With the recent blizzard, no one in the Northeast needs reminding that February is in full swing. This means all that shoveling earns you some time to stay warm and cozy and cuddle up with some good reading.  (If you are a lucky southerner, you can cool down from your laps with your reading by the pool.) Either way, it’s time to review some of the top wellness news from last month!

As usual, I’ve provided you with a skim-through and reader-friendly overview. Feel free to go into more detail with the sources and references links if you want to exercise your brain as much as your biceps.

Before I get started, I have a few quick announcements for the beginning of 2015:

1. I’m going to be separating my e-blasts and newsletters into two segments in order to optimize your time and interests. I will continue with my regular newsletters, but I will also have another option to sign up for more frequent weekly e-blasts on essential oils and health tips.

If you are one of my subscribers, make sure to check your inbox for details on this. (If you haven’t been receiving emails and you have subscribed, make sure you skim through your spam or junk folders.)

1. The book is set to release this year. The holdup has been in the editing process and my recent relocation. It’s in its final stages now! I’ll be posting updates for this on my social media pages and this blog

 

Okay, now that the “housekeeping” is out of the way, let’s get to it!

Without more ado, here’s your top wellness news in the areas of nutrigenomics, health, wellness, medications, and integrative, functional, and naturopathic medicine.

 

HEALTH UPDATES

 

 

 

 

 

 

Nature Wins Over Nurture For Immune Response

To study differences in immune robustness between individuals, 204 measurements of different parameters were analyzed among 210 healthy twins (aged 8-82 years). The authors found that 77% of those tested were dominated and 58% almost completely determined by “non-heritable influences.”

In addition, some of these parameters become more variable with age, suggesting the cumulative influence of environmental exposure. Similarly, the serological responses to seasonal influenza vaccination are also determined largely by non-heritable factors, likely due to repeated exposure to different strains.

Source: Variation in the Human Immune System Is Largely Driven by Non-Heritable Influences. Cell. January 2015. http://dx.doi.org/10.1016/j.cell.2014.12.020

 

The Gut-Skin Connection

DNA analysis of gut microbiota and several inflammatory markers were assessed among 15 patients with psoriasis, 16 patients with psoriatic arthritis, and 17 controls:

CONCLUSION: Patients with PsA and patients with skin psoriasis had a lower relative abundance of multiple intestinal bacteria. Although some genera were concomitantly decreased in both conditions, PsA samples had a lower abundance of reportedly beneficial taxa. This gut microbiota profile in PsA was similar to that previously described in patients with inflammatory bowel disease and was associated with changes in specific inflammatory proteins unique to this group, and distinct from that in patients with skin psoriasis and healthy controls…

Note: Patient groups showed a relative decrease in abundance of Coprococcus species, PsA patients also showed a marked reduction in Akkermansia, Ruminococcus, and Pseudobutyrivibrio.

Source: Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. 2015 Jan;67(1):128-39. doi: 10.1002/art.38892.

 

Fat Isn’t All Bad

When in proper balance, a little bit of padding may help ward off infections. When there’s too much, it’s presence can promote pro-inflammatory conditions and autoimmune disease:

Ling Zhang, PhD, the first author of the paper, exposed mice to S. aureus and within hours detected a major increase in both the number and size of fat cells at the site of infection. More importantly, these fat cells produced high levels of an antimicrobial peptide (AMP) called cathelicidin antimicrobial peptide or CAMP. AMPs are molecules used by the innate immune response to directly kill invasive bacteria, viruses, fungi and other pathogens.

Sources:

• Lafee, S. Fat Isn’t All Bad: Skin Adipocytes Help Protect Against Infections. January 05, 2015. UCSD EDU. http://health.ucsd.edu/news/releases/Pages/2015-01-05-fat-cells-fight-infection.aspx
• Dermal adipocytes protect against invasive Staphylococcus aureus skin infection. January 2, 2015; 347 (6217):67-71. DOI: 10.1126/science.1260972.

