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July 2006

HEALTH TOPICS:

Health and Fitness
(health information and
your personal health)
Vol.5, No. 7, July 7, 2006
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Coffee Protects Against Liver Cirrhosis

Exercise Can Reverse Risk Of Heart Disease

Avian Flu Threat Exaggerated

Benefits Of Arthritis Drug Outweigh Cancer Risk

Better Blood Pressure Control With New Drug

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Coffee Protects Against Liver Cirrhosis

Coffee has been used as a stimulant for centuries, and more recent research has shown that moderate use of coffee can be beneficial.
The flavorful brew has been used as a wake-up drink, especially after a bad night's sleep. Those suffering of a hangover after too much alcohol have also brewed it and felt better afterwards.
A new study in the June 12 Archives of Internal Medicine found that there was more benefit than just headache relief for those who drank too much booze. Heavy alcohol drinkers who also drank coffee reduced their risk for liver cirrhosis. (Liver cirrhosis is one of the severe side effects of too much alcohol use.)
Researchers examined the data of 125,580 subjects between the 1978 and 1985. Nearly 200 of these people developed alcoholic cirrhosis by 2001. The researchers found that for each coffee drink per day, there was a 22% drop in the risk of alcohol induced liver cirrhosis.
Generally tea is considered a beneficial beverage due to the bioflavonoids content. The large study examined, whether tea consumption would also decrease the cirrhosis risk, however no similar benefits were found for tea drinkers.

National Review of Medicine June 30, 2006

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Exercise Can Reverse Risk Of Heart Disease

A growing health concern is cardiovascular illness. As a rule the risk increases with unhealthy life style choices. The most common neglect is the lack of physical activity, and a couch-potato existence is a sure recipe for poor health. Often juvenile "couch potatoes" lay the groundwork for health problems in their middle age years.
Jennifer Robbins of Duke University in Durham, N.C. led a follow-up study on a group of participants. The objective was to examine, how much impact an exercise program would have on the overall condition of the participants. Fitness parameters included weight, waist circumference, visceral and subcutaneous fat, cholesterol levels and metabolic score.
In a control group 61 subjects were instructed not to change their dietary habits or exercise habits for 6 months. Researchers expected that the general health condition of these people would stay the same. What was observed, however, was a deterioration of all the fitness parameters. The sedentary group actually got worse! At the end of the study, all the 61 were offered to participate in one of the exercise programs offered to the other groups. 53 participants decided to take part, and they were enrolled in a low- intensity, medium-intensity and high- intensity exercise program. The two lower groups managed to reverse the detrimental effects of inactivity on cardio-vascular risk in a half-year exercise program. The researchers noted also, that the ones who had deteriorated the most during the sedentary period achieved the most improvement from the exercise program.
Exercise Physiologist Jennifer Robbins and her team concluded, that the study result gives encouragement to those who don't exercise and feel bad about it, as they will reap the most benefits. The results also give doctors more incentive to make physical exercise part of a prescription regimen. With a word of recommendation from the physician patients are more likely to enroll in an exercise program and stick with it.

The Medical Post, June 20, 2006, page 47

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Avian Flu Threat Exaggerated

Disconcerting headlines about avian influenza has caused widespread concern. Warnings have been issued to brace for an onslaught of a pandemic that could paralyze and decimate entire nations. Countries that showed cases of avian flu were scrutinized closely. Travel stopped to areas where poultry was affected. Despite reassurance to the consumer, buyers felt unsure about choosing chicken for dinner.
It has been stated before, that at this point the virus of the avian flu has not made a mutation, and it is not passed from human to human. It can be transmitted from diseased fowl to human who are in close contact with the diseased animal.
The word pandemic seems to trigger a response of fear, but it has to be mentioned that a pandemic is not new. It is universally accepted that there have been 3 pandemics in the 20 th century. Pandemics are defined by an increased number of influenza deaths. One influenza wave hit in 1968, prior to this the year 1957 showed a similar picture. Pandemics are not all equal. The outbreak of influenza in 1918/19 was severe, and young and old were affected alike. Death was in many cases due to the primary viral infection.
In the meantime flu preparedness is much more common than in previous years. Flu shots are available, antibiotics can help treat secondary infection, laboratories are working on vaccines for new influenza strains, and lately antiviral medications have come into the picture.
While the work of scientists is invaluable, in some cases the statements are too simplistic. The avian flu virus H5N1 could mutate. Looking at the facts, the virus has been around since 1997, and it has not mutated. Reporters write stories about possible future pandemics, and there is worry in the population. They need to know the truth! The truth is that we should plan. The truth is also, that a pandemic is not more imminent today than it has been since 1918. In fact it is not more imminent than a multitude of other emergencies. The outbreak of SARS has shown that it is the front-line public health and hospital staff that handles the virus most of all. The production of vaccines and a strong vaccination program is being worked on. This does not leave the rest of the population with nothing what they can do. Good hygienic measures have to be followed. The most important one (and often neglected one) is hand washing. It does not stop a pandemic like the one in 1918/19, but it certainly makes a difference to annual influenza rates. The annual vaccination against influenza is a highly effective weapon against the influenza outbreak that happens every year, and improved vaccines will make a difference between wellness and the opposite!

