Testing It Up

A study presented at the annual meeting of the American Society of Clinical Oncology in Orlando, Florida, indicate that hormone therapy taken by women as treatment for the effects of menopause can increase the risk of lung cancer.

The lead author for the study is Dr. Rowan Chlebowski of the Harbor-UCLA Medical Center, who was quoted saying that women should not use combined hormone therapy and tobacco at the same time. The data should reportedly serve as a warning for women who continue to take hormones to stop smoking. Dr. Chlebowski also said that for every one hundred women who both underwent hormone therapy and smoked, one avoidable lung cancer death occurred over eight years.

The data analyzed for the study was from Women’s Health Initiative. Women in the study either took Prempo, a drug which combined estrogen and progestin, or a placebo. The study, however, was discontinued in 2002 due to the fact that it was discovered that the therapy increased the risk for developing breast cancer.

The new study focused on analyzing the occurrence of lung cancer during the five and a half years that the group was either undergoing therapy or taking a placebo until more than two years after.

Occurrence of lung cancer among the estimated 8,000 women who underwent hormone therapy was at 96 cases of non-small cell lung cancer, which is the most common type of lung cancer. When compared to the 72 cases that occurred among the women who took placebo, the difference in number was not deemed as significant.

Looking at the number of deaths due to lung cancer, however, there were 67 deaths among hormone users as opposed to 39 deaths among those who were only given placebo, which is statistically significant.

The Chief Medical Officer of the American Cancer Society, Dr. Otis Brawley, reportedly said, though, that due to the fact that there was only a significant difference between the number of deaths and not the number of cases, he was not convinced that the results were not due to chance.

May 31st marks World No Tobacco Day, where an effort is made towards stressing the adverse effects of tobacco use to the health of people worldwide. On this day, people are enjoined to either spread the word about the ill effects of tobacco or, for those who are smokers, try to stay away from smoking at least for a day. This year, the commemoration focuses on warnings placed on tobacco products and the need for the inclusion of more graphic warnings on packages.

The American Lung Association is encouraging citizens to write to their respective senators about the inclusion of graphic labels on tobacco products. A pending legislation before the US Senate, the Family Smoking Prevention and Tobacco Control Act, will empower the US Food and Drug Administration and give them control over the marketing, manufacture and sale of tobacco products. This means that the FDA will also have the authority to modify warning labels to make sure that these remain effective.

The World Health Organization also sees the need to graphic warnings on packages. The agency said that “cigarette packages should include images of sickness and suffering caused by tobacco, along with written warnings.”

Tobacco is known as the leading cause of preventable death, and is responsible for the death of more than 5 million people worldwide annually. In the US, it is responsible for the deaths of more than 392,000 Americans each year. It is also the only consumer product that is legal that “kills when used exactly as intended by the manufacturer.” Normally, it is the other way around.

The drive for more graphic warnings stems from the fact that warning pictures have been known to be successful at helping smokers quit or preventing others from getting hooked. This observation is as true in the US, as indicated on the American Lung Association’s website, as it is in other places in the world. The WHO revealed consistent findings in studies of similar campaigns conducted in Brazil, Canada, Singapore and Thailand.

A drug that is being groomed as a possible treatment for cocaine addiction failed in mid-stage trials, sending the stocks of the drug’s manufacturer into a tailspin.

Catalyst Pharmaceuticals Partners Inc. began trading publicly in November 2006, reportedly raising $21 million in capital. The company’s selling point is the development of a drug with massive potential. The drug, CPP-109, is commonly called vigabatrin. It was developed in the 1970s for the treatment of epilepsy. In the 1980s, it was studied by researchers for the US government for possible application in the treatment of addiction as it causes the suppression of the response of the brain to striking increases in dopamine.