 

Young and Healthy= Older and Vibrant

A 20 year (1991-2011) follow up prospective analysis found an association between healthy lifestyle choices early on and health outcomes in later years. The study involved 88,940 young women (aged 27 to 44 years) from the Nurses’ Health Study II. Researchers found an inverse relationship to heart disease and risk factors attributed to a healthy lifestyle (not smoking, a normal body mass index, physical activity, television viewing, diet, and intake of alcohol).

Source:Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women. J Am Coll Cardiol. 2015;65(1):43-51. doi:10.1016/j.jacc.2014.10.024

 

Obamacare Mandate Holds In Supreme Court

WASHINGTON (Reuters) – The U.S. Supreme Court on Monday declined to take up another broad challenge to President Barack Obama’s signature healthcare law. The court rejected an appeal filed by the Association of American Physicians and Surgeons and the Alliance for Natural Health USA. The groups had challenged various aspects of the law known as Obamacare including the so-called individual mandate that requires people to obtain health insurance or pay a tax.

Source: Hurley, L. U.S. Top Court Rejects New Challenge to Obamacare Law. Reuters Health Information. January 13, 2015. http://www.medscape.com/viewarticle/837931?src=wnl_edit_medn_wir&uac=146852BY&spon=34

 

Where Does Fat GO? Forget Burning It Off, Breathe It Off?

According to researchers from the University of New South Wales in Australia, when weight is lost, the majority of it is breathed out as carbon dioxide. Their paper is published in the Christmas issue of The BMJ….

Excess dietary carbohydrates and protein are converted to a type of fat called triglyceride. When people attempt to lose weight, they are attempting to metabolize these triglycerides while keeping their fat-free mass intact, explain the authors. Triglycerides are comprised of three types of atom: carbon, hydrogen and oxygen. Triglyceride molecules can be broken down only by unlocking these atoms, through a process known as oxidation.

Source: Majority of weight loss occurs ‘via breathing’. Medical News Today. December 17, 2014. http://www.medicalnewstoday.com/articles/287046.php

 

 

 

 

 

 

 

 

 

 

Click here to read my Top Wellness Updates On Environmental Impacts on Health

 

The Power of Placebo

The small study, involving 12 people, suggests that Parkinson’s patients seem to feel better — and their brains may actually change — if they think they’re taking a costly medication. On average, patients had bigger short-term improvements in symptoms like tremor and muscle stiffness when they were told they were getting the costlier of two drugs. In reality, both “drugs” were nothing more than saline, given by injection. But the study patients were told that one drug was a new medication priced at $1,500 a dose, while the other cost just $100 — though, the researchers assured them, the medications were expected to have similar effects.

Sources:

• Study Underscores Power of Placebo Effect. Yale Medical Group. January 28, 2015. http://yalemedicalgroup.org/info/health.aspx?ContentTypeId=6&ContentId=695894
• American Academy of Neurology. Does getting ‘expensive’ drug affect how much patient benefits? EurekAlert. January 28, 2015. http://www.eurekalert.org/pub_releases/2015-01/aaon-dg012215.php

 

Childhood Adversity Linked to Biological Changes In Mitochondria

This study involved 299 healthy adults who provided information on childhood parental loss and treatment. Subjects were categorized into four groups based on presence or absence of adversity and psychological disorders. Telomere length and mitochondrial DNA were measured to determine cellular aging:

This study provides the first evidence of an alteration of mitochondrial biogenesis with early life stress and with anxiety and substance use disorders. We replicate prior work on telomere length and psychopathology, and show that this effect is not secondary to medication use or comorbid medical illness. Finally, we show that early life stress and psychopathology are each associated with these markers of cellular

Sources:

• Alterations of Mitochondrial DNA Copy Number and Telomere Length with Early Adversity and Psychopathology. Biological Psychiatry; 2015; DOI: 10.1016/j.biopsych.2014.12.025
• Women & Infants Hospital. Connection between childhood adversity, psychiatric disorders seen at cellular level. Science Daily. January 20, 2015. www.sciencedaily.com/releases/2015/01/150120142817.htm.

