Day: 09/25/2012

Considering Death Row for Organs.

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Before Gov. John Kitzhaber of Oregon established a moratorium on his state’s death penalty last year, Christian Longo, a death row inmate, started a campaign to allow the condemned to donate their organs.

Mr. Longo argued that a new execution protocol that many states — including Texas — have adopted leaves inmates’ organs viable for transplantation.

“While I can potentially help in saving one life with a kidney donation now, one preplanned execution can additionally save from 6 to 10 more lives,” Mr. Longo wrote in a plea that Oregon officials denied.

No state allows death row inmates to donate their organs. Although Texas recently abandoned a three-drug cocktail in favor of a single-drug method for execution, the Texas Department of Criminal Justice said it did not intend to change its policy. There are 11,000 Texans on the organ transplant waiting list.

Criminal justice and medical experts say that the idea of recovering organs from willing convicted murderers is fraught with moral, ethical and medical challenges that make it unlikely to ever be an option.

“It’s complicated in ways that are very messy and very fuzzy,” said Richard C. Dieter, executive director of the nonprofit Death Penalty Information Center.

The Criminal Justice Department allows offenders in the general prison population to donate organs, like kidneys, while they are alive in certain cases and after death if they complete a donor form.

The prospect of death row organ donation, though, prompts several questions, said Dr. David Orentlicher, a co-director of the Hall Center for Law and Health at Indiana University’s Robert H. McKinney School of Law. Is an inmate giving free and informed consent, or is he hoping to win favorable treatment? Would a donation affect jurors in murder cases who are weighing the death penalty versus life sentences? Or prosecutors deciding whether to seek the death penalty? Or governors deciding whether to grant clemency?

There is also the possibility that allowing death row organ donation could lead jurors to issue more death sentences, Dr. Orentlicher said.

For prospective recipients, there are emotional and mental considerations, he added.

“People might say, ‘Gosh, I’m walking around with the organ of a murderer,’ ” he said. “It may be irrational, but I suspect that’s lurking there.”

The condemned have a high risk of carrying diseases like hepatitis and H.I.V. And conditions in the death chamber are not conducive to organ recovery, said Mike Rosson, regional director of the Texas Organ Sharing Alliance. To keep organs viable, they must have oxygen after the brain dies, which means the donor must be on a ventilator, and surgery must be done quickly.

“You don’t have the facility for recovery, and you have transplant surgeons whose oath is to do no harm,” Mr. Rosson said. “The situation is just ethically challenging.”

Even if all the moral, ethical and medical questions could be adequately addressed, he said, the yield of usable organs from death row inmates is likely to be small.

“I think there are avenues other than prisoners that the effort expended toward trying to increase donation would be better spent,” Mr. Rosson said.

Source: NY Times.

Israel Revolutionizes Liver Disease Treatment.

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Israeli scientists are developing a treatment for people suffering from liver disease.

Nonalcoholic steatohepatitis (NASH) is a  “silent” liver disease which affects two to five percent of Americans – approximately six to fifteen million people.  Another ten to twenty percent of Americans, thirteen to twenty three million people, have fat in their livers but have not yet developed NASH.  Tens of millions of people around the world also are at risk of suffering from NASH.

The US National Institutes of Health explains:  ”It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol.  The major feature in NASH is fat in the liver, along with inflammation and damage.  Most people with NASH feel well and are not aware that they have a liver problem.  Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.”

Currently the only treatments for NASH are available in injection (hypodermic needle) form.  The problem with injections is that the treatments must first go through the bloodstream and then into the liver.

The Solution

NasVax, an Israeli company based in Ness-Ziona, is forging new ground in developing a treatment for people suffering from NASH.  The CEO of NasVax is Guy Yachin, a seasoned MBA graduate from the Technion – Israel Institute of Technology and the research and development is lead by Dr. Ronald Ellis, who holds a Ph.D. in Biology from Cornell University.  The team in Israel realized that an oral treatment would be much more effective because it can go directly to the intestinal system and into the liver and they developed a drink to suppress the disease.  The drink, an Oral anti-CD3 monoclonal antibody (aCD3 MAb) immunotherapy is currently directed toward the treatment of inflammatory and autoimmune diseases, and is in Phase 2A clinical studies on patients.  Research shows that the patients are doing better than patients who are taking traditional treatments.

