Black Cat- 1920
Hepatitis transmission risk needs to be studied in nail salons, barbershops
New analysis questions adequacy of disinfection regulations
Washington, DC -- The risk of hepatitis transmission through non-single use instruments –- such as nail files, nail brushes, finger bowls, foot basins, buffers, razors, clippers, and scissors –- during nail salon and barbershop visits cannot be excluded, according to the results of a new report unveiled today at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC.
David A. Johnson, M.D., FACG of Eastern Virginia Medical School presented an abstract which analyzed a report developed by the Virginia Department of Health entitled, "Assessment of the Risk of Bloodborne Pathogen Transmission in Nail Salons and Barber Shops and Regulatory Requirements in Virginia." Dr. Johnson's assessment of the Virginia report indicated that there might be potential transmission of bloodborne pathogens (e.g., hepatitis B and C viruses) if non-single use instruments are not fully cleaned and disinfected according to the state regulations. The Virginia Department of Health found that the current Virginia regulations (dated September 1, 2011), which require intermediate-level disinfection for non-single use items in nail salons or barbershops, are sufficient in preventing bloodborne pathogens transmission, if there is full compliance.
"Whether there is sufficient compliance with disinfection requirements is an important variable in the safety of salon and barbershop services from a public health perspective," commented Dr. Johnson. "The risk of transmission of infectious disease, particularly hepatitis B and C, in personal care settings is significantly understudied in the United States."
Dr. Johnson explained that a report of a case of acute hepatitis C (HCV) that was "clearly related to a manicure/pedicure treatment" prompted this evaluation of the current patient risks associated with salon exposures.
A group coordinated by the Office of Epidemiology at the Virginia Department of Health conducted the aforementioned study. This Virginia Health Department study included a comprehensive literature search on Pubmed and Google using relevant key words such as nail salon, manicure, pedicure, barber, razor and hepatitis. Additionally, the group reviewed the safety regulations in Virginia and compared them with those in 13 other states and the District of Columbia.
The review of the published literature identified eighteen papers, including nine case-control studies, three case-series studies, and six population-based surveys, that assessed manicure, pedicure, or barbering as potential risk factors for HBV and/or HCV infection. Of the nine case-control studies, five evaluated HBV and/or HCV in nail salon settings and three of the five showed association with HBV and one of the five showed association with HCV. Eight of the nine case-control studies evaluated HBV and/or HCV in barbershop settings and five showed association with HBV and two showed association with HCV. The case-series studies and surveys are less indicative of an association for HBV and HCV in nail salon or barbershop settings. Caution is required in interpreting these findings because there are substantial heterogeneities in the population studied, sample size, case and control selection, analytic method, and control of confounding variables across studies. Furthermore, none of the nine case-control studies was conducted in the United States.
The federal Occupational Safety and Health Administration (OSHA) does not have specific guidelines for the prevention of HBV or HCV infection in nail salons and barbershops, according the Virginia Department of Health, and neither the current CDC case report form for HBV or HCV nor the National Electronic Disease Surveillance System captures barbering, manicures or pedicures as risk factors for transmission of hepatitis infection.
"The absence of infection control guidelines from federal health agencies (CDC and OSHA) for the prevention of hepatitis infections in nail salons and barbershops implies that barbering, manicure and pedicure have not emerged as significant risk factors for HBV and HCV infections in the United States," commented Dr. Johnson. "The true magnitude of this risk has yet to be defined and clearly needs further study."
In the meantime, Dr. Johnson urged nail salon and barbershop customers to be aware of the potential risks for hepatitis transmission, and to take precautions including asking questions to determine whether or not the nail salon or barbershop is properly cleaning and disinfecting tools and equipment. He also suggests customers bring their own equipment like clippers, razors and nail files (both men and women).
"No one should accept on blind trust that a business is taking the necessary steps to prevent transmission of bloodborne infections such as hepatitis," said Dr. Johnson. "Health care providers need to be aware of these risks –both for appropriate counseling of their patients, and when assessing possible causality in patients with hepatitis B or C."
