the nervous system.
Professor Stone is looking forward to completing animal studies with saffron for other neurological issues like Parkinson's and Alzheimer's. Then those would go into human clinical trials also.
His results, combined with the Italian study, impressed Professor Stone enough to create his own line of saffron capsules for the market. He qualified it as a safe nutraceutical that shouldn't require any more testing for FDA approval.
Source: http://www.naturalnews.com/039150_saffron_macular_degeneration_cure.html#ixzz2LPB2RnFa
Tuesday, 19 February 2013
Two antihypertensives plus NSAID ups risk of acute kidney injury
Taking two antihypertensive medications--a diuretic and an ACE inhibitor or angiotensin-receptor blocker (ARB)--along with nonsteroidal anti-inflammatory drugs (NSAIDs) significantly increases the risk of hospitalization for acute kidney injury, particularly in the first 30 days of treatment, a new retrospective case-control study demonstrates [1].
And although the absolute risk for individuals is low, physicians and patients need to be aware of this potential problem, and doctors will need to prescribe alternative anti-inflammatory and/or analgesic agents where warranted, say Dr Francesco Lapi (Jewish General Hospital, Montreal, QC) and colleagues in their report published online January 8, 2013 in BMJ.
"More and more patients, especially the elderly, are taking many medications at the same time, and drug-drug interactions are always important. With the size of the population that we have access to now, we are able to study questions we could not address before," senior author Dr Samy Suissa (McGill University, Montreal, QC) told heartwire . "The message to clinicians is to be vigilant during that early period of treatment," he added.
In an editorial accompanying the paper [2], Drs Dorothea Nitsch and Laurie A Tomlinson (London School of Hygiene and Tropical Medicine, UK) agree. "Clinicians must advise patients who are prescribed diuretics, ACE inhibitors, or ARBs of the risks associated with NSAID use, and they must also be vigilant for signs of drug-associated acute kidney injury in all patients," they observe.
"Triple" Therapy Ups Risk of Kidney Injury by 80% in First 30 Days of Use
Clinicians must advise patients who are prescribed diuretics, ACE inhibitors, or ARBs of the risks associated with NSAID use, and they must also be vigilant for signs of drug associated acute kidney injury.
Lapi and colleagues say that acute kidney injury is a major public-health concern, which has been associated with a mortality rate exceeding 50%. To study the question of how often this occurs with concurrent use of antihypertensives and NSAIDs, they used the UKClinical Practice Research Datalink (previously known as the General Practice Research Database)--which is the world's largest computerized store of primary-care records--to assess a cohort of 487 372 users of antihypertensive drugs between 1997 and 2008. This was linked to the Hospital Episodes Statisticsdatabase to see whether a double therapy combination of a diuretic, ACE inhibitor, or ARB with an NSAID or the triple therapy combination of two of those antihypertensives plus an NSAID was associated with increased risk of hospitalization for acute kidney injury.
During a mean follow-up of almost six years, 2215 cases of acute kidney injury were identified (incidence rate of seven per 10 000 person-years), and each was compared with up to 10 matched controls.
Overall, current use of double therapy was not associated with an increased risk of acute kidney injury, but current use of triple therapy--two antihypertensives plus an NSAID--was associated with an increased rate of this end point (rate ratio 1.31, 95% CI 1.12–1.53). And the highest risk was seen in the first 30 days of use (rate ratio 1.82, 95% CI 1.35–2.46). These results remained consistent after adjustment for potential confounders.
"If you are taking two antihypertensive medications--a diuretic and an ACE inhibitor or ARB--and then you add on an NSAID, the adding of the NSAID increases the risk of acute kidney injury, particularly in the first 30 days, so you are identifying some susceptible patients when you expose them to NSAIDs in that first month," Suissa explains.
He adds that those who get through the 30-day period without any problem will likely be fine, "at least in terms of acute kidney injury"; he noted that the study was not designed to assess the issue of chronic renal problems.
But Is "Double" Therapy Safe?
