Saturday April 26, 2008

India recalls measles vaccine after child deaths

396.jpgNEW DELHI (AFP) - India has recalled over four million doses of a measles vaccine supplied by a south Indian drug manufacturer after four children died following inoculation with the drug, reports said Friday.

“All state governments have been instructed to stop use of the measles vaccine manufactured by the Indian Immunological Limited until further orders,” Health Minister Anbumani Ramadoss told the Press Trust of India news agency.

Further supplies from the manufacturer have also been halted, he said.

The government late Thursday ordered the recall of some four million doses of the vaccine already supplied by Hyderabad-based Indian Immunologicals Limited out of an overall order of nine million, the Indian Express daily said.

The recall came after four infants who received the measles vaccine in the southern state of Tamil Nadu died on Wednesday.

Parents said their babies started frothing at the mouth and nose and died within 15 to 20 minutes of being administered the vaccine, news channel NDTV reported.

The state health minister has said the children might have had a severe allergic reaction to the vaccine, noting that some 20,000 children in Tamil Nadu were inoculated against measles with the same drug Wednesday.

Samples of the vaccine have been sent to a national laboratory for testing and a team of health experts is examining how the vaccine was stored and how health workers administered it.

For now, Tamil Nadu state has suspended its measles vaccination programme and inoculation programmes in other states are also likely to be hit by the recall.

An Indian minister expressed concern that the development could jeopardise India’s larger immunisation efforts, sometimes beset by rumours about the safety of the injections.

In the past, India’s attempts to eradicate polio have been delayed after some Islamic clerics spread rumours the vaccines would harm Muslim children.

Medical marijuana patients face transplant hurdles

386.jpgSEATTLE - Timothy Garon’s face and arms are hauntingly skeletal, but the fluid building up in his abdomen makes the 56-year-old musician look eight months pregnant.

His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.

But Garon’s been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons.

“I’m not angry, I’m not mad, I’m just confused,” said Garon, lying in his hospital bed a few minutes after a doctor told him the hospital transplant committee’s decision Thursday.

With the scarcity of donated organs, transplant committees like the one at the University of Washington Medical Center use tough standards, including whether the candidate has other serious health problems or is likely to drink or do drugs.

And with cases like Garon’s, they also have to consider — as a dozen states now have medical marijuana laws — if using dope with a doctor’s blessing should be held against a dying patient in need of a transplant.

Most transplant centers struggle with the how to deal with people who have used marijuana, said Dr. Robert Sade, director of the Institute of Human Values in Health Care at the Medical University of South Carolina.

“Marijuana, unlike alcohol, has no direct effect on the liver. It is however a concern … in that it’s a potential indicator of an addictive personality,” Sade said.

The Virginia-based United Network for Organ Sharing, which oversees the nation’s transplant system, leaves it to individual hospitals to develop criteria for transplant candidates.

At some, people who use “illicit substances” — including medical marijuana, even in states that allow it — are automatically rejected. At others, such as the UCLA Medical Center, patients are given a chance to reapply if they stay clean for six months. Marijuana is illegal under federal law.

Garon believes he got hepatitis by sharing needles with “speed freaks” as a teenager. In recent years, he said, pot has been the only drug he’s used. In December, he was arrested for growing marijuana.

Garon, who has been hospitalized or in hospice care for two months straight, said he turned to the university hospital after Seattle’s Harborview Medical Center told him he needed six months of abstinence.

The university also denied him, but said it would reconsider if he enrolled in a 60-day drug-treatment program. This week, at the urging of Garon’s lawyer, the university’s transplant team reconsidered anyway, but it stuck to its decision.

Dr. Brad Roter, the Seattle physician who authorized Garon’s pot use for nausea, abdominal pain and to stimulate his appetite, said he did not know it would be such a hurdle if Garon were to need a transplant.

That’s typically the case, said Peggy Stewart, a clinical social worker on the liver transplant team at UCLA who has researched the issue. “There needs to be some kind of national eligibility criteria,” she said.

The patients “are trusting their physician to do the right thing. The physician prescribes marijuana, they take the marijuana, and they are shocked that this is now the end result,” she said.

No one tracks how many patients are denied transplants over medical marijuana use.

Pro-marijuana groups have cited a handful of cases, including at least two patient deaths, in Oregon and California, since the mid-to-late 1990s, when states began adopting medical marijuana laws.

Many doctors agree that using marijuana — smoking it, especially — is out of the question post-transplant.

The drugs patients take to help their bodies accept a new organ increase the risk of aspergillosis, a frequently fatal infection caused by a common mold found in marijuana and tobacco.

But there’s little information on whether using marijuana is a problem before the transplant, said Dr. Emily Blumberg, an infectious disease specialist who works with transplant patients at the University of Pennsylvania Hospital.

