State Sued Over Ruling On Dental Mercury

http://www.courant.com/news/local/hc-mercsuit1025.artoct25,0,483061.story?&track=rss

-->Courant Staff ReportOctober 25 2005Opponents of dental mercury filed suit against the state Department of Environmental Protection on Monday, more than a month after DEP Commissioner Gina McCarthy ruled that the use of mercury amalgam to fill teeth does not violate the state's anti-mercury law. The suit was filed in Superior Court in New Britain by Consumers for Dental Choice, a nonprofit advocacy group based in Washington, and a number of Connecticut foes of dental mercury, including Adam Breiner, a Trumbull naturopath and spokesman for the Coalition to Enforce Connecticut's Zero Mercury Law, a coalition of anti-mercury groups.McCarthy ruled on Sept. 8 that dentists may continue to use fillings that contain mercury. She had been asked by opponents of dental mercury to rule whether the practice should be stopped under the state's Mercury Reduction and Education Act of 2002, which bans or phases out many mercury-containing products. Mercury is a toxic substance that can cause a host of human health problems. Connecticut dentists are required to install and use devices that capture mercury and prevent it from washing down dental office drains. Critics contend that fillings cause illnesses in the patients who have them, but large studies have failed to show this. Dentists argue that amalgam may be the only choice for certain repairs and that it should remain available to dental patients. The use of amalgam fillings has declined sharply in recent years, replaced by durable tooth-colored materials.

FDA removes 'dangerous' drug from shelves

http://www.int.iol.co.za/index.php?set_id=1&click_id=31&art_id=qw1130215682316R131

Washington - The Food and Drug Administration (FDA) has withdrawn approval for a drug used to treat attention deficit hyperactivity disorder because it has been associated with liver problems, including death, agency officials said.The move means drug manufacturers will no longer produce generic versions of pemoline, which was developed by Abbott Laboratories and sold under the name Cylert. Abbott discontinued the drug earlier this year, but generic versions have remained available.FDA is not recalling the drug, instead allowing pharmacies to sell their remaining stock as doctors still using it switch patients to alternative treatments, the agency said in a statement.The lack of a recall drew fire from the consumer advocacy group Public Citizen."It is reckless and insensitive to the health and lives of children and adults using this drug for the FDA and the involved drug companies to fail to institute an immediate recall of these dangerous products," said Dr Sidney Wolfe and Dr Peter Lurie, who lead the organisation's Health Research Group, in a letter to the FDA.In a statement, the FDA said it has 13 reports of liver failure resulting in transplant or death among people who took the drug, which has been available for 30 years. There are additional reports of less serious problems.Although that is a small number, it is well above what the normal rate of such problems among the general population, the FDA said."FDA has concluded that the risk of liver failure with this drug outweighs the potential benefits," the agency statement says, noting that alternative treatments for ADD have come on the market since pemoline was introduced.The drug acts as a stimulant to the central nervous system. - Sapa-AP

Glaxo Stops Testing of AIDS Drug on Liver Concerns (Update3)

http://www.bloomberg.com/apps/news?pid=10000102&sid=a8.dc9Qtyp8g#

Oct. 25 (Bloomberg) -- GlaxoSmithKline Plc, the biggest maker of treatments for HIV, halted studies of an experimental AIDS medicine because of concerns it may cause liver damage.

The drug, known as aplaviroc, was in phase III trials, the final stage usually required for regulatory approval, the London- based company said today. Glaxo said it halted all studies after a patient was found with elevated liver enzymes and bilirubin, which can indicate liver disease.

`It's clearly not good news,'' Robin Gilbert, an analyst at Numis Securities, said in an interview. `But it's just one of many, many products Glaxo has under development.'' Gilbert has a ``hold'' recommendation on the stock.

Last month, Glaxo and its partner Ono Pharmaceutical Co., said phase II tests revealed the drug may cause liver abnormalities. The trials were conducted with HIV patients who had never been treated with other drugs for the virus.

``Clearly we're disappointed, but our primary concern is to protect the safety and health of our patients,'' Glaxo spokesman Chris Hunter-Ward said in an interview.

While Glaxo intends to stop all patients from taking aplaviroc, those who are considered to be receiving clinical benefit from it can choose to continue taking it until an alternative therapy is found, the company said.

Shares of Glaxo fell 27 pence, or 1.9 percent, to 1,401 pence at the close of trading in London.



To contact the reporter on this story:
Etain Lavelle in London at at elavelle1@bloomberg.net.

Last Updated: October 25, 2005 12:02 EDT

Promising Treatment for Hot Flashes Reported in Journal of Palliative MedicineTuesday

http://biz.yahoo.com/bw/051025/255168.html?.v=1

October 25, 8:02 am ET
NEW ROCHELLE, N.Y.--(BUSINESS WIRE)--Oct. 25, 2005--Hot flashes can dramatically affect a woman's quality of life as she goes through menopause caused by chemotherapy; but many women may get relief from hot flashes by taking a commonly prescribed antidepressant, citalopram (Celexa)--even when newer antidepressant medications cannot control symptoms, according to a report in the October issue (Volume 8, Number 5) of Journal of Palliative Medicine, a peer-reviewed publication of Mary Ann Liebert, Inc., and the official journal of the American Academy of Hospice and Palliative Medicine. The paper is available free online at www.liebertpub.com/jpm.
Hot flash scores were reduced by more than half after four weeks among 30 women who took citalopram, report Charles Loprinzi, M.D., from the Mayo Clinic College of Medicine (Rochester, MN), and colleagues in a paper entitled, "Pilot Evaluation of Citalopram for the Treatment of Hot Flashes in Women with Inadequate Benefit from Venlafaxine." The women who participated in the study had not received adequate relief of hot flash symptoms with venlafaxine (Effexor), a newer antidepressant medication commonly used to treat this disorder.
Ever since the adverse effects of hormone replacement therapy came to light, researchers have searched for an effective approach to alleviating hot flashes, which are a major problem for many menopausal women. Newer antidepressants--the serotonin and norepinephrine reuptake inhibitors, called SNRIs--such as venlafaxine, can substantially reduce hot flashes in many women, but some women will have only limited relief. The present study was designed to test whether classic antidepressants--the so-called SSRIs, or selective serotonin reuptake inhibitors--could provide an effective alternative form of treatment.
"In addition to women going through menopause, these data will help us treat those women and men with cancer whose treatment gives them hot flashes," says Charles F. von Gunten, M.D., Ph.D., Editor-in-Chief of Journal of Palliative Medicine, and Director of the Center for Palliative Studies, San Diego Hospice & Palliative Care.
Journal of Palliative Medicine, published bimonthly in print and online, is an interdisciplinary journal that reports on the clinical, educational, legal, and ethical aspects of care for seriously ill and dying patients. It includes coverage of the latest developments in drug and non-drug treatments for patients with life-threatening diseases including cancer, AIDS, cardiac disease, pulmonary, neurologic, respiratory conditions, and other diseases. The Journal reports on the development of palliative care programs around the United States and the world, and on innovation in palliative care education.
Mary Ann Liebert, Inc. is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Journal of Women's Health, Disease Management, Alternative and Complementary Therapies, and The Journal of Alternative and Complementary Medicine. Its biotechnology trade magazine, Genetic Engineering News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, newsmagazines, and books is available at www.liebertpub.com.

Leading groups offer NIH direct links to journals to make research access easy for public

http://www.eurekalert.org/pub_releases/2005-10/dp-lgo102505.php

(October 25, 2005) – Rockville, MD – Fifty-seven of the nation's leading medical and scientific nonprofit publishers today announced they have offered a proposal to Elias Zerhouni, M.D., director of the National Institutes of Health (NIH), that would allow the NIH to bring vast amounts of research findings to the public efficiently and at no cost.
In a joint letter to Dr. Zerhouni, the group detailed a plan that would allow the NIH to provide online access to articles on their journal websites using the existing system of links from abstracts that are indexed on NIH's Medline. The transparent linking system would make it easier for the public to view more than 1 million research articles and would avert the need to create a new taxpayer-funded publishing infrastructure within the NIH.
The public-private partnership being proposed by the non-profit publishers would fulfill the NIH's goal to provide complete public access to all NIH-funded research. It also would allow seamless online access to a staggering amount of additional scientific and medical research, including 1 million free research articles from science, social sciences and the humanities, more than15,000 additional free articles each month, and a library of 1.7 million full-text research articles dating to 1849.
"Overnight and at no cost to taxpayers, this proposal will make it easy for the public to access vast amounts of the most accurate scientific and medical information available," said Chris Lynch, vice president of publishing for the Massachusetts Medical Society, which publishes the New England Journal of Medicine. "Essentially, what we are proposing is for the NIH to become the public's doorway into the universe of research that non-profit publishers already provide to the public everyday."
The proposal was conceived, in part, in response to the NIH's implementation of its "Policy on Enhancing Public Access to Archived Publications Resulting from NIH Funded Research" on May 2, 2005. The policy requests NIH grantees submit to the NIH any manuscripts that report on NIH-funded research. The voluntary program asks participating researchers to submit their manuscripts to the agency after they have been peer reviewed and accepted for publication, but before they have undergone final copyediting.
The publishers' proposal to Dr. Zerhouni eliminates concerns that placing research manuscripts into public view prior to final editing, as the NIH policy calls for, could inadvertently pave the way for the rapid spread of confusing and potentially serious errors. Under today's proposal, only the final, published versions of research would be made public; the scientific record on which researchers depend would be maintained; and copyright protections would be preserved.
"Our plan preserves the critically important role of scientific journals," said Martin Frank, Ph.D., executive director of the American Physiological Society, a signatory of the proposal. "Nonprofit publishers add significant value to the original research through peer reviewing, copyediting, publishing, and disseminating the articles. Because we are offering our materials at no charge to NIH, they will not need to cut research funding for cancer, Alzheimer's and other diseases in order to develop their own system, which would mimic ours. This plan is a win-win for everyone involved."
Lenne P. Miller, senior director of publications at The Endocrine Society, said the proposal underscores the fact that nonprofit scientific and medical societies have worked closely with NIH for many years to see that important research findings are published and disseminated to the public.
"This is simply another step in fostering collaboration among the scientific communities and the public," Miller said. "We look forward to hearing back from Director Zerhouni and to meeting with him to move forward on an exciting partnership that would deliver enormous public benefits for generations to come."
The nonprofit publishers signing the joint letter to the NIH Director are: American Academy of Periodontology, American Association for Cancer Research, American Association for Clinical Chemistry, American Association of Immunologists, American College of Chest Physicians, American College of Physicians, American Dairy Science Association, American Dental Association, American Diabetes Association, American Geriatrics Society, American Institute of Biological Sciences, American Physiological Society, American Psychiatric Association, American Roentgen Ray Society, American Society for Biochemistry and Molecular Biology, American Society for Clinical Pathology, American Society for Investigative Pathology, American Society for Nutrition, American Society for Pharmacology and Experimental Therapeutics, American Society of Animal Science, American Society of Hematology, American Society of Human Genetics, American Society of Plant Biologists, American Society of Tropical Medicine and Hygiene, American Thoracic Society, Association for Molecular Pathology, Biophysical Society, Botanical Society of America, Cold Spring Harbor Laboratory Press, European Molecular Biology Organization, Federation of American Societies for Experimental Biology, HighWire Press, Stanford University, Infectious Diseases Society of America, Massachusetts Medical Society, Ornithological Council, Poultry Science Association, Project Hope, Society for Experimental Biology and Medicine, Society for Leukocyte Biology, Society for the Study of Reproduction, Society of Nuclear Medicine, Society of Toxicologic Pathology, The American Society of Nephrology, The Association for Research in Vision and Ophthalmology, The Endocrine Society, The Entomological Society of America, The Histochemical Society, The Physiological Society, The Protein Society, The International and American Associations of Dental Research, The Radiological Society of North America, The RNA Society, The Rockefeller University Press, The Royal College of Psychiatrists and The Society of Surgical Oncology.
A listing of the journals the non-profit publishers issue is available at: www.DCPRinciples.org.

