Living Cell Treatment Heals Diabetic Foot Sores Fast - Diabetes Symptoms and Care
April 9, 2008
Morris "Mo" Moses and his wife Ida thought they were doing everything they could for Mo’s health. A Type II diabetic, with multiple medical problems, Moses had an ugly, uncomfortable sore>diabetes produces very dry feet. He has also lost a good deal of sensation in his feet.
Extremely dry feet and loss of sensation are two high risk factors for developing blisters and ulceration. These can lead to infection and even amputation.
As for Mo, he is wearing his protective shoe and is very happy that his foot has healed. He understands that he is still at risk for developing other foot ulcers but right now he is looking forward to getting back on his feet and enjoying life.
Most Back Pain Could Be Cured Without Surgery Or Drugs - Back Pain Relief
April 9, 2008
If you’re suffering from back pain and unable to find relief, it may be because the real cause of your pain — weak, stressed and damaged muscles, not your spine — has never been recognized or treated, says Norman Marcus, M.D.,>pain in all the right places."
Anesiva Announces Clinical Trial Of Adlea For Reducing Post-Surgical Pain Following Knee Replacement - Pain Relief
April 9, 2008
Anesiva’s pivotal Phase 3 clinical trial evaluating Adlea, its long-acting, non-opioid analgesic drug candidate, in patients following total knee replacement surgery, is underway.
In September 2007, Anesiva initiated a multicenter, randomized, double-blind, placebo-controlled Phase 2 trial to evaluate the safety and efficacy of a single 5 or 15 mg dose of Adlea or placebo administered into the surgical site in patients undergoing total knee replacement surgery. Having completed enrollment of the initially planned 80 patients, Anesiva has converted this trial into a Phase 3 trial by expanding the planned enrollment by approximately 134 patients for a total sample size of 214, increasing the number of trial sites, and focusing enrollment on the 15 mg and placebo groups.
"Total knee replacement is a commonly performed orthopedic surgery that can significantly enhance patients’ quality of life," said Keith Candiotti, M.D., Associate Professor of Clinical Anesthesiology and Internal Medicine; Director of Clinical Research, Chief, Division of Perioperative Medicine, University of Miami Leonard M. Miller School of Medicine, and investigator in the Phase 3 study. "The effective management of post-surgical pain is critical since patients must begin walking and moving the knee soon after the procedure in order to begin recovery and avoid complications. Adlea may offer additive pain relief and possibly reduce the use of other pain medications such as opioids, whose systemic side effects can interfere with the recovery process."
The primary efficacy endpoint of the Phase 3 trial is a time-weighted pain score (using a standard 0 - 10 numerical rating scale of pain intensity) from four to 48 hours following knee replacement surgery. The study will also evaluate pain scores during the first two weeks following surgery, as well as opioid consumption. The safety of Adlea will be evaluated throughout the study.
"We now have two pivotal Phase 3 trials in progress for Adlea, in total knee replacement surgeries and bunionectomy surgeries, and expect to have top-line data from both by year-end," said John P. McLaughlin, chief executive officer of Anesiva. "We also are conducting a Phase 2 trial in total hip replacement surgeries and plan to initiate a Phase 2 trial in arthroscopic shoulder surgeries to support a broad label of pain management following orthopedic surgery."
Anesiva has previously completed Phase 1 and 2 trials of Adlea in total knee replacement and bunionectomy surgeries, as well as in osteoarthritis of the knee, elbow tendonitis and Morton’s neuroma.
Allowing Tax Cuts To Expire Would Not Help Federal Budget, Opinion Piece Says
April 9, 2008
Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) plan to “finance longer-term entitlement growth” by allowing the tax cuts implemented by President Bush to expire, but these proposals “fail budget arithmetic and economics,” John Cogan, a senior fellow at the Hoover Institution and former deputy director of the Office of Management and Budget, and R. Glenn Hubbard, dean of Columbia Business School and former chair of the Council of Economic Advisers, write in a Wall Street Journal opinion piece.
Cogan and Hubbard write, “Proponents of bigger government invariably argue” that allowing tax cuts enacted by Bush to expire in 2010 is “necessary in the longer term to finance the retirement and health care promises made to the baby-boomer generation.” They write, “As has so often been true in the past, the economic damage caused by the tax increases and tax avoidance behavior will prevent the promised revenues from being realized” while “the promise of higher revenues will encourage Congress to continue its profligate spending.” Cogan and Hubbard continue, “As a result, a tax increase won’t lower the budget deficit.”
According to Cogan and Hubbard, the “proper way” to address rising costs in entitlement programs includes “three essential elements”:
- “Change entitlements to slow their cost growth”;
- “[E]liminate all nonessential spending in the remainder of the budget”; and
- “[A]dopt policies that promote economic growth” to create a “larger economic pie” from which to draw funds for the programs (Cogan/Hubbard, Wall Street Journal, 4/8).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Diabetics Can Reverse Atherosclerosis With Cholesterol, Hypertension Control - Diabetes Symptoms and Care
April 9, 2008
Aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes may help to prevent – and possibly reverse – hardening of the arteries, according to new research supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Hardening of the arteries, also known as atherosclerosis, is the number one cause of heart disease and can lead to heart attack, stroke, and death.
The three-year study of 499 participants is the first to compare two treatment targets for LDL (“bad”) cholesterol and systolic blood pressure levels, key risk factors for heart disease, in people with diabetes. Results are published in the April 9 issue of the Journal of the American Medical Association.
“This study provides good news for adults with type 2 diabetes,” said Elizabeth G. Nabel, M.D., NHLBI director. “These patients are two to four times more likely than people without diabetes to die from heart disease. For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.”
In the Stop Atherosclerosis in Native Diabetics Study (SANDS), approximately one-half of the participants (247) were asked to lower to standard levels their LDL cholesterol (to 100 milligrams per deciliter) and blood pressure (systolic blood pressure of 130 mmHg or lower), while the other half (252) aimed for more aggressive lowering of LDL cholesterol to 70 mg/dL or lower and of systolic blood pressure to 115 mmHg or lower. All participants were American Indians 40 years or older (average age of 56) who had diabetes, high blood cholesterol, and high blood pressure but no history of heart attack or other evidence of heart disease. The study was conducted at four clinical centers in southwestern Oklahoma; Phoenix, Ariz.; northeastern Arizona; and South Dakota. All participants continued to receive their medical care, including diabetes management, dietary and exercise counseling, and smoking cessation, from their health care providers with the Indian Health Service. Like the NIH, the Indian Health Service is part of the U.S. Department of Health and Human Services.
“American Indians have a high rate of diabetes and cardiovascular disease related to diabetes, but there are few clinical trials that address these issues in this population,” said Barbara V. Howard, Ph.D., of MedStar Research Institute in Hyattsville, Md., lead author of the paper. “These study results provide needed evidence to help develop community-based programs to treat and prevent the epidemic of cardiovascular disease among American Indians. At the same time, we are increasing our understanding of the effects of intensively lowering cholesterol and blood pressure in adults with type 2 diabetes, which might also apply to other populations.”
During the three-year study, participants were examined by study clinicians one month after enrollment, then every three months, to assess their blood cholesterol and blood pressure levels and general well being. Food and Drug Administration-approved blood pressure and cholesterol medications were added and adjusted as needed to help participants achieve their treatment goals. The same medications were available to participants in the standard and the aggressive treatment groups. Participants were also encouraged to follow lifestyle approaches to help meet their blood pressure and cholesterol treatment targets, such as following a heart-healthy eating plan, being physically active, maintaining a healthy weight, and not smoking.
To assess the impact of the treatments on the participants’ cardiovascular health, researchers used ultrasound to measure the thickness of the carotid (neck) artery — an indication of hardening of the arteries, a leading effect of high blood pressure and cholesterol and an early sign of cardiovascular disease. In addition, ultrasound was also used to measure the size and function of the left ventricle, the heart’s main pumping chamber. Enlarged hearts are known to be predictors of increased risk of heart attack and stroke. These measurements were taken at enrollment, at 18 months, and at 36 months, when the study ended.
On average, participants in both groups reached and maintained their target goals for blood cholesterol and blood pressure levels. The numbers of heart attacks and other cardiovascular events were similar between the two groups and lower than expected.
In addition, carotid artery thickness measurements of participants in the aggressive treatment group were significantly lower than those in the standard treatment group. Researchers report that, compared to baseline, carotid artery thickness increased slightly in the standard group and regressed in the aggressive treatment group, indicating a partial reversal of atherosclerosis. Furthermore, although heart size decreased from baseline in both groups, the beneficial change was significantly greater among participants in the aggressive treatment group.
“Many patients with diabetes do not reach their blood pressure and cholesterol goal levels and thus remain at high risk for heart attacks and stroke,” noted Howard. “In our study, participants successfully managed their blood cholesterol and blood pressure to reach their goal levels. Our message to doctors, nurses, and patients is that you can reach your goal levels, and we should work together to help you do that.”
As with any therapy, the benefits and risks must be considered for each patient. In SANDS, participants in the aggressive treatment group on average needed more medications and higher doses than the standard treatment group, and they were slightly more likely to have side effects from blood pressure-lowering medications than those in the standard group. Such adverse effects generally resolved, however, after the medication was changed or the dose reduced. There were no differences in side effects related to cholesterol-lowering drugs between the standard and the aggressive treatment groups.
“These encouraging findings from SANDS suggest that more aggressive blood pressure and cholesterol targets than those currently recommended in patients with diabetes may reduce their future cardiovascular risk,” said Jerome L. Fleg, M.D., NHLBI project officer of the study and a coauthor of the paper. “Longer term followup of this population as well as additional studies in other populations are needed to confirm the benefit and cost-effectiveness of these lower targets.”
Tart Cherries May Lower Risk For Type 2 Diabetes - Diabetes Symptoms and Care
April 8, 2008
A new study shows tart cherries, one of today’s hottest "Super Fruits," may help reduce inflammation, potentially lowering the risk of type 2 diabetes and cardiovascular disease in animals. The study was presented by University of Michigan researchers today at the Experimental Biology annual meeting. As science continues to reveal inflammation may be a marker for many chronic diseases, the researchers say emerging studies like this are important in examining the role diet may play in disease management and prevention.
At-risk rats with metabolic syndrome (obese, pre-diabetic) and lean, healthy rats were fed a cherry-enriched "Western Diet," characterized by high fat and moderate carbohydrate — in line with the typical American diet. Cherry-enriched diets, which consisted of whole tart cherry powder as 1 percent of the diet, reduced two known markers of inflammation by up to 50 percent. TNF-alpha was reduced by 50 percent in the lean rats and 40 percent in the at-risk rats and interleukin 6 (IL-6) was lowered by 31 percent in the at-risk rats and 38 percent in the lean rats.
While inflammation is a normal process the body uses to fight off infection or injury, according to recent science, a chronic state of inflammation could increase the risk for diseases.
"We’re learning how important reducing inflammation is for our overall health and lowering the risk for heart disease and type 2 diabetes — two of the most critical health epidemics we have in this country today," said study co-author Dr. Steven F. Bolling, a cardiac surgeon at the University of Michigan Cardiovascular Center who also heads the U-M Cardioprotection Research Laboratory, where the study was performed. "This study offers further promise that foods rich in antioxidants, such as cherries, could potentially reduce inflammation and lower disease risk."
Both lean and at-risk rats also experienced lower cholesterol and triglyceride levels on the cherry-enriched diet, two other key risk factors for heart disease. The most at-risk animals also reduced their abdominal fat and total fat mass — particularly important given the link between excess abdominal fat and disease.
Researchers say the animal study is encouraging and will lead to further clinical studies in humans to explore the link between diet, inflammation and lowering disease risk.
Adverse Effects Of Estrogen Replacement Therapy (ERT) Are Dose Related
April 8, 2008
Recent clinical trials indicate that estrogen replacement therapy (ERT) may increase the risk of cardiovascular diseases. A new study in mice has examined whether adverse effects of ERT are related to the doses used. The study found that moderate and high doses of ERT increased problems in the kidney and heart. These results suggest that ERT dosage may be an important determinant in a woman’s overall health.
The study, Dose-Response Effect of Estrogen on the Kidney and Heart, was conducted by Xiaomei Meng, Martin Antonio D’Ambrosio, Tang-Dong Liao and Xiao-Ping Yang. The researchers are members of the Hypertension and Vascular Research Division of Henry Ford Hospital, Detroit, MI. Dr. Yang is presenting her team’s findings during the 121st Annual Meeting of the American Physiological Society, part of the Experimental Biology 2008 scientific conference
Background
The frequency of cardiovascular disease (CVD) and the deaths that are associated with it are much lower in premenopausal women than in men of similar age. This female gender advantage becomes far less or disappears with increased age and reduced estrogen levels after menopause, suggesting that ovarian hormones, most likely estrogen, protect women against CVD.
Studies have show that postmenopausal women who receive hormonal replacement therapy (HRT) have a lower incidence of CVD and die less frequently than those not receiving HRT. As a result, HRT has commonly been used for prevention of CVD in postmenopausal women. However, recently published data by the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI) showed an unfavorable effect of HRT on the risk and events of CVD in women. But while the data were convincing, there are other considerations such as composition of the drugs, dosage, time when HRT was initiated, age, and pre-existing risk factors for CVD, which may have affected the outcome of HERS and WHI.
The dosage of estrogen may also be a contributing factor in the unfavorable outcome of HRT since it has been shown that certain types of estrogen can decrease heart attacks and stroke in women who have no history of CVD. Conversely, certain levels of estrogen, in combination with progestin, increase the risk of stroke.
The Study
In an effort to isolate the factors involved in the estrogen-CVD connection, and more specifically, to understand what role the dose of the drug might play, the researchers examined whether the adverse effects of ERT were related to the doses being used. For a 60 day period ovariectomized (OVX) mice received the estrogen hormone 17β-estrodial (E2), a drug very similar to that used in treating the symptoms of menopause. The mice received one of four dosing levels every day throughout the study period: a very low (VL) dose (0.001 μg/d); a low (L) dose (0.42 μg/d); a moderate (M) dose (4.2 μg/d); or a high (H) dose (28.3 μg/d).
The researchers found that:
* Moderate and high doses of ERT increased the plasma estrogen levels in the mice more than four fold (4.5). This was associated with fluid retention in the uterus, amounts of protein in the urine, and dilated kidneys.
* By contrast, low doses of E2 restored plasma estrogen to levels similar to the control rats and neither fluid retention nor renal damage was found in this group of mice.
* Moderate and high doses of E2 also increased atrial natriuretic peptide (ANP), a cardiac hormone that is increased as a marker of severity of heart failure. At low level dosing this did not occur.
* Overall blood pressure and cardiac function were not changed by ERT at any given dose.
Conclusions
“This shows that the size of the estrogen dose may be critical in determining whether ERT leads to cardiovascular or kidney disease,” said Dr. Yang, the study’s lead researcher. Other factors such as the ratio of estrogen to progestin, the age when the therapy begins and the cardiovascular health of the patient when treatment starts may also be important factors to investigate.”
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Physiology is the study of how molecules, cells, tissues and organs function to create health or disease. The American Physiological Society has been an integral part of this discovery process since it was established in 1887.
The APS annual meeting is part of the Experimental Biology 2008 (EB ‘08) gathering runs April 5-9, 2008 at the San Diego, CA Convention Center.
Source: Donna Krupa
American Physiological Society
Risk Of Sudden Death In Women May Be Raised By Malfunctioning Kidneys
April 8, 2008
Women whose kidneys are poor at filtering impurities from the blood are at heightened risk of sudden cardiac death, according to a report published in Hypertension: Journal of the American Heart Association.
The study analyzed 2,760 postmenopausal women with a history of some heart disease to determine whether less serious, unrecognized deficiencies in kidney function also raised the risk of sudden cardiac death (SCD). After controlling for several baseline risk factors - including heart failure, age, smoking, heart rate and level of high-density lipoproteins (HDL, “good” cholesterol) - researchers found the risk of SCD in women with advanced kidney dysfunction was 3.16 times higher than in women with normal kidney function.
Sudden cardiac death occurs when the heart abruptly and unexpectedly stops beating, leading to death within minutes of the first symptoms. It causes about 310,000 deaths each year among U.S. adults, according to American Heart Association statistics.
“Sudden cardiac death is an important public health problem, but it is poorly understood and understudied, especially in women,” said lead author Rajat Deo, M.D., the study’s lead author and a fellow in cardiac electrophysiology at Johns Hopkins Hospital in Baltimore.
Many people who die of SCD have pre-existing heart disease or heart disease risk factors. People with end-stage kidney disease, who require dialysis to survive, are at particularly high risk: about 22 percent of deaths in these patients are caused by SCD. Chronic kidney disease is also associated with SCD risk in people with advanced heart failure (their heart muscles are weakened and can’t pump all the blood the body needs).
Deo and colleagues from the University of California-San Francisco, examined data on postmenopausal women who participated in the Heart and Estrogen/progestin Replacement Study (HERS). The women, average age 67 with none over 79, had been diagnosed with coronary heart disease because of a previous heart attack, coronary artery bypass surgery, angioplasty or tests showing more than 50 percent narrowing in one or more coronary arteries. Some of the women had mild heart failure, but none had severe heart failure or end-stage renal disease.
At the start of HERS, researchers measured blood creatinine, a waste product that healthy kidneys remove from the blood. Creatinine levels were used to estimate the filtering ability of the kidneys (the glomerular filtration rate, or eGFR).
During the 6.8-year follow-up period, 135 of the women experienced SCD:
* 36 (3.5 percent) of those had normal kidney function (eGFR over 60 milliliters per minute [ml/min]);
* 69 (4.6 percent) of those had moderate kidney dysfunction (eGFR 40-60 ml/min);
* 30 (13 percent) of those had advanced kidney dysfunction (eGFR less than 40 ml/min).
Other women at heightened SCD risk during the HERS study were those who had a heart attack or were hospitalized one or more times for heart failure during the follow-up period. However, after controlling for these events, the risk remained 2.27 times as high for women with advanced kidney dysfunction.
“We found a strong, independent association between kidney function and SCD in a group of women with coronary heart disease who were not on dialysis and had less sick hearts than patients in previous studies,” Deo said.
“We already know that patients with kidney disease are at greater risk of heart attack, heart failure and stroke. This study extends that concern to SCD and supports previous recommendations that people with kidney disease be monitored aggressively for cardiac risk factors.”
Whether women had received estrogen/progestin replacement therapy or a placebo as part of the HERS trial had no impact on their chance of SCD, Deo said.
Although the analysis involved only women, the researchers believe it will apply to men, too. They are preparing an analysis of kidney function and SCD risk in elderly men and women.
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Co-authors are: Feng Lin, M.S.; Eric Vittinghoff, Ph.D.; Zian H. Tseng, M.D.; Stephen B. Hulley, M.D., M.P.H.; and Michael G. Shlipak, M.D., M.P.H.
The study was funded in part by an American Heart Association Established Ivestigator Award to the senior author, Dr. Shlipak. Statements and conclusions of study authors that are published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.
Source: Karen Astle
American Heart Association
Infants Who Sleep Less Can Become Overweight In School - Sleep Disorder and Apnea
April 8, 2008
Infant children?who sleep less than 12 hours per day or have dcreased levels of sleeping pattern?have an increased risk of being overweight as preschoolers than those who sleep 12 hours or more, according to a report in the April issue of Archives of Pediatrics & Adolescent Medicine, a theme issue>Sleeping and TV
Adjusting for the amount of television viewed only minimally changed the associations between sleep and overweight, the authors note. However, the combination of little sleep and more hours spent watching television conferred the highest risk of being overweight. “Our findings lend support to childhood overweight prevention interventions that target both reduction in television viewing and ensuring adequate sleep duration,” the authors write.
“The mechanisms underlying the association between sleep duration and adiposity [amount of body fat] are unclear,” the authors write. In addition to altering hormone levels, sleeping less at night may lead to daytime sleepiness and reduced activity levels during waking hours, they note. Finally, more time spent awake could offer more opportunities to eat.
"Strategies to improve sleep duration among young children may be an important component of behavioral interventions that promote childhood overweight prevention," the authors conclude. "Our findings suggest that clinicians and parents may wish to use evidence-based sleep hygiene techniques to improve sleep quality and perhaps increase sleep duration."
AIDS Project New Haven Launches Program To Educate Older Women About HIV
April 7, 2008
AIDS Project New Haven in Connecticut has launched an initiative aimed at educating postmenopausal women about HIV/AIDS in an effort to prevent the spread of the virus among older women, the New Haven Register reports. The Center for Interdisciplinary Studies on AIDS at Yale University is partnering with APNH on the initiative, called Wise Women Win.
Six women older than age 50 recently received training to participate in the program as mentors and educators to other women ages 50 and older, APNH program coordinator Nick Boshnack said. These women then recruit other women to join a group in which they provide education about HIV/AIDS and safer-sex practices and help spread the messages among seniors. Senior centers, residential developments and retail stores have participated in the program.
According to the Register, many older women have little knowledge about HIV/AIDS but engage in unprotected sex because they are not concerned about pregnancy. Although some people consider seniors to be at low risk of HIV, many are still sexually active and at risk of contracting the virus. “There are women who are sexually active after divorce or after they are widowed,” Boshnack said, adding that older women are not familiar with HIV prevention because the virus “wasn’t around” when they first began having sex.
HIV is rising rapidly in women older than age 50, according to a report from the AIDS Research Institute at the University of California-San Francisco. In 2007, people older than age 50 accounted for 19% of new HIV/AIDS diagnoses, 29% of people living with HIV/AIDS and 36% of deaths from AIDS-related causes, according to CDC (Garriga, New Haven Register, 4/2).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