 

Smile- It’s Good For Your Heart!

Using the American Heart Association’s criteria, a study of 5,000 adults found that the most optimistic people had twice the odds of being in ideal cardiovascular health as their pessimistic counterparts.

Sources:

• University of Illinois at Urbana-Champaign. Optimistic people have healthier hearts, study finds. ScienceDaily. January 9, 2015. www.sciencedaily.com/releases/2015/01/150109123502.htm.
• Optimism and Cardiovascular Health: Multi-Ethnic Study of Atherosclerosis (MESA). Health Behavior and Policy Review, 2015; 2 (1): 62 DOI: 14485/HBPR.2.1.6

 

Smile, It’s Good For Your Bones!

Findings from an ongoing study (Kupio Osteoporosis Risk Factor and Prevention) which included 2167 women who underwent femoral bone mineral density assessment in 1999 and 1147 following up in 2009 was done to investigate factors that influenced bone health.

The researchers gauged life satisfaction via a 4-point scale relating to interest in and easiness of life, happiness, and loneliness. On the basis of responses, the women were divided into a satisfied group, a middle group, and an unsatisfied group.At baseline, the satisfied group had the highest BMD, whereas dissatisfied women had the highest body mass index, the lowest grip strength, and were more likely to be smokers. The dissatisfied group also had higher morbidity and used more medications than the other two groups.

Source: Brooks, M. Happy Life, Happy Bones? Medscape Medical News > Psychiatry. January 15, 2015. http://www.medscape.com/viewarticle/838276?src=wnl_edit_medn_wir&uac=146852BY&spon=34

 

U.S. Mental Health Ranked By State

Although it is too soon to get a big-picture assessment of the effect the Affordable Care Act (ACA) has had on US mental health services, a new report from Mental Health America (MHA, formerly the National Mental Health Association) offers a snapshot of the nation’s mental health care status based on the most recent data, and it is not a pretty picture…

In the overall ranking, the top five states, reflecting the lowest prevalence of mental illness and the highest rates of access to care, were Delaware (5), North Dakota (4), Maine (3), Vermont (2), and Massachusetts, which was ranked number 1.

Source: Melville, N. US Mental Health Services Ranked by State. Medscape Medical News: Psychiatry. January 13, 2015. http://www.medscape.com/viewarticle/838042?src=wnl_edit_medn_wir&uac=146852BY&spon=34

 

TV Viewing & Toddlers

Among 75 children who were frequently exposed to television, young children watched a daily average of 67.4 min of television before age 2, which was excessive according to the American Academy of Pediatrics. Viewing television increased the risk of delayed cognitive, language, and motor development in children who were frequently exposed to television. Cognitive, language, and motor delays in young children were significantly associated with how much time they spent viewing television. The type of care providers was critical in determining the television-viewing time of children.

Source: Ying-Lin Yin et al. Effects of television exposure on developmental skills among young children. Infant Behav Dev. 2014 Dec 25;38C:20-26. doi: 10.1016/j.infbeh.2014.12.005. [Epub ahead of print]

 

 

 

 

 

 

European Study Associates Greater Mortality Risk Reduction With More Activity

A study was done between 1992-2000 with 334,161 men and women participating in the huge epidemiological study known as EPIC (European Prospective Investigation into Cancer and Nutrition). Researchers assessed participants’ height, weight, and waist circumference, and used questionnaires’ to quantify the volunteers’ levels of physical activity at work and home.

Just under a quarter (22.7 percent) of participants were categorized as inactive, because they had a sedentary occupation and reported having no exercise routine or significant physical recreation. The participants were then followed for more than 12 years, during which time 21,438 participants died. A team of EPIC researchers compared the participants’ weight and activity levels to their risk of death, and adjusted the results to account for other known risk factors.

The results linked twice as many deaths to lack of physical activity, compared with fatalities attributable to obesity.

