Friday, May 25, 2007

Medications and Sunburnt Effects

Some Medications Can Make You More Vulnerable To Sunburn

Thursday May 24, 2007

You know the drill - don't go outside in this blazing heat without sunscreen on to protect you from the dangers of sunburn. But even as you lather on the lotion, there are other concerns that what's inside you may be as important as what's on you.

And it all depends on which medications you're taking. There are certain pills and potions that may be good for your health, but leave you much more prone to getting a burn. Some meds actually increase your skin's sensitivity to sunlight, and allow you to skip the tanning stage and head straight to a burn. It may also lower the amount of time you can spend under Old Sol without coming out beet red - or worse.

So what are the musts to avoid when it comes to exposing yourself to the elements? Here are few to watch out for:

Brand Name Generic Name Therapeutic Class
Motrin ibuprofen NSAID, antiarthritic
Crystodigin digitoxin antiarrhythmic
Sinequan doxepin antidepressant
Cordarone amiodarone antiarrhythmic
Bactrim trimethoprim antibiotic
Diabinese chlorpropamide antidiabetic (oral)
Feldene piroxicam NSAID, antiarthritic
Vibramycin doxycycline antibiotic
Phenergan promethazine antihistamine

Source: U.S. FDA and Citynews.ca

Thursday, May 24, 2007

Hormones Affect Diet Success

Another failed diet? Blame hormones

Weight-loss success may depend on more than just motivation and willpower, according to a study reported last week in the Journal of the American Medical Association. It appears that which diet works best may depend on your hormones.

There has been debate among scientists regarding the most effective diet for weight loss. Recent studies that have pitted diet against diet - low-fat, low-carbohydrate and low-glycemic-load - have delivered inconsistent findings, with some suggesting one diet is superior and others indicating no difference between them.

Why some people do well on a conventional low-fat diet and others do poorly is often chalked up to compliance: People just aren't motivated to stick to their diet long term.

But perhaps there's another explanation. Inherent differences in insulin secretion may affect one's ability to lose weight on a diet. (Insulin is the hormone that clears sugar from the bloodstream.)

In the new study, participants classified as "high-insulin-secreting" lost five times more weight on a low-glycemic-load diet than on a conventional low-fat diet.

Low-glycemic-load diets limit rapidly digested carbohydrates that sharply raise blood sugar (glucose) and insulin levels. High-glycemic-load foods cause blood sugar and insulin levels to rise higher than do those with a low glycemic load. In response to excess insulin secretion, blood-sugar levels drop lower over the next few hours, which can trigger hunger and overeating.

Researchers from Children's Hospital Boston assigned 73 obese adults, aged 18 to 35 years, to either a low-fat diet (55 per cent carbohydrates, 20 per cent fat, 25 per cent protein) or a low-glycemic-load diet (40 per cent carbohydrates, 35 per cent fat, 25 per cent protein) for six months. Participants were then followed for an additional 12 months.

Volunteers on the low-glycemic-load diet emphasized whole grains, nuts, legumes, fruits and non-starchy vegetables and limited their intake of high-glycemic-load foods (white bread, white rice, refined breakfast cereals, potatoes, fruit juices, sweets).

Individuals who followed the low-fat diet were counselled to eat grains, vegetables, fruits and legumes and to limit sweets and high-fat snacks. Low-fat diets generally contain more carbohydrates and raise insulin higher than low-glycemic-load diets.

The diets involved no calorie restrictions or measuring of food. Participants received ongoing counselling and were told to "eat when hungry, but before famished" and to "stop eating when satisfied, before feeling stuffed."

Initially, all volunteers were given an oral-glucose tolerance test to measure their insulin response. (The test requires drinking a liquid containing 75 grams of glucose. Blood is taken before, and again every 30 to 60 minutes after, drinking the solution.) In this study, insulin concentration was measured at 30 minutes.

After six months, changes in body weight and body fat did not differ between the two diet groups. However, when the researchers analyzed the results based on insulin levels, there were noticeable differences.

High insulin secretors lost 2.2 lbs (1 kg) per month on the low-glycemic-load diet versus only 0.9 lbs (0.4 kg) on the low-fat diet. After 18 months, total weight loss was 12.8 lbs (5.8 kg) in the low-glycemic-load group, but only 2.6 lbs (1.2 kg) in the low-fat group of high insulin secretors.

Among the low insulin secretors, body weight and fat loss did not differ significantly between the two weight-loss plans.

Regardless of insulin secretion, following the low-glycemic-load diet boosted HDL (good) cholesterol and lowered concentrations of triglyceride (a blood fat) in the blood, effects that were not seen on the low-fat diet.

This isn't the first study to suggest how much insulin you secrete might predict how well you do on a diet. A study in 2005 from Tufts-New England Medical Center in Boston found that overweight adults with higher insulin secretion lost more weight when assigned to a low-glycemic-load diet than to a conventional low-fat diet. Among people who had lower insulin secretion, weight loss did not differ on the two diets.