Dr. Ellis estimates that the treatment will be available to the public in seven to eight years.  He cautions that there are many factors in a clinical studies, so an exact timeline cannot yet be set.  For example, the team is working on converting the drink into tablet (pill) form but this will require a lot of testing to reach the same effectiveness as the drink.  He also explains that drinks and tablets also have side benefits. “Traditional injection treatments for NASH often have negative side effects.  But we do not see these side-effects with our treatment.”  In addition, “Traditional injection treatments are not easy for patients.  People do not like going to a clinic once a week or once a month.  It is easier to take a pill from the pharmacy.”

Innovation Nation

CEO Guy Yachin explains “NasVax has a history of taking research from universities and small companies.  We look for opportunities at early states.  Of our four major products, all began in biotech start-ups or universities.  There is a lot of innovation in Israel, and we can tap it.  Then we develop it for clinical trials and commercialization.”

Mr. Yachin explains how NesVax fills a gap between the early start–up and large corporations.  “We bring medical treatments into Phase 2 Clinical Trials.  Then we look for a partner who has the resources to put the treatments into the finals states of clinical trials.  These are usually large pharmaceutical or biotechnological corporations with deep resources.”

Dr. Ellis describes how he was drawn to immunology.  “I have been vaccines and immunotherapeutics for over thirty years.  What motivates me to continue?  I want to benefit humanity and prevent suffering.”

CEO Guy Yachin describes business innovation in Israel:  ”My background is in engineering and business.  I was attracted to the medical devices field.  Eventually, I shifted my career to biotech.  I love the opportunity to do something good, and to develop something that is unique with a talented group of people.”

Yachin adds, “We are in the US and Israel.  Most of our research and development is in Israel.  We have been listed on the Tel Aviv Stock Exchange since December 2005.”

Dr. Ellis describes what makes Israeli biotechnology companies unique. “Israeli companies are much more cost effective and move rapidly.  We use financial resource with more focus than American companies. Israeli biotechnology companies have limited resources compared to their counterparts in the US.  We do a lot more outsourcing, and spend most of our time managing other companies.  For example we know that other companies can do many functions better and at a lower cost than if we did everything on our own.  When we need to produce an antibody, run clinical trials, or sequence a DNA molecule, we find a firm that is an exert in that function.”

Source: http://unitedwithisrael.org

 

USPSTF Draft Recommendation: Clinicians Should Screen Adults for Alcohol Misuse, Provide Behavioral Counseling.

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Primary care clinicians should screen adults for risky drinking behaviors and offer brief behavioral counseling interventions to those who screen positive (grade B recommendation), according to a draft recommendation statement published by the U.S. Preventive Services Task Force.

With respect to hazardous drinking in adolescents, the task force says the evidence to weigh the risks and benefits of screening and counseling is insufficient (grade I). Both recommendations reaffirm the group’s last guidance on the topic, published in 2004.

A USPSTF evidence review supporting the draft statement appears in the Annals of Internal Medicine. The review points out that counseling can reduce, among adults, both the number of weekly drinks and the number of heavy-drinking episodes. In clinical trials, such counseling generally involved multiple, brief contacts with primary care clinicians. Of note, the trials usually excluded individuals with alcohol dependence, so the evidence is limited to those with drinking behaviors characterized as “risky” or “hazardous.”

Source: Annals of Internal Medicine article

Newer Oral Anticoagulants Associated with ‘Dramatic Increase’ in Bleeding After ACS .

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When used to prevent thrombotic events after an acute coronary syndrome, the newer oral anticoagulants (for example, apixaban, dabigatran, and rivaroxaban) are associated with increased rates of major bleeding that offset their antithrombotic benefit, according to an Archives of Internal Medicine meta-analysis.

Researchers examined seven randomized controlled trials comprising over 30,000 patients who were hospitalized with ACS and received antiplatelet therapy. Compared with placebo recipients, those on new-generation oral anticoagulants had “a dramatic increase in major bleeding events.” Significant (but moderate) reductions in the risks for stent thrombosis and other ischemic events were seen, but there was no significant effect on overall mortality.

An editorialist concludes that routine use of these drugs in patients with ACS “is unwarranted.”

Source: Archives of Internal Medicine

 

AAP Strongly Discourages Recreational Use of Trampolines .

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Pediatricians should advise children and their parents against recreational use of trampolines, pointing out that various safety measures have not successfully reduced injury rates, according to a policy statement from the American Academy of Pediatrics published in Pediatrics.