Further complicating matters, Blumberg said, is that some insurers require proof of abstinence, such as drug tests, before they’ll agree to pay for transplants.

Dr. Jorge Reyes, a liver transplant surgeon at the UW Medical Center, said that while medical marijuana use isn’t in itself a sign of substance abuse, it must be evaluated in the context of each patient.

“The concern is that patients who have been using it will not be able to stop,” Reyes said.

Dale Gieringer, state coordinator for the California chapter of NORML, the National Organization for the Reform of Marijuana Laws, scoffed at that notion.

“Everyone agrees that marijuana is the least habit-forming of all the recreational drugs, including alcohol,” Gieringer said. “And unlike a lot of prescription medications, it’s nontoxic to the liver.”

Reyes and other UW officials declined to discuss Garon’s case.

But Reyes said that in addition to medical concerns, transplant committees — which often include surgeons, social workers, and nutritionists — must evaluate whether patients have the support and psychiatric health to cope with a complex post-operative regimen for the rest of their lives.

Garon, the lead singer for Nearly Dan, a Steely Dan cover-band, remains charged with manufacturing weed. He insists he was following the state law, which limits patients to a “60-day supply” but doesn’t define that amount.

“He’s just a fantastic musician, and he’s a great guy,” said his girlfriend, Leisa Bueno. “I wish there was something we could do legally. … I’m going to miss him terribly if he passes.”

Thursday April 24, 2008

Today in Your Health Matters: April 24, 2008

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12 million Americans corrected their vision with lasik surgery. But after dozens of recent reports citing problems with the procedure…the FDA is taking a seconds look at lasik.

Millions of Americans suffer from foot pain…and exercise your toes and feet can help!

Before you hit send, you may want to pick up the phone to get medical advice. A recent survey shows American doctors aren’t all that receptive to emails.

Vets Call Suicide Hotline In Record Numbers

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SAN FRANCISCO (KCBS)  — The number of Iraq war veterans contacting a suicide hotline soared last month, according to information revealed Thursday during a federal trial in San Francisco.

Dr. Michael Kussman, Undersecretary for the Department of Veterans Affairs, was called to the stand by plaintiffs who are suing the government for failing to implement its own Mental health Strategic plan.

Kussman testified that the suicide hotline recieved 5,000 calls from veterans last month. That makes March the busiest month for the hotline since it was established in July of 2007.

“It’s a failure to implement the programs to deal with these veterans. This is an epidemic of suicides with veterans coming back from the war, and there’s a lot of trouble with Vietnam vets,” said attorney Gordon Erspamer, who represents the plaintiffs.

War veterans are returning with severe brain injuries and suffer from post traumatic stress disorder. Under intense questioning, Dr. Kussman agreed that access to mental health care is among the top complaints, but that the V.A. is ideally poised to care for veterans as they transition out of the military.

Kussman admitted 16% of V.A. facilities have no referral system for vets at risk of suicide.

Alzheimer’s drug may be tested on humans in 2 years

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Scientists have devised a new drug to fight the most common form of dementia that could be tested on patients within two years.

  • Drug companies ‘chasing wrong Alzheimer’s target’
  • Dementia “type three diabetes”
  • Glaucoma could be early warning for Alzheimer’s

    There are around three quarters of a million people in the UK with dementia and Alzheimer’s is becoming increasingly common as the population ages. However, there are no effective treatments.

  •  

    Now a new way to fight the devastating disorder has emerged from devising a novel way to prevent what some scientists believe is the underlying cause, the build up of protein deposits in the brain, and in precisely the place where this damage occurs.

    The new drug was found to be effective when tested on fruit flies and mice that have been genetically engineered to develop the disease, showing that it could halve the harmful deposits in a few hours. Tests on humans are planned in around two years, after more testing on animals.

    Today, in the journal Science, the team of academics at the Max Plank Institute, Dresden, led by the company Jado Technologies, describes how the new approach has emerged from the discovery of a way to target an enzyme that is central to the build up of deposits in the brain of a protein called beta amyloid.

    The drug targets the membrane of brain cells, focusing on compartments in the membrane, called “rafts”, that play a central role in many cellular processes.

    Although this drug is not the first to target the enzyme, called beta secretase, it is the first to do so in the right place, in the “intracellular membrane compartment” where the enzyme triggers the protein deposit build-ups. The team has devised a way to anchor the drug to the membrane to stop the harmful deposits.