Moreover, numerous studies have shown that eating low-glycemic foods delays hunger, decreases subsequent food intake and increases satiety compared with high-glycemic foods.

In my opinion, you don't need a blood test to determine if you should follow a low-glycemic-load diet.

A low-glycemic-load diet that's also low in saturated fat is good for anyone trying to lose weight, especially if you have high insulin levels. It's a healthy way to eat even if you don't need to trim down.

Lightening the load

The glycemic index and glycemic load are complicated concepts to grasp. Perhaps that's why almost four in 10 Canadians have little awareness of the glycemic index. Diets based on these concepts require you to choose foods based on numbers - glycemic index and glycemic load values.

The glycemic index is a scale that ranks carbohydrate-rich foods by how fast they raise blood sugar levels compared with pure glucose. The glycemic load of a food is calculated by multiplying its glycemic index by the grams of carbohydrates it provides.

To me, this sounds confusing and impractical. No one wants to carry around a calculator or a list of glycemic load values. I certainly don't. Fortunately, there are simpler ways to reduce the glycemic load of your diet.

Think concept, forget numbers.

Eat more unprocessed fresh foods such as whole grains, legumes, nuts, fruits and vegetables. These have a low GI value compared with highly processed foods, which also may contain a concentrated amount of sugar.

Include at least one low-GI food per meal, or base two of your meals on low-GI choices.

Pay attention to breads and breakfast cereals because these foods contribute the most to the high glycemic load of the North American diet.

Avoid eating high-GI snacks like pretzels, corn chips and rice cakes as these can trigger hunger and overeating. Opt for fresh fruit, low-fat dairy products, nuts or plain popcorn.

Choose fruits that are more acidic (e.g. oranges, grapefruit, cherries) as these have a low GI and will lower the glycemic load of a meal.

Use salad dressings made from vinegar or lemon juice - the acidity will result in a further reduction in the GI of your meal.

Watch portion size. When it comes to weight control, excess calories add up regardless of how they affect your blood glucose and insulin.

Source: The Globe and Mail.com

Wednesday, May 23, 2007

Weight Training Rejuvenates Aging Muscles

Weight training reverses aging damage in muscles: study

Healthy seniors benefit from strength training by rejuvenating their muscle tissue, say Canadian and U.S. researchers who found the proof at the molecular level.

Dr. Mark Tarnopolsky, director of the neuromuscular and neurometabolic clinic at McMaster University in Hamilton and Simon Melov of the Buck Institute for Age Research in Novato, Calif., compared tissue samples from 25 healthy older men and women who did six months of weight training and a similar group of 26 younger people.

The researchers looked at the molecular "fingerprint" of aging in mitochondria, the powerhouse that supplies energy to cells. Studies suggest poor mitochondrial function is involved in the loss of muscle mass and function commonly seen in older people.

Older adults showed a decline in gene activity for mitochondrial function, but exercise was linked to a reversal back to levels similar to those of younger adults, the team reports in Wednesday's issue of the journal PloS One.

Before exercise training, the older adults were also 59 per cent weaker than the younger adults, but after the training, their strength was only 38 per cent weaker.

After four months of follow up, most of the older adults were no longer exercising at a gym but continued to do resistance exercise at home by lifting soup cans or elastic bands.

"They were still as strong, they still had the same muscle mass," Tarnopolsky said in a release. "This shows that it's never too late to start exercising and that you don't have to spend your life pumping iron in a gym to reap benefits."

Aging reversal

While aging studies on worms, fruit flies and mice have shown similar results, Melov said the researchers were surprised at the extent of the results in humans.

"The fact that their 'genetic fingerprints' so dramatically reversed course gives credence to the value of exercise, not only as a means of improving health, but of reversing the aging process itself, which is an additional incentive to exercise as you get older."

The younger participants were 20 to 35 with an average age of 26, while those in the older group were all over 65 with an average age of 70. Both groups were similar in terms of diet and exercise, and none took medication or had diseases that affect mitochondrial function.

The hour-long resistance training sessions were done twice a week on standard gym equipment, involving 30 contractions of each muscle group.

Tissue samples were taken from the thigh muscle, and the strength test was based on knee flexion.

Future studies are planned to determine if resistance training has any genetic impact on organ tissues. The researchers also want to determine whether endurance training such as running or cycling affects mitochondrial function and aging.

Source: CBC.ca

Tuesday, May 22, 2007

Getting the Lead Out of Toronto Tap Water

Lead In Old Water Pipes May Be A Health Hazard In GTA

You know what they say about oil and water? Try substituting lead. Toronto is one of 35 towns and cities across the province that the Ministry of the Environment has ordered water be tested to measure the amount of lead that could be in it. How do you know if your home is in danger? A lot depends on its age. Experts estimate any residence built before 1955 could have a problem. It's not that the water itself isn't clean. It's the old pipes that carry the liquid you and your family drink every day. If they're made of lead, there's the danger of contamination leaching into your supply.