In 2009, the rate of trampoline-associated injuries was 160 per 100,000 among 5- to 14-year-olds, the AAP notes. About three fourths of injuries occurred when more than one person was on the trampoline at the same time, with small children particularly at risk.

For families who continue to use trampolines, the AAP makes a series of recommendations, including:

  • Only one person at a time should use a trampoline.
  • Trampolines should be equipped with protective padding.
  • Somersaults and flips should not be allowed.
  • An adult willing to enforce safety rules should always be present.
  • Homeowners should check whether their insurance policies cover trampoline-associated claims.

Source: Pediatrics

Do Tanning Beds Really Cause Melanoma?

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If you believe all the negative hype on tanning beds that’s going around lately, you’ll run the other way instead of enjoying this easy and pleasurable way to get some vitamin D. But Dr. William Grant of the Vitamin D Council has taken a closer look at the claims that sunbeds can cause melanoma – and an untimely death – and found that the observational studies showing tanning booths are harmful didn’t consider many of the confounding factors for melanoma risk, such as:

  • Skin type
  • Solar UV exposure
  • Type of UV lamp

Additionally, he points out that observational studies are not generally accepted by the health or medical community as proof of cause. In fact, he says, “many of the same authors largely rejected observational studies of beneficial effects of vitamin D in reducing risk of cancer, although allowed that findings for colon cancer were reasonably strong.”

A Closer Look at Tanning Beds and Melanoma Risk

A study published in the July issue of the British Medical Journal1 estimates that sunbed use in 18 European countries accounts for nearly 2,000 cases of melanoma per year for men and just over 2,340 cases per year for women in 2008. The authors claim your risk of melanoma doubles if you begin using a sunbed before the age of 35. But according to Dr. Grant:

“A more important question in melanoma risk is death from melanoma. The mortality rate can be estimated by the ratio of melanoma deaths to cases in the 27 countries of the European Union, available from GLOBOCAN. Assuming that the EU-18 used… account for 71 percent of both cases and deaths, there would be 186 melanoma deaths for men and 304 deaths for women in 2008.

Any evaluation of whether something should be used should also estimate benefit. This was not done…

Sunbeds are a good source of vitamin D, producing at least 10,000 IU in a single session. There are about 15 types of cancer for which solar ultraviolet-B (UVB) irradiance has been found inversely correlated with incidence or mortality rate in ecological studies. Vitamin D production is the only mechanism suggested to explain the findings.”

He goes on to discuss how one can estimate the benefits of reducing the risk of internal cancers with the use of tanning beds. Citing a 2010 Swedish study2 that investigated the relation between prediagnostic vitamin D levels and incidence of breast, colorectal, and other cancers, Dr. Grant claims the benefit-to-risk ratio based on overall cancer deaths to melanoma cancer deaths is 47 to 1 for men and 37 to 1 for women.

“Since there are many other health benefits of vitamin D, the overall benefit-to-risk ratios are much higher,” he writes. “There have been several papers reporting health benefits of sunbed use including higher bone mass density, reduced risk of thrombotic events, and reduced risk of endometrial cancer.

It should also be noted that the role of UV in risk of melanoma is complex. Those who have chronic UV exposure do not have higher risk of melanoma than others. Solar UVB light is the primary source of vitamin D for most people. In winter at high latitudes, it is impossible to make vitamin D from solar UVB. One source for vitamin D in winter is artificial UVB as from sunbeds…”

Interestingly, another meta-analysis that didn’t get any traction in the mainstream press was published in the April issue of Public Health Nutrition.3 It states quite succinctly:

“The literature was searched in the electronic database MEDLINE to indentify published data between 1981 and 2011. Studies were included if they reported relative risk for cutaneous malignant melanoma (CMM) associated with sunbed use, vitamin D and UV effects on human health. UV from sun and sunbeds is the main vitamin D source. Young people with white or pigmented skin in northern Europe have a low vitamin D status. A number of health benefits from sufficient levels of vitamin D have been identified. However, UV exposure has been suspected of causing skin cancer, notably CMM, and authorities warn against it.

Conclusions: The overall health benefit of an improved vitamin D status may be more important than the possibly increased CMM risk resulting from carefully increasing UV exposure. Important scientific facts behind this judgement are given.”

