Plavix and Aspirin Are Not Good For Stroke Prevention
By jeremyc | February 8, 2012
A recent study has revealed that combining Plavix, a drug with the generic name clopidogrel, with aspirin is not effective in preventing recurrent brain strokes. In fact, this combination was also found to increase the risk of death and severe bleeding as a result of the stroke. This randomized, double-blind study was published as an abstract report.
During this study, patients received dual antiplatelet therapy and suffered twice the risk of major bleeding as compared to those who were on a combination of aspirin and a placebo. The study was conducted by the University of British Columbia in Vancouver, Canada and headed by Oscar Benavente, MD and colleagues. The study further revealed that the annual risk of death in patients on the combined therapy was 2.1%, while the risk was 1.1% for patients on aspirin and a placebo. This abstract report was presented at the American Stroke Association’s International Stroke Conference in New Orleans.
The abstract report also showed that the combination of aspirin and clopidogrel reduced the risk of hemorrhagic and ischemic stroke by 8%, which was not considered significant enough. The risk of ischemic stroke alone was reduced by 15%, while that of hemorrhagic stroke was reduced by 7%. Both numbers were considered non-significant. On the other hand, this combination therapy was seen to double the risk of hemorrhages occurring outside the central nervous system.
The preliminary results of this SPS3 (Secondary Prevention of Small Sub-cortical Strokes) Trial and the decision of the data monitoring board forced the researchers to end their study in August 2011. After looking at all the observed data of this abstract study, the conclusion was that there was only a small benefit of going through a combination treatment procedure instead of using aspirin as the lone medication. Oscar Benavente said, “These results are not supportive of the combination of aspirin and clopidogrel for preventing strokes in patients suffering from small subcortical strokes.”
At present, the AHA/ASA has guidelines in place that recommend aspirin and clopidogrel as standalone therapies, but not together as a combination therapy. The study which was conducted is the first large scale study of patients suffering from subcortical strokes, which are known to be the most common cause of vascular disease. It is interesting to note that vascular diseases are commonly associated with lacunar strokes and are responsible for over a quarter of all brain infarctions.
This disease is highly prevalent in minority communities. During the course of this large-scale study, researchers enrolled more than 3,000 participants located in 81 clinical sites and across 8 countries. They then observed these patients over the course of 3.5 years. The randomization drug trial took place in the period between March 2003 and April 2011. Previous trials have shown no link between the combination of aspirin and clopidogrel and the rate of death, but this link may have been mixed up with vascular death.
According to Benavente, the result of this trial does not mean that new anti-clotting agents cannot be studied for treating subcortical strokes. The second part of this SPS3 trial is being conducted with the aim of examining the effects of hypertension treatments. The results of this test may be published in July this year.
Topics: Stroke | No Comments »
Smoke Exposure in Teenagers’ Cars Reduced
By jeremyc | February 7, 2012
A new nationwide study has concluded that the number of teenagers who inhale secondhand smoke inside cars has reduced. This report has come in light of continuing efforts to keep a check on the limit of secondhand smoke exposure, and is seen as a positive result to these efforts.
The Centers for Disease Control and Prevention, Atlanta, had conducted this study. Brian A. King, PhD, who works in the center and played an important role in this study, said that the number of adolescents who rode in cars in which someone was smoking fell from around 48 percent to around 29 percent from 2000 to 2009. During this time, the number of nonsmoking teenagers exposed to secondhand smoke inside cars had reduced from 39 percent to approximately 22 percent. The rate of change was calculated at an amazing 71 percent.
In spite of the good news, continued efforts are still required. According to the report published by the researchers, “Over one fifth of nonsmoking students reported exposure in a car in the previous seven days (in 2009).” According to the American Academy of Pediatrics, even the smallest degree of exposure to secondhand smoke is unsafe for young people because of their increased susceptibility to the effects of smoke. There has been some significant progress reported in the formation of public smoke-free areas over the past few years. Some states have gone further to ban smoking in a car when there are children inside.
