Archive for June 19th, 2006
By: University of Manchester
Herbal remedies for breast cancer
Researchers at the University of Manchester are testing a secret herb in a
bid to stop the severe hot flushes that besiege breast cancer patients on hormone treatment.
Professor Alex Molassiotis, of the School of Nursing, Midwifery and Social Work, says the herb - one of the mint family, found in any kitchen - is thought to stop the hot flushes and night sweats which can be so bad that some women have to change their clothes three or four times a night.
It is traditionally used by Mediterranean women undergoing the menopause, but Professor Molassiotis cannot name it as he and his team are carrying out a double blind trial (neither the patient nor the doctor is allowed to know whether they are in the group taking the herb or a placebo).
The women are taking hormone treatment to lower oestrogen and progesterone levels as these affect the growth of some breast cancer cells. This can lead to early or revisiting menopause with symptoms such as anxiety, dry skin, bone thinning and hot flushes, with some women having up to 30 flushes a day. It is too risky for them to take Hormone Replacement Therapy (HRT) as this will increase the hormone levels again. Instead they are advised to cut out tea, coffee and nicotine, try alternative remedies or a certain type of anti-depressant.
Professor Molassiotis said: “It is hoped that the herbal remedy will be simpler and cheaper to take, as well as more effective, thus improving the lives of women who need all their energy to fight the disease.”
He and his team are now recruiting 170 volunteers for the randomized trial, half of whom will take the phytooestrogen herb in the form of a pill and half of whom will take a placebo, from Greater Manchester and Cheshire. Only breast cancer patients who have or are receiving hormone treatments for their cancer are allowed to take part, and only if they experience at least one hot flush a day of moderate and above severity for at least a month. The treatment will be for a total of three months, taking one pill a day. The team will assess the volunteers’ hot flushes four times over six months from starting the trial with questionnaires and a blood sample.
June 19th, 2006
By: Baylor College of Medicine
Adolescent athletes who take creatine to “bulk up” should do so with caution.
Creatine monohydrate, a dietary supplement often marketed as a way to enhance athletic performance and to increase weight, muscle size and strength, could cause health problems for some adolescents.
“Creatine is found naturally in the body and is essential for your muscles during quick, high-intensity exercise, said Dr. Joseph Chorley, an assistant professor of pediatrics, adolescent and sports medicine at Baylor College of Medicine in Houston. “However, there are no quality safety tests that define its short-term and long-term side effects.”
It is generally considered safe for adult athletes, however, there is little information about potential health risks for young athletes. Creatine is produced by the liver, kidneys and pancreas, and is also found in fish and meat
Creatine works in the body by delivering a three- to 10-second energy boost to the muscles, allowing you to reach your maximum effort while exercising. However, when muscles run out of creatine, the body relies on its natural supply of carbohydrates for energy, causing muscles to tire. The most common side effects are muscle tears, kidney disorders, dehydration, diarrhea and cramping.
“For parents who are concerned that their child might be using creatine, their worry is appropriate,” Chorley said. “We do not have a clear idea of what adverse reactions could occur, nor do we know how creatine could interact with prescription medications.”
To increase size and performance, Chorley recommends following a properly balanced diet and adequate fluid intake as well as planned strength training.
June 19th, 2006
By: Lifespan
African-American women need to be the first to receive the newly approved human papillomavirus (HPV) vaccine according to infectious
disease experts. This is the view expressed in a commentary published in the July 2006 issue of The Lancet Infectious Disease by researchers at The Miriam Hospital and Brown Medical School.
The commentary is in response to an article in the January edition of the journal posing the question, “Who should be vaccinated against human papillomavirus?”- as well a review piece on HPV infection in men in the same issue.
The HPV vaccine protects women from acquiring two types of HPV, a sexually transmitted disease believed responsible for 70 percent of cervical cancer cases. Research shows that African American women are at twice the risk of dying from cervical cancer than Caucasian women.
“Although the reason for the disparity of HPV in African American women is not well understood – simply knowing that this group is disproportionately affected should lead to targeted vaccination efforts that administer the safe, effective, three-dose prevention tool to them,” says Loida E. Bonney, MD, MPH, a research fellow at The Miriam Hospital and lead author.
