Friday, April 23, 2010

Cancer May Be Linked To Chronic Illnesses.

People With High Blood Pressure, Diabetes, Heart Attack More Likely to Have Cancer
By Jennifer Warner
WebMD Health NewsReviewed by Laura J. Martin, MDApril 2, 2010 --

Having a heart attack or chronic illness may raise the risk of being diagnosed with cancer, according to a new survey.

Researchers found that people with high blood pressure, high cholesterol, or diabetes were about twice as likely to have cancer as healthy people without these chronic illnesses.

In addition, the survey found that people who had suffered a heart attack were nearly three times more likely to have a cancer diagnosis than those who hadn't.

The survey was conducted as part of the Gallup Healthways Well-Being Index and based on telephone interviews with more than 350,000 adults in the U.S. conducted between Jan. 2- Dec. 30, 2008, and Jan. 2- Dec. 29, 2009. It has a sampling error of no more than 1 percentage point.

The survey showed the relationship between a cancer diagnosis and the following health conditions:

Health Condition % Diagnosed With Cancer

High blood pressure 11.8

No high blood pressure 5.0

High cholesterol 11.7

No high cholesterol 5.3

Diabetes 12.7

No diabetes 6.4

Heart attack 18.1

No heart attack 6.5

The risk of developing any of these chronic illnesses increases with advancing age, but researchers say the link between these illnesses and cancer remained significant within every age bracket. The relationship between cancer and some of the conditions, such as heart attack, were especially pronounced under age 45.

Researchers point out that the results do not necessarily mean any of these chronic illnesses cause cancer, but they do show that cancer and chronic conditions share many risk factors and may be interrelated.

For example, smoking cigarettes is a risk factor for both heart attack and lung cancer, and cholesterol itself is not a cancer-causing substance but can enhance the effects of other carcinogens in the body.

Friday, April 16, 2010

B.C. Government poised to take eye care back to Third World status!

On May 1st, the B.C. Health Minister is proposing to almost deregulate the eye care professionals and bring the standard of care in this province to that mostly seen in third world countries!
Opticians will be allowed to ‘sight test’, which involves checking the patient’s prescription, without ANY form of eye health assessment! As you all know, we routinely find eye disease and even life-threatening diseases every day in asymptomatic patients. If the regulations go through in B.C., many patients would forgo a regular complete eye health assessment, assuming that a ‘sight test’ is all that is needed. This would needlessly increase the rate of blindness in this province. There is no other jurisdiction in North America that allows a prescription check without the rest of the eye health assessment.
In addition, ANYONE will be allowed to open an optical shop and sell glasses or contact lenses without any license or education whatsoever. Even more amazing is that you would be able to get glasses or contact lenses WITHOUT a prescription! So... if you feel you see well with your sister’s glasses, you could just have them neutralized at the local optical shop and voila... you now have your new glasses! (or maybe you would like a pair of contacts from her Rx too... no problem!... we can even mail them to you without ever checking them on your eyes)
What is the B.C. government thinking????
So far, the B.C. health minister is ignoring the pleas of the optometrists, medical doctors, the CNIB and even the opticians themselves to stop this legislation. Apparently, he is making the changes only to appease an internet contact lens retailer (Clearly Contacts) and keep this company prospering in B.C. Exchanging the visual health of B.C. residents for the financial health of a contact lens company hardly seems like a fair trade to me!
It turns out that Clearly Contacts has paid over $10,000 dollars in political contributions to the government to help make this new legislation a reality. It is really a bit unbelievable that the Health Minister does not even want to discuss the matter with any of the stake-holders. (optometrists, medical doctors, opticians, CNIB, etc)

If you have a few minutes to spare, please become a fan of the ‘Speak Out for Eye Health’ facebook site and add your name to the growing list of eye care providers, staff and patients who are making their displeasure known!!/speakoutforeyehealth

Many thanks!

Toby Mandelman

Researchers Use Infrared Laser Treatment To Treat Cataracts

From the New York Times:
Published: March 22, 2010

Cataracts are the leading cause of blindness in the world, and are often related to aging. In a common form of cataracts, proteins in the lens change over time, developing chromophores — molecular add-ons that absorb color in the blue part of the spectrum. Chromophores reduce the amount of light reaching the retina (and give the lens a yellow-brown appearance), but they also disrupt the structure of the lens proteins, causing light to scatter.

