This treatment marks a milestone in medical research as it is the first human trial of an embryonic stem cell based therapy.  In the evolving field of what is termed regenerative medicine, this marks a major advance.  Though the research is preliminary, stem cell researchers are encouraged to see these trials begin so soon after the discovery of the properties and potential of stem cells.  It has only been 12 years since the discovery of human embryonic stem cells.  Scientist soon speculated on the regenerative properties of such cells, leading to the concept of regenerative medicine.

This patient was the first to be enrolled and treated in a safety trial, known as GRNOPC1.  The trial is being run by Geron, an American company, which is the first clinical study of any such cell treatment. Geron Corporation is based in Menlo Park, California. They have worked in conjunction with researchers at the University of California, Irvine, in the development of this drug model. The company’s stated mission is to develop first-in-class biopharmaceuticals for the treatment of cancer and chronic degenerative diseases, including spinal cord injury, heart failure and diabetes. They are also actively working on advancing an anti-cancer drug and as well as a cancer vaccine that target the enzyme telomerase.  Multiple clinical trials for different cancers are ongoing.

Embryonic stem cell-derived neural cells have been used by researchers to treat nervous system disorders in animal models. In spinal cord injuries, neural cells derived from animal embryonic stem cells and injected into the spinal cord injury site produced significant recovery of the animal’s ability to move and bear weight.  In addition to spinal cord injury, GRNOPC1 may have value for other central nervous system indications, such as Alzheimer’s disease, Canavan disease and multiple sclerosis. Genron has entered into collaborations with academic groups to test GRNOPC1 in animal models of these diseases.

It was just in January of 2009 that Genron announced it had received approval from the FDA for a study of its stem-cell treatment for spinal cord injuries.  The trial was approved for up to 10 patients. At that time, the announcement capped more than a decade of advances in the company’s labs.  It also came in conjunction with an expected shift in U.S. policy toward support of embryonic stem-cell research.

This medical first does not come without controversy.  Many have voiced ethical concerns. Basic bio-science researchers believe embryonic stem cells to be the most versatile stem cells.  Using such cells they have regrown tissue and cured diseases in animals. However, to get these cells, scientists have to destroy an embryo, which many feel is akin to abortion. A judge in August blocked federal funding of embryonic stem cell research. Accordingly, researchers are proceeding with caution, being well aware of the medical complexity and social sensitivities involved in this line of work. Development of this drug has been funded totally with private dollars and his been underway for years. Embryonic stem cells are derived from embryos that develop from eggs that have been fertilized in vitro—in an in vitro fertilization clinic—then donated for research purposes with informed consent of the donors. They are not derived from eggs fertilized in a woman’s body.

Some have argued that adult stem cells can be used for these purposes, avoiding the moral questions raised by many over the use of embryonic stem cells. To date, it is not clear if adult stem cells hold the same potential, though research continues. An adult stem cell is an undifferentiated cell, found among differentiated cells in a tissue or organ. These cells can renew themselves and have the potential to differentiate into some or all of the major specialized cell types of the tissue or organ. The primary roles of adult stem cells in a living organism are to maintain and repair the tissue in which they are found.

This first patient treatment is the very beginning of human trials, labeled phase one trials.  Nearly 40% of all drugs developed never make it past phase one, which is a trial based totally on the safety of the drug or treatment.  Researchers note that despite this advance, it could be years before we know if any drug developed at this stage will actually work. The trial is formally named: hESC-Derived Oligodendrocytes – GRNOPC1 for short.

Clearly, for many suffering with chronic, debilitating, or incurable diseases and injuries this research holds great promise.  Only time will tell if the promise will be realized . . . ben kazie md

What are embryonic stem cells? – http://stemcells.nih.gov/info/basics/basics3.asp

What are adult stem cells? – http://stemcells.nih.gov/info/basics/basics4.asp

Genron – http://www.geron.com

First Embryonic Stem-Cell Trial Gets Approval From the FDA – http://online.wsj.com/article/SB123268485825709415.html

Paralyzed patient receives first embryonic stem cell treatment – http://www.myfoxtampabay.com/dpp/health/paralyzed-patient-first-embryonic-stem-cell-treatment-101110

