SciQuest.org

A common acne medication that has been available for over 30 years has the potential to delay the progress of multiple sclerosis and if proven effective, will offer an inexpensive option for the treatment of early MS, says the MS Society of Canada.

Clinical researchers in Calgary and 13 other Canadian centres will be taking an in-depth look at an oral therapy known as minocycline after initial studies have shown promising results. A new $4 million multi-centre clinical trial involving 200 participants from across Canada is being funded through the MS Society’s related MS Scientific Research Foundation.

“The benefits of minocycline are straight forward: it’s relatively cheap, has few side effects and can be taken in pill format,” says Dr. Luanne Metz, principal investigator for the study and a professor of clinical neurosciences at the University of Calgary Faculty of Medicine. “The aim of our research is to see if this common drug can reduce the occurrence of further disease activity in people who have experienced an initial attack of MS symptoms and who are at high risk of progressing to definite MS. Without treatment, two thirds of people facing this circumstance are expected to be diagnosed with MS within 6 months. We believe minocycline can reduce this number. “

In MS, myelin, which is the protective coating of the nerve fibres of the brain and spinal cord, becomes inflamed. This inflammation can be seen as characteristic lesions by magnetic resonance imaging (MRI). Previous clinical tests of minocycline have shown an 84 per cent reduction of MS lesion activity on MRI.

“There is obvious benefit in delaying the rate of disease progression in MS, from improved quality of life to reduced healthcare expenses,” says Dr. William McIlroy, national medical advisor for the MS Society of Canada. “The breadth of the study, the reputation of the researchers involved and the early clinical data supports the view that there is considerable promise for minocycline. We would not be involved if this were not the case.”

Minocycline works by inhibiting the activities of an enzyme and immune cells that are keys to initiating MS attacks. It has been used in acne treatment for its anti-bacterial effects but studies have shown its anti-inflammatory properties could be important factors in slowing down MS. These insights were discovered through pioneering research funded by the MS Society of Canada and led by Dr. V. Wee Yong at the University of Calgary (U of C). Drs. Metz and Yong lead the MS program at the Hotchkiss Brain Institute at U of C where many of the early studies on minocycline took place.

In comparing minocycline to current therapies, the cost savings would be substantial. In generic form, minocycline is available for as low as $800 per year. Current MS therapies can cost between $18,000 and $40,000 per year. Researchers note that minocycline would not necessarily replace current therapies, but might delay the timeframe in which they would be required.

The study will be randomized and double-blind by design. Investigators will compare 100 mg of oral minocycline twice daily to placebo over a period of two years.

Enrolment will begin in early 2008 and 14 MS clinics are involved including institutions in Calgary, Vancouver, Burnaby, Edmonton, Red Deer, Saskatoon, London, Toronto, Kingston, Ottawa, Montreal, Quebec City, Sherbrooke and Halifax.

Another disease can be added to the list of smoking-related disorders - psoriasis. Researchers have found that smoking increases the risk of developing psoriasis, heavier smoking increases the risk further, and the risk decreases only slowly after quitting. Investigators from the Massachusetts General Hospital, Brigham and Women’s Hospital, the Harvard School of Public Health, all in Boston, USA, and Vancouver General Hospital, Vancouver, BC, Canada, have published the results in the November 2007 issue of The American Journal of Medicine.

This study is the largest prospective assessment of multiple markers of smoking status, duration, and intensity in relation to the risk of psoriasis. Using data from the Nurses Health Study II (NHS II), an ongoing longitudinal study of 116,608 female registered nurses from 15 states between the ages of 25 and 42 years at baseline who completed and returned an initial questionnaire in 1989, the researchers documented 887 incident cases of psoriasis during the 14 years of follow-up. Lifetime smoking exposure was measured in pack-years, equal to smoking 20 cigarettes per day for one year.