It's a big problem with a potentially big area - tens of thousands of homes across Ontario and as many as 45,000 in the city alone may be affected. If your water is contaminated by lead, you might never know it until health problems start showing up. Children under six and pregnant women are at the highest risk. But it's not good for anyone.

The situation first came to light when Ontario's Chief Drinking Water Inspector tested the taps in London, Ontario and discovered a full 25 percent of older homes had unsafe lead levels. But Jim Smith insists there's nothing for most people to worry about. "I think all expecting mothers and children under six should be able to drink the water without taking precautions," he maintains. That doesn't do much to reassure a mother of a young child. "I want to make sure that the water that she's going to be drinking is going to be safe," she demands.

What can she - and you - do? The city has a program in place that literally tests your water for any danger. You can also access a program to replace those old pipes. It will cost you about $2,000 by the time it's all done, and while it's a big price tag, it's a small one to pay for your family's health.

And many believe you can flush out your system by running the water for a few minutes in the morning before you drink any of it or use it for things like coffee. But not all experts are convinced this actually works.

Source: CityNews.ca

Diabetes drug and greater risk of heart attack

The widely prescribed diabetes drug Avandia is linked to a greater risk of heart attack and possibly death, a new scientific analysis revealed, and the U.S. government issued a safety alert Monday.

The Food and Drug Administration urged diabetics taking the pill to talk to their doctors, but stopped short of forcing a sharper warning label on the drug sold by GlaxoSmithKline PLC of London.

More than 6 million people worldwide have taken the drug since it came on the market eight years ago. Pooled results of dozens of studies revealed a 43 per cent higher risk of heart attack, according to the review published by the New England Journal of Medicine.

Experts said the overall risk was small and cautioned people not to stop taking the drug on their own but to talk to their doctors.

The company played down the report of heart risks, saying the analysis by Dr. Steven Nissen and statistician Kathy Wolski at the Cleveland Clinic is not definitive scientific proof. In a conference call Monday, Dr. Lawson McCartney who leads Glaxo's diabetes drug development, said the company is not seeing "anything like" the problems reported in the medical journal.

"We remain very confident in the safety and of course in the efficacy of Avandia as an important diabetic medicine," Dr. McCartney said.

The government will take no immediate action on a label change or other measures regarding the drug, said Dr. Robert J. Meyer of the FDA's Centre for Drug Evaluation and Research.

Some data suggests "that there is a potentially significant increase in the risk" but there also is risk if patients switch drugs or do not keep their blood-sugar under control, an FDA statement says.

FDA officials acknowledged that Glaxo submitted information last August indicating some increased risk from the drug but that other studies were contradictory. However, several members of Congress expressed alarm and said they would hold hearings on the safety issues.

Avandia is used to treat Type 2 diabetes, the most common form of the disease, which is linked to obesity and afflicts 18 million Americans and 200 million people worldwide. This form of diabetes occurs when the body does not make enough insulin or cannot effectively use what it manages to produce.

Avandia helps sensitize the body to insulin and was considered a breakthrough medication for blood-sugar control.

Worried patients should not quit Avandia on their own and should discuss concerns with their doctors, wrote Dr. Bruce Psaty and Dr. Curt Furberg in an editorial in the New England Journal. Dr. Psaty is with the University of Washington in Seattle and Dr. Furberg is with Wake Forest University.

However, to the extent that the new analysis shows valid risks, the drug "represents a major failure of the drug-use and drug-approval processes in the United States," they said.

When the drug was approved, "evidence was at best mixed" on its benefit, wrote the two doctors. Both have been frequent critics of the FDA's failure to spot dangers in the drug approval process and its conduct in the case involving Vioxx. The popular arthritis medicine sold by Merck & Co. was taken off the market in 2004 when heart problems came to light after it had been taken by millions of people

Several experts said Avandia was another example of the FDA failing to detect a safety problem early enough.

Glaxo's shares trading in the United States fell $3.85, or 6.6 per cent, to $53.89 in afternoon trading.

The report on the diabetes drug's risks follow Glaxo's $2.5-million settlement of a lawsuit filed by former New York Attorney General Eliot Spitzer over the release of data on the safety and effectiveness of its drugs. Mr. Spitzer, now New York governor, accused Glaxo of fraudulently withholding some results of studies that had examined the safety of prescribing the antidepressant Paxil to children.

GlaxoSmithKline disputed that it attempted to mislead anyone, and said it has always been in favor of widespread disclosure of clinical trial results.

The company's clinical trials registry is available to the public, although the reports within it are highly technical and may appear incomprehensible to an untrained reader.