Integrative medicine pioneer Weil going mainstream, to a degree

http://kvoa.com/Global/story.asp?S=4015396&nav=HMO6

Oct 22, 2005, 09:41 PM EDT
The best-known practitioner of integrative medicine, melding alternative and traditional approaches, has gone mainstream.
Dr. Andrew Weil, whose 10th book came out Oct. 18, intends to raise the public consciousness about aging, and why it is and should be healthy.
In his view, advocates of antiaging medicine, who tout regimens ranging from growth hormone to Botox and cosmetic surgery to stop the aging process, have become the 21st century equivalent of snake-oil purveyors, long on pitch and short on scientific substance. It's a charge that's been leveled at Weil for years.
Weil calls antiaging advocates "false prophets who are putting out a message that aging is reversible or that we can stop it."
"I think those are very wrong ideas," he says during a recent interview at his Vail ranch, about 30 miles southeast of Tucson. "Aging is a universal natural process, and I think if you set yourself up in opposition to it, you're in a very wrong relationship with nature."
In his latest book, "Healthy Aging," Weil argues that there are no effective antiaging medicines. Publisher Alfred A. Knopf is banking that Weil's streak of four straight best sellers will continue, with an initial printing of 650,000 copies.
Throughout his career, Weil has championed herbal remedies, acupuncture, osteopathy, cranial therapy, hypnotherapy and nutritional approaches to wellness, as well as traditional medicine.
He majored in botany as an undergrad at Harvard University, where he also went to medical school, graduating in 1968. He left the National Institutes of Mental Health after the first year of an internship to travel the world, pursuing his interest in plant study and herbal remedies.
He largely supported himself through college and the 1970s as a freelance magazine writer.
Then his car broke down in Tucson during the warm, wet winter of 1973, with the desert in full bloom, and he never left.
Weil continued writing and eventually began lecturing at what was the University of Arizona's then-fledgling medical school about marijuana, which he said in interviews at the time was a mild intoxicant.
Later, he began giving lectures on alternative medicine. He launched a first-of-its-kind integrative medicine program in the College of Medicine in 1997.
"My strong conviction always had been that the main business of doctors should be to teach people how not to get sick," he says. "That is, there should be a real emphasis on prevention and lifestyle adjustment."
He also believes that pharmaceutical drugs often "caused too much harm."
His focus on alternatives has put him at odds with many mainstream practitioners and academics.
One persistent critic, Dr. Arnold Relman, an editor emeritus of the New England Journal of Medicine and professor emeritus at Harvard Medical School, said he's long disagreed with Weil because "he believes in miracles, at least he used to."
"He believed in the healing power of thought, and going back to his earliest career, he's taken a position that usually flies in the face of science, and for that reason I've disagreed with him." But Relman does acknowledge that Weil has advocated some sensible things about diet and lifestyle.
Still, Weil's advocacy of such positions as broccoli being a cancer treatment and reliance on anecdotal evidence from patients "can't stand the light of scientific examination," Relman said. If Weil's antiaging stand is based on hard, scientific, objective evidence, he added, "then I applaud it."
Weil said he decided to write about aging because of his concern about the rise of antiaging medicine and said he hopes the book will trigger a national dialogue.
"The most damaging perception out there is that the worth of human life diminishes with aging, and I've tried to make a case that aging brings its own rewards _ that there can be an increase in the value of life, like fine wine," he says.
He acknowledges that skillfully done cosmetic procedures can provide "pleasing results" and enhance quality of life. But he takes issue if the reason for surgery is to deny that aging happens.
Weil's own appearance, including his trademark full white beard and a bald head, help to underscore his own age, 63.
He remains very active, though a casual, almost idyllic home setting helps offset the hectic pace that swirls around him.
He is divorced, his teenage daughter is in boarding school and he's "involved in a relationship."
A frequent guest on TV talk shows, he's committed to a 23-city, seven-week book tour, and he just appeared for the second time on the cover of Time magazine, which previously heralded him as one of the world's 100 most influential people.
He works part time in the University of Arizona's integrative medicine program, writes a newsletter and a column for Prevention magazine.
He offers vitamin, antioxidant and nutritional supplements, endorses skin care products and even pet foods on his Web site, http://www.drweil.com, while giving daily advice on healthy living.
And he's just been sued over a five-year, $14 million deal, accused of failing to adequately market and promote an online pharmacy company as the exclusive distributor of his endorsed health care products. He called it a contract dispute.
Weil has lived for 11 years on his 120-acre ranch. It's one of about 30 "ranchettes," mostly 40-acre plots, carved out of the X-9 Ranch, once a historic cattle operation spread over 36,000 acres. Weil's property, set off behind a gated entrance, is the nowhere reached at the end of a three-mile rutted, tooth-jarring washboard dirt road.
Weil, who is partial to shorts, sandals and loose-fitting Hawaiian-style sports shirts, lives in a comfortable but hardly lavish setting in what was the X-9's main ranch house, rebuilt after a 1938 fire. "I have lots of friends; I have my dogs, who are wonderful companions," he says about Rhodesian ridgebacks Jambo and Daisy.
Large picture windows in his Mexican-tiled home look onto a patio and the Rincon Mountains. A spring-fed swimming pool sits on grounds dappled in shade by cottonwood, walnut and mesquite trees. There's also an outdoor garden and a large greenhouse. His various enterprises are run in nearby offices.
Weil believes he's aging gracefully. "I think I'm doing a pretty good job. I keep very active. I like my body. I'm generally not so bad. I enjoy coming into my own as an elder."
Some critics view him as a self-promoter and product huckster, but Weil says that all after-tax profits from his books and product sales go to his Weil Foundation to help fund his integrative medicine program.
And Weil does have his medical supporters.
Cardiologist Dr. Joseph Alpert of the University of Arizona, Weil's best friend from medical school, calls Weil a top leader in integrative medicine. "Has he brought credibility among physicians? Probably not. Has he brought credibility among patients? Definitely, yes. He's tremendously bright, an excellent communicator and a very good writer," Alpert said.
Twenty-six American medical schools and three in Canada have integrative or alternative medicine programs, and the Congress, recognizing a growing public interest, created the National Center for Complementary and Alternative Medicine in 1999.
"From what it's meant to the public, he (Weil) has been the father of integrative medicine," raising public awareness and interest through his down-to-earth, sensible writing style, said Dr. Richard Liebowitz, medical director of Duke University's Center for Integrative Medicine.
But while Andrew Weil pushes a diet rich in nuts and olive oil, multigrain breads, soybeans and fresh, organic fruits, vegetables and fish, he's been known to indulge a sweet or two.
On this day, it's a 20-pound peach pie sent by a friend and baked by Pam Rinella, who operates the mountaintop Mount Lemmon Cafe about 90 minutes from Weil's ranch.
"I haven't had any of her pies in years," he says, eying the fruity treat.
"That's a serious pie."

