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Weight and see: New alert on diet pills

Posted in Consumer, Diet, Health, Health Care, Medicine by Erineus on May 8, 2009

CONSUMERLINE By Ching M. Alano Updated May 05, 2009 12:00 AM

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Illustration by REY RIVERA

Oh, to live and diet! The battle with the bulge rages. You’ve tried every diet program on the planet, every fat-zapping procedure and diet pills there are. But so far, the only thing they’ve successfully reduced is your hard-earned money.

Wait, did we just say diet pills? Before you pop that pill into your mouth, here’s a mouthful: The Food and Drug Administration recently warned the public against weight loss products that are tainted by potentially dangerous ingredients. Many of these products claim to be “natural” or “herbal,” when in fact, they contain drugs — and in very high doses at that. Now, that’s a bitter pill to swallow.

In its new alert, FDA lists these dangerous drugs found in weight loss products (stop, look, and see if your diet pill has them):

Sibutramine, a controlled substance.

Phenytoin, an anti-seizure medication.

Phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent.

Bumetanide, a diuretic.

Since it made the issue public in December last year, the FDA has found 72 weight loss products, most of them imported from China, which are tainted with hidden and potentially dangerous drugs and chemicals. Among these are:

Cetilistat — an experimental obesity drug that can cause serious health risks in certain populations.

Fenproporex — a stimulant not approved for marketing in the US, which can cause increased blood pressure, uncontrollable movements or shaking, palpitations, arrhythmia, and possibly sudden death.

Fluoxetine — the active pharmaceutical ingredient in Prozac, a prescription antidepressant, which can increase the risk of suicidal thinking and suicide in children, adolescents, and young adults.

Furosemide — the active pharmaceutical ingredient in Lasix, a potent diuretic that can cause profound dehydration and electrolyte imbalance, leading to dehydration, seizures, GI problems, kidney damage, lethargy, collapse, and coma.

Rimonabant — the active pharmaceutical ingredient in Zimulti, which has not been approved in the United States because of increased risk of neurological and psychiatric side effects, such as seizures, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts among patients.

(The full list of contaminated products can be found in FDA’s web site.)

These tainted weight loss supplements on the list are not FDA-approved and available over-the-counter without a prescription, which is not to say that those that are FDA-approved or available by prescription don’t have serious side effects.

Two of the most well-known diet drugs in the United States are Xenical, a prescription-only drug, and its non-prescription version Alli. Unpublished studies on Xenical have revealed the following alarming data:

• Xenical increases the precursor markers to colon cancer by 60 percent in rats.

• When eating a high-fat diet and taking Xenical, the cancer risk increased 2.4 fold.

• Fat-soluble vitamin E depletion, due to Xenical’s fat-blocking action, raises the risk of colon cancer even further.

• Recorded adverse reactions to Xenical include: 39 cases of increased abnormal blood thinning, several cases of bleeding episodes, 10 hospitalizations (four with life-threatening reactions), and one death.

• Dangerous thinning of the blood can occur in people taking drugs like Warfarin (an anti-coagulant), or who suffer from vitamin K deficiency.

On the other hand, Alli, which blocks the absorption of about 25 percent of consumed fat, can also result in loose stools, hard-to-control bowel movements, and gas with an oily discharge. But the manufacturer calls these “treatment effects.”

Fat chance you’ll lose weight with diet pills alone. Fact is, the Mayo Clinic reports that the average weight loss for prescription-strength Xenical is only about six pounds greater than diet and exercise alone after one year. Since Alli is half the strength of Xenical, they reasoned Alli could conceivably result in an average of just three extra pounds lost in a year.

Certainly, diet pills are a big business in the US. According to health activist Dr. Joseph Mercola, who wouldn’t be tempted by the promise of shedding unwanted pounds without sweating — simply take a pill, then sit back and relax as the pounds melt away.

According to Mercola, “for the 15 percent of American adults who say they’ve used weight-loss supplements, many probably thought, ‘Why not?’ What could they lose other than the money to buy them and possibly some extra pounds?”

