Friday, August 29, 2008

Fruit Juice and Pharmaceuticals Collide

We reported on this site long ago that grapefruit juice is known to boost the absorption of certain medications. You'll find your doctor has plenty to say about taking these drugs along with grapefruit juice, and the pharmacist will also pass along a stern warning.

But now it turns out that grapefruit juice isn't the only juice that doesn't mix well with drugs. The Canadian researcher who first identified the ill effects of grapefruit juice has gone on to publish new science that shows a few other fruit juices have the same problem.

Orange and apple juice, two of the most common fruit juices in today's refrigerator, may limit the body's absorption of drugs and compromise their effectiveness. Dr. David Bailey, a professor of medicine and pharmacology at the University of Western Ontario presented his research recently at the American Chemical Society's national meeting, in Philadelphia.

"The original finding is that [grapefruit juice] markedly boosts the amount of drug that gets into the bloodstream," Bailey said. He first reported that nearly 20 years ago when he discovered that grapefruit juice increased the body's blood levels of felodipine (Plendil), used to treat high blood pressure. Since the original finding, other researchers have identified dozens of other medications that could interact adversely with grapefruit juice.

The American Academy of Family Physicians says that doctors traditionally warn against drinking grapefruit juice if you're taking certain medications for high cholesterol, high blood pressure and heart rhythm problems.

In his latest research, Bailey found that grapefruit juice, as well as orange and apple juice, can lower the body's absorption of some medications. Those drugs include the anti-cancer drugs etoposide (Etopophos, Vepesid); certain beta blockers like tenormin (Atenolol) and talinolol (Cordanum), used to treat high blood pressure and prevent heart attacks; cyclosporine, which is used to prevent organ transplant rejection; and some antibiotics, including ciprofloxacin (Cipro), levofloxacin (Levaquin), and itraconazole (Sporanox).

Bailey also found that healthy volunteers who took the allergy drug fexofenadine (Allegra) with grapefruit juice absorbed only half the amount of the drug, compared with volunteers who took the medicine with water.

In each case, substances in the juices affected the absorption of the drugs. Some chemicals block a drug uptake transporter, reducing drug absorption; other chemicals block a drug metabolizing enzyme that normally breaks down the drugs.

Dave

Wednesday, August 27, 2008

Mystery of Premature Births Solved?

Researchers at the Stanford University School of Medicine have found one answer to why some women have premature births, while others go full term. Previously unrecognized and unidentified infections of amniotic fluid may be the single most significant cause of premature birth.

A press release from Stanford describes this analysis of amniotic fluid from women in preterm labor. It found that a full 15 percent of the fluid samples harbored bacteria or fungi, which represents an increase of 50 percent over previous estimates.

This is a concern for many doctors because the heavier the burden of infection, the more likely it is that the woman will deliver a younger, sicker infant.

“If we could prevent these infections in the first place, or detect them sooner, we might one day be able to prevent some of these premature births,” said researcher Dan DiGiulio, MD, who conducted the study in the laboratory of David Relman, MD. About 12 percent of all births in this country are premature and the frequency of premature birth is increasing. This issue of increasing amounts of bacteria and fungi is one reason behind the increase.

The study is published in the Aug. 26 issue of PLoS-ONE.

For this study, DiGiulio used a highly sensitive technique called polymerase chain reaction, or PCR, to track down micro-organisms in amniotic fluid samples collected from 166 women in preterm labor at the Detroit Medical Center between October 1998 and December 2002. Of these, 113 women went on to deliver their infants prematurely. Although not all these women were infected, such microbial invasion is thought to contribute significantly to the overall number of preterm births.

Researchers cast a wide net and got the results to show for it. They used both PCR and laboratory cultures to determine that 25 of the 166 samples were infected with either bacteria or fungi. Seventeen bacterial and one fungal species were identified in the positive samples.

Infection of the amniotic fluid likely contributes to preterm delivery by causing an inflammatory response in the pregnant woman. It occurs most commonly either by microbes from the vagina that infiltrate the amniotic sac, or by microbes that travel through the mother’s bloodstream from other parts of her body, such as the mouth. In fact, both gum disease and bacterial vaginosis have been shown to increase a woman’s risk of delivering her baby prematurely.

