Monday, December 22, 2008

Headphones and Heart Pacemakers: Lethal Bedfellows?

Given that AARP baby-boomers who were there for the birth of rock n’ roll have bought the i-Pod craze hook line and sinker, will this be an accident waiting to happen?

By: Ringo Bones

Yep, it’s true. During the 1970’s and 1980’s it was microwave ovens, now the magnetic headphones of i-Pods might be endangering users with implanted heart pace makers. And given that this Holiday Season where baby-boomers who had recently become AARP members might be getting / receiving their first or umpteenth i-Pod players should be careful about using magnetic headphones of their i-Pods.

Cardiologists across America had recently warned that the fairly powerful magnets of the headphones used in personal stereos / Walkman / i-Pods can interfere with proper heart pacemaker function and also that of defibrillator-type implants. This is especially true when fairly powerful magnets are placed squarely on the pacemaker. Given that the inductive coils of implanted pacemakers that deliver live-saving jolts of electricity to the heart are very susceptible to external magnetic fields, placing a magnet of sufficient power squarely on a pacemaker could interfere with the device’s intended function. Either the voltage level delivered by the pacemaker could go dangerously too high or too low. Though cardiologists had warned of microwave oven radiation of heart pacemaker recipients during the 1980’s, they seem to overlook the dangers of hand-held police radar which operate at the K-Band - i.e. microwave oven frequencies.

Though the normal placement of headphones for normal listening – on the ears – is quite far enough from the usual pacemaker location, keeping magnets away from one’s pacemaker could be more than just a “mere” precautionary measure. Doctors have not yet warned patients with pacemakers who reposition their loudspeakers, given that those have more powerful magnets touching squarely at their chest area. To be safe, people with pacemakers should avoid devices with strong magnetic fields when possible. This prudent practice could make our aging baby-boomers rocking for the foreseeable future.

Friday, November 21, 2008

A New Era in Transplant Medicine and Tissue Engineering

A recently performed medical procedure performed by Spanish doctors successfully replaced a damaged trachea. Will the “Holy Grail” of tissue engineering – replacing whole organs – be that much closer?

By: Vanessa Uy

Doctors in Spain recently replaced one of the windpipes or trachea of 30-year-old Claudia Castillo after a bout with tuberculosis damaged the organ. What made the procedure unique is that the donated trachea came from a non-genetically compatible donor. Plus, the new procedure made the use of post-operative anti-rejection drugs unnecessary by making the donated organ acquire an all-out total histocompatibility with the recipient.

The uniqueness of this new medical procedure involves the use of the recipient’s own stem cells to make the donated organ rejection-proof, even if it came from a non-compatible donor. The new procedure involved a trachea obtained from a recently deceased organ donor. The donated trachea is then cleansed of the donor’s own genetic material until all that is left is just a collagen scaffold of a trachea. The next step involved infusing the donated trachea collagen scaffold with Claudia Castillo’s own stem cells to make the donated trachea both immunologically and genetically compatible – total histocompatibility - with her own body.

This cutting-edge medical procedure was made possible due to a collaboration of three doctors from Spain, Britain, and Italy. At present, this new medical procedure is still prohibitively expensive to be done on a routine basis. But the success of this particular trial serves as a proof of concept that stem-cell therapy works in increasing transplanted organ’s histocompatibility with their recipients and is now more than a mere laboratory curiosity.

Even though this newfangled medical procedure is seen by everyone as the newest and latest in medical science, it can trace it’s roots back to more than 40 years of laboratory research. Back in 1965, Marshall R. Urist of the University of California at Los Angeles probably kicked-off the science of tissue engineering – creating semi-synthetic living organs that can be used as human replacement parts – by demonstrating that new bony tissue would form in test animals that received implants of powdered bone. Fast forward to 2006, a team of American doctors successfully “created” a human bladder by growing the organ out of stem cells - which can be very useful in treating urinary incontinence of the elderly and bladder reflux in children without the need of post-operative anti-rejection drugs and their negative side-effects.

Before receiving the life-saving tracheal transplant, Claudia Castillo was often out of breath due to her tuberculosis damaged left trachea, if left untreated, her left might become disease becoming withered and then die off. The new procedure that gave Claudia Castillo the genetically compatible trachea really did suit her particular case. If she had undergone a “conventional” tracheal transplant procedure, it might have necessitated the use of anti-rejection medication. Anti-rejection medication would have been the last thing she needs because these drugs are notorious for wrecking havoc with the human immune system. Thus making her susceptible with diseases that attack people with weakened immune systems like tuberculosis, which was the root cause of Claudia Castillo’s problem in the first place. Worse still, she might contract pneumonia, which often happens to patients taking anti-rejection medication. But thanks to this new medical procedure, those worries are behind her or the next patient who undergoes this procedure. This truly is the new era of transplant medicine and tissue engineering. The next step now is to make the procedure much cheaper than what it current costs so that more people that badly needed it can avail of this particular procedure without going bankrupt.

Wednesday, October 29, 2008

Cervical Cancer Vaccine Innovation: Still a Long Way to Go?

With one of this years Nobel Prize for Medicine’s recipient had worked for over thirty years on the virus that causes cervical cancer, will a cure be not that far behind?

By: Vanessa Uy

German-born Harald Zur Hausen became one of the recipients of the 2008 Nobel Prize for Medicine on his work on the human papilloma virus or HPV as the cause of cervical cancer. His work on the relation of HPV and cervical cancer dates back to the 1970’s. During the 1990’s, Harald Zur Hausen obtained proof on the role of the human papilloma virus in causing cervical cancer.

The Nobel assembly focused their attention on the way Harald Zur Hausen “went against current dogma” when he found that some variants of the human papilloma virus, or HPV, caused cervical cancer. He realized that genetic material like DNA of some HPV variants or species could be detected in cervical cancer tumors. Harald Zur Hausen then uncovered a family of HPV types, which only some of them cause cancer.

Cervical cancer is a form of cancer that affects women usually of childbearing age. Its tumors develop in the cervix, the entrance between the vagina and the uterus. It was only when Harald Zur Hausen’s work passed peer review scrutiny that the medical community reached the consensus that cervical cancer is caused by some variants of the human papilloma virus or HPV.

According to the work of Munoz N. et al as published in the New England Journal of Medicine published in 2003, there are more than 200 variants or types of HPV and at least 30 of these cause cervical cancer. This particular study showed that the cancer causing variants of HPV caused 99.7% of cervical cancer cases. Globally, HPV variants designated as types 16, 18, 45, and 31 account for 80% of the cases of cervical cancer.

On an incidence basis, cervical cancer is the second most common form of cancer affecting women worldwide, with half a million women diagnosed annually. Latest studies estimates that up to 50 to 80% of women will acquire an HPV infection during their lifetime. Usually via persistent infection of the cancer causing variants of HPV resulting in pre-cancerous lesions and cervical cancer.

The bad news is that human papilloma virus infection can be easily transmitted via skin-to-skin genital contact and one could become infected with the HPV virus without “normal” / “conventional” sexual intercourse. Infected men carry the HPV virus on the skin of their genitalia and yet they don’t succumb to the virus’ cancer-causing effects. Using condoms may reduce the risk but are by no means foolproof. Women who are sexually active – this means of childbearing age in a “civilized society” – are at risk of exposure to HPV variants that cause cervical cancer.

The Pap smear is currently the most important screening method that has been proven to be very good in early detection of cervical cancer. By taking a sample of cervical cells, a pathologist prepares them on a slide for microscopic examination. The microscopic examination by the pathologist determines whether the cell sample looks normal or abnormal. The earlier the pre-cancerous changes in the cervix are detected, the more positive will be the prognosis for a recovery.

The frequency of Pap smears usually varies with a woman’s age. A good point to start would be about 3 years after the start of regular sexual activity. Ideally, women should get a Pap Smear every year until the age of 30. After 30, women who have had 3 consecutive normal results on their annual Pap Smear can be re-screened every 2 to 3 years. Screening may be done if the woman has abnormal vaginal bleeding, pain, sores, or itching.

Since Harald Zur Hausen’s study of the link between human papilloma virus and cervical cancer, newer screening methods and treatments for the disease had been devised. Cervical cancer can now be detected via HPV DNA test to check for the presence of cancer-causing variants of HPV, which many doctors and gynecologists had praised for its accuracy. The development of a vaccine against cancer-causing strains of HPV has fostered a great hope in the fight against cervical cancer. Though Harald Zur Hausen says that more needs to be done since currently available HPV vaccines do not have a broad enough spectrum to combat all strains of cervical cancer-causing HPV.