Encouragingly, the analysis showed that modest increases in physical activity could have significant health benefits. The authors estimate that doing exercise equivalent to just a 20 minute brisk walk each day – burning between 90 and 110 calories – would reduce an inactive person’s risk of premature death by an average of 23 percent.

Sources:

• Wetherby, C. Exercise Lack Found Riskier than Obesity. Vital Choice Newsletter. January 9, 2015.
• Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Am J Clin Nutr. January 14, 2015, doi: 10.3945/ajcn.114.100065.
• Nainggolan, L. Inactivity More Deadly Than Obesity, Large New Study Finds. Medscape Medical News. January 15, 2015.

Note: Caveats in heterogeneity of studies and self-reporting.

 

Too Much Sitting Not Okay, Even With Exercise

Meta-analyses was performed on physical activity in relationship to  the health outcomes of cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). All but three studies were prospective cohort designs.

Conclusion: Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity.

Source: Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 2015 DOI: 10.7326/M14-1651

 

Organic Farming May Have Potential To Feed World

Study shows organic farming has potential to yield similar food production as compared to methods using more chemicals that are associated with health concerns.

Here, we revisit this topic comparing organic and conventional yields with a new meta-dataset three times larger than previously used (115 studies containing more than 1000 observations) and a new hierarchical analytical framework that can better account for the heterogeneity and structure in the data. We find organic yields are only 19.2% (±3.7%) lower than conventional yields, a smaller yield gap than previous estimates. More importantly, we find entirely different effects of crop types and management practices on the yield gap compared with previous studies.

Source: 2015 Diversification practices reduce organic to conventional yield gap.Proc. R. Soc. B 282:20141396. http://dx.doi.org/10.1098/rspb.2014.1396.

Other Sources:

• UC Berkley: http://newscenter.berkeley.edu/2014/12/09/organic-conventional-farming-yield-gap/
• Increasing Cropping System Diversity Balances Productivity, Profitability and Environmental HealthPlos One.October 10, 2012. DOI: 10.1371/journal.pone.0047149.

 

Is Big Business Hiding GMO Concerns?

According to a new report from the nonprofit group, U.S. Right to Know, we are not getting all the information we need to make decisions about GMOs.

Read the press release here.

Read the report here. (Organic Consumers Association. Seedy Business.USRTK. January 2015. https://www.organicconsumers.org/sites/default/files/seedybusiness.pdf)

 

California’s “Seal” On Eggs

Within just a few days, on Jan. 1, all eggs sold in California will have to come from chickens that live in more spacious quarters — almost twice as spacious, in fact, as the cages that have been the industry standard.

Source: Charles, D. How California’s New Rules Are Scrambling The Egg Industry. NPR. December 29, 2014. http://www.npr.org/blogs/thesalt/2014/12/29/373802858/how-californias-new-rules-are-scrambling-the-egg-industry

 

Do Viruses Make Us Smarter?

Inherited viruses that are millions of years old play an important role in building up the complex networks that characterize the human brain, researchers say. They have found that retroviruses seem to play a central role in the basic functions of the brain, more specifically in the regulation of which genes are to be expressed, and when.

Sources:

• Liana Fasching, Adamandia Kapopoulou, Rohit Sachdeva, Rebecca Petri, Marie E. Jönsson, Christian Männe, Priscilla Turelli, Patric Jern, Florence Cammas, Didier Trono, Johan Jakobsson. TRIM28 Represses Transcription of Endogenous Retroviruses in Neural Progenitor Cells. Cell Reports. 2015; 10 (1): 20 DOI: 10.1016/j.celrep.2014.12.004
• Lund University. Do viruses make us smarter? ScienceDaily. January 12, 2015. www.sciencedaily.com/releases/2015/01/150112093129.htm

 

ZERO Deaths from Supplements In 2013 – Annual Report In Poison Exposure

The top five substance categories most frequently involved in human poisonings were analgesics (12%), cosmetics/personal care products (8%), household cleaning substances (8%), sedatives/hypnotics/antipsychotics (6%) and antidepressants (4%).