Catalyst Pharmaceuticals revealed through a press release that CPP-109 trials did not indicate that a significant number of CPP-109 treated test subjects were cocaine-free during the last couple of weeks of treatment as opposed to those who were only given placebo. The results were surprising, however, as three prior human trials with the drug had been successful. Patrick J. McEnany, Catalyst Chief Executive, told the press that they have only begun to analyze data, but this did not prevent the company’s stocks from taking a nosedive, dropping to as low as 90 cents.

A separate study in Mexico, though, reportedly had more positive results, so Catalyst will be looking into differences in demographics as a possible cause of the conflicting results.

According to a report on Reuters, the company has enough cash to fund trials through the end of 2010. Among the adjustments that they made was to temporarily halt the enrollment of new subjects for the mid-stage trial for the use of CPP-109 to treat addiction to methamphetamine. The company plans to analyze the data to over the next few months to determine whether they would try another study for cocaine addicts.

I always hold people who choose careers in medicine in high esteem. While I am far from inadequate intellectually, I cannot begin to imagine being responsible for someone else’s life as literally as doctors or anyone in the medical profession do, and I admire these people for that. For me, these are people who cannot afford to make mistakes; and I fully trust that they do not. But the fact that they are also human makes us realize that mistakes are bound to happen.

This is why though I was disheartened by the mistakes that VA hospitals have admitted to, mistakes that have placed the lives of other people in jeopardy, I wasn’t that surprised. People do make mistakes – but in the field of medicine, mistakes simply cannot be tolerated.

According to reports, a congressional panel will be making inquiries into the reported mistakes of three VA hospitals. Officials of the Department of Veterans Affairs will be facing questions regarding how patients were placed at risk for exposure to HIV and other diseases that are transferred through exchange of bodily fluids.

More the ten thousand patients who underwent colonoscopies or were evaluated using ENT scopes in VA hospitals in Miami, Murfreesboro, Tennessee and Augusta, Georgia, were recommended to be asked to submit themselves to follow-up blood checks. As of May 18, about 8,000 of the patients who were possibly affected have been notified, and of those who have already done so, five have tested positive for HIV and 43 have tested positive for hepatitis.

In the case of the VA hospital in Murfreesboro, an incorrect valve in equipment may have allowed the transfer of bodily fluid from patient to patient. It is has not been established whether this was an isolated incident that occurred for just one day, or whether it has gone on since the equipment’s installation in 2003.

A tube that was supposed to be cleaned after each colonoscopy was instead only cleaned out at the end of each day in Miami, affecting patients between May 2004 and March 2009. In Augusta, ENT scopes used for looking into the nose and throats of patients were not properly cleaned, affecting patients between January 2008 and November 2008.

Authorities in a couple of states in Germany – Hesse and North-Rhine Westphalia – have reportedly prohibited retailers from selling Red Bull Cola. A nationwide ban in Germany may also be in the offing for the product, which is also available in the United Kingdom. At this time, Rewe, a German retail giant, has ordered the removal of Red Bull from its shops.

The discovery was made by a food safety institute in North-Rhine Westphalia after an elaborate chemical test on samples of Red Bull Cola. This was revealed by Bernard Kuehnle, Head of the Food Safety Department at the Federal Ministry for Consumer Protection. What the investigation yielded was the presence of de-cocainized coca leaf extract in the drink.

While reports indicate that the levels of cocaine found in the samples were not necessarily life threatening, it is nevertheless deemed illegal. The presence of cocaine meant that the drink will need to be classified as a narcotic as opposed to a food product, and will require a special license to be marketed as such.

A spokesperson for Red Bull has released a statement on behalf of the manufacturer, saying that the de-cocainized coca leaf extract found in the drink is used as a natural flavoring in food worldwide. It is also arguing that Red Bull Cola as well as other food that contain coca leaf extract are considered as safe in the US and in the European Union.

Red Bull products are sold and used in some parts of the world as an energy drink. In Europe, Red Bull is popular as a “clubber’s drink” and is often mixed with vodka, according to reports. The company claims that the drink contains caffeine, vitamins and sugar which “kick-start the body’s metabolism and keeps people alert.”