Monday, September 8, 2008

A Healthcare Plan for Cord Blood Storage: Not Economically Viable?

Umbilical cord blood is probably the most ethical source of stem cells for medical research and therapeutic use. Some healthcare providers have been flirting with a scheme to store one for a fee. Another unnecessary medical expense?

By: Vanessa Uy

Stymied by the ethical row over the extraction of stem cells from early trimester aborted fetuses, medical science has started to search them from other sources. Recently, the medical community has found out that umbilical cord blood can be a viable source of stem cells. After learning from this discovery, many healthcare providers from around the world had offered their services – for a fee of course – to cryogenically store your newly born baby’s umbilical cord blood for up to 20 years. The procedure usually involves cryogenically cooling the umbilical cord blood to be stored with liquid nitrogen for later use as a source of therapeutic stem cells. Does this procedure remind you of something?

In Phoenix, Arizona a company called ALCOR became rich – but mostly famous - during the 1980’s by offering a “medical procedure” of storing someone’s recently diseased loved one cryogenically for “posterity”. Posterity is somewhat open to interpretation on what the company hopes to accomplish. It truly means sometime in the far-off future when medical science advance to a level were it is possible to revive and eventually cure what caused this certain person to die of in the first place. And by the way, ALCOR charges 300,000 dollars for a whole body cryogenic storage and 100,000 dollars for cryogenically storing just the head since according to them a new body can be cloned. This was in “when Ronald Reagan was still leader of the free world “ US dollars by the way. Given that majority in the medical community – until now – has doubts about ALCOR ‘s fiscal and medico-legal practicality of the services they are offering, should we be storing our newly born baby’s cord blood cryogenically for possible future use?

Given the relatively small volume of umbilical cord blood that would be stored, it would be way cheaper to store it cryogenically for 20 or so years compared to storing a recently deceased person after being prepped-up for cryogenic storage for an indefinite period of time (possibly for centuries?). And given that advances in stem cell therapy has been unnecessarily hampered by the politics surrounding its ethical implications. Medical research into stem cell therapy has been incrementally advancing in the past few years despite the challenges of demagoguery and petty political lobbying. The expense of storing umbilical cord blood for possible future use could certainly be a worthwhile investment.

Despite of the possible advantages, cryogenically storing umbilical cord blood for possible future use still has a sizable number of detractors in the medical community. Expert in the medical field has doubts whether the most common application of this stem cell resource – childhood leukemia therapy – is a good use of this very limited resource. It is already well known that a child’s own previously stored umbilical cord blood can’t be used for leukemia treatment because this form of blood cancer has a very high rate of reoccurrence. The previously stored umbilical cord blood would just simply provide temporary – albeit somewhat pricey – relief. But who knows what future developments might bring. And also there is a likely possibility that a number of children will be “lucky” enough not to be afflicted with diseases that necessitates the use of their previously stored umbilical cord blood for treatment.

Whether the practice is a waste of money or a very wise investment for the future, it Is ultimately up to the customer whether the services provided by certain healthcare companies to cryogenically store their newly born baby’s umbilical cord blood really is worth it. The most likely problems that would likely come up with regards to this issue is that not enough customers who avail themselves of this service didn’t get an informed enough consent in justifying their decision.

Thursday, September 4, 2008

Gender Selection Diet

A somewhat controversial finding on how women can now choose the gender of their unborn child with increased certainty by watching the amount of food they eat during conception. Eating into a brave new world?

By: Vanessa Uy

When I first heard this recent finding in a health and wellness section of a news broadcast, my first thoughts were, Isn’t this a social rather than a health issue? Given that the research’s findings might benefit both mother and child not just physiologically but psychologically as well, who am I to argue. The findings of this particular research currently implies that women who eat a “healthy” diet – i.e. a higher than their average intake of calories diet – around the time of conception especially a high cereal diet during breakfast increases their chances of having a boy / male child by 50%. (50%!? The last time I heard there were only two genders, a boy and a girl. Is this what they mean by “convoluted statistics”? Its always 50-50, or do they mean more likely to be a boy). The PR representative of the study was Fiona Mathews of Exeter University who delivered the study’s latest findings to the press back in April of 2008.

This research is more than just a recondite abstraction of an academic study on the factors that affect gender determination. This particular research study is inherently made more understandable to the layman due to the “diet factor” of the study. The “dearth” of the number of male / boy children being born in the Industrial West in the past 30 years might be due to women of childbearing age being “persuaded” to consume fewer and fewer calories due to the dictates of contemporary fashion. Add to that an increasingly hectic lifestyle were most women of childbearing age are more often than not chose to skip breakfast just to avoid job tardiness – i.e. being late for work.

Even though this study is first and foremost a health issue, the ramifications have an overwhelming bearing on our contemporary society. Western cultures – or is that most “living cultures” on the planet – has an overwhelming preference for a male heir. The title “Man of the House” still carries power and prestige in the present like it did 5,000 or so years ago. Imagine if the first few wives of King Henry VIII knew something bout this, history would have been written much more differently. Maybe the research data / results of this study will prove very invaluable in countries with a de facto One-Child-Policy. Are you familiar with the title “Man of the house”? It just goes to show that Western Society is a chauvinistic society, at times even misogynic.

Thursday, August 7, 2008

Abiraterone: The Best Hope for Prostate Cancer?

Touted as the most significant development in the field of prostate cancer therapy in 70 years, will abiraterone finally end the scourge of prostate cancer?

By: Ringo Bones

As the results of the early stage trials were published in the Journal of Clinical Oncology, abiraterone instantly gained rave reviews as the miracle drug to treat prostate cancer. The mainstream media immediately pounced on the story during the middle of July 2008, hailing the drug as the most significant development in the field of prostate cancer therapy in 70 years. Despite the promising results during its early trials, abiraterone might have rightfully earned its bragging rights. Given that in the history of prostate cancer research shows that on a worldwide basis, almost a third of men diagnosed with the disease die from it.

Prostate cancer usually affects men who have reached their fifties, and the risk increases the older they get. To detect or examine suspected prostate cancer cases, the doctor usually starts with a prostate specific antigen or PSA bloodwork then a biopsy when a check up shows positive indicators for the disease. At present, only early detection guarantees recovery in most prostate cancer cases.

The male hormone testosterone – even though it performs a vital function in the male anatomy – stimulates prostate cancer tumors to grow. Current therapeutic methods used to cure prostate cancer usually involve stopping the body making testosterone. This method can slow down the growth of preexisting tumors, or even shrink it. Most of the testosterone in the male anatomy is made by the testes but a significant – though small amount – is synthesized by other tissues in the body, including the cancer itself. To synthesize or create testosterone, the body needs an enzyme called cytochrome P17, usually referred to as CYP17 in the research’s “White Paper”.

Abiraterone, whose chemical name is abiraterone acetate, also known as CB7630 works differently in comparison to other current hormone treatments for prostate cancer. Abiraterone acetate has a broad-spectrum effect in blocking the enzyme CYP17, thus preventing the testes and other tissues in the body from synthesizing testosterone. Abiraterone has just been recently used on clinical trials as an experimental treatment for prostate cancer. These early clinical trials focused on men with advanced prostate cancer whose previous treatments no longer works and also men with advanced prostate cancer that has spread or metastasized beyond the prostate gland.

Results of the phase 1 trial have recently been published in the Journal of Clinical Oncology. During the abiraterone trials, 80% of the men had a fall in their levels of prostate specific antigen (PSA) in their blood accompanied by tumor shrinkage. A fall in PSA levels usually that the number of cancerous cells had gone down. Some of the men who were suffering from chronic pain resulting from their prostate cancer tumors were able to take much lower doses of painkillers, a sure sign of improvement. PSA level reduction lasted from just over two months in some men while on other subjects, level reductions lasted for 18 months.

Side effects were generally mild but are reminiscent of patients under hormone replacement therapy. These include a change in the levels of sodium and potassium in the blood, a build-up of fluid in the ankles / joint edema, a rise in blood pressure, headaches, loss of appetite, fatigue, and hot flushes.

