Edmund's Newsletter
October 28, 2008
Issue: #44 Volume 8
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In This Issue
Green Tea May Delay Onset Of Type 1 Diabetes
Post-cardiac Arrest Care Key To Survival
High-Dose Flu Vaccine Boosts Immunity Safely in the Elderly
Doctors Often Prescribe Placebo Treatments
Drug Improves Outcomes for Gout Patients
If Your Systolic Stinks, Rotten Egg" Gas May Be Why
Researchers Identify Novel Type of Antibody that Potently Inhibits HIV Infection
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News From MedWatch
Recently Approved Drugs/Indications
FDA Recalls and Safety Alerts in the Past 60 Days
Drug Shortages
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Green Tea May Delay Onset Of Type 1 Diabetes
A powerful antioxidant in green tea may prevent or delay the onset of type 1 diabetes, Medical College of Georgia researchers say.

Researchers were testing EGCG, green tea's predominant antioxidant, in a laboratory mouse with type 1 diabetes and primary Sjogren's syndrome, which damages moisture-producing glands, causing dry mouth and eyes.

"Our study focused on Sjogren's syndrome, so learning that EGCG also can prevent and delay insulin-dependent type 1 diabetes was a big surprise," says Dr. Stephen Hsu, molecular/cell biologist in the School of Dentistry.
Post-cardiac Arrest Care Key To Survival
The urgent need for treatment doesn't end when a person regains a pulse after suffering sudden cardiac arrest - healthcare providers need to move quickly into post-cardiac arrest care to keep a person alive and ensure the best outcome.

That's the conclusion of the American Heart Association science advisory published in Circulation: Journal of the American Heart Association.

Brain injury, heart dysfunction, systemic inflammation and the underlying disease that caused the cardiac arrest all contribute to the high death rate of patients who initially have their pulse re-started. Collectively, these symptoms are known as post-cardiac arrest syndrome.

The largest modern report of cardiac arrest resuscitation was published by the National Registry of CPR in 2006. Among the 19,819 adults and 524 children whose hearts were re-started, in-hospital mortality rates were 67 percent and 55 percent, respectively.

The new statement says there is growing evidence that post-cardiac arrest care can lower the death rate and improve functional outcome for these patients.
High-Dose Flu Vaccine Boosts Immunity Safely in the Elderly
Increasing the dose of a standard influenza vaccine raised immune responses safely in individuals 65 and older and should improve protection against flu outbreaks, researchers reported.

Although the recommended doses of influenza vaccines produce significant responses in most susceptible younger adults, immune competence appears to decrease with increasing age. One way to improve immunogenicity in inactivated vaccines is to increase the dose of antigen in the current U.S. vaccine, researchers wrote in the May 22 Archives of Internal Medicine.

At present, recommended vaccines contain 15µg of inactivated virus per strain, said Wendy Keitel, M.D., at Baylor College of Medicine here, and colleagues.

In a dose-response study of 202 ambulatory individuals ages 65 and older (mean age 72.4.), participants (41% women) were randomly assigned to a placebo or a single intramuscular injection of a flu vaccine in one of three formulations: 15µg, 30 µg, or 60 µg of hemagglutinin per strain (up to 180 µg total per dose).
Doctors Often Prescribe Placebo Treatments
American doctors regularly prescribe placebo pills that are intended to have a psychological effect, a new survey finds.

However, the placebos reported by the 679 physicians in the survey often aren't the inactive substances used in controlled clinical trials, said Dr. Farr A. Curlin, an assistant professor of medicine at the University of Chicago, and a member of the team reporting the finding in the Oct. 24 issue of the BMJ.

"Most people when they say 'placebo' think of something like a sugar pill," Curlin said. "But doctors can use a treatment that may have some effects but that they think will not have a direct effect on the patient except by the placebo effect."

The placebo effect, well-established in countless studies, is a benefit produced by assuring someone that whatever is being given will benefit whatever the problem happens to be -- "optimism or confidence that something is being done," as Curlin phrased it.

Only 3 percent of the doctors responding in the survey reported prescribing sugar pills. But 41 percent said they used over-the-counter painkillers as placebos, 38 percent used vitamins, 13 percent used antibiotics, and 13 percent used sedatives.
Drug Improves Outcomes for Gout Patients
The drug pegloticase (Puricase) may help gout patients who've had no luck with other treatments, according to researchers who studied 212 patients who'd run out of treatment options.

They were randomly assigned to receive six months of intravenous treatment with either pegloticase or a placebo. One group of patients received 8 milligrams of pegloticase every two weeks, another group received 8 milligrams of pegloticase every four weeks, and a third group received the placebo.

