Some 20 Million Condoms Recalled In South Africa

South Africa's health department said Tuesday it has recalled 20 million potentially defective condoms approved by an official accused of taking bribes from a manufacturer.

Unsafe sex is especially risky in South Africa, which has one of the world's highest HIV infection rates with an estimated 12 percent of its 47 million people infected with the virus.

There are up to 1,000 AIDS-related deaths in South Africa every day and free condom distribution is a crucial part of the government's efforts to combat the spread of the epidemic.

"An official of the South African Bureau of Standards (SABS), has put millions of people at risk by illegally passing millions of condoms, which had not met the quality assurance requirements," said health department spokesman Sibani Mngadi.

Mngadi said even though only a batch of 7 million condoms was affected, the department decided to recall all 20 million condoms supplied by the manufacturer since last year, and will no longer be dealing with that company.

The SABS official accused of taking bribes and two directors of the manufacturing company have been arrested and are out on bail, said the spokesman. They will be appearing in a Pretoria court on September 10 to face charges of corruption and fraud.

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LEGAL ACTION

The condoms did not meet several standard tests for strength, pressure and lubrication, said Mngadi.

The SABS Web site alerted the public, saying the faulty condoms were distributed by brand names including Ultramour, Randy Rat and Positions.

SABS said it had instructed Latex Surgical Products (LSP) to recall the condoms and that it would take legal action against the manufacturer.

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The Health Department is also recalling condoms produced by LSP from its national HIV/AIDS supply chain.

LSP was not immediately available to comment.

Besides a struggling health-care system characterized by a lack of doctors and nurses, many of whom have left the country for better pay abroad, the fight against AIDS has been hampered by conflicting messages from senior government officials.

Researchers, scientists and health-care workers said in a conference in South Africa in June that they were encouraged by the government's fresh approach to the crisis and improved weapons to protect those most at risk of infection.

But fresh controversy over the government's AIDS policies has erupted.

President Thabo Mbeki sacked Deputy Health Minister Nozizwe Madlala-Routledge this month for insubordination, sparking an outcry from AIDS activists who strongly backed her policies and critics who say she was fired for political reasons.

Madlala-Routledge had clashed with Health Minister Manto Tshabalala-Msimang, dubbed "Dr Beetroot," who had horrified

AIDS activists with her advocacy of garlic, lemon and African potatoes over conventional anti-retroviral drugs.

The health department said it does not know how many of the defective condoms have been used, and it is urging the public to return them.

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Moderate Exercise Relaxes Blood Vessels

Moderate exercise might help older adults' blood vessels relax, a study has found - pointing to one reason why exercise lowers the risk of heart attacks and strokes.

As people age, their blood vessels can become more constricted and less pliable in response to blood flow, a change that contributes to high blood pressure and clogged arteries.

But in the new study, older men who took up regular exercise were able to substantially reduce this effect of ageing.

The findings are good news for sedentary older adults, researchers say, because the benefit required only moderate activity - namely, taking a walk five times a week.

"This is exercise that I would stress can be done by most older adults," said senior study author Dr Christopher A. DeSouza of the University of Colorado in Boulder.

He and his colleagues report the findings in the medical journal Hypertension.

The study included 28 healthy but sedentary men: 13 in their 20s and 15 in their 60s. For the first phase of the research, DeSouza and his colleagues used a test called plethysmography to measure blood vessel function in each man's forearm. They found that the older men's blood vessels were generally more constricted than those of their younger counterparts.

Next, the researchers had eight of the older men begin a three-month exercise program, while the rest remained sedentary. The exercisers worked out moderately, typically walking for about an hour, five days per week.

At the end of the three months, the exercise group showed a sharp turnaround in blood vessel constriction - with test results looking more like those of the younger men from the earlier study than the sedentary group their own age.

The improvement in blood vessel function occurred without improvements in the men's weight, body fat, blood pressure or other traditional indicators of heart health.

This is important, DeSouza told Reuters Health, because even if people aren't seeing obvious benefits from exercise - like a smaller waistline - they may still be making improvements on the inside.

Another key point, he noted, is that all of the older men in the study had been long-time couch potatoes, yet were still able to benefit from starting an exercise routine in their 60s.

"It's that old adage, 'It's never too late to start," DeSouza said.

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Short-Burst Oxygen Therapy Benefits Few COPD Patients

Although home use of short-burst oxygen therapy is widely prescribed in the UK for patients with COPD, it may be helpful only in a small minority of patients, researchers report in the current issue of Thorax.

"Short-burst oxygen therapy is used extensively despite little evidence of benefit," lead investigator Dr Simon J Quantrill told Reuters Health. Although "18 million pounds ($A44.13 million) per year are spent on oxygen cylinders used for short-burst oxygen therapy," he noted, "no guidelines exist on how and when to use short-burst oxygen therapy."

To investigate whether short-burst oxygen therapy helps COPD patients with daily activities, Quantrill and colleagues at Whipps Cross University Hospital, London, studied 39 patients who all reported that short-burst oxygen therapy was helpful.

They were asked to choose two routine activities, such as walking upstairs or vacuuming, for which they used short-burst oxygen therapy to relieve breathlessness. The patients were then given two cylinders, one of which contained oxygen and the other, compressed air.

Using nasal prongs, the participants inhaled from one cylinder to recover from breathlessness after performing one of the tasks, and then, at least 15 minutes later, they used the other cylinder after repeating the task. The subjects then went on to use the same two-cylinder procedure for their other chosen activity.

Based on the results of pulse oximetry, the average recovery time over two activities was 38 seconds less when oxygen rather than compressed air was inhaled. The recovery time reported by the patients was about the same, at 34 seconds.

Five of the patients were able to correctly identify when oxygen was employed and the difference in recovery times with oxygen versus indicated a greater benefit of oxygen therapy.

"There may be a small group of patients with severe COPD who do in fact benefit" from short-burst oxygen therapy, Quantrill said.

Nevertheless, he noted, "this needs further research with bigger numbers of patients." Moreover, Quantrill concluded, "further research is needed to be able to produce guidelines on short-burst oxygen therapy usage."

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Inflammatory Bowel Disease Low Among Children Exposed To Farm Animals

Infants who are regularly exposed to farm animals appear to be less likely than others to develop inflammatory bowel disease in childhood, according to the findings of a German study published in the journal Paediatrics.

"Approximately 12,000 children and adolescents in Germany suffer from inflammatory bowel disease (IBD)," write Dr Katja Radon and colleagues at Ludwig-Maximilians-University, Munich.

The recent increase in Crohn's disease, a type of inflammatory bowel disease, especially in industrialised countries, and its pronounced geographical variation, suggest that environmental factors contribute this condition.

The researchers examined the association between contact with farm animals in infancy and the development of Crohn's disease or ulcerative colitis in childhood. Data were analysed for 748 IBD cases (444 with Crohn's disease and 304 with ulcerative colitis) and 1,481 healthy "control" children.

The children with IBD were more likely than the control children to live in urban areas. Regular contact with farm animals during the first year of life was inversely associated with IBD, the investigators report.

Specifically, the children with Crohn's disease or ulcerative colitis were about 50 per cent less likely to have regular contact with farm animals in infancy compared with the healthy children.

"The results of this study indicate that farm animal contact during infancy, one of the major factors protecting individuals against childhood allergies, might also decrease the risk of juvenile IBD," Radon's team concludes. The findings also support the hypothesis that allergic diseases and IBD might have similar paths of development.

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Alcohol Reduces Risk Of Kidney Cancer

Alcohol consumption may lower the risk of developing kidney cancer, according to a report in the British Journal of Cancer.

Dr Alicja Wolk from the Karolinska Institute, Stockholm, and colleagues investigated the association of different types of alcoholic beverages and of total alcohol consumption with the risk of kidney cancer in a large population-based study in Sweden.

The study involved 855 subjects with kidney cancer and 1204 "controls" without cancer.

They reported their alcohol consumption in terms of standard portion sizes - a glass of beer being 200 millilitres, a glass of wine being 100 mL, and a glass of strong wine or hard liquor equal to 40 mL.