    “Our data provide proof-of-principle of a new approach for directing small molecule inhibitors to disease causing raft targets in cellular membranes. In this instance, by directing inhibition to the sub-compartment where the enzyme is active, the approach has potential to be used in the design of more effective beta-secretase inhibitors for the treatment of Alzheimer’s disease,” noted Prof Kai Simons, Max-Planck Institute of Molecular Cell Biology and Genetics, Dresden, and co-founder of Jado.

    In tests on animals, the drug reduced beta-amyloid formation in the brain by 50 per cent over four hours, when targeted this way. However, when not targetted at the membrane the drug was ineffective.

    The key was using another molecule, called sterol, as the “anchor” for the enzyme inhibitor.

    Dr Lawrence Rajendran, first author, believes that this way of anchoring drugs to the cell membrane is a “proof-of-principle” for an approach that could be crucial for treating many other diseases too, such as Ebola and Aids. “It is like hitchhiking into the cell: We use cellular strategies to deliver the inhibitors to the exact site where they are needed - and maybe, one day, to combat Alzheimer’s disease.”

    “Routine animal studies have to be performed before we go to clinical trials,” he says. “We expect that this might take about two years.”

    “This seminal paper is the culmination of many years pioneering research by this team in the emerging field of raft intervention therapeutics. At Jado we have taken this approach to the next level and are building a pipeline of compounds targeting rafts for the treatment of allergic disorders and infectious diseases,” says Charl van Zyl, CEO.

    Alzheimer’s affects one in 20 of those over 65, causing loss of memory, personality changes and, eventually, death.

    Wednesday April 23, 2008

    Mom’s diet may play role in whether baby is boy or girl

    1110.jpgCHICAGO - Snips and snails and puppydog tails … and cereal and bananas? That could be what little boys are made of, according to surprising new research suggesting that what a woman eats before pregnancy influences the gender of her baby.

    Having a hearty appetite, eating potassium-rich foods including bananas, and not skipping breakfast all seemed to raise the odds of having a boy.

    The British research is billed as the first in humans to show a link between a woman’s diet and whether she has a boy or girl.

    It is not proof, but it fits with evidence from test tube fertilization that male embryos thrive best with longer exposure to nutrient-rich lab cultures, said Dr. Tarun Jain. He is a fertility specialist at University of Illinois at Chicago who wasn’t involved in the study.

    It just might be that it takes more nutrients to build boys than girls, he said.

    University of Exeter researcher Fiona Mathews, the study’s lead author, said the findings also fit with fertility research showing that male embryos aren’t likely to survive in lab cultures with low sugar levels. Skipping meals can result in low blood sugar levels.

    Jain said he was skeptical when he first heard about the research. But he said the study was well-done and merits follow-up study to see if the theory proves true.

    It’s not necessarily as far-fetched as it sounds. While men’s sperm determine a baby’s gender, it could be that certain nutrients or eating patterns make women’s bodies more hospitable to sperm carrying the male chromosome, Jain said.

    “It’s an interesting question. I’m not aware of anyone else looking at it in this manner,” he said.

    The study was published Wednesday in the Proceedings of the Royal Society B, a British medical journal.

    The research involved about 700 first-time pregnant women in the United Kingdom who didn’t know the sex of their fetuses. They were asked about their eating habits in the year before getting pregnant.

    Among women with the highest calorie intake before pregnancy (but still within a normal, healthy range), 56 percent had boys, versus 45 percent of the women with the lowest calorie intake.

    Women who ate at least one bowl of breakfast cereal daily were 87 percent more likely to have boys than those who ate no more than one bowlful per week. Cereal is a typical breakfast in Britain and in the study, eating very little cereal was considered a possible sign of skipping breakfast, Mathews said.

    Compared with the women who had girls, those who had boys ate an additional 300 milligrams of potassium daily on average, “which links quite nicely with the old wives’ tale that if you eat bananas you’ll have a boy,” Mathews said.

    Women who had boys also ate about 400 calories more daily than those who had girls, on average, she said.

    Still, no one’s recommending pigging out if you really want a boy or starving yourself if you’d prefer a girl.

    Neither style of eating is healthy, and besides all the health risks linked with excess weight, other research suggests obese women have a harder time getting pregnant.

    The study results reflect women at opposite ends of a normal eating pattern, not those with extreme habits, Mathews said.

    Professor Stuart West of the University of Edinburgh said the results echo research in some animals.

    And Dr. Michael Lu, an associate professor of obstetrics, gynecology and public health at the University of California at Los Angeles, said the results “are certainly plausible from an evolutionary biology perspective.” In other words, since boys tend to be bigger, it would make sense that it would take more calories to create them, Lu said.

    Still, Lu said a woman’s diet before pregnancy may be a marker for other factors in their lives that could influence their baby’s gender, including timing of intercourse.

    “The bottom line is, we still don’t know how to advise patients in how to make boys,” he said.

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