Speaking personally, I would think (check with your doctor) that a good regimen of probiotics would be helpful. "Good" bacteria have the effect of minimizing the bad ones.

Dave

Tuesday, August 26, 2008

Scientists Discovering New Approaches to Diabetes

Typically, the solution to type 1 diabetes is insulin. However, in an important laboratory recently (UT Southwestern Medical Center) a number of terminally ill rodents with type 1 diabetes have been restored to full health with a single injection of a substance other than insulin.

Type 1 diabetes (insulin-dependent diabetes) in humans has been treated since 1922 by injecting insulin to lower high blood sugar levels and prevent diabetic coma. New findings by UT Southwestern researchers, which will appear soon in the Proceedings of the National Academy of Sciences suggest that insulin isn’t the only agent that is effective. They've discovered that leptin, a hormone produced by the body’s fat cells, also lowers blood glucose levels and maintains them in a normal range for extended periods. This is really good news; it may lead at some point to a whole new way of treating Type 1 diabetics.

“The fact that these animals don’t die and are restored to normal health despite a total lack of insulin is hard for many researchers and clinicians to believe,” said Dr. Roger Unger. This fellow, a professor of internal medicine and senior author of the study, says that many scientists thought it would be a waste of time to give leptin in the absence of insulin. He believes that many doctors have been "brainwashed into thinking that insulin is the only substance that can correct the consequences of insulin deficiency."

The mechanism of leptin’s glucose-lowering action appears to involve the suppression of glucagon, a hormone produced by the pancreas that raises glucose levels. Rsearchers tested whether a single injection of the leptin gene given to insulin-deficient mice and rats on the verge of death from diabetic coma could reverse the severe condition and prevent the animals from dying. The animals that received the leptin gene began producing excessive amounts of leptin, which reversed all the measurable consequences of type 1 diabetes including weight loss, hyperglycemia and ketoacidosis, a potentially fatal condition that develops when the body doesn’t have enough insulin to meet basic metabolic requirements.

“These animals were actually dying,” write the researchers. “But if we gave them the leptin gene, within two weeks, the terminally ill rodents were restored to full health without any other treatment.”

Dave

Monday, August 25, 2008

The Move to Make Aging a Disease

We see them all the time, the 30 or 60 second spots on TV that show an older person enjoying life with their grandchildren, or looking passionately at their spouse as they enter the bedroom with a wink to the camera. No matter what ails the aging person, pharmaceutical companies have something to offer to improve those "symptoms."

Does it seem like these huge corporations are trying to make billions of dollars in profits out of what are simply normal aspects of aging? Personally, I think so.

Recently I read the book "How Doctors Think" by Dr. Jerome Groopman. In that excellent book, Groopman makes the case that certain aspects of aging may not need to be "fixed." The example he gives is of testosterone replacement for aging men. There doesn't appear to be much of a case for most of what these testosterone replacement drugs are prescribed for, as lowered testosterone levels are just a part of life. Men can perform well in all aspects of their life even when their testosterone levels dip as much as 50% below normal.

The market for these drugs began a number of years ago when advertisements were being developed by pharma companies that target consumers. A Time magazine ad showed a car running with its fuel gauge nearing empty. "Fatigued? Low sex drive? Depressed mood?" it asked the readers. It showed the same car with its fuel gauge set at full at the bottom of the ad. (How's that for skirting FDA requirements for making unsupported claims?).

This is where the expression "male menopause" comes from. The market grew from nothing to hundreds of millions or more in sales. Another example of how the pharmaceutical industry influences us all lies in the original best-seller behind female hormone therapy, Feminine Forever, by Dr. Robert A. Wilson. After reaching the top of the charts, it was discovered that the doctor was paid to write it by a pharmaceutical company.

I think we all need to look a bit more critically at pharmaceutical industry ads and marketing methods in the future.

Dave

Sunday, August 24, 2008

Ear Infections Can Lead to Taste Problems and Obesity

Anyone who has raised a child knows that small children get ear infections quite often. New research shows that that this painful rite of passage may be linked to people’s preference for fatty foods, which increases their risk of being overweight as they age. At the American Psychological Association’s 116th Annual Convention, scientists from around the world discussed these chronic problems in children.