The full text article is available for free download at http://www.aapcc.org/annual-reports/ . Minerals, herbs, amino acids and other supplements are in table 22B, pages 1247-1249. (pg 217 downloaded)

Sources:

• 2013 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 31st Annual Report. Clinical Toxicology (2014), 52, p 1032-1283. ISSN: 1556-3650 print / 1556-9519 online. DOI: 10.3109/15563650.2014.987397.
• American Association of Poison Control Centers Releases Annual Poison Exposure Report. December 29, 2014. http://www.aapcc.org/press/38/

 

NUTRIGENOMICS

 

Sugar Verses Fructose

A mouse study found rodents with higher fructose diets over 40 weeks had detrimental effects in females in regard to reproductive health and mortality rates. No difference was found in males. The diets were composed of 25% calories from either an equal ratio of fructose/glucose or sucrose or 63% of calories from carbohydrates.

Sources:

• Compared to Sucrose, Previous Consumption of Fructose and Glucose Monosaccharides Reduces Survival and Fitness of Female Mice. J. Nutr. March 1, 2015. doi: 10.3945/jn.114.202531
• University of Utah. Fructose More Toxic than Table Sugar in Mice. January 5, 2015.http://unews.utah.edu/news_releases/fructose-more-toxic-than-table-sugar-in-mice/

 

More On the Sweet Spot Of Salt

Researchers analyzed 10-year follow-up data from a prospective cohort study of 2642 older adults (age range, 71-80 years) to determine the effect of dietary sodium intake and incidence of cardiovascular disease and heart failure.

 In older adults, food frequency questionnaire–assessed sodium intake was not associated with 10-year mortality, incident CVD, or incident HF, and consuming greater than 2300 mg/d of sodium was associated with nonsignificantly higher mortality in adjusted models.

Source: Dietary Sodium Content, Mortality, and Risk for Cardiovascular Events in Older AdultsThe Health, Aging, and Body Composition (Health ABC) Study. JAMA Intern Med. Published online January 19, 2015. doi:10.1001/jamainternmed.2014.6278

 

The Balance of Fish Oil

An analysis of the Seychelles Child Development Study Nutrition Cohort 2, an observational study in the Republic of Seychelles which is a high fish-eating population, was done to investigate the associations of prenatal methyl mercury (MeHg) exposure and maternal fatty acid (PUFA) status on child development at 20 months of age.

Among 1265 mother-child pairs with complete data, it was found that mothers with higher omega-3 fatty acid status and increased mercury exposure had children with improved psychomotor development. (Could selenium be protective in combination with healthy fats?)

However, increased mercury exposure in mothers with higher omega 6-fatty acid to omega-3 fatty acid ratios had children with lower psychomotor development. Furthermore, higher levels of DHA (docosahexaenoic acid) was associated with higher communicative development and elevated omega 6/omega 3-fatty acid ratios were associated with poor scores on measures of communicative development. (This means ratio of healthy fats is important.)

Sources:

• Prenatal exposure to methyl mercury from fish consumption and polyunsaturated fatty acids: associations with child development at 20 mo of age in an observational study in the Republic of Seychelles. American Journal of Clinical Nutrition. January 2015 DOI: 10.3945/ajcn.114.100503
• University of Rochester Medical Center. Fatty acids in fish may shield brain from mercury damage. ScienceDaily. January 21, 2015. www.sciencedaily.com/releases/2015/01/150121144835.htm

 

Carb Restriction and Diabetes

Abstract excerpt:

Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.

Source: Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015 Jan;31(1):1-13. doi: 10.1016/j.nut.2014.06.011. Epub 2014 Jul 16.

 

Nordic Diet Influences Inflammation

Fifty-six obese adults with metabolic syndrome features took part in an 18-24 week randomized intervention study to compare the effects of a Nordic diet (ND) with a control diet (CD) on gene expression. The subjects were selected from the SYSDIET study, carried out within the Nordic Centre of Excellence of the Systems Biology in Controlled Dietary Interventions and Cohort Studies. The researchers measured SAT (subcutaneous adipose tissue) biopsy samples before and after the intervention and analyzed global transcriptome analysis to assess for gene pathways influenced. They found that 128 genes were expressed in the SAT samples differently in the ND and CD.