Based on the Virginia Department of Health report there are several proposed recommendations to eliminate the potential transmission of HBV, HCV and HIV infections in nail salon and barbershop settings. These include: training for all nail salon and barbershop technicians, educating them about transmission of blood-borne infections and emphasizing principles of good hygiene, antisepsis and disinfection; as well as more stringent personal hygiene, storage, disinfection and inspection requirements.
Hepatitis, an inflammation of the liver, refers to a group of viral infections that affect the liver. The most common types are Hepatitis A (HCA), Hepatitis B (HBV)), and Hepatitis C (HCV). HBV and HCV are primarily transmitted through blood.
According to the Centers for Disease Control and Prevention (CDC), viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. While an estimated 4.4million Americans are living with chronic hepatitis--most do not know they are infected. About 80,000 new infections occur each year although the clinical consequences of severe liver disease (e.g. cirrhosis/cancer) may not be recognized for 10-20 yrs after the infection.
Injection drug use accounts for most HCV infections in the United States and most developed nations. In developing nations, unsafe medical injections and blood transfusions are the primary risk factors for HCV infections.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 12,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. http://www.acg.gi.org View releases on other research breaking at the ACG meeting at http://www.acg.gi.org/media/press.asp Follow ACG on Twitter http://twitter.com/#!/AmCollegeGastro
New research on improved treatment options and screening strategies for Hepatitis C
Washington, DC -- Studies reporting on the effectiveness of new therapies for chronic Hepatitis C virus are among the clinical science presented at the American College of Gastroenterology's 76th Annual Scientific Meeting, where investigators also presented findings from an age-based risk assessment and screening intervention for Hepatitis C among Baby Boomers, patients aged 50-65, who saw a gastroenterologist for routine colon cancer screening.
With the recent introduction of new direct acting anti-viral therapies, physicians now have more options for treatment of chronic hepatitis, a chronic viral liver disease that infects more than 4 million Americans. Several studies of the new drug telaprevir in combination with the standard of care (pegylated interferon and ribavirin) looked at the drug's effectiveness among populations of patients who, because of race or failure of previous treatment, are considered hard-to-treat.
"Treatment Effect and Resistance Profiles were Similar Between Black/African American and Non-Black/African American Patients Treated with a Telaprevir Combination Regimen"
Dr. Andrew Muir of Duke University Medical Center and a group of investigators in a large multi-center trial evaluated data on safety and efficacy from two Phase 3 trials (ADVANCE and ILLUMINATE) of the direct acting anti-viral drug telaprevir in combination with the standard of care (peylated interferon and ribavirin) for the treatment of chronic hepatitis C.
In African Americans, a group for whom the need for effective therapies is particularly urgent, a combination treatment of telaprevir with pegylated interferon and ribavirin provided a substantial improvement in "Sustained Viral Response" (SVR) – compared to the standard treatment. SVR means that the hepatitis C virus level is undetectable 6 months after stopping therapy and signifies the patient has been cured of the infection. Patients in the Black/African American group had an SVR rate of 61% when treated with the telaprevir combination compared to 25% with the previous standard of care.
"Response-guided Telaprevir Treatment in Genotype 1 Chronic Hepatitis C Patients who had Prior Relapse to Pegylated Interferon/Ribavirin"
Dr. Muir was also involved in an analysis of results of the Phase 2 (PROVE3) and Phase 3 (ADVANCE, ILLUMIATE and REALIZE) telaprevir studies of patients who relapsed to a prior treatment with the standard of care (pegylated interferon and ribavirin.) Prior relapsers are eligible for shortened duration with the telaprevir combination, and this analysis provides some of the rationale for the response-guided therapy approach for these patients.
The investigators looked at patients with prior relapse with peginterferon and ribavirin and then reported their response when given the telaprevir combination. The study reported SVR and relapse rates and studied the effect of the varying treatment durations in the different studies. They compared these results with the outcomes of those who had never been treated for Hepatitis C in the past.
