Nat Scholz examines how pesticides that run off the land and mix in rivers and streams combine to have a greater than expected toxic effect. He examines the salmon nervous system, but these mixtures in the food supply for humans may also pose unexpected health risks for people.
According to Scholz, “We have a pretty good handle on how to assess the health effects of single chemicals in conventional toxicity trials. But the real world is usually more complex, and exposures to mixtures of chemicals can be more of the rule than the exception. One of the major scientific challenges of our generation is to develop new approaches to anticipate and head off any ill effects of interacting chemicals.”
Scholz and his colleagues found that salmon died when exposed to combinations of pesticides that were not deadly in the same amounts individually. The research points to the need for more study of how combinations of pesticides found on fruits and vegetables affect humans.
21 February 2008
Vaccine Linked to Pneumonia Deaths
WASHINGTON (Reuters) - GlaxoSmithKline Plc's rotavirus vaccine is associated with increased pneumonia-related deaths and other adverse reactions, U.S. regulatory staff said in documents posted on Friday.
The review comes ahead of a Food and Drug Administration advisory meeting next Wednesday to consider approval of the oral vaccine to prevent the most common cause of severe diarrhea and dehydration among infants and young children in the world.
The review comes ahead of a Food and Drug Administration advisory meeting next Wednesday to consider approval of the oral vaccine to prevent the most common cause of severe diarrhea and dehydration among infants and young children in the world.
FDA staff said its analysis of 11 studies revealed that in the largest trial, there was a statistically significant increase in deaths related to pneumonia compared with placebo, documents posted on the FDA's Web site said.
That study, which enrolled about 63,000 children, also found an increase in convulsions in children given the drug, named Rotarix. Another study found an increased rate of bronchitis, compared with placebo.
In a conclusion section, the FDA documents noted the pneumonia-related deaths and convulsions, but did not appear to make a recommendation to the advisory panel.
That expert panel will weigh the staff review, but makes its own recommendation, which is typically followed by the FDA.
Bernstein Research analyst Tim Anderson said safety issues could mar his current forecasts for the drug of reaching sales of $1.3 billion by 2012.
The drug could compete with Merck & Co's RotaTeq vaccine.
The review comes ahead of a Food and Drug Administration advisory meeting next Wednesday to consider approval of the oral vaccine to prevent the most common cause of severe diarrhea and dehydration among infants and young children in the world.
The review comes ahead of a Food and Drug Administration advisory meeting next Wednesday to consider approval of the oral vaccine to prevent the most common cause of severe diarrhea and dehydration among infants and young children in the world.
FDA staff said its analysis of 11 studies revealed that in the largest trial, there was a statistically significant increase in deaths related to pneumonia compared with placebo, documents posted on the FDA's Web site said.
That study, which enrolled about 63,000 children, also found an increase in convulsions in children given the drug, named Rotarix. Another study found an increased rate of bronchitis, compared with placebo.
In a conclusion section, the FDA documents noted the pneumonia-related deaths and convulsions, but did not appear to make a recommendation to the advisory panel.
That expert panel will weigh the staff review, but makes its own recommendation, which is typically followed by the FDA.
Bernstein Research analyst Tim Anderson said safety issues could mar his current forecasts for the drug of reaching sales of $1.3 billion by 2012.
The drug could compete with Merck & Co's RotaTeq vaccine.
Alternative Therapies Are Best for Neck Pain
A seven-year, international study published today finds that some alternative therapies such as acupuncture, neck manipulation and massage are better choices for managing most common neck pain than many current practices. Also included in the short-list of best options for relief are exercises, education, neck mobilization, low level laser therapy and pain relievers.
Therapies such as neck collars and ultrasound are not recommended. The study found that corticosteroid injections and surgery should only be considered if there is associated pain, weakness or numbness in the arm, fracture or serious disease.
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders 236 page review of the current research on neck pain is published in the journal Spine. The multi-national and inter-disciplinary study team included Canadian, American, South American, Australasian and European researchers. The Task Force was created to help neck pain sufferers and health professionals use the best research evidence to prevent, diagnose and manage neck pain.