Optimizing Your Vitamin D Levels Can Cut Your Internal Cancer Risk IN HALF

As Dr. Grant and the Public Health Nutrition review concluded, the dramatic reduction in overall cancer risk, along with all the multi-varied health benefits associated with improved vitamin D status, more than makes up for any potential increase in melanoma risk when using a tanning bed. Again, the benefit-to-risk ratio of reducing your risk of dying from any particular type of cancer, compared to your risk of dying from melanoma could likely be anywhere from 37 to 47 to 1 according to Dr. Grant.

According to the authors of that Swedish study Dr. Grant cited above:4

“These analyses estimated that the 50 percent reduction in incidence occurs for a value of 78 nmol/L [31 ng/ml] compared with the value at 24 nmol/L [10 ng/ml] for breast cancer, and a value of 60 nmol/L [24 ng/ml] compared with the value at 15 nmol/L [6 ng/ml] for colorectal cancer.”

A rather voluminous amount of research now attests to the protective effect of vitamin D against at least 16 different types of cancer, and as stated above, normalizing your vitamin D levels can cut your internal cancer risk IN HALF! And that’s just by raising your levels up to the 30 ng/ml range, which is still believed to be a deficiency state by most vitamin D experts. Ideally, you want your vitamin D levels in the 50-70 ng/ml range, and even upwards of 100 ng/ml if you have or are seeking to prevent cancer or heart disease.

Sensible Sunlight Actually Protects Against Melanoma

Another important factor to remember is that exposure to UVB light is actually protective against melanoma – or rather, the vitamin D your body produces in response to UVB radiation is protective. As written in The Lancet:5

“Paradoxically, outdoor workers have a decreased risk of melanoma compared with indoor workers, suggesting that chronic sunlight exposure can have a protective effect.”

Another study in Medical Hypotheses6 suggested that indoor workers may have increased rates of melanoma because they’re exposed to sunlight through windows, and only UVA light, unlike UVB, can pass through window glass. At the same time, these indoor workers, who get three to nine times less solar UV exposure than outdoor workers, are missing out on exposure to the beneficial UVB rays, and have lower levels of vitamin D. The study even noted that indoor UV actually breaks down vitamin D3 formed after outdoor UVB exposure, which would therefore make vitamin D3 deficiency and melanoma risk even worse. A number of associations between regular sun exposure and decreased melanoma risk can be found in the medical literature. For example:

  • Occupational exposure, such as farmers and fishermen, and regular weekend sun exposure are associated with decreased risk of melanoma
  • Sun exposure appears to protect against melanoma on skin sites not exposed to sun light, and melanoma occurring on skin with large UV exposure has the best prognosis
  • Patients with the highest blood levels of vitamin D have thinner melanoma and better survival prognosis than those with the lowest vitamin D levels

Beneficial Health Effects of UV Radiation Besides Vitamin D Production

While discussions about the health benefits from sun exposure typically center around vitamin D, which your skin produces in response to UVB rays, UVB exposure actually has a number of other health effects unrelated to vitamin D production – whether it’s from the sun or a safe tanning bed.

Ultraviolet (UV) radiation affects a number of other pathways. For example, UV exposure can help improve your mood through the release of endorphins, and may even help reduce fibromyalgia pain. Several skin diseases can be treated with sun exposure or phototherapy, i.e. the use of a tanning bed, including:

  • Psoriasis
  • Vitiligo
  • Atopic dermatitis
  • Scleroderma

Symptoms of multiple sclerosis can also be suppressed with UV exposure, independent of vitamin D synthesis (which is also beneficial for MS. In fact, vitamin D deficiency may be a contributing factor in nearly 60 percent of MS cases). Additionally, UVA radiation, which is generally more harmful in terms of its potential to cause skin cancer, is not entirely without merit. For example, UVA’s generate nitric oxide (NO), which can help reduce blood pressure and has a beneficial effect on cardiovascular health, in addition to having an antimicrobial effect.7

UV Radiation has Long History of Use as Treatment of Disease

According to a recent article in DermatoEndocrinology:8

“Solar ultraviolet (UV) radiation has been used since ancient times to treat various diseases. This has a scientific background in the fact that a large number of molecules (chromophores) in different layers of the skin interacts with and absorbs UV.

…Phototherapy is a valuable option in the treatment of many psoriatic and nonpsoriatic conditions, including atopic dermatitis, sclerosing skin conditions such as morphea, scleroderma, vitiligo, and mycosis fungoides. Phototherapy is the treatment of certain skin disorders with UV radiation which can be produced by the sun, fluorescent lamps, short arc lamps with UV filters and lasers.

