Monday, March 3, 2008
American Lung Association Applauds Introduction Of Legislation That Would Give Food And Drug Administration Authority Over Tobacco Products
Tobacco-related diseases are the leading preventable cause of death in the United States, causing more than 438,000 deaths each year. Each day, more than 1,140 kids become regular smokers -- and one-third of them will ultimately die from their habit. The tobacco companies spend more than $15.15 billion a year marketing their deadly products -- preying on our children, who make up the "replacement generation" of smokers.
In August 2006, U.S. District Court Judge Gladys Kessler correctly concluded that tobacco companies have engaged in a long-term, fraudulent scheme to mislead the American people about the health risks of smoking, the addictiveness of their products, and their tactics for marketing their products to children. In her decision, Judge Kessler wrote that the tobacco companies have "marketed and sold their lethal products with zeal, with deception, with a single-minded focus on their financial success, and without regard for the human tragedy or social costs that success exacted." Unless this important legislation becomes law, the tobacco companies will continue to aggressively market their products to children and lie about the health consequences of smoking.
The American Lung Association is committed to working with Congress to ensure that the legislation becomes law in 2007.
American Lung Association
American Lung Association
New Blood Thinner For Patients With Leg And Lung Clots
Other medications and even diet can dramatically impact blood levels of warfarin, or Coumadin™, increasing the risk of bleeding or clotting, says Dr. James R. Gossage Jr., pulmonologist at the Medical College of Georgia.
"You eat too much broccoli or spinach and it sends your levels out of whack; almost every other medicine affects Coumadin," says Dr. Gossage, who calls warfarin a "high-maintenance" medication.
Unfortunately, many people, including those with a clot in their legs - called deep vein thrombosis - or their lungs - called pulmonary embolism - may need it for months or years, Dr. Gossage says.
An international study of 2,000 adult patients with these problems will determine if dabigatran, manufactured by Boehringer Ingelheim, a Germany based pharmaceutical company, makes long-term clot control easier.
Deep vein thrombosis or a pulmonary embolism generally are treated with intravenous blood thinners; really big clots also may need a clot-buster like tPA, says Dr. Gossage, a principal investigator on the study. Blood thinners keep the clot from growing while the body's endogenous clot-busters eliminate it. That can take a while, especially when clots measure several inches or more, so patients also need a blood thinner they can take at home for months or longer, depending on their diagnosis. When patients start taking warfarin, they need daily, then weekly monitoring until levels stabilize, then at least monthly checks as long as they take the drug, he says.
At the right level, the drug works well, inhibiting vitamin K, which is involved in the synthesis of several coagulation factors and found in abundance in green leafy vegetables, vegetable oils, cranberries and even licorice. "It's very uncommon for a person taking warfarin to have a blood clot if his or her level is in the proper range," Dr. Gossage says.
The trouble is that a big helping of collard greens, for example, can dramatically reduce the drug's effectiveness and increase clotting risk. Patients are encouraged to eat stable diets, but even so, Dr. Gossage has patients whose blood levels, charted on a graph, look like a roller coaster.
Many common over-the-counter and prescription drugs contribute to the problem by affecting the liver mechanism that determines how much and how fast warfarin is eliminated, Dr. Gossage says. "We are looking for medicines that are more like most others we take; they are not affected by our diet and by every other pill we take," he says.
Previous work with dabigatran indicates it could fit the bill. It works early in the clotting process, inhibiting thrombin, one of the main clotting factors. "When you cut yourself, platelets start sticking, thrombin comes in and activates the whole cascade of coagulation factors that form a clot. Warfarin works later in the cascade, so getting something that works earlier may be even better," says Dr. Gossage.
"Hopefully we won't have these big swings in the level and people won't have these periods where they are at great risk," says Dr. Gossage. "I can give you a dose and it's going to work the same way whether you are eating broccoli or spinach or taking penicillin or some other antibiotic"
This phase III study randomizes patients to warfarin or dabigatran and closely follows them for 18 months. If dabigatran appears ineffective, patients are moved to more standard therapy. All blood thinners can have the side effect of bleeding, he notes.
Immobility, blood vessel injury and anything that increases blood's tendency to clot, called hypercoagulability, are risk factors for clots. "Most people think you have to have at least two of those, says Dr. Gossage.
Long plane rides or hospital stays can put patients at risk ; trauma, even an intravenous line needed for medicine, can injure vessels. A host of things contribute to hypercoagulability, including birth control pills, hormone replacement therapy, age, and perhaps smoking and obesity. Cancer, particularly solid tumors, is a big risk factor for clotting. Ironically its primary treatments, chemotherapy and radiation therapy, can narrow blood vessels and add to the risk.