Phase 2 trials are currently being carried out but the results are yet to be published. It focused on the men whose previous hormone therapy no longer works. These men were given abiraterone and when the abiraterone no longer worked, they were then given a steroid called dexamethasone. The early results were announced in June 2008, and because they looked promising, were hailed by the media as the greatest advance in prostate cancer research. Men who were taking abiraterone alone – most of them – show a fall in their PSA levels. A sure sign of the treatment stopped the cancer from growing or developing. In 50% of the men with tumors could be measured on the scan, the cancer shrank or didn’t grow further. The PSA levels were cut in half in almost 70% of the men taking part in the clinical trials even though the PSA levels of the men taking part rose again after 7 months. Despite the promising results, abiraterone is currently only available to men who will take part in a clinical trial.

Based on early tentative results, the latest abiraterone trial participants must be screened as a precaution. Because the drug changes the levels of sodium and potassium in the blood and raises blood pressure, men with a history of heart disease and high-blood pressure are not allowed to participate in abiraterone trials. So do men who had undergone treatment using a drug called ketoconazole, have history of liver disease or currently have another type of cancer and /or secondary cancer in the brain. Experts say that all hormone-based therapy to cure prostate cancer – including abiraterone – carries the risk of impotence, urinary tract problems and incontinence.

In the past, prostate cancer awareness was usually spearheaded when someone famous overcame the disease helped only by the existing treatment regimen of the period. Back in November 1987, then US President Ronald Reagan underwent transurethral prostate surgery because of benign prostatic hypertropy, thus causing a flurry of prostate cancer awareness. In the entertainment world, Bill “The Fox” Foster emcee of Comedy Central’s “The Man Show” died of prostate cancer in May 10, 2000. His family asks that we (The Man Show fans) honor his memory by urging male viewers to get their prostates examined regularly by their doctor. Many opined that with early detection, Bill “The Fox” Foster’s death could have been prevented.

Thursday, July 31, 2008

Acetaminophen: Over the Counter Danger?

As an analgesic that can be bought over the counter with ease – even without prescription, does the general public know the inherent dangers posed by acetaminophen / paracetamol medication?

By: Vanessa Uy

Despite the medication’s widespread use, most of the general public remain oblivious when it comes to the inherent health risk posed by apparently harmless over the counter analgesics like acetaminophen - also known as paracetamol. Even though most of these analgesics have warnings clearly posted on their box that these medications can cause liver failure in high doses, incidences of acetaminophen overdoses still occur.

Persons taking high doses of acetaminophen – especially those not overseen by a qualified physician – often run the risk of liver damage and / or impaired liver function. The liver can be overwhelmed in metabolizing high doses of acetaminophen / paracetamol. Young children are especially at risk. The established recommended dose of acetaminophen is around 50 milligrams per kilogram of body weight per day. While the upper limit maximum dosage – usually administered in special cases – is 3 to 4 grams (3,000 to 4,000 milligrams) per day even though this amount can be harmful to a statistically significant portion of the population. Susceptibility to liver damage by high doses of acetaminophen is not just limited to overweight persons – as previous studies suggest – but also on healthy individuals as well. Even though precautions about taking paracetamol / acetaminophen is clearly posted in the medication’s packaging, why then there are still incidences of individuals overdosing on this specific drug?

The still common incidence of overdosing on acetaminophen is largely blamed on medical professionals prescribing the drug for pain in which the drug has shown only marginal effectiveness like pre and post operative dental work – i.e. toothache. Given acetaminophen’s somewhat marginal effectiveness in relieving such maladies the patient often resort to taking the drug in doses far beyond their doctor or dentist’s recommended dose just to relieve existing pain.

Even though acetaminophen is primarily utilized to decrease fever by a hypothalamic effect leading to sweating and vasodilation the drug can also cause analgesia (pain relief) by inhibiting Central Nervous System prostaglandin synthesis; however, due to minimal effects on peripheral prostaglandin synthesis, acetaminophen has no anti-inflammatory or uricosuric effects. Unlike aspirin, which this particular drug was designed to replace, acetaminophen does not cause any anticoagulant effect or ulceration of the gastrointestinal tract. But compared to nonsteroidal anti-inflammatory drugs like Bextra and Vioxx which has gained widespread press notoriety due to it’s unforeseen side-effects, acetaminophen / paracetamol is still magnitudes safer compared to those drugs. Yet a degree of prudence still needs to be exercised in taking supposedly safe medication because the old adage still holds true today that the difference between a medicine and a poison is in the dosage.

Friday, June 13, 2008

The Hidden Dangers of ADHD

Despite the studies being done on this disorder over the years, majority still harbor the perception that ADHD only affects kids and is an untreatable form of insanity. Even the rich multinational drug companies are part of the problem. Suffer the children?

By: Vanessa Uy

Basing on the scientific studies on the disorder – as opposed to politically charged demagoguery and prevailing speculation – ADHD or Attention Deficit and Hyperactivity Disorder is a treatable non-contagious mental disorder that impair one’s concentration and ability to control behavior. This disorder affects 4 percent of American adults and 3 to 7 percent of American children according to the American Psychiatric Association. Though treatable by a number of therapeutic regimens developed over the years, it is in the method of treatment where ADHD now gets its controversy du jour.

From time to time, everyone has had trouble sitting still or managing time, or completing an assigned task. But the behavior of persons suffering from ADHD goes beyond occasional fidgeting, disorganization and procrastination. For them, performing tasks can be so hard that it interferes with their ability to function effectively – and efficiently – at work, at home, at school, and it even affects their social life in a negative way.

A diagnostic manual compiled by the American Psychiatric Association identifies three types of ADHD: inattentive, hyperactive-impulsive, and combined. A person with inattentive ADHD, previously known as Attention Deficit Disorder or ADD has trouble focusing on activities, organizing and finishing tasks and following instructions. Children with hyperactive-impulsive ADHD are in constant motion, dashing around, touching everything in sight, and jumping on and off furniture. They often blurt out inappropriate comments, don’t wait their turn, show excessively intense emotions, or hurt others when upset. Hyperactive and impulsive adults feel restless, are constantly “on the go” and try to do multiple tasks at once. They are often perceived as not thinking before they act or speak. Individuals with the combined form of ADHD show symptoms of both inattention and hyperactivity.

Experts – even at present – still continue to debate whether children can expect to outgrow the symptoms of ADHD by the time they reach adulthood. Behavioral modification therapy via psychotherapist’s counseling is the safest form of treatment due to the fact that it doesn’t involve the use of pharmaceuticals. While the pharmaceutical industry and a large number of doctors question the level of effectiveness of psychological methods used in treating ADHD.

Majority of existing ADHD therapies, especially ones involving amphetamine-like drugs such as methylphenidate hydrochloride (Ritalin) and atomoxetine hydrochloride (Strattera). Scientific research studies done in the previous years by major drug companies that manufacture Ritalin and Strattera have shown that sudden death from heart attacks does occur in children suffering from ADHD while prescribed by the two drugs mentioned earlier. But it occurred with such rarity that the link between the anti-ADHD drugs and heart attacks are yet to be proven.

Just to be on the safe side, the US Food and Drug Administration has just recently approved in the middle of April 2008 a new therapeutic regimen for ADHD. The FDA advised doctors to prescribe Beta-Blockers together with reduced Ritalin and Strattera dose to reduce the dangers of heart attacks and other cardiovascular problems. Especially now in America where childhood obesity is on the rise. Amphetamine-like drugs that are used to treat ADHD can unnecessarily strain our cardiovascular system.
These risks were proven by the fact that Rock Stars who used to take cocaine and amphetamines on a regular basis are putting themselves at risk of suffering cardiovascular problems at a relatively young age. Even after quitting, these “Rock Stars” still need regular check-ups by their physicians for early detection of any heart problems and other cardiovascular complications. Though not often mentioned, the additional financial burden involved since only a few school kids have Rock Star budgets. Maybe parents should ask about ADHD therapies that don’t involve medications with harmful side effects.

Tuesday, May 6, 2008

Vytorin: Desperately Seeking Effectiveness?

One of the latest generation of cholesterol-lowering drugs that raised much controversy when a leading medical journal questioned the drugs effectiveness. Is Vytorin any better than older cholesterol-lowering drugs like Lipitor?

By: Vanessa Uy

Ever since that damning editorial by the New England Journal of Medicine came out questioning the effectiveness of Vytorin in reducing plaque build up which might lead to heart attack later. It not only shocked the medical community, but also to thousands of patients who were prescribed by their doctors to take the drug. Others in the medical community also questioned the wisdom of promoting and prescribing Vytorin even though there are older and therefore much cheaper drugs - like Lipitor for example – are still very effective in their cholesterol-lowering role. But before we condemn Vytorin, let’s examine first what’s going for it.