The investigators also developed a viral dynamic model to predict SVR rates by different treatment durations of prior therapy with pegylated interferon and ribavirin, both in prior relapsers and treatment naїve patients. The observed clinical data supported the predictions of the model.
"Findings of this analysis suggest that among prior relapsers who had an early viral response and in whom the Hepatitis C virus was undetectable at 4 weeks and 12 weeks of therapy with a 24-week telaprevir combination treatment, their rates of sustained viral response were comparable to those in treatment-naїve patients, and relapse rates were low," explained Dr. Muir. Based on their findings, the investigators conclude that modeling predictions and the observed clinical data support the use of response-guided therapy in prior relapse patients.
Screening Baby Boomers for Hepatitis C during a Routine Colon Cancer Screening
Investigators at Scott & White Hospital in Temple, Texas developed and tested a screening intervention to identify those at high-risk for Hepatitis C virus among patients ages 50 to 65 who came to the hospital for a routine colonoscopy exam. This age cohort is an important target for Hepatitis C screening because research suggests that as much as 70 percent of the undiagnosed Hepatitis C infection in the United States is among Baby Boomers. At Scott & White, over one third of the 376 participants in the study had at least one risk factor for chronic Hepatitis C infection.
"Gastroenterologists are in the unique position of conducting colonoscopies and being experts on viral hepatitis," said Dawn Sears, M.D., the lead investigator. "We sought to assess the feasibility and acceptance of assessing risk factors and testing for viral hepatitis infection during colonoscopy."
The three-month study recruited patients from among the 50 -65 age group undergoing routine colorectal cancer screening to complete questionnaires regarding vaccination, exposure, previous history of Hepatitis A or Hepatitis B or Hepatitis C. The patients were asked to disclose any risk factors including high risk sexual activity, injection drug use, tattoos placed before 2000, HIV status or hemophilia, among others.
The gastroenterology setting creates an opportunity to reach patients who, based on infection patterns in their age cohort, may carry chronic viral Hepatitis C infection but may be unaware of their status, because the recommendations for colorectal cancer screening begin at age 50.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 12,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. http://www.acg.gi.org View releases on other research breaking at the ACG meeting at http://www.acg.gi.org/media/press.asp
WASHINGTON, Oct. 31, 2011 /PRNewswire via COMTEX/ -- Fecal Transplants, Hepatitis C, Efficacy of Probiotics, Smoking's Impact on GI Health, Vitamin D in IBD Therapy, Adult IBS and Childhood Trauma Link Among Featured Science
Many of the world's preeminent gastroenterologists have convened this week for the American College of Gastroenterology's (ACG) 76th Annual Scientific Meeting at the Gaylord National Hotel and Conference Center at the National Harbor to review the latest scientific advances in gastrointestinal research, treatment of digestive diseases and clinical practice management.
Groundbreaking treatments such as fecal microbiota transplantation for serious gastrointestinal conditions like antibiotic-associated diarrhea and inflammatory bowel disease; innovative prevention strategies for a host of GI-related health conditions including hepatitis C and colorectal cancer; new insights on the relationship between adult irritable bowel syndrome (IBS) and childhood trauma and the impact lifestyle factors like smoking and alcohol consumption have on digestive health, are among the highlights of this year's scientific presentations.
A press kit with highlights of important new science presented at the meeting is available online at the ACG Web site www.acg.gi.org/media/press.asp
Highlights from this year's ACG Scientific Meeting include:
Antibiotics May Not Be Only Cause of Community-Acquired C. difficile Infection; Patient's Place of Residence May Allow for "On-Admission" Prediction Model of Disease SeverityAntibiotics may not be the only risk factor associated with community-acquired Clostridium difficile infection, indicating that other undefined causes of the potentially life-threatening infection may exist and could also predict whether or not a patient will require hospitalization, according to researchers from the Mayo Clinic College of Medicine in Rochester, MN.
