Once again the "common folk" is a victim of the C-reactive protein (CRP) hype. A study done in 2003 showed pre-menopausal women that took birth control had twice as much CRP in their blood than women who did not take the pill. Since chronically high CRP has been linked to heart disease and inflammation and is believed to play a key role in narrowing and hardening of the arteries, it would be easy to believe the pill promotes inflammation (had we not all recently learned CRP is not the best indicator of inflammation)! However the pill has also been studied to reduce the risk of ovarian cancer due to the estrogen present.. But that's a whole other story. Pros and cons, pros and cons.
The same study revealed that even though levels of CRP were twice as high in the women who took the pill, both group's levels were considered to be in the "normal" range.
So what do we get from all this... Women currently on birth control pills shouldn’t throw them out strictly based on the fear of increased CRH levels and heart disease. Remember, heart disease is most commonly linked to other important factors such as SMOKING, diet, and genetics. Also, there are other important risk factors associated with the pill that we should be concerned with (as discussed in the discussion about stroke and blood clots linked to the pill). In conclusion, More research is necessary on this topic and hopefully next time it will include more factors besides good ol' CRP.
SOURCES: American Physiological Society annual meeting, San Diego. Darlene M. Dreon, DrPH, director of clinical research, Galileo Pharmaceuticals, Inc, Santa Clara, Calif. Trent MacKay, special assistant for obstetrics and gynecology in the Contraception and Reproductive Health Branch of the National Institute for Child Health and Human Development, National Institutes of Health.
04 May 2010
Statistics on Countries using turmeric in food VS those that don't and the incidence of RA in these countries.
So, I was very curious after reading about turmeric being used as a spice in many Asian cultures, is there evidence showing a lower incidence in RA in these types of countries compared to the United States. I found an article with statistics of how many people are affected by RA in each country. The US has upwards of 2 millions, while some rural Asian countries are in the low thousands. I have to speculate this being because of the population difference, but it would make sense if these countries show a lower incidence of RA. The article I presented in class today shows that the curciminoids in the turmeric are very effective at inhibiting the inflammatory response causing RA problems before the RA has infected the patient. After the onset of RA there is no evidence shown that turmeric curciminoids will have any affect. So if the rural Asian countries have used turmeric as a spice in their cuisine for centuries then why wouldn't they be more prone to be effected by the inflammatory responses to RA. Maybe we should take this into account and start using more spices with turmeric. This could help our problem of millions of people in the US that suffer from RA. We could reduce this risk of RA in the US simply by putting this into our foods. This is not a totally proven way of decreasing RA but it seems to sure help. My only concern is that the turmeric curciminoids could have other effects on our body with it's inflammatory inhibitor response. It could cause us to inhibit inflammation when we really need it and just cause more problems for us. I guess this is always the issue when dealing with new ways to deal with inflammation and other diseases though.
03 May 2010
Hey guys check out this link to an article that states that high altitude wines are more beneficial in repairing arteriole walls than low altitude wines!
http://www.jancisrobinson.com/articles/jr876
I only researched this because I recently sat next to a metabolic surgeon on an airplane and we talked the entire flight about inflammatory diseases and their relations to metabolic surgery. He was the one who informed me of the latest trends of wine drinking.
http://www.jancisrobinson.com/articles/jr876
I only researched this because I recently sat next to a metabolic surgeon on an airplane and we talked the entire flight about inflammatory diseases and their relations to metabolic surgery. He was the one who informed me of the latest trends of wine drinking.
Polypharmacy
A random note about the topic of polypharmacy that we went over briefly last class:
I work at an optometrist office and sometimes I enter patient history information into the computer system, especially if we have a new patient. One of the questions on the patient history form asks the patient to list out any medication they are currently taking. This patient that I was working with needed help with that portion because she said she did not know all of the medication she was on. She said she was on "hundreds," and although that was an exaggeration, it is a good example of polypharmacy. When asked if she had some sort of list, she said "no."