Compared with women who never smoked, the risk of psoriasis was 37% higher among past smokers and 78% higher among current smokers. Pack-years were associated with a graded increase in the risk for psoriasis. Compared with never smokers; the risk was 20% higher for 1-10 pack-years, 60% higher for 11-20 pack-years, and more than two times higher for ≥21 pack-years. The significant trends persisted with smoking duration in both current and past smokers. Furthermore, exposure to passive smoke during pregnancy or childhood was associated with an increased risk of psoriasis. The risk of psoriasis among former smokers decreases nearly to that of never smokers 20 years after cessation.

Writing in the article, Hyon K. Choi, MD, DrPH, states, “These findings, along with well-established hazardous health effects of smoking, provide clear incentives for smoking cessation in those at risk for and suffering from psoriasis. Beyond the potential effect on psoriasis, smoking cessation would lead to a better overall clinical outcome in psoriasis patients, who often suffer co-morbidities related to smoking.”

The study is “Smoking and the Risk of Psoriasis in Women: Nurses’ Health Study II” by Arathi R. Setty, MD, MPH, Gary Curhan, MD, ScD, and Hyon K. Choi, MD, DrPH. It appears in The American Journal of Medicine, Volume 120, Issue 11 (November 2007), published by Elsevier.

Every Sunday the new Post Secrets are online. They only last a week. Don’t miss out at this sad, amusing, wonderful look at mankind.

Under new guidelines experienced nurses in Britain will be given the power to decide on the resuscitation of patients; it is thought the move will avoid the “heartache” many families experience over what are often futile efforts at revival.

The Royal College of Nursing said its members were often in the best position to decide if someone should receive cardiopulmonary resuscitation (CPR) or be left to die in dignity.

The guidelines which were published last week will extend the power of judgment in such matters to “suitably experienced” nurses; currently it is only consultants and family doctors who are allowed to make that decision.

The new guidelines signal an agreement by the British Medical Association (BMA), the Royal College of Nursing and the Resuscitation Council; they aim to prevent the “unnecessary” resuscitation of patients who would not benefit.

Regardless of how it may be portrayed in films and television, the reality of CPR is that survival rates can be as low as 5% for certain individuals and the Resuscitation Council says it can be a prolonged and traumatic procedure.

Health professionals say that decisions about CPR may be extremely distressing for patients and those emotionally close to them.

According to the new guidelines each patient should be individually assessed and a plan of treatment communicated to all healthcare professionals who come into contact with them.

Dr. Peter Carter, general secretary of the Royal College of Nursing (RCN), says very often it is the nurse who has the closest bond with the patient and their family and is in the best position to decide if CPR is in their interest.

Dr. Carter says CPR is not the miracle cure all TV dramas would have us believe and in reality survival rates are very low.

Dr. Carter also says the guidance has the backing of doctors and the Resuscitation Council and should help spare patients and their families the heartache and indignity of repeated and sometimes futile resuscitation attempts.

The guidelines stress that the only nurses with this authority should be those that are suitably experienced and also clearly states that it is not always appropriate to distress a person who is dying, perhaps in the last few days of life, by discussing attempted resuscitation when clearly CPR would not be successful.

The new guidance also has the support of the Patients Association.

An implantable brain device meant to help Parkinson’s disease patients better control their movements, has been found to have some worrying side-effects.

Parkinson’s disease is a brain degenerative disorder that results from the deterioration of nerve cells in the brain that produce dopamine; it is a degenerative disorder of the central nervous system that affects the sufferer’s motor skills and speech.

It’s characteristics are muscle rigidity, tremor, difficulty walking and balancing, a slowing of physical movement and in extreme cases, a loss of physical movement.

Parkinson’s disease is both chronic and progressive and while there is no known cause the symptoms are sometimes the result of toxicity, drugs, genetic mutation, head trauma, or other medical disorders.

The implantable brain device delivers ‘Deep Brain Stimulation’ (DBS), which initially offered significant benefits; however gradually some rather unsettling side effects began to appear.