An estimated 600,000 pulmonary embolisms occur each year in the United States and deep vein thrombosis is about twice as common. Many patients have both because a clot in the leg has nearly a straight shot to the lungs through the venous system.
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Contact: Toni Baker
Medical College of Georgia
Treatment Of Health Problems Related To World Trade Center Collapse Costs $393M Annually, Report Finds
Comments
Bloomberg said, "What is unclear and can't yet be possibly known are those illnesses that may appear in the future. But that's not going to stop us from caring for those who are sick today and building the capacity to identify and respond to illnesses that may reveal themselves tomorrow" (New York Times, 2/14). He added, "We're not about to abandon the men and women who helped lift our city back onto its feet during our time of greatest need. They deserve first-class care without exception, and we will work to ensure that they get it" (AP/New York Times, 2/13).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Breath Test Detects Lung Cancer In Early Stages
Dr. Michael Phillips, CEO of Menssana Research, the company that developed the breath test, said, "We developed a breathalyzer that is one billion times more sensitive than those the police use to measure alcohol in the breath. It detects around 200 different chemicals in a person's breath, and some of these chemicals are markers of cancer. A breath test has great advantages over most other medical tests - it is completely safe, painless and non-invasive. All you have to do is breathe gently into a tube for two minutes. There are no potentially dangerous x-rays to worry about, and it will certainly be a lot less expensive than chest imaging."
In a study funded by the National Institutes of Health that will be published in Cancer Biomarkers, researchers studied 404 smokers and ex-smokers aged over 60. The breath test predicted lung cancer with almost the same accuracy as computerized tomography, or chest CT, the best screening test for lung cancer currently available.
Early detection is essential to save lives. Lung cancer affects over 170,000 Americans annually and more than 95% of them are dead within 5 years if the tumor has metastasized to other organs, versus only 20% if the tumor is found while it is still confined to the lung.
The breath test will not be available in the USA until approved by the Food and Drug Administration, but may be available sooner in the European Union.
Menssana Research is currently developing breath tests to detect several other diseases in their early stages, including pulmonary tuberculosis, breast cancer, and ischemic heart disease. The FDA has already approved the Heartsbreath test for heart transplant rejection. Dr. Phillips said he hopes that physicians and patients will eventually consider a breath test the way we think of a chest x-ray or blood test: as an inexpensive and convenient screening test which can detect several diseases in their earliest and most treatable stages.
Menssana Research, Inc.
http://www.menssanaresearch.com/
Nicotine Mouth Spray Is Preferred Replacement Therapy For Smoking Cessation
Various formulations of nicotine replacement therapy are commercially available. It was the aim of this study to test preference, safety and efficacy of a new nicotine mouth spray (1 mg/actuation; NicoNovum). To this effect, 100 healthy smokers wanting to quit (mean age 43.1 В± 11.2 years) were included. They were given the mouth spray, as well as 2-mg nicotine gums and nicotine oral inhalers to try out for 1 week. Subsequently, all participants were randomized into 3 groups mouth spray (n = 50), gum (n = 25) and inhaler (n = 25) п" and treated for 3 months.
Fifty-four of the 100 smokers preferred the spray, compared with 28 and 18 who preferred the gum and inhaler, respectively (p < 0.01 for spray vs. both the gum and inhaler). At 6 months, the sustained abstinence rates were 8 (16%), 5 (20%) and 2 (8%) for the mouth spray, gum and inhaler, respectively (p values = n.s.). Adverse effects were mostly drug-related local symptoms, most frequently reported at the end of the tryout period: out of 106 drug-related adverse effects, 90 were due to the spray, 11 and 5 to the inhaler and gum, respectively. The three most frequent adverse effects were almost exclusively caused by the spray: burning of the tongue/throat reported by 35, nausea by 18, and hiccup by 16 participants.
Despite a higher rate of local adverse effects, participants preferred the mouth spray over the gum and inhaler. The efficacy of the mouth spray seemed comparable with the one obtained by the gum and inhaler. Further studies are therefore necessary to show whether a reduction in the dose per actuation to about 0.5 mg would result in less side effects, which in turn might yield higher long-term drug compliance and possibly higher success rates than the ones achieved with other forms of nicotine replacement therapy.
About S. KARGER AG
With over a century of experience in connecting the world of biomedical science, Karger publishes nearly 80 scientific, peer-reviewed journals and 150 serial and non-serial books and supplement issues annually for a global scientific readership.