Vytorin is a cholesterol-lowering drug and is composed by a combination of two drugs, namely simvastatin (Zocor) and ezetimibe (Zetia). When Vytorin is prescribed, it is used along with a special diet and an exercise regimen to lower the amount of fatty material in the blood. Namely triglycerides and low density lipoproteins (LDL) sometimes called “bad cholesterol” because it will build up into fatty plaque deposits that increases the body’s risk of heart attacks. The two components Vytorin works in a different way to lower the levels of fat in the blood. Normally, our liver produces most of the cholesterol that we need to maintain a healthy balance. Cholesterol in the right amount is vital in the proper maintenance of our nervous system. One of Vytorin’s components simvastatin works by interrupting the process of the liver’s cholesterol production, the other one ezetimibe, works by reducing the amount of dietary bad cholesterol that can be absorbed by the intestines.

Vytorin should only be prescribed if diet, exercise, and weight loss fail to bring down the patient’s cholesterol levels under control. The doctor may prescribe Vytorin if the patient’s risk factors for coronary heart disease is high and when the patient’s cholesterol level is above 130 mg / dL. The drug is also prescribed to patients whose cholesterol levels are above 190 mg / dL, even if their risk factors for coronary heart disease are low.

A disadvantage of Vytorin is that quite a number of the population shows allergic reactions to the two main components of the drug, namely simvastatin (Zocor) and ezetimibe (Zetia). The precautions of taking the drug are quite numerous. Pregnant and lactating women are not allowed to take Vytorin because it might affect the child’s nervous system development. Patients with impaired liver function should not be allowed to take Vytorin because the drug will further tax their compromised liver. Though Vytorin should not be taken when the patient had recently or will about to drink alcoholic beverages. Even seemingly innocuous drinks - such as grapefruit juice – can have an adverse interaction with the drug. Vytorin can cause breakdown of the muscle tissue that can lead to serious kidney damage and even death from kidney failure.

Any doctor who is familiar with cholesterol-lowering drugs could conclude that the precautions in taking and prescribing Vytorin is somewhat similar to other common cholesterol-lowering medication like Lipitor (atorvastatin calcium). But should the patient suffer through these unfortunate side effects even if current medical research had shown that Vytorin is no more – even less – effective in lowering cholesterol when compared to older drugs like Lipitor? Maybe we should be campaigning for more awareness of healthier diets and lifestyles at the school level, rather than treating the effects of obesity and high cholesterol via a magic pill. This would drastically reduce the burden of our health care infrastructure.

Friday, April 25, 2008

Caffeine – A health Supplement?

Ever since coffee was touted as a health tonic because it contains beneficial antioxidants, every government approved health supplement manufacturer has been jumping on the bandwagon. But should everyone beware of caffeine’s possible risks?

By: Vanessa Uy

From caffeine containing wake-up pills to cellulite removal cremes, it seems like this primary component of our morning coffee has become the health tonic du jour almost overnight. Apart from the somewhat still disputed claims of the health benefits of anti-oxidants found in our age-old drinks like coffee and tea, caffeine’s effects for boosting our metabolism is well-known – as is its dangers to our cardiovascular system when taken in high doses. Nonetheless, caffeine made possible the efficient running of the North American Space Command’s Cheyenne Mountain complex. And it has performed these and other thankless tasks despite the miserly praise.

The cosmetic arm of the healthcare industry has been exploiting caffeine’s ability to improve our skin’s aesthetics by adding it to various topical creams ranging from spray-on tans to cellulite removal cream. Though its effectiveness ranges from the just noticeable to marketing on a yet-to-be-understood-human-physiological-function. But first, let’s briefly examine the rational behind these caffeine-containing products.

Cellulite elimination creams exploit on our skin’s ability to absorb caffeine through our skin, increasing our metabolic rate. Thus allowing us to burn excess fat with somewhat increased ease. Cellulite elimination creams work but only in conjunction with an exercise regime. Though losing weight by this means can increase the workload of your liver and lymphatic system, not to mention your own heart rate.

Caffeine containing shampoos – though pricey – has steadily gained widespread acceptance due to user’s positive testimonials. Caffeine containing shampoos can make your hair grow back and is the most commonly prescribed cure against hormonally induced baldness. Since too much testosterone – especially in men – is the leading cause of baldness, women with hormonal imbalances – though rarely - are also affected, thus the market for these shampoos are not restricted by gender. But the science backing up this product is somewhat misleading. Caffeine containing shampoos’ positive laboratory results are due to the product being tested on hair culture, not on the actual scalps of human test subjects. Nevertheless, the skin improving benefits of topically applied caffeine is retained despite the product’s being on the knife-edge of being to costly compared to the much-touted yet marginal benefits.

Caffeine containing pills works – no ifs and buts – but consult first with your General Practitioner before using such products if you have a preexisting heart or other cardiovascular condition. Heavily featured in ads since the end of World War II as wake-up pills and weight loss pills, caffeine containing pills should be used with caution since they contain as much caffeine as ten cups of coffee, some even more. Also, if you’re daily diet includes chocolate, tea and coffee. Caffeine containing pills certainly are not a good idea.

Caffeine certainly has benefits for our health and well being. Latest research shows that moderate amounts can stave off heart attacks, strokes, and other coronary afflictions. Also, caffeine improves our skin appearance, improves our alertness, and lets face it without it, our now industrialized labor-intensive civilization will grind to a halt without it. But, in my personal experience, caffeine is better taken via our regular cup of coffee. Not only that it is less expensive compared to other alternatives, but its more effective – albeit slower acting – compared to the competition. And coffee drinking provides the much-needed job security of coffee growers were the majority of which resides in the more economically depressed parts of our planet.

Wednesday, March 26, 2008

Of Thimerosal and Autism

It was known for quite a long time that mercury and its compounds causes neurological damage to the human body when taken internally. Yet we use a compound of mercury to preserve vaccines to be given to kids, is this just an unfortunate oversight?

By: Vanessa Uy

Our present pluralistic society – for all intents and purposes – is knowledge and information based. Unfortunately kids afflicted with autism are unjustly barred from participation. Forever imprisoned in a fantasy world that’s far removed from existing reality, thus denying them from enjoying the fruits of contemporary society. Sadder still, their autism might had been prevented if the clear and present danger posed by thimerosal was recognized and acted upon.

For sometime now, the dangers posed by mercury poisoning was portrayed in children’s literature. Remember the “Mad Hatter” character in Lewis Carroll’s “Alice’s Adventures in Wonderland”? The Mad Hatter’s moniker is taken from the Victorian-era England expression “mad as a hatter” describing furriers / hat makers suffering from mercury poisoning due to chemical compounds of mercury being used in the fur industry.

Even Isaac Newton suffered from mercury poisoning induced dementia during his latter years. This was due to his secretive interest of an esoteric mystical Medieval Jewish practice of Cabbalah – together with Medieval Alchemy – allows anyone to turn base metals into gold. The bad news is there are “rituals” which the practitioner exposes himself or herself with toxic levels of mercury vapor. Is this the primary reason why modern practitioners of Cabbalah speak with an annoyingly fake British accent, especially aging celebrities?

Even though the use of thimerosal as a vaccine preservative has been discontinued since 1999, older lots are still being stocked on the clinic shelves. The furor over thimerosal and its link to the increased incidence of autism in kids has been dismissed as groundless by most of the medical community, even though the community-at-large has been aware of the dangers of mercury poisoning for some time now. The medical community say that the amount of thimerosal being used as a preservative in vaccines are way below toxic levels, never mind causing neurological damage. But nevertheless, the medical community and drug companies choose to discontinue the use of thimerosal as a vaccine preservative due to “political pressure” rather than genuine results from scientific research that point to the relationship between autism and the mercury-based vaccine preservative thimerosal.

Even at present, there are quite a number of concerned parents who opt not to inoculate their kids due to the autism-causing vaccine preservative thimerosal. That’s politics overriding reason in action for you. If these people continue to delude themselves with an unfounded paranoia, may I suggest using chelating agents like British Anti-Lewisite or other emergency treatment reserved only to infantrymen exposed to a chemical weapon attack? Let’s hope their kid’s liver and kidneys are strong enough to endure medical regimens like BAL.

Friday, February 29, 2008

Obesity: A Rapidly Growing Public Health Crisis?