Here, you could lose a lot, warns Mercola, including your health, if you take many of these weight-loss supplements.

Dieting is much more than having a bikini-worthy figure, according to Mercola. “It’s about having more energy, fighting disease, protecting your heart and, above all else, choosing a lifestyle that will support your entire body and your health.”

He gives this weighty tips:

Tailor your diet to your nutritional type. These are the foods that are right for your biochemistry, and foods that will push your body towards its ideal weight. (They may be high in fat or carbs, heavy on protein or veggies, it all depends on you.)

This is not a diet — no need to deprive yourself, no need to count calories. In fact, if you still feel hungry after eating, you are definitely not eating according to your nutritional type.

Consider exercise as a drug. When you’re trying to lose weight, a casual walk here and there is not going to cut it. Many studies find that exercising for one hour, five days a week is actually needed — agree! Sometimes you may even need up to 90 minutes of aerobic activity every day.

Take double note: There is also strong compelling evidence that strength training and high-intensity anaerobic interval training may be especially effective for weight loss.

The safe and effective way to lose weight, according to Mercola is to eat right, exercise, and address the nagging issues, big and small, in your life. You have nothing to lose but those stubborn unwanted pounds.

* * *

We’d love to hear from you. E-mail us at ching_alano@yahoo.com

View previous articles of this column.

http://www.philstar.com/Article.aspx?articleId=464177&publicationSubCategoryId=80

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Hair today, more hair tomorrow?

Posted in Diseases/Disabilities, Medicine by Erineus on May 8, 2009

AN APPLE A DAY By Tyrone M. Reyes, M.D. Updated May 05, 2009 12:00 AM

For men and women experiencing the most common type of hair loss — androgenetic alopecia, or pattern hair loss — and pondering what, if anything, could be done about it, there’s a mix of encouraging and discouraging news. There’s still no great way to easily restore your hair to its former glory. No drug treatment has gained US FDA approval since 1997, and the most effective existing therapy — hair transplant — is expensive and unlikely to come down in price. But on a more positive note, for those who can afford them, hair transplants now offer increasingly satisfying results — thanks to improved surgical techniques. Also heartening is the news that recent biotechnology discoveries may lead to less invasive treatments.

Falling Follicles

As a teenager, the average person has about 100,000 scalp hairs. Nearly everyone experiences some hair loss with age, but for people with pattern hair loss — a genetic condition inherited from one’s parents that causes hair on top of the head to gradually fall out — the problem is more noticeable. About half of men have significant hair loss by about age 50, and 38 percent of women have it by age 70.

Pattern hair loss is caused by a gradual shrinkage of hair follicles on top of the head, so they become less effective at sprouting hair. Normally, each hair grows for two to six years, rests for several months, and falls out. Then a new hair emerges. In a healthier scalp, more than 90 percent of hair follicles are in the growth phase. But as our hair follicles shrink, the growth phase gets shorter and the resting phase, longer. The result is double trouble: Not only are the new hairs shorter, there are also fewer of them. These older, smaller follicles also produce thinner hair. Men with pattern hair loss (and a very small percentage of women) have a third problem: the follicles shrink so much they stop producing hair altogether, so the bald patch starts to take over.

Follicles become less productive because hormone levels change. An enzyme called 5-alpha-reductase converts testosterone to dihydrotestosterone(DHT), which stimulates the growth of hair follicles, but typically on the face and other parts of the body and not the scalp, where it has the opposite effect. Young men and women with androgenetic alopecia have higher levels of 5-alpha-reductase, as well as lower levels of an enzyme that converts testosterone into estrogen. Still, the cause of women’s pattern hair loss is less well understood. Researchers believe that several enzymes and hormones may combine to produce effects that are similar to DHT. Estrogen seems to be protective against hair loss, so some research suggests that the estrogen-to-testosterone ratio may be a factor. Although hair thinning can occur at any time after puberty, many women first experience it in their 50s, possibly as a result of ebbing estrogen levels.