There is very little reliable information available on the ongoing secondhand smoke exposure rates in cars, so researchers from the CDC used the data from the National Youth Tobacco Survey conducted for high school and middle school students. According to this data, high school students were seen to have a decreased reduction to secondhand smoke in cars, with the percentage dropping from around 51 percent to around 33 percent. The numbers also dropped from 46 percent to 28 percent for middle school students.
In terms of gender, boys were seen to have an exposure of around 27 percent, which was a decline from 46 percent. Exposure among girls had also declined from around 49 percent to 32 percent. The higher rate of secondhand smoking exposure among girls may be due to the fact that the rate of actual smoking is higher in boys. These boys may then be exposing their female companions and friends to cigarette smoke when riding together. However, more research would be needed to see if this theory holds any truth.
An astonishing fact about this survey report is that no states had passed a smoke-free legislation during the time of survey initiation. However, by the middle of 2011, almost half of the states had already passed their own laws. The passing of these laws over the years has led to a large decrease in smoke exposure numbers, and this positive trend is expected to continue further. These laws have also led to the passing of smoke-free policies in public and private locations, including homes. Other facts that may have played a role in this reduction include greater awareness and acceptance about the evils of secondhand smoke and changes in the attitude of people in accepting smoking next to children and other non-smokers.
Topics: Smoking Cessation | No Comments »
More exercise means less silent strokes
By jeremyc | September 26, 2011
It is a known fact that people who spend more time in the gym, or in other words work out more pose lower risks of neurological disorder. A new study suggests that older adults who regularly break a sweat might be less likely to have a “silent stroke” than non-exercisers. Strokes are often responsible for brain damage by blocking the supply of blood to the brain. Such major strokes can easily be identified by its basic symptoms such as weakness on one side of the body and fumbling while speaking. But the silent strokes are even more deadly as because they come without any warning! Subtle memory and mobility problems are some of the common symptoms of silent strokes. Also, an increased risk of future strokes is also an indication that a person may have the silent again in his/her lifetime.
A research conducted by the Columbia University and the University of Miami which started in the year 1993 involved 1238 participants which focused on the risk factors for vascular disease. All the participants in this study were 55 years and above old. None of them had any symptoms of stroke at their level of physical activity. The study revealed that 43% weren’t regularly active, 36% did light exercise such as walking or golfing and 21% engaged in moderate to heavy exercise such as jogging, biking and swimming.
Several years later, when the respondents were 70 years old on an average, they were put to MRI scans. It was found that the forty-three percent of participants had no regular exercise; 36% engaged in regular light exercise, such as golf, walking, bowling or dancing; and 21% engaged in regular moderate to intense exercise, such as hiking, tennis, swimming, biking, jogging or racquetball. There was no difference between those who engaged in light exercise and those who did not exercise. Among the participants, 16 percent had experienced a silent stroke, known as silent brain infarcts.
Study author Dr. Joshua Wiley of the Columbia University says –
“It is important to note that light-intensity physical activity is likely to have protective effects against multiple other conditions associated with aging and our findings should not discourage individuals from performing even light intensity activities.”
According to the American Heart Association, ideal cardiovascular health includes 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise a week. Many other experts believe that the study did not address the fact that why more strenuous exercise appears to be helpful. Dr. Joshua Willey says that some of the effects of exercise appear to be related to improving other health conditions that affect the risk of stroke, such as hypertension, obesity, high cholesterol and low HDL, diabetes, atherosclerosis (hardening of the arteries) and heart disease.
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Why do we put on weight after we quit smoking?
By jeremyc | September 26, 2011
If you want to quit smoking, it will definitely bring you a lot rewards as far as the emotional aspects of your life are concerned. But a few days ago, new research conducted by the researchers in the Yale University have come up with the reasons behind smokers becoming fat after quitting smoking. The Yale University researchers conducted experiments on mice. Through these experiments they found that the nicotine activates neurons located in the hypothalamus region of the human brain which sends the ‘I am full’ message to the entire body, which in turn helps in regulating the dieting habits of a human body.