It seems the DBS affected the ability of some patients to act rationally in certain situations.

The human brain is designed in such a way that when we are up against a tricky situation we stop and consider.

The DBS implant, while it stops the tremors experienced by Parkinson’s patients, appears to take away this inhibition and makes people much more impulsive.

In a study involving 46 participants, 15 were Parkinson’s patients who were taking dopamine drugs, 17 had received the DBS implant, while the other 14 were healthy elderly adults who did not have Parkinson’s.

All were asked to tackle specialized computer games which tested their decision making behavior.

The first test used pairs of Japanese written characters and the participants were asked to select the ‘correct’ one in each pair.

The participants gauged their progress by observing the computer’s response to each of their decisions - the computer would respond with either ‘correct’ or ‘incorrect’.

The idea is that the more the game is played and the computer response watched, the more skilled the player becomes at spotting the correct characters.

When the symbols after a while were paired differently so that there might be pairs which were both correct, pairs which were both incorrect, and mixed pairs, the patients on dopamine and the healthy participants hesitated, while the DBS patients did not hesitate at all.

As soon as the implants were switched off the DBS patients also started to hesitate, which not only demonstrated that the implants were encouraging impulsive behavior, it also showed that the implants did not block learning (otherwise the patients would not have hesitated as they would not have learnt anything during the first round ).

Experts have known that Parkinson’s medications can sometimes trigger compulsions, such as pathological gambling and the DBS device appears to stop the patients thinking rationally at times, with the result that decisions are made or things are done which are later regretted.

Experts say despite this undesirable side effect the benefits of the device nevertheless far outweigh the negatives.

They believe they are not a reason to avoid the therapy but rather that adjustments should be made to benefit the patient’s quality of life.

The researchers say when the brain stimulation was turned off, the Parkinson’s patients with the devices acted totally normally, regaining the ability to think appropriately under stressful situations.

The study is published in the journal Science.

Chinese experts say they have found that pregnant women infected with the H5N1 bird-flu virus can pass the disease on to their unborn babies.

In a study by scientists at Peking University tissue taken from the body of a 24-year-old pregnant woman who died from bird flu, found the virus was also present in the placenta and had infected the fetus.

Gu Jiang, director of the School of Basic Medical Sciences which is affiliated to Peking University, says this however does not mean that the bird flu virus can be transmitted from one person to another.

Gu Jiang who led the study says the virus was also found in the alimentary canal, brain, blood cells and respiratory tract of both the mother and the fetus and the unborn child’s lungs and liver were also affected.

Gu Jiang says to date no substantiated case of inter human transmission has been recorded but all will depend on how the virus further mutates.

Gu says his research project, which also involved studying tissue from a 35-year-old man killed by the virus, was the eighth of its kind worldwide and is significant for the treatment and prevention of bird flu.

Gu says blood and feces from people infected with the virus must be handled extremely carefully to avoid further spreading of the disease.

The World Health Organization (WHO) also says example of transfer does not prove that the virus can be transmitted from one human to another, as the mother and her unborn child are considered to function as one body.

Latest reports say that that bird flu outbreaks have occurred in Vietnam’s northern Cao Bang Province bringing the number of localities in Vietnam affected by the disease to three.

According to officials a total of 480 ducks and 80 chickens in 13 households in Trung Khanh district were infected with the H5N1 bird flu virus strain and local veterinary officials have collected all the infected birds and isolated the affected areas.

A £12m million study has found that organic foods are healthier than ordinary produce because they contain more antioxidants.

The study which was funded by the European Union (EU) is believed to be the most expensive one ever conducted into the value of organic produce.

The study involved researchers growing fruits and vegetables on a 725 acre area where fields were split into two so that conventional and organic produce could be grown side by side.

The study has allowed scientists to compare organic and regular foods and test whether organic foods are a better health option.