Source: The Globe and Mail.com

Friday, May 18, 2007

Toxic Car Seats

Chemicals used on car seats 'toxic' to children, study warns

A new study suggests that "toxic" chemicals used in the materials to make car seats can put children in danger of developing health problems if ingested or inhaled.

The study, released Wednesday by the Michigan-based environmental group Ecology Center, provides analysis of more than 60 different car seat models for chemicals including bromine, chlorine and lead.

"These chemicals can be associated with developmental disorders, learning impairment, liver disease, cancer, as well as other allergic type diseases," said Jeff Gearhart, lead author of the report.

"This report shows that the same toxic chemicals that are used to make interior auto components are also used to make child car seats," the report said.

Car seat manufacturer Graco, whose TurboBooster Emily and TurboBooster SafeSeat were named in the report as having high concentrations of chemicals in the booster seat category, said they are currently examining the study's methodology and findings.

"At Graco, we take claims such as this very seriously," the company said in a statement. "Safety is always a top priority and nothing is more important than the well-being of the children who use our products."

The company Britax, whose Marathon Platinum seat was found to have the highest levels of chemicals in the convertible car seat category, did not return calls.

Health Canada, which evaluates the use and safety of chemicals used in products sold in Canada, said in a statement on car seat safety that the presence of a chemical does not necessarily mean it poses a health risk.

Keep window ajar, car seat out of sunlight: report

Gearhart recommends that owners of car seats that tested poorly should keep the window ajar when travelling in the car. He also says the seat should be kept out of direct sunlight and use of the product should be restricted to use in the car.

"We do recommend that you limit the time your child spends in the car seat," he said. "It should be used exclusively in the vehicle, and not used to transport your baby outside the vehicle."

The authors of the report caution that parents should always use a car seat, despite the presence of potentially harmful chemicals.

In March, the Ecology Center released a report saying that plastics and materials used inside the car, from the steering wheel to the dashboard to the carpets — can expel gas or leach into the environment.

Source: CBC.ca

Thursday, May 17, 2007

75 to Feel Alive

Bit of exercise helps overweight women improve fitness: study

Exercising about 75 minutes a week may be enough to improve fitness levels in inactive women who are overweight, researchers say.

The U.S. Centers for Disease Control and U.S. National Institutes of Health recommend at least a half hour on most days a week of moderate exercise to reduce the risk of heart disease, stroke and cancer.

Dr. Timothy Church of Louisiana State University in Baton Rouge and his colleagues set out to look at the effects of exercising 75 minutes a week, 135 minutes a week or 190 minutes a week — half, the same and 150 per cent of the recommended amount.

"This information can be used to support future recommendations and should be encouraging to sedentary adults who find it difficult to find the time for 150 minutes of activity per week, let alone 60 minutes per day," the researchers wrote in Wednesday's Journal of the American Medical Association.

Surveys suggest about one in five adults in the U.S. report no physical activity, and lack of time is the major reason they give.

The researchers studied 427 overweight women with high or borderline-high blood pressure who had an average age of 57. Participants were randomly assigned to not exercise or to do one of the three levels of moderate intensity physical activity, by walking on treadmills or riding stationary cycles, three or four times a week.

"The lowest exercise dose, the 75 minute a week group, actually not only did not lose fitness, but they actually gained fitness during the six months, and that's an exciting result — that 75 minutes a week produces significant health benefits," Church said in a release.

Slimmer waists

All of the women who exercised were fitter based on measurements of oxygen intake during exercise, and their waists were smaller. That is important because belly fat increases the risk of premature death, Type 2 diabetes, cholesterol problems and hypertension.

None of the women in the exercise groups showed significant changes in blood pressure values or weight after six months compared with the control group, although the study was not designed for weight loss.

The more women exercised, the more they improved their physical fitness, the researchers found. They did not recommend lowering public health guidelines for physical activity, but suggested taking the results into account as revisions are developed.

Given cost and feasibility concerns, the trial used three patterns of physical activity, while in real life there are infinitely more, I-Min Lee of Brigham and Women's Hospital and Harvard Medical School in Boston, said in a journal commentary.

"The study by Church et al does provide important information on the dose of physical activity to improve physical fitness, a strong predictor of chronic disease and premature mortality," Lee wrote.

"This may be succinctly summarized for patients and clinicians as 'Even a little is good; more may be better!'"

Source: CBC.ca

Tuesday, May 15, 2007

Coke Drinks and Cancer Causing Benzene Settlement

Coca-Cola reaches settlement in lawsuits over claims of benzene in drinks

The Coca-Cola Co. has agreed to offer replacements to people who purchased two soft drinks to settle lawsuits over ingredients that can form cancer-causing benzene, the plaintiffs said Monday.