Depending on the shape of the spectrum of radiation emitted by the source, phototherapy can be divided into broadband UVB (290-320 nm), narrow band UVB (310-315 nm), monochromatic UVB (308 nm from an excimer laser), broadband UVA (320-400 nm) and UVA-1 (340-400 nm).

…Traditionally, broadband UVB phototherapy has been used to treat psoriasis, which is an inflammatory skin disease, characterized by keratinocyte hyperproliferation with 1-2 percent prevalence in the general population. However, now more often narrowband UVB or monochromatic UVB are used for the clearance of psoriasis. Narrow-band UVB clears psoriasis faster and produces longer remissions than broadband UVB. Action spectra for UV-induced erythema, DNA damage, photoimmunesuppression, squamous cell carcinoma and vitamin D synthesis are very similar, all in the UVB spectral region of 280-310 nm.

Narrowband UVB do not contain the most erythemogenic and carcinogenic wavelengths.

…Sunbathing or tanning beds seem to have a potential to reduce pain in patients with fibromyalgia. Patients with the chronic pain condition fibromyalgia have reported a greater short-term decrease in pain after exposure to UV compared with non-UV radiation exposure…” [Emphasis mine]

Another article written by Richard J. Wurtman9, while older, still contains a lot of interesting information about the health benefits of sunlight, and is well worth a read-through. He rightfully points out the role of sunlight on synchronizing the hormonal rhythms of your body. Melatonin, for example, which is synthesized by your pineal gland, is profoundly affected by light and dark, and proper exposure to bright sun during the day is important for maintaining your internal rhythm. Melatonin, as you may recall, is also a potent antioxidant with cancer-fighting properties, so please do not underestimate the importance of daily UV exposure – as well as the avoidance of artificial light after sunset.

What Makes for a Safe Tanning Session?

There are two primary concerns with tanning beds that you need to be aware of:

  1. UV dose. The FDA uses a unit called “one erythemal dose” as a means of calibration for the indoor tanning industry – which is just a fancy word for one tanning session. One erythemal dose equates to the amount of time it takes for a tanning device to produce erythema (slight pinkening of the average person’s skin), and this erythema indicates you have achieved a safe dose of UV – which translates to an optimal dose of vitamin D.

However, keep in mind that the erythemal dose can differ for each person based on skin type and strength of lamps – just as a safe “dose” of sunshine differs for people based on their skin type, geographic location, and time of day. Start with the lowest recommended dose (time) to avoid getting burned, especially if you are light skinned.

The FDA also makes recommendations about how often you should receive a dose, stating you should wait 24-48 hours between tanning sessions. The reason for this is that it takes at least 24 hours for the erythema to go away.

The FDA’s exposure schedule can be described as CONTROLLED SUNSHINE, making it a very safe way to receive the benefits of the sun while indoors. Once you have a base tan, you can then enjoy more time in the sun without burning, and in that respect, you receive some protection that you would not otherwise have.

  1. EMF exposure. Most tanning equipment use magnetic ballasts to generate light. These magnetic ballasts are well known sources of EMF fields that can contribute to cancer. If you hear a loud buzzing noise while in a tanning bed, it has a magnetic ballast system. I strongly recommend you avoid these types of beds and restrict your use of tanning beds to those that use electronic ballasts.

Why Does Sun Exposure Get so Much Negative Press?

The negative press about sun exposure and tanning is more than simple ignorance or lack of education on the part of government agencies and scientists. The truth is out there to be found, for those who want to find it. It again boils down to blatant greed. Multi-million-dollar corporations enjoy enormous profits from the products they sell to allay your fears. They create the fear so that they can sell you their solution:

  • Suntan lotions and creams
  • Sunless bronzers
  • Moisturizers with SPF
  • Sun-protective clothing
  • Anti-aging skin care

Think about how the ads for these products abound in winter and early spring when people worldwide flock to sunny climates for long-awaited vacations. This is the peak season for indoor tanning as well, and the market forces take full advantage. Consider the money to be made in a pairing between suntan lotion manufacturers and the travel industry – airlines, cruise lines, and the like.

Big Industry knows you will never give up your sunshine, and they’ve learned how to capitalize on it by creating a “sun-phobia” – with a lot of help from Big Pharma and the AMA.

It’s all about the money.

Source: Dr. Mercola