The area was attached to Newcastle University and other sites across Europe were also used.

The research has revealed that milk from organic herds of cattle contained 90 percent higher levels of antioxidants than the milk from non-organic cattle - antioxidants are thought to prevent cancer and heart diseases.

The study also revealed that organic food contained more beneficial minerals such as iron and zinc.

According to Professor Carlo Leifert, the coordinator of the four-year study, the results of the research are useful because it demonstrates a way for people who do not eat the recommended portions of fruits and vegetables a day, to increase their intake of nutrients.

Findings from the project which is the first to investigate systematically the physiology of produce from the different farming techniques, will be peer reviewed and published over the next 12 months.

Professor Leifert, who is the leader of the “QualityLowInput-Food (QLIF)” project says the research has shown up to 40% more beneficial compounds in vegetable crops and up to 90% more in milk; it has also found high levels of minerals such as iron and zinc in organic produce.

The results support other studies which have also shown that organic food is healthier; a recent Californian study comparing organic tomatoes with those grown conventionally, found the organic ones had double the level of flavonoids, an antioxidant thought to reduce the risk of heart disease.

The QLIF project involves 33 academic centres across Europe and is led by Newcastle University.

According to new research smokers have a higher risk of developing the skin condition psoriasis.

Psoriasis affects millions of people and there are many different forms of the disease.

It is a disease which affects the skin and joints and causes red scaly patches to appear on the skin.

The scaly patches are areas of inflammation and excessive skin production and skin plaques quickly accumulate at these sites with a silvery-white appearance.

The plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals.

Psoriasis is thought to be related to the body’s immune system and is not contagious but is a chronic recurring condition which varies in severity from minor localised patches to complete body coverage; fingernails and toenails are often affected.

Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis which affects ten to fifteen percent of people with psoriasis.

While the exact cause of psoriasis is unknown, but it is believed to have a genetic basis and several factors are thought to aggravate the condition including stress, excessive alcohol consumption, and smoking.

Individuals with psoriasis may suffer from depression and loss of self-esteem so quality of life is an important factor in evaluating the severity of the disease.

There are many treatments available but because of its chronic recurrent nature psoriasis is a challenge to treat.

It is common knowledge that cigarette smoke contains hundreds of toxins and chemicals and cigarette smoking has been linked to a plethora of diseases and conditions.

The U.S. researchers suggest that heavy smokers have a greater risk of the skin condition and which remains for years after they have quit.

The study of 79,000 nurses by researchers at the Harvard Medical School in Boston and the University of British Columbia in Vancouver, Canada, found that people with psoriasis who smoked had the more severe disease.

They believe the toxins in cigarette smoke may affect parts of the immune system associated with psoriasis.

Previous research has also implied a link between smoking and psoriasis but it was unclear whether smoking occurred before the onset of the condition.

This latest study provides long-term data as it reported on 887 cases of psoriasis over a 14-year study period.

The researchers found that compared with women who never smoked, the risk of psoriasis was 37% higher among past smokers and 78% higher among current smokers; what is more the heavier the smoking habit, the higher the risk appeared to be and it took as long as two decades after stopping smoking before the risk fell back to that of non-smokers.

The team also found that exposure to passive smoke during pregnancy or childhood was associated with an increased risk of psoriasis.

Study leader, Dr. Hyon Choi says the findings provide a clear incentive for those with psoriasis to stop smoking as well as those at risk of the condition.

Dr. Choi says stopping smoking may decrease the level of smoke induced inflammation in the body by lowering levels of circulating immune cells.

Experts say people with psoriasis should always aim to cease smoking for their general health and to help improve their psoriasis but psoriasis remains an immensely complex condition and there are people with psoriasis who do not and have never smoked.

The research is published in the American Journal of Medicine.

According to the latest survey as many as one-third of American adults is under extreme stress.

An online survey by the American Psychological Association(APA) has revealed that 32 percent say they are experiencing extreme stress but this is just one of many worrying revelations of the survey.