The authors suggest that developing a school-based vaccine delivery program would provide an effective strategy for reaching the broadest number of at-risk African American females.
“School-based vaccine delivery surpasses traditional primary care provider vaccination rates, but this avenue is not widely used,” Bonney says.
At-risk adolescents, the group that would be targeted for the HPV vaccine, remain the most difficult to vaccinate because of various barriers to care including the need for parental consent to receive vaccines. Bonney and her colleagues feel that parental consent should be waived for the HPV vaccine as it is for other sexually transmitted infection-related health care, such as treatment for gonorrhea and chlamydia.
In addition to school-based vaccination clinics, juvenile detention centers and prisons with high populations of African American adolescents and young adults are institutions the authors say should be actively targeted for vaccine delivery.
Historically, multi-dose vaccines, such as the HPV vaccine, have been difficult to distribute successfully. Bonney cites the approval of the hepatitis B vaccine as an example. Despite being made readily available in 1982, hepatitis B had low vaccination rates until a strategy was adopted for universal infant vaccinations in the early 1990’s. The authors call for mandates and funding from the national level to support the development of early and aggressive intervention programs to avoid similar issues with distribution of the HPV vaccine.
The article states that although HPV does not affect all groups equally, it is imperative that the most vulnerable populations be proactively reached from the start to avoid another generation of cervical cancer tragedies.
June 19th, 2006
By: American Academy of Periodontology
People have a new reason to stick to their resolution to lose excess weight besides fitting into the latest fashion trends.
Researchers from University at Buffalo found that obesity is a significant predictor for periodontal disease, independent of age, gender, race,
ethnicity, and smoking. This study printed in a recent supplement to the Journal of Periodontology (JOP).
Furthermore, analysis of this national sample suggests that insulin resistance mediates the relationship between obesity and periodontal disease. It was found that the severity of periodontal attachment loss increased proportionally with increasing insulin resistance. In addition, the number of teeth lost increased significantly with increasing levels of insulin resistance. Individuals in the highest insulin resistance category lost 1.1 more teeth compared to individuals in the lowest category.
“People who have a higher body mass index produce cytokines (hormone-like proteins), that lead to systemic inflammation and insulin resistance,” said Robert J. Genco, vice provost at the University at Buffalo and editor of the JOP. “We propose that chronic stimulation and secretion of proinflammatory cytokines associated with periodontal infection also occurs, contributing to insulin resistance, which may further predispose to diabetes mellitus.”
Genco and his research team recently showed that diabetics with periodontal disease may have greater mortality from diabetic complications such as cardiovascular disease and kidney complications than diabetics with little or no periodontal disease.
“The presence of periodontal infection combined with obesity may contribute to type 2 diabetes and its complications, such as coronary heart disease,” said Kenneth A. Krebs, DMD and AAP president. “Although further studies are needed, people should remember that living a healthy lifestyle along with daily brushing and flossing and visiting your oral health care provider is always in fashion.”
A total of 12,367 non-diabetic individuals 20 to 90 years old participated in the dental section of the NHANES III study. Of these 53 percent were men and 47 percent were women and 43 percent of all the individuals were overweight.
A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org
June 19th, 2006
By: Stanford University
Few women are consulting their doctors before opting to use herbal therapies and soy products to treat their menopausal symptoms,
researchers at the Stanford University School of Medicine have found.
The trend is of particular note because growing numbers of women are turning to alternative therapies to relieve such symptoms as hot flashes, headaches, mood swings and sleep disruptions because of concerns about health risks associated with hormone therapy, which is still considered the most effective way of treating such difficulties. The researchers recommend that physicians learn more about these products so that they can help their patients choose safe, effective methods of treating their symptoms.
“We’re not promoting the use of these alternative therapies,” said lead author Jun Ma, MD, PhD, research associate at the Stanford Prevention Research Center. “We’re just saying that the demand for these therapies is growing and that physicians should be prepared to talk to their patients about it.”
