And the winner is…

While SRxA’s Word on Health may not have been on the red carpet last night…we thought we’d share with you our “winners” from the past 12 months.

For those of you who may have missed our most viewed blog posts, here’s a chance to see them again.

In reverse order:

Coming in at #10 we have: Ouchless Flu Vaccine – a story about a BandAid based drug delivery system.

#9  New Use Identified for Birth Deformity Drug – which detailed how thalidomide may reduce both the severity and frequency of nosebleeds in patients suffering from hereditary hemorrhagic telangiectasia disease.

#8 No Excuse for sleeping on the job! – a story from March 2010 about new study findings that showed working memory -a key element of executive functioning- was essentially unaffected by as much as 51 hours of total sleep deprivation.

#7  Eye injection that could save the sight of the over 30’s.  This blog announced the FDA approval of a new dexamethasone intravitreal implant heralded as the first effective treatment of macular edema.

The #6 most viewed story was actually our debut post which asked the question: If Martin Luther King had lived would he have had asthma?

At #5 is a story entitled Alzheimer’s Disease could be reversed by rheumatoid arthritis protein . In this post we were encouraged to learn that scientists have discovered that a chemical normally produced by the body to fight arthritis, could also reverse the memory loss associated with Alzheimer’s Disease.

#4 Patients are from Mars, Physicians are from Venus! This post reviewed results from a study that showed a huge disparity between patients’ expectations of angioplasty versus those of their cardiologists.  While the majority of heart patients harbor the notion that the procedure will cut their risk of heart attacks and death, cardiologists believe that its value is limited to reducing chest pain.

The #3 most viewed post was entitled Asthma though the Ages.  It traced the history of asthma from the earliest recorded reference to wheezing and respiratory distress  around 2,600 B.C. through to modern times.

In the runner-up spot, the best supporting blog goes to  Pac-Man Physiology.  This posting described new research suggesting that macrophages do much more than act as antimicrobial warriors.  Turns out they also play critical roles in immune regulation and wound-healing.   Additionally, they can respond to a variety of cellular signals and change their physiology in response to local cues.

And now with a big drum role, a pregnant pause and an outburst of emotion we are pleased to announce…

“And the winner is….”   High hopes for long term hemophilia B therapy.  in this most-viewed post, we  brought you the preliminary results of a gene-therapy study that showed that a single injection of  the new treatment could turn a patient with severe hemophilia into one with moderate disease .

Do you agree with our readers?  Should there have been other winners?  We’d love to hear from you.

Differentiating Chronic Fatigue Syndrome and Lyme Disease

Both chronic fatigue syndrome (CFS) and Lyme disease can result in profound exhaustion that may be prolonged and debilitating. It can be accompanied by either excessive sleeping or insomnia. Yet oftentimes these diseases are dismissed by family, friends and physicians or attributed to simple tiredness from overwork or stress.

For such patients, hope may be in sight.  A new study reveals that researchers have discovered a test that can distinguish patients with Lyme disease from those with chronic fatigue syndrome, and also from people in normal health.

In the study, investigators analyzed spinal fluid from 43 patients with chronic fatigue syndrome, 25 people who had been diagnosed with and treated for Lyme disease, (neurologic post-treatment Lyme disease – nPTLS) and 11 healthy people.

Until now, there have been no known biomarkers to distinguish between Lyme disease and Chronic Fatigue Syndrome , nor strong evidence that the central nervous system was involved in the two conditions.

“Spinal fluid is like a liquid window to the brain,” says Steven E. Schutzer MD, of the University of Medicine and Dentistry of New Jersey.

The researchers identified 738 proteins present only in the spinal fluid of CFS patients and 692 proteins found only in the spinal fluid of nPTLS patients.

One next step will be to find the best biomarkers that will give conclusive diagnostic results,” said Dr. Schutzer. “In addition, if a protein pathway is found to influence either disease, scientists could then develop treatments to target that particular pathway.”