Yesterday, we did a feature pointing out the differences between food intolerance and food allergies, as the two are normally mistakenly taken as one or the other. While the symptoms of food intolerance are not as immediate and severe unlike food allergies, the two conditions have one thing in common — they can both be prevented through the diligent avoidance of intake of the foods that cause them.

There are no medications to treat food allergy or food intolerance, and as previously mentioned, the only way to prevent its occurrence is by diligently avoiding these foods. However, due to the common nature of the symptoms – nausea, abdominal pain, bloating and diarrhea – which are usually unpleasant but not necessarily viewed as harmful, it is often difficult to associate these symptoms with food intolerance. In this case, it may be beneficial to undergo a food intolerance test to identify the food types and ingredients that one is intolerant to, so that these foods can be cut from his or her diet.

Once the offending food types are known, these can be removed from a person’s diet. At this point, it is important to be careful about the specific ingredients in the food that one is taking in. Food labels should be scrutinized carefully, and when eating out, be sure to inform the waiter about cases of intolerance so that the establishment will be able to recommend dishes that you can order without getting sick.

Nowadays, however, food intolerance no longer necessarily equates to food deprivation, as there are now food intolerance products or “free-from” products. You can now purchase “lactose-free” milk and other such products, which will allow you to indulge your food fancy without worrying too much about intolerance.

Based on the 2009 Cancer Statistics Report released by the American Cancer Society, it looks like Americans are doing something right as far as prevention, detection and treatment of the various forms of cancer is concerned. This includes the various agencies and organizations that develop and perform researches that lead towards innovation in cancer treatment, prevention and detection.

Death rates due to cancer between 1990 and 2005, a period of 15 years, were reviewed, and the analysis of the data showed a consistent decline in cancer death rates. Cancer death rates in men dropped 19.2% in the 15-year period, while death rates in women dropped by 11.4%. Both these figures are considered encouraging.

The decrease in death rates is being attributed to self-imposed prevention by Americans, such as choosing to quit smoking, especially among women. It is also being attributed to an increased awareness in detection techniques, such as early detection and screening for colorectal cancer, breast cancer and cervical cancer. Lastly, cancer treatment has definitely evolved and improved in the last 15 years, saving more lives down the line.

If all these factors continue to improve for the better, then we may, by consequence, see cancer death rates decline even further.

A decline in smoking will especially be beneficial, as it is a risk factor for at least 15 types of cancer. According to the report, patients who develop tobacco-related cancers such as cancers of the lung and the esophagus have the highest risk of developing a second cancer. Most cancer survivors are more likely to develop another type of cancer versus someone who has never had a diagnosis. Survivors of breast cancer constitute almost half of women who end up developing a second cancer.

Despite these promising figures, though, cancer remains to be the leading cause of death among persons under 85, and still cause 25% of deaths in the US.

Clara Ogren, a Baltimore Examiner, shared helpful information on the differences between food allergy and food intolerance. Most people use these two terms interchangeably, probably because they use the same method of prevention of the appearance of symptoms — staying away from the food that cause them. Needless to say, the two conditions are different from each other and it is rather important that one is able to distinguish between the two.

Food allergies are responses of a person’s immune system to food. People who have an allergic reaction to certain foods do so because their body incorrectly identifies an ingredient in the food – usually a protein – as harmful, so as a reaction, the body generates anti-bodies against it. Allergy symptoms are usually immediate and dramatic, and in some cases can be life-threatening. Among the symptoms mentioned by Ogren in her feature are coughing, wheezing, runny nose, difficulty breathing, tingling in the mouth and throat, swelling of the lips, face, tongue and throat, rashes, hives, eczema and anaphylactic shock, which will require emergency intervention. Aside from these visible symptoms, gastro-intestinal symptoms such as vomiting, cramping and gas may also occur.

