February 24th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, Research
Tags: Birth Defect Risk, Birth Defects, CHD, Congenital Heart Disease, Dr. Linda Burke-Galloway, Family Medical History, Family Medicine, Fetal Health, Genetic Counseling, Genetics, Heart Defects, Maternal-Fetal Medicine, OB/GYN, Obstetrics And Gynecology, Unborn Child
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Birth defects, particularly those of the blood vessels, account for the majority of infant deaths, especially after the first week of life. Congenital heart disease (CHD) — meaning defects of the heart — is responsible for one-third of deaths between birth and the first year of life. Therefore, the diagnosis of CHD is critical in order to plan life-saving treatments, such as the proper place for the delivery, the type of delivery, and its timing. If it’s known in advance that an unborn baby has a heart problem and is delivered in a hospital that provides special care, its survival and future health will increase dramatically.
Who’s at risk for having CHD and which expectant moms should have further evaluation? Families who have a history of CHD — especially mothers, fathers, and siblings — should receive genetic counseling. Multiple medical studies over the past fifteen years have demonstrated the significance of genetics as a main culprit of CHD. Parents of a child with CHD have a two percent to three percent chance of having another affected child. If a mother or father has CHD, a fetal cardiac echo (an ultrasound of the heart) is definitely warranted.
Because the treatment of CHD in many cases is surgical, there’s an increasing number of patients who have survived into adulthood and have ultimately become parents. Research has documented that 4.1 percent of their children will have CHD. Children with mothers who have CHD are at a greater risk of inheriting the disease than if they have fathers with CHD. Mothers with cyanotic heart disease — that is, blood that is without oxygen that bypasses the lungs and goes directly to the blood vessels — also have a greater risk of having a baby with CHD. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
February 24th, 2011 by Harriet Hall, M.D. in Health Tips, Research
Tags: Big Pharma, Big Suppla, Big Supplement, CAM, Complimentary and Alternative Medicine, Diet Supplement Health and Education Act, Diet Supplements As Medicines, Dietary Supplements, Dietary Supplements As Medicine, Dr. Harriett Hall, DSHEA, FDA, Food and Drug Administration, Food and Nutrition, Food As Medicine, Herbal Medicine, Medicine As Food, Nutritional Supplements, SBM, Science Based Medicine
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I was surprised to get this e-mail from a reader:
Surely, Dr. Hall, the public mania for nutritional supplements is baseless. All the alleged nutrients in supplements are contained in the food we eat. And what governmental agency has oversight responsibility regarding the production of these so-call nutritional supplements? Even if one believes that such pills have value, how can the consumer be assured that the product actually contains what the label signifies? I have yet to find a comment on this subject on your otherwise informative website.
My co-bloggers and I have addressed these issues repeatedly.Peter Lipson covered DSHEA (The Diet Supplement Health and Education Act) nicely. It’s all been said before, but perhaps it needs to be said again — and maybe by writing this post I can make it easier for new readers to find the information.
Food, Medicine, or Something In Between?
The FDA regulates foods and has been instrumental in improving the safety of our food supply. It regulates prescription and over-the-counter medications, requiring evidence of effectiveness and safety before marketing. Surveys have shown that most people falsely assume these protections extend to everything on the shelves including diet supplements, but they don’t.
Under the 1994 Diet Supplement Health and Education Act (DSHEA), a variety of products such as vitamins, minerals, herbs and botanicals, amino acids, enzymes, organ tissues, and hormones can evade the usual controls if they are sold as diet supplements. Under the DSHEA, the manufacturer doesn’t have to prove to the FDA that a product is safe and effective; it is up to the FDA to prove that it isn’t safe, and until recently there was no systematic method of reporting adverse effects (required reporting is still limited to serious effects like death).
So far the FDA has only managed to ban one substance, ephedra, and it took the death of a prominent sports figure and considerable skirmishing with the courts to accomplish that. Independent lab tests of diet supplements have found a high rate of contamination (with things like heavy metals and prescription drugs) and dosages wildly varying from the label. A striking example was Gary Null’s recent poisoning with vitamin D from one of his own products which contained 1,000 times the intended amount.
The FDA has issued rules on good manufacturing practices, but standardization is not required and it remains to be seen whether the new rules will effectively improve product quality. Read more »
*This blog post was originally published at Science-Based Medicine*
February 23rd, 2011 by RyanDuBosar in Better Health Network, Research
Tags: ACP Internist, Adverse Cardiac Events, Body Clock, Cardiology, Cardiovascular Disease, Cardiovascular Risk, Circadian Rhythm, Coronary Stent Thrombosis, Heart Health, JACC Cardiovascular Interventions, Mayo Clinic, Ryan DuBosar, Time Of Day, Time Of The Year
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Add coronary stent thrombosis to the list of cardiac events influenced by circadian rhythms, with more events occurring during the early morning hours and in a summertime window of late July and early August.
Coronary stent thrombosis joins several other adverse cardiac events that also follow a circadian pattern, such as stroke, unstable angina pectoris, acute myocardial infarction and sudden cardiac death, according to researcher published in JACC: Cardiovascular Interventions.
Most studies that addressed circadian variations in cardiovascular disease were done before the advent of stents, so, researcher from Mayo Clinic-Rochester conducted a retrospective analysis of medical records and the clinic’s registry, finding 124 patients who presented with coronary stent thrombosis between February 1995 and August 2009.
Researchers determined the time of day, day of week, and season of year that the stent thrombosis occurred and recorded when potential triggers were present. In addition, the team categorized each stent thrombosis based on the number of days since the initial stenting procedure: early=0 to 30, late=31 to 360 days, very late=more than 360 days.