But Nitsch and Tomlinson go on to question the finding that an NSAID added to one of the three antihypertensives is not associated with acute kidney injury.
I don't think we can say we are absolutely confident that [double therapy] is safe, but it is certainly not a high risk.
The confidence intervals for the estimates of risk for double drug combinations were "wide," they note, so the study "probably underestimates the true burden of drug-associated kidney injury. The jury is still out on whether double drug combinations are indeed safe," they state.
Suissa acknowledges that the number of patients taking this double therapy was small, "so we cannot exclude a small increased risk. I don't think we can say we are absolutely confident that it is safe, but it is certainly not a high risk," he told heartwire .
He adds that the study findings are indicative of how hypertension is now being managed. "It's being controlled with two drugs, not just one, and then if you have pain, we will add an NSAID to that. In our cohort of antihypertensive-drug patients, 11% were treated with this triple therapy, which is quite large. We were surprised."
Source: http://www.medscape.com/viewarticle/777349?src=nldne&uac=129655SZ
And although the absolute risk for individuals is low, physicians and patients need to be aware of this potential problem, and doctors will need to prescribe alternative anti-inflammatory and/or analgesic agents where warranted, say Dr Francesco Lapi (Jewish General Hospital, Montreal, QC) and colleagues in their report published online January 8, 2013 in BMJ.
"More and more patients, especially the elderly, are taking many medications at the same time, and drug-drug interactions are always important. With the size of the population that we have access to now, we are able to study questions we could not address before," senior author Dr Samy Suissa (McGill University, Montreal, QC) told heartwire . "The message to clinicians is to be vigilant during that early period of treatment," he added.
In an editorial accompanying the paper [2], Drs Dorothea Nitsch and Laurie A Tomlinson (London School of Hygiene and Tropical Medicine, UK) agree. "Clinicians must advise patients who are prescribed diuretics, ACE inhibitors, or ARBs of the risks associated with NSAID use, and they must also be vigilant for signs of drug-associated acute kidney injury in all patients," they observe.
"Triple" Therapy Ups Risk of Kidney Injury by 80% in First 30 Days of Use
Clinicians must advise patients who are prescribed diuretics, ACE inhibitors, or ARBs of the risks associated with NSAID use, and they must also be vigilant for signs of drug associated acute kidney injury.
Lapi and colleagues say that acute kidney injury is a major public-health concern, which has been associated with a mortality rate exceeding 50%. To study the question of how often this occurs with concurrent use of antihypertensives and NSAIDs, they used the UKClinical Practice Research Datalink (previously known as the General Practice Research Database)--which is the world's largest computerized store of primary-care records--to assess a cohort of 487 372 users of antihypertensive drugs between 1997 and 2008. This was linked to the Hospital Episodes Statisticsdatabase to see whether a double therapy combination of a diuretic, ACE inhibitor, or ARB with an NSAID or the triple therapy combination of two of those antihypertensives plus an NSAID was associated with increased risk of hospitalization for acute kidney injury.
During a mean follow-up of almost six years, 2215 cases of acute kidney injury were identified (incidence rate of seven per 10 000 person-years), and each was compared with up to 10 matched controls.
Overall, current use of double therapy was not associated with an increased risk of acute kidney injury, but current use of triple therapy--two antihypertensives plus an NSAID--was associated with an increased rate of this end point (rate ratio 1.31, 95% CI 1.12–1.53). And the highest risk was seen in the first 30 days of use (rate ratio 1.82, 95% CI 1.35–2.46). These results remained consistent after adjustment for potential confounders.
"If you are taking two antihypertensive medications--a diuretic and an ACE inhibitor or ARB--and then you add on an NSAID, the adding of the NSAID increases the risk of acute kidney injury, particularly in the first 30 days, so you are identifying some susceptible patients when you expose them to NSAIDs in that first month," Suissa explains.
He adds that those who get through the 30-day period without any problem will likely be fine, "at least in terms of acute kidney injury"; he noted that the study was not designed to assess the issue of chronic renal problems.