Have you been misdiagnosed, mistreated or accused of malingering?  SRxA’s Word on Health would love to hear from you.

Long, long sneezy days of summer

Seems it’s not just polar bears and politicians who need to be concerned about global warming. According to a new study, allergy sufferers are going to be in for a hard time too.  Researchers from the US Department of Agriculture have discovered that ragweed pollen levels are rising along with the temperatures.

The team of researchers, who analyzed ragweed pollen counts from Texas to Saskatoon over a 15-year period , also concluded that the length of the ragweed season, which is dependent on warm temperatures, would increase in northern latitudes.

From 1995 – 2009, Madison  and LaCrosse, WI saw an increase in their ragweed season of 12 and 13 days respectively while Minneapolis, MN and Fargo, ND, saw their ragweed season increase in length by 16 days. Further north, in Winnipeg and Saskatoon the ragweed seasons lengthened  by 25 – 27 days.

Better news though for those in the South.  The ragweed season  in Texas and Arkansas actually decreased by three or four days although the amount of allergen in the air during the season increased.

This study is a confirmation of what the Intergovernmental Panel on Climate Change has been projecting. We’ve gone from a theoretical projection of changes in the timing of ragweed season, to boots on the ground starting to see it happen,” said study author Lewis Ziska, a plant physiologist at the Agricultural Research Service.

This all adds up to a lot of summer suffering. At least 1 in every 10 people in the United States is sensitive to ragweed and the pollen is the culprit in more than a quarter of all allergy cases.

SRxA’s teams of expert Allergy and Ocular Advisors are on hand to help pharmaceutical companies educate physicians and patients  on this latest aspect of global warming.

Happy Birthday Mr. President – Get well soon!

As many American’s celebrate Presidents’ Day,  SRxA’s Word on Health has been musing about the health of America’s founding father.  Although George Washington was physically strong, he was not the indominatable human force that popular history paints. He was often sick, particularly with infections. These were serious infections, many of them life-threatening.

Our research reveals that over the course of his lifetime, Washington suffered from diphtheria, malaria, smallpox, tuberculosis, dysentery, quinsy, pneumonia and epiglottitis.  In later life, he had dental problems, progressive deafness, short-sightedness and infertility.

From the age of 17 to almost the end of his life, Washington had recurrent attacks of malaria. Malaria was then common in Virginia. Interestingly, an effective treatment for malaria had been discovered in the previous century. But, for some reason, Washington did not receive the treatment until 1784, when he was in his 50s.

At age 19 Washington spent time on Barbados. Around this time George developed a severe case of smallpox, which ultimately left his skin scarred for life. Shortly after returning from Barbados, Washington developed tuberculosis.

Washington had a tendency to become depressed when ill. He was haunted by premonitions of death, perhaps because his father and half-brother both died prematurely. Thomas Jefferson wrote that Washington was, in all aspects of his life, “inclined to gloomy apprehensions.”

In 1759 Washington married Martha Dandridge Custis. He was 26, she was a 28 year old widow who had borne four children during her previous marriage. Martha never became pregnant during her 40-year marriage to Washington. Given her previous fertility, it could well be concluded that the difficulty was not with her but with her husband.

Washington’s height, sterility, large hands, pockmarks, plus certain personality features and even his well-documented dental problems have led to the suggestion he had XYY syndrome.

By middle age Washington had no teeth left. Washington’s clumsy, ill-fitting dentures distorted his lips. This undoubtedly contributed to his dour expression.

No one is quite sure what killed Washington. He was in fine health at age 67 when he developed hoarseness and a sore throat. There was little alarm until he awoke in the middle of the night with difficulty breathing, almost unable to talk. A doctor was summoned, but Washington did not wait, ordering an employee to bleed him. The doctor arrived and, according to the principles of the day, bled him again. Eventually, Washington requested no further bleeding be performed, but he was bled again anyway. The bleedings inflicted by Washington’s doctors hastened his end. Some 80 ounces of blood (about 35% of his total blood volume) were removed in 12 hours.