A separate study by researchers from Winthrop University Hospital, in Mineola, New York, who assessed predictors of hospitalization in a population-based cohort of community -acquired Clostridium difficile infection (CA-CDI), found that nursing home patients should receive special attention at the time they are diagnosed with C. difficile infection, as this variable appears to outperform other "on admission" variables including the Charleson comorbidity index in predicting outcomes in CDI.
Celiac Patients Face Potential Hazard As Information on Cosmetic Ingredients Difficult to Find The lack of readily available information about cosmetic ingredients may cause patients with celiac disease who use lip, facial or body products to unknowingly expose themselves to gluten--an ingredient they need to avoid, according to researchers from George Washington University. The study, prompted in part by a patient case, where a 28-year old woman experienced exacerbation of her celiac symptoms after using a body lotion advertised as "natural," focused on the top 10 cosmetic companies in the United States in order to evaluate the availability of information about cosmetic ingredients and the accessibility of gluten-free products.
Cigarette Smoking's Impact Lingers after Cessation: Current, Former Smokers May Face Impaired Pancreatic Duct Cell Function, Elevated Colorectal Cancer Risk that Persists Longer for WomenCigarette smoking appears to impair pancreatic duct cell function--even for those that quit--putting all smokers at risk of compromised digestive function regardless of age, gender and alcohol intake, according to researchers from Center for Pancreatic Disease at Brigham and Women's Hospital in Boston.
In a separate smoking-related study, researchers from the University of Connecticut and the White River Junction VA Medical Center in Vermont found that the risk of advanced pre-cancerous tissue changes (neoplasia) was significantly elevated for women --even if they stopped smoking--but not for men--suggesting that the effects of smoking for women has a longer effect than in men.
Fecal Microbiota Transplants Effective Treatment for C. difficile, Inflammatory Bowel DiseaseGrowing evidence for effectiveness of fecal microbiota transplants as a treatment for patients with recurrent bouts of Clostridium difficile (C.difficile) associated diarrhea is presented in three studies, including a long-term follow-up of colonoscopic fecal microbiota transplant (FMT) for recurrent C. difficile Infection that included 77 patients from five different states.
In a fourth study, investigators from the Centre for Digestive Diseases in Australia explored fecal bacterial transplantation as a treatment for Inflammatory Bowel Disease. While this is a new area of research, results of this study show success in treating IBD when the fecal transplant is done recurrently.
Hepatitis Transmission Risk Needs to Be Studied in Nail Salons, Barbershops: New Analysis Questions Adequacy of Disinfection RegulationsThe risk of hepatitis transmission through non-single use instruments - such as nail files, nail brushes, finger bowls, foot basins, buffers, razors, clippers, and scissors - during nail salon and barbershop visits cannot be excluded according to David A. Johnson, M.D., FACG of Eastern Virginia Medical School who presented an abstract which analyzed a report developed by the Virginia Department of Health.Dr. Johnson's assessment of the Virginia report indicated that there might be potential transmission of bloodborne pathogens (e.g., hepatitis B and C viruses) if non-single-use instruments are not fully cleaned and disinfected according to the state regulations.
Moderate Alcohol Consumption is Associated with Small Intestinal Bacterial OvergrowthJust one drink per day for women--two for men--could lead to small intestinal bacterial overgrowth (SIBO) and subsequently cause gastrointestinal symptoms like bloating, gas, abdominal pain, constipation and diarrhea, according to researchers from Dartmouth-Hitchcock Medical Center and the Mayo Clinic. While previous studies have focused on alcoholics, who were found to have high rates of SIBO, this study is one of the first to look at the relationship between moderate alcohol consumption and SIBO.
Probiotics Effective in Combating Antibiotic-Associated Diarrhea; Promising as Anti-Inflammatory Agent for Patients with Ulcerative Colitis, Psoriasis, Chronic Fatigue SyndromeIn four different studies, researchers explored the effectiveness of probiotics for antibiotic-associated diarrhea; as an anti-inflammatory agent for patients with ulcerative colitis, psoriasis and chronic fatigue syndrome; and for people with abdominal discomfort and bloating who have not been diagnosed with a functional bowel disorder, such as irritable bowel syndrome (IBS).