As part of the settlement in the cases in New Jersey, Kansas and Florida, the world's largest beverage maker agreed to offer replacement drinks to anyone who purchased Fanta Pineapple or Vault Zero before September 2006, according to a copy of the agreement.

Coca-Cola previously decided to voluntarily reformulate the two beverages in question, said Ray Crockett, a spokesman for the soft drink maker.

Lawyers for the plaintiffs agreed to dismiss their claims against Coca-Cola, Crockett said. Other soft-drink makers, including Purchase, N.Y.-based PepsiCo Inc., remain defendants in related lawsuits.

"We've basically done the settlement as an expeditious way to get the issue behind us," Crockett said.

He said the reformulated products are currently making their way to the marketplace. The settlement agreement says the reformulated products have a label with a best-before date of January 2008 or later.

Coca-Cola also agreed as part of the settlement to pay $500 to each of four plaintiffs and to pay the plaintiffs' attorneys an amount to cover their fees an expenses that is subject to an arbitrator's determination.

The lawsuits alleged that ingredients in Fanta Pineapple and Vault Zero had the potential in certain circumstances to combine to form benzene, and asserted claims for breach of warranty, unfair and deceptive trade practices and unjust enrichment.

According to the settlement agreement, Coca-Cola continues to deny all of the allegations in the lawsuits.

The plaintiffs and their lawyers said in a statement that they are pleased with the settlement.

"We filed these lawsuits because our children shouldn't be exposed to benzene at any level," said Lisbeth Gordon of Crawfordville, Fla., an emergency room nursing supervisor and mother who was one of plaintiffs.

Coca-Cola began production of Vault Zero in February 2006 and has sold roughly 7.7 million individual units from that time through December 2006. From January 2003 through August 2006, it sold roughly 27.4 million individual units of Fanta Pineapple, according to the settlement papers.

It changed the formulation of the two products on or about Sept. 1, 2006, the settlement papers say.

Benzene can form in soft drinks containing vitamin C, also called ascorbic acid, and either sodium benzoate or potassium benzoate. Scientists say factors such as heat or light exposure can trigger a reaction that forms benzene in the beverages.

Coca-Cola will no longer sell the two products in question with both sodium benzoate and ascorbic acid as ingredients.

Friday, May 11, 2007

Pharma Execs Guilty of Misleading Public

The maker of the powerful painkiller OxyContin and three of its current and former executives pleaded guilty Thursday to misleading the public about the drug's risk of addiction, a federal prosecutor and the company said.

Purdue Pharma LP, its president, top lawyer and former chief medical officer will pay US$634.5 million in fines for claiming the drug was less addictive and less subject to abuse than other pain medications, U.S. Attorney John Brownlee said.

The plea agreement settled a national case and came two days after the Stamford, Conn.-based company agreed to pay $19.5 million to 26 states and the District of Columbia to settle complaints that it encouraged physicians to overprescribe OxyContin.

"With its OxyContin, Purdue unleashed a highly abusable, addictive, and potentially dangerous drug on an unsuspecting and unknowing public," Brownlee said. "For these misrepresentations and crimes, Purdue and its executives have been brought to justice."

Privately held Purdue learned from focus groups with physicians in 1995 that doctors were worried about the abuse potential of OxyContin. The company then gave false information to its sales representatives that the drug had less potential for addiction and abuse than other painkillers, the U.S. attorney said.

Ken Jost of the Justice Department's Office of Consumer Litigation said this case should put pharmaceutical companies on notice that they won't be able to get away with breaking the law to make a profit.

"The things that they plot in their boardrooms, the things that they do behind closed doors will not stay behind closed doors," Jost said. "We have the people, we have the resources. We'll take the time and we'll take the effort to find out what they did and how they did it."

Purdue Pharma said it accepted responsibility for its employees' actions.

"During the past six years, we have implemented changes to our internal training, compliance and monitoring systems that seek to assure that similar events do not occur again," the company said in a news release.

OxyContin, a trade name for oxycodone, is a time-release painkiller that can be highly addictive. Designed to be swallowed whole and digested over 12 hours, the pills can produce a heroin-like high if crushed and then swallowed, snorted or injected.

From 1996 to 2001, the number of oxycodone-related deaths nationwide increased fivefold while the annual number of OxyContin prescriptions increased nearly 20-fold, according to a report by the U.S. Drug Enforcement Administration. In 2002, the DEA said the drug caused 146 deaths and contributed to another 318.

The U.S. attorney said the guilty pleas were entered Thursday morning in U.S. District Court in Abingdon, southwest of Roanoke. In an unusual move, Brownlee said, company chief executive officer Michael Friedman, general counsel Howard Udell and former chief medical officer Paul Goldenheim each pleaded guilty to a misdemeanour count of misbranding the drug. Of the total fine, $34.5 million was levied on those three.