“Middle ear infection is a common childhood disease and obesity is a growing problem worldwide,” said Linda Bartoshuk, PhD, of the University of Florida. “Any potential association between these two public health issues is of considerable interest.” Bartoshuk presented some preliminary findings that a strong link between localized taste damage from chronic middle ear infections (or otitis media) and an increased preference for high-fat foods.

A series of studies address this issue. In one, 6,584 people between 16 and 92 years old responded to a series of health questions that determined their history of middle ear infections, comparing them with their body mass index (BMI). Those with a moderate to severe history of ear infections were 62 percent more likely to be obese.

In another piece of research, Dr. John Hayes of Brown University and his colleagues at the University of Connecticut found associations between otitis media exposure, taste, food choice and obesity. Among middle-aged women, those with taste functioning consistent with taste nerve damage preferred sweet and high fat foods more and were more likely to have larger waists. In another study, they found preschoolers with a severe history of ear infections ate fewer vegetables and more sweets and tended to be heavier. “This suggests that taste damage from ear infections may alter food choice and thus lead to obesity risk.” said Hayes.

A researcher at the University of Minnesota also spoke about recent findings that showed ear infections treated with tubes can also lead to higher body mass in toddlers. Obesity has doubled over the past 20 years among preschool children. Perhaps chronic ear infections are just one reason for this?

Dave

Wednesday, August 20, 2008

Wham: The Best Lycopene is in Home Made Tomato Sauce

Lycopene is a hot commodity right now on healthy sites like this one. It is a tomato ingredient with tremendous disease fighting power. But, new research is proving that the lycopene in tomatoes can become much more powerful when there is heat processing applied before ingestion.

Ohio State University research suggests that turning up the heat on the red tomato during processing has the potential to give the popular garden staple added power. Scientists there have found that lycopene molecules in tomatoes that are combined with fat and subjected to intense heat during processing are restructured in a way that appears to ease their transport into the bloodstream and tissue.

The tomato is the primary food source of lycopene, a naturally occurring pigment linked to the prevention of cancer and other chronic diseases. Lycopene is also available in supplement form, but it is unclear as to the digestibility of the ingredient as a supplement. Like most ingredients, it's better to get the biochemical in its food form.

In its standard structure in the average red tomato, the lycopene molecule is laid out in a way that hinders the molecule’s absorption through intestinal walls and into the blood. Steven Schwartz, a professor of food science and technology at Ohio State, has found that most of the lycopene that is found circulating in human blood is configured in a another molecular form -- a form that actually appears "bent." This means that either the human body somehow transforms lycopene molecules through reactions that have yet to be identified, or that the bent molecular structures of lycopene are much more likely to be absorbed into the blood and transported to tissue – a necessary step in preventing disease.

Schwartz and colleagues have devised a way to process red tomatoes by applying heat and fat, producing a sauce that seems to speed the ingestion and absorption of lycopene into the body. Professor Schwartz described the research today (8/20) at the American Chemical Society meeting in Philadelphia.

Heat is essential to the process, but so is adding some fat, Schwartz said. In previous work, he and colleagues determined that consuming fat and lycopene simultaneously improved absorption, but the scientists weren’t sure exactly why.

Schwartz said most currently available commercial products don’t contain the right [bent] type of lycopene molecules. But he noted that some home cooking practices might be able to produce the same results as the special processing method he and colleagues designed. That's why if you are truly interested in lycopene as a supplement to your diet, you'll make your own sauce at home, using meat or oil along with high temperatures, to make the lycopene much more easily absorbed.

“Some people like to cook tomato sauce for prolonged periods, sometimes reheating it day after day, because it tastes better on the second and third day. They add fat by using oil or meat, and that’s going to start to induce [the good kind] of lycopene if fat is present and the cooking continues,” Schwartz said. “So it’s possible people could induce this process and increase lycopene absorption by routine food preparation procedures.”

Dave

Tuesday, August 19, 2008

How Much Arsenic is in Your Drinking Water?

I recently read a press release from Johns Hopkins about the damage that small amounts of arsenic may cause when it is in your drinking water. When I read some of this new research, I immediately looked further to see exactly what I am drinking. Sure enough, my water here in Sedona contains some arsenic.