Even though the likeliness of a complication arising when dealing with an eye exam is very slim, it was just a good example showing that if a patient is taking more medication than they can remember, they should always carry around a list with them.
I work at an optometrist office and sometimes I enter patient history information into the computer system, especially if we have a new patient. One of the questions on the patient history form asks the patient to list out any medication they are currently taking. This patient that I was working with needed help with that portion because she said she did not know all of the medication she was on. She said she was on "hundreds," and although that was an exaggeration, it is a good example of polypharmacy. When asked if she had some sort of list, she said "no."
Even though the likeliness of a complication arising when dealing with an eye exam is very slim, it was just a good example showing that if a patient is taking more medication than they can remember, they should always carry around a list with them.
02 May 2010
Herbal Medicine
Herbal medicine relies on active plant chemicals with biological properties. Many conventional medicines are synthetic compounds designed to mimic the action of plant chemicals. For instance, the heart medication digoxin is derived from the foxglove plant. In herbal medicine, active chemicals are extracted from the plant parts (stems, seeds, roots, or leaves) that are the richest sources. The active chemicals can be quantitatively measured and prepared in the form of capsules, tinctures, teas, tonics, oils, or poultices. Aromatic herbs such as lavender can also benefit the immune system when used topically or as healing oils.
Inflammation is a key feature in autoimmune disease. In some conditions, such as Hashimoto's thyroiditis, inflammation contributes to the disease process. In other conditions, such as Crohn's disease, inflammation may occur as a result of the disease. Inflammation occurs as the immune system reacts to injury, infection, environmental agents, malignancy, and cellular changes. In skin, inflammation is most visible because it causes noticeable swelling, redness, discomfort and pain. The process leading to inflammation, which is known as the inflammatory response, also induces changes that aren't seen but influence the effects of inflammation and their severity.
The inflammatory response is a complex cascade of steps that include an activation of white blood cells, the release of immune system chemicals such as complement and cytokines, and the production and release of inflammatory mediators and prostaglandins. Inflammation may be acute or chronic or relapsing-remitting depending on the disease course. Most conventional treatments for autoimmune disease, including corticosteroids, work by reducing or suppressing inflammation.
Many herbs also possess anti-inflammatory (also known as antiphlogistic) characteristics. Herbs can be used as the sole therapy in autoimmune disease or as complementary corticosteroid-sparing therapies allowing patients to take smaller doses or shorter courses of corticosteroids. Treatment protocols today often rely on both alternative and conventional treatment options in a discipline known as integrative medicine.
Inflammation is a key feature in autoimmune disease. In some conditions, such as Hashimoto's thyroiditis, inflammation contributes to the disease process. In other conditions, such as Crohn's disease, inflammation may occur as a result of the disease. Inflammation occurs as the immune system reacts to injury, infection, environmental agents, malignancy, and cellular changes. In skin, inflammation is most visible because it causes noticeable swelling, redness, discomfort and pain. The process leading to inflammation, which is known as the inflammatory response, also induces changes that aren't seen but influence the effects of inflammation and their severity.
This article describes the use of plant chemicals with anti-inflammatory properties as complementary therapies for patients with autoimmune disease. Also this article I found it interesting because it gives another alternative to the consumption of NSAIDS or other drugs; the alternative way is the use of herbal products that will eventually treat the symptoms.
01 May 2010
While researching more of the scientific articles I came to find an interesting article relating to anti-inflammatory drug use and the risk for Parkinson's disease.