Used to be confined to affluent nations, but now obesity is spreading to developing nations that a generation ago barely has enough to eat. Will proper diet and exercise reverse the trend?

By: Vanessa Uy

Latest trends around the world show that diseases related to overeating like obesity, cardiovascular disease and type-2 diabetes is on the rise. Physicians and other health consultants had time and again been extolling the virtues of regular exercise and a proper diet, but in this day and age, such regimented routines are easier said than done.

Since the dominance of the fast food industry which started in the last 40 years, the concept and the practice of a proper diet / nutrition had become an increasingly difficult routine as the years go by. Foods saturated with unhealthy levels of saturated fats and sugars while deficient in vitamins and other essential nutrients had become a staple in the fast food industry. So if one is living in a highly urbanized area - chances are - he or she will have an unhealthy diet since a “proper meal” is either too labor intensive to prepare or deemed too expensive for our urban poor brethren.

What about regular exercise? If you are particularly well off that expensive gym membership won’t be an issue for you, then you can sweat it out with your heart’s content – but first consult with your physician on the type of exercise regimen that’s right for you. But in sympathy to our urban poor brethren who can’t even walk home after leaving their workplace because this means passing through a “bad neighborhood” just highlights the issues of the difficulties of maintaining a healthy body while living in an highly urbanized environment. But if you manage to find a dietary and exercise routine that works despite the difficulties of living in an “Urban War Zone”, then good for you.

The greatest affliction affecting those who have difficulty “losing those pounds” is type-2 diabetes. Type-2 diabetes results from overeating in which your pancreas can’t process the excess sugar in your bloodstream resulting from excessive caloric intake (too much food). This is different from type-1 diabetes, which is a result of a hereditary / genetic disorder when one’s own immune system destroys the part of their pancreas that produced insulin, thus requiring regular insulin shots just to stay healthy and or alive. With proper diet and exercise, one can escape the “nightmare” of type-2 diabetes. But every pound or kilo you lose can make a difference.

Thursday, January 3, 2008

Bextra: 21st Century Thalidomide

Despite existing strict safeguards, drugs with unknown side effects still manage to get through current well- established screening programs.

By: Ringo Bones and Vanessa Uy

It’s quite ironic that a drug formulated to relieve pain became known as: “the cure worse than the disease.” The drug Bextra –also known by it’s generic name as valdecoxib- that is marketed by the drug firm G.D. Searle and Company, was a popular pain reliever often used to treat the symptoms (i.e. pain) of rheumatoid arthritis and osteo arthritis in adults. The drug was recalled once it was linked to life threatening side effects including the autoimmune disorder Stevens Johnson syndrome, heart attacks, and strokes. Bextra was recalled from market circulation, however, the action came too late for the thousands of Bextra users who were harmed by the drug.

Drugs that manage to enter the market before their serious side effects are fully known is by no means a recent phenomenon. Back in 1960, thalidomide was this supposedly über-harmless sedative which was later found out to be a serious teratogen i.e. affects fetal development. Physicians in the then West Germany began noticing a spike in the occurrence of birth defects of one particular type. The babies are affected with phocomelia (from the Greek words: phoke, a seal, and melos, a limb). Toward the end of 1961 a persistent German pediatrician, Dr. Widukind Lenz tracked down thalidomide as the agent responsible in the case of the seal babies. Thalidomide usage had then spread from Germany to other European countries as well as to Canada, South America, Japan, and the Near East. In November 1961 the German manufacturer of thalidomide halted production, but the total number of thalidomide affected babies ultimately exceeded 5,000 in Germany and at least 1,000 in other countries.

At the time, American mothers were spared of the “full brunt” of the “thalidomide disaster” through the diligence of Frances Kelsey, a doctor then working for the US Food and Drug Administration. An American drug company had then applied for permission from the FDA to distribute the drug in the US, but Dr. Kelsey repeatedly refused to approve the application until she had conclusive evidence of thalidomide’s safety. When the news of the “thalidomide disaster” in Germany spread, the manufacturers withdrew their application to market thalidomide. Meanwhile, however, the drug companies had already sent out some thousands of free samples to physicians. Fortunately only a few of those got taken by pregnant women: American thalidomide babies numbered less than ten, and most of them were caused by pills brought in from Europe.

Recently, the drug firm involved with the marketing of Bextra is now resolving personal injury tort claims of the thousands of affected users via structured settlement. Is the Bextra incident a sign of increasing complacency of the established consumer product “watchdog” arm of the FDA? If so, then we the taxpayers deserve something better to get our money’s worth. Isn’t it what our taxes are for in the first place?

Vioxx: Beyond Pain Relief?

Is it due to the current profit driven health care system/industry that drugs with undesirable side effects still manage to enter the market?

By: Ringo Bones and Vanessa Uy

Ever since the discovery of aspirin over a hundred years ago, medical science had been busy searching / designing for a substitute drug that’s just as effective in managing pain without aspirin’s broad-spectrum somewhat undesirable side effects. One of these drugs is Vioxx whose generic name is rofecoxib. Vioxx / rofecoxib is a non steroidal anti-inflamatory drug (NSAID for short) developed by the drug firm Merck and Company to treat osteoarthritis, acute pain conditions, and dismenorrhoea. Rofecoxib was approved as safe and effective by the US Food and Drug Administration (FDA) on May 20, 1999 and was subsequently marketed under the brand name Vioxx, Ceoxx, and Ceeoxx.

Ever since FDA approval, rofecoxib gained widespread acceptance. Over 80 million people were prescribed rofecoxib at some time. On September 30, 2004, Merck voluntarily withdrew rofecoxib from the market because of concerns about increased risks of heart attack and stroke associated with long term high-dosage use of the drug. Rofecoxib was one of the most widely used drugs ever to be withdrawn from the market. Vioxx was Merck’s “Golden Goose” because it made them US$ 2.5 billion.

Merck’s withdrawal of Vioxx from the market is by no means an open and shut case. There’s the New England Journal of Medicine (NEJM) “controversy” on the Vioxx trial where certain data submitted to the FDA were not published in the NEJM article about the evaluation of Vioxx. The risks of prescribing rofecoxib to patients with pre existing cardiovascular disorders was found during the 2000 – 2001 Merck studies to find out if rofecoxib slows down the onset of Alzheimer’s disease or if the drug is a potential cure.

It’s quite unfortunate that Vioxx / rofecoxib was riddled with controversy like the other NSAID type drug Bextra / valdecoxib were the extent of the effects on the human cardiovascular system was not immediately known during the drug’s evaluation process. The rationale behind major drug companies producing and developing these kinds of drugs is sound because the medical community had always been searching for a substitute drug for aspirin in applications where it’s broad- spectrum of physiological effects would make it an undesirable choice. Lets not forget that if aspirin were to go through the stringency of current FDA standards of evaluation, it would never be approved for human use due to its broad –spectrum of physiological effects. Aspirin is primarily used as an analgesic and pain reliever but it also works as a mild anti-coagulant which it is used as a heart attack “preventive” for patients who are at risk for this. But aspirin’s use for this purpose requires a doctor’s supervision.

Despite of a number of drugs with attendant controversies, the medical community can’t immediately rule out their possible future potential applications. Studies have shown that Vioxx / rofecoxib is a potential Alzheimer’s disease preventive and / or possible cure. There was an article in Nature about how the teratogenic effects of thalidomide was “overlooked” because the drug doesn’t affect significantly the developing embryos of rabbits – the standard lab animal then in use back in the 1950’s - while the teratogenic nature of thalidomide was clearly evident in higher primates. Despite of thalidomide’s dangerous side effects, it has been recently used once again but this time it’s in the treatment of heart failure patients. Back in 2005, a BBC World documentary titled “Kill or Cure” featured recent trials of thalidomide being used as treatment of heart failure patients. This caused howls of protests from various thalidomide victims’ organizations around Europe criticizing the medical communities’ “failure to learn from history.”

When it comes to developing new and better drugs, the recent realities of the uneasy “marriage” between the drug industry and the medical community will always result in a “convoluted” path in drug evaluation and marketing. This is due to the results of trying to balance the demands of making a profit while staying true to the “Hippocratic Oath.”

Psychotherapy: Humbug?

As depression becomes a public health issue, how can an increasingly skeptical public benefit from the fruits of modern psychotherapy?