Arsenic is a semi-metal element in the periodic table. It is odorless and tasteless. It enters drinking water supplies from natural deposits in the earth or from agricultural and industrial practices. Some of arsenic's effects can include thickening and discoloration of the skin, stomach pain, nausea, vomiting; diarrhea; numbness in the hands and feet, partial paralysis, and even blindness. Arsenic has been linked to cancer of the bladder, lungs, skin, kidney, nasal passages, liver, and prostate.

The EPA has set the arsenic standard for drinking water at 10 parts per billion to protect consumers served by public water systems from the effects of long-term, chronic exposure to arsenic. Still, many public water systems flirt with these numbers and even this trace amount can be dangerous.

Take the example from Johns Hopkins, Bloomberg School of Public Health, which has found that arsenic may increase the risk of developing type 2 diabetes. The study found that individuals with diabetes had higher levels of arsenic in the urine compared to individuals without diabetes. The results are published in the August 20, 2008, issue of JAMA.

“Our findings suggest that low levels of exposure to inorganic arsenic may play a role in diabetes,” said Ana Navas-Acien, MD, PhD, lead author of the study and assistant professor. “While prospective studies are needed to establish whether this association is causal, these findings add to the existing concerns about the long-term health consequences of low and moderate exposure to inorganic arsenic.”

Inorganic arsenic is found naturally in rocks and soils. In the U.S., most exposure to inorganic arsenic comes from contaminated drinking water. Foods such as flour and rice can also provide small quantities of inorganic arsenic, particularly if grown or cooked in areas with arsenic contamination in soil or water.

Researchers examined randomly selected urine samples taken from 788 U.S. adults 20 years or older that participated in a 2003—2004 National Health and Nutrition Examination Survey. The results were adjusted for diabetes risk factors, including body mass index and for organic arsenic compounds found in seafood.

Areas where the concentration of inorganic arsenic in the public water supply exceeds those EPA standards include the West, Midwest and Northeast regions. Dietary intake of inorganic arsenic in the U.S. ranges from 8.4 to 14 micrograms per day for various age groups.

Dave

Monday, August 18, 2008

Antidepressants Appear to Impact Driving Safety

A study just released at the annual convention of the American Psychological Association suggests that people taking prescription antidepressants appear to drive worse than people who aren’t taking such drugs, and that depressed people on antidepressants have even more trouble concentrating and reacting behind the wheel.

University of North Dakota psychologists recruited 60 people to participate in a driving simulation in which participants had to make a series of common driving decisions, such as reacting to brake lights, stop signs or traffic signals while being distracted by speed limit signs, pylons, animals, other cars, helicopters or bicyclists. The simulation tested steering, concentration and scanning. Thirty-one of the participants were taking at least one type of antidepressant while 29 control group members were taking no medications with the exception of oral contraceptives in some cases.

The group taking antidepressants was further divided into those who scored higher and lower on a test of depression. The group taking antidepressants who reported a high number of symptoms of depression performed significantly worse than the control group on several of the driving performance tasks. Those who did not report depression scored in the normal range.

This research is important in light of the rapid increase in the number of Americans taking antidepressants. Americans’ use of antidepressant drugs such as Prozac, Paxil or Zoloft, nearly tripled in a decade, according to the 2004 Health United States report, issued by the National Center for Health Statistics. Among women, one in 10 takes an antidepressant drug, according to the government.

It is important to note that while the results of herbal supplements were not tested on the same simulations, herbal products such as St. Johns Wort or Rhodiola rosea may be a safer alternative. Rhodiola rosea is one of the fastest growing categories in the herbal dietary supplement category for depression; the herb is noted to increase cognition and mental acuity, which should make drivers more aware of safe driving practices.

Dave

Friday, August 15, 2008

Mushrooms are a Healthy Substitute for Meat

Anyone trying to lose a few pounds would be interested in a new study out of Johns Hopkins, conducted by Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center.

The clinicians at Hopkins studied the effects of substituting mushrooms for lean ground meat, and found it to be an excellent substitute for preventing or treating obesity. Preliminary research shows these mushroom entrées as just as satiating and palatable as meat entrées. This is good news for the more than one-third of U.S. adults age 20 and older who are obese, according to the Center for Disease Control. Obesity is a risk factor for cardiovascular disease, certain types of cancer, and type 2 diabetes.

