Edmund's Newsletter January 29, 2008 Issue: #5 Volume 8 Join Our List In This Issue NSAIDs No Better Than Other Over-the-Counter Drugs for Low Back Pain Stanford Study Finds Transplant Patient Thrives Two Years After Stopping Immunosuppresive Drugs Drugs to Bulk Up Muscles May Make Injuries More Likely Pharmacists Believe Drive-Through Windows Contribute To Delays And Errors Saline Nasal Wash Helps Improve Children's Cold Symptoms Einstein Researchers: Do National Dietary Guidelines Do More Harm Than Good? Pros, Cons of Drug Proven to Prevent Prostate Cancer Should Be Considered, Researchers Recommend Quick Links Edmund's Blog Edmund's Newsletter Edmund's Web Page Past Issues SPECIAL THANKS TO Michael R. Cohen President The Institute for Safe Medication Practices and Dr. Stephen Barrett Quackwatch Some links in Edmund's Newsletter will point to a page that requires registration.  In all cases the most you will have to do is fill out a simple form to enroll as a member.  In no case will I point you to a site that requires payment to view the page. PRAY FOR PEACE © 2001,2002, 2003, 2004, 2005, 2006, 2007 Join Our List NSAIDs No Better Than Other Over-the-Counter Drugs for Low Back Pain When low back pain strikes, many people turn to non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen and ibuprofen, or their newer COX-2 inhibitor cousin Celebrex. However, these drugs work no better than old faithful acetaminophen (Tylenol), according to a new review of studies. Review data "support guidelines for the management of low back pain in primary care that recommend NSAIDs as a treatment option after paracetamol has been tried, since there are fewer side effects with paracetamol," said lead reviewer Pepijn Roelofs. Paracetamol is the European version of Tylenol. The researchers examined 65 studies, covering more than 11,000 low back pain sufferers. They concluded that NSAIDs are "slightly effective" for short-term symptomatic relief, allowing a return to normal activity in patients with acute and chronic low back pain without sciatica. The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic. Read more..... Stanford Study Finds Transplant Patient Thrives Two Years After Stopping Immunosuppresive Drugs  Luck smiled on Larry Kowalski when his brother agreed to donate a kidney Kowalski needed to live. He was even luckier that his brother's kidney was such a good match. That last stroke of luck led Kowalski to connect with a team of researchers at the Stanford University School Medicine, whose efforts have enabled him for two years to live free of the heavy-duty drugs that transplant patients normally have to take for the rest of their lives. The researchers describe Kowalski's case in a brief report published in the Jan. 24 issue of The New England Journal of Medicine on the technique they developed, based on 25 years of research by Samuel Strober, MD, professor of immunology and rheumatology. The journal issue also includes two reports from other research groups, describing their efforts to achieve organ transplantation without long-term immunosuppressive drugs. Kowalski, now 50, was 3 years old when doctors discovered he had been born with only one kidney. His single kidney held out until he was 47. Then a blood test indicated that it was beginning to fail. Read more..... Drugs to Bulk Up Muscles May Make Injuries More Likely A study in mice by U-M post-doctoral research fellow Christopher Mendias, left, and John Faulkner, professor in the Department of Molecular and Integrative Physiology at the U-M Medical School, suggest that a promising class of drugs to build up muscles may have a downside: brittle tendons.   That may sound like a good idea to people with muscle-wasting diseases such as muscular dystrophy, and to older people, whose muscles naturally get smaller and weaker with age. Drugs that restrict the protein myostatin, which normally prevents muscles from being overly bulky, are currently under study, but not on the market, for some medical conditions. Such drugs, called myostatin inhibitors, also are stirring interest among body builders and athletes. There are already signs of a nascent black market for what might become another illegal performance-enhancing drug in organized sports. Now, a new University of Michigan study in mice suggests that while myostatin inhibitors may indeed bulk up muscles, they may also bring a troubling side effect - small, brittle tendons that could make muscle injuries more likely. Read more..... Pharmacists Believe Drive-Through Windows Contribute To Delays And Errors Consumers who pick up their prescription medications at a pharmacy drive-through window might be jeopardizing their own safety in the name of convenience. A new study indicates that pharmacists who work at locations with drive-through windows believe the extra distractions associated with window service contribute to processing delays, reduced efficiency and even dispensing errors. The surveyed pharmacists reported that the design and layout of their workplace has an impact on dispensing accuracy, especially the presence of drive-through window pick-up services. Results also indicate that automated dispensing systems in pharmacies are likely to reduce the potential for errors and enhance efficiency. The study suggests pharmacy design should emphasize minimal workflow interruptions but it also offers a caution to consumers to check their prescription medications, especially those obtained from a pharmacy's drive-through window, said Sheryl Szeinbach, the study's lead author and a professor of pharmacy practice and administration at Ohio State University. Read more..... Saline Nasal Wash Helps Improve Children's Cold Symptoms A saline nasal wash solution made from processed seawater appears to improve nasal symptoms and may help prevent the recurrence of respiratory infections when used by children with the common cold, according to a new report. Infections of the upper respiratory tract and sinus infections are common among children, according to background information in the article. "Nasal irrigation with isotonic [balanced] saline solutions seems effective in such health conditions and is often used in a variety of indications as an adjunctive treatment," the authors write as background information in the article. "Although saline nasal wash is currently mentioned in several guidelines, scientific evidence of its efficacy is rather poor." Ivo Slapak, M.D., of Teaching Hospital Brno, Brno, Czech Republic, and colleagues randomly assigned 401 children age 6 to 10 with cold or flu to two treatment groups, one receiving standard