The investigators rated the alcohol content of different beverages: medium-strong beer had 2.8 grams alcohol per 100g, red wine had 9.9 g per 100 g, and hard liquor 32g alcohol per 100g.

The team found that the odds of developing kidney cell cancer was about 40 per cent lower among those who consumed 620g ethanol per month compared to those who did not drink at all.

Drinking more than two glasses of red wine per week was associated with a 40 per cent reduction in kidney cell cancer risk compared with drinking no red wine, the investigators observed, and there were similar trends for more than two glasses per week of white wine or strong beer.

In contrast, there was no relation between kidney cell cancer risk and consumption of light beer, medium-strong beer, strong wine, or hard liquor.

"A reduced risk associated with consumption of wine and beer might be due to the phenolics they contain as these possess antioxidant and antimutagenic properties," the authors speculate.

"However, the lower risk that we observed for three different alcoholic beverages and total ethanol intake suggests that alcohol itself rather than a particular type of drink is responsible for the reduction in risk.

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Pregnancy Where Orgasm Is Not Safe.

Orgasms cause the uterus to contract, sometimes with great intensity, lasting for one-half to one hour after intercourse. Contractions are more frequent as the due date approaches, but may be present in the early second trimester. In general, these contractions do not result in a change in the cervical dilatation or effacement.

If contractions persist for more than an hour after intercourse, or if there is an increase in pelvic pressure or heavy vaginal bleeding, you should contact your caregiver immediately.

For most women, intercourse results in no problems. However, in certain high risk pregnancies (premature labor, incompetent cervix, multiple gestations, placenta previa), "pelvic rest" is advocated to decrease the possibility of premature labor or bleeding. There currently is great debate over the relationship of intercourse to premature labor.

Chemicals present in seminal fluid, called prostaglandins, also cause increased uterine activity. For some women near term, unprotected intercourse can result in more contractions that may cause cervical dilatation or effacement. However, it is impossible to predict who would benefit from having intercourse to stimulate the onset of labor.

Quite often, the mother's pregnant abdomen can cause intercourse to be awkward, and some couples worry that intercourse may, in some way, harm the fetus. In an uncomplicated pregnancy, intercourse is completely safe for both mother and child.

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Bird flu Spreads To 2 More Provinces In Vietnam

Bird flu has spread to two more provinces in Vietnam, killing hundreds of chickens and ducks, the Agriculture Ministry says.

The outbreak of H5N1 in the northern province of Thai Nguyen and Dong Thap to the south brought to four the number of provinces on the government's current bird flu watchlist.

Vietnam has 64 provinces.

A total of 150 ducks and 35 chickens fell sick on Wednesday in Thai Nguyen, 80 km north of Hanoi, and tests have confirmed they had the H5N1 virus, the ministry's Animal Health Department said in a report.

The virus also struck a farm in the southern Mekong delta province of Dong Thap where 250 chickens were found dead on Sunday, it said.

Bird flu has infected seven people in Vietnam so far this year, four of whom have died, bringing the death toll since late 2003 to 46, the government said.

Globally, the H5N1 virus has killed 195 people out of 322 known cases, according to a tally of the World Health Organisation. Hundreds of millions of birds have died or been slaughtered.

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Impotence Drug, Viagra, Increases Feelings Of Love

Impotence drugs such as Viagra may do more than help men physically have sex - they may also boost levels of a hormone linked with feelings of love, US researchers said today.

Viagra, known generically as sildenafil, raised levels of the hormone oxytocin in rats, the team at the University of Wisconsin-Madison said in a report published in the Journal of Physiology.

This hormone is involved in nursing and childbirth but also in orgasm and feelings of sexual pleasure.

And it seems Viagra and related drugs act on the part of the brain that controls release of oxytocin, said Wisconsin physiology professor Meyer Jackson.

"This is one piece in a puzzle in which many pieces are still not available," Prof Jackson said.

"But it raises the possibility that erectile dysfunction drugs could be doing more than just affecting erectile dysfunction."

Viagra, made by Pfizer, is an inhibitor of an enzyme called phosphodiesterase type 5.

Related drugs such as Eli Lilly's Cialis, known generically as tadalafil, and Levitra or vardenafil, sold by GlaxoSmithKline, Bayer and Schering-Plough, are also PDE-5 inhibitors.

They block this enzyme, which in turn breaks down other compounds. This increases blood flow in the muscles but it also affects a brain structure known as the posterior pituitary.

This, in turn, boosts oxytocin, at least in the rats. It probably does the same thing in people, Prof Jackson said.

"It does the same thing it does in smooth muscle - instead of (levels) coming down in a minute or two, they stay up a little longer," Prof Jackson said.

Oxytocin was known for years to be involved in labour and it is the hormone that causes the "let-down" of milk in breastfeeding babies. Only in recent decades has it been found to have a function in men - in sexual arousal and function.

This could suggest other uses for Viagra and related drugs, Prof Jackson said - perhaps promoting social bonding.

"What I hope is that people read our paper who can test these ideas in animals and humans," Prof Jackson said.

"I hope that this doesn't cause some wild orgy of inappropriate recreational use."

Some groups have complained that people use the impotence drugs for fun, instead of using them as prescribed for sexual dysfunction caused by low blood flow to the genitals.

The drugs can cause fatal side-effects if used with certain other drugs, and some studies also suggest they may affect the eyes in some patients, so doctors stress they are not for casual use.

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West Nile Virus Infection Reported In The State Of Indiana

Indianapolis State health officials report two probable human cases of West Nile virus, one in Lake County and another in Randolph County. These are the first two human cases of West Nile virus infection in Indiana this year. In 2006, there were 80 cases of West Nile virus, including 5 deaths.

"West Nile virus is potentially a very serious disease," said State Health Commissioner Judy Monroe, M.D. "We have seen cases where healthy, active individuals who become infected with the virus left devastated by the disease, including being unable to walk without assistance. I cannot underscore enough how important it is for people to take the simple steps necessary to protect themselves."

Dr. Monroe recommends that people take the following protective steps when they are outdoors:

* Avoid being outdoors during prime mosquito biting times, dusk to dawn, when possible;
* Apply insect repellent containing DEET, picaradin, or oil of lemon eucalyptus to clothes and exposed skin; and
* Wear long-sleeved shirts and pants.

West Nile virus is transmitted to humans by mosquitoes that have first bitten an infected bird. A person bitten by an infected mosquito may show symptoms three to 15 days after the bite.

Health officials say that although individuals over age 50 are at greatest risk for serious illness and even death from West Nile virus, people of all ages have been infected with the virus and have had severe disease.

The virus usually causes West Nile fever, a milder form of the illness, which can include fever, headache, body aches, swollen lymph glands, or a rash. However, a small number of individuals can develop a more severe form of the disease with encephalitis or meningitis and other neurological syndromes, including flaccid muscle paralysis.

"There is no cure for West Nile virus, but it is preventable," said Dr. Monroe. "In the past, we've seen most of the human cases in the state reported in the months of August and September, so this is an important time for people to protect themselves and their families."

State health officials say the previous hot, dry weather conditions have created the perfect breeding environment for the mosquitoes that carry the West Nile virus.

As a result, Dr. Monroe is also asking Hoosiers to take steps to rid their properties of potential mosquito breeding grounds by:

* Repairing failed septic systems;
* Drilling holes in the bottom of recycling containers that are left outdoors;
* Keeping grass cut short and shrubbery trimmed;
* Disposing of old tires, tin cans, plastic containers, ceramic pots or other unused containers that can hold water;
* Cleaning clogged roof gutters, particularly if leaves tend to plug up the drains;
* Aerating ornamental pools, or stock them with predatory fish; and
* Emptying containers holding water from recent rain storms.

Indianapolis State health officials report two probable human cases of West Nile virus, one in Lake County and another in Randolph County. These are the first two human cases of West Nile virus infection in Indiana this year. In 2006, there were 80 cases of West Nile virus, including 5 deaths.

"West Nile virus is potentially a very serious disease," said State Health Commissioner Judy Monroe, M.D. "We have seen cases where healthy, active individuals who become infected with the virus left devastated by the disease, including being unable to walk without assistance. I cannot underscore enough how important it is for people to take the simple steps necessary to protect themselves."