Conclusion: A healthy Nordic diet reduces inflammatory gene expression in SAT compared with a control diet independent of body weight change in individuals with features of the metabolic syndrome.

Source: Healthy Nordic diet downregulates the expression of genes involved in inflammation in subcutaneous adipose tissue in individuals with features of the metabolic syndrome. Am J Clin Nutr. 2015 Jan;101(1):228-39. doi: 10.3945/ajcn.114.092783. Epub 2014 Nov 19.

 

An Avocado a Day Keeps the Heart Doctor Away?

A randomized, crossover, controlled trial with 45 overweight or obese participants with high LDL-C levels (low density lipoprotein cholesterol) was done to assess the effects of a lower-fat diet, and two moderate-fat diets. The moderate-fat diets contained either an avocado diet (AV) or high oleic oils to match the avocado nutrient profile.

 Inclusion of one avocado per day as part of a moderate–fat, cholesterol-lowering diet has additional LDL–C, LDL–P, and non–HDL–C lowering effects, especially for small, dense LDL. Our results demonstrate that avocados have beneficial effects on cardio–metabolic risk factors that extend beyond their heart?healthy fatty acid profile.

Source: Effect of a Moderate Fat Diet With and Without Avocados on Lipoprotein Particle Number, Size and Subclasses in Overweight and Obese Adults: A Randomized, Controlled Trial. J Am Heart Assoc. 2015; 4: e001355 originally published January 7, 2015 doi: 10.1161/JAHA.114.001355

 

Blueberries and Heart Health in Postmenopausal Women

The effects of daily blueberry consumption (22 g freeze-dried blueberry powder) by 48 postmenopausal women with pre-and stage 1-hypertension was done to assess this fruit’s effects on blood pressure and arterial stiffness over 8 weeks.

Conclusions: Daily blueberry consumption may reduce blood pressure and arterial stiffness, which may be due, in part, to increased nitric oxide production.

Source: Daily Blueberry Consumption Improves Blood Pressure and Arterial Stiffness in Postmenopausal Women with Pre- and Stage 1-Hypertension: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Acad Nutr Diet. 2015 Jan 2. pii: S2212-2672(14)01633-5. doi: 10.1016/j.jand.2014.11.001

 

Tumeric Enhances Synthesis Of DHA In Tissue Study

Curcumin (diferuloylmethane), which is a principal component of the spice turmeric, complements the action of DHA in the brain, and this study was performed to determine molecular mechanisms involved. We report that curcumin enhances the synthesis of DHA from its precursor, ?-linolenic acid (C18:3 n-3; ALA) and elevates levels of enzymes involved in the synthesis of DHA such as FADS2 and elongase 2 in both liver and brain tissues. Furthermore, in vivo treatment with curcumin and ALA reduced anxiety-like behavior in rodents. Taken together, these data suggest that curcumin enhances DHA synthesis, resulting in elevated brain DHA content.

Sources:

• Curcumin boosts DHA in the brain: Implications for the prevention of anxiety disorders. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease. December 27, 2014. doi:10.1016/j.bbadis.2014.12.005
• Ji, S. Why Tumeric May Be a Vegetarians Best Friend. Green Med Info. January 3, 2014. http://www.greenmedinfo.com/blog/why-turmeric-may-be-vegetarians-best-friend

 

MEDICATION UPDATES

Use Of Birth Control Linked to Odds Of Glioma

This study included 317 cases of glioma (tumor originating in the brain or spine) and 2,126 controls to assess the relationship of hormonal birth control and tumor incidence. Use of hormonal contraceptives was associated with incidence of glioma, with progesterone-only and duration of use increasing this association.