Cataracts can be treated by lens-replacement surgery, but the procedure is invasive and costly, requiring special equipment and skilled eye surgeons. To make cataract treatment available to more people around the world, a less-invasive, less-expensive technique is needed.

Line Kessel, an ophthalmologist at Glostrup Hospital of the University of Copenhagen in Denmark, and colleagues have come up with what they say is a promising alternative to replacement surgery. In their approach, described in the open-access journal PLoS ONE, they “bleach” the lens with a laser.

Ultraviolet light can alter chromophores so they no longer absorb color, but UV light can damage the retina. So the researchers use infrared light, delivered by an extremely fast-pulse laser. The pulses are so fast, Dr. Kessel said, that two photons hit a target molecule simultaneously, with the same effect as if UV light was used.

The laser treatment reduces the light absorption and also helps restore the lens proteins to their proper structure. Much more research and development work remains, Dr. Kessel said, but the goal is a relatively simple procedure that would last half an hour at most and use largely automated equipment in mobile clinics.

Sunday, April 11, 2010

Most Babies Should Take Vitamin D Supplement, Study Indicates

By Liz Szabo, USA TODAY

Most babies should take a daily vitamin D supplement, a new study shows.
That will be a big change for most parents — and even many pediatricians.

Only 1% to 13% of infants under 1 year now get a vitamin D supplement, available in inexpensive drops, according to a study published online today in Pediatrics.

Those drops are needed, the study says, because only 5% to 37% of American infants met the standard for vitamin D set by the American Academy of Pediatrics in 2008: 400 international units a day.

Vitamin D strengthens bone and the immune system and also appears to prevent type 1 diabetes, heart disease and cancer, the paper says.

Few breast-fed babies — 5% to 13%, depending on their age — received the recommended amount of vitamin D, researchers estimated. Although breast milk is the perfect food in every other way, it's often low in vitamin D, says pediatrician Nicolas Stettler, a spokesman for the pediatrics academy who wasn't involved in the study. Because humans originated in equatorial areas with year-round sunshine, babies in the distant past wouldn't have needed to get vitamin D from breast milk, he says.

Yet many formula-fed infants don't get enough, either. Babies need to drink about 32 ounces of fortified formula a day to get 400 international units of vitamin D, says study author Cria Perrine of the Centers for Disease Control and Prevention. Babies younger than 6 months can rarely drink that much. A supplement can give babies all they need.

Many mothers also are vitamin D-deficient.

A second study in Pediatrics reports that 58% of newborns and 36% of mothers were deficient in vitamin D, according to blood tests. Although taking prenatal vitamins helped, more than 30% of moms who took them were still deficient. Getting lots of sunlight helped raise vitamin D levels in moms, but not in their newborns.

The American Academy of Pediatrics recommends babies get no direct sunlight in their first six months, to prevent skin damage and cancer. After 6 months, the academy says, babies should wear sunscreen, hats and protective clothing in the sun.

Relatively few pediatricians today talk about vitamin D with parents, says Wendy Sue Swanson, a pediatrician at Seattle Children's Hospital who wasn't involved in the new research. That may be because the pediatrics academy's previous vitamin D recommendation — 200 international units a day, set in 2003 — was easier to meet, Swanson says.

Friday, April 2, 2010

Senate report links diabetes drug Avandia to heart attacks

February 20, 2010 4:39 p.m. EST
CNN's Lisa Desjardins, Saundra Young, Miriam Falco and Arthur Brice contributed to this report.

(CNN) -- The diabetes drug Avandia is linked with tens of thousands of heart attacks, and drugmaker GlaxoSmithKline knew of the risks for years but worked to keep them from the public, according to a Senate committee report released Saturday.

The 334-page report by the Senate Finance Committee also criticized the Food and Drug Administration, saying that the federal agency that regulates food, tobacco and medications overlooked or overrode safety concerns found by its staff.

"Americans have a right to know there are serious health risks associated with Avandia and GlaxoSmithKline had a responsibility to tell them," said U.S. Senator Max Baucus, a Democrat and committee chairman. "Patients trust drug companies with their health and their lives and GlaxoSmithKline abused that trust."