The fines will be distributed to state and federal law enforcement agencies, the federal government, federal and state Medicaid programs, a Virginia prescription monitoring program and individuals who had sued the company. About $5 million will go toward a six-year company program to monitor compliance with the agreement.

When he took office in 2001, Brownlee said, his office was handling a number of cases related to OxyContin abuse, including crimes by addicts seeking to support their habits and arrests of street dealers and even pharmacists and physicians.

"But it always seemed, I think to me and to the investigators, that there was more," he told a news conference.

Investigators from a number of state and federal agencies worked together on an investigation of Purdue Pharma and began to subpoena company records in 2002, Brownlee said.

"From these millions of records, they picked out probably 300 to 500 documents and pieced together a case," he said.

The Food and Drug Administration was part of the investigation. A spokesman for Connecticut Attorney General Richard Blumenthal said the agency had not acted on a citizen petition Blumenthal's office filed more than three years ago. The petition raised concerns about misbranding and called for stronger warnings and fuller disclosure about OxyContin's dangers.

Kim Rice of the FDA told the news conference that over time the agency has mandated increasingly stronger warnings on labels about OxyContin's abuse potential.

Source: CBC.ca

Thursday, May 10, 2007

Oral Sex and Throat Cancer Link

Oral sex can lead to throat cancer

The same virus that causes cervical cancer is the principal cause of throat cancer, according to a new study.

The research also suggests that unprotected oral sex is a major reason people are contracting throat cancer - not just smoking and excessive alcohol consumption, as previously believed.

"It's the human papillomavirus that drives the cancer," said Maura Gillison, assistant professor of oncology and epidemiology at Johns Hopkins University in Baltimore, Md., and lead author of the study.

She said the more oral-sex partners a person has, the greater the risk of contracting oral cancers (located in the tonsils, back of the tongue and throat). The good news is that the risk remains low over all.

"People should be reassured that oropharyngeal cancer is relatively uncommon, and the overwhelming majority of people with an oral HPV infection probably will not get throat cancer," Dr. Gillison said.

A new vaccine protects against infection by several strains of HPV, including the one associated with oral cancer, HPV-16. However, Dr. Gillison said it has not been specifically tested for its effectiveness against oral cancer.

The new research is published in today's edition of the New England Journal of Medicine, which features several articles about HPV and the effectiveness of the vaccine.

Sold by Merck Frosst Canada Ltd. under the brand name Gardasil, the vaccine prevents infection by four strains of human papillomavirus that account for roughly 70 per cent of cases of cervical cancer.

Gardasil offers protection that lasts for at least three years, according to newly published data in the New England Journal of Medicine.

Another study, published today in the journal, suggests the vaccine protects against cancer of the vulva and cancer of the vagina, which are principally caused by HPV. (Penile cancer is also caused largely by the virus, although the effectiveness of the vaccine in men has not yet been demonstrated.)

In the most recent federal budget, the Conservative government set aside $300-million for an HPV vaccination program, which would target girls aged 9 to 11.

Health groups are divided on the wisdom of an immunization program, given the cost of the vaccine (more than $400 for the required three doses) and the limited data on its long-term effectiveness. There is also debate about whether vaccination should be limited to girls, and whether the vaccine should be offered to older teens who are already sexually active.

The new research should help assuage fears a bit, and broaden the appeal of the vaccine because of its effectiveness against other types of cancer.

About 1,350 women will be diagnosed with cervical cancer in 2007, and an estimated 390 will die. By contrast, approximately 3,200 Canadians will be diagnosed with oral cancer this year, and 1,100 will die, according to the Canadian Cancer Society.

Dr. Gillison's study involved 100 men and women who were newly diagnosed with oral cancer. They were compared to 200 similar people without cancer.

Dr. Gillison and her team found that those with HPV infection were 32 times more likely to have developed cancer. By comparison, the risk increased threefold for smokers and twofold for drinkers.

Study participants who reported having oral sex - be it fellatio or cunnilingus - with six or more partners were at greatest risk of contracting oropharyngeal cancer.

There is no screening test for oral cancer; it is usually detected when there is a sore in the mouth that does not heal.

Source: The Globe and Mail

Tuesday, May 8, 2007

Salt Solutions

Slashing Canadians' salt intake by half would trim health costs by $430-million a year, according to a new study.

By cutting excessive salt consumption, it's estimated about one million cases of hypertension would disappear.

This, in turn, would result in a 23 per cent drop in the use of medication for high blood pressure and a 6.5-per-cent drop in doctors' visits and laboratory tests, according to research published in today's edition of the Canadian Journal of Cardiology.

"I was shocked by the numbers," said Norm Campbell, a general internist at the University of Calgary, and lead author of the study.

"But our analysis is a marked underestimate because we looked only at the direct cost of hypertension and we didn't factor in the cost of events like heart attack and stroke."