The association between the onset of stent thrombosis was lowest at 8 p.m. and highest at 7 a.m. (P=0.006). However, when the team divided the analysis into early, late, and very late stent thrombosis, only the association between early stent thrombosis and time of day remained significant (P=0.030, P=0.537, P=0.096, respectively). Day of week wasn’t associated, but stent thrombosis rates peaked between the end of July and the beginning of August (P=0.036). Read more »
*This blog post was originally published at ACP Internist*
February 22nd, 2011 by PJSkerrett in Opinion, Research
Tags: Bad Taste, Chicken Soup for a Cold, Cochrane Collaboration, Common Cold, FDA, Food and Drug Administration, Harvard Health Publications, Harvard Heart Letter, Harvard Medical School, Harvard University, Havard Health Blog, Institute of Medicine, Loss Of Smell, Meenu Singh, Natural Remedies, Nausea, PJ Skerrett, Rashmi Das, Zinc Lozenges, Zinc-Based Cold Remedies, Zinc-Containing Nasal Sprays
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Media channels are a-twitter with the news that zinc can beat the common cold. CBS News, the LA Times, the Huffington Post, and hundreds of others are treating a quiet research report as big news that will have a life-changing effect. After reading the report and doing a little digging into the dark side of zinc, I’m not rushing out to stock up on zinc lozenges or syrup.
The latest hubbub about zinc was sparked by a report from the Cochrane Collaboration. This global network of scientists, patients, and others evaluates the evidence on hundreds of different treatments. In the latest review, on zinc for the common cold, researchers Meenu Singh and Rashmi R. Das pooled the results of 13 studies that tested zinc for treating colds. By their analysis, taking zinc within 24 hours of first noticing the signs of a cold could shorten the cold by one day. They also found that taking zinc made colds a bit less severe.
Sounds good so far. But instead of saying, “Hey, take zinc if you have a cold,” the researchers concluded like this:
“People taking zinc lozenges (not syrup or tablet form) are more likely to experience adverse events, including bad taste and nausea. As there are no studies in participants in whom common cold symptoms might be troublesome (for example, those with underlying chronic illness, immunodeficiency, asthma, etc.), the use of zinc currently cannot be recommended for them. Given the variability in the populations studied (no studies from low- or middle-income countries), dose, formulation and duration of zinc used in the included studies, more research is needed to address these variabilities and determine the optimal duration of treatment as well as the dosage and formulations of zinc that will produce clinical benefits without increasing adverse effects [bold is mine], before making a general recommendation for zinc in treatment of the common cold.”
Not exactly a ringing endorsement. Read more »
*This blog post was originally published at Harvard Health Blog*
February 22nd, 2011 by Felasfa Wodajo, M.D. in News, Research
Tags: Advanced Melanoma, Biomedical Software, Cancer Research, Chemotherapy, Clinical Decision-Making, Clinical Web Apps, CollabRx, Dr. Felasfa Wodajo, Dr. Jay Marty Tenenbaum, Empowered Patients, FDA, Food and Drug Administration, Genetic Mutations, Good Medical Decision Making, Health Apps Accelerator, Healthcare and Internet Technology, Healthcare Decision Making, iMedicalApps, Information Technology and Clinical Medicine, Jeffrey Shrager, Karkinos, mHealth, Mobile Device Integration, Mobile Devices and Medicine, Mobile Health, Mobile Healthcare Apps, Mobile Medical Apps, Modern Era of Cancer Therapy, Oncology, Online Therapy Tools, Personalized Cancer Treatment, Physician Empowerment, Stanford University, Targeted Therapies Online, Visible Tumor
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The word cancer comes from the greek word for crab “karkinos,” so named by Hippocrates who visualized the tumor and its surrounding vessels looking like a crab, dug stubbornly into the sand with its legs. We know far more about cancer today than the ancient Greeks, but the vision of an entrenched opponent, almost impossible to extract whole, appears to be vividly prescient.
What we have realized over the last half century is that removal of the visible tumor is not enough. Even as we learned how to do bigger and more destructive surgeries, the cancer still managed to sneak back in, growing later at different locations. The crab’s legs are still embedded in the patient.
Thus the discovery that certain chemicals could extinguish these rogue cells opened the modern era of cancer therapy and led to the first “cures” from cancer. Many of these compounds were exquisitely toxic. Early experimenters even used nitrogen mustard, quite literally a poison, as Siddhartha Mukherjee tells in his excellent history of cancer, “The Emperor of All Maladies.”
To many, the battle looked grim. For the founder of CollabRx, who himself was living in the shadow of advanced melanoma, this was the signal to take his expertise in internet information technologies and apply it to cancer. Thus a “biomedical software company” was founded, with the mission:
…to save lives by using information technology to personalize cancer treatments and accelerate research.
The rapid proliferation of knowledge about the molecular underpinnings of different cancers, has brought hope for a new age of “targeted” therapies. These drugs are designed to find and destroy cells with aberrant biochemical pathways, while bypassing the normal body tissues. Immense hopes rest on them. Read more »
*This blog post was originally published at iMedicalApps*
Birth defects, particularly those of the blood vessels, account for the majority of infant deaths, especially after the first week of life. Congenital heart disease (CHD) — meaning defects of the heart — is responsible for one-third of deaths between birth and the first year of life. Therefore, the diagnosis of CHD is critical in order to plan life-saving treatments, such as the proper place for the delivery, the type of delivery, and its timing. If it’s known in advance that an unborn baby has a heart problem and is delivered in a hospital that provides special care, its survival and future health will increase dramatically.