Study: Obesity surgery riskier than expected

http://www.cnn.com/2005/HEALTH/diet.fitness/10/18/obesity.surgery.ap/index.html

CHICAGO, Illinois (AP) -- Obesity surgery, which is fast becoming a popular way to battle the nation's weight crisis, may be a lot riskier than most patients realize.
New research found a higher-than-expected risk of death in the year after surgery, even among young patients.
"It's a reality check for those patients who are considering these operations," said University of Washington surgeon Dr. David Flum, lead author of a Medicare study that analyzed the risks.
The findings appear in Wednesday's Journal of the American Medical Association.
Some previous studies of people in their 30s to their 50s -- the most common ages for obesity surgery -- found death rates well under 1 percent.
But in a study of 16,155 Medicare patients who underwent obesity surgery, more than 5 percent of men and nearly 3 percent of women aged 35 to 44 were dead within a year. And slightly higher rates were found in patients 45 to 54.
Among patients 65 to 74, nearly 13 percent of men and about 6 percent of women died. In patients 75 and older, half of the men and 40 percent of the women died.
There are several types of operations to lose weight, most generally involving surgically shrinking the stomach and usually restricted to "morbidly" obese people more than 100 pounds overweight.
Those patients often have medical problems brought on by their girth, including heart trouble, diabetes and breathing difficulties -- problems which obesity surgery can sometimes resolve but which can also contribute to making the surgery risky.
Patients studied underwent surgery between 1997 and 2002.
"This is a major operation in a high-risk population. "When you do a complicated operation in a complicated population, we should expect to see adverse outcomes" occasionally, Flum said.
Dr. Neil Hutcher, president of the American Society for Bariatric Surgery, said that Medicare patients are probably sicker than the general U.S. population and that complication rates have declined as surgeons' expertise has increased.
But Flum argued that some previous research showing lower risks came from "reports from the best surgeons reporting their best results," while the new study is more of a real-world look.
A JAMA editorial said even if Medicare patients do face higher risks, they should not be denied obesity surgery.
"These patients may also represent the potential greatest benefit associated with major lasting weight loss given their associated disease burden," the editorial said.
The surgery may be lifesaving when done on the right patients, by experienced surgeons, the editorial said.
The study offered no breakdown on causes of death, but obesity surgery's potentially deadly complications can include malnutrition, infection and bowel and gallbladder problems. Also, surgery in general can be a deadly shock to the system, especially in older patients.
The American Society for Bariatric Surgery predicts obesity surgery will be performed more than 150,000 times this year in the United States. That is more than 10 times the number in 1998, according to a second JAMA study. The increase parallels a surge in the portion of U.S. adults who are at least 100 pounds overweight, from about 1 in 200 in 1986 to 1 in 50 in 2000, that study said.
Flum said the new study suggests that in many cases, obesity surgery may not be right for an older person "who already has the burden of 60 years of obesity on their heart" and other organs.
Medicare covers obesity surgery if it is recommended to treat related conditions such as diabetes and heart problems. The government is considering whether to cover surgery to treat obesity alone.
Medicare is for younger Americans with disabilities and for patients 65 and older. Flum said most of the patients he studied were under 65 and probably qualified for Medicare because of obesity-related ills, including heart and joint problems.
Flum's study lumped together data on different operations, but the most common U.S. obesity surgery, gastric bypass, involves creating an egg-size pouch in the upper stomach and attaching it to a section of intestine.
Researchers said one reason men may have higher post-surgery death rates is that they tend to wait longer than women to seek medical help and may be sicker at surgery.
Hutcher said patients should seek experienced surgeons, should be thoroughly evaluated before and after surgery, and should receive long-term follow-up care.
Most patients "will receive a good outcome," Hutcher said. "A good outcome does not mean there's no risk for complications or mortality."
Copyright 2005 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Gold and silver have absolutely stunning effect upon human organism
10/19/2005 12:15

http://english.pravda.ru/main/18/90/360/16326_jewellery.html

The traditional and alternative medicine state that people's health depends upon the amount of metal items they wear
Chains or bracelets worn on wrists perform the role of a closed circuit and have a particular effect on the human organism, the same way it happens when people wear wedding rings. Wedding rings have an effect upon the nerves of the third finger.
People suffering from raise and drops of mood or having regular nervous disorders should remember that metal jewellery may even aggravate the problems. Specialists recommend such peopel not wear too much chains or bracelets on such bad days.
The general characteristic of metals used for making chains or bracelets, usually gold or silver, is their ability to destroy structures. At that, metals can destroy negative information structures of people which is very good indeed.
Every good acupuncture specialist has two sets of acupuncture needles made of gold and silver. When acupuncture is done with gold needles it gives anti-inflammatory action upon organs connected with points on the body. Acupuncture with silver needles relieves or localizes inflammation of organs. In case some organ is weak to function normally, an acupuncture doctor will offer performing acupuncture with a gold needle to stimulate the energy flow.
The wonderful qualities of gold explain why many years ago people chose this metal for making wedding rings. Gold stimulates the energy flow delivering energy to the urogenital system. And thanks to the anti-inflammatory action of silver people began to make dishes, spoons and forks of silver to be less open to infections.
Doctors tell that sometimes women cannot become pregnant and have some gynecological problems even though they are absolutely healthy. At that, they wear many rings on fingers. When doctors recommend such patients to take rings off and do not wear them for some period, patients feel offended and do not believe the advice may help solve their problems. But later it turns out that women get rid of their gynecological problems or become pregnant if they decide to follow the recommendation.
In general, experts recommend wearing jewellery made of gold if you have collapse or slackness. And silver jewellery will do better for those who are short of temper and nervy.

FDA warns doctors about acid reflux treatment

http://www.cnn.com/2005/HEALTH/10/18/reflux.treatment.ap/index.html

WASHINGTON (AP) -- The government is warning doctors to stop using Enteryx, an injection used to treat acid reflux disease, saying it has been connected to serious health problems and, in at least one case, death.
Many of the problems with Enteryx have occurred when it is injected imprecisely, missing its intended destination and passing through the wall of the esophagus, sometimes entering other internal organs or the bloodstream, risking blockage of blood vessels, the Food and Drug Administration said. Doctors have not always immediately detected a faulty injection.
Enteryx is injected as a liquid that solidifies into a spongy material that cannot be removed. When it is injected properly, it strengthens the lower esophagus, helping prevent stomach acid from entering it and causing pain.
The FDA did not provide specifics on the number of problems that have been discovered. Manufacturer Boston Scientific issued a recall on September 23 but blamed the problems entirely on faulty injection technique.
The FDA also cited at least two instances in which Enteryx was injected properly but patients still developed problems.
The death was blamed on Enteryx being injected into the wall of the aorta.
The FDA said people who received the injection and are suffering from chest, stomach or side pain, flu-like symptoms, including fever, cough or shortness of breath, or fainting spells should contact their doctor immediately.
Boston Scientific is advising people who have received an Enteryx injection in the last 30 days to see their doctor for a follow-up, but the FDA said some problems associated with the injection have occurred seven weeks later.
Copyright 2005 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Alternative medical practice explained

http://www.thedailyaztec.com/media/paper741/news/2005/10/19/City/Alternative.Medical.Practice.Explained-1025104.shtml

By Stephanie Nehmens, Senior Staff Writer On Saturday Oct. 8, San Diego Students of Naturopathic Medicine held its first Prenaturopathic Medical Conference in Montezuma Hall called "Naturopathic Physician Impact Today and in the Future.""Naturopathic medicine is just like allopathic medicine (traditional medical practice) in terms of how you diagnose, physical exams and lab work," Naturopathic Doctor Amy Fasig said. "But it comes from a different place in terms of philosophy and principles." Fasig has a part-time naturopathic practice in Seattle, Wash. and serves as the ND advisor for Bastyr University.Fasig said there's no one thing that is considered naturopathic medicine. It's the way the NDs use that medicine that distinguishes it from allopathic practices. "So it's using our principles and our philosophy in a therapeutic order," Fasig said. "It is how we use anything that makes it naturopathic. "We really want to get to the core issue, so we don't look just as symptomatology, we try to get to the core reason of why that person is sick or not having optimal wellness." Naturopathy is based around four great modalities: physical medicine, clinical nutrition, botanical medicine and homeopathy, Fasig said. "Clinical nutrition is the number one modality - we do that with every patient," she said. "We're well educated about clinical nutrition and diet therapy and being able to individualize a diet for each patient."ND Jonathan Kalman said most common ailments people seek naturopathic treatment for are fatigue, weight and thyroid problems, allergies, menstruation, headaches and other common afflictions."Why do you need us?" Kalman asked. "When 400 million people could die by 2015 from preventable illnesses, like heart disease, there's a need."One of the exciting things about being in naturopathic medicine is that I will never say there is never an option because the options are unbelievable, what we can do to the human body to help someone heal," Kalman said. Certain states in the United States, such as Washington, allow naturopathic doctors to prescribe medication like antibiotics and perform minor surgeries.Fasig said there are four accredited schools in the United States for Naturopathy: Bastyr University in Seattle, Wash.; National College of Naturopathic Medicine in Portland Ore.; Southwest College of Naturopathic Medicine in Phoenix Ariz.; and University of Bridgeport in Connecticut. "Any graduate from any of those schools is able to sit for the board exam, which you take after graduation to then get your license to practice," Fasig said. "It takes four years after you get your bachelor's degree." Sociology freshman Laura Cuarenta said she learned new things at the conference about naturopathic medicine."I hadn't heard about it before today but I learned new concepts," Cuarenta said. "I'm thinking about actually looking into it."Biology senior and founder of the SDSNM, Elizabeth Avery, said she hopes to bring recognition to SDSU by bringing the naturopathic program to campus."If we can get a school here or a clinic, all the better, and if SDSU can do that that will be great having that doctoral program," Avery said. "We are the first (naturopathic student organization) in the United States." SDSNM was founded in October 2004. The organization is located on campus but is open to all students in the nation, SDSNM's Web site said.

Zambia tests HIV 'herbal remedy' Zambia has begun trials of three herbal medicines to see if they can be used to treat HIV/Aids, it says.

Twenty-five people with HIV will take part in the three-month trial, which the health minister said conforms to World Health Organization guidelines.
The United Nations estimates that one in six Zambians has HIV/Aids.
An Aids charity spokesperson was sceptical about the trials, saying the only known effective treatment was anti-retroviral (ARV) drugs.
At a press conference in the Zambian capital Lusaka, Health Minister Sylvia Masebo said: "It is a momentous occasion for Zambia which establishes a partnership between conventional medicine and traditional medicine."
Dr Patrick Chikusu, principal investigator of clinical trials of traditional herbal remedies, said 14 natural remedies had been narrowed down to three to be submitted to the final stage of clinical trials.
'Desperate'
One of the three drugs is a formulation mixed by a former government minister and constitutional lawyer, Ludwig Sondashi.
The cost of ARV drugs, which have been shown to be effective in suppressing the effects of the virus in the West, are too expensive for most people in developing countries to afford.
Genevieve Clark, of the British charity Terence Higgins Trust, said: "I can understand why people are desperate to find anything that helps."
"Anything that boosts the immune system helps... Anything you can do in terms of eating healthily and being healthy is to be welcomed."
But she added: "Herbal remedies have not been proven to help... The only thing proven is anti-retroviral treatments."
She also expressed concern that the test sample of 25 people was not large enough to be a "proper clinical trial".
Story from BBC NEWS:http://news.bbc.co.uk/go/pr/fr/-/2/hi/africa/4358458.stm

Battle against breast cancerDoctor urges women to take preventative steps with supplements, diet

http://www.theolympian.com/apps/pbcs.dll/articleAID=/20051020/LIVING/510200406/1004

BY SHARON WOOTTON
FOR THE OLYMPIAN
Dr. Christine Horner wants to end the epidemic of breast cancer in the United States. She wants to end fear, mastectomies, 211,000 new diagnoses and 43,300 deaths a year. She wants to put an end to chemotherapy, radiation and despair.