New Research on Improved Treatment Options and Screening Strategies for Hepatitis CDr. Andrew Muir of Duke University Medical Center and a group of investigators in a large multi-center trial evaluated data on safety and efficacy from two Phase 3 trials (ADVANCE and ILLUMINATE) of the direct acting anti-viral drug telaprevir in combination with the standard of care (peylated interferon and ribavirin) for the treatment of chronic hepatitis C.
Dr. Muir was also involved in an analysis of results of the Phase 2 (PROVE3) and Phase 3 (ADVANCE, ILLUMINATE and REALIZE) telaprevir studies of patients who relapsed to a prior treatment with the standard of care (pegylated interferon and ribavirin.) Prior relapsers are eligible for shortened duration with the telaprevir combination, and this analysis provides some of the rationale for the response-guided therapy approach for these patients
Psychological Traumas Experienced Over Lifetime Linked to Adult Irritable Bowel SyndromeThe psychological and emotional traumas experienced over a lifetime--such as the death of a loved one, divorce, natural disaster, house fire or car accident, physical or mental abuse--may contribute to adult irritable bowel syndrome (IBS), according to researchers from the Mayo Clinic in Rochester, MN. This is the first study that looks at multiple forms of trauma (not just sexual abuse), the timing of those traumas, and traumas in a family setting.
Screening Baby Boomers for Hepatitis C during a Routine Colon Cancer ScreeningInvestigators at Scott & White Hospital in Temple, Texas developed and tested a screening intervention for Hepatitis C virus which identified patients at-risk for chronic Hepatitis C infection by targeting patients ages 50 to 65 who came to the hospital for a routine colonoscopy exam. Research suggests that as much as 70 percent of the undiagnosed Hepatitis C infection in the United States is among Baby Boomers. At Scott & White, over one third of the 376 participants in the study had at least one risk factor for chronic Hepatitis C infection.
Physicians Who Play Mozart While Performing Colonoscopy May Improve Adenoma Detection RatePhysicians who listen to Mozart while performing colonoscopy may increase their detection rates of precancerous polyps, according to researchers from the University of Texas Health Science Center at Houston, who found that adenoma detection rate--the proportion of patients undergoing screening colonoscopy in whom an adenomatous polyp is found and an important measure of a high quality endoscopic exam -- increased from baseline values with music as compared to without music for two endoscopists whose baseline adenoma detection rates were calculated over a one-year period prior to the start of the study.
Research Highlights Training to Improve Colorectal Cancer Detection and Assesses Impact of Pre-Cancerous Changes in the Far Reaches of the ColonOne study was the first study to assess improvements in detection of pre-cancerous growths in the colon through intensive physician training. Other studies highlighted the relationship between the location of pre-cancerous growths in the colon and the development of colorectal cancer in high risk populations, as well as detection rates for pre-cancerous growths in the upper reaches of the colon.
Social Media Has Role in Delivery of Healthcare but Patients Should Proceed With CautionTwo social media related studies highlight the pros and cons of social networking sites like Facebook and YouTube in the delivery of patient care and information. Researchers from the Mayo Clinic in Florida concluded that their Facebook group is vital resource for esophageal cancer survivors and their caregivers. After analyzing the top 100 most viewed IBD-related videos for content, popularity and as a source of patient education information, researchers at the Cleveland Clinic Foundation found that while YouTube can be a powerful tool for patient education and support, overall Inflammatory Bowel Disease (IBD) content posted on YouTube was poor.
