Supplements blamed for 23,000 ER visits in US each year

MIAMI -- Over the counter supplements, including vitamins, sexual enhancements and weight loss aids, are being blamed for 23,000 visits to US emergency rooms each year, according to a decade-long study this week.

The findings published in the New England Journal of Medicine are based on reports from a nationally representative sample of 63 emergency departments from 2004 through 2013.

The study raised new concerns among experts over the safety of an industry that critics say is largely unregulated and yet highly popular among consumers -- bringing in $14.8 billion in 2007, or one third of the out-of-pocket expenditures for prescription drugs, according to background information in the article.

More than one quarter (28 percent) of visits were by adults aged 20 to 34.

Weight loss aids were a leading culprit in this age group, causing more than half of emergency room visits, commonly for heart related symptoms including palpitations, chest pain, or irregular heartbeat.

More than one fifth (21 percent) of emergency visits were due to children swallowing supplements.

"Child-resistant packaging is not required for dietary supplements other than those containing iron, and despite such packaging, iron supplements were the second most commonly implicated type of supplement in unsupervised ingestion by children," said the study.

When it came to people, swallowing problems caused nearly 40 percent of emergency department visits for supplement-related adverse events.

Just 2,000 people are hospitalized annually after taking supplements.

The research did not track any deaths that might have been linked to supplement use.

The study pointed out that although the US Food and Drug Administration is tasked with overseeing supplements, "neither safety testing nor FDA approval is required before the marketing of dietary supplements."

The researchers also said their estimates are likely lower than the actual number because patients do not always report using supplements.

The Council for Responsible Nutrition, an industry group, said the findings should be viewed in context, and defended the safety of supplements.

"The results of this study reinforce that dietary supplements are safe products, particularly when put into context with the number of people -- over 150 million Americans -- who take dietary supplements every year," said Duffy MacKay, senior vice president of scientific and regulatory affairs.

"To put this projected number of 23,000 annual emergency room (ER) visits into context, we estimate that far less than one tenth of one percent of dietary supplement users experience an emergency room visit annually."

source: interaksyon.com

Shorter height directly linked to higher risk of heart disease - study

WASHINGTON -- The shorter you are, the more your risk of coronary heart disease, according to a new study out Wednesday that attributed the link in part to genetics, rather than purely to nutrition or lifestyle factors.

The study, published online in the U.S. journal New England Journal of Medicine, examined 180 genetic variants that affect height in almost 200,000 persons with or without coronary heart disease, which is the commonest cause of premature death worldwide.

It showed that for every change in height of 6.5 cm caused by these variants the risk of coronary heart disease changed on average by 13.5 percent.

"The more height increasing genetic variants that you carry the lower your risk of coronary heart disease and conversely if you were genetically shorter the higher your risk," Christopher Nelson, one of the researchers from Britain's University of Leicester said, in a statement.

For example, compared to a 1.68-meter tall person, a 1.52-meter tall person on average has a 32 percent higher risk of coronary heart disease because of their relatively shorter stature.

Lead author Sir Nilesh Samani, professor of cardiology at the University of Leicester, said: "For more than 60 years it has been known that there is an inverse relationship between height and risk of coronary heart disease."

"Now, using a genetic approach, researchers ... have shown that the association between shorter height and higher risk of coronary heart disease is a primary relationship and is not due to confounding factors," Samani said.

Coronary heart disease is the condition where the arteries that supply blood to the heart muscle become narrowed due to a deposition of fatty material, or plaque, in the walls of the arteries. If a blood clot forms over the plaque then the artery can become completely blocked suddenly giving rise to a heart attack.

The researchers said further exploration of genes that affect height may suggest new ways to reduce the risk of heart disease.

"While we know about many lifestyle factors such as smoking that affect risk of coronary heart disease, our findings underscore the fact that the causes of this common disease are very complex and other things that we understand much more poorly have a significant impact," Samani said.

"While our findings do not have any immediate clinical implications, better and fuller understanding of the biological mechanisms that underlie the relationship between shorter height and higher risk of coronary heart disease may open up new ways for its prevention and treatment."

 source: interaksyon.com

Colonoscopies could reduce cancer risk by 40 percent

WASHINGTON DC - A colonoscopy every 10 years could prevent 40 percent of colorectal cancers, according a massive US study out Wednesday, supporting the effectiveness of the commonly-used test.

Those with family history of these types of cancer -- the second-leading cause of cancer deaths in the US -- should have more frequent screenings, the study in the New England Journal of Medicine said.

The results confirm the current recommendations for colonoscopies, offering evidence it is particularly useful in preventing cancers that originate in the proximal, or upper, part of the colon.

"Our study provides strong evidence that colonoscopy is an effective technique for preventing cancers of both distal and proximal regions of the colorectum," said Shuji Ogino, a lead author from the Havard School of Public Health.

The screening is crucial in preventing proximal cancers, he explained, because another test, called sigmoidoscopy, uses a scope to examine only the lower part of the colon and "alone is insufficient for preventing proximal cancer."

Unlike sigmoidoscopy, a colonoscopy examines the entire colon, using a camera-equipped device that also has tools to remove cysts and benign tumors.

The authors analyzed data from nearly 89,000 participants in two long-term studies, basing their conclusions on surveys completed every two years between 1988 and 2008.

The researchers also obtained information on any colonoscopies and sigmoidoscopies conducted. They documented 1,815 cases of colorectal cancer and 474 resulting deaths.

They found that both screenings reduced the risk of developing, or dying from, colorectal cancers.

But only the more complete, colonoscopy screening reduced the risk of cancers in the upper part of the colon -- though even still, its effects were less successful than for preventing lower bowel cancers.

They estimated that, if all the participants had undergone a colonoscopy, the overall risk of colorectal cancers would have been reduced by 40 percent -- preventing 61 percent of lower colon cancers and just 22 percent of upper colon cancers.

The researchers speculated there may be molecular or biological differences between upper and lower colon cancers behind the lower success rate.

source: interaksyon.com

Researchers map genetic mutations in adult blood cancer

WASHINGTON DC - US researchers on Wednesday said they have identified virtually all of the major mutations that drive acute myeloid leukemia (AML), a fast-growing blood cancer in adults that often is difficult to treat.

The findings, published online in the journal New England Journal of Medicine, pave the way for developing better treatments for AML patients. They also could lead to ways to more accurately predict the severity of disease in individual patients.

"We now have a genetic playbook for this type of leukemia," says study co-leader Timothy Ley at the Washington University School of Medicine in St. Louis.

"We don't know all the rules yet, but we know all the major players. This information can help us begin to understand which patients need more aggressive treatment right up front and which can be treated effectively with standard chemotherapy."

The study included some 200 patients newly diagnosed with AML. The researchers sequenced the DNA of each patient's leukemia cells and compared the data to DNA from each patient's healthy cells. In this way, they found the mutations that only occurred in the cancer cells and contributed to the development and progression of AML in each patient.

Cancer cells in the AML patients had an average of 13 mutated genes, far fewer than the several hundred typically found in breast, lung, and other solid tumors, according to the study.

By studying a large number of AML cases, the scientists believe they have found nearly all of the major mutations that occur in patients with the disease.

source: interaksyon.com