In the study led by Dr. Cheskin, funded by the Mushroom Council, study participants were randomly chosen to receive either beef or mushroom lunch entrées over four days – lasagna, napoleon, sloppy Joe and chili. Subjects then switched entrées to consume the other ingredient (mushroom or beef) the following week.1

Energy (calorie) intakes were significantly higher during meat meals than mushroom meals, a difference that averaged 420 more calories and 30 more fat grams per day over the four-day test period. Subjects' ratings for palatability (meal appeal), appetite, satiation (after meal fullness) and satiety (general fullness) did not differ between groups.

That's a very good sign, because typically when another, lower-calorie substitution is made in meat dishes, the dieter finds other ways to bring in additional calories. This did not happen with the mushrooms.

"The most intriguing finding was that subjects seemed to accept mushrooms as a palatable and suitable culinary substitute for meat," said Dr. Cheskin.

The preliminary findings of Cheskin's team follow findings from other initial data that suggested if men substituted a 4-ounce Portabella mushroom for a 4-ounce grilled hamburger every time they ate a grilled hamburger over the course of a year, and didn't change anything else, they could save more than 18,000 calories and nearly 3,000 grams of fat.3 That's the equivalent of 5.3 pounds or 30 sticks of butter. More research is needed to further understand mushrooms' role in weight management as a low-energy density food.

Dave

Tuesday, August 12, 2008

Wham: Lack of Vitamin D Seen in Link to Chronic Pain in Women

As you know, Vitamin D is the nutrient made by the skin when it is exposed to sunlight. It is also a fairly easy nutrient to add via supplementation.

British researchers who studied nearly 7000 45-year-olds found that almost 15% of women with vitamin D shortages reported experiencing chronic pain - nearly twice the 8.2% prevalence reported among women with higher readings.

This wasn't true with men, however. Oddly, vitamin D levels appeared to make no difference in the number of men who reported pain symptoms.

Further studies are required to establish whether pain would be lessened if patients increased their vitamin D intake, but it is a relatively easy step for physicians to suggest more D to their chronic pain patients when tests show their levels of the nutrient are low.

This study was published recently in the journal Annals of the Rheumatic Diseases. The authors included medical data from 6824 persons who were examined between 2002 and 2004, when they were at age 45. Information was collected on their smoking and alcohol habits, time spent outdoors, time spent watching television or at a computer and dietary supplements, including vitamin D.

Dave

Friday, August 8, 2008

Bone Density Drugs May Have Nasty Side Effects

Some of the most-advertised drugs are those used for treating bone density problems in women, such as osteoporosis. Doctors often prescribe these drugs, known as bisphosphonates, for this condition as well as certain cancers.

These medications (such as Boniva® or Fosamax®) can help promote bone density in women with osteoporosis, and taken intravenously, they can help stop the spread of cancer in chemotherapy patients. However, the use of bisphosphonates has also been linked to osteonecrosis of the jaw, more commonly known as “dead jaw.”

How's that for a side effect? The ability to eat, talk, and manipulate one's mouth would seem to be a rather crucial part of day-to-day life.

This issue, osteonecrosis, occurs when part of the jawbone essentially dies and becomes exposed. The disease is more prevalent among patients who receive bisphosphonates through an I.V., but Jon Suzuki, D.D.S, Ph.D., M.B.A., professor and director of the graduate program in periodontology at Temple University’s Maurice H. Kornberg School of Dentistry, says physicians and dental professionals should still keep a close eye on their patients who take the oral form as well.

Previous studies have found between 1 and 10 patients out of 100 who receive bisphosphonates through an IV are at risk of the disease, while only about 1 in 100,000 patients taking the oral form are at risk. Still, those are odds you may not have considered when the doctor suggested these medications you see advertised on TV all day long.

Existing research suggests that taking these medications orally for more than three years or intravenously for more than six months could disturb the balance between bone cells that produce calcium and those that remove calcium. This condition can lead to oral health problems including loose teeth, jaw and gum pain, swelling and infection, numbness and gum loss.