U.S. Research Confirms Latitude Variation in Incidence of Chronic Digestive DiseasesInvestigators Explore Potential Role of UV Light Exposure and Vitamin D in Crohn's TherapyNew research points to potential role for UV light exposure and vitamin D status in chronic digestive conditions, Crohn's disease, a serious inflammatory condition in the small intestine, and ulcerative colitis (UC). Results from two large prospective studies among large cohorts of nurses enrolled in the U.S. Nurses Health Study I and II revealed a significant north-south gradient in the association between latitude and incidence of Crohn's disease and ulcerative colitis in the United States, which affects as many as 1.4 million patients in United States, suggesting a link to UV light exposure.
About the American College of GastroenterologyFounded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 12,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. www.acg.gi.org View releases on other research breaking at the ACG meeting at www.acg.gi.org/media/press.asp Follow ACG on Twitter
SOURCE American College of GastroenterologyAstex to present data on Hepatitis C Virus drug
Serum AFP level at the time of diagnosis with Hep C-related hepatocellular carcinoma is an independent predictor of mortality, reports November's issue of Clinical Gastroenterology & Hepatology.
Astex Pharmaceuticals is set to present its data on its first-in-class direct acting antiviral agents (DAA) used to treat Hepatitis C Virus (HCV).
Astex has utilized its proprietary fragment-based drug discovery approach - Pyramid to target an unknown allosteric binding site on the full length HCV NS3 protease - helicase complex.
The company noticed that the agents acting at this site have a novel mode of action and a different resistance profile compared to NS3 protease inhibitors.
The data represent a new approach to develop targeted agents to treat HCV infection.
The company is choosing a clinical candidate with a view to filing an Investigational New Drug (IND) application next year.
The research program has been supported with £2 million funding from the Wellcome Trust Seeding Drug Discovery initiative, is wholly owned by Astex.
α-Fetoprotein predicts mortality in Hep C–related liver cancerClin Gastroenterol Hepatol 2011: 9(11): 989-994
31 October 2011
HPV Vaccine Beneficial in Men Who Have Sex with Men
A quadrivalent HPV vaccine significantly reduced the rate of anal intraepithelial neoplasia in this high-risk population.
The incidence of anal cancer has been increasing in recent years. Often caused by infection with human papillomavirus (HPV), particularly types 16 and 18, this cancer is preceded by high-grade anal intraepithelial neoplasia (AIN; grade 2 or 3). Might the quadrivalent HPV vaccine, which is protective against high-grade cervical intraepithelial neoplasia in women, also protect against AIN? To find out, investigators conducted a multinational, double-blind, controlled vaccine trial in men who have sex with men — a group at high risk for HPV infection and its oncologic complications. The trial was partially funded by the vaccine manufacturer.
A total of 602 men, aged 16 to 26 and HIV negative at the time of enrollment, were randomized to receive three doses of quadrivalent HPV vaccine or placebo. Serum specimens for HPV serologic testing were obtained at baseline and at month 7; detailed anal examinations occurred at baseline and over the next 36 months.
No cases of anal cancer occurred, which was expected because of the relatively young age of trial participants. Vaccine efficacy against AIN associated with the four vaccine HPV types — 6, 11, 16, and 18 — was 50.3% (95% confidence interval, 25.7–67.2) in the intent-to-treat population and 77.5% (95% CI, 39.6–93.3) in the per-protocol population. Efficacy against persistent anal infection with a vaccine HPV type was 59.4% (95% CI, 43.0–71.4) and 94.9% (95% CI, 80.4–99.4), respectively. Adverse events were mostly local injection-site reactions and were similar between the two groups; no serious vaccine-related adverse events or deaths were reported.
Comment: As noted by the authors, HPV vaccination in this population presents special problems. By the time young males have "come out" to their parents or physicians, they have probably already initiated sexual activity, thus precluding maximal protection from the vaccine. Furthermore, they would gain little or no benefit from any herd immunity that might result from vaccinating girls and women. This trial supports the continued expansion of HPV vaccine use — and provides an additional reason to immunize boys before the onset of sexual activity.
Published in Journal Watch Infectious Diseases October 26, 2011
Palefsky JM et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med 2011 Oct 27; 365:1576.