One of the three doctors attending him objected to continued bleeding, arguing instead for tracheotomy which would have been  life-saving in epiglottitis. However, back then this treatment was considered experimental and dangerous.

Nevertheless, a  fourth physician, arrived at Mount Vernon the day after Washington died. The doctor hoped that Washington was in a suspended state, from which he could be aroused and then treated with tracheotomy.  It was proposed that the body be thawed gradually, first in cool water and then with warm blankets and rubbing of the skin, with the subsequent performance of a tracheotomy, artificial respiration at the tracheotomy site, and transfusion of lamb’s blood.

Sadly, we will never know if this would have worked as Martha Washington vetoed the plan!

Sweet Protection Against Parkinson’s Disease

New research shows men and women who regularly eat berries may have a lower risk of developing Parkinson’s disease.  Men may further lower their risk by regularly eating apples, oranges and other sources rich in dietary flavonoids.

The study which was supported by the National Institutes of Health involved 49,281 men and 80,336 women. Researchers gave participants questionnaires and used a database to calculate intake amount of flavonoids. They then analyzed the association between flavonoid intakes and risk of developing Parkinson’s disease. They also analyzed consumption of five major sources of foods rich in flavonoids: tea, berries, apples, red wine and oranges or orange juice. The participants were followed for 20 to 22 years.

During that time, 805 people developed Parkinson’s disease. In men, the top 20% who consumed the most flavonoids were about 40% less likely to develop Parkinson’s disease than the bottom 20% of male participants who consumed the least amount of flavonoids.

In women, there was no relationship between overall flavonoid consumption and developing Parkinson’s disease. However, when sub-classes of flavonoids were examined, regular consumption of anthocyanins, which are mainly obtained from berries, were found to be associated with a lower risk of Parkinson’s disease in both men and women.

This is the first study in humans to examine the association between flavonoids and risk of developing Parkinson’s disease,” said study author Xiang Gao, MD, PhD, with the Harvard School of Public Health in Boston.

Fruit consumption has also been related to health benefits in a whole range of conditions including cancer, stroke, heart disease, diverticulosis, hypertension, cataracts, diabetes, asthma, and bronchitis.

Do you have any fruity stories to share?  SRxA’s Word on Health would love to hear from you.

Something for the weekend Sir? Now we have an app for that!

In New York and need to find a condom in a hurry?

Starting this week, the city’s health department‘s has you covered.

To coincide with Valentine’s Day, the city’s health department unveiled a free iPhone app that allows users to find five places close by where they can pick up a free male or female condom.

We are trying to reach everyone having sex,” said Monica Sweeney of the department’s HIV/AIDS Prevention and Control division. “The younger generation uses their iPhone and we want to make it convenient for them to access condoms.”

New Yorkers can also download the application on the Android or go to www.nyc.gov/health and type in their zip code to find locations with free NYC Condoms. They’re available at many community centers, health clinics, neighborhood stores – even tattoo parlors and barber shops. With the aid of GPS, the app will even give walking, driving and subway directions to the site.

The city gave out more than 36 million NYC Condoms in 2010 and is prepared to hand out “as many as people need this year” says Sweeny.

(Wo)Man’s Best Friend???

The press recently reported how an accidental head butt from Martha Stewart’s French Bulldog Francesca resulted in an injury requiring nine stitches to repair the damage to the domestic diva’s lip.

I feel your pain, Ms. Stewart, I really do.

This post is brought to you as your Word on Health blogger recovers from knee surgery stemming from another pet-related injury. And while I wish the analgesia would take away not only the pain, but also the humiliating memory of being dragged face first along a muddy riverbank by my canine companions as they attempted to become better acquainted with a passing pooch, I take some comfort from the fact that Martha and I are not alone.