It would be easy to dismiss Horner as just another doctor cashing in on yet another health book -- except that she has a track record of moving mountains.
Two events were turning points for Horner: Her mother died of breast cancer, and one of Horner's patients, a 34-year-old woman who had to have a double mastectomy, was distraught because her insurer wouldn't pay for breast reconstruction.
So Horner, a plastic surgeon, was the driving force behind the 1998 federal Women's Health and Cancer Rights Act that requires insurance companies to pay for breast reconstruction.
Now she wants to end the breast cancer epidemic -- a goal that fits nicely into October, which is Breast Cancer Awareness Month, and Friday, which is National Mammography Day.
Horner became frustrated with Western medicine's approach to breast cancer: It stresses early detection, chemicals, radiation and surgery -- but not prevention.
"I said, 'Wait a minute. This is really off. There's got to be things women can do to lower risk,' " Horner said.
She examined thousands of cancer-related studies before launching her campaign.
"Forty different factors play a significant role in initializing or accelerating growth of breast cancer (or) have extremely protective effects. It was very simple to find them.
"It was very upsetting to me. Here it is in the medical literature in reputable journals but nobody knows about them, or at least very little. We have all the information we need to end the breast cancer epidemic."
For Horner, the key statistic is the very low incidence of breast cancer in Asia. Within one generation of moving to America and adopting the diet and lifestyle here, Asian women's risk matched that of American women, she said.
Horner, who gave up her practice in Cincinnati in 2002, has written "Waking the Warrior Goddess: Harnessing the Power of Nature and Natural Medicines to Achieve Extraordinary Health."
In it, she advocates a Chinese medicine approach combined with a 5,000-year-old system of healing called Ayurveda, both of which focus on prevention and balance, primarily through eating foods that lead to good health and avoiding foods that, according to many medical studies, can lead to breast cancer or stimulate cancer cells into rapid growth.
Her approach can co-exist with Western medicine, she said. Describing them as alternative medicine is not accurate; there are only techniques that work and those that don't, she said.
Horner writes that many common foods, natural spices, herbs and supplements can significantly help protect women from breast cancer.
She offers detailed explanations, from green tea ("It's unbelievably important") to a vitamin-like substance called CoQ10.
She also has developed a supplement with concentrated amounts of breast-health enhancing ingredients from foods and herbs. Horner acknowledged that eating well, particularly taking an organic approach and supplements, is more expensive.
"That's something that is limiting for people. But nothing is more expensive than going through cancer treatment," she said.
She remains dedicated to her battle against breast cancer, whose incidence has risen 21 percent in the past four years -- though researchers report that statistic is due in large part to better detection techniques.
"I want to see the breast cancer epidemic end and the numbers start turning around in my lifetime and I think we can do that," Horner said. "There's no reason why the numbers can't start turning around."

New $10M grant boosts alternative medicine studies

http://www.mddailyrecord.com/pub/5_397_thursday/businessnews/172860-1.html

By KAREN BUCKELEW DAILY RECORD BUSINESS WRITER
Under a new, $10 million federal grant, the University of Maryland Center for Integrative Medicine is forming two new centers to study increasingly popular Eastern therapies.

Photo by Sonja Kinzer
The center, now in its 14th year of studying alternative therapies with a focus on Chinese medicine, will use the grants from the National Institutes of Health’s National Center for Complementary and Alternative Medicine to continue its investigation of acupuncture and herbal medicine in pain relief, and to form an international collaboration with Chinese scientists to examine use of the methods in treating bowel disorders.
“We know that people are using these therapies,” said the center’s director, Dr. Brian Berman. “We as an institution want to make sure what patients are doing is safe and effective, and can even complement what we can do with standard care.”
Studies show at least half of Americans are using complementary alternative medicine, he added.
A grant for nearly $6 million is going to the formation of a Center of Excellence for Arthritis and Traditional Chinese Medicine Research within the center, to conduct a clinical trial on the effectiveness of a Chinese herbal formula called HLXL in treating osteoarthritis of the knee.
That center also will expand on a previous, 570-patient clinical trial university investigators completed last year that examined use of acupuncture in osteoarthritis of the knee. That study found acupuncture reduced pain for a significant number of patients compared to a placebo therapy.
Researchers now will probe the reasons acupuncture is effective, including the neurochemicals it stimulates to release in the brain, Berman said.
A second, $4 million, grant will create the International Center for Research on Complementary and Alternative Medicine, led by the university and including Chinese University in Hong Kong, the University of Illinois and the University of Western Sydney in Australia.
The international effort will study the effectiveness of herbal therapies and acupuncture compared to standard methods of care in each country in the treatment of bowel disorders, such as irritable bowel syndrome.
The grant funds six new studies altogether, three per center, to add to the Center for Integrative Medicine’s 18 to 20 current studies of alternative therapies, said Berman.
“We don’t have all the answers with just our standard methods of care,” Berman, a specialist in family medicine, said. “We need to find out if there are other options with traditional Chinese medicine or other methods.”
He said alternative treatments continue to grow in popularity for a number of reasons, among them the rising expense of prescription drugs. In the case of arthritis and other chronic pain conditions, he said, there have been concerns about the safety of pain-relieving drugs such as Vioxx.
“And,” Berman added, “people also want ways that they can help themselves, to add some of their own control over their own health.”
Officials at the Tai Sophia Institute, a Laurel-based school that educates about 350 students at any one time on topics like acupuncture and herbal medicine, said Western medical studies of Eastern therapies are encouraging. However, to them, the centuries-old therapies have been proven time and again.
“The odd thing about this is acupuncture and herbal medicines are the oldest forms of healing on the planet,” said Tai Sophia President and co-founder Robert M. Duggan. “The most primitive of people used food and herbs to heal themselves.”
“What Brian and his colleagues are doing is this scientific research documenting that, explaining in Western scientific terms the why and the how,” he added. “That’s an extraordinary complement to this institute, where we’re training people to carry on these traditions.”
Still, Duggan said, such studies often are in extremely controlled environments, while true acupuncture is used in conjunction with other factors like lifestyle changes and yoga.
Acupuncture supporters, he said, would like to see federal funding for data collection among clients at institutes like Tai Sophia, where 35,000 acupuncture treatments are administered each year in concert with other therapies.
“We know there’s a lot of data there, but we’ve never had the funds to find out what effects patients are reporting,” said Duggan.

Fears of Biopiracy Hampering Research in Brazilian AmazonOctober 20, 2005 — By Michael Astor, Associated Press

http://www.enn.com/today.html?id=9065

RIO DE JANEIRO, Brazil — Somewhere in the Amazon there may be flora and fauna that hold the key to curing diseases ranging from cancer to multiple sclerosis. That, at any rate, is the dream. But the reality is that the search for the next miracle drugs is being hampered by a deep Brazilian suspicion of "biopiracy." Some politicians, retired generals and Web sites seem convinced that the world's biggest rain forest is crawling with biopirates scooping up seeds, leaves and animal blood samples whose genetic code might deliver the next miracle drug. The government has imposed strict regulations which apply to both Brazilians and foreigners, but foreigners are more likely to get arrested. Over the past decade more than 30 have been detained, and their research samples confiscated or destroyed. The Amazon rain forest is thought to contain at least 30 percent of all plant and animal species on the planet, most of them uncatalogued. At the same time, loggers and farmers are shrinking its area at a rate equivalent to six football fields a minute. But scientists say the rules are so stringent and overzealously enforced that it has become impossible to ship samples abroad for analysis, reducing research to a crawl and driving many scientists to move their research to Ecuador, Bolivia and Peru. Last year, police tracked two German researchers across eight Brazilian states and seized the spiders they were allegedly planning to ship to the United States. In 2002, Marc Van Roosmalen, a Dutch scientist who has discovered some 20 new monkey species, was accused of biopiracy after authorities removed 27 rare monkeys from his home in the Amazon city of Manaus. Roosmalen says he was only studying and caring for the animals, not exploiting them for profit, and had applied for permits in 1996 and never heard back. Brazilian scientists are feeling the squeeze too. "The situation is so frustrating, I've all but given up," says Paulo Buckup, a professor of ichthyology at the Federal University of Rio de Janeiro who collects river fish for research. "Brazil has lost the capacity to control its own resources because it doesn't know what it has." Biopiracy haunts Brazilian history, beginning with Henry Wickham, an Englishman who smuggled rubber seeds out of the country in the 19th century and broke Brazil's global rubber monopoly. Then came the 1992 Earth Summit in Rio de Janeiro, which produced a convention entitling nations to a share of the profits from substances yielded by their flora and fauna. "All the signers bought into a concept no one knows how to implement. Anyone can claim you're not sharing the benefits, and the government is afraid of being held responsible," said Dr. Roberto Cavalcanti, a zoology professor at the University of Brasilia. Cavalcanti agrees regulation is necessary, but feels the best way to fight biopiracy is more investment and more Brazilians doing their own collecting. He also says the biopiracy concept "has been hijacked" by opponents of measures to protect the rain forest against commercial overexploitation. A congressional committee is investigating biopiracy, and several prominent foreign scientists have been forced to prove they are not biopirates, including Thomas Lovejoy, the U.S. scientist credited with putting the plight of the rain forests on the world's radar screen in the early 1980s. He acknowledges he shares the blame for the biopiracy panic because of his own role in publicizing biodiversity. "From my point of view, the real biopiracy is the destruction of the biodiversity of the Amazon," said Lovejoy, president of the Heinz Center for Science Economics and the Environment. Lovejoy was eventually cleared of vague charges that he was a CIA agent when he did research for the Smithsonian Institute in the Amazon years ago, and Congressman Jose Sarney Filho, a former environment minister on the biopiracy committee, acknowledges the investigation so far has little to show for its work. "Up to now, we haven't found a single concrete case of biopiracy," Sarney told The Associated Press. "There are cases of spiders being contrabanded to American laboratories and things like that, but no material proof that our flora or fauna has been converted into medicine without following the legislation." But that doesn't silence the cries of alarm. "The internationalization of the Amazon goes far beyond the economic area and the occupations of lands," Amazonas state Gov. Eduardo Braga warns. "They will take from us our flora and our fauna." Manaus Mayor Serafim Correa says Brazilians must "take care that we don't allow our Amazon to be invaded." On the Web site "Amazon Love it or Leave It," Gen. Luiz Gonzaga Schroeder Lessa, former chief of the Amazon Military Command, claims collectors disguised as religious or environmental groups are taking samples to be turned into medicines for which Brazilians will later have to pay them royalties. "It's biopiracy and it goes on almost unchecked in the Amazon," he writes. Sarney, the congressman, says most Brazilians confuse biopiracy with things like a recent case where a Japanese company trademarked "Cupuacu," a fruit unique to the Amazon. The trademark was revoked following protests from Brazil. Rogerio Magalhaes, an environment ministry official, acknowledges the bureaucracy is frustrating, but denies it stops researchers from doing research. "They're doing it but they're doing it illegally," he says. The legal limbo provides little comfort to scientists like Carlos Joly, director of the Botanical Institute at the University of Campinas in Sao Paulo state. "Right now it seems like we -- the ones who are doing research -- are the pirates," said Joly. "The best way to protect Brazil's biodiversity is to know its characteristics and potential. That's what the country should be investing in."