Source: Hormonal contraceptive use and risk of glioma among younger women a nationwide case-control study. British Journal of Clinical Pharmacology, 2014; DOI: 10.1111/bcp.12535

 

Implantable Device Approved for Obesity

The US Food and Drug Administration (FDA) has approved a novel implantable device for treating obesity.

Source: Tucker, M. FDA Approves Novel Implanted Device for Treating Obesity. Medscape Medical News. January 14, 2015.

 

FDA Updates Labels for Pregnant and Breastfeeding Women

The following updates go into effect June 30, 2015, allowing a few years for previous approved drugs to adjust:

• The “pregnancy,” “labor and delivery,” and “nursing mothers” subsections will be replaced with subsections titled “pregnancy,” “lactation,” and a new subsection titled “females and males of reproductive potential.”
• The pregnancy and lactation subsections will include information from available human and animal studies, known or potential maternal or fetal adverse reactions, and dose adjustments needed during pregnancy and the postpartum period.
• The subsection on females and males of reproductive potential will include information on pregnancy testing, birth control, and the drug’s possible effect on fertility when needed.

Source: FDA Updates Labels for Pregnant and Breastfeeding Women. FDA on Medscape > FDA Expert Interview. Medscape.com. January 9, 2015.

 

Laxative Use In Children

More than 7,000 reports related to an active ingredient in laxatives have been filed by the FDA’s Adverse Event Reporting System (FAERS). Among these events were neurological problems due PEG 3350.

• Miralax and other laxatives with the active ingredient polyethylene glycol 3350 (PEG 3350) are commonly given to children even though they’re only approved for use in adults…
• An FDA study detected small amounts of the antifreeze chemicals ethylene glycol (EG) and diethylene glycol (DEG) in PEG laxatives

Sources:

• Scrutiny for Laxatives as a Childhood Remedy. Mercola.com. January 21, 2015. http://articles.mercola.com/sites/articles/archive/2015/01/21/miralax-laxatives.aspx
• Scrutiny for Laxatives as a Childhood Remedy. New York Times. January 5, 2015. http://www.nytimes.com/2015/01/06/science/scrutiny-for-a-childhood-remedy.html?partner=rss&emc=rss&_r=4
• Department of Health and Human Services. The Use of Polyethylene Glycol in the Pediatric Population (R01). June 4, 2014. http://grants.nih.gov/grants/guide/rfa-files/RFA-FD-14-088.html#sthash.tOmGkbMM.dpuf.

 

Meta-Analysis Comparing Treatments for Knee Osteoarthritis- Hyaluronic Acid Wins

Data was analyzed from 137 studies and 33,243 participants to assess pain and stiffness treatments for knee osteoarthritis. The studies were of short term duration and included randomized trials with acetaminophen, diclofenac, ibuprofen, naproxen, celeocoxib, intra-articular (IA) corticosteroids, IA hyaluronic acid, oral placebo, and IA placebo.

For pain, all interventions significantly outperformed oral placebo, with effect sizes from 0.63 (95% credible interval [CrI], 0.39 to 0.88) for the most efficacious treatment (hyaluronic acid) to 0.18 (CrI, 0.04 to 0.33) for the least efficacious treatment (acetaminophen). For function, all interventions except IA corticosteroids were significantly superior to oral placebo. For stiffness, most of the treatments did not significantly differ from one another.

Source: Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2015;162(1):46-54. doi:10.7326/M14-1231

 

Influenza Season Harsher Than Expected, Viral Mutation Drift Underestimated By Shot

Earlier this month, CDC Director Thomas Frieden, MD, MPH, cited two reasons why influenza may hit especially hard in the season that began on October 1. The first is that A(H3N2), the principal virus in circulation, typically is more virulent than others, causing twice as many hospitalizations and deaths. Compounding this bad draw of viruses is a recent genetic mutation or drift in the strain of A(H3N2) virus chosen for the 2014 to 2015 vaccine, which makes the shot less effective.

Source: Robert Lowes. Influenza Hospitalizing Twice as Many as Last Year. December 30, 2014. Medscape Medical News.