The bipartisan report also was signed by Sen. Chuck Grassley, the top-ranking Republican on the committee.

GlaxoSmithKline rejected any assertions Saturday that the drug is not safe.

"We disagree with the conclusions in the report," company spokeswoman Nancy Pekarek told CNN. "The FDA had reviewed the data and concluded that the drug should be on the market."

Seven clinical trials on the drug prove that it is not linked to heart attacks, Pekarek said.

"None of that data shows a statistically significant correlation between Avandia and myocardial ischemia or myocardial infarction [heart attack]," she said.

Ischemia is a condition in which blood flow and oxygen are blocked from going to certain parts of the body.

The Senate committee investigation stems from concerns that Avandia and other high-profile drugs put "public safety at risk because the FDA has been too cozy with drug makers and has been regularly outmaneuvered by companies that have a financial interest in downplaying or under-exploring potential safety risks," the report states.

FDA Commissioner Margaret Hamburg said she is waiting for the recommendations of an advisory committee that will hear reports on the drug this summer.

"Meanwhile," Hamburg said in a statement, "I am reviewing the inquiry made by Senators Baucus and Grassley and I am reaching out to ensure that I have a complete understanding and awareness of all of the data and issues involved."

The Senate report was developed over the past two years by committee investigators who reviewed more than 250,000 pages of documents provided by GlaxoSmithKline, the FDA and several research institutes. Committee investigators also conducted numerous interviews and phone calls with GlaxoSmithKline, the FDA and anonymous whistleblowers.

According to the Senate report:

• FDA scientists estimated in July 2007 that Avandia was associated with approximately 83,000 heart attacks since the drug came to market.

"Had GSK considered Avandia's potential increased cardiovascular risk more seriously when the issue was first raised in 1999 ... some of these heart attacks may have been avoided," the report states.

• GlaxoSmithKline undertook attempts to undermine information critical of Avandia.

"GSK executives attempted to intimidate independent physicians, focused on strategies to minimize or misrepresent findings that Avandia may increase cardiovascular risk and sought ways to downplay findings that a competing drug might reduce cardiovascular risk," the report says.

As an example, committee investigators say they found that GlaxoSmithKline experts verified an outside study showing the cardiac problem, but the company publicly attacked the findings as incorrect.

• Two FDA safety officials sounded a clear alarm in October 2008 writing, "There is strong evidence that rosiglitazone [Avandia] confers an increased risk of [heart attacks] and heart failure compared to pioglitazone [rival drug on market]." They concluded and trials comparing the two would be "unethical and exploitive." Yet, the trial is still under way, the senators say.

GlaxoSmithKline counters that the Senate report relies on outdated information.

"In essence, the report is a compilation of information and events that took place years ago," spokeswoman Pekarek said. "There's no new data there."

The FDA has evaluated at the drug, Pekarek said, and updated product labeling in 2007 to say information on Avandia's relationship to myocardial ischemia is inconclusive.

"The FDA exists to ensure patient safety," she said. "That is their purpose."
Avandia has been under scrutiny for years. The New England Journal of Medicine called the drug's safety into question in 2007. The Journal of the American Medical Association also questioned whether Avandia was safe in 2007.

"Among patients with impaired glucose tolerance or type 2 diabetes, rosiglitazone use for at least 12 months is associated with a significantly increased risk of myocardial infarction and heart failure, without a significantly increased risk of cardiovascular mortality," the AMA journal wrote, adding that the "findings have potential regulatory and clinical implications."

"Regulatory agencies ought to re-evaluate whether rosiglitazone should be allowed to remain on the market," the report said. "Health plans and physicians should not wait for regulatory actions. They should avoid using rosiglitazone in patients with diabetes who are at risk of cardiovascular events, especially since safer treatment alternatives are available."

Read the report

In 2007, an FDA panel recommended by a vote of 22-1 that Avandia should remain on the market despite an analysis showing links to increased risk of heart attack. The vote was not binding, but a suggestion to FDA regulators.

The panel also voted 20-3 at the same meeting in support of data that showed Avandia increased the risk of cardiac ischemia in patients with the most common type of diabetes.

The Senate report does not address the issue of whether Avandia should be removed from the market.