April

Veterinarians have long warned that pain medications like ibuprofen are toxic to pets. And it now looks like merely using a pain relief cream can put cats at risk.

That’s what happened in two households, according to a report issued Friday by the Food and Drug Administration. Two cats in one household developed kidney failure and recovered with attention from a veterinarian. But in a second household, three cats died.

When the veterinarians performed necropsies on the three dead cats, they found physical damage in the cats’ intestines and kidneys, evidence of the toxic effects of nonsteroidal anti-inflammatory drugs, or NSAIDs. NSAIDs include ibuprofen, like Advil and Motrin, and naproxen, which is in Aleve.

Ibuprofen is the most common drug that pets eat, according to the American Veterinary Medical Association, perhaps since many of the pills are candy-coated. In pets, the drugs can cause stomach or intestinal ulcers and kidney failure.

But these cats died by flurbiprofen, another NSAID. In the case of its most recent victims, the cat owner applied a lotion or cream containing flurbiprofen to treat muscle or arthritis pain.

Source: NPR

The risk of developing cancer is significantly higher in survivors of an acute MI compared to the general population, according to a large Danish national registry study.

“Greater focus on long-term cancer risk is warranted in MI survivors. This could potentially have implications on future patient care for MI patients, outpatient follow-up strategies, and distribution of health care resources,” Morten Winther Malmborg said at the annual meeting of the American College of Cardiology.

He presented a nationwide cohort study including 3,005,734 Danish adults with no baseline history of MI or cancer who were followed for up to 17 years in the comprehensive Danish National Patient Registry. During the study period, 125,926 of these individuals had a nonfatal MI.

The subsequent incidence of cancer in the MI survivors was 167 cases per 10,000 person-years compared with 95 per 10,000 person-years in the control group, reported Mr. Malmborg, a fourth-year medical student at the University of Copenhagen.

Source: Family Practice News

If you’re being treated for cancer, an iguana might not be the pet for you.

Ditto if you’re pregnant, elderly or have small children at home.

Pets can transmit dozens of diseases to humans, but doctors aren’t always as good as they should be in asking about pets in the home and humans’ health issues, a study finds.

And that goes for people doctors and animal doctors. “The fact that they’re equally uneducated is concerning,” says Jason Stull, an assistant professor of veterinary preventive medicine at Ohio State University and lead author of the review, which was published Monday in the Canadian Medical Association Journal. “There hasn’t been a great dialogue between the veterinary community, the human health community and the public.”

The people doctors aren’t asking their patients what kind of pets they have, Stull says, and veterinarians aren’t asking owners about health issues that might increase their risk of acquiring unpleasant, even life-threatening, infections. His paper includes a long list of possibilities, including…

Source: NPR

A new study may help explain why glucose tolerance — the ability to regulate blood-sugar levels — is lower at dinner than at breakfast for healthy people, and why shift workers are at increased risk of diabetes.

In a highly controlled study of 14 healthy individuals, a team led by researchers from Harvard-affiliated Brigham and Women’s Hospital (BWH) measured the independent influences that behavioral factors (mealtime, sleep/wake cycle, and more), the body’s internal clock (circadian system), and misalignment between these two components had on a person’s ability to control blood-sugar levels. The team reports its findings — with implications for shift workers and for the general public — in the week of April 13 in PNAS.

“Our study underscores that it’s not just what you eat, but also when you eat that greatly influences blood-sugar regulation, and that has important health consequences,” said co-corresponding author Frank Scheer, Harvard Medical School (HMS) associate neuroscientist and assistant professor of medicine in the Division of Sleep and Circadian Disorders and Departments of Medicine and Neurology at BWH. “Our findings suggest that the circadian system strongly affects glucose tolerance, independent from the feeding/fasting and sleep/wake cycles.”

Source: Harvard Gazette

Companies have added thousands of ingredients to foods with little to no government oversight. That’s thanks to a loophole in a decades-old law that allows them to deem an additive to be “generally recognized as safe” — or GRAS — without the U.S. Food and Drug Administration’s blessing, or even its knowledge.

The loophole was originally intended to allow manufacturers of common ingredients like vinegar and table salt — when added to processed foods — to bypass the FDA’s lengthy safety-review process. But over time, companies have found that it’s far more efficient to take advantage of the exemption to get their products on shelves quickly. Some of these products contain additives that the FDA has found to pose dangers. And even ingredients the agency has agreed are GRAS are now drawing scrutiny from scientists and consumer groups that dispute their safety.

Critics of the system say the biggest concern, however, is that companies regularly introduce new additives without ever informing the FDA. That means people are consuming foods with added flavors, preservatives and other ingredients that are not reviewed at all by regulators for immediate dangers or long-term health effects.