Evidence from studies suggests a role of neuroinflammation in the pathogenesis of Parkinson's disease (PD). This study takes advantage of the well established American Cancer Society's Cancer Prevention Study II (CPS-II) Nutrition Cohort, and was able to further examine the relation between NSAID use and PD risk with more detailed information on different types of NAIDs. The cohort is a study that was initiated in 1992 to investigate the factors for cancer. Participants were from a cohort who replied to a mailed survey in 1982. In 1992 they answered a questionnaire on four types of common used analgesics. Follow-up surveys were conducted in 1997,1999, and 2001. In 2001's survey a specific question on the lifetime occurrences of PD was asked. Follow-up started on the date of return of the 1992 questionnaire and ended on the date when the first symptoms of PD were noticed for PD cases or September 30, 2001 for participants without PD.
In the '92 questionnaire, participants were asked whether they took the following analgesics regularly during the past year: aspirin, acetaminophen, ibuprofen, or other nonsteroidal analgesics. They were also asked how many days per month they took each drug, how many tablets they took per day, and the duration of use. The '97 survey asked about "baby or low dosage aspirin" and "regular or extra strength aspirin". Four baby aspirin was counted as one tablet. Users were categorized according to dosage: fewer than 2 tablets/ week; 2 to 6.9 tablets/week; and 1 or more tablets a day. Results of the study showed significant inverse association was suggested between the cumulative updated dosage of ibuprofen use and PD risk. Overall, ibuprofen users had a lower PD risk than nonusers. Unlike ibuprofen, the use of aspirin and other NSAIDs, or acetiminophen was not associated with PD risk. Non aspirin NSAID users had a 26% lower risk than nonusers.
Results were consistent with previous findings that users of non aspirin NSAIDs but no aspirin, had a lower risk for PD than nonusers. This study also further suggested that only certain non-aspirin NSAIDs such as ibuprofen reduce the risk for PD. However there is insufficient information on the optimal dosage, and it remains uncertain whether this effect is mediated by COX inhibition or through other mechanisms specific to ibuprofen and possibly some other selected NSAIDs.
The full article can be found on PubMed, the title of the article is: Nonsteroidal Antiinflammatory Drug use and the Risk for Parkinson's Disease.
Evidence from studies suggests a role of neuroinflammation in the pathogenesis of Parkinson's disease (PD). This study takes advantage of the well established American Cancer Society's Cancer Prevention Study II (CPS-II) Nutrition Cohort, and was able to further examine the relation between NSAID use and PD risk with more detailed information on different types of NAIDs. The cohort is a study that was initiated in 1992 to investigate the factors for cancer. Participants were from a cohort who replied to a mailed survey in 1982. In 1992 they answered a questionnaire on four types of common used analgesics. Follow-up surveys were conducted in 1997,1999, and 2001. In 2001's survey a specific question on the lifetime occurrences of PD was asked. Follow-up started on the date of return of the 1992 questionnaire and ended on the date when the first symptoms of PD were noticed for PD cases or September 30, 2001 for participants without PD.
In the '92 questionnaire, participants were asked whether they took the following analgesics regularly during the past year: aspirin, acetaminophen, ibuprofen, or other nonsteroidal analgesics. They were also asked how many days per month they took each drug, how many tablets they took per day, and the duration of use. The '97 survey asked about "baby or low dosage aspirin" and "regular or extra strength aspirin". Four baby aspirin was counted as one tablet. Users were categorized according to dosage: fewer than 2 tablets/ week; 2 to 6.9 tablets/week; and 1 or more tablets a day. Results of the study showed significant inverse association was suggested between the cumulative updated dosage of ibuprofen use and PD risk. Overall, ibuprofen users had a lower PD risk than nonusers. Unlike ibuprofen, the use of aspirin and other NSAIDs, or acetiminophen was not associated with PD risk. Non aspirin NSAID users had a 26% lower risk than nonusers.
Results were consistent with previous findings that users of non aspirin NSAIDs but no aspirin, had a lower risk for PD than nonusers. This study also further suggested that only certain non-aspirin NSAIDs such as ibuprofen reduce the risk for PD. However there is insufficient information on the optimal dosage, and it remains uncertain whether this effect is mediated by COX inhibition or through other mechanisms specific to ibuprofen and possibly some other selected NSAIDs.