The occurrences of true food allergies are considered a rarity. It reportedly affects 2 to 4% of adults and 6 to 8% of children. In comparison, food intolerance is considered more common.

Food intolerance or food sensitivity, on the other hand, is the response of a person’s digestive system to food, as opposed to the immune system in the case of food allergy. People who are intolerant to certain foods either have their digestive systems irritated by these foods, or their bodies are unable to properly digest these foods due to a lack of certain enzymes. As opposed to the immediate and dramatic reaction seen in food allergies, reactions as a result of food intolerance can take hours or even days before they appear. Symptoms are typically gastro-intestinal in nature — heartburn, diarrhea, constipation, nausea and abdominal pain, including gas, cramps and bloating. Migraines, irritability, anxiousness, exhaustion and nervousness were also listed as possible symptoms. Another interesting fact shared by Ogren is that some people can get a certain “high” from eating offending foods, so it can actually lead to people being “addicted” to food that they are intolerant to.

Another difference between allergies and intolerance is that symptoms due to allergies can normally be triggered even after the consumption of small amounts of the offending food, while intolerances can normally still manage to consume certain amounts of the offending food without exhibiting symptoms, although the amount can vary from person to person.

Most smokers will agree on two things — how easy it is to get hooked on smoking, and how difficult it can be to quit. It is for this reason that various ways to help smokers quit have been developed, and the help that some smokers need may conveniently be found online.

A study published in the Archives of Internal Medicine indicates that web- and computer-based smoking-cessation programs are proving to be effective. Some of these programs are even interactive.

One of the study’s researchers, Joel Moskowitz, PhD, director of the Center for Family and Community Health at the University of California, Berkeley School of Public Health, told WebMD that these programs are “cost-effective alternatives to telephone hotlines or counseling services.” They come in the form of discussion forums such as blogs, and will assist its users in evaluating the benefits of kicking the habit, such as “how much money you will save and how much longer you will live,” according to Moskowitz.

The study involved an analysis of pooled data from 22 trials, where smokers signed up for web- or computer-based smoking-cessation programs, and smokers who tried to quit smoking without the support of these programs. There was available data on almost 30,000 participants, including more than 16,000 who were randomly assigned to a web- or computer-based cessation program. These trials were conducted in the US, UK, Australia, Germany and Switzerland.

At three months, the cessation rates for those the two groups were similar, but 9.9% of those who enrolled in programs sustained cessation for a year after the programs, as opposed to only 5.7% of those who tried to quit on their own.

These programs may be of help to those who would like to quit smoking but cannot afford professional treatment or are wary of the stigma that goes with seeking treatment.

The outbreak of H1N1 flu may have already peaked in the United States, except for the states of New York, New Jersey and New England. According to Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention, the occurrence of influenza nationwide is starting to decrease.

This does not mean, though, that the country can relax. Dr. Anne Schuchat adds that they are keeping a close tab on the lessons that history has to offer. Lessons that can be learned from the flu epidemic of 1918 are being kept in mind; the epidemic claimed around 20 million lives in the United States alone. During that year, the epidemic began with mild cases in the spring, followed by devastating illnesses in the fall.

The CDC has the following statistics regarding this year’s H1N1 outbreak — there were 6,764 confirmed or probable cases and 10 deaths nationwide. This figure is more than half of the total figure of 12,954 cases reported worldwide as of Tuesday. It is for this reason that US health officials are bracing themselves for what fall may bring.

Since it looks like the flu is starting to decline in North America, the CDC is trying to negotiate for the monitoring of the behavior of the virus in Latin America and other countries in the Southern Hemisphere during the winter flu season, which usually peaks in June or July. Negotiations are being conducted with the Pan American Health Organization and health ministries of the countries involved. According to Keiji Fukuda of the WHO, the behavior of the flu in these countries over the next few weeks may be used as an indicative factor in the determining whether there is a need for a vaccine or not.

The CDC and the WHO are currently working on a vaccine against the H1N1 flu.