Source: NPR

Hypertension is the primary risk factor for stroke.  However, none of the previously reported trials compared blood pressure control over the treatment period. Our trial attempted to ensure the comparability of blood pressure levels between the treatment groups both at baseline and throughout follow-up, during which blood pressure control was achieved using a standard protocol of enalapril, 10 mg/d, plus other antihypertensive agents as needed. As such, the CSPPT lends further support that folic acid therapy can lead to an additional 21% risk reduction of first stroke compared with antihypertension treatment alone. A synergy of enalapril (an angiotensin-converting enzyme inhibitor) with folic acid is possible based on the findings of a subanalysis in the WAFACS trial.

Inadequate folate intake is prevalent in most countries without mandatory folic acid fortification, including in Asia and other continents. The MTHFR 677 TT variant, which leads to a 60% reduction in the enzyme function, is present in all populations but with variable frequency (usually 2%-25%).  Based on recently published US National Health and Nutrition Examination Survey folate data and our unpublished folate data from the Boston Birth Cohort, there is substantial variability in blood folate levels within the US population and across racial/ethnic groups. We speculate that even in countries with folic acid fortification and widespread use of folic acid supplements such as in the United States and Canada, there may still be room to further reduce stroke incidence using more targeted folic acid therapy—in particular, among those with the TT genotype and low or moderate folate levels.

Source: JAMA

Until recently, the only approved way to dispose of expired or leftover opioid painkillers, such as Oxycontin, Percocet, and Vicodin, was to flush them down the toilet or wait for a drug take-back day nearby. And many of us didn’t bother to throw away the drugs at all.

But because of new rules from the Drug Enforcement Administration, you can now take those medications and others to disposal drop-off spots at pharmacies, hospitals, clinics, and long-term-care centers any time of the year, no appointment needed. (Believe it or not, it used to be illegal for those places to accept unused narcotic drugs.)

Those potent pain relievers—including drugs like codeine, fentanyl (Duragesic and gener­ic), hydrocodone (Vicodin and generic), meperidine (Demerol and generic), morphine, and oxycodone (Oxycontin, Percocet, and generic)­—might otherwise be left in medicine cabinets, where they could be misused (or abused) by household members or taken accidentally. In fact, this sort of overuse and abuse of these drugs contributes to more than 420,000 visits to emergency rooms each year and almost 16,000 deaths, according to the national Centers for Disease Control and Prevention.

Source: Consumer Reports

Living decades with high cholesterol greatly increases the risk for heart disease, according to a recent study that bolsters a push by some doctors for regular cholesterol testing and perhaps early drug treatment of people in their 30s and 40s.

About 37% of young adults have never had their cholesterol checked, according to the Centers for Disease Control and Prevention. And when elevated cholesterol levels are found, doctors typically won’t prescribe a drug until patients are in their 50s or 60s. By then, significant damage from years of cholesterol buildup has been done, the new research indicates.

“If we wait until people are in their 50s and 60s to be thinking about high cholesterol, it is probably too late,” said Ann Marie Navar-Boggan, a cardiology fellow at Duke Clinical Research Institute in Durham, N.C., and lead author of the study, which was published in the journal Circulation in January. The risk of developing heart disease increases by 39% for every 10 years a person lives with high cholesterol, the research found.

Heart disease can be prevented through healthier eating, more exercise and weight loss, though many patients find it difficult to make the necessary lifestyle changes. Although statins have been proved to lower cholesterol and reduce the risk of heart attack, the safety and effectiveness of taking the drugs for several decades hasn’t been closely studied. In short-term studies, some people experience side effects to statins including muscle pains.

Source: WSJ

The Presidential Healthcare Center Provides Advanced Cardiovascular Screening.

Lung cancers is the leading cause of cancer related mortality in the United States, with 159,000 deaths estimated in 2014.  Age older than 55 years and smoking are the strongest risk factors for lung cancer.  Smoking cessation is the main intervention to prevent lung cancer in 20% of Americans who continue to smoke, but only 15% of cessation efforts succeed.  Outcomes in lung cancers depend crucially on the stage of diagnosis, with 5-year survival for non-small cell lung cancer estimates at 71% – 90% for stage IA and 42% – 75% for stage IB cases, compared with less than 10% for those diagnosed with stage IV.  Currently only 15% of lung cancer cases are diagnosed at stage I, and large trials have not supported the value of chest radiography or sputum cytology for screening.  Low-dose computed tomography (CT) has emerged as a potentially useful screening method, with 55% – 85% of detected cancers found to be stage I.  Approximately 9 million Americans would potentially be eligible for this screening guideline, divided roughly equally between current smokers and former smokers who have quit within the past 15 years.

Source: JAMA

The Presidential Healthcare Center’s Executive Physicals include cancer screening and tumor marker tracking.