The patients -- mostly men with an average age of 55 years -- had a significantly better response to pegloticase than to the placebo. While there wasn't a significant difference in number of gout flares, more of the patients who took the drug had more complete resolution of tophi, which are chalky deposits or uric acid. The patients who took pegloticase also noticed improved physical function.
If Your Systolic Stinks, Rotten Egg" Gas May Be Why
Anyone with a nose knows the rotten-egg odor of hydrogen sulfide, a gas generated by bacteria living in the human colon. Now an international team of scientists has discovered that cells inside the blood vessels of mice - as well as in people, no doubt - naturally make the gassy stuff, and that it controls blood pressure.

Having discovered that hydrogen sulfide, or H2S, is produced in the thin, endothelial lining of blood vessels, the researchers, including scientists from Johns Hopkins, report today in Science that H2S regulates blood pressure by relaxing blood vessels. As the newest member of a family of so-called gasotransmitters, this messenger molecule is akin in function, if not form, to chemical signals like nitric oxide, dopamine and acetylcholine that relay signals between nerve cells and excite or put the brakes on mind-brain activities.

"Now that we know hydrogen sulfide's role in regulating blood pressure, it may be possible to design drug therapies that enhance its formation as an alternative to the current methods of treatment for hypertension," says Johns Hopkins neuroscientist Solomon H. Snyder, M.D., a co-author of the paper.
Researchers Identify Novel Type of Antibody that Potently Inhibits HIV Infection
A small antibody fragment that is highly effective in neutralizing the human immunodeficiency virus (HIV) by preventing the virus from entering cells has been identified by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). This finding may provide insight into the development of new treatments against HIV and other viruses, hopefully in the not too distant future. The study appears online Oct. 20, 2008, in Proceedings of the National Academy of Sciences.

Treating HIV-infected individuals is difficult because the virus is able to mutate and become resistant to antiretroviral drugs. "In the United States, it is estimated that more than 50 percent of patients who are receiving antiretroviral therapy for their HIV infection carry strains of the virus that are resistant to treatment with at least one of the currently available antiretroviral drugs," said NCI Director John E. Niederhuber, M.D. "The development of new drugs against HIV is an urgent public health need."

Antibodies are large proteins naturally produced by the immune system to help fight disease-causing foreign invaders, such as viruses and bacteria. Although the general structure of all antibodies is very similar, a small region at the tip of the protein is extremely variable, allowing millions of antibodies, characterized by slightly different tip structures, to exist and bind to different targets, known as antigens. Previous research has shown that reducing antibodies to the smallest independently functional fragment, known as a variable domain, can extend their utility as therapeutic agents. These fragments, called domain antibodies (dAbs), retain the variable tip structure and, therefore, the antigen-binding specificity of the parent antibody. Because of their small size, they are able to access targets that cannot be reached by much larger, whole antibodies.
Believe it or not
Dallas hospital bills woman who never saw a doctor

Digg Facebook Newsvine del.icio.us Reddit StumbleUpon Technorati Yahoo! Bookmarks Print Tue Oct 21, 8:14 pm ETDALLAS - A woman says she waited 19 hours at Parkland Memorial Hospital's emergency department for treatment of a broken leg and never did get to see a doctor - but still got a bill for $162. Amber Joy Milbrodt, who said she broke a bone in her leg while playing volleyball, received the bill two weeks after her Sept. 24 visit.

Parkland officials said the bill was appropriate because a nurse spent time checking her vital signs to assess her level of need.

But that's not how Milbrodt sees it. "It should have been more like them paying me for having to sit in the emergency room for 19 hours," she told The Dallas Morning News.

The assessment by the nurse, which lasted a few minutes, established her place in line that night. By that time, Milbrodt said, she had already been waiting about 3 1/2 hours.

She still had not been called more than 15 hours later, so she gave up and went home. She an X-ray taken at a chiropractic school where she is a student had already confirmed that she had a fracture.

"She's not paying for waiting," says Rick Rhine, the hospital's vice president in charge of billing. "She's paying for the assessment she received."

Milbrodt, 29, who has no insurance, said she does not plan to pay. After leaving the ER, she rested at home for a few days and then put her leg in a brace, which she still wears. It seems to be healing, she said.

A few days before Milbrodt's visit, a 58-year-old man who went to the ER with stomach pains also waited 19 hours - and then suffered cardiac arrest and died.

Hospital officials say they need more beds to handle the excessive number of patients who need care. A bond measure on the Nov. 4 ballot would provide funds for a new, larger hospital.

Fort Worth's large public hospital, John Peter Smith, shares Parkland's policy of charging for a triage assessment. But other hospitals in Dallas, such as Baylor University Medical Center, don't charge if the person never sees a doctor.
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
 
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