The study appears in the May/June issue of The Journal of the North American Menopause Society. The study was funded by GlaxoSmithKline Consumer Healthcare, which had no role in the study design, data collection or preparation of the manuscript for publication. The pharmaceutical company manufactures the herbal product RemiFemin Menopause.
The study was based on a 2004 online survey of a random sample of 781 U.S. women between the ages of 40 and 60. Because the sample size was small, Ma cautioned that the findings may not accurately represent all women, but said the data provide useful insights into women’s attitudes toward menopause treatments and how much physician guidance they have received in deciding which therapies to use.
Among the women surveyed, nine out of 10 reported having experienced at least one menopausal symptom at some point. When it came to treating their symptoms, 37 percent reported using hormone therapy while slightly less than that - 31 percent - used herbal products. Soy supplements were used by 13 percent.
What interested Ma and her colleagues was that three-quarters of the women who had formerly taken hormone therapy said they stopped primarily because of concern about potential risks. “A majority of the women who had discontinued their hormone therapy were not on any therapy - not because of lack of need or desire to continue, but because they didn’t know which therapy would best suit their clinical needs,” Ma said.
The concerns about hormone therapy stem largely from the federally funded Women’s Health Initiative, a long-term study that turned the conventional wisdom about hormone therapy on its head. For many years, observational studies indicated that in addition to relieving menopausal symptoms, hormone therapy helped protect women against heart disease. However, the WHI found that neither estrogen nor the combination of estrogen and progestin helped prevent heart disease. Instead, although both forms of hormone therapy offered some benefits in easing menopausal symptoms, they both posed substantial health risks.
Despite these risks, hormone therapy is still considered the most effective approach for treating menopausal symptoms. Women are advised to use the lowest possible dose of hormones and to limit the duration of the treatment in order to minimize the risks.
But the new study shows that many women are instead turning to herbal and soy products to ease their menopausal symptoms. The most commonly used herbal products reported by survey participants were ginkgo biloba, ginseng, St. John’s wort, black cohosh or a combination product.
“The reduced use of menopausal hormone therapy, while an appropriate response to the WHI findings, has left both patients and their physicians in a difficult position,” said Randall S. Stafford, MD, PhD, associate professor of medicine and senior author of the study. “While other pharmaceuticals and alternative therapies are available, many physicians are not fully prepared to discuss these options, particularly given the limited data available about the effectiveness of these options.”
Among the women who used herbal therapies, 55 percent chose the products because of concerns about hormone therapy while 45 percent said they wanted to use a natural remedy. But Ma said many women mistakenly equate the term “natural” with “safe,” and falsely believe that herbal products won’t interact with other medications. “That misperception really needs to be corrected,” she said.
In fact, herbal products may have side effects. For instance, some studies have shown that St. John’s wort interacts with selective serotonin-reuptake inhibitors, which are the most commonly prescribed class of antidepressants, and it is recommended that the two not be combined.
Additionally, Ma said there is little in the way of high-quality data on the efficacy of many of the alternative therapies, adding that most of the data are limited to short-term use of the products.
The women in the study regarded physicians as their most-trusted source of information about alternative therapies, yet many said they didn’t get enough guidance in choosing a remedy for their menopausal symptoms. Nearly 75 percent of the women said that they - not their doctors - initiated discussions about possible treatments for their symptoms. And when it came to alternative therapies, 20 percent of the women weren’t confident in their doctors’ ability to discuss the treatments knowledgeably.
“Hormone therapy is unique in that patient preference is important in deciding what therapy to use,” Ma said. “A balanced dialogue is essential because it’s a treatment decision that a physician should make with a patient, not for a patient.”
Ma suggested that physicians know enough about alternative menopause therapies to put them in four categories: those that have data suggesting some effectiveness, those that have data demonstrating concerns about side effects, those with neutral data and those lacking any data.
“It’s OK to tell patients that little is known about a product, despite any anecdotal stories they may have heard. Anecdotal stories should not be taken as a substitute for rigorous clinical evidence,” Ma said.
June 19th, 2006