"The case for dietary supplements is collapsing. A succession of large-scale human studies…suggests that multivitamins and many other dietary supplements often don't have health benefits -- and in some cases may even cause harm. The data have prompted some nutrition researchers to say taking vitamins is a waste of money for those without a specific nutrient deficiency or chronic illness. Such findings have also fueled a debate about whether the field should continue conducting expensive human trials to figure out whether particular supplements affect health…For instance, vitamins B-6 and B-12 are often touted as being good for the heart, but several studies have failed to find that they lower risk of cardiovascular disease...Vitamin C hasn't been shown in many studies to lower a person's risk of getting a cold. Calcium, while important to bone health, doesn't lower risk of heart disease or cancer and may increase risk of kidney stones…Researchers and nutritionists are still recommending dietary supplements for the malnourished or people with certain nutrient deficiencies or medical conditions. For instance folic acid -- the supplement form of folate -- reduces the likelihood of a common birth defect if taken by pregnant women. Studying the effects of vitamins and supplements in the real world is difficult, since people eat foods with multiple nutrients that can interact with supplements and skew results. And observational trials can only show an association, not cause and effect…Micronutrients, which include antioxidants like vitamin C, hormones like vitamin D and metals like iron, are essential to the body in small amounts because they help facilitate important reactions in and between cells. Too much of them, however, can cause problems. The effectiveness of many dietary supplements remains untested and makers aren't required to do tests before selling a product. Still, about half of Americans reported taking at least one supplement a month in 2006…The supplement industry brought in $28 billion in sales in 2010…Vitamin users may derive a benefit from the placebo effect, experts say. And they often are convinced the supplements make them feel better, regardless of what studies show."
ScienceDaily (Oct. 28, 2011) — Scientists including those from Queen's University have discovered that taking regular aspirin halves the risk of developing hereditary cancers.
Hereditary cancers are those which develop as a result of a gene fault inherited from a parent. Bowel and womb cancers are the most common forms of hereditary cancers. Fifty thousand people in the UK are diagnosed with bowel and womb cancers every year; 10 per cent of these cancers are thought to be hereditary.
The decade-long study, which involved scientists and clinicians from 43 centres in 16 countries and was funded by Cancer Research UK, followed nearly 1,000 patients, in some cases for over 10 years. The study found that those who had been taking a regular dose of aspirin had 50 per cent fewer incidents of hereditary cancer compared with those who were not taking aspirin.
The research focused on people with Lynch syndrome which is an inherited genetic disorder that causes cancer by affecting genes responsible for detecting and repairing damage in the DNA. Around 50 per cent of those with Lynch syndrome develop cancer, mainly in the bowel and womb. The study looked at all cancers related to the syndrome, and found that almost 30 per cent of the patients not taking aspirin had developed a cancer compared to around 15 per cent of those taking the aspirin.
Those who had taken aspirin still developed the same number of polyps, which are thought to be precursors of cancer, as those who did not take aspirin but they did not go on to develop cancer. It suggests that aspirin could possibly be causing these cells to destruct before they turn cancerous.
Over 1,000 people were diagnosed with bowel cancer in Northern Ireland last year; 400 of these died from the disease. Ten per cent of bowel cancer cases are hereditary and by taking aspirin regularly the number of those dying from the hereditary form of the disease could be halved.
Professor Patrick Morrison from Queen's University in Belfast, who led the Northern Ireland part of the study, said: "The results of this study, which has been ongoing for over a decade, proves that the regular intake of aspirin over a prolonged period halves the risk of developing hereditary cancers. The effects of aspirin in the first five years of the study were not clear but in those who took aspirin for between five and ten years the results were very clear."
"This is a huge breakthrough in terms of cancer prevention. For those who have a history of hereditary cancers in their family, like bowel and womb cancers, this will be welcome news. Not only does it show we can reduce cancer rates and ultimately deaths, it opens up other avenues for further cancer prevention research. We aim now to go forward with another trial to assess the most effective dosage of aspirin for hereditary cancer prevention and to look at the use of aspirin in the general population as a way of reducing the risk of bowel cancer.