Dr. Monroe recommends that people take the following protective steps when they are outdoors:

* Avoid being outdoors during prime mosquito biting times, dusk to dawn, when possible;
* Apply insect repellent containing DEET, picaradin, or oil of lemon eucalyptus to clothes and exposed skin; and
* Wear long-sleeved shirts and pants.

West Nile virus is transmitted to humans by mosquitoes that have first bitten an infected bird. A person bitten by an infected mosquito may show symptoms three to 15 days after the bite.

Health officials say that although individuals over age 50 are at greatest risk for serious illness and even death from West Nile virus, people of all ages have been infected with the virus and have had severe disease.

The virus usually causes West Nile fever, a milder form of the illness, which can include fever, headache, body aches, swollen lymph glands, or a rash. However, a small number of individuals can develop a more severe form of the disease with encephalitis or meningitis and other neurological syndromes, including flaccid muscle paralysis.

"There is no cure for West Nile virus, but it is preventable," said Dr. Monroe. "In the past, we've seen most of the human cases in the state reported in the months of August and September, so this is an important time for people to protect themselves and their families."

State health officials say the previous hot, dry weather conditions have created the perfect breeding environment for the mosquitoes that carry the West Nile virus.

As a result, Dr. Monroe is also asking Hoosiers to take steps to rid their properties of potential mosquito breeding grounds by:

* Repairing failed septic systems;
* Drilling holes in the bottom of recycling containers that are left outdoors;
* Keeping grass cut short and shrubbery trimmed;
* Disposing of old tires, tin cans, plastic containers, ceramic pots or other unused containers that can hold water;
* Cleaning clogged roof gutters, particularly if leaves tend to plug up the drains;
* Aerating ornamental pools, or stock them with predatory fish; and
* Emptying containers holding water from recent rain storms.

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Adequate Intake of Vitamin D Reduces Breast and Colon Cancer Rates

Sufficient intake of Vitamin D3 might prevent 60,000 cases of colon and breast cancer every year across the globe, a new study has found.

Vitamin D3 is available through diet, supplements and exposure of the skin to sunlight.

The study was conducted by a team of researchers led by Cedric F. Garland at the Moores Cancer Center at the University of California, San Diego (UCSD).

As part of the study, researchers combined data from surveys of serum vitamin D levels during winter from 15 countries. The data was then applied to 177 countries to estimate the average serum level of a vitamin D metabolite of people living there.

The study found an inverse association of serum vitamin D with risk of colorectal and breast cancer and estimated that 250,000 colorectal cancer cases and 350,000 cases of breast cancer could be prevented worldwide by increasing intake of vitamin D3, particularly in countries north of the equator.

“For the first time, we are saying that 600,000 cases of breast and colorectal cancer could be prevented each year worldwide, including nearly 150,000 in the United States alone,” Garland said.

The researchers suggested that increasing vitamin D levels in populations, particularly those in northern climates, might both prevent and possibly serve as an adjunct to existing treatments for cancer.

“This could be best achieved with a combination of diet, supplements and short intervals – 10 or 15 minutes a day – in the sun. It could be less for very fair-skinned individuals. The appropriate dose of vitamin D in order to reach this level, could be very little in a lifeguard in Southern California… or quite a lot for someone in Northern Europe who tends to remain indoors most of the year,” Garland said.

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Do-Good Protein Related To A Brutal Toxin That Kills

Australian scientists have uncovered an unlikely family relationship between two archenemies in the disease world - a protein that fights infection and a brutal toxin that kills.

In a surprise discovery, researchers found that immune proteins enlisted by the body to fend off cancer and infection belong to an ancient and lethal toxin family previously only found in bacteria.

These bacterial toxins are responsible for deadly diseases like anthrax, flesh-eating disease, gas gangrene and scarlet fever.

The findings, published in the international journal Science, will be used to develop new ways to fight disease.

Study leader Professor James Whisstock, from the School of Biomedical Sciences at Monash University in Melbourne, said he was astounded to find these "yin and yang" fighters - proteins called perforins and nasty bacterial toxins - had a common ancestor.

"Over millions of years of evolution bacteria developed these proteins as weapons of attack," Prof Whisstock said.

"But as it turns out, animals stole that toxin from the bacteria and turned it on the enemy.

"I find that completely extraordinary. It's a molecular arms race and there's still no clear winner."

Perforins got their name because they kill bacteria, virally-infected cells and cancerous cells by punching tiny holes that perforate them.

People who lack one of these perforins can develop a serious blood disease called hemophagocytic lymphohistiocytosis, and may be predisposed to develop cancer, he said.

Prof Whisstock said certain perforins were not only important for defending humans against attack by bacteria and viruses, but also helped propagate the human species because of their role in embryo implantation.

"It is ironic that we fear diseases such as anthrax yet from the same family of toxins comes a protein that is involved in reproduction," he said.

But these proteins could also be dangerous, wreaking "absolute havoc" in the immune system if they're not controlled properly.

The researchers investigated how they work to find ways to control them in infectious diseases and areas such as transplantation rejection.

Using X-ray crystallography, the team worked out the structure of a perforin called Plu-MACPF, which, due to its similarity to the bacterial toxins, told them how the whole perforin family worked.

The findings are a culmination of nine years of research.

"Now we finally know what perforins look like and how they work, we can use this knowledge to develop new ways to fight disease," said co-author Dr Michelle Dunstone.

The research team included scientists from the National Health and Medical Research Council, the Australian Research Council and the Peter MacCallum Cancer Centre.

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Gastric Bypass Surgery Increase Longevity And Drops Obese Weight

Gastric bypass surgery not only helps obese people drop weight and look better, it also helps them live significantly longer, according to two reports published on Wednesday.

The studies in the New England Journal of Medicine confirm what doctors had long suspected but never proved.

The years gained are significant, with life span prolonged by up to 40 per cent and rates of diabetes, cancer and heart disease all lower.

"The question as to whether intentional weight loss improves life span has been answered, and the answer appears to be a resounding yes," Dr George Bray of Louisiana State University wrote in a commentary.

More than 30 per cent of the US population is now considered obese, with severely obese people tending to die five to 20 years earlier than people of healthy weight.

At the same time, more than 100,000 stomach operations of some type are performed in the United States each year to help people lose weight.

One of the studies found that gastric bypass surgery - in which doctors reduce the size of the stomach to limit the amount of food a person can eat - cut the death rate by 40 per cent among 7,925 volunteers who had been followed for an average of seven years.

The risk of heart disease dropped 56 per cent, the diabetes rate was 92 per cent lower and the likelihood of cancer was 60 per cent less compared with 7,925 severely obese people identified by data from their drivers' licences.

But the news was not completely good for the surgery patients.

The chance of death from something other than disease, including accidents, suicide and poisoning, was 58 per cent higher in the surgery group.

Earlier research has shown that obese people who have the operation are more likely to suffer from mood disorders, post-traumatic stress disorder or the after-effects of childhood sexual abuse.

"After a mean follow-up of 7.1 years, in the surgery group, 171 deaths from disease were prevented per 10,000 operations," Ted Adams of the University of Utah School of Medicine and colleagues wrote in their study.

"On the other hand, there was an increase of 35 non-disease deaths per 10,000 operations, for a net prevention of 136 deaths."

The other study, conducted in Sweden, found that about 11 years after surgery, the death rate was 27 per cent lower among 2,010 patients who had undergone some type of operation, including gastric bypass, to lose weight.

That team, led by Lars Sjostrom of Gothenburg University, found gastric bypass produced the greatest sustained weight loss - about 25 per cent - and that the death rate during the follow-up period was 5 per cent in the surgery group, compared to 6.3 per cent among those who did not have an operation.

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World Health Report - Infectious Disease Emerging And Spreading Worldwide

Infectious diseases were emerging more quickly around the globe, spreading faster and becoming increasingly difficult to treat, the World Health Organisation (WHO) has said.