The Yale University team led by psychiatrist Marina Picciotto found that nicotine also binds with the receptors which act as appetite-regulating neurons which do not get involved in addicting the human brain to smoking. The Yale University School of Medicine and Baylor College of Medicine in Houston performed a combination of molecular, pharmacological, behavioral and genetic experiments on mice. Thereafter, they found that nicotine influences the human body’s hypothalamic melanocortin system which is the collection of central nervous system circuits.
According to Marina Picciotto nicotine hijacks various neural circuits in the brain which are involved in the reward region of the human brain responsible for nicotine addiction. The receptors which aid nicotine addiction increase the activity of pro-opiomelanocortin (POMC) neurons, known for their effects on obesity in humans and animals. This is the reason why people become skinny while they are on the habit and tend to put on weight as soon as they quit smoking.
By understanding the link between nicotine and obesity can lead to the discovery of new drugs that target the nicotine receptors on appetite-controlling cells, giving smokers a way to quit without the weight gain. But Marian Picciotto affirms the fact that these kinds of drugs may be helpful in controlling the nicotine intake by a human body, but they increase the chances of high blood pressure and weakening the function of the human heart. Since the nicotine receptors are closely linked to a human body’s fight-or-flight stress response, activating those receptors brings havoc for the human body including its heart.
In the experiment conducted by Marina Picciotto and her team from the Yale University School of Medicine and Baylor College of Medicine in Houston, they found that when the mouse was subjected to nicotine, one lacking the pro-opiomelanocortin (POMC) pathway did not lose weight. On the other hand, the mice with the pro-opiomelanocortin (POMC) pathway did lose weight.
Marina Picciotto stresses on the fact that the fear of weight gain should not keep anyone from leaving the nicotine habit. Smoking invites diseases like blood pressure, stroke and also heart attack to a human body.
Topics: Smoking Cessation | No Comments »
Facial wrinkles reflect weaker bones in women
By jeremyc | June 25, 2011
A new study by the Yale School of Medicine has revealed that wrinkles in the skin reflect the weak stature of bones in women. These wrinkles would increase the chances of ailments from osteoporosis and hard to heal breaks and fractures as they start ageing. But the scientists have also confirmed that diagnosing brittle bones will be as simple as diagnosing someone’s face in the coming years. Osteoporosis is a disease that lowers bone mineral density and affects 200 million women worldwide. Currently, three million women in Britain have come under its vicious affects. According to International Osteoporosis Foundation, this disease is more common among women above the age of 50 and it often leads to breaks in the wrists, spine and hips.
America’s Yale School of Medicine studied 114 women in their late forties and early fifties who have recently gone through menopause. It does not include women who used Botox or other cosmetic procedures to smooth their furrows. Thereafter the researchers chose 11 points on each test subject’s face and neck and measured the number of wrinkles and also their depth. The firmness of forehead and cheek skin of women was also noted along with the density of bones in these two points, which was again measured by the X-rays. In addition to linking wrinkles to low bone density, the researchers showed that women with firm facial and forehead skin had greater bone density. In the Endocrine Society’s annual conference in Boston, it was confirmed that women with worst wrinkles also had the weakest bones. This particular phenomenon was not only evident in the older women, but younger women were also seen with these complications.
Sex hormones expert and a part of this research, Lubna Pal said that deepening and worsening skin wrinkles are related to lower bone density among the study participants. She also added that the connection between bones and skin may seem unclear but they share their common building blocks – collagens. When the human body starts ageing, changes in collagen starts taking place that accounts for age-related skin changes which includes worsening skin wrinkles and sagging skin. It also results in deterioration in bone quality and quantity. Women are more prone to fracturing bones, specially the hip bones. In postmenopausal women, the appearance of the skin may offer a glimpse of the skeletal well-being, a relationship not previously described.
Lubna Pal also stressed on the fact that the study will be helpful for the clinicians to identify fracture risk in post-menopausal women at a glance without depending on costly tests. The study has also confirmed the fact that a 20-year-old can expect to have 56 per cent more wrinkles by the time she is 28, while one aged 40 can expect a 73 per cent rise in wrinkles by the age of 48. But the older women need not worry because after the age of 60 or 70, few new lines appear!