By: Vanessa Uy

If one dares to point a finger on who destroyed the credibility of modern / contemporary psychotherapy, then the blame should be directed at the current American pop culture. Ever since the TV series “The Sopranos” gained it’s legions of fans, the folks who mistrust modern psychotherapy finally gained a platform in which their “statement” finally got the “sex appeal” it badly deserves. Or is it the “Soprano” – spoof movie “Analyze This” and the sequel “Analyze That” where the Italian-American community’s mistrust of “shrinks” finally got worldwide mass-media attention. And what about the famous actor Tom Cruise airing his views on the science of psychology as a whole during his appearance on the TV talk show “Oprah”. It seems like America has abandoned her faith on psychotherapy, but it isn’t always been this way.

Back in the late 1980’s and early 1990’s - friends of mine who are old enough to have experienced first hand the worldwide cultural phenomena called Guns N’ Roses. They also remembered on how the practice of seeing shrinks / psychotherapists / psychoanalysts became fashionable even though those who visit one are not currently suffering any known mental illness. The band’s mercurial frontman – W. Axl Rose – never forgot to mention during his press interviews about the virtues of “shrinks” i.e. psychotherapists. Back then, it’s even fashionable to visit to shrinks and “chill out” with one even though it was (is) a somewhat expensive proposition at 75 to 100 US dollars- an- hour. At that time, Newsweek and Time even criticized the peoples growing over reliance on shrinks. There’s even a blurb about talking someone out of his or her diabetes (!). But during the same time in the Philippines, the existing sentiments on shrinks are pretty much like the TV series “The Sopranos”. Back in 1989- era Philippines, only “crazy people” i.e. the mentally ill went to shrinks. Even though this is my view, I know of native New Yorkers of Filipino ancestry who says that Filipino’s distrust of shrinks / psychotherapists are born of “repressed Catholic anti-Semitism”. Is this because of what Sigmund Freud said that he is Jewish- by- race- and- not-by-religion as an expression of Jewish pride in defiance of Nazi-era Germany?

Today, the Filipino society – in general – don’t trust modern psychotherapy. The existing idea that only the mentally ill visit shrinks is still the norm. Ironically, the practice of astrology, fortune telling and other Gypsy / Roma style mysticism are used as substitute for legitimate psychoanalysis by the very rich and local celebrities. To me, it’s their loss.

RNAi Therapy: Hope or Hype?

Touted as the latest cutting-edge therapy to turn the tide of battle against the AIDS pandemic, will RNA interference (RNAi) therapy succeed where protease inhibitor based drugs failed?

By: Ringo Bones

Growing up during the 1980’s, one can’t seem to ignore the doomsayer’s predictions on how humanity will be wiped out by the relentless spread of HIV infection or AIDS. Since at the time the existing therapeutic regimen are next to useless compared to the drugs set to replace them in the coming years. In the 1990’s came protease inhibitor based drugs that proved very promising – albeit very expensive – in saving the lives of AIDS sufferers in the early stages of the disease. Due to the high cost of the therapeutic regimen (Did it used to cost US$30,000 a year per patient?), only the extremely rich like NBA basketball star Magic Johnson can afford the expense. A decade or so later, the cost of the drugs came down dramatically that philanthropic institutions - like the Bill and Melinda Gates Foundation could provide the same therapy to parts of Africa seriously affected by AIDS at a cost of less than a dollar a day for every patient.

Though somewhat still awaiting field trials, RNA interference or RNAi therapy is the latest cutting edge therapy that has the necessary fighting chance to cure AIDS. RNAi therapy has the capability of switching off the pathogen that causes disease. If successful, RNAi therapy could not only cure AIDS but also hepatitis-C infections and further research could make RNAi therapy as a cure for cancer.

RNAi therapy was pioneered by an Australian biotech company called BENITEC. On July 2007, BENITEC was about to start dosing patients in the first human trials of their RNAi therapy, which attacks HIV infections on three separate fronts. Dr John Rossi from the Beckman Research Institute, City of Hope, California, outlined BENITEC’s RNA interference (RNAi) therapy – which he has collaborated on – and said that the first patient in the Phase I clinical trial will be dosed sometime by the end of July 2007.

Although the virus that causes HIV / AIDS can built up resistance to existing protease inhibitor based drugs alarmingly quickly, Dr John Rossi explained that attacking the virus on three separate fronts could enable the RNAi based drug to fend resistance for longer. It’s easy for the AIDS virus to mutate around one thing but much more difficult if there are three factors to contend with. Also, the mutated viruses that he has observed so far are much weaker that their previous “generation” as observed by Dr Rossi. But later, the virus reverted back to its original sequence.

Dr Rossi explained that the RNAi based drug uses a lentivirus vector to deliver the genes that encode for the three different forms of RNA to battle the virus. RNAi in the form of short hairpin RNA (shRNA), that targets an exon in the transactivator or transcription (Tat) and Regulator of Virion (Rev) gene (ShI). A decoy for the HIV TAT – reactive element (TAR) and a ribozyme that targets the host cell CCR5 chemokine receptor (CCR5RZ).

The scientists at BENITEC are using two different techniques to introduce the DNA into the body. The first one is where they remove the patient’s own bone marrow progenitor cells, genetically modifying them using the virus and then reinfuse them into the patient during a bone marrow transplant. BENITEC claims that – if successful – the new treatment could allow patients’ bodies to produce HIV-resistant white blood cells indefinitely.

BENITEC and City of Hope are also using a similar approach, only with T cells instead of stem cells explained Rossi. He went on to explain that the anti-CCR5 ribozyme may prevent the virus from entering the cell but if it does get in and starts to produce RNA’s, the drug will capture that RNA and also move the Tat away from the virus.

Not only does the drug attempt to knock back virus levels, Rossi said it also aims to destroy the lymphoma that develops in many HIV-positive patients. The trial itself will be treating five patients in this subgroup, with the results expected within a year.

From what I learned so far from virus physiology, using the “reproductive” phase of the pathogenic virus to “kill” it or render the virus impotent is a good way to tackle fast mutating RNA based viruses like HIV / AIDS. But a part of me that’s been reading (and watching) far too many science fiction stories find this technology rife for abuse. Especially further on when the science behind RNA interference therapy can be made to make one’s own immune system attack ones own body or make each and every cell in one’s body into a bunch of malignant tumors. As with any scientific “tool”, it’s up to the global community to police its applications.

Michael Moore versus the US Health Care System

After “Bowling for Columbine” and “Fahrenheit 911”, Michael Moore is now tackling the US health care system with “Sicko.”

By: Vanessa Uy

Using the 60th Cannes Film Festival - as a springboard- to launch his latest opus, Michael Moore’s latest documentary is no less a “scathing critique” on the US health - care system. To me, Michael Moore has chosen a very good topic with “Sicko” because the US health care system is long overdue for a long hard look.

Ever since the US President Teddy Roosevelt established universal health care for all Americans back in 1912, the lofty goals of the US health care system has been found wanting especially when it comes to results. Fast-forward to the Reagan years, it seems like Roosevelt’s “universal health care for all Americans” is more of a dream than reality. This is so because of the systems arcane bureaucracy has causes more harm- than- good. One of the excerpts of interest of the documentary is the “choosing which finger scene” where the accident victim is asked to decide whether he should choose to attach the middle finger for US$60,000 or choose to attach the ring finger for US$12,000. How can civilized people rationalize to have that kind of situation be accepted as the norm in America’s health care system?

Even though Michael Moore failed to include the Abu Ghraib Prison scandal in “Fahrenheit 911”, because the scandal leaked out-near the end of April 2004- a few months after the release of that documentary. The scandal that surrounds the US health care system probably can be dated back to the Ronald Reagan administration, inspiring songs like Metal Church’s “Fake Healer.” To me, there will probably be no other surprises in store that might suddenly emerge about the US health care system. Even 6 months after the premier of Michael Moore’s “Sicko.”

One of the points-of-contention in “Sicko” is Michael Moore comparing the US health care system with the one that is provided by Fidel Castro’s Cuba. As for anyone who’ve watched that BBC documentary about Cuba’s national health care system back in 2006. Here the BBC journalists were very impressed on Cuba’s national health care program which they described as efficient and very effective despite of operating on a budget that’s only a fraction of it’s American counterpart. And Cuba’s very good national health care system is what allowed Cuban citizens to achieve an average life expectancy that’s better than the US average despite of their national health care system operating on a “shoestring budget.”

Despite of the truth, the US authorities continue to vilify Michael Moore by placing him under arrest. This is due to some violating of some arcane law about prohibiting US citizens from traveling into Cuba or something.