People, it seems are not only falling for their pets, apparently, large numbers of us are falling over them, too.

In fact, a national sample of ER visits from 60 hospitals over a six year period reported 7,456 visits were related to falls caused by pets. On a national level, this translates to nearly 90,000 fall injuries associated with cats and dogs per year. Dogs are 7 times more likely to cause falls than cats and women are twice as likely as men to be injured as a result.

That’s the equivalent of 240 ER trips a day, and roughly 1% of the 8 million visits for falls of all sorts.

Exactly how many of the falls occurred isn’t known. Nevertheless, the study, gives a rough sketch of hazardous activities. Almost 35% of injuries are caused by tripping over the animal while about 25% occurred during walks. Surprisingly, less than 3% result from running away from a dog, and <0.5% percent while breaking up a dog-fight.  Being pulled by the animal caused a fifth of the falls.

While one-third of the falls broke bones, about one-quarter caused bruises, one-fifth caused sprains and a little more than one-tenth caused cuts.   Nothing on the list, I note, about tearing a cartilage – trust my dogs to  go one step better!

Been injured by Fido or Fluffy?  Share your stories with us.

Man develops own life-saving heart implant

A serious heart problem inspired a man with Marfan syndrome to develop a device that offers hope not just for himself but for thousands of other patients with the same condition.

In 2000, Tal Golesworthy, a process engineer from the UK, was told that the aortic root in his heart had expanded and was in danger of splitting. He had two choices; undergo surgery to insert a mechanical valve or risk a sudden and fatal heart attack.

The first option filled him with almost as much dread as the second. Surgery would involve cutting out the damaged section of the artery  and replacing it with a piece of tubing. It would also mean that he would be placed on warfarin, a blood-thinning drug, also used as rat poison, which carries the risk of severe bleeding. “That’s not something I wanted to rely on for the rest of my life,” said Golesworthy. “The thought of that dismayed me more so than the surgery.”

Golesworthy thought he could engineer a better solution. What excited him was the use of. He believed that by combining magnetic resonance imaging (MRI) and computer-aided design (CAD) with rapid prototyping (RP) techniques he could manufacture a tailor-made support that would act as an internal bandage to keep his aorta in place.

The concept, he hoped, would reduce the risk of harmful clots forming due to the mechanical valve and importantly, eliminate the need to take warfarin. Time was crucial if Golesworthy was to save himself. So he enlisted the help of Prof Tom Treasure, a cardiothoracic surgeon at Guy’s Hospital, and Prof John Pepper, a surgeon from the Royal Brompton Hospital.

Although conceptually, it was very simple to do, the actual engineering was significantly more complex.” explained Golesworthy.

He set about devising a means of wrapping the aorta in a sleeve to prevent it expanding, and came up with a solution called Ears — external aortic root support — which is now being marketed through his firm, Exstent.    The team looked at a number of different processes, such as 3D embroidery, but ended up using a standard medical polymer, polyethylene terephthalate (PET) in a textile solution. The mesh weighed less than 5g, was an exact fit for the ascending aorta and could be sutured into place by the surgeon.  Each sleeve is created using scans of the individual patient’s aorta and computer-assisted drawing to produce a bespoke device.

The process, from proposal to final product, took just under two years.  “My aorta was dilating all through that period,’”said Golesworthy.

Golesworthy believes that projects such as this demonstrate that the interface between engineers and the rest of the world isn’t functioning in the way it should. “When it does function, huge advances can be made in a very short time period, on very little money,” he said. “We have changed the world for people with aortic dilation and we have done it on a fraction of the cost.”

In May 2004, Golesworthy became the first recipient of his own invention.  Since then, 23 patients have successfully had the implant fitted and another seven are hoping to undergo the procedure.

Word on Health is continually amazed at what people can do when their life is on the line. Although as  Golesworthy himself says “When you’ve got the scalpel of Damocles hanging over your sternum, it motivates you into making things happen.”