In its annual World Health Report, the United Nations agency warned there was a good possibility that another major scourge like AIDS, SARS or Ebola fever with the potential of killing millions would appear in the coming years.

"Infectious diseases are now spreading geographically much faster than at any time in history," the WHO said.

It said it was vital to keep watch for new threats like the emergence in 2003 of SARS, or Severe Acute Respiratory Syndrome, which spread from China to 30 countries and killed 800 people.

"It would be extremely naive and complacent to assume that there will not be another disease like AIDS, another Ebola, or another SARS, sooner or later," the report warned.

Since the 1970s, the WHO said, new threats have been identified at an "unprecedented rate" of one or more every year, meaning that nearly 40 diseases exist on Friday which were unknown just over a generation ago.

Over the past five years alone, WHO experts had verified more than 1,100 epidemics of different diseases.

With more than two billion people travelling by air every year, the UN agency said: "an outbreak or epidemic in one part of the world is only a few hours away from becoming an imminent threat somewhere else."

The report called for renewed efforts to monitor, prevent and control epidemic-prone ailments such as cholera, yellow fever and meningococcal diseases.

International assistance may be required to help health workers in poorer countries identify and contain outbreaks of emerging viral diseases such as Ebola and Marburg haemorrhagic fever, the WHO said.

It warned that global efforts to control infectious diseases have already been "seriously jeopardised" by widespread drug resistance, a consequence of poor medical treatment and misuse of antibiotics.

This is a particular problem in tuberculosis, where extensively drug-resistant (XDR-TB) strains of the contagious respiratory ailment have emerged worldwide.

"Drug resistance is also evident in diarrhoeal diseases, hospital-acquired infections, malaria, meningitis, respiratory tract infections, and sexually transmitted infections, and is emerging in HIV," the report declared.

Although the H5N1 bird flu virus has not mutated into a form that passes easily between humans, as many scientists had feared, the next influenza pandemic was "likely to be of an avian variety" and could affect some 1.5 billion people.

"The question of a pandemic of influenza from this virus or another avian influenza virus is still a matter of when, not if," the WHO said.

It said all countries must share essential health data, such as virus samples and reports of outbreaks, as required under international health rules, to mitigate such risks.

Accidents involving toxic chemicals, nuclear power and other environmental disasters should also be communicated quickly and clearly to minimise public health threats.

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Sulforaphane From Broccoli, Brussels Sprouts.... Helps to Prevent Skin Disease

Sulforaphane, a chemical present at high levels in a precursor form in broccoli and related veggies (cauliflower, Brussels sprouts, etc.), helps prevent the severe blistering and skin breakage brought on by the rare and potentially fatal genetic disease epidermolysis bullosa simplex (EBS).


The researchers treated newborn mice with a severe form of EBS—so bad they all died within three days—with a topical solution containing sulforaphane and found marked improvement; after four days more than 85 percent of the treated mice were alive and blister-free. These findings appear online this week in Proceedings of the National Academy of Sciences.

The basis of EBS, notes study author Pierre Coulombe, Ph.D., professor of biological chemistry, lies in two specific genes that make proteins known as keratins. Normally, the keratins join together and form highly resilient fibers in the lower portion of skin, helping make it durable. If either keratin is defective, they don’t mesh and the lower skin tissue becomes unusually fragile and gets damaged from the mildest mechanical stress — leading to blistering pain, a higher risk of infection, and in the most severe cases, death.

'Humans have around 54 distinct keratins, many of which are similar in structure and function,' says Coulombe. 'We figured we might be able to exploit this similarity and dial up a replacement by triggering the activation of a suitable signaling pathway in skin.' He predicted that sulforaphane might stimulate the formation of a surrogate skin-strengthening keratin to stand in for the defective one.

The desire to learn more about sulforaphane led Coulombe and his co-workers to Paul Talalay, M.D., professor of pharmacology who had previously identified sulforaphane as a cancer-preventive agent. 'It turns out that treatment with low doses of sulforaphane triggers the expression of selected keratin genes in skin,' says Coulombe. 'So we began what evolved into a highly rewarding collaboration and found it does indeed work in a mouse model for EBS.'


'This is the first suggestion that we may be able to treat this terrible disease,' adds Talalay, a co-author of this study. 'And we didn’t need to invent a new drug; sulforaphane is naturally found in our diet.'

The team will next test whether sulforaphane can stimulate the proper keratin protein in the appropriate subset of human skin cells — a vital matter for any future medical hopes. Beyond that are issues of how effective a topical application would be on human skin, which is considerably thicker than mouse skin, as well as examining the long term effects of sulforaphane treatment.

'If we can clear these important hurdles, then sulforaphane can potentially be a tremendous therapeutic, with the added benefit of having anticancer properties,' Coulombe says. 'And when you consider that the only current option for EBS is wrapping gauze around trauma-prone areas to minimize breakage, and otherwise avoiding infection and making sure blisters heal properly, then even a mild success would be a significant benefit for these patients.'

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New Vaccine To Control Immune System Of Alzheimer's Sufferers

Researchers at the NYU Medical Center believe that a new vaccine can harness the immune system in Alzheimer. The vaccine can fight the pathological form of tau protein, a key protein related to Alzheimer’s disease.

The researchers created the vaccine in mice that suppresses aggregates of tau protein which otherwise amasses into dangerous tangles in the memory center of the brains of Alzheimer’s patients. The research was led by Einar Sigurdsson Ph.D., Assistant Professor of Psychiatry and Pathology at New York University School of Medicine.

The vaccine successfully slowed the deterioration of motor abilities produced by excessive amounts of tau in the central nervous system of mice, according to the study published in the August 22, 2007 issue of the Journal of Neuroscience. Dr. Sigurdsson plans to conduct follow-up studies using mice that slowly develop tangles and cognitive impairments without movement problems.

The study used mice that were genetically engineered to produce abnormal tau proteins early in life. These became entangled in several regions of the central nervous system. The resulting loss of motor coordination was significantly reduced in those immunized with a specific piece of the detrimental tau protein. By producing antibodies that could enter the brain and bind to irregular tau, the immune system prevented their harmful aggregation and associated behavioral impairments.

“This approach may have extensive therapeutic implications because you can specifically target the problematic protein,” said Dr. Sigurdsson. “Tau aggregates are inside the cell, making it especially difficult to develop a therapy to target and clear them from the cell.” Alzheimer’s disease is estimated to affect five million Americans. While treatments exist that may modestly alleviate its symptoms, none delay or prevent the onset of the disease, according to the Alzheimer’s Association.

The disease is associated with neurons in the memory center of the brain becoming choked by the buildup of two types of proteins: tau, which turns destructive when it is prone to forming fibrous tangles, and amyloid beta. Compared to extracellular amyloid plaques, tau aggregates are confined inside of brain cells, making them more difficult to reach.

“It’s likely that there’s a synergism in the pathology,” said Dr. Sigurdsson. “Amyloid pathology may cause tau pathology and tau pathology might cause more amyloid pathology. What you have is a vicious cycle. If you can target both of these proteins you’ll likely have more efficacious treatment.”

The therapeutic approach is based on using fragments of abnormal tau protein as a vaccine. These fragments are studded with phosphate groups, which are thought to promote the aggregation of tau. The antibodies generated by the vaccine are therefore likely to bind to abnormal tau and promote its breakdown. Normal tau, which would be far less affected, has such important biological functions as facilitating transport of chemicals within neurons and maintaining their structure.

In previously published studies and in ongoing work, Dr. Sigurdsson has been developing ways to target the amyloid beta peptide, the other major hallmark of Alzheimer’s disease. Those experiments employed a different but complementary approach and were performed in collaboration with NYU School of Medicine’s Thomas Wisniewski, M.D., Professor of Neurology, Pathology and Psychiatry, David Quartermain, Ph.D., Professor of Neurology and Neuroscience and Physiology and Blas Frangione, M.D., Ph.D., Professor of Pathology and Psychiatry.

The transgenic mice in the new study were predisposed to forming tau tangles early in life. Although a decline in motor abilities had progressed by eight months, the mice still remained healthy enough to walk, feed and attempt simple behavioral tasks. But the mice did not undergo thorough cognitive testing, which requires intact mobility to navigate various mazes.