"Neck pain is not a trivial condition for many people," says Task Force president Dr. Scott Haldeman, clinical professor, department of neurology at the University of California, Irvine; and adjunct professor, department of epidemiology University of California Los Angeles. "It can be associated with headaches, arm and upper back pain and depression. Whether it arises from sports injuries, car collisions, workplace issues or stress, it can be incapacitating. Understanding the best way to diagnose and manage this problem is of high importance for those who are suffering and for those who manage and pay for its care."
The study found that neck pain is a widespread experience that is a persistent and recurrent condition for the majority of sufferers. It is disabling for approximately two out of every 20 people who experience neck pain and affects their ability to carry on with daily activities says the Task Force.
A key recommendation of the Task Force is that neck pain, including whiplash-related pain, be classified and treated in a common system of 4 grades:
Grade 1: neck pain with little or no interference with daily activities
Grade 2: neck pain that limits daily activities
Grade 3: neck pain accompanied by radiculopathy ("pinched nerve" -- pain weakness and/or numbness in the arm)
Grade 4: neck pain with serious pathology, such as tumor, fracture, infection, or systemic disease.
"The majority of neck pain falls into Grades 1 or 2," says Task Force member, Dr. Linda Carroll, Associate Professor, School of Public Health at the University of Alberta, and Associated Scientist, Alberta Centre for Injury Control and Research (ACICR). "Many sufferers manage to carry on with their daily activities. Others find their pain interferes with their ability to carry out daily chores, participate in favorite activities or be effective at work. For these people, the evidence shows there are a relatively small number of therapies that provide some relief for a while, but there is no one best option for everyone."
In addition to its comprehensive review of the existing body of research on neck pain, the Task Force also initiated a new study into the association between chiropractic care of the neck and stroke. This innovative piece of research found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician. The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops.
"This type of stroke is extremely rare and has been known to occur spontaneously or after ordinary neck movements such as looking up at the sky or shoulder-checking when backing up a car," noted the study's lead author, Dr. David Cassidy, professor of epidemiology at the University of Toronto and senior scientist at the University Health Network at Toronto Western Hospital.
For the minority of neck pain sufferers who experience Grade 3 neck pain -- that is neck pain accompanied by pain, weakness and/or numbness in the arm, also referred to as a "pinched nerve", corticosteroid injections may provide temporary relief says the study. Surgery is a last resort according to the findings and should only be considered if accompanying arm pain is persistent or if the person is experiencing Grade 4 pain due to serious injury or systemic disease.
Top findings for neck pain suffers:
* Stay as active as you can, exercise and reduce mental stress.
* Don't expect to find a single "cause" for your neck pain.
* Be cautious of treatments that make "big" claims for relief of neck pain.
* Trying a variety of therapies or combinations of therapies may be needed to find relief -- see the therapies for which the Task Force found evidence of benefits.
* Once you have experienced neck pain, it may come back or remain persistent.
* Lengthy treatment is not associated with greater improvements; you should see improvement after 2-4 weeks, if the treatment is the right one for you.
* There is relatively little research on what does or does not prevent neck pain; ergonomics, cervical pillows, postural improvements etc. may or may not help.
"This is an important body of research that will help to improve the quality of patient care by incorporating the best evidence into practice and patient education," says Dr. Carroll. "Neck pain can be a stubborn problem -- we hope this comprehensive analysis of the evidence will help both sufferers and health care providers better manage this widespread complaint."
Therapies such as neck collars and ultrasound are not recommended. The study found that corticosteroid injections and surgery should only be considered if there is associated pain, weakness or numbness in the arm, fracture or serious disease.
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders 236 page review of the current research on neck pain is published in the journal Spine. The multi-national and inter-disciplinary study team included Canadian, American, South American, Australasian and European researchers. The Task Force was created to help neck pain sufferers and health professionals use the best research evidence to prevent, diagnose and manage neck pain.
"Neck pain is not a trivial condition for many people," says Task Force president Dr. Scott Haldeman, clinical professor, department of neurology at the University of California, Irvine; and adjunct professor, department of epidemiology University of California Los Angeles. "It can be associated with headaches, arm and upper back pain and depression. Whether it arises from sports injuries, car collisions, workplace issues or stress, it can be incapacitating. Understanding the best way to diagnose and manage this problem is of high importance for those who are suffering and for those who manage and pay for its care."