Topics: Osteoporosis | No Comments »
New study finds high salt diet to be good for health
By jeremyc | June 25, 2011
A new European research suggests that contrary to popular belief a high salt diet is actually good for our health. The researchers found that people on a high sodium diet were less likely to develop heart diseases.
The study led by Jan A. Staessen of the University of Leuven, Belgium had 3,681 participants. Each of the participants was aged near about 40 and was deemed clinically healthy at the start of the study. The researchers measured the urinary sodium levels of the participants and followed their health for the next eight years. The participants were divided into three groups: high sodium intake group, average sodium intake group and low sodium intake group.
It was found that the chances of developing blood vessel diseases or heart diseases were the same for all the three groups. However, surprisingly mortality rate from heart related diseases was found to be the highest among the low sodium intake group (4%) while the high sodium intake group had the lowest mortality rate (1%) in the eight years.
Another significant discovery was that the change in blood pressure as compared to change in salt intake. It was found that though systolic blood pressure increased with increase in salt intake, the change was not significant enough, i.e. salt intake had practically very little effect on blood pressure.
Though the study failed to find any evidence of dietary salt to affect blood pressure, Staeseen still considers it to be safe to reduce salt consumption for patients with high blood pressure. According to him, “It’s clear that one should be very careful in advocating generalized reduction in sodium intake in the population at large. There might be some benefits, but there might also be some adverse effects.”
Dr. Hillel Cohen, epidemiologist, Albert Einstein College of Medicine, New York, however, warned people from changing their salt-eating behavior on the basis of limited studies. She also pointed out the potential risks of ordering low-sodium meals at restaurants. According to her by reducing the salt content the restaurants may add other harmful preservatives to make up for the taste.
On the other hand, the researchers have also pointed out that the findings of the result hold true for white Europeans only. They discourage generalization of the result as it may not hold true for other ethnicities.
Meanwhile, Salt Institute, the representative trade group of the salt industry in the United States, has lashed out at the American Heart Association (AHA) guidelines as well as the official US salt guidelines. The AHA recommends a daily sodium intake of 1,500 milligrams. The usual sodium intake of an average American is 3,500-4,800 milligrams a day.
President of the Salt Institute, Lori Roman, heralded the findings of the study and said, “We now know conclusively that the U.S. government’s war on salt consumption will cause harm. This study confirms previous research indicating that reductions in sodium lead to an increased risk of disease and death.”
However, Ralph L. Sacco, president of the AHA, dismissed Roman’s claims saying, “We need to take this article with a large grain of salt. There are major problems with it, and there is only this one article with these findings, which are contrary findings to what we and others have found.”
Topics: General Health News | No Comments »
Cancer drug form Novartis approved for pancreatic tumor treatment
By jeremyc | June 14, 2011
Afinitor (everolimus), the cancer drug from Novartis, have been approved by the Food and Drug Administration (FDA) of the United States for the treatment of progressive pancreatic neuroendocrine tumors. Such tumors are usually metastasized and it is not possible to remove them through surgery. Though it is rare in occurrence—the strike rate is 0.32 cases per 100,000 people— and progresses slowly the limited treatment options have made this type of pancreatic cancers quite dreaded. With the new approval, patients as well as doctors across the world are sure to heave a sigh of relief.
Richar Pazdur, director, Office of Oncology Drug Products, Center for Drug Evaluation and Research, FDA, said, “Patients with this cancer have few effective treatment options. Afinitor has demonstrated the ability to slow the growth and spread of neuroendocrine tumors of the pancreas.”
To determine the effectiveness of Afinitor in the treatment of progressive pancreatic neuroendocrine tumors, a clinical trial was conducted with 410 participants. All the participants had locally advanced or late-stage tumors. The participants were randomly chosen and assigned placebo or Afinitor. The aim was to find out if Afinitor increased progression-free survival among the patients. It was found that the median progression-free survival among the patients who were given placebo was 4.6 months. However, the same for the patients who were assigned Afinitor was 11 months.