"For anyone considering taking aspirin I would recommend discussing this with your GP first as aspirin is known to bring with it a risk of stomach complaints, including ulcers."
The research was published online Oct. 28 in The Lancet.
ROCHESTER, Minn. -- Patients who complain of upper gastrointestinal (GI) symptoms often face a diagnosis of either gastroesophageal reflux disease (GERD) or functional dyspepsia. Because the two conditions often overlap, it can be difficult to distinguish between them and diagnose them properly. Yet ambulatory care facilities and hospitals have reported a dramatic increase in the number of GERD-related visits/discharges in recent years.
This led a team of researchers at Mayo Clinic, others from the United States, Europe and Australia to question if "observer bias" plays a role in the diagnosis of GERD, compared to a diagnosis of functional dyspepsia. As reported today during the American College of Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course, such a bias exists and increases the likelihood of a diagnosis of GERD. This theory is supported by the following findings from the study:
- In the last 20 years, the number of GERD diagnoses has increased despite a simultaneous decrease in GERD symptoms.
- In the presence of both functional dyspepsia and GERD symptoms, GERD is diagnosed most commonly.
- GERD is the most likely diagnosis in the presence of functional dyspepsia symptoms only.
"These findings serve as a reminder to all physicians to keep an open mind when patients complain of upper GI pain," says senior author G. Richard Locke, M.D., a Mayo Clinic gastroenterologist. "It is worth considering every possible cause of the symptoms, including the sometimes challenging-to-treat functional dyspepsia. Plus, if we believe the patient's symptoms are caused by GERD, we must confirm that diagnosis."
The study also found that:
- Between 1985 and 2009, diagnosis rates of GERD rose from 325 per 100,000 patients to 1,866.
- Symptom reporting for GERD actually decreased from 12 percent during the period from 1988 to 1994, to 7.6 percent in 2008-2009.
- Overall functional dyspepsia diagnosis rates rose from 45 in 1985 to 964 in 1999, yet decreased to 452 between 1999 and 2009.
- Functional dyspepsia symptom reporting was stable at around 5 percent throughout the various survey periods.
- The chance of receiving a GERD diagnosis when reporting GERD symptoms was 63 percent, while the chance of receiving an functional dyspepsia diagnosis when reporting functional dyspepsia symptoms was 12.5 percent.
- Forty-five percent of subjects reporting both GERD and functional dyspepsia symptoms were diagnosed with GERD only.
- Fifty percent of subjects reporting functional dyspepsia symptoms only were diagnosed with both GERD and functional dyspepsia.
About GERD, Functional Dyspepsia
Gastroesophageal reflux disease, or GERD, is a condition in which stomach contents leak backward from the stomach into the esophagus, the tube that connects the mouth to the stomach. This can irritate the esophagus, causing heartburn and other symptoms. Functional dyspepsia is a common, but poorly understood, upper GI condition that is described as nonulcer stomach pain. Functional dyspepsia causes chronic abdominal pain/indigestion and a sensation of fullness, pressure or discomfort in the upper abdomen.
About Mayo Clinic
U.S. Health Care
(The Wall Street Journal, New York, October 25, 2011)
"As hospitals get better at keeping serious infections from spreading to patients, a new source of worry is emerging: outpatient clinics, where reports of dangerous transmissions of bacteria and viruses have been on the rise. The Centers for Disease Control and Prevention [CDC]…is launching a campaign to reduce the rate of infection among the more than one million cancer patients a year who receive chemotherapy and radiation treatments in outpatient oncology clinics. Health care provided by outpatient clinics...has surged in recent years because the centers are typically cheaper and more convenient than hospitals. Unlike hospitals, however, the clinics are not tightly regulated or inspected and may not have formal infection-control programs. In the past decade, the CDC says, more than 125,000 patients have had to be notified of potential exposure to disease from unsafe injection practices alone."..
Obama Issues Executive Order On Drug Shortages