The survey of 1,848 adults was carried out in September and was conducted by Harris Interactive on behalf of the APA.

It was also found that within the previous month, 77 percent of the respondents had experienced a number of physical complications such as fatigue, headache, upset stomach, muscle tension, change in appetite, teeth grinding, change in sex drive, and feeling dizzy, as a result of stress.

Seventy three percent had also endured psychological discomforts within the previous month such as irritability, anger, nervousness, lack of energy, and feeling on the verge of tears, again as a result of stress.

It was found that work and money were identified by the respondents as the foremost inducers of stress, with 74 percent and 73 percent respectively.

Workload and children came a close second at 66 and 64 percent, followed by health concerns (55 percent) and health problems affecting a spouse, partner or children (55 percent).

Housing costs and intimate relationships were found at the bottom of the scale, although they nevertheless garnered a significant amount of votes with 51 percent and 47 percent.

Stress also affected sleep with 48 percent saying that they had lost 21 hours of sleep during the last 30 days; while 43 percent of Americans overate and indulged in unhealthy foods due to stress.

As many as 60 percent of the respondents said they would change their lifestyle if it made them feel better, while 38 percent said they would change if their spouse or partner recommended it; 70 percent thought a mental health professional could help them.

The research is published by the American Psychological Association.

The Canadian Food Inspection Agency (CFIA) has issued a warning to the public regarding various beef products.

According to the CFIA the products may be contaminated with E. coli O157:H7 bacteria and have now been recalled.

The affected products were found as result of the CFIA’s investigation and traceback conducted on contaminated beef involving the now defunct Canadian meatpacker Ranchers Beef, in Balzac, Alberta.

The CFIA believes the meat plant was the “likely source” of beef that caused an outbreak of food-borne illnesses in the United States and Canada, which resulted in almost 100 cases of illness.

The U.S. Food Safety and Inspection Service (FSIS) says a comparison of “DNA fingerprints” of beef samples pointed to the Ranchers Beef company.

The FSIS has advised U.S. food makers not to use boneless beef “trim” from Ranchers Beef and to hold all raw products made from it until both nations complete the investigation.

The FSIS removed Ranchers Beef’s approval as an importer on October 20th and the meatpacker was linked to the contaminated products which prompted the Topps Meat expanded recall on September 29th.

Topps Meat was the largest U.S. producer of frozen beef patties; the recall which involved 21.7 million pounds of beef resulted in the demise of the company.

Ranchers Beef ceased operating on August 15th but some of its products remained in storage and were tested by CFIA as part of its investigation into illnesses in Canada.

The U.S. Center of Disease Control and Prevention (CDC) says the PFGE patterns from Ranchers Beef matched those from patients who became ill and from beef samples taken by New York state officials.

The CFIA says 45 cases of illness caused by E. coli were reported in five Canadian provinces from July to September, which included one death.

The CDC says as of last Friday there have been 40 reported illnesses under investigation in eight U.S. states.

The products in question are boneless chuck steak and ground beef products sold at Shoppers Wholesale and Mr. G retail outlets in Prince George between June 20 and June 30 and ground beef sold at Buy-Low Foods in Lillooet between August 14th and 24th.

Distributors are voluntarily recalling any of the affected products still in the marketplace and the CFIA advises consumers with the affected meat in their freezers not to consume it.

Food contaminated with E. coli O157:H7 may not look or smell spoiled but consumption of food contaminated with the bacteria may cause serious and potentially life-threatening illnesses.

Symptoms include severe abdominal pain and bloody diarrhea and some people may have seizures or strokes and some may need blood transfusions and kidney dialysis.

Others may live with permanent kidney damage and in severe cases people may die.

The CFIA is monitoring the effectiveness of the recalls.

For more information, consumers and industry can call the CFIA at 1-800-442-2342 / TTY 1-800-465-7735 (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).