Even though the advisory panel has unanimously chosen Afinitor as the preferred drug for the treatment of the tumors in question there are concerns regarding the various side effects of the drug, many of which are serious in nature. Some of the side effects of the drug are rash, fatigue, stomatitis, nausea, diarrhea, abdominal pain, edema, headache and fever.
Presently Afinitor is approved for the treatment of advanced renal cell carcinoma (especially when treatment with sunitinib and sorafenib fail to bring the desired results) and subependymal giant cell astrocytoma associated with tuberous sclerosis (when surgery cannot be performed). On the other hand, Zortress, another trade name for Afinitor, is approved for the prevention of organ rejection following a kidney transplant.
Following the FDA approval for the treatment of progressive pancreatic neuroendocrine tumors, Novartis released a statement that said, “Data show Afinitor delays tumour growth and reduces risk of disease progression in patients with advanced neuroendocrine tumours (NET) of pancreatic origin. This marks the first approval of a treatment for this patient population in the United States in nearly 30 years.”
Topics: Cancer | No Comments »
Biphosphonates may trigger atypical fractures: Study
By jeremyc | June 14, 2011
While there are many drugs that are prescribed for osteoporosis a recent research suggests that many of these make the recipients more vulnerable to fractures. Known as bisphosphonates, these drugs cause the people who use them to have what is known as atypical fractures or unusual.
The research that was conducted by the Swedish Research Council tested 12, 777 women over the age of 55 and using drugs for osteoporosis were tested. Out of all these women, 59 were found to be suffering from atypical fractures.
But just as there is a risk of such unusual fractures occurring, the good news seems to be that the bisphosphonates cure about 50-60 cases of fractures caused due to osteoporosis for every one case of unusual fracture. Thus the doctors across the world agree that the risk factor about consuming bisphosphonates is quite low and that there is no need to stop the continuation of the medicine whatsoever.
In terms of statistics, this translates into five cases of unusual fracture occurring for patient -years of 10,000. Another important statistic that emerged through this research was that the longer a person took the drug, the more increased were the chances of getting unusual fractures. At the same time, there was a 70% drop of risks for every year that the patient did not consume the drug.
Another important fact mentioned by Dr. Per Aspenberg, who led this research, is that if patients have taken the drug for five years then they can very well go off the drug as its effects will definitely last for another five years. This being the case, the patients who have consumed bisphosphonates for five years at a stretch but have stopped its consumption afterwards can successfully reduce their chances of getting unusual fractures.
Robert R. Recker however refuses to accept the conclusion of the research. He has pointed out that in most of the cases of atypical fractures mentioned in the study the women who had suffered from fractures had some precedence of bone problems. That being the case, he says it cannot be proved whether bisphosphonates actually caused the fractures or they were just the trigger that worsened the pre-existing condition.
With such dividing opinions it can be safely assumed that there is little chance of discontinuation of bisphosphonates in near future. In fact, more conclusive studies need to be conducted in order to confirm the adverse effects of the drug.
The findings of the study were published in an edition of the New England Journal of Medicine.
Topics: Osteoporosis | No Comments »
Allergy season at its worst in the US
By jeremyc | June 10, 2011
Proving all the poets wrong, spring is far removed from welcome for Americans who suffer from allergies. Frequent changes in climate including heavy snowfall and rains have caused trees to pollinate longer while a sudden change of warm weather in other parts of the country has brought about robust release of pollens. Random deluges coupled with flood have also increased the mold volume.
People are frequenting the offices of allergy specialists all over America with seasonal allergy symptoms such as itchy eyes, stuffy noses and plugged ears helping pharmacists earn that extra dollar. The spring of 2011 is turning out to be a worst nightmare for nearly 35 million Americans hit by hay fever, popularly known as seasonal allergic rhinitis. Adding to the woes of the patients doing the rounds of hospitals not is the news that not only is the allergy season failing to show any sign of ending in the near future, it may in fact take a turn for the worse.
70 years old Lynne Ritchie is among the many suffering from the severe allergy season. As she takes her medicine from the counter of a Manhattan drugstore Ritchie says that the season seems to be worsening every week. A warning has been issued by allergy specialists about the difficult season all over the country.