The study found that neck pain is a widespread experience that is a persistent and recurrent condition for the majority of sufferers. It is disabling for approximately two out of every 20 people who experience neck pain and affects their ability to carry on with daily activities says the Task Force.
A key recommendation of the Task Force is that neck pain, including whiplash-related pain, be classified and treated in a common system of 4 grades:
Grade 1: neck pain with little or no interference with daily activities
Grade 2: neck pain that limits daily activities
Grade 3: neck pain accompanied by radiculopathy ("pinched nerve" -- pain weakness and/or numbness in the arm)
Grade 4: neck pain with serious pathology, such as tumor, fracture, infection, or systemic disease.
"The majority of neck pain falls into Grades 1 or 2," says Task Force member, Dr. Linda Carroll, Associate Professor, School of Public Health at the University of Alberta, and Associated Scientist, Alberta Centre for Injury Control and Research (ACICR). "Many sufferers manage to carry on with their daily activities. Others find their pain interferes with their ability to carry out daily chores, participate in favorite activities or be effective at work. For these people, the evidence shows there are a relatively small number of therapies that provide some relief for a while, but there is no one best option for everyone."
In addition to its comprehensive review of the existing body of research on neck pain, the Task Force also initiated a new study into the association between chiropractic care of the neck and stroke. This innovative piece of research found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician. The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops.
"This type of stroke is extremely rare and has been known to occur spontaneously or after ordinary neck movements such as looking up at the sky or shoulder-checking when backing up a car," noted the study's lead author, Dr. David Cassidy, professor of epidemiology at the University of Toronto and senior scientist at the University Health Network at Toronto Western Hospital.
For the minority of neck pain sufferers who experience Grade 3 neck pain -- that is neck pain accompanied by pain, weakness and/or numbness in the arm, also referred to as a "pinched nerve", corticosteroid injections may provide temporary relief says the study. Surgery is a last resort according to the findings and should only be considered if accompanying arm pain is persistent or if the person is experiencing Grade 4 pain due to serious injury or systemic disease.
Top findings for neck pain suffers:
* Stay as active as you can, exercise and reduce mental stress.
* Don't expect to find a single "cause" for your neck pain.
* Be cautious of treatments that make "big" claims for relief of neck pain.
* Trying a variety of therapies or combinations of therapies may be needed to find relief -- see the therapies for which the Task Force found evidence of benefits.
* Once you have experienced neck pain, it may come back or remain persistent.
* Lengthy treatment is not associated with greater improvements; you should see improvement after 2-4 weeks, if the treatment is the right one for you.
* There is relatively little research on what does or does not prevent neck pain; ergonomics, cervical pillows, postural improvements etc. may or may not help.
"This is an important body of research that will help to improve the quality of patient care by incorporating the best evidence into practice and patient education," says Dr. Carroll. "Neck pain can be a stubborn problem -- we hope this comprehensive analysis of the evidence will help both sufferers and health care providers better manage this widespread complaint."
20 February 2008
Probiotics Protect Top Athletes
Probiotic supplements have been shown to reduce the number and length of infections suffered by long-distance runners. Strenuous training can affect the immune system and make athletes vulnerable to coughs and colds, but a study has shown that taking probiotics more than halves the days that runners show symptoms.
The study focused on 20 top-level endurance runners during their intensive winter training program. All 20 received two month-long courses of pills -- one containing the bacterium Lactobacillus fermentum, and the other containing no active ingredients.
There were a total of 72 days in which people taking the "dummy" pills complained of cough or cold symptoms, compared to only 30 days on the course of probiotics.
Sources:
* BBC News February 14, 2008
The study focused on 20 top-level endurance runners during their intensive winter training program. All 20 received two month-long courses of pills -- one containing the bacterium Lactobacillus fermentum, and the other containing no active ingredients.
There were a total of 72 days in which people taking the "dummy" pills complained of cough or cold symptoms, compared to only 30 days on the course of probiotics.
Sources:
* BBC News February 14, 2008
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