Mesothelioma: A 21st Century Pandemic?

Mesothelioma, a rare and invariably fatal form of cancer that is caused by prolonged exposure to asbestos fibers might become more common by the middle of the 21st Century courtesy of the September 11,2001 attacks.

By: Ringo Bones and Vanessa Uy

The valiant men and women who helped the victims of the terrorist attack on the World Trade Center that fateful morning of September 11, 2001 may be in for an unpleasant surprise by the middle of the 21st Century. Everyone at “Ground Zero”, victims and rescuers alike might invariably come down with mesothelioma. The “twin towers” of the World Trade Center were built before the comprehensive ban on the use of asbestos fibers for building construction was ratified thus both rescue workers and victims were exposed to large amounts of asbestos fibers. The following months after the September 11, 2001 attacks- New Yorkers were continuously exposed to asbestos fibers wafting around as the clean up at “Ground Zero” went on. The big question is, should everyone be concerned?

A research was conducted at Mount Sinai Medical Center in New York 60 years before. The researchers spent 20 years studying 933 workers who produced asbestos insulation at a manufacturing plant in Paterson, New Jersey from 1941 to 1954. The researchers discovered that 186 of the workers had developed a then unique form of lung cancer. In 1973, the researchers began X-ray examinations of some of the worker’s families. The researchers found out that nearly 40 per cent of the 210 families tested had lung abnormalities common to asbestos workers. Four people who had come into contact with asbestos workers when they were children developed mesothelioma, a rare and invariably fatal form of cancer that is caused by exposure to asbestos fibers. Using this “occupational health study” data, the Mount Sinai Medical Center researchers feared that a plague of mesothelioma might break out around the year 2000. The World Trade Center / 9-11 incident could change mesothelioma forecasts for the 21st Century for the worse.

The pathologic description of malignant mesotheliona –according to Robbins’ “Pathologic Basis of Disease”- refers to an uncommon tumor of mesothelial cells. This tumor occurs most often on the pleura and rarely in the peritoneum or other organs. It is associated with exposure to asbestos in 90% of cases, but only 20% of patients have actual pulmonary asbestosis. The lifetime risk in heavily exposed individuals is 7 to 10%, and the latent period between exposure and the development of mesothelioma is 25 to 45 years. Nevertheless, bronchogenic carcinoma remains the most common lung tumor found in asbestos workers. The clinical features of mesothelioma are patients present with chest pain, dyspnea, and recurrent pleural effusions.

Since the recent scandal of soldiers wounded in action in Iraq receiving substandard treatment became headline news during the first few months of 2007. Many are concerned weather firefighters and law enforcement personnel who responded to the World Trade Center attacks will have adequate medical coverage if they develop mesothelioma in the future. Even Michael Moore is rumored to be already planning a sequel to his latest documentary “Sicko” devoted solely to the NYFD and NYPD personnel who will be diagnosed with mesothelioma in the future and how the US Government treats them. I hope that the next administration will take the ramifications of this issue very seriously.

Drug Rehab and Alcohol Treatment Centers: Fame and Fortune’s Final Destinations

Not just for movie stars anymore, NASA astronauts could soon be frequenting to a local substance abuse treatment center near you.

By: Vanessa Uy

From Lindsay Loan checking into the “celebrity” substance abuse treatment center called “Promises” located in Malibu (should “they” change their name to “Vague Promises” in lieu of Lohan’s “alcohol treatment” track record) to Paris Hilton and Britney Spears’ “revolution” to establish a “Nation of Inebriation”. Will “famous people” –and these days they now include “allegedly” drunken NASA astronauts- be able to resist the temptations of substance abuse? Or is drug addiction and alcoholism a symptom of a much deeper psychosis of the Western Society’s “Culture of Avarice” that makes it an “uneasy” raison d’être for drug rehab and alcohol treatment facilities?

Older acquaintances of mine that were active feminists during the 1970’s recommended Jaqueline Susann’s “Valley of the Dolls” as required reading. I’m somewhat perplexed by the relevance of the “feminist cause” to this work of literature which is more akin to “E News” / celebrity scandal type topics. It’s only recently came to me that the substance abuse described by Jaqueline Susann in “Valley of the Dolls” is a symptom of a social problem that the capitalist consumerism lifestyle breeds an unhealthy level of unhappiness to the general population. To me, she had no choice but to downplay her critique of capitalism during the time -late 1960’s early 1970’s America-were expressing such views was deemed “unpatriotic.”

After watching the entire series of documentaries on BBC World titled “The Happiness Formula.” I can safely form an opinion that some –if not all- “famous people” at some point in their lives will resort to alcohol and drug abuse as a coping mechanism in our current “Western” society which for all intents and purposes had gradually become the “Stepford Wives” “metaverse.” I can see now the wisdom of the nation of Bhutan’s reluctance to accept Western style consumerism to avoid the “unhappiness” that has plagued Western society.

In today’s hectic society ruled by capitalist consumerism, one could find that it’s getting harder and harder to resist the temptations of substance abuse. A method of ending one’s struggle with substance abuse that is widely adopted by the various “schools of thought” is by avoiding the “negative influence” of certain personal acquaintances. This “idea” is even adopted by one of the most effective “school of thought” that combat’s substance abuse namely Alcoholics Anonymous. If one takes the crucial step of restructuring their “social networks” i.e. avoiding the people who lead them to the path of drug and alcohol-based ruin.

To me, avoiding the influence of “negative people” is the path I took to achieve a relatively happy existence. I believe I’ve established my own “social infrastructure” to avoid substance abuse in the future. I -and the world at large- doesn’t need another Tomás de Torquemada as a friend. And as every counselor, psychotherapist or anyone working in today’s alcohol treatment and drug rehab facility fix society one person at a time. Their biggest wish is that they will no longer be needed when every one lives an addiction-free life.

Depression: An Overlooked Public Health Crisis?

From famed artists like Vincent Van Gogh and Edgar Allan Poe to a steadily rising part of the general public, should we adopt a pro-active rather than a reactive response in dealing with this mental health crisis?

By: Vanessa Uy

The inevitability for urgent concern might be a long time coming but a World Health Organization (WHO) study shows that mental health issues like depression is largely ignored by healthcare providers around the world. A WHO report aired in November 13, 2007 shows depression had already reached parity with other “preventable” public health concerns like coronary heart disease and even AIDS. The existing lack of urgency when it comes to dealing with mental health problems like depression is largely due to the pre-existing stigma attached to most mental health disorders in addition to general mistrust of the general public on the science of psychology.

Depression by itself is generally harmless, since most of us live in the Northern Hemisphere and when winter season comes the daylight hours gets shorter and shorter. This gives rise to a melancholic feeling commonly referred to as Seasonal Affective Disorder (SAD). The more serious form of depression that could lead to suicides are usually a product of manic – depressive disorder also known by its modern more politically correct name of bipolar disorder. Sufferers of bipolar disorder usually resort to suicide during the depressive part of their mental illness. While in their manic state, the sufferer could be manifesting his or her creative genius in various art forms like music, literature, and other creative outlets in ways far beyond the abilities of “normal” people.

With the aid of the latest existing mental health diagnostic tools like the fourth edition of the American Psychiatric Association’s handbook, the Diagnostic and Statistical Manual of Mental Disorders, referred to as the DSM-IV, had made analyzing mental illness across cultures much more easier and accurate. The latest WHO report also shows that mainland China probably has 100 million undiagnosed sufferers of depression that if left untreated could lead to suicide. Local studies have shown that rural parts of China has a much higher rates of suicide that urban areas due to increased isolation and hardship in day –to –day living.

Even though the basic facts in overcoming depression rest’s on the individual sufferer, to me, it still takes a skilled psychotherapist / counselor / social worker to bring back someone from the brink. Many of us –including me – had been taking for granted that every time we suffer from “the blues” we don’t wind up killing ourselves. As someone with above average creative skills, it always pays to keep close tabs with one’s selves. After all, you’ll know things are getting out of hand when you become your own worse enemy.

Medical Marijuana: Beyond Reproach?

Is it because of the relentless highly politicized “unscientific” vilification by the Moral Majority on the true nature of cannabis sativa i.e. marijuana during the Reagan Administration that allowed the “drug” to gain it’s unjustly earned “mystique”?

By: Ringo Bones and Vanessa Uy

In July 2007, the British medical journal Lancet published the result of a study that cannabis / pot users are 40% more likely to develop psychological illness like schizophrenia. Even if those conducting this recent study could refine their methods to a level of absolute certainty that’s beyond reproach, the results / data are likely to fall on deaf ears (or blind eyes) because marijuana has gained somewhat of a saint-like status that can be traced back to 1980’s America.