First human study of stem cell therapy underway – http://www.necn.com/10/12/10/First-human-study-of-stem-cell-therapy-u/landing_health.html?blockID=330163&feedID=4210

Geron Corp. Begins First Embryonic Stem Cell Treatment on Patient for Spinal Cord Injuries – http://abcnews.go.com/Health/geron-corp-begins-embryonic-stem-cell-treatment-patient/story?id=11853497&page=3

hESC – Derived Oligodendrocyte Progenitor Cells (GRNOPC1) Spinal Cord Injury – http://www.geron.com/patients/clinicaltrials/hESC.aspx

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Vioxx was used to treat arthritis.  Merck recalled Vioxx after 5 years of marketing when a study suggested the drug doubled the risk of heart attacks after 18 months of treatment. An earlier study published in 2000 suggested the medicine posed heart risks and led to calls for further research into the drug’s side effects.

Avandia, at one time the world’s best-selling diabetes drug, was linked to a 43% higher risk of heart attacks in an analysis released in 2007, eight years after its approval. Glaxo, of London, said last week that it would stop promoting the drug as a result of new FDA restrictions and European regulators’ decision to withdraw the product completely.

Meridia, a 13-year-old diet pill, was tied to 16% more major cardiovascular complications in a 6 year study of 10,000 patients released this month. Abbott Park, Illinois-based Abbott no longer promotes the drug in the U.S.

This finding has resulted in calls from legislators and doctors for closer government review of side effects. FDA has used administrative and insurance claims databases to investigate safety questions about FDA regulated products.  For the most part, FDA has worked with one particular health care system at a time to evaluate a given safety issue.  FDA as set as it’s goal creation of fully integrated, linked, sustainable system.  The conceptual system which FDA is striving for has been termed their “Sentinel System”.  This ideal system will draw on existing automated health care data from multiple sources to actively monitor the safety of medical products continuously and in real-time.  FDA has implemented the Adverse Event Reporting System (AERS).  This system is a a computerized information database designed to support the FDA’s post-marketing safety surveillance program for all approved drug and therapeutic biologic products. The FDA uses AERS to monitor for new adverse events and medication errors that might occur with these marketed products.

Clearly, on going data collection after approval of new medications is essential in order to fully understand the potential medium and long term side-effects which may occur with new drugs.  FDA is taking a step in the right direction in utilizing modern forms of data collection and inter-connectivity in order to properly monitor adverse medication effects.  It will be interesting to see how technology impacts these efforts by FDA . . . ben kazie md

Recalled Drugs Tied to Heart Risk Spurs Call for FDA Review – http://www.bloomberg.com/news/2010-09-28/recalled-drugs-tied-to-heart-risk-spurs-call-for-fda-review.html

Guidance for Industry E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs – http://www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM129357.pdf

FDA’s Sentinel Initiative – http://www.fda.gov/Safety/FDAsSentinelInitiative/ucm149340.htm

Guidance for Industry Diabetes Mellitus -Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes – http://www.fda.gov/OHRMS/DOCKETS/98fr/FDA-2008-D-0118-gdl.pdf

Adverse Event Reporting System (AERS) – http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/default.htm

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High fructose corn syrup (HFCS) is a sweeter form of corn syrup and in terms of nutritional intake is a newer food. Just as in the case of basic corn syrup, HFCS is made from corn by using enzymes to alter it.

Some researchers have also reported that HFCS intake is linked to obesity.  The past two centuries  have seen a major rise in obesity rates.  These rises parallel the increased consumption of fructose in the diet.  This has been particularly true over the past two decades with the major increased use of HFCS.  Americans now consume 30% more fructose than they did 20 years ago.  They consume four times as much fructose as was the case 100 years ago when obesity rates were below 5%.  Historically, these facts have coincided with the rise in occurrence of hypertension.  Previous studies, while suggestive, were inconsitent in linking excess fructose in the diet to high blood pressure development.