Making things worse pollen counts and allergy attacks are not uniform throughout the country. A wet winter followed by an equally dry spring produced perfect conditions for storms. Areas located to the east of the Mississippi River experienced the wettest April since 1895. Molds growing under fallen leaves and blooming trees are making things difficult for people prone to multiple airborne allergens. Knoxville,Tenn, Lousiville,Ky and Charlotte, N.C. have made it to the Asthma and Allergy Foundation’s list of “2011 spring allergy capitals.”
The Asthma and Allergy Foundation used a mechanism to measure airborne grass, weed pollen and tree pollens, mold spores and came out with statistics showing medications used on each patients and the total number of allergy specialists inhabiting per capita.
Continuous rain accompanied by heat waves and Santa Ana winds increased the miseries of people in Los Angeles while Chicago saw the highest pollen count in the past three years. People who haven’t suffered from allergies in the last few years have also fallen prey this time. The allergy bouts are at times so severe that even medications are failing to generate any effect and multiple drugs ranging from eye drops to nasal drops are proving to be insufficient in fighting the condition.
However, specialists suggest that following certain precautions can lessen the impact. Hair and clothes should be washed regularly to get rid of pollens. Even pets should be kept in rooms as their hair can catch pollens. Doors and windows should be kept fastened to stop the breeze from entering and any kind of exposure to pollen-laden air should be avoided. One can take recourse to glares while going out as doing so may prevent pollen grains from entering the eyes. However, if all these precautions fail to protect you, you should rush to you nearby allergy specialist as soon as you notice the slightest symptom of an allergy.
Topics: Allergies | No Comments »
Suffering from heart pain? Don’t go for pain relievers
By jeremyc | June 10, 2011
A recent study published in the Journal of the American Heart Association points out that taking nonsteroidal antiflammatory drugs (NSAIDs) post heart attack increases your risk of experiencing another attack within a week of operation by 45%. Use of such drugs further increases the risks of another attack within three months of surgery by 33%. It seems that NSAIDS can be equally harmful for healthy people as well as people with ischemic hearts.
The main components of NSAIDS are ibuprofen (23%), diclofenac(13.4%), rofecoxib(4.%) and celecoxib (4.8%), indocin, voltaren and selective COX-2 inhibitor celebrex. Diclofenac users are likely to be at a three times more risk as compared to non-users. This revelation has led FDA to issue a warning against use of diclofenac especially after a bypass surgery. The study, however, confirms that naproxen usage does not bring about cardio vascular attack even though it might lead to gastrointestinal bleeding.
The researchers collected data from Danish National Patient registry. Out of 83,675 Danish adults with an average age of 68 and all having their first heart attack between the years 1997 and 2006, about 42% of the survivors had taken NSAIDs. The findings brought to the light the 2007 Association’s report claiming the risks behind taking NSAIDS among heart patients and advising the use of it only under unavoidable circumstances for the shortest period possible in negligible amounts.
This is because NSAIDs stop the production of COX enzymes. Cerebex a common COX-2 enzyme increases the rate of blood clotting while COX 1 type has a slow reaction. Aspirin, a type of NSAID that thins the blood, blocks the COX-1 enzyme.
Dr.Atman of Harvard Medical School, Boston who spearheaded the study, firmly believes that NSAIDs can be prescribed to patients suffering from severe pains like rheumatoid arthritis or lupus. But it does not curtail the risk factor. Physical therapy, proper diet or other compositions of pain killers should be tried before surrendering to NSAIDs, he says.”Some patients have such debilitating arthritis that we need to work down the list [of NSAIDs], recognizing as we get down the list we’re getting into increasingly dangerous territory,” Antman said. If they’re already on one, it must be seen that they do not stay on it. Many doctors do not have the habit of monitoring the medication use therefore patients stay on long after attacks.
However, the findings of the study are not beyond doubts because of its observational nature. Random trials are more likely to bring a better rate of accuracy to the research in the future.
Topics: Heart | No Comments »