Source: Associated Press

Nutrition is key to the learning processBy CHRIS MORRIS - Tribune Managing Editor

http://www.news-tribune.net/articles/2005/10/20/news/new_albany_tribune/news15.txt

It’s a proven fact the food students put in their bodies can impact their attention span during the school day.
That’s what motivates Pam Wright each day.
“We want to make sure kids know that performance in school is directly related to the nutrition they put in their bodies,” Wright said.
Wright, director of food services for the New Albany-Floyd County Consolidated School Corporation, and her staff planned several activities this past week to celebrate National School Lunch Week. Festivities included giveaways, prizes and promotions designed to capitalize on students’ love of music, and promote the connection between eating well and performing well — in class, on the playing field and in the arts.
“We’ll be telling kids that healthy school meals help put them in tune with success, in school and beyond,” Wright said. “With the right nutrition, all kids can make beautiful music in school.”
Wright and her crew serve an estimated 8,350 meals each day to students in the school system.
“They do an excellent job,” NA-FC Superintendent Dr. Dennis Brooks said. “We feed many children each day and I am proud of what we are able to do.”
Wright said school lunches have changed over the years. She said it is important that students receive a balanced breakfast and lunch.
“A renewed focus on nutrition and its direct relationship to the health of children has brought about recent changes in programs offered at the national and state level,” she said. “These changes insure that meals served in our programs are consistent with the dietary guidelines for Americans.”
Wright said the changes in the school lunch program “provide a variety of meals, increased satisfaction and increased awareness.”
“Today’s children are sophisticated consumers and have grown up dining out with their parents,” she said. “Our menus have changed to reflect the demands of our customer and keep current with today’s restaurant trends.”
Brooks said many children in the corporation depend on the breakfast and lunch program at the schools.
“It’s a necessary program,” he said. “It’s also important that we teach proper nutrition. Childhood obesity has become a real problem.”
National School Lunch Week was established in 1963 by a proclamation from President John F. Kennedy. It is designed to help raise awareness of and garner support for the role that school food service and nutrition programs play in the lives of America's children today, and in the strength of America tomorrow. The federally funded National School Lunch Program feeds more than 28 million children every school day.
Each week’s menu is carefully planned out. For example, federal regulations require that a school lunch provide one-third of the calories needed for each age group, and recommended dietary allowance for five key nutrients — protein, calcium, iron, vitamin A and vitamin C. There are also fat restrictions and other requirements.
“We work hard to improve the satisfaction of our young customers for we truly believe that healthy eating means better learning,” Wright said.
There are 125 food service workers in the NA-FC School Corporation and all lunches are cooked onsite.
Wright said children of every socio-economic levels are at risk of poor nutrition.
“This may be due, in part, to the lack of sufficient funds to purchase food,” she said. “However, as the workforce increases and parents spend less time at home, poor nutritional habits or a lack of time to prepare nutritious meals are fundamental problems as well.”
The NA-FC School Corporation also sponsors the Summer Food Service Program each year to provide free, nutritious meals to school age children in the community.

Crumbs... How a loaf a day will make you thin New diet regime finds bread is the slimmer's best friend, not the enemy

http://observer.guardian.co.uk/uk_news/story/0,6903,1593199,00.html

Myles Mayall, David Smith and Anushka AsthanaSunday October 16, 2005The Observer
After falling foul of the diet police in recent years, bread is set to enjoy a renaissance. A new book puts the humble loaf back on top by asserting the pound-shedding merits of The Bread for Life Diet.
Olga Raz, a nutritionist from Israel, argues that sandwiches and toast - made taboo by the protein-laden Atkins Diet because of their high level of carbohydrates - are in fact good for you. She claims that eating eight to 12 slices of wholemeal light bread a day can help dieters lose 10lb in two weeks.
The theory is that bread's 'feelgood factor' makes people less likely to turn to sugary snacks. Bread's carbohydrate content causes the body to release tryptophan, which helps it produce the chemical serotonin, a mood-booster that means people are less in need of a sugar rush.
Serotonin also prevents the metabolism from slowing down, making it more likely that the person will burn calories than store fat.
But there is a downside: alcohol is banned and the dieter is expected to exercise for at least 30 minutes a day.
Raz, director of nutrition at Sourasky Medical Centre in Tel Aviv, said the diet was about eating regular, small meals, and keeping away from foods high in simple carbohydrates, such as sugar and processed cereals, and from fat. 'I advise people to eat wholegrain and low-calorie breads, fresh fish, low-fat yoghurts, fruit and any favourite foods as long as they don't contain simple carbs or fat.
'You must remember to eat every three to four hours. The way your body works means you should have snacks or small meals regularly.'
Raz criticised the strict regime of the Atkins Diet. 'It is all about protein, and this is no way of living. We need many of the complex carbohydrates in bread and other foods, not just endless protein.
'People are really brainwashed that carbs are the enemy. This is true for simple carbs, like in sugar, but not for complex forms. Complex carbs are our friends. Eating bread, for example, makes the level of serotonin go up in your brain. Serotonin is important because it helps to stop cravings, improves your mood and tells your brain that you are satisfied with what you've eaten.
'I have spent the last 20 years working with obese people, and we found that wholegrain and low-calorie breads helped to stop their cravings and improve their mental health.'
She added: 'Me and my husband both follow the diet. My husband wasn't fat, but he used to be just a little too heavy. He has lost 25lb and feels very fit and happy.'
Bread for Life dieters can eat as many vegetables as they like along with the bread (which can be spread thinly with butter, cottage cheese or cream cheese), one serving of fruit a day, three or four eggs a week, two to three tablespoons of olive oil a day, and plenty of water.
For three meals a week the dieter can eat limitless amounts of lean meat and fish, but must reduce their carbs by two to four slices that day. In addition, vitamin D and calcium tablets should be taken daily.
After two weeks of bread, toast and sandwiches you can add some beans, brown rice, sweet potatoes, muesli or high-fibre cereals.
Raz says the diet is already very popular in Israel and Russia and she hopes it will boom elsewhere. But experts are unconvinced.
Claire MacEvilly of the Human Nutrition Research centre at Cambridge university, said: 'This is just another spin on healthy eating. We would say you should eat seven to eight carb servings per day such as bread, other cereals or potatoes. My worry with this is the idea of encouraging people to take supplements - there is no need if you have a healthy diet.'
She said the diet was not varied enough and people would get bored: 'After two weeks you will be sick of the sight of bread.'
MacEvilly said her department was researching the GI diet, where people eat foods with a low glycaemic index. She said that, although the evidence is not there to support its weight-loss advantages, it is 'interesting'.
A study recently suggested that the GI phenomenon may skip the 'fad' nature of most diets and last.
Fads tend to fail, say experts, because they are hard to stick to. Dr Becky Lang, of the Association for the Study of Obesity, said: 'The main reason people lose weight on diets like these is that they are eating less - 10 slices of bread with lots of vegetables is probably fewer calories, and you cut out alcohol. The diet is repetitive and limited.'
However, Lang said that Raz had tried to include most food groups such as carbs, protein and fats. 'It is not horrific,' she said, but warned that it may not work in the long term.
The diet
8am-10am Two slices of toast with cottage cheese or a boiled egg. Coffee or tea, but if you like it sweet, make sure it's with sugar substitute.
11am-1pm Sandwich with wholegrain or low-calorie bread, filled with avocado, turkey or salmon. Limitless amount of vegetables, fresh fruit or low-fat yoghurt can be eaten as snacks.
2pm-4pm Scrambled eggs on one slice of bread.
5pm-7pm Large salad or sandwich with a kiwi fruit.
8pm-10pm Vegetable soup with toast.
11pm Low-fat yoghurt
Plus 7-8 glasses of fluid every day: tea, coffee, water or fruit juice. Olive oil is fine in moderate amounts. Three times a week, poultry or other light meats are allowed.