An estimated five million Canadians have high blood pressure, which is one of the leading causes of heart attacks and strokes. Adults can safely eat about three-quarters of a teaspoon of salt daily but they are ingesting about two teaspoons, according to Statistics Canada data from earlier this year.

The U.S.-based Institute of Medicine, an independent organization, has established "tolerable upper intake levels" for sodium. A maximum of 2,300 mg is deemed acceptable for people aged 14 and older. The Statscan study found that in 2004, Canadians consumed, on average, 3,092 mg of sodium daily, not including salt they added to their food at the table.

The cost-savings calculations in the new study were based on Canadians reducing their salt intake to 1,840 mg daily.

"To have a real impact on hypertension, we have to reduce our salt intake by about half," Dr. Campbell said. "That may be naive, but I think we can do it."

Stephen Samis, director of health policy at the Heart and Stroke Foundation of Canada, said it could be done through a combination of consumer education, and working with industry to reduce the salt content of foods and with governments to monitor and regulate the food supply.

"We truly are what we eat," Mr. Samis said.

According to Statscan, an estimated 72,338 people died of cardiovascular disease in 2004, the most recent year for which mortality data are available.

Source: The Globe and Mail

Monday, May 7, 2007

Ontario Medical Transparency

For the first time, Ontario patients will be able to easily discover if a doctor has been found guilty of medical malpractice, has a criminal conviction and why or what limits have been put on a physician's licence.

Public light will be shone not only on the records of doctors, but those of all regulated health professionals – from nurses to dentists to acupuncturists. All will now be required to report findings against them to their respective professional colleges. And those colleges must release the information to the public. As well, findings against medical professionals will no longer be wiped clean after six years. These changes are all amendments to legislation moving through the Ontario Legislature to improve hospital safety.

In addition, all Ontario hospitals will be required to report safety information such as medical errors – what hospitals call adverse events – to the province, which will make it public on websites. These changes to existing provincial legislation will ensure that secrecy will end.

The changes will put Ontario at the forefront of medical transparency in Canada.

Health ministry officials say the move comes in response to a Toronto Star series on medical secrecy that began last October. The series highlighted the absence of safety information available to patients once they step inside Ontario's hospitals. For instance, patients have no idea how many cases of hospital-borne infections have swept through a hospital or how many have died after a specific surgical procedure.

The Star has pursued the issue of medical secrecy since 1997.

This is all part of improving quality of care, said Health Minister George Smitherman. "If you measure things, you hold yourself to a test," the minister told the Star yesterday. "This is, accordingly, a big step forward. But it's not just about me saying this and you recording it in your newspaper. It is a really complicated and challenging step. We'll have to work really hard with a lot of different players to make it work well."

Those partners are the Ontario Hospital Association, the Ontario Medical Association and all the regulated colleges such as the College of Physicians and Surgeons of Ontario.

"We've had several discussions with government over the last several weeks," said Patrick Nelson, a spokesperson for the OMA, the professional group representing 24,000 doctors.

Nelson said it was important to the OMA that health professionals maintain their right to a fair hearing – they believe doctors' rights would be denied if complaints were publicly posted without due process. "We needed to make sure that action only be taken on transparency if a health professional has been found guilty of misconduct. It's not fair to take action before a hearing or finding."

The changes do not go as far as releasing complication rates of individual doctors or surgeons.

The Star series exposed the plight of women who claim they were victims of medical negligence at the hands of a Scarborough obstetrician and gynecologist. The former patients of Dr. Richard Austin held a press conference on April 19, calling on the province to lift the veil of secrecy over doctors' complication rates, malpractice suits and complaints. More than 50 women have now contacted the Star to allege they were victims of medical errors by Austin. The series revealed a pattern of lawsuits, complication rates and unintended cuts to internal organs by Austin that medical experts call well above average.

At least 15 of the women have filed lawsuits since 1983. In one case, a judge ruled Austin guilty of battery against a patient. Four are before the courts. Six suits were settled out of court, four were dropped, including three in which complainants cited high legal costs as part of the decision to abandon their cases.

Austin and his lawyers have not answered repeated requests for an interview.

Frances Borrow was one of the women at the press conference. She has been living with a plastic bag strapped to her stomach to collect her urine ever since her bladder was accidentally cut during a hysterectomy in 1990. "I'm very pleased to hear this. It would've changed my decision if I'd known that kind of information when I had surgery." Toronto lawyer Amani Oakley is acting on behalf of many of the women. She called the proposed and mandatory changes an amazing first step. "It's an excellent step toward transparency. But it doesn't make sense to stop at the edge. Individual (physician) complication rates are key," she said. "You can still see cases like Austin that would be a problem. We have two rights bumping up against each other – the right of the physician to hide poor complication rates versus the right of patients to know if bad complication rights exist. In this case, it seems overwhelmingly obvious that the public would favour the right of the patient to know."

Settlements made after a claim of medical malpractice is made will not be part of the changes.