The battery of behavioral tests at five and eight months of age showed that immunized mice performed better—they traveled faster during exploratory activity, exhibited better balance on a rotating rod and committed less foot-slips while traversing a narrow wooden beam. These mice were also found to have less tau protein tangles in the brain. Object-recognition test showed that immunized mice and their controls remained cognitively normal, although mental deficits were expected to appear after the maximum 8-month period allowed in the study.

The mice in the study also had tau aggregates in the hippocampus, a brain region important for cognition and memory. The vaccine cleared tangles in this region as well, suggesting the immunotherapy could improve cognition.

The antibodies raised by the vaccine must reach the brain by traversing the organ’s protective blockade, the blood brain barrier. “Normally antibodies aren’t getting into the brain in any large quantities,” said Dr. Sigurdsson. “In this animal model—and also in Alzheimer’s disease—there’s a breakdown of the blood brain barrier.

In addition, it is well established that neurons have receptors that can bind to and promote uptake of antibodies and our studies seem to indicate that sick neurons that are accumulating tau aggregates take up more antibodies than healthy neurons. The antibodies then end up at the site where they can interact with pathological tau protein in the neuron, and promote its clearance.”

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Teflon Version Drug From Frog Skin - A Good Antibiotic

A research team led by biological chemist E. Neil Marsh has created a Teflon version drug from frog skin which is a good antibiotic. This new drug is much better at preventing bacterial defenses and it also enhances their efficiency.

This natural antibiotic called antimicrobial peptides (AMPs) is produced by all animals from insects to human especially in injured or infected frog skin, the linings of the human respiratory and gastrointestinal tracts. AMPs are the immune system's early line of defense, battling microbes at the first places they try to penetrate: skin, mucous membranes and other surfaces and crank out the short proteins in response to invading pathogens. AMPs have many medical benefits as they not only fight bacteria but also attack viruses, fungi and even cancer cells.

Scientists have been interested in exploiting these natural antibiotics since their discovery in the 1980s, but they haven't been able to overcome some limitations. In particular, AMPs are easily broken down by protein-degrading enzymes (proteases) that are secreted by bacteria and are also naturally present in the body. Increasing the concentration of AMPs in an effort to get around that problem can cause toxic side effects, such as the destruction of red blood cells---those critical carriers of oxygen in the bloodstream. That seems to happen because sticky parts of the AMP molecule interact with the cell membrane in a harmful way.

Marsh had the idea of replacing sticky portions of the peptides with nonstick analogs. His inspiration came from the kitchen as much as the chemistry lab: nonstick cookware is coated with fluorinated polymers, plastic-like compounds composed of chains of carbon atoms completely surrounded by fluorine atoms. The fluorine not only makes Teflon slippery, it also makes the coating inert to almost every known chemical.

When Marsh and co-workers swapped sticky parts of their AMP molecule with nonstick, fluorinated versions, the molecules became much more resistant to proteases.


"The difference was quite striking," said Marsh, a U-M professor of chemistry. "When we treated them with purified proteases, the nonfluorinated AMPs were all degraded within 30 minutes. Under the same conditions, the fluorinated AMP was completely intact after 10 hours. We think that should make them more effective, as they'll stay around longer in the body.

"We also showed that they seem to be at least as good at killing bacteria as their nonfluorinated counterparts, and for some bacteria they're actually significantly better."

Next, the researchers plan experiments to learn whether Teflon AMPs are also less toxic than their stickier equivalents. If they are, and if further studies continue to point to their promise, eventually producing large enough quantities of fluorinated AMPs for clinical trials should be quite feasible, Marsh said.

Though the research now has obvious practical applications, it started as an exploration in basic science.

"We were just interested in translating useful properties of man-made materials into biological molecules," Marsh said. "But fairly immediately we saw the potential for applying our fundamental science to a very important clinical problem, which is the way that more and more bacteria are becoming resistant to more and more conventional antibiotics."

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The Basics Of Skin Fungi Infections

Skin fungus infections are hard to recognize. The itching, flaking, redness, and thickened skin of fungal infections can look just like other types of dermatitis or skin allergies. In fact, eczematous skin often becomes infected with fungi, so both are present simultaneously. Doctors use microscopes to help them diagnose skin fungus infections, so there’s no way you can really be sure at home. The Advisory will focus on the five most easily recognized skin fungus infections, but even after looking at the pictures don’t be too confident. If the recommended treatment doesn’t work after two weeks, see your doctor.

Athlete’s Foot (tinea pedis). Every year, over 10% of the U.S. population develops this problem. Probably 75% of us will have athlete’s foot at some time during our lives. The most common form occurs between your third, fourth, and fifth toes, sometimes spreading to the sole. Between the toes, your skin becomes white, moist, and easily rubbed off; the tops of the toes may be red, dry, and flaky. Intense itching and burning are the rule. Athlete’s foot usually occurs with hot, moist conditions, or if you wear shoes constantly.

Jock Itch (tinea cruris). The same conditions of heat, moisture (sweat) and poor air circulation leading to athlete’s foot also cause fungus infections of the groin, or jock itch. As its name implies, intense itching and burning are the usual symptoms. You will also find redness, flaking and peeling on the inner thighs, pubic area, and scrotum.

Ringworm (tinea corpora). This is caused by a microscopic fungus, not a worm. The infected area spreads out slowly from its central starting point and creates a slightly raised, intensely red ring surrounding a less red, flaky, itchy area. Over weeks, the ring slowly enlarges. It can occur anywhere on the body and in multiple sites at once, so it’s often confused with other kinds of dermatitis.

Candidiasis. This brownish-red, itchy discoloration affects the underarms, corners of the mouth, rectal area, and beneath the breasts. The same type of fungus causes vaginal yeast infections (candida albicans).

Tinea Versicolor. This fungus actually changes the color of the skin it infects; the patches may be lighter or darker than your normal surrounding skin. This spotted pattern and the fine scaly flakes at the margins make this fungal infection the easiest to identify. Since itching and irritation are mild, it’s also the least bothersome.


Prevention

Warmth, humidity, sweating, and poor air circulation all help bring about these fungal infections. But they are contagious, too. Athlete’s foot is believe to be passed on locker room and shower floors, and by sharing footwear and socks; you can acquire tinea versicolor from vinyl surfaces of weight lifting benches; and of course ringworm is contagious through direct contact (usually kids).

Because of all these factors, prevention is a matter of both personal hygiene and minimizing contact with potential carriers or contaminated objects. See the chart below for guidelines on prevention.

Preventing Skin Fungus Infections

Personal Hygiene

Use anti-perspirants and talcum powder to keep high-risk areas dry.

If you’re susceptible to athlete’s foot, use an anti-fungal powder (see Recommended Products section) and anti-fungal socks.

In high humidity, keep clothing loose and light; avoid knits and less breathable synthetic materials.


Avoidance

Don’t share towels or clothes.

Wear thongs or other footwear in public locker rooms, pools, and showers.

Always wear a thick T-shirt or sweatshirt and long shorts or sweat pants while sharing exercise equipment.

Wipe off vinyl surfaces with a dry towel before using exercise equipment.


Treatment

There are several effective OTC anti-fungal medications. Because different fungi affect different locations, medications are sometimes specific for those locations. The recommendations below should help you sort it out.

Athlete’s Foot - Tolnaftate is the only OTC medicine approved for both prevention and treatment of athlete’s foot. Be patient, though. It could take a month or more of daily treatment for it to completely clear. Consider preventive use if the condition recurs.

Tinea Versicolor - Although not a Category I agent, selenium sulfide shampoo is universally recognized by dermatologists as an effective OTC remedy for tinea versicolor. Since it often affects large areas of the trunk, applying this shampoo once a day for five minutes, then washing off, is a lot easier and cheaper than using a whole tube of anti-fungal cream twice daily. Tinea versicolor also tends to recur easily, but this shampoo can prevent it if used once a week after the initial 2-4 week treatment cycle.