medication and the other also receiving a nasal wash with a modified processed seawater solution. "Patients were observed for a total of 12 weeks, from January to April 2006, during which health status, symptoms and medication use were assessed at four visits over the course of the trial," the authors write. "Acute illness was evaluated during the first two visits (up to three weeks), prevention during the following two visits (up to 12 weeks). The third visit, scheduled for week eight after study entry, could be conducted over the telephone." Read more..... Einstein Researchers: Do National Dietary Guidelines Do More Harm Than Good? For nearly three decades, Americans have become accustomed to hearing about the latest dietary guidelines, which are required by federal regulation to be revised and reissued at five-year intervals. Mid-way to the drafting of the 2010 guidelines, researchers at Albert Einstein College of Medicine of Yeshiva University raise questions about the benefits of federal dietary guidelines, and urge that guideline writers be guided by explicit standards of evidence to ensure the public good. The researchers, led by Paul Marantz, M.D., MPH, associate dean for clinical research education at Einstein, outline their argument in the January 22 online edition of the American Journal of Preventive Medicine. "When dietary guidelines were initially introduced in the late 1970s, their population-based approach was especially attractive since it was presumed to carry little risk," says Dr. Marantz, who also is professor of epidemiology and population health, and of medicine at Einstein. "However, the message delivered by these guidelines might actually have had a negative impact on health, including our current obesity epidemic. The possibility that these dietary guidelines might actually be endangering health is at the core of our concern about the way guidelines are currently developed and issued." Dr. Marantz and colleagues argue that if guidelines can alter behavior, such alteration could have positive or negative effects. They cite how, in 2000, the Dietary Guideline Advisory Committee suggested that the recommendation to lower fat, advised in the 1995 guidelines, had perhaps been ill-advised and might actually have some potential harm. The committee noted concern that "the previous priority given to a 'low-fat intake' may lead people to believe that, as long as fat intake is low, the diet will be entirely healthful. This belief could engender an overconsumption of total calories in the form of carbohydrates, resulting in the adverse metabolic consequences of high-carbohydrate diets," the committee wrote, while also noting that "an increasing prevalence of obesity in the United States has corresponded roughly with an absolute increase in carbohydrate consumption." Read more..... Pros, Cons of Drug Proven to Prevent Prostate Cancer Should Be Considered, Researchers Recommend Findings by UT Southwestern Medical Center researchers encourage men to weigh both the potential benefits and side effects of the drug finasteride before taking it to prevent prostate cancer. In today's online issue of Cancer, UT Southwestern doctors analyzed data gathered by the National Cancer Institute's Prostate Cancer Prevention Trial, or PCPT. The trial, which began in October 1993, was designed to test whether finasteride could prevent prostate cancer in men 55 years of age and older. It was stopped early        UT Southwestern's analysis of the PCPT data indicates that cost effectiveness and quality of life issues associated with taking the drug are not clear cut, said Dr. Yair Lotan, assistant professor of urology and the Cancer study's senior author. The PCPT data show that in addition to preventing prostate cancer, finasteride also reduces urinary-tract symptoms associated with benign prostatic hyperplasia. It also decreased sexual desire and caused impotence in 5 percent of the trial participants. Some PCPT participants who did develop prostate cancer also had high-grade tumors, although there is ongoing debate whether this result might have been due to sampling bias. "Finasteride is currently the only drug that has been shown to prevent prostate cancer in a large randomized trial but is used for this purpose in very few men," Dr. Lotan said. "A large number of patients are currently taking over-the-counter supplements to prevent prostate cancer, even though there is no scientific evidence to support these products' claims. It's important for patients to be aware of this scientific trial and to ask their doctors if finasteride could benefit them." Read more..... Believe it or not Sweden to study belching cows A Swedish university has received $590,000 in research funds to measure the greenhouse gases released when cows belch.   About 20 cows will participate in the project run by the Swedish University for Agricultural Sciences in Uppsala, about 40 miles north of Stockholm, officials said Monday. Cattle release methane, a greenhouse gas believed to contribute to global warming, when they digest their food. Researchers believe the level of methane released depends on the type of food the eat. Project leader Jan Bertilsson said that the cows involved in the study will have different diets and wear a collar device measuring the methane level in the air around them. He said 95 percent of the methane released by cows comes out through the mouth. "This type of research is already being conducted in Canada so we will be in contact with Canadian agricultural researchers in the near future," he said. The research will be funded by a grant from the government's Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning News From MedWatch Keep up-to-date on all of the recent MedWatch reports that gives you timely safety information on the drugs and other medical products regulated by the U.S. Food and Drug Administration by  CLICKING HERE   Recently Approved Drugs/Indications Keep up-to-date on all of the recently approved drugs and/or approved new indications on already FDA approved drugs by CLICKING HERE   FDA Recalls and Safety Alerts in the Past 60 Days: To see a list of all FDA Recalls and product safety alerts for the last 60 days CLICK HERE   Drug Shortages: As many of you are aware, many drugs in the US are either unavailable or in short supply.  To view a list of these drugs CLICK HERE   Recommend Edmund's Newsletter Edmund's Newsletter is published for only one reason and that is expand our knowledge base, join people together with like minds and to disseminate valuable information. 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