S. KARGER AG
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New Drugs Trials Could Slash Treatment Times
Trials of a new drug combination to treat tuberculosis could cut the length of time patients have to take their medicine by a third.
Researchers at St George's, University of London, hope that speeding up the treatment will help to reduce the 20 million cases of the disease that exist globally many caused by patients abandoning their medication halfway through because of the long trek to a treatment centre or at the first signs it is working.
In the four-year trial, a high dose of antibiotic drug rifapentine and a broad-spectrum antibiotic, called moxifloxacin, will be given once a week to patients with pulmonary TB in Mozambique, Zambia, Zimbabwe and South Africa. Both rifapentine and moxifloxacin are already used in the treatment of TB, though not in combination. It is hoped that RIFAQUIN, as the new combination is called, will cut the treatment time from six to four months.
Dr. Stanley Mungofa, the Head of the Harare City Health Department, Harare, Zimbabwe, and an investigator in the RIFAQUIN trial, said: "TB treatment just like treatment for chronic diseases tends to be difficult for both the patient and the health system given the fact that when patients feel better they confuse better for cure and abandon their treatment.
"If treatment becomes shorter there is a better chance of them finishing their medication and being cured."
The trial will start in July 2007and is being carried out by INTERTB, an international consortium of scientists coordinated by Dr Amina Jindani at St George's, University of London. Professor Denis Mitchison, who successfully pioneered the reduction of treatment from 18 to six months, and Dr Tom Harrison are also on the St George's INTERTB team.
Dr Jindani said: 'The development of a new anti-tuberculosis drug could take 15 years and the cost estimated by the Stop TB partnership is almost 5 billion US dollars. By testing a new combination of drugs we already use we can cut that development time by 10 years at a far lower cost.'
The trial has already attracted grants of в'not4,281,991 (В2.855million) from the European & Developing Countries Clinical Trials Partnership (EDCTP) and a further В200,000 from the Wellcome Trust.
INTERTB is organising a one-day meeting to discuss the contribution of UK researchers to reduce TB treatment duration. The meeting will be held at St. George's, University of London, on Thursday 22nd March, 2007 and will be attended by researchers in the United Kingdom as well as donor agencies, NGOs and members of the All Party Parliamentary Working Group on TB.
About ST GEORGE'S, UNIVERSITY OF LONDON
St George's, University of London is the only independently governed medical school in England and provides training to a wide range of healthcare students on one site. As well as providing courses in medicine and biomedical sciences, the Medical School also offers courses in midwifery, nursing, physiotherapy, radiography and social work in conjunction with Kingston University. The school is extremely active in research and has a high reputation in areas such as infection as well as diseases of the heart and circulation. Other areas of expertise include stroke rehabilitation, air pollution and addictions.
ST GEORGE'S, UNIVERSITY OF LONDON
Cranmer Terrace
London SW17 ORE
http://www.sgul.ac.uk/
Moscow Bird Flu From A Single Market
Although H5N1 is suspected, further laboratory tests need to confirm this. It will be the first H5N1 bird flu outbreak in the Moscow area if tests results come back positive. Whether of not H5N1 has been confirmed is slightly confusing at the moment - some officials say tests have come back positive while others deny this. While a Ministry spokesman, Alexei Alexeyenko, has confirmed H5N1 was present in two places, Valery Sitnikox, Moscow's Chief Veterinary Inspector, say we won't know about the lab test results until Monday, February 19th.
Valery Sitnikox said authorities in the central Moscow region have implemented all measures to stem the spread of bird flu. "The situation is under control - the veterinary service is in control of everything. Measures to vaccinate birds will begin tomorrow." He added that current measures will make sure further outbreaks can be prevented. He is extremely hopeful that the current chain of events have been stopped - the market where the infected birds were brought to has been shut down.
Nobody knows where the infected birds came from. Authorities stressed that this outbreak poses no threat to human health.
Scientists fear that the H5N1 bird flu virus strain, the most virulent one, will eventually mutate and become easily human transmissible. This has not happened yet. It is extremely difficult for birds to infect humans, and even harder for a human to infect another human.
It is believed that one of the ways H5N1 could mutate would be by infecting a person who is sick with the normal human flu virus. The bird flu virus would then have the opportunity to exchange genetic information with the bird flu virus and acquire its ability to spread easily from human-to-human (become easily human transmissible). If this happened, we could be facing a serious, global flu pandemic.
If we can keep the number of outbreaks among birds down to a minimum, then the number of humans becoming infected is also low - giving the bird flu virus fewer opportunities to mutate.
Written by: Christian Nordqvist
Editor: Medical News Today