Pillows: A Hot Bed Of Fungal Spores

http://www.sciencedaily.com/releases/2005/10/051015093046.htm

Researchers at The University of Manchester funded by the Fungal Research Trust have discovered millions of fungal spores right under our noses -- in our pillows.
Aspergillus fumigatus, the species most commonly found in the pillows, is most likely to cause disease; and the resulting condition Aspergillosis has become the leading infectious cause of death in leukaemia and bone marrow transplant patients. Fungi also exacerbate asthma in adults.
The researchers dissected both feather and synthetic samples and identified several thousand spores of fungus per gram of used pillow - more than a million spores per pillow.
Fungal contamination of bedding was first studied in 1936, but there have been no reports in the last seventy years. For this new study, which was published online today in the scientific journal Allergy, the team studied samples from ten pillows with between 1.5 and 20 years of regular use.
Each pillow was found to contain a substantial fungal load, with four to 16 different species being identified per sample and even higher numbers found in synthetic pillows. The microscopic fungus Aspergillus fumigatus was particularly evident in synthetic pillows, and fungi as diverse as bread and vine moulds and those usually found on damp walls and in showers were also found.
Professor Ashley Woodcock who led the research said: "We know that pillows are inhabited by the house dust mite which eats fungi, and one theory is that the fungi are in turn using the house dust mites' faeces as a major source of nitrogen and nutrition (along with human skin scales). There could therefore be a 'miniature ecosystem' at work inside our pillows."
Aspergillus is a very common fungus, carried in the air as well as being found in cellars, household plant pots, compost, computers and ground pepper and spices. Invasive Aspergillosis occurs mainly in the lungs and sinuses, although it can spread to other organs such as the brain, and is becoming increasingly common across other patient groups. It is very difficult to treat, and as many as 1 in 25 patients who die in modern European teaching hospitals have the disease.
Immuno-compromised patients such as transplantation, AIDS and steroid treatment patients are also frequently affected with life-threatening Aspergillus pneumonia and sinusitis. Fortunately, hospital pillows have plastic covers and so are unlikely to cause problems, but patients being discharged home - where pillows may be old and fungus-infected - could be at risk of infection.
Aspergillus can also worsen asthma, particularly in adults who have had asthma for many years, and cause allergic sinusitis in patients with allergic tendencies. Constant exposure to fungus in bed could be problematic. It can also get into the lung cavities created by tuberculosis which affects a third of the world's population, causing general ill-health and bleeding in the lung, as well as causing a range of plant and animal diseases.
Dr Geoffrey Scott, Chairman of the Fungal Research Trust which funded the study, said: "These new findings are potentially of major significance to people with allergic diseases of the lungs and damaged immune systems - especially those being sent home from hospital."
Professor Ashley Woodcock added: "Since patients spend a third of their life sleeping and breathing close to a potentially large and varied source of fungi, these findings certainly have important implications for patients with respiratory disease - especially asthma and sinusitis."
###
The Fungal Research Trust (www.fungalresearchtrust.org) is a registered charity which funds research into and education about fungal infection. It was set up in 1991 and since then has distributed in excess of£1 .6m in research grants resulting in more than 80 research publications in clinical and scientific aspects of fungal infection. It also supports the Aspergillus Website which achieves around 160,000 page requests a month. As well as being a key resource for clinicians, the website also devotes a section to patients and relatives to help them understand more about the disease. It can be found at www.aspergillus.man.ac.uk.

NCCAM Expands Research Centers Program with Three Centers of Excellence and Two International Centers

http://www.nih.gov/news/pr/oct2005/nccam-14.htm

The National Center for Complementary and Alternative Medicine (NCCAM) announces funding of three centers of excellence and two international centers for the study of complementary and alternative medicine (CAM). With these new awards NCCAM, a component of the National Institutes of Health (NIH), continues to enhance CAM research capacity by funding centers at leading U.S. institutions and by establishing new global partnerships.
Three of the five new centers will explore therapies used in traditional Chinese medicine, including acupuncture and Chinese herbal mixtures. The other two centers will study a type of energy medicine (millimeter wave therapy) and botanical therapies used by traditional healers in Africa.
“We are excited by the addition of these centers to our research program and the unique collaborations and approaches they bring to studies of CAM practices,” said Stephen E. Straus, M.D., NCCAM Director. “All five centers will strengthen our research portfolio for major health problems — HIV/AIDS, arthritis, asthma, and pain. Plus, the new international centers will conduct basic and clinical studies of promising CAM interventions drawn from traditional medicine indigenous to the locations of international partners.”
Centers of Excellence for Research on CAMThe three new Centers of Excellence provide 5 years of support for experienced researchers at some of the Nation’s leading universities. These researchers apply cutting-edge technologies to identify the potential benefits and underlying mechanisms of CAM practices. The three new centers and their first year funding totals are:
Center for Arthritis and Traditional Chinese Medicine; $1,197,651Principal Investigator: Brian Berman, M.D.Institution: University of Maryland, Baltimore, MDThis center will study traditional Chinese medicine approaches — acupuncture and herbs — for the treatment of arthritis. Researchers will conduct a clinical trial of an 11-herb Chinese formula (known as HLXL) for osteoarthritis of the knee; assess acupuncture’s effect on inflammatory pain in an animal model; and study the efficacy of HLXL in an animal model of autoimmune arthritis.
Center for Chinese Herbal Therapy; $1,144,274Principal Investigator: Xiu-Min Li, M.D.Institution: Mount Sinai School of Medicine, New York, NYCenter researchers will investigate a three-herb Chinese formula (known as ASHMI) as a therapy for allergic asthma. Studies of the herbal formula will look at mechanism of action in an animal model, characterize the herbs’ active components, and investigate the formula’s use in asthma patients.
Center for Mechanisms Underlying Millimeter Wave Therapy; $1,025,895Principal Investigator: Marvin Ziskin, M.D.Institution: Temple University School of Medicine, Philadelphia, PAThis center will study the mechanisms of action of millimeter wave therapy (use of low-intensity millimeter wavelength electromagnetic waves) for a variety of diseases and conditions, as well as looking at the therapy’s use in animal models of chronic neuropathic pain and pruritis (itching).
International Centers for Research on CAMThe International Centers for Research on CAM are the outgrowth of planning grants awarded by NCCAM to 11 international teams in 2003. These teams had 2 years to develop a research collaboration and infrastructure that could compete for 4-year centers grants. The recipients of these international centers grants will now carry out research on CAM and traditional medicine practices in countries where the practices are indigenous. These partnerships between researchers in U.S. and foreign institutions will address whether the traditional practices can aid in health care locally and globally and build CAM research capacity internationally. Co-funders for these centers include NIH’s Office of Dietary Supplements, Office of AIDS Research, and Fogarty International Center. In addition, the National Cancer Institute will fund a third international center.
The two NCCAM recipients and their first year funding totals are:
Functional Bowel Disorders in Chinese Medicine; $807,253Principal Investigator: Brian Berman, M.DPartner Institutions: University of Maryland, Baltimore, MD; Chinese University of Hong Kong, China; University of Illinois, Chicago, IL; University of Western Sydney, Sydney, AustraliaThis center will conduct multidisciplinary research on traditional Chinese medicine (TCM) practices — acupuncture and herbs — for the treatment of irritable bowel syndrome (IBS). Researchers will study effects of acupuncture and a TCM herbal preparation in an animal model of IBS and conduct a preliminary study of the herbal preparation with IBS patients.
The International Center for Indigenous Phytotherapy Studies: HIV/AIDS, Secondary Infections and Immune Modulation; $1,100,000Principal Investigator: William Folk, Ph.D.Partner Institutions: University of Missouri, Columbia, MO; University of the Western Cape, Bellville, Republic of South Africa; along with University of KwaZulu-Natal, University of Cape Town, and the South African Medical Research CouncilThis center will study the safety and efficacy of traditional African plant-based therapies already in wide-spread use for HIV/AIDS and some of its secondary infections. Researchers will conduct a small clinical trial using sutherlandia (Lessertia frutescens) in adults with HIV and conduct preclinical and clinical research with African wormwood (Artemisia afra), which is used by traditional healers for treatment of many conditions seen in people with HIV/AIDS.
The National Cancer Institute will fund the:
International Center of Traditional Chinese Medicine for CancerPrincipal Investigator: Lorenzo Cohen, Ph.D.Partner Institutions: M.D. Anderson Cancer Center, Houston, TX; Fudan University Cancer Hospital, Shanghai, ChinaThis center will conduct preclinical and clinical studies of TCM approaches — herbs, acupuncture, and qi gong — for treating cancer and its symptoms, as well as treatment-related side effects.
The National Center for Complementary and Alternative Medicine’s mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. For additional information, call NCCAM’s Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov. NCCAM is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

Pain drives Canadian youth to seek alternative medical treatment14 Oct 2005

http://www.medicalnewstoday.com/medicalnews.php?newsid=32035#

Aching backs and chronic pain are the most common reasons for Canadian adolescents to seek complementary or alternative medical treatment. And there's a wide disparity - both in where they live and their family income - between young people who use alternative treatments and those who don't. These are two of the findings from a new Queen's University study into the use by Canadian youth of complementary and alternative medicine (CAM), which includes massage therapy, acupuncture, homeopathy and naturopathy. Funded by the Hospital for Sick Children Foundation, this is the first population-based study of its kind. "We don't like to think Canada has a two-tiered health system, yet this is clearly a service which is more accessible to those who have the resources to pay for it than those who don't," says lead investigator Dr. Mary Ann McColl of Queen's Centre for Health Services and Policy Research. "In the desperate situation these families may find themselves - having a child in pain, with persistent problems - the availability of options is different for well-off kids than it is for poorer kids." Also on the team are Alison James (Centre for Health Services and Policy Research), Diane Davies (Canadian Adolescents at Risk Research Network), Michelle Garieri (Kingston Wellness Centre) and research analyst Nancy Churchman. The new study analyzes data collected by Statistics Canada as part of the Canadian Community Health Survey in 2000-2001. A total of 17,545 adolescents across the country, between the ages of 12 and 19, are included in this health-care snapshot. "Disability" is defined by the researchers as having at least one impairment (for example a visual or mobility problem) and at least one activity restriction. Among the key findings: * 4.9 per cent of Canadian adolescents visited a CAM practitioner in the preceding 12 months, with girls outnumbering boys by more than 2:1* Back problems (16.7 per cent) and disabilities (nine per cent) are the most common reasons for seeking alternative help, followed by asthma and allergies (seven per cent) * CAM use is highest in western Canada (six per cent per capita) and lowest in the Atlantic provinces and the North (three per cent per capita) * 75 per cent of CAM users come from families with household income in the top two quartiles* Massage therapy is the most common type of CAM used by youth Dr. McColl suggests that the east-west gradient may be explained by the fact that complementary and alternative medicine receives more regulatory and financial support (through publicly-funded insurance coverage) in the western provinces. While the study does not look at the effectiveness of these treatments, "what's concerning is that young people across the country have different levels of access to alternative therapies as publicly-funded services," says Dr. McColl. "There are noticeable differences in access and utilization based on education, income and geographic location."