Patel and associates report in the recent online early publication in the Journal of the American Society of Nephrology their findings.  They note, “the recent increase in fructose consumption in industrialized nations mirrors the rise in the prevalence of hypertension, but epidemiologic studies have inconsistently linked these observations. We investigated whether increased fructose intake from added sugars associates with an increased risk for higher BP levels in US adults without a history of hypertension. We conducted a cross-sectional analysis using the data collected from the National Health and Nutrition Examination Survey (NHANES 2003 to 2006) involving 4528 adults without a history of hypertension. Median fructose intake was 74 g/d, corresponding to 2.5 sugary soft drinks each day. After adjustment for demographics; comorbidities; physical activity; total kilocalorie intake; and dietary confounders such as total carbohydrate, alcohol, salt, and vitamin C intake, an increased fructose intake of 74 g/d independently and significantly associated with higher odds of elevated BP levels: It led to a 26, 30, and 77% higher risk for BP cutoffs of 135/85, 140/90, and 160/100 mmHg, respectively. These results suggest that high fructose intake, in the form of added sugar, independently associates with higher BP levels among US adults without a history of hypertension.”

This article supports the widespread belief that HFCS is not a healthy alternative to natural cane sugar in beverages or foods.  Perhaps the most alarming finding is that the simple equivalent of 2.5 sugary soft drinks per day (which usually contain HFCS) is the all that is required to push one over the edge as it were in terms of a significant increase in risk of developing high blood pressure.  It would behoove us all to cut our intake of sugar overall.  Most particularly, we should attempt to limit our intake of HFCS as much as possible.  To this end, many soft drink manufacturers are offering alternatives which are sweetened with cane sugar as opposed to HFCS.  Diet and dietary intake it seems we learn more and more each day, play a crucial role in our health and wellness, as well as our development of chronic disease . . . ben kazie md

Increased Fructose Associates with Elevated Blood Pressure – http://jasn.asnjournals.org/cgi/content/abstract/ASN.2009111111v1

High Fructose Intake from Added Sugars: An Independent Association With Hypertension – http://www.sciencedaily.com/releases/2009/10/091029211521.htm

High fructose corn syrup – http://www.sciencedaily.com/releases/2009/10/091029211521.htm

Increased fructose intake is associated with elevated blood pressure – http://www.news-medical.net/news/20091030/Increased-fructose-intake-is-associated-with-elevated-blood-pressure.aspx

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Recently, the medical, nutrition and research literature has seen an influx of new information regarding the role of various factors in the development of cancer and other major illnesses.  Of particular interest has been the role of vitamin D in disease prevention and causation.

Vitamin D is one of the fat-soluble vitamins (like vitamin E).  In nature it is found in only a few food items. Most commonly one sees it as a food additive or as a dietary supplement. Vitamin D is produced naturally when sunlight (ultraviolet rays) strike the skin.  These UV rays trigger vitamin D synthesis in the skin.  Regardless of how it is obtained, from sun exposure, food, or supplements vitamin D is biologically inactive.  In order to be of use, it must be activated via chemical reactions in our bodies. The first reaction occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second reactions occurs primarily in the kidney and forms the active 1,25-dihydroxyvitamin D [1,25(OH)₂D], also known as calcitriol. [2]

The major role played by vitamin D is maintenance of normal blood levels of calcium and phosphorus. Vitamin D aids in calcium absorption from our stomach via digestion, which helps form and maintain strong bones. New research points to a role for vitamin D in prevention of osteoporosis, hypertension (high blood pressure), cancer, and several autoimmune diseases. [3, 4]

Dr. John Cannell, Executive Director of the Vitamin D Council has commented that “humans make thousands of units of vitamin D within minutes of whole body exposure to sunlight; from what we know of nature, it is unlikely such a system evolved by chance.” Dr. Frank Lipman, an internationally recognized expert in the fields of Integrative and Functional Medicine and practicing physician has commented that, “for hundreds of thousands of years, man has lived with the sun: our ancestors were outdoors far more often than indoors and we developed a dependence on sunshine for health and life, so the idea that sunlight is dangerous does not make sense. How could we have evolved and survived as a species, if we were that vulnerable to something humans have been constantly exposed to for their entire existence?” Dr. Frank Apperly, in