But Is "Double" Therapy Safe?
But Nitsch and Tomlinson go on to question the finding that an NSAID added to one of the three antihypertensives is not associated with acute kidney injury.
I don't think we can say we are absolutely confident that [double therapy] is safe, but it is certainly not a high risk.
The confidence intervals for the estimates of risk for double drug combinations were "wide," they note, so the study "probably underestimates the true burden of drug-associated kidney injury. The jury is still out on whether double drug combinations are indeed safe," they state.
Suissa acknowledges that the number of patients taking this double therapy was small, "so we cannot exclude a small increased risk. I don't think we can say we are absolutely confident that it is safe, but it is certainly not a high risk," he told heartwire .
He adds that the study findings are indicative of how hypertension is now being managed. "It's being controlled with two drugs, not just one, and then if you have pain, we will add an NSAID to that. In our cohort of antihypertensive-drug patients, 11% were treated with this triple therapy, which is quite large. We were surprised."
Source: http://www.medscape.com/viewarticle/777349?src=nldne&uac=129655SZ
Flu virus can spread up to 6ft, no cough or sneeze required
The influenza virus can spread up to 6 feet from a patient's head via submicron particles during routine hospital care, according to a study of patients admitted to the emergency department (ED) and throughout a tertiary care hospital with influenza-like illness during the 2010 to 2011 influenza season. It was previously thought that the virus traveled only a short distance via large particle droplets during coughing or sneezing. Submicron particles are released in the air during talking and breathing.
Werner E. Bischoff, MD, PhD, an assistant professor in the Section on Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, and colleagues published their findings online January 31 inClinical Infectious Diseases.
According to the World Health Organization and the Centers for Disease Control and Prevention, transmission mainly occurs when large-particle respiratory droplets travel a short distance, and face masks worn by healthcare professionals block those particles. Fit-tested respirators are only required when aerosol-generating procedures such as bronchoscopy are performed.
Particle size may affect infection risk and severity on the basis of the virus' ability to travel to the lungs instead of being confined to the upper respiratory tract.
"Protecting [healthcare professionals] against influenza virus requires a clear understanding of how this virus is aerosolized and by whom it is emitted," the authors write.
Investigators enrolled 94 patients with influenza-like illness in the study. They obtained patient history and took nasopharyngeal swab specimens. The researchers then collected quantitative impaction air samples 1 foot or less, 3 feet, and 6 feet from the patient's head during routine care. Rapid test and polymerase chain reaction were used to detect influenza virus.
Of the 94 patients, 61 (65%) were influenza-positive (31 influenza A, 30 influenza B). Of those patients, 26 (43%) emitted influenza virus into room air (13 inpatients and 13 ED patients). Of the emitters, 5 (19%) released up to 32 times more virus than other patients. There were no statistical differences in other characteristics or symptoms.
Higher nasopharyngeal viral loads were found in emitters compared with nonemitters. Patients with increased nasopharyngeal viral load were the only patients in whom coughing and sneezing during air sampling was connected with the release of increased virus into room air (P < .05). Emitters exceeded the airborne 50% human infectious dose of influenza virus at all locations sampled.
All emitters in the study were less likely to report chills and more likely to experience higher illness severity and interference with daily living than nonemitter ED patients (P < .05).
As distance from the patient's head increased (from 1 to 6 feet), the viral load decreased significantly (P < .05). The amount of small particles also increased significantly relative to the amount of large particles. Healthcare professionals were primarily exposed to small influenza virus particles (diameter, < 4.7 μm).
There were no detectable differences between influenza virus types, emitters and superemitters, and patient location.
In an accompanying editorial, Caroline Breese Hall, MD, professor in the Department of Pediatrics and the Department of Medicine at the University of Rochester School of Medicine and Dentistry in New York, notes that more advanced forms of personal protection equipment that effectively block small particles (such as N95 respirators) are expensive and that their use in all influenza-positive patients is "usually not feasible."