Improving Asthma Adherence

A new study, published in the Journal of Allergy and Clinical Immunology, shows that patients who are more confident about the benefits of their asthma controller therapies tend to report higher levels of adherence.

The Trial of Asthma Patient Education (TAPE) study examined the effect of an educational program aimed at increasing expectations of treatment benefit on medication adherence.

Patients with sub-optimally controlled asthma were randomized to either placebo or the active drug – montelukast (Singulair) in conjunction with an interactive computer-based multimedia educational presentation that was either neutral or designed to increase outcome expectancy.

The enhanced presentation was specifically designed to increase the expectation that the drug would adequately control asthma symptoms, while the neutral presentation included information on asthma care and management but without active promotion of the benefits of medication. The presentations were shown before the study drugs were dispensed, and again 2 weeks into the study.

Adherence was monitored electronically over 4 weeks and was defined as ≥80% use of prescribed doses. Medication adherence was measured electronically using devices fitted onto the medication bottles to record the date and time of each bottle opening.

Outcome expectancy, peak expiratory flow, prebronchodilator FEV1, asthma control (Juniper asthma control questionnaire), and asthma-related quality of life were assessed at baseline and at the 4-week follow-up.

Results showed that the enhanced presentation mode was associated with improved adherence to active drug. Additionally, when a patient expected a higher benefit from treatment, their breathing test scores improved and self-reported asthma control scores tended to be higher. There was also an accompanying trend for improvement in asthma-specific quality of life.

These results suggest that the manner in which medications are introduced to patients may not only affect their expectations about the potential benefits of the therapy, but may also impact their level of adherence and sense of improved health. The authors dubbed this The Madison Avenue effect.

This study further supports the results of work undertaken by SRxA’s Health Outcomes Advisors:  Dr. Allan Luskin and Dr. Don Bukstein.  Together with SRxA, Drs Luskin and Bukstein, both world authorities on Health Outcomes, have developed fully integrated Practice Management programs to improve medication adherence and patient outcomes. These programs can be customized for almost any drug or treatment modality.  Pharmaceutical companies wanting to know more about these guaranteed result programs should contact us today.

Homeopathy gets a Nobel nod

Dr. Luc Montagnier, the French virologist who won the Nobel Prize in 2008 for discovering the AIDS virus, has surprised the scientific community with his strong support for homeopathic medicine.

In a remarkable interview published in Science magazine, Professor Montagnier expressed support for the often maligned and misunderstood medical specialty of homeopathic medicine. Although homeopathy has been around for >200 years, most conventional physicians and scientists have expressed skepticism about its efficacy due to the extremely small and highly diluted doses of medicines used.

Montagnier disagrees. “I can’t say that homeopathy is right in everything. What I can say now is that the high dilutions (used in homeopathy) are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules.”

His experimental research confirms that even after sequential dilution, electromagnetic signals of the original medicine remains in the water and can have dramatic biological effects.

Montagnier has just taken a new position at Jiaotong University in Shanghai, China where his work will focus on the phenomenon of electromagnetic waves produced by DNA in water. He and his team will study both the theoretical basis and the possible applications in medicine.

He is confident  that these new observations will lead to novel treatments for many common chronic diseases, including but not limited to autism, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis.

In the Science magazine interview Montagnier also expressed real concern about the unscientific atmosphere that presently exists on certain unconventional subjects such as homeopathy. When asked if he is concerned that he is drifting into pseudoscience, he replied adamantly: “No, because it’s not pseudoscience. It’s not quackery. These are real phenomena which deserve further study.”

This is in stark contrast to the recent statement from the British Medical Association who referred to homeopathy as “witchcraft.”

So, who’s right?  SRxA’s Word on Health wonders if it’s the case that when one goes on a witch hunt, one inevitably finds “witches!”

Let us know what you think.