 

Seasonal Influenza Vaccine Estimated At 23% Effective

An early analysis of the 2014 to 2015 influenza season notes that two thirds of the circulating influenza A (H3N2) viruses differ from the H3N2 component of the 2014 to 2015 influenza vaccine. The 2014 to 2015 seasonal influenza vaccine is thus estimated to be only 23% effective in preventing medically attended, laboratory-confirmed influenza H3N2 infection in the overall population. Vaccine effectiveness against H3N2 viruses is estimated at just 12% for individuals aged 18 to 49 years.

Sources:

• Morb Mortal Wkly Rep. 2015;64:10-15. Full text
• Pullen, L. Seasonal Influenza Vaccine Only 23% Effective This Year. Medscape Medical News.January 15,2015. http://www.medscape.com/viewarticle/838241?src=wnl_edit_medn_wir&uac=146852BY&spon=34

Other Flu Sources:

• Situation Update: Summary of Weekly FluView. January 16, 2015 Season. http://www.cdc.gov/flu/weekly/summary.htm
• Transcript for CDC Telebriefing: Update on Flu Season 2014-15. December 2014. http://www.cdc.gov/media/releases/2014/t1204-flu-season.html
• Fischer, B. Another Epic Fail For Flu Vaccine. Mercola.com. January 20, 2015. http://articles.mercola.com/sites/articles/archive/2015/01/20/epic-fail-influenza-vaccine.aspx

 

New Influenza Test In Office

In June, the FDA approved the Alere i Influenza A & B Test (Alere Inc), but limited it to laboratories designated to perform tests of moderate and high complexity under federal regulations called the Clinical Laboratory Improvement Amendments (CLIA). Today, the agency issued a CLIA waiver for the test so it could be used in nontraditional laboratory sites such as physician offices, hospital emergency departments, and health department clinics. It is the first CLIA waiver granted to a nucleic acid-based test.

Source: Molecular 15-Minute Flu Test Cleared for Physician Offices. FDA Approvals > Medscape Medical News. January 6, 2015.

 

Vaccine Adverse Event Reporting System On Hib Vaccine (1990-2013)

Results: VAERS received 29?747 reports after Hib vaccines; 5179 (17%) were serious, including 896 reports of deaths. Median age was 6 months (range 0-1022 months). Sudden infant death syndrome was the stated cause of death in 384 (51%) of 749 death reports with autopsy/death certificate records…

Key: adverse events (AEs), Haemophilus influenzae type b (Hib) vaccines

Source: Adverse Events following Haemophilus influenzae Type b Vaccines in the Vaccine Adverse Event Reporting System, 1990-2013. J Pediatr. 2015 Jan 15. pii: S0022-3476(14)01163-9. doi: 10.1016/j.jpeds.2014.12.014Bottom of Form

 

Antibiotic May Increase Risk of Side Effects When Combined With Statin

Combining a statin not metabolized by cytochrome P450 3A4 (CYP3A4) with the antibiotic clarithromycin is associated with an increased risk of adverse events, according to the results of a new analysis. Individuals taking rosuvastatin (Crestor, AstraZeneca), pravastatin, or fluvastatin with clarithromycin had a 65% increased risk of hospitalization for acute kidney injury, a more than twofold increased risk of hyperkalemia, and a 43% increased risk of all-cause mortality compared with individuals taking non-CYP3A4-metabolized statins and azithromycin^[1].

Source: ‘Modest’ Increased Adverse-Event Risk With Clarithromycin Plus Some Statins. Medscape:Heartwire. December 29, 2014.

 

Antipsychotics Off Label Use- 50% in UK

More than half of the prescriptions for antipsychotics in the United Kingdom are prescribed to individuals with no diagnosis of a serious mental illness (SMI), a major study of primary care records has revealed. Investigators at University College London also found that off-label antipsychotic prescribing is more likely to occur in women, older people, and socially and economically disadvantaged individuals.

Source: Davenport, L. More Than 50% of Antipsychotics Prescribed Off Label. December 30, 2014. Medscape Medical News > Psychiatry.