The Medical Post, June 20, 2006, page 47

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Benefits Of Arthritis Drug Outweigh Cancer Risk

Any medication that is very effective in one area may also have side effects.
An analysis of randomized trial has confirmed, that rheumatoid arthritis patients who are treated with anti- tumor necrosis (TNF) antibodies, are at an increased risk for cancer. A study from the Mayo Clinic and other studies from institutions in the U.K. showed that patients who are treated with the monoclonal antibodies infliximab (Remicade) and adalimumab (Humira) are at a higher risk for serious infections.
This may sound like a blow to any patient with rheumatoid arthritis. Treatment with Monoclonal antibodies and anti-Tumor necrosis antibodies has revolutionized the care of these patients. The medications are highly effective and have made a difference for many affected with rheumatoid arthritis.

 

Dr. Eric Matteson, a study co-author and professor of medicine in the division of rheumatology at the Mayo Clinic points out, that the concerns about infection and malignancy are not new. They are already mentioned in the drug labeling. The risk for cancer was statistically significant only in the high-dose groups. It was also impossible to draw any conclusions about whether any type of malignancy occurred more often than another. He also emphasized, that doctors and patients have to be alert to signs of infection, and age-appropriate cancer screening is of great importance for the patient who takes these particular medications.
Dr. John Esdaile from the University of British Columbia mentions some additional points. These medications are not handed out freely to any patient with R.A. The treatment cost of about $18,000 per year does not make this a standard medication for anybody with R.A. Patients with severe disease who have failed to get relief from any conventional medications would be the ones who are considered for this treatment. Most patients would likely be receiving doses in the lower range of the spectrum, and patients usually know within 3 months, whether the medication is helping them. The medications do not work in everyone, but for 50% of the patients the effect is dramatically positive. The patient, whose joints were being destroyed by rheumatoid arthritis, can go from a state of terrible pain and disability to being able to return to a good quality of life.
The key is close screening of patients regarding the suitability of the therapy. The possible increased risk for malignancies and infection must be discussed with candidates for anti-TNF therapy. Finally close monitoring for infection and cancer screening is necessary.

The Medical Post, June 2, 2006, page 1 and 7.

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Better Blood Pressure Control With New Drug

Numerous medications for blood pressure control are in circulation. Treatment of high blood pressure patients is crucial in the prevention of strokes, but despite the multitude of drugs that are on the market, the treatment has its challenges. Some of the drugs have side effects, like an irritating cough, and a suitable medication has to be tried out first. Even, when all is well and there are no unpleasant side effects, many patients have a problem with compliance. Pills that have to be taken several times per day are forgotten. As a result, the patient will have poor blood pressure control.
Blood pressures must be controlled on an ongoing basis. Ideally there are no big fluctuations, whether it is day or night. For this purpose, a medication has to stay in the system of the patient long enough. This time stretch is called the half-life of a drug.
The first drug in a new class of agents for the treatment of high blood pressure does exactly that: it has a long half-life, so blood pressure control is smooth and continuous, day or night. The oral direct rennin inhibitor aliskerin has the potential to protect the heart and other organs with a once-daily dosage of 300 mg. The drug is being developed by Novartis, and clinical trials are on their way.
The medication in combination with a diuretic provides significant additional blood pressure reduction. The agent at work is a rennin inhibitor. In the past, renin inhibitors for treatment of hypertension (high blood pressure) could only be used as intravenous solution and was only effective for a short time. The new development is a breakthrough, as the medication continues to work even when the drug is gone from the blood stream. It is ideal for daily dosing, and there is no apparent buildup in the body.

The Medical Post, June 13, 2006, page 38

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