Nancy Dorrancedorrance@post.queensu.caQueen's Universityqueensu.ca

Complementary medicine may be too costly for NHS14/10/2005

http://www.dehavilland.co.uk/webhost.asp?wci=default&wcp=NationalNewsStoryPage&ItemID=15066505&ServiceID=8&filterid=10&searchid=8

Complementary medicine may not be a cost-effective option for the NHS, according to a new report. Researchers from the Peninsula Medical School in Plymouth found that a number of studies into the benefits of complementary medicine against cost-effectiveness were 'poor' and it was therefore difficult to determine its benefit to the NHS. They looked at the effect of complementary medicine on headaches and spinal injuries, since they were the only two areas previously reviewed for cost-effectiveness and health benefits. The team were only able to find five studies measuring the cost-effectiveness of complementary treatments in the UK before April 2005 - one on acupuncture for headaches and four on spinal manipulation for back pain. The report, published in the British Medical Journal today found that "spinal manipulation and acupuncture represent an additional cost to usual care in the UK". Researchers concluded that more "rigorous cost effectiveness studies are needed" to determine the value of alternative medicine to the NHS. The studies challenge an earlier report this week commissioned by Prince Charles which found that some complementary therapies could be cost-effective for the NHS. However, some warned that the benefits of complementary and alternative medicine (CAM) should not be discounted until more research is done. Professor Gene Feder found that one in ten adults seek treatment from CAM and 90 per cent do so without the NHS. Professor Feder wrote in the BMJ this week that the report by Peninsula Medical School had failed to address the "complexities" of measuring complementary and alternative medicine against cost-effectiveness. He warned that, "uncertain evidence of cost effectiveness should not exclude complementary medicine from reviews and guidelines".

Marijuana could be antidepressant 14/10/2005

http://www.dehavilland.co.uk/webhost.asp?wci=default&wcp=newsstorypage&ItemID=15066541&ServiceID=8&filterid=10&searchid=8

The chemical compounds that exist in marijuana may have positive effects on the brain, according to a new study.A team from the Canadian University of Saskatchewan have found synthetic cannabinoids can promote the generation of new neurons in the brain, or neurogenesis.This medical use of cannabinoids was also seen to have anti-anxiety and antidepressant-like effects.Normally drugs such as alcohol, nicotine and cocaine affect the hippocampus, the part of the brain where neurogenesis occurs, stopping the production of new neurons and perhaps increasing the chance of becoming dependent.However, after a month rats given the potent synthetic cannabinoid HU210 seemed to display increased newborn neurones in the hippocampus.The report, led by Xia Zhang, also highlights the negative effects of the drug, pointing out that when it is used illicitly it can result in acute memory impairment and dependence and withdrawal symptoms in chronic users.Previously, in this controversial area of medical research, it has been suggested that cannabinoids appear to be able to modulate pain, nausea, vomiting, epilepsy, multiple sclerosis, tumours, and other disorders.Mental health charity Rethink, which has campaigned for more public information on the effects of cannabis on mental health, has welcomed the research but emphasised that the drug's effects on the brain are "complex" and produce "conflicting evidence" in medical studies."Cannabinoids are an exciting new area for medical research, but it is important to recognise that there are over 60 active ingredients in cannabis - synthetic cannabinoid may be showing evidence of nerve regeneration," Paul Corry, director of campaigns and communication at the charity, said.He added: "For most people with severe mental illness, raw cannabis remains a risky substance. All medical research needs to be checked before it would make a difference to the hundreds of thousands of people living with severe mental illness in the UK."Cannabis has recently been reclassified from a class B drug to a class C drug.

The study was published in the Journal of Clinical Investigation.

Effects of Herbal Supplements On the Kidney

http://www.rednova.com/news/health/272397/effects_of_herbal_supplements_on_the_kidney/index.html?source=r_health