Dave

Thursday, August 7, 2008

Sham: Two Common Infertility Treatments Show Little Effect

It looks as if two of the long established medical interventions that doctors use to help couples with infertility problems do not improve fertility, according to a study published in the British Medical Journal (bmj.com).

One in seven couples in Great Britain experience infertility; the numbers are nearly the same in most developed countries. Unexplained infertility affects a quarter of these couples and common interventions to help them have been used for many years. One of those is the drug clomifene citrate, and the other is actual intra-uterine insemination of what is called "unstimulated" sperm.

As it turns out, in this research a team of researchers led by the University of Aberdeen compared the effectiveness of these two specific interventions with women who had no treatment at all.

They recruited 580 women who had experienced unexplained infertility for more than two years from four teaching hospitals and a district general hospital in Scotland. The women were randomized into three groups—one group of women were encouraged to try naturally for a pregnancy without any medical interventions at all; one group took oral clomifene citrate (CC) which is believed to correct subtle ovulatory dysfunction; and the last group had unstimulated intra-uterine insemination (IUI) of sperm.

Overall, 101 women became pregnant and had a live birth during the course of the study. That's good, as pregnancies were the goal of the program. Unfortunately, the numbers did not bear out any statistical improvements for those who had the medical interventions.

The women with no interventions had a live birth rate of 17%, the group taking oral CC had a birth rate of 14%, and the group having unstimulated sperm injections had a birth rate of 23%. While that sounds like a modest improvement, it would have to be a greater improvement than 6% to be statistically meaningful. [ADDED LATER: As pointed out by reader James in a discussion of this material, when you can't conceive, even a low level shot at improving your odds may be worth trying].

Side effects for women including abdominal pain, bloating, hot flushes, nausea and headaches were highest in women taking oral CC, affecting 10–20% of women. Combined with the lower results in pregnancies, these side effects certainly appears to make that drug a poor choice. This product is marketed under various names, including Clomid, Serophene, and Milophene.

The researchers conclude: “These interventions, which have been in use for many years, are unlikely to be more effective than no treatment.”

Dave

Tuesday, August 5, 2008

Psychotropic Drugs for Children: 75% of their use is "Off Label"

Dr. Julie Zito, professor of pharmacy and psychiatry at the UMB School of Pharmacy (Baltimore, MD) recently authored a study of how psychotropic medications are frequently used on children in the USA. These drugs act on the central nervous system to alter emotion or behavior temporarily.

While Zito's study was specifically how doctors treat youths in foster care, her paper tells us a great deal about the general overuse of these drugs beyond what has been approved by the US Food and Drug Administration.

Because there is a lack of “substantive evidence of their effectiveness and safety,” according to Dr. Zito, this issue should be recognized as a real danger to children. Doctors are over-medicating kids with drugs that were never designed for their growing bodies. "We are generalizing our [knowledge] from adults to children without knowing enough about pharmacokinetics, dosing, or long-term safety in the pediatric population,” warns Zito.

In a study of Texas children with Medicaid coverage, foster care youth received at least three times more psychotropic drugs than comparable children in poor families. But there is no clear treatment advantage to the foster children. The Texas study indicated that decisions to give some children three or more psychotropic drugs may be largely based on behavioral and emotional symptoms rather than conclusive diagnosis of a specific mental condition. “These data do not provide sufficient information to address questions of severity and impairment that might explain such complex drug regimens,” Zito suggests.

These children, it seems, are simply targets for drugs being thrown at them by doctors and pharmaceutical companies with a "who cares" attitude. If it can be billed to Medicaid, than why not.

This study was published earlier this year in the journal Pediatrics. More than 75 percent of the psychotropic medication use for children is off-label, a practice of prescribing drugs for a purpose other than the approved use on its label.

Dave

Monday, August 4, 2008

Women with Vaginal Infections Face Increased Risk in HIV Infection

University of North Carolina at Chapel Hill researchers have found that a common vaginal infection may make women more susceptible to contracting HIV, the virus that causes AIDS.

Data from more than 30,700 women from around the world, detailed in more than 23 scientific studies, shows that women with bacterial vaginosis – the most common type of infection in women of reproductive age – were far more likely than others to be infected with HIV. The association between bacterial vaginosis (BV) and HIV was stronger for women without high-risk sexual behavior. This new data was published in the peer-reviewed journal, AIDS.