The full article can be found on PubMed, the title of the article is: Nonsteroidal Antiinflammatory Drug use and the Risk for Parkinson's Disease.
Aspirin Decreases the Risk of Breast Cancer Deaths
It was revealed in February 2010 that the use of anti-inflammatory drugs such as aspirin (and other NSAIDs such as ibuprofen and naproxen) has shown to decrease the risk of dying from breast cancer. This information comes out of the Nurses’ Health Study which has followed 4,164 registered nurses who were diagnosed with stages I, II, or III breast cancer between 1976 and 2002 until their death or June 2006, whichever came first. This study has looked at a wide range of health issues in these women. In particular, they started in 1976 looking at which of the women took aspirin on a regular basis (often to reduce risk of heart attack and stroke) and have attempted to draw correlations in other health areas.
The researchers looked at the breast cancer mortality risk and the number of days per week of aspirin use (0,1,2 etc.). They found that women who took aspirin two to five days a week had a 60 percent reduced risk of their cancer spreading and a 71 percent lower risk of breast cancer death. Six to seven aspirins a week lowered the risk of spread by 43 percent and the risk of breast cancer death by 64 percent. In the end they concluded that among women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death. The researchers state that more information is needed but the use of aspirin could affect tumor growth or recurrence through a decrease in inflammation.
Interestingly, it was revealed in January 2009 based on data from the Nurses’ Health Study that the use of aspirin or other NSAIDs does not decrease the risk of getting breast cancer among premenopausal women. The information from both of these papers is intriguing and points to the role of inflammation at different stages of a variety of disease states. It is likely that a baby aspirin does more than treat muscle pains, headaches and offer protection from heart disease. More information is needed however, it is promising that anti-inflammatories may have a beneficial role in decreasing mortality risk after cancer.
Holmes MD, Chen WY, Li L, Hertzmark E, Speigelman D, Hankinson SE. Aspirin intake and survival after breast cancer. J Clin Oncol 28(9): 1467-72, 2010.
Eliassen AH, Chen WY, Spiegelman D, Willett WC, Hunter DJ, Hankinson SE. Use of aspirin, other nonsteroidal anti-inflammatory drugs, and acetaminophen and risk of breast cancer among premenopausal women in the Nurses’ Health Study II. Arch Intern Med 169(2): 115-21, 2009.
The researchers looked at the breast cancer mortality risk and the number of days per week of aspirin use (0,1,2 etc.). They found that women who took aspirin two to five days a week had a 60 percent reduced risk of their cancer spreading and a 71 percent lower risk of breast cancer death. Six to seven aspirins a week lowered the risk of spread by 43 percent and the risk of breast cancer death by 64 percent. In the end they concluded that among women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death. The researchers state that more information is needed but the use of aspirin could affect tumor growth or recurrence through a decrease in inflammation.
Interestingly, it was revealed in January 2009 based on data from the Nurses’ Health Study that the use of aspirin or other NSAIDs does not decrease the risk of getting breast cancer among premenopausal women. The information from both of these papers is intriguing and points to the role of inflammation at different stages of a variety of disease states. It is likely that a baby aspirin does more than treat muscle pains, headaches and offer protection from heart disease. More information is needed however, it is promising that anti-inflammatories may have a beneficial role in decreasing mortality risk after cancer.
Holmes MD, Chen WY, Li L, Hertzmark E, Speigelman D, Hankinson SE. Aspirin intake and survival after breast cancer. J Clin Oncol 28(9): 1467-72, 2010.
Eliassen AH, Chen WY, Spiegelman D, Willett WC, Hunter DJ, Hankinson SE. Use of aspirin, other nonsteroidal anti-inflammatory drugs, and acetaminophen and risk of breast cancer among premenopausal women in the Nurses’ Health Study II. Arch Intern Med 169(2): 115-21, 2009.
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