There are an increasing number of people –like us – who compares marijuana to a criminal who got acquitted from a prima facie case due to shoddy police work. Or maybe these are just people who grew up during the 1980’s being endlessly bombarded on the then politically-motivated-scientific-findings on the “brain-damaging” effects of delta-9 tetra hydro cannabinol, the main psychoactive component of marijuana. Back then, a book titled “The Emperor Wears No Clothes” by Jack Herer – which was secretly published in 1985 to the underground “Hemp” community is the only unbiased albeit pro hemp source of information on how marijuana affects a relatively large community. This book also serves as a manifesto that indicted the US Government’s hypocritical stance on marijuana use. During the Reagan Administration, there was an established government conspiracy to suppress findings on how hemp could be used as a viable source of BIOMASS to end America’s dependence on Middle Eastern petroleum. This came to pass despite of a well-known historical knowledge that Betsy Ross made the first US Flag “Old Glory” from hemp fiber. In 1942, the United States Department of Agriculture -with behest from the US Government – produced a 30 minute film titled “Hemp for Victory.” The film promotes the positive aspects of the Hemp Plant from the government’s own mouth.

The legislation that brought about the legalization of marijuana use – albeit for medical purpose – was due to scientific findings on it’s therapeutic effects on glaucoma. Facing relentless public pressure due to suppression of scientific results extolling the positive aspects of marijuana plus the relatively “liberal” political climate of the Clinton Administration, the US Government finally started legal proceedings allowing for the legalization of marijuana for medical use despite the protests of the “conservative” States. Though it’s been legal for a long time in “liberal” territories like the Netherlands, marijuana use – especially in the “coffee shops” of Amsterdam – are viewed as nothing more than recreational drug use by the cynical policymakers around the world. As recently as the 21st of August 2007, when a woman in Germany suffering from multiple sclerosis was prescribed with medical marijuana for pain relief after “conventional” pain medications failed to work caused an- uproar in the “conservative” community.

From the Alternative Medicine standpoint, marijuana –like the “perennially experimental” bee venom therapy for multiple sclerosis – still warrants more definitive research. This is so because the medical community could very much benefit on finding out which chemical components of cannabis sativa i.e. marijuana has genuine medicinal / therapeutic properties that can be separated from those components responsible only for psychoactive and / or narcotic effects.

To the rest of the world (except maybe the Netherlands of course), the legitimacy of medical marijuana will be found wanting due to lack of research and due to the political baggage that the plant endured under “REAGANISM.” While a large majority see “Medical Marijuana” as something really beyond reproach like Al Gore supporters conveniently overlooking Tipper Gore’s circa 1989 PMRC in the name of “Political Correctness.” Maybe Abraham Lincoln said it best “Prohibition will work great injury to the cause of temperance. It is a species of intemperance within itself, for it goes beyond the bounds of reason, in that it attempts to control a man’s appetite by legislation and to make a crime of things that are not crimes. A prohibition law strikes a blow at the very principles upon which our government was founded.” Except that Lincoln’s GOP is a whole different animal compared to the 21st Century “incarnation.”

Innovations in Pharmacology: An Arrested Development?

With the recent controversies surrounding the side - effects of BEXTRA and VIOXX, does this mean that recent advances in pharmacology had reached a dead end?

By: Ringo Bones and Vanessa Uy

The supposedly side – effect free and more effective substitutes for aspirin – BEXTRA and VIOXX- are fast becoming a non-starter for the multi-million dollar pharmaceutical industry. By now, almost all of us are wondering if the “miracles of modern science” has recently abandoned the field of pharmacology. Is this problem truly insurmountable as implied by the latest buzz - words in pharmaceutical / pharmacological publications? Let’s cite some examples.

Before the advent of antibiotics like penicillin, the only cure available for venereal diseases are arsenical compounds (developed during the 19th Century) so toxic that the cure was more likely to kill you than cure you. Now -the problem created by the misuse of our tried-and-true arsenal of antibiotics - are the drug-resistant pathogens engendered by the improper use and administration of antibiotics. That’s why back in the 1990’s arsenicals were re-introduced as a venereal disease cure against multi drug resistant syphilis.

Back in the 1950’s, thalidomide was developed as a much safer substitute for barbiturate-based sleeping pills. It was reported back then that one woman attempted to commit suicide by taking thalidomide based pills and failed to take her own life. Then the teratogenic effects of thalidomide surfaced after the drug was already widely marketed in Europe.

Probably developed during the height of the Cold War i.e. mid to late 1950’s – pyridostigmine bromide – was developed as a substitute for atropine sulfate to counteract the effects of cholinesterase inhibitor based weaponry i.e. nerve gas / nerve agents. Atropine sulfate was known to interfere with the infantry’s physical exertion i.e. dodging bullets upon intramuscular injection. Pyridostigmine bromide was designed to avoid this “inconvenience.” But back in April 1995, pharmacologist Mohamed Abou-Donia, while examining the nature of “Gulf War Syndrome” discovered that pyridostigmine bromide while effective at protecting soldiers against nerve agents by binding to – and shielding – the enzyme that nerve gas attacks. But it also grabs onto enzymes that help break down toxic chemicals thus the probable agent responsible for causing “Gulf War Syndrome.” This is quite the opposite of what atropine sulfate does – by increasing the body’s metabolism so that the nerve agents are flushed out of the body before it can do serious damage.

While a number of pharmaceutical companies choose to wait for unfortunate side – effects to occur before pulling their product off the market. Some – like the ASTRA ZENECA company, choose to voluntarily withdraw their product before a large number of unfortunate side – effects or fatalities could occur. ASTRA ZENECA developed the anticoagulant XIMELAGATRAN as a less toxic replacement for warfarin. XIMELAGATRAN was the first member of direct thrombin inhibitors that can be taken orally. For the benefit of those who do not know what is warfarin, it is the main ingredient in rat poison. Warfarin kills rats by making them bleed to death due to its anti coagulant effects. Also, warfarin makes a good rat poison / rodenticide because in case of accidental poisoning to humans, Vitamin K tablets can be used as a very effective antidote. In 2006, ASTRA ZENECA – the manufacturer of XIMELAGATRAN – announced that it would not attempt to market XIMELAGATRAN after reports of hepatoxicity (liver damage) during trials,and to discontinue it’s distribution in countries where the drug had been approved.

While in the last week of July 2007, the type-2 diabetes maintenance drug AVANDIA – a ROSIGLITAZONE and METFORMINE combination in one convenient pill - has been under scrutiny because recent studies of 7,500 patients have shown that 1 in 50 developed a heart attack. While some, developed fluid retention problems. One-fourth of their test subjects is aged below 50. This report has caused the stock value of GlaxoSmithKlein – AVANDIA’s manufacturer – to fall. Due to lack of a suitable replacement, and since AVANDIA had become ubiquitous with type-2 diabetes sufferers around the world. Majority of the world’s pharmaceutical regulatory bodies has just advised General Practitioners to closely monitor their patients who are presently taking AVANDIA.

This bothersome phenomena where innovations can no longer improve a trusty –but – rusty “workhorse” has finally invaded the world of pharmacology. This “phenomena” had plagued the hi-fi / audio industry for the past 20 –or so – years. It has the effect of rendering the decade –or more- advances in digital recording unable to “out – beauty” the good ol’ analogue sound recording i.e. 30 in/sec magnetic tape recording.

Will the tropanol derivative atropine – despite its negative physiological effects – be the “better” choice in protecting the fighting men and women the world over against cholinesterase inhibitor based weaponry well into the next century for the reason that replacements are proven to do more harm than good? And what about aspirin, are we just fortunate that it was discovered and marketed well before draconian laws to govern the pharmaceutical industry were legislated and enforced? From a pharmacological standpoint, it seems that chemical – based pharmaceuticals are inherently toxic to the human physiology. This is why the major pharmaceutical companies the world over are investing millions in their Research and Development department to develop drugs / agents that work using the principles of the science of genetic engineering like BENITEC’s RNA interference therapy. Presently, it seems the careful management of therapeutic regimens is the only viable option. In retrospect, the progress of the science of pharmacology has always been dependent – or hindered depending your point of view – to the current “politics” that engendered the legislation of draconian laws that regulate the pharmaceutical industry.