Quoting the authors from the UNC press release: “Given that bacterial vaginosis and HIV infection are both transmitted sexually, it is difficult to determine whether associations found are causal, or if there is some other reason why women with BV are more likely than others to become infected with HIV,” said Jennifer S. Smith, epidemiology research assistant professor in the UNC School of Public Health. The authors indicate that future prevention of HIV infection should include placing more importance on the treatment of BV.

Bacterial vaginosis is an imbalance in the type of bacteria normally found in the vagina. BV has been shown to cause gynecological and obstetrical problems including preterm delivery, pelvic inflammatory disease and upper genital tract infections. Other research has shown that BV results in several changes in the vagina that could explain why it increases the risk of HIV, such as a depletion in a type of bacteria that are believed to play a role in defending the vagina against microorganisms including HIV, and higher pH levels that may increase the adherence and survival of the virus.

As I read the details on this one (in bold text above), I am reminded of how important the colonization of "friendly" bacteria are to personal health and hygiene. Hopefully, suppliers of probiotic products are working on ways for women to replenish the friendly bacteria in this part of the body in order to keep BV at bay, and to have a higher level of protection against HIV.

The studies analyzed by Smith and colleagues included women from the U.S., Malawi, Kenya, South Africa, Thailand, Uganda, Zimbabwe, Tanzania, South Africa, Nigeria, Burkina Faso and Gambia. Prevalence of BV in women in these countries ranged from about 11 percent to as high as 70 percent.

The analysis of data indicates that BV increases the risk of acquiring HIV by about 60 percent.

Dave

Friday, August 1, 2008

Strokes Can Happen at Any Age

Many people believe that strokes only happen to senior citizens. My Mom had a stroke, and I remember a very nice neighbor of ours had a stroke a couple of years ago. She was also an older person. Recently, a press release came across my desk from the Loyola University Chicago Stritch School of Medicine which describes strokes happening in children. It was after reading this that I realized strokes are a lot more common than I had thought.

The material I read describes young Sideria Hendricks of Forest Park, Illinois, only 10 years old, who has already suffered from two strokes. The first occurred on Christmas Eve a few years ago. Sideria suddenly couldn't speak, and her left arm and left leg went limp. She eventually recovered, but later she suffered a second minor stroke.

This young lady has sickle cell disease, which is among the more than 100 risk factors for strokes in babies, children and young adults that Dr. Jose Biller, chairman of the department of neurology at Loyola University Health System,has identified in a new publication. Although strokes are among the top ten causes of death in childhood, family members and doctors often are slow to recognize the symptoms.

Biller is co-author of new guidelines for the prevention and treatment of strokes in infants and children. The guidelines are published in Stroke: Journal of the American Heart Association.

Strokes can occur at any age -- even before birth. According to conservative estimates, about 3,200 strokes occur each year in youths under age 18. And more than 3,000 people under age 45 die of strokes each year. This age group accounts for between 5 percent and 10 percent of all strokes. Survivors can experience lifelong learning disabilities, seizures, movement disorders, language problems, cognitive deficits and paralysis on one side of the body. Between 6 percent and 20 percent of children who have strokes die, and at least half are left with some degree of disability.

"The impact of strokes in this age group is devastating to the child or young adult, their families and society," Biller said.

In older adults, about 85 percent of strokes are "ischemic," meaning they are caused by blood clots. About 15 percent are caused by hemorrhages (bleeding). By contrast, nearly half of strokes in children are caused by hemorrhages. Causes of hemorrhagic strokes in children include malformations of blood vessels in the brain, illicit drug use (cocaine, amphetamines, heroin, hallucinogens, amphetamine look-alikes, etc.) systemic infections, brain tumors and blood disorders such as hemophilia and sickle cell disease.

Sickle cell disease can cause several different forms of stroke. For example, misshapen red blood cells can clog the flow of blood in the brain. To reduce the risk, Sideria receives blood transfusions every three weeks. The quicker a child or young adult is diagnosed and treated for a stroke, the better the outcome. But family members often are slow to recognize strokes. Symptoms can be more subtle in children. It's especially difficult to recognize symptoms in babies who have not begun to walk or talk.

Dave