Candidiasis, Ringworm, and Jock Itch - Miconazole or clotrimazole are quickly effective (1-2 weeks) for each one of these conditions, and come in cream, lotion, or spray. Avoid alcohol-based products since they can sting chafed and delicate skin.


Recommended Products

* Dermisil AF. This soothing all-natural product is excellent for the treatment of athlete’s foot fungus and jock itch.

* Selsun Blue shampoo (active ingredient: selenium sulfide). See Treatment for discussion of using this shampoo for Tinea Versicolor.

* Dermisil R. This breakthrough product has a high cure rate for skin fungus infections like ringworm.

When To See Your Doctor

There are situations where self-treatment of fungus infections is inappropriate:

* Spread of athlete’s foot into the toenail beds. (toenails can't be successfully treated with OTC products)

* Bacterial secondary infections of athlete’s foot (indicated by spreading redness or swelling from the original site, extreme tenderness, foul odor, and yellow or cloudy drainage from a weeping area between the toes).

* Large areas impractical to treat with topical creams (prescription tablets treat the entire body).

* Recurrent infections despite appropriate treatment (other underlying medical problems or medication side-effects could be the real culprits).

As mentioned above, many different skin conditions mimic the appearance of fungal infections. If following the treatment guidelines above with appropriate medications doesn’t resolve the suspected fungal infection, have a doctor evaluate your rash. Examination and further testing may reveal something completely unexpected.

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Australian Lawyers Question Discrepancies Surrounding The Use Of Prexige

Lawyers have questioned why the banned drug Prexige was available in Australia at higher doses and with fewer warnings than in other countries.
Product liability law firms have started fielding calls from patients claiming to have suffered serious side-effects on the osteoarthritis painkiller urgently withdrawn one week ago.
The Therapeutic Goods Administration (TGA) pulled Prexige after receiving eight reports of liver damage, including two deaths and two patients who required liver transplants.
About 60,000 Australians have taken Prexige since it was registered in November 2005, with most prescribed after it joined the Pharmaceutical Benefits Scheme last August.
Most were on the controversial 200mg dose - double the dose recommended in other countries - and all eight cases under investigation involved 200-400mg doses.
Brisbane-based law firm Nicol Robinson Hallets, which has received legal queries from Prexige patients, said high dosing and poor warnings had put Australians at increased risk.
"We want to know why the TGA was allowing prescriptions to be authorised at 200mg and more," said lawyer Simon Harrison.
"There are 50 countries in the world that have approval for Prexige and only 15 actually sell it, and not one of those 15 countries have a dosage that's in excess of 100mg, so why did we?"
Mr Harrison also said Australia's Prexige pack labels contained none of the liver damage warnings included in other nations.
"In the UK, for example, the warning labels make four separate references to potential liver damage," he said.
"But warnings handed out on prescription labels here contain no reference to liver damage at all."
Mr Harrison said these discrepancies would strengthen the legal case for patients suffering adverse effects from the drug.
Bill Madden, head of medical negligence action at law firm Slater and Gordon, said the company had received at least four calls from patients "very severely affected" by the drug.
He expected numbers to grow over the next month as people return to their doctors to get liver function tests.
"There may some form of a claim under the Trade Practices Act against the manufacturer or the distributor," Mr Madden said.
"And there may also be some broader negligence claims, but they will depend a lot on what the manufacturer knew about these effects and whether the warnings were adequate."
Mr Harrison said the legal case would bear some similarities to another disgraced drug in the problematic Cox-2 inhibitor family, Vioxx, which was linked to cardiac problems.
However, the Prexige case was more straightforward because liver problems, unlike heart problems, were usually only triggered by alcohol abuse or genes, he said.
The TGA did not respond to media queries on Prexige dosage and warnings.

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Western Australian Government To Cut Down Amphetamines Use In ADHD Treatment

The Western Australian government aims to cut reliance on amphetamines in treating Attention Deficit Hyperactivity Disorder (ADHD) under a multi-million-dollar program.
Studies show dexamphetamines account for a substantial amount of amphetamine use by young people in WA.
The state has the nation's highest rate of amphetamine usage overall, and the highest rate of prescriptions of amphetamines for children diagnosed with ADHD.
WA Premier Alan Carpenter announced $9 million would be pumped into treatment of ADHD and the associated use of dexamphetamine.
"The teams will include professionals from a range of disciplines including psychiatrists, paediatricians, clinical psychologists, clinical nurses, speech pathologists, occupational therapists and social workers," Mr Carpenter said.
"While medication may still be required for severe cases of ADHD, this new approach will ensure that stimulant medication is not the first line of treatment."
The move is one of 49 recommendations adopted after a summit meeting held last month to tackle the illicit amphetamine scourge in WA.
Mr Carpenter said there was evidence to link the use of dexamphetamines during childhood to the broader use and abuse of amphetamines in adulthood.
"There is some evidence and a strongly held view amphetamines for the treatment of ADHD leads and encourages the use of amphetamines more broadly and clearly, obviously, the abuse," Mr Carpenter said.
Drug and Alcohol Office executive director Terry Murphy said the use of medication for ADHD patients was not wrong, but reliance on amphetamines in ADHD treatment was too heavy.
"Medication is not wrong per se. There will be some people for whom that is the optimum treatment, but here in Western Australia with the highest (rate) in the country, we think there is too heavy a reliance on that," Mr Murphy said.
Mr Murphy said 6.5 per cent of WA high school students reported using amphetamines and 5.5 per cent reported using diverted dexamphetamines.
"There's a big overlap between those two figures," Mr Murphy said.
A $16 million package has been earmarked to carry out recommendations to curb amphetamine use in WA, including tougher penalties for dealers who sell drugs around children or near licensed premises.
Under the changes, the sale of drugs to a child at or near a school or a public place where children are often present, will be considered an aggravated offence.

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Recurrence of Stage III Colon Cancer Traced to High-Fat Diets

After curative surgery and adjuvant chemotherapy for stage III colon cancer, patients who ate a high-fat diet were more likely to have a recurrence than those who ate a so-called prudent diet, found researchers here.

Those with a higher recurrence risk ate more meat, fat, French fries, refined grains, and desserts. Jeffrey A. Meyerhardt, M.D., M.P.H., of the Dana-Farber Cancer Institute, and colleagues, reported in the Aug. 15 issue of the Journal of the American Medical Association.