By Combest, Wendell; Newton, Marian; Combest, Austin; Kosier, June Hannay
A recent and frequently cited survey of alternative medicine revealed that 42% of Americans use alternative therapies, with 12% of these therapies being the use of herbal supplements at a cost of $5 billion annually. Furthermore, 60% of people using alternative therapy do not report this information to their health care providers (Eisenberg, Davis, & Ettner, 1999). One problem with dietary supplement use is lack of consistent requirements for rigorous safety, efficacy, and purity testing resulting in varying amounts of active constituents from batch to batch.
Although herbal medicine use continues to grow in many disease conditions, the risk from use may over shadow potential benefit, especially in the renal compromised patient population (Foote & Cohen, 1998; Isnard et al., 2004). Vulnerable times for the renally compromised patient include predialysis, dialysis, and the post- renal transplant periods. They may also be confronting co-morbid dis ease states such as hypertension or diabetes. Renal patients may reach for additional therapy in the form of herbal dietary supplements because they experience adverse side effects or lack of efficacy from conventional medicines.
Plants with Known Direct Renal Toxicity
The most dramatic and highest profile case of herbal nephrotoxicity occurred from 1990-1992 in over 100 people in Belgium who ingested a Chinese weight loss/slimming remedy containing aristolochic acid principally from the plant Aristolochia fangchi (Vanherweghem et al., 1993). Seventy of these patients required renal transplants or dialysis and 30 subsequently developed urothelial carcinoma. In 2000, the FDA identified two new cases of interstitial renal fibrosis from aristocholic-containing herbal products. The resulting nephropathy is referred to as "aristolochic acid nephropathy" or less accurately "Chinese herb nephropathy." Aristolochic acid is a nitrophenanthrene carboxylic acid which forms DNA adducts in renal as well as other tissues after metabolic activation (Volker, Stiborova, & Schmeister, 2002). The DNA adducts result in genotoxic mutations resulting in urothelial carcinoma as well as the characteristic renal interstitial fibrosis and extensive loss of cortical tubules. Aristolochic acid is found in several other plants particularly in the Asarum and Bragantia genera. Hundreds of additional cases have been reported in several European and Asian countries since these early reports in Belgium. The FDA has imposed strict guidelines to prevent any Chinese herbal products containing aristolochic acid from entering the U.S. market.
A similar type of nephropathy has been reported in the Balkans and has been termed "Balkan endemic nephropathy" (Tatu, Oren, Finkelman, & Feder, 1998). The causative agent in this type of nephropathy is plant products contaminated by the fungal mycotoxin ochratoxin A. It also forms mutagenic DNA adducts in renal tissue which likely underlies the observed pathology.
Many traditional medicines and foods especially in the tropical regions of Africa and Asia contain renal toxic plants. One such food/ medicine is the djenkol bean, a pungent smelling edible fruit of the hardwood tree Pithecellobium labatum (Areekul, Kirdudom, & Chaovanapricha, 1976). A 70% ethanol extract of the djenkol bean containing the toxic compound djenkolic acid was fed to monkeys, rats, and mice. Histologie examination of their kidneys showed severe tubular necrosis with a lesser degree of glomerular cell necrosis. A traditional remedy in South Africa called "Impila" is made from the roots of the plant Callilepis laureola. It is used to treat a number of conditions and has marked hepatic and renal toxicity. The renal damage caused is characterized by acute proximal convoluted tubule and loop of Henle necrosis which can lead to kidney failure (Stewart, Steenkamp, van der Merwe, Zuckerman, & Crowther, 2002).
There have been reports of acute renal failure in individuals ingesting wild mushrooms containing the nephrotoxin orellanine (Mount, Harris, Sinclair, Finlay, & Becker, 2002). Renal biopsy showed marked tubular interstitial nephritis and fibrosis. There has been one case report of acute renal failure in a patient with systemic lupus erythematosus taking the popular Peruvian herb cat's claw (Uncaria tomentosa) (Hileps, Bellucci, & Mossey, 1997).
Herbs That May Alter Serum Potassium Or Contain Oxalic Acid
Several medicinal plants have the potential to alter plasma levels of potassium resulting in either hypokalemia or hyperkalemia. Licorice root (Glycyrrhiza glabra), especially when used at high doses and for prolonged periods, has a well-known pseudoaldosterone- like effect on the reabsorption of sodium and potassium (Stewart et al., 1987). Sodium retention is increased, potentially increasing blood pressure with a corresponding decrease in K+ leading to hypokalemia. Hypokalemia may in turn increase the toxicity of drugs such as digoxin by increasing its binding to cardiac membranes. The mechanism of this effect relates to glycyrrhizic acid in licorice root being hydrolyzed to glycyrrhetenic acid which is an inhibitor of renal 11-hydroxysteroid dehydrogenase. This enzyme catalyzes the inactivation of cortisol to cortisone. Cortisol accumulates in the kidney and stimulates the aldosterone receptors in cells of the cortical collecting duct thus increasing Na^sup +^ reabsorption (Funder, Pearce, Smith, & Smith, 1988).
Several herbal remedies taken as laxatives contain active compounds called anthraquinones. The laxative herbs senna (Senna alexandria), cascara sagrada (Rhamnus purshiana), and rhubarb (Rheum officinale) can lead to electrolyte imbalance especially hypokalemia (Westendorf, 1993). Another herbal supplement of possible concern to the renal patient is noni juice. Juice made from the noni fruit (Morinda citrifolia) could contribute to the development of hyperkalemia due to its high content of potassium (56.3 mEq/L) (Mueller, Scott, Sowinski, & Prag, 2000). Dandelion (Taraxacum officinale), stinging nettle (Urtica dioica), horsetail (Equisetum arvense), and alfalfa (Medicago sativa) are also high in potassium (Leung & Foster, 1996). Plants high in oxalic acid such as rhubarb (Rheum officinale) may increase the formation of kidney stones (Leung & Foster, 1996). There has also been a report of acute oxalate nephropathy following ingestion of star fruit (Averrhoa carambola) (Chen, Fang, Chou, Wang, & Chung, 2001).
Medicinal Plants with Diuretic Activity
These herbs may be of particular interest to patients pre- dialysis who believe that they may be able to stimulate their declining kidney function and thus delay the need for dialysis. The following herbs have traditional use as diuretics: juniper berry (Juniperus communis), parsley (Petroselinum crispum), dandelion (Taraxacum officinale), horsetail (Equisetum arvense), asparagus root (.Asparagus officinalis), lovage root (Levisticum officinale), goldenrod (Solidago virgaurea), uva ursi (Arctostaphylos uva ursi), stinging nettle leaf (Urtica dioica), and alfalfa (Medicago sativa) (Fetrow & Avila, 1999). These herbs with varying degrees of diuretic activity require caution even in healthy individuals but should be especially a concern for the renalcompromised patient. Most of these herbs should more accurately be called "aquaretics" in that they increase glomemlar filtration rate and urine output but do not stimulate electrolyte secretion. Some act as direct tubular cell irritants and others may alter serum electrolytes with resultant cardiovascular consequences.
Juniper berries contain terpine-4-ol in the volatile oil fraction which may cause kidney irritation and damage in excess (Newall, Anderson, & Pbillipson, 1996). In Germany, parsley and goldenrod are indicated for systemic irrigation of the urinary tract and for preventing kidney stones. The diuretic effect of parsley leaf and root is due to its volatile oil components myristicin and apiole (Newall et al., 1996). Also in Germany, dandelion, horsetail, and uva ursi are licensed as standard medicinal teas to stimulate diuresis.
Herbal Products Adulterated with Drugs And Heavy Metals
There have been many reports especially of Chinese and Ayurvedic herbal products containing nephrotoxic heavy metals such as lead, mercury, cadmium, and arsenic (Espinosa, Mann, & Bleasdell, 1995; Keen, Deacon, Delves, Moreton, & Frost, 1994; Wu, Hong, Lin, Yang, & Chien, 1996). To add to the complication, many heavy metals are considered medicinal in these medical systems but their presence in some imported formulations are not revealed on their labels. In addition some of these same herbal products contain pharmaceutical drugs. Formulations containing nonsteroidal anti-inflammatory drugs (NSAIDs) may lead to renal failure via changes in intrarenal blood flow. Another example is a case where a Chinese herbal formula contained the drug phenylbutazone which caused analgesic nephropathy (Segasothy & Samad, 1991). The California Department of Health Services recently screened 260 imported Asian patent medicines and found that 83 contained undeclared drugs or heavy metals (Marcus & Grollman, 2002).
Herbs and the Transplant Patient
The transplant patient is also at risk for complications from herbal remedies such as Echinacea (Echinacea purpurea), which is promoted as an immune system stimulant (Combest & Nemecz, 1997). This ef\fect could endanger the transplant patient taking immunosuppressant drugs. Furthermore, St. John's wort (Hypericum perforation) causes a decrease in cyclosporine, an immunosuppressant, serum levels thus compromising the success of the organ transplant (Mandelbaum, Pertzborn, Martin-Facklam, & Wiesel, 2000). Although not yet demonstrated, many other herbal supplements may have a similar effect on the metabolism of cyclosporine as well as other drugs used to treat the transplant patient (see Table 1).
Table 1.
Nephro-Toxic Herbs and Dietary Supplements
Nephro-Protective Herbs and Dietary Supplements
Milk thistle (Silybum marianum) seeds containing several potent antioxidant flavonolignans collectively called silymarin have both hepatic and renal protective effects in rodent models (Combest, 1998). The main constituents composing silymarin are silibinin, silicristin, isosilibinin, and silidianin. Silibinin and silicristin, aside from their antioxidant effects against damaging free radicals, also stimulate RNA and protein synthesis which is important for renal and hepatic repair mechanisms. In addition these same flavonolignans protect kidney cells in culture from the renal toxic effects of the drugs paracetamol, cisplatin, and vincristine (Sonnenbichler, Scalera, Sonnenbichler, & Weyhenmeyer, 1999). Another study in rats demonstrated that silibinin protected renal tubular cells from the oxidative damage from cisplatin (Gaedeke, Pels Bokemeyer, Mengs, Stolte, & Lentzen, 1996). Silibinin also protects against experimental cyclosporine nephrotoxicity (Zima et al., 1998).
Table 2.
Nephro-Protective Herbs and Dietary Supplements
Another potentially useful nephro-protective medicinal herb popular in Ayurvedic medicine is picroliv (Picrorhiza kurrooa). Extracts from the roots and rhizomes offer protection against various hepatic and renal toxins. Picroliv protects the kidney in a renal ischemia-reperfusion induced injury (IRI) model in rats (Seth et al., 2000). Pretreatment of rats orally with picroliv for 7 days before initiation of experimental IRI lowered renal lipid peroxidation, reduced apoptosis, and generally increased the viability of renal cells. Another study in rats found that oral administration of picroliv to rats exposed to the carcinogen 1,2 dimethylhydrazine decreased the extent of renal necrosis [Rajeshkumar & Kutton, 2003). As with milk thistle animal studies using picroliv support their potential clinical benefit as nephro- protectants. However, human clinical studies are needed to confirm these results in cell culture and animal models.
Astragalus (Astragalus membranaceus), a popular herb used in Chinese traditional medicine, is effective against experimentally induced glomerulonephritis in rats, especially in reducing proteinuria (Su et al., 2000). Several clinical studies also showed a reduction in proteinuria in patients with chronic glomerulonephritis by Astragalus (Shi et al., 2002). Cordyceps (Cordyceps sinensis), a fungus found growing in caterpillar larvae of certain moths, has long been valued as a kidney tonic in China (Zhu, Halpern, & Jones, 1998). One study in 61 patients with lupus nephritis showed that a combination of 2 g to 4 g of cordyceps powder together with 0.6 grams of artemisinin from the plant Artemisia annua for 3 years improved kidney function as measured by creatinine clearance (Lu, 2002). Another study found that cordyceps lessened the nephrotoxicity of cyclosporine in kidney transplant patients (Xu, Huang, Jiang, Xu, & Mi, 1995). An antioxidant protective mechanism was postulated for this protective effect. The Japanese traditional remedy Sairei-to, a 12 herb mixture, has shown in human and animal studies to protect the kidney in gentamicin renal toxicity, IgA nephropathy, and lupus nephritis (Ohno et al., 1993). Another study in rats showed that extracts from the root of the plant Salvia miltiorriza (Danshen) along with fructose 1-6 diphosphate prevented the decline of renal cortical Na-K-ATPase activity induced by ischemia and gentamicin (Lu & Li, 1989). Further, extracts of the plant Herniaria hirsute inhibit calcium oxalate crystal aggregation and thus could be useful in preventing kidney stone formation (Atmani & Khan, 2000). In summary, there seems to be many potentially protective medicinal plants and supplements that may protect the kidney perhaps via acting primarily as anti-oxidants (see Table 2).
Nursing Care
The nurse may be one of the first members of the health care team to be approached by the patient using or contemplating the use of an herbal product for renal failure symptoms. The nurse should establish dialogue with patients regarding use of herbal supplements which affect the kidney. The nurse should be armed with information and legitimate Internet sources regarding the effect of dietary supplements on the kidney. As nurses, we want to be proactive during the routine history and physical and include questions such as "Tell me about any herbal supplements you may be using because we want to provide the safest care possible for you and need to know all medications and supplements you take. Some prescribed medications may interact with the supplements and some may affect kidney function." The nurse should also have evidencebased herbal dietary supplement references to share with patients such as the Professional's Handbook of Complementary and Alternative Medicines published by Amazon Books and the Natural Medicines Comprehensive Database available online and in print (Barrett, 2000). Table 3 lists interventions to facilitate safe care for renal patients using herbal dietary supplements.
Table 3.
Approaches to Facilitate Safe Care for Renal Patients Using Herbal Dietary Supplements
Conclusion
The increased patient use of alternative medicine requires the nurse to be aware of potential risks and benefits that alternative medicines may offer. Nephrotoxic plants containing aristolochic acid and djenkol bean must be avoided in all patients but especially in renal-compromised patients. Other herbal remedies such as licorice root, senna, cascara, and rhubarb may alter serum potassium values or increase the risk of kidney stones high in oxalic acid. Transplant patients must be made aware of the potential risk of complications from Echinacea and St. John's wort as these medicinal plants may cause a decrease in the effect of immunosuppressant drugs. In summary, the nurse plays a vital role in monitoring the ingestion and effects of herbal supplements in the renal- compromised patient.
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Wendell Combest, PhD, is a Professor of Pharmacology, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, VA.
Marian Newton, PhD, RN, PMHNP, is a Professor, Division of Nursing, and Adjunct Professor, Pharmacy, Shenandoah University and PMHNP, Northwestern Community Services, Winchester, VA.
Austin Combest, BS, is a Member of the Department of Biology, East Carolina University, Greenville, NC, and a Doctor of Pharmacy Student, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, VA.
June Hannay Kosier, MS, RN, CNN, is a Clinic Manager, Albany Regional Kidney Center, Albany, NY.
Copyright Anthony J. Jannetti, Inc. Oct 2005