Smitherman has maintained he's not sure how best to capture and report complication rates – by health team or specific doctor or nurse. "We have a lot of work to do with our partners."

Some of Ontario's highest-ranking medical officials have been calling for greater transparency. Three weeks ago, Dr. Alan Hudson, head of the Ontario Wait Times Strategy and former president of the University Health Network, announced hospital funding would be tied to disclosure of quality and safety information.

"If you are going to buy a house in Ontario, you check the roof, you check the wiring and plumbing. This is slightly more important," said Hudson. "This is your life."

Dr. Michael Baker, UHN Physician-in-Chief who advises the Ministry of Health on patient safety, said: "Analyzing mortality rates and infections and other issues lead us to analyze what we can do better. The American evidence does suggest that it leads to improvements in safety. We can't look bad if we disclose. We can only look good for sharing what we have."

As many as 23,750 people die each year from in-hospital adverse events, according to the Canadian Institute for Health Information, more than the number who die from breast cancer, car accidents and HIV combined.

The OMA said most adverse events in hospitals are not the fault of one person. "We know the majority of adverse events in hospitals are the result of systemic problems, not the result of an individual," said Nelson. "For this reason, we've maintained that improved patient outcomes require a systemic team-based approach."

Source: Toronto Star

Thursday, May 3, 2007

Soul Science

What if your doctor told you to take two steps toward being a better person and call him in the morning?

Patients at a California health maintenance organization are being prescribed generous behaviour as part of a program called Rx: Volunteer, one of various new research projects described by Stephen Post in his book Why Good Things Happen To Good People, out next week. Dr. Post chronicles the link between doing good and living a longer, healthier life.

“The science shows that we're hardwired to be giving,” he says. “We're talking here about a one-a-day vitamin for the soul.”

A growing number of researchers are supporting his claim with studies that show how the human body benefits from everything from gratitude to generosity.

Dr. Post, the president of Case Western Reserve University's Institute for Research on Unlimited Love, believes in the scientific equivalent to The Secret, the self-help phenomenon that preaches positivity as a means to personal reward.

No, being a good person won't necessarily get you a new car or help you lose 10 pounds, Dr. Post says, but there is a karma of the brain, where the body physically rewards acts of kindness and forgiveness. “The remarkable bottom line of the science of love is that giving protects overall health twice as much as Aspirin protects against heart disease,” he says.

For example, psychologist Robert Emmons studied organ-transplant recipients and found that the more gratitude they felt, the faster they recovered.

A 2001 study of trauma survivors by psychologist Russell Kolts found that gratitude was associated with lower symptoms of post-traumatic stress disorder.

And a Wellesley College study that has tracked 200 people since the 1920s, interviewing them for five hours every decade, found that people who were charitable in high school had better physical and mental health in late adulthood.

“The connection for mental health is particularly strong, but the physical health results are also highly significant,” psychologist Paul Wink notes.

Helping other people can aid in personal relaxation and stress as well.

Researchers at the University of Michigan found that people who offered social support to others in a financial crisis saw a marked reduction in their own anxiety about money.

The movement toward studying human goodness has even spawned its own diagnostic manual, Character Strengths and Virtues: A Handbook and Classification.

It was written to contrast the Diagnostic and Statistical Manual, which doctors use to classify human behaviour by pathology.

Dr. Post, whose institute offers funding to many of these studies, believes that people who want to prolong their lives should work on their attitude, the same way they would change their diet or exercise routines.

And he thinks the culture is ready for a shift toward the positive.

He was encouraged by the behaviour of some young people in the aftermath of last month's mass shooting at Virginia Tech, who reached out to one another online and promised to be kinder to strangers.

“The truth is ours we have a duty to be true to ourselves. Smile at people you usually never even looked at talk to people u hated,” Quebec student Pierre-Olivier Laforce wrote in a Facebook post quoted in The New York Times.

And also last month Ryan Fitzgerald, an unemployed 20-year-old from Boston, received more than 5,000 calls after posting his phone number on YouTube for strangers who needed to talk.

Mr. Fitzgerald said he was inspired by Juan Mann, an Australian whose efforts to hug strangers landed him as a guest on Oprah Winfrey's couch.

And the impulse to take a higher road is not just infecting idealistic young people.

Toronto consultant Peggie Pelosi decided she needed to rethink her priorities while working as a vice-president at a health sciences company. After establishing a charitable partnership for her employees, she watched their productivity soar. She now helps companies form philanthropic partnerships and has written a book, Corporate Karma: How Business Can Move Forward By Giving Back.

“I think there's a lack of opportunity for people to find and express compassion,” she says of her baby-boomer generation. “We've gotten to the point in our lives where we would like to have some meaning.”

Source: TheGlobeandMail.com

Wednesday, May 2, 2007

Tuesday, May 1, 2007