"[I]nfection control procedures should be commensurate with the concern generated by the clinical observations of the intensity and severity of the community outbreak. The efficacy of the recommended infection control program, however, is less dependent on which specific procedures are included than on the consistent education of healthcare personnel," Dr. Hall noted. "Included in this should be their vaccination, their compliance with the recommended procedures, and their awareness of the risks of nosocomial infection among patients and personnel."
She concludes, "This study not only adds to our understanding of these risks, but helps define the questions that still need answering."
Dr. Hall died on December 10, 2012, at the age of 73 years. She was internationally known for her work in pediatric infectious diseases.
Source: http://www.medscape.com/viewarticle/778674?nlid=28043_1301&src=wnl_edit_dail&uac=129655SZ
Werner E. Bischoff, MD, PhD, an assistant professor in the Section on Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, and colleagues published their findings online January 31 inClinical Infectious Diseases.
According to the World Health Organization and the Centers for Disease Control and Prevention, transmission mainly occurs when large-particle respiratory droplets travel a short distance, and face masks worn by healthcare professionals block those particles. Fit-tested respirators are only required when aerosol-generating procedures such as bronchoscopy are performed.
Particle size may affect infection risk and severity on the basis of the virus' ability to travel to the lungs instead of being confined to the upper respiratory tract.
"Protecting [healthcare professionals] against influenza virus requires a clear understanding of how this virus is aerosolized and by whom it is emitted," the authors write.
Investigators enrolled 94 patients with influenza-like illness in the study. They obtained patient history and took nasopharyngeal swab specimens. The researchers then collected quantitative impaction air samples 1 foot or less, 3 feet, and 6 feet from the patient's head during routine care. Rapid test and polymerase chain reaction were used to detect influenza virus.
Of the 94 patients, 61 (65%) were influenza-positive (31 influenza A, 30 influenza B). Of those patients, 26 (43%) emitted influenza virus into room air (13 inpatients and 13 ED patients). Of the emitters, 5 (19%) released up to 32 times more virus than other patients. There were no statistical differences in other characteristics or symptoms.
Higher nasopharyngeal viral loads were found in emitters compared with nonemitters. Patients with increased nasopharyngeal viral load were the only patients in whom coughing and sneezing during air sampling was connected with the release of increased virus into room air (P < .05). Emitters exceeded the airborne 50% human infectious dose of influenza virus at all locations sampled.
All emitters in the study were less likely to report chills and more likely to experience higher illness severity and interference with daily living than nonemitter ED patients (P < .05).
As distance from the patient's head increased (from 1 to 6 feet), the viral load decreased significantly (P < .05). The amount of small particles also increased significantly relative to the amount of large particles. Healthcare professionals were primarily exposed to small influenza virus particles (diameter, < 4.7 μm).
There were no detectable differences between influenza virus types, emitters and superemitters, and patient location.
In an accompanying editorial, Caroline Breese Hall, MD, professor in the Department of Pediatrics and the Department of Medicine at the University of Rochester School of Medicine and Dentistry in New York, notes that more advanced forms of personal protection equipment that effectively block small particles (such as N95 respirators) are expensive and that their use in all influenza-positive patients is "usually not feasible."
"[I]nfection control procedures should be commensurate with the concern generated by the clinical observations of the intensity and severity of the community outbreak. The efficacy of the recommended infection control program, however, is less dependent on which specific procedures are included than on the consistent education of healthcare personnel," Dr. Hall noted. "Included in this should be their vaccination, their compliance with the recommended procedures, and their awareness of the risks of nosocomial infection among patients and personnel."
She concludes, "This study not only adds to our understanding of these risks, but helps define the questions that still need answering."
Dr. Hall died on December 10, 2012, at the age of 73 years. She was internationally known for her work in pediatric infectious diseases.
Source: http://www.medscape.com/viewarticle/778674?nlid=28043_1301&src=wnl_edit_dail&uac=129655SZ
Subscribe to:
Posts (Atom)