Be Gentle

In the early stages, you can minimize hair loss by treating your hair gently. Hair is more fragile when it’s wet, so it’s important to softly dry it with a towel — and don’t pull at it with a comb or brush. Twirling your hair can twist it off its follicle moorings. Head scratching may help you think, but it’s hard on your hair. If you’ve got an itchy scalp, the hair-friendly solution is to use some kind of an anti-itch shampoo. Hairstyles with braids — indeed, any style that pulls the hair back — can speed hair loss because they tug on the hair.

Treatments

You can find plenty of treatments for hair loss on the Internet. Some are combinations of “specially formulated” shampoos and herbal supplements in capsule form that may have saw palmetto as an ingredient. But aside from paid “it really works” testimonials, there’s not much evidence that these remedies are effective. Save your money. Of course, a hairpiece of some sort is an option, but it tends to wear out or fade after a year or two of regular use because of combing, sun exposure, and routine cleaning. The less detectable ones are often expensive.

The US FDA has approved only two drugs for hair loss: over-the-counter minoxidil (Rogaine and generic) and prescription finasteride (Propecia). Minoxidil is available as a two-percent liquid solution for women and a two-percent or five-percent solution for men. In studies, between a quarter and a half of people who apply minoxidil twice a day notice a slowdown in their hair loss or even some hair regrowth. The most common side effects are itching and skin irritation, and the monthly cost is about P2,000.

Finasteride comes as a one-milligram tablet when used as a hair loss treatment. Men take it in larger doses as a treatment for an enlarged prostate gland. The drug, which blocks the conversion of testosterone to DHT, is only approved for use by men; some recent studies suggest that finasteride might be effective in women under certain circumstances, but early trials came out negative. Finasteride is more effective than minoxidil, with up to two-thirds of users reporting hair regrowth. It also costs about P 2,000 a month. Side effects are rare but may include impotence and decreased libido. A major drawback of minoxidil and finasteride is that you need to keep taking them to sustain the benefits. If you stop, your scalp will return to the balding state it was in before you started using the medicines. So year after year of treatment can start to get expensive. Doctors usually advise patients with significant pattern hair loss to try the conventional drug treatments for at least a year. If results aren’t satisfactory, a hair transplant is an option.

Splitting Hair Follicles

Hair transplants involve removing hair follicles from areas of growth on the sides of the head and implanting them in bald or thinning areas. One of the main obstacles is money: The labor-intensive surgery, which typically takes a surgical team of up to nine people five hours to perform, is expensive. One or two procedures may be needed for the best results. Hair transplant has steadily improved since its introduction in the 1950s, making for a more natural hairline and appearance. Surgeons have moved from large grafts (known as plugs) to a combination of minigrafts (three to six hair follicles) and micrografts (one or two hair follicles).

The most recent development, known as follicular unit transplantation, or FUT, continues the trend towards smaller and smaller grafts. A follicular unit is a small bundle that includes one to four follicles, oil glands, a tiny muscle, and other tissues. Once follicular units are extracted — either in a narrow strip or one unit at a time — the surgeon dissects away extra tissue before implanting the individual follicular units (see drawing on Page D-1).

This technique allows for a denser packing of transplanted hair and minimizes inadvertent damage to the follicles as they are being transplanted. FUT has improved results for women, so they’re now better candidates for hair transplantation. About 80 percent of transplanted hair falls out within three weeks, but about three months after that, the follicles start producing hair at a normal rate, and hair continues to grow from then on. Applying minoxidil can accelerate this process. Complications are rare but may include bleeding, infection, and scarring.

Getting Abrasive

Several drugs that preserve the health of functioning follicles are in the pipeline. Conceptually, this is the same approach that minoxidil and finasteride take. But some companies hope to develop entirely new approaches that would involve creating hair follicles from scratch. One example started with a University of Pennsylvania researcher’s discovery that mice healing from wounds can produce new hair follicles. In a report published in 2007 in the prestigious scientific journal Nature, the researcher, Dr. George Cotsarelis, showed that when skin is damaged, the skin cells behave like stem cells and generate new hair follicles. A company he founded is working to apply the discovery to humans which, in theory, would involve using an abrasive gel to gently damage the skin and then the application of a topical cream to switch on the follicle-generating genes.