By contrast, a "prudent diet," high in fruits, vegetables, poultry, and fish, had no effect on cancer recurrence or death.
The findings came from a prospective observational study of 1,009 patients with stage III disease enrolled in a randomized adjuvant chemotherapy trial from April 1999 through May 2001. The NCI-sponsored Cancer and Leukemia Group B (CALGB) trial compared with weekly fluorouracil and leucovorin with weekly irinotecan, fluorouracil, and leucovorin.
Previous epidemiological studies have indicated that dietary factors are associated with the risk of developing colon cancer, the researchers wrote. "However, the influence of diet and other lifestyle factors on the outcome of patients with established colon cancer is largely unknown," they added.
It is possible, they said, that after resection of stage III colon cancer, increasing intake of the high-fat and processed foods in the Western diet may facilitate a milieu that allows residual microscopic disease to proliferate and spread.
Also, they said, patients rated high for consumption of foods in the Western diet after diagnosis may have had a similar diet before diagnosis and consequently may have had more biologically aggressive tumors. Nonetheless, there was no significant association between dietary pattern and tumor-related characteristics, the researchers said.
Patients filled out a semiquantitative food frequency questionnaire during and six months after adjuvant chemotherapy. Using factor analysis, the researchers identified two major dietary patterns, the fat-heavy Western diet and the prudent diet. Patients were then followed up for cancer recurrence or death.
During a median follow-up of 5.3 years for the overall cohort, 324 patients had a cancer recurrence, 223 died as a result, and 28 died without documented cancer recurrence.
Compared with patients in the lowest quintile of the Western pattern, those in the highest quintile had a more than three-fold higher risk of cancer recurrence or death (adjusted hazard ratio hazard ratio for disease-free survival, 3.25, 95% confidence interval 2.04-5.19; P for trend <0.001).
Patients in the highest quintile were also 2.9 times more likely to have a recurrence than those in the lowest quintile (adjusted HR, 2.85; CI, 1.75-4.63, P for trend <0.001).
Similarly, a significantly higher overall risk of death was observed compared with the lowest quintile (adjusted HR, 2.32; CI, 1.36-3.96, P for trend <0.001).
The reduction in disease-free survival with the Western diet was not significantly modified by sex, age, nodal stage, body mass index, physical activity level, baseline performance status, or treatment group.
No relationship was seen for recurrence-free survival (P for trend =0.84) or overall survival (P for trend =0.54) across various intakes of the prudent dietary pattern.
The adjusted hazard ratio comparing the highest and lowest quintiles of the prudent diet was 1.20 (CI, 0.83 -1.75) for disease-free survival (P for trend 0.78).
Similarly, no relationship was seen for recurrence-free or overall survival across the various intakes for those who ate a prudent diet.
Higher prudent diet scores were found for patients who were physically active, had a lower BMI six months after adjuvant therapy, and were less likely to be smokers.
Higher undesirable Western scores were seen among men, whites, and past or current smokers.
In contrast, other characteristics, particularly tumor types known to predict prognosis, did not vary significantly among the quintiles of either dietary pattern, the researchers reported.
The researchers pointed out that they could not completely exclude the possibility that a higher intake of the Western pattern may have reflected other predictors of poor prognosis.
Nevertheless no significant association between diet and predictors associated with cancer recurrence (extent of invasion into bowel wall, number of positive lymph nodes) was observed.
Because the study was observational, causality cannot and should not be drawn from these data, Dr. Meyerhardt wrote. Nonetheless, the data suggest that eating more red and processed meat, sweets and desserts, French fries, and refined grains increases the risk of recurrence and decreases survival.
"Further analyses are under way to better delineate specific nutrients or food groupings that may have the strongest association," the authors concluded.
Eric Jacobs, Ph.D., a senior epidemiologist at the American Cancer Society, called the study by Dr. Meyerhardt and colleagues well-designed and addressing "an important question that has not been studied so far."
He pointed out that diet and the risk of colon cancer studies have not been consistent, but there has been almost nothing about the risk of recurrence. "The effect of diet on recurrence may be biologically different from the original risk," he noted. "Other studies will have to attempt to duplicate the results and then see where it leads."
As to why the prudent diet showed no benefit beyond not stimulating recurrence is an important question, he added. "Stay tuned," Dr. Jacobs said. "It's a really important question and needs more research."

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Do Not Ignore Those Heat Cramps

Heat cramps occur in people who are exerting themselves during periods of significant heat and humidity. They shouldn't be ignored, because heat cramps can be the first signs of more serious conditions, including heat exhaustion or heat stroke.The American Red Cross suggests these steps if you get heat cramps or additional warning signs of heat-related illness:
If you have heat cramps or more serious symptoms of heat-related illness, immediately stop all activity and rest. Go to an air-conditioned or shady place, if possible.
Symptoms of more serious heat-related illness include: moist, pale skin; headache, dizziness, weakness, exhaustion or nausea.
Drink cool water or a sports drink slowly and in small amounts.
Stretch the cramped muscles, and hold the stretched position for about 20 seconds. Repeat the stretching until the cramps have stopped.
If symptoms persist, seek immediate medical attention. Resume activity only if you no longer have any symptoms. But be very careful of overexertion and overheating.

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Pictures Of Mattel Toy Recall

Mattel has a reputation for being one of the most conscientious toy makers and is known for having sophisticated inspection and testing systems at many of its China facilities to guard against flawed, defective or tainted products. However, Mattel has recently voluntarily recalled some products for two different reasons: impermissible use of lead paint and risks associated with small, high-powered magnets. Below are photographs of such toys.

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Painkiller Prexige Recalled In Australia

A PAINKILLER used by 60,000 Australians has been ordered off the shelves after the deaths of two people.

The Therapeutic Goods Administration yesterday announced the urgent recall of the drug Prexige, used to treat osteoarthritis and acute pain. Patients using the drug, also known by its chemical name lumiracoxib, are advised to stop taking it immediately and ask their doctor for an alternative prescription.

The TGA made the decision after receiving reports of eight people who suffered serious liver reactions, including two deaths and two liver transplants. Six of the reports occurred since the beginning of July.

TGA medical adviser Rohan Hammett said in a statement yesterday the drug was being recalled to prevent further cases of severe liver damage.

"It seems that the longer people are on the medicine, the greater chance of liver injury," Mr Hammett said.

Australia is the first country in the world to withdraw the drug, which is produced by Novartis Pharmaceuticals. Novartis estimates the drug has been used by about 60,000 Australians.

It is not yet known whether the 50 other countries that sell the drug will follow suit. Prexige is still awaiting approval by the US Food and Drug Administration.

Prexige went on sale in Australia in November, 2005 and gained widespread use since being listed on the Pharmaceutical Benefits Scheme in August last year. At the time, patients were warned to exercise caution with Prexige because it belonged to a family of drugs known as Cox-2 inhibitors linked with heart attack and stroke.

Cox-2 inhibitors, dubbed "super aspirin", have been under a cloud since a popular painkiller Vioxx was withdrawn in 2004 for increasing the risk of cardiovascular disease. Australia's National Prescribing Service - an independent, government-funded agency that advises doctors about the safe use of medications - warned last year that not enough was known about the long-term safety of Prexige.

Novartis spokeswoman Rebecca Fisher-Pollard urged people who used the drug not to panic. She said liver damage was known as a possible side effect but the incidence was rare.

"The information has always been there," Ms Fisher-Pollard said.

Novartis has set up a patient helpline to answer queries. Patients are advised to return any unused Prexige tablets to their pharmacist, who will give them a full refund. All GP groups and pharmacists have been alerted about the drug recall.

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Babies' Health In Danger From Plastic Baby Bottles

A federal panel of scientists concluded Wednesday that an estrogen-like compound in plastic could be posing some risk to the brain development of babies and children.

Bisphenol A, or BPA, is found in low levels in virtually every human body. A component of polycarbonate plastic, it can leach from baby bottles and other hard plastic beverage containers, food can linings and other consumer products.

Culminating months of scientific debate, the decision by the 12 advisors of the Center for the Evaluation of Risks to Human Reproduction -- part of the National Institutes of Health -- is the first official, government action related to the chemical. Their recommendation will be reviewed for a federal report that could lead to regulations restricting one of the most used chemicals.

The scientists ranked their concerns about BPA, concluding they had "some concern" about neurological and behavioral effects in fetuses, infants and children, but "minimal" or "negligible" concern about reproductive effects. The findings put the panel roughly in the middle -- between the chemical industry, which has long said there is no evidence of danger to humans, and the environmental activists and scientists who say it is probably harming people.

Steve Hentges of the American Chemistry Council's polycarbonate division said the panel's report was "strong reassurance to consumers" that products containing BPA are safe.

Frederick vom Saal, a University of Missouri-Columbia reproductive toxicologist who has conducted studies on BPA, was disappointed that the panel did not rank the risk higher. But, he said, "the panel is now on record saying there are human health concerns."

The panel reviewed about 500 animal studies, many of which reported that the estrogen-like chemical alters various functions and parts of the body. Some have found altered brain development, precancerous changes in prostates and mammary glands, low sperm counts, and damage to the uterus. Plastics industry representatives say the lab experiments are inconclusive and flawed.

No study has looked for effects in people exposed to the plastic products, which have contained BPA for 50 years.

The panel had five rankings for its findings: negligible concern, minimal concern, some concern, concern and severe concern. In its conclusion, the level was "some concern."

For fetuses, pregnant women, infants and children, the panel reported there was "some concern that exposure to bisphenol A causes neural and behavioral effects." In studies of newborn animals, low doses of BPA cause structural changes in the brain that trigger learning deficits and hyperactivity.

For fetuses and children, they said there was "minimal concern" that BPA harms the prostate gland and causes premature puberty, and "negligible concern" that it causes birth defects.

For adults, they reported "negligible concern about adverse reproductive effects."

John Bucher, associate director of the National Toxicology Program, which oversees the reproductive health center, said the panel gave the most weight to neurological effects in children, infants and fetuses because studies consistently have found those effects when newborn animals are exposed to low doses similar to what people encounter. Bucher said that because the science remains uncertain, it is up to individuals to decide whether they want to avoid products containing BPA.

"To me, we're still in that stage of scratching around at the surface of this issue," he said.

Last week, Vom Saal and 37 other scientists published a consensus statement in a scientific journal concluding it was likely that BPA affected humans, even at low doses. The federal panel's findings were not as strongly worded.

Environmentalists lambasted the panel, saying it had minimized the risks and ignored important research.

"Only the chemical industry agrees with the decision that BPA has little or no human health risks. That by itself should speak volumes about the corrupted process endorsed by the panel today," said Dr. Anila Jacob of the Environmental Working Group.

In March, the Los Angeles Times reported that the panel's preliminary report on BPA was drafted by a private consulting firm with financial ties to the chemical industry. The National Toxicology Program fired the company but ruled that the report was unbiased.

Part of the reason the panel ranked the risks as less serious than did the other group of scientists is that the panel rejected several dozen animal studies that found reproductive effects. In those studies, animals were exposed through injections, rather than through their diet. The decision to reject the studies has been controversial with toxicologists.

Two of the panel's scientists are from private pharmaceutical companies, six from universities and two from federal agencies. It was chaired by Robert Chapin, head of developmental toxicology at Pfizer Inc. None has expertise in BPA.

Their recommendations will go to the National Toxicology Program, the federal scientists who help regulators mold policy about toxic substances. Officials there will send their report out for review by other scientists before deciding whether to declare BPA toxic to humans. Bucher said he would also update it with the consensus statement and studies published last week.

The final report could trigger a review of BPA by California officials under Proposition 65, which requires warnings on consumer products that pose a risk of cancer or reproductive harm.

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FDA OK Prilosec And Nexium For Heartburn

The popular heartburn drugs Prilosec and Nexium don't appear to spur heart problems, the Food and Drug Administration announced Thursday.

The agency reviewed the issue after the drugs' manufacturer, AstraZeneca, sent regulatory officials a preliminary analysis of two small studies in May that suggested the possibility of a risk.

Those studies compared treating the chronic heartburn known as gastroesophageal reflux disease, or GERD, with drugs or surgery. The company's initial analysis counted more patients treated with drugs who had heart attacks, heart failure or heart-related sudden death.

The FDA followed up on those studies, and found that they seemed skewed: Patients who underwent surgery were younger and healthier than those treated by drugs, suggesting the heart link was a coincidence.

The agency then looked at 14 additional studies of the drugs, and found no evidence of heart risks. In fact, in a few studies where patients received either medication or a dummy pill, those who took the heartburn drugs actually had a lower incidence of heart problems.

The FDA plans to complete its probe within three months, but issued a public notice Thursday that it "does not believe that health care providers or patients should change either their prescribing practices or their use of these products at this time."

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Drugs Currently Available For Treating Infertility

Do you know enough about the drugs used to stimulate your ovaries when you go through a cycle of assisted reproduction? Do you know which drugs are currently available, and what are the differences are between them?
Infertility Network UK believes all patients should have access to up to date information about every aspect of their treatment, and that includes any drugs which may be prescribed. Some centres will give one drug or another without any discussion on the subject, whilst others may discuss treatment options with you and offer a choice in the drugs prescribed. But do you feel you know enough to make a decision?
The drugs used to stimulate the ovaries during IVF are mainly female hormones. Human eggs are contained within follicles which grow from microscopic size to large cystic structures as they mature. The principle stimulant is Follicle Stimulating Hormone (FSH) which makes follicles grow, and it is administered to create raised concentrations (high / normal) in the blood, with the aim of producing a number of eggs in just one cycle. There are occasions where the other main drug of this type (luteinising hormone, LH) is also required – and this can be supplied in two formats: directly in a pure form or in a combined form.
Drugs used in fertility treatment
MENOPUR - is a highly purified urinary product comprising FSH and LH activity. It is injected subcutaneously (just under the skin) using a small needle. Patient injection kits are made available by the manufactures that help with administration.
MERIONAL HP - A similar product to Menopur
GONAL F – A recombinant FSH which is injected subcutaneously, and comes ready prepared, in a multidose administrator by use of an injection pen. It is administered by mass (weight) rather than as ‘international units’.
PUREGON - A recombinant FSH, injected subcutaneously. Puregon comes in a ready-for-use solution. A multidose cartridge is also available and both are administered via an injection pen. The product is marketed in multiples of 50 IU.
All these hormone drugs are administered once per day, as they are quite efficiently cleared in the urine.
It is important to note that the concentrations of these hormones in your blood are generally similar to normal levels found in women with normal menstrual rhythm, even when higher doses are given, and much lower than in a menopausal woman. Administration of the drugs over a number of days does however, lead to high estrogen concentrations for a few days, and so the responses do need to be monitored. However, as the drug concentrations are normal, the process has generally a low risk potential, when monitored sensibly.
Other drugs commonly used
Unfortunately, FSH is not the only drug needed, as most programmes use other hormones called GnRH analogues, which can be used in two different ways to do the same job. They are used to stop the process of ovulation (release of the eggs) happening before the eggs can be collected. The traditional, well established method is using GnRH agonists in multi-dose or in depo formulations. It was found that when given in a high frequency (say 4 or 5 times per day, or in a depo under the skin) these drugs block the release of LH, which is the hormone that causes release of the egg from mature follicles (ovulation). The ‘ovulation’ process must be timed precisely so that eggs can be collected at the right time directly from the ovary. The ovulation blocking effect of GnRH-agonists needs about 2 weeks continued treatment to work effectively, so these drugs are started either a week before a menstrual bleed (in the cycle prior to treatment), or soon after a menstrual bleed, and the FSH injections are delayed for 10 to 15 days later. The GnRH agonists can be administered by daily injection (eg Suprecur s.c.), multiple nasal spray applications each day (Suprecur n/s, Nafarelin), or by a single depo under the skin that lasts for approximately one month (Prostap SR, Gonapeptyl s.c.).
The newer versions of these drugs are the GnRH antagonists, which require no pre-treatment as their blocking action is immediate, and they can suppress LH very rapidly. They are needed only when there is a threat of increased LH in the blood, which generally starts around 5 days after starting FSH injections. They generally require daily administration until it is time to stop the FSH treatment and prepare for the egg pickup. The two main products of this type are Cetrotide (0.25mg daily, but also available in a 3.0mg preparation, which lasts for 3 days) or Ganirelix (0.25mg).
When discussing these drug packages with your consultant, what would you want to take into consideration?
Most analyses of effectiveness of the different products in routine IVF programmes, show that, in general, no individual drug or method is significantly more effective than another.
It is important to remember that how much you pay depends on where you buy them. If you are going to have to foot the bill yourself, compare prices and ask your clinic where they recommend you purchase your drugs. You may be able to save yourself considerable sums on whichever drug you have chosen. Many centres now use ‘home delivery services’ to provide the drugs, and also the equipment required, so that the patient deals directly with the pharmacy provider.
If you want to know more about the drugs you've been prescribed, you shouldn't feel nervous about asking the medical team who are treating you. Talk to them about which drugs they recommend, and why. The majority of patients may be perfectly happy to follow their consultant's suggestions, but just knowing more about what you are taking and why may help you to feel more in control of your treatment.
Anyone who needs to purchase infertility drugs should look carefully at the options open to them. Savings can be made by “shopping around” to get the best price. Generally the options available to purchase the drugs are:
· From the hospital/clinic pharmacy
· From the a High Street/Supermarket Pharmacy
· From the a ‘home delivery service’
Each of the above will give you a price for the drug you have been prescribed and enable you to choose your preferred option. Don't forget, you do have a choice and you should be given the information by your clinic which will enable you to make an informed choice. Discuss the options open to you with your clinic or contact Infertility Network UK for more information.
For advice on fertility drugs being used in a treatment cycle or the administration of these drugs, patients should always contact the clinic where they are being treated.

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