Another biotech possibility is a technique in which hair-forming cells are extracted, multiplied under controlled conditions (such as a culture), and reimplanted into the scalp.

Your Choice

Aside from the psychological implications, pattern hair loss has no negative health consequences. What you choose to do about it — which may be absolutely nothing — is a personal decision, best made after talking over the options with a dermatologist, family, and maybe some fairly objective friends. You’ll need to take into account your age, the extent of your hair loss, your expectations, and your bank account. There’s no right or wrong decision — just what you consider worthwhile relative to your personal appearance, inconvenience, and the cost.

View previous articles of this column.

http://www.philstar.com/Article.aspx?articleId=464168&publicationSubCategoryId=80

MRI may increase mastectomy for early-stage breast cancer

Posted in Cancer, Medicine by Erineus on March 16, 2009

YOUR DOSE OF MEDICINE By Charles C. Chante, MD Updated March 08, 2009 12:00 AM

Preoperative magnetic resonance imaging may be a factor in the rising rate of mastectomy among women with early-stage breast cancer, a retrospective study suggests.

Investigators reviewed 5,596 stage 0-11 breast cancers in 5,463 women who underwent surgery for the malignancy between 1997 and 2006 at the Mayo Clinic in Rochester, Minn. They found that mastectomy rates decreased from 45% in 1997 to 30% in 2003, but then increased to 43% in 2006.

The rebound occurred in tandem with a doubling in the percentage of women who underwent preoperative breast magnetic resonance imaging, one of the investigators noted in a preview of the findings presented during a press briefing at the annual meeting of the American Society of Clinical Oncology.

It was reported at the Mayo Clinic that 11% of the women who were studied in 2003 underwent preoperative breast MRI, but this had increased to 22% of women in 2006.

Patients who underwent preoperative breast MRI were significantly more likely to undergo preoperative breast MRI (52% vs. 38%).

A similar increase in mastectomy rates was seen, however, in those who did not undergo preoperative MRI, with rates in those patients increasing from 28% in 2003 to 41% in 2006.

After adjustment for age, stage, contralateral breast cancer, and density, pre-operative MRI was found to be an independent predictor of mastectomy (odds ratio 1.7, P less than .0001).

Surgical year was also found to be a predictor of mastectomy.

Compared with 2003, the odds ratios for mastectomy were 1.4 for 2004, 1.9 for 2005 and 1.7 for 2006 (P less than .0001).

It was noted that other factors might also play a role in the increasing number of women who are undergoing mastectomy.

It cited patient preference, some women choose mastectomy over lumpectomy to maximize their risk reduction and changes in medical procedures and technologies, such as improved breast reconstruction options and the introduction of genetic testing.

Chair of the ASCO Cancer Communications Committee and moderator of the press briefing, added that studies have shown that when breast MRI is performed at the time of early stage breast cancer diagnosis, more cancer is found in both the breast known to be affected and the contralateral breast than is found on mammography.

Doctor of the University of Washington and the Fried Hutchinson Cancer Research Center, both in Seattle said that it may be that these surgeries based on MRI are appropriate.

MRI referrals bias might also play a role in the increased mastectomy rates.

Additional study is required to further elucidate the influence of these various factors on surgical management, and to assess whether the changing trends in surgical management improve outcomes for women with breast cancer.

View previous articles of this column.

http://www.philstar.com/Article.aspx?articleId=446542&publicationSubCategoryId=64

Medicines still expensive despite law

Posted in Congress, Consumer, Laws, Legislation, Medicine, Pharmaceuticals by Erineus on February 27, 2009

Philippine Daily Inquirer
First Posted 01:09:00 02/27/2009

The Cheaper Medicines Bill was signed into law by President Gloria Macapagal-Arroyo in June 2008. Eight months have passed since then and the costs of the medicines that we regularly buy as “maintenance” to keep ourselves “alive” on Earth have remained the same, i.e., “napakamahal pa rin” [still very expensive].

The big question is: When will this law be finally implemented? Will this law follow the sad pattern of many other laws that have come (and gone) before it, turning out to be mere pieces of papers and creating false hopes among our people?

It is indeed very sad to admit that the executive branch of government has gained notoriety for the non-implementation of many laws. This being the case, Congress might as well stop making laws, otherwise the un-implemented laws will just continue to pile up and, worse, we will just be wasting a lot of money. (We all know it costs millions of pesos to pass a single bill in Congress.)

PAUL R. MORTEL, MBLA Court, Malanday, Marikina City

http://opinion.inquirer.net/inquireropinion/letterstotheeditor/view/20090227-191280/Medicines-still-expensive-despite-law

Cheaper drugs law not working

Posted in Health, Legislation, Medicine by Erineus on February 25, 2009

THE cheaper medicines law will not benefit the poor because the reduced prices for drugs will not make lower income groups prioritize spending for medicine over cell cards.

Asian Institute of Management professor Emmanuel Leyco, executive director of the Center for Legislative Development International, said the government’s pricing response as a “policy response” to the high cost of medicine will not work.

He said studies they conducted showed that medical care ranks eighth in the list of top 10 expenditures of Filipinos. Food, housing and transportation and communications ranked first, second and third, respectively.

“The poor spend more for transportation and communication compared to health care. They would prefer to buy cell phone cards than medicines. They will purchase the same things they consider essential,” Leyco told Standard Today in an interview after yesterday’s “Kapihan Para sa Kalusugan” at the AIM building in Makati City. Even as he acknowledged the efforts of lawmakers to lower the cost of medicine, Leyco said they should have considered the people’s income profile and spending pattern.

For those who are in the marginalized or poor sector, reduced prices mean very little because of the lack of savings.

“Close to 50 percent of our people do not have income and those who have less income than they spend will not consider buying medicines even with lower costs,” Leyco said.

“So the bottom 50 percent or the poor Filipinos will not benefit from the cheaper medicine law,” he said.

Data available show that 61 percent of all the healthcare facilities are located in Luzon with almost half of them clustered in Metro Manila. Filipino medical professionals also prefer to practice in the more advanced urban centers.

At present, only 10 percent of the country’s doctors, dentists, pharmacists; 20 percent of medical technicians; and 35 percent of nurses can be found practicing in rural areas. In 1999, there were only 3,941 of them who went abroad to work. A few years later, more than 22,000 left for overseas assignments.

By Macon Ramos Araneta
http://www.manilastandardtoday.com/?page=politics4_feb25_2009

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Medicinal properties of seaweeds cited By Rudy A. Fernandez

Posted in Agriculture, Alternative Medicines, Medicine by Erineus on February 24, 2009

By Rudy A. Fernandez
Updated November 23, 2008 12:00 AM

Seaweeds, aside from their commercial value, have health and wellness properties.

This explains why people who regularly consume these so-called “ocean herbs”, notably the Japanese, have longer life span and are healthier.

Scientific studies have shown that seaweeds have more protein than meat, more calcium than milk, and higher fiber than vegetables, according to the University of the Philippines Diliman-College of Science-Marine Science Institute (UPD-CS-MSI).

Dr. Marco Nemesio Montaño of the UPD-CS-MSI said that the many beneficial properties of these dietary algae include being anti-oxidant, anti-viral, anti-inflammatory, anti-bacterial, anti-tumor, and anti-wrinkle.

Moreover, seaweed lowers blood pressure, glucose, and cholesterol, and inhibits cell-cell adhesion, he said at the 2008 Agriculture and Fisheries Technology Commercialization Forum organized recently by the Bureau of Agricultural Research (DA-BAR).

Reporting on the strides achieved in seaweed research, Dr. Montaño said that there are some phytochemicals (plant chemicals) unique to seaweed. These include carotenoids (seaweed pigments) such as fucoxanthin, seaweed sterols, fibers, seaweed anti-herbivore chemical defenses, and acidic polyssacharides (carrageenan, fucoidan).

Fucoxanthin is a pharmacologically active caretenoid commonly distributed in brown algae. It acts as an anti-oxidant (“sweeper” of the body’s toxins or “radicals,”, among other things) and inhibits colon cancer cells and cells of neuroblastema (malignant tumor).

“It has been found that fucoxanthin reduces the viability of prostate cancer cells by inducing apoptosis (natural cell death) to a greater extent than the other carotenoids. Moreover, it can induce apoptosis in human leukemia cells,” said Montaño, as reported by BAR’s Christmas de Guzman.

In terms of wellness, a new product line developed by UPD-CS-MSI from seaweed extracts is the Seamoy (with approved patent and trademark).

This is a seaweed-based, low-cost air freshener gel that uses floral scents to give rooms, cabinets, lockers, and cars a clean, fresh smell. The gel can be easily handled and packed in many ways.

The use of seaweeds as a base ingredient for air fresheners has improved the quality of those existing in the market today, said Montaño.

Air freshener gels usually last only for two to three weeks whereas some soft gels, which may contain soft paraffin, can cause clogging in air-conditioning units.

Such gels also are expensive owing to the high production cost of its base ingredient, carrageenan, an algal polysaccharide used to give the air freshener gel a clear appearance. Carrageenan is extracted from certain types of seaweeds.

Summing up, Dr. Montaño encouraged people interested in venturing into seaweed business to initiate R&D activities that would facilitate funding and improve the seaweed industry.

View previous articles from this author.

Meds in your closet

Posted in Home Living, Medicine, What/How/Why/Where/When by Erineus on February 24, 2009

By Ed Biado

What’s in your medicine cabinet? Is there actually medicine in it? In theory, a medicine cabinet should contain over-the-counter drugs that can be used to treat minor conditions and injuries. But since it is a humid place being at close proximity to the shower and bath, it’s not the ideal place for your pills. The perfect “medicine cabinet” is a cool, dark and dry closet. And here are the meds that you should keep in it:

1. Analgesics – Aspirin, mefenamic acid and ibuprofen are among the most common pain relievers in the market. Every home should have a stash of painkillers for the occasional headache, other minor pains and symptoms like fever.

2. Topical analgesics – Relieving muscle and joint pains, analgesics in cream or gel form are also available. They’re usually a combination of methyl salicylate and menthol.

3. Antacids – For the acidic or heartburn-prone, counteracting stomach hyperacidity is as easy as popping an antacid. Or have those soluble sodium bicarbonates that you can drink with water.

4. Bowel stabilizers – Loperamide, an over-the-counter solution to diarrhea, is your best bet against the almost always unexpected nasty-nasty (usually caused by gastroenteritis or inflammatory bowel disease). You never know when you’re gonna have loose bowels, so it’s wise to have some stock.

5. Laxatives – The total opposite of LBM is constipation. Therefore, laxatives are also important.

6. Cough syrups – Typically expectorants, cough syrups ease the respiratory tract of mucus buildup. For simple coughs with no symptoms, guaifenesin should do the trick. But for more serious cases, visit your friendly neighborhood physician.

7. Decongestants – Nasal congestion (clogged nose, runny nose, postnasal drip and other associated symptoms) are easily treated with decongestants. Most of the ones in the market also contain antihistamines and analgesics.

8. Anti-allergens – The most effective anti-allergy medications are histamine blockers. Allergic reactions sometimes occur unexpectedly because we don’t know everything we’re allergic to. Taking a tab the moment it gets uncomfortable will save us the trouble of sneezing for hours.

9. Skin treatments – Itchy and/or prickly skin, fungal infection and other mild skin conditions are common among kids who spend too much time in the sun and the outdoors. Parents should always have a tube of anti-inflammatory ointments and creams readily available.

10. Prescription meds – Obviously, if any member of your household is on a prescription, it would totally be irresponsible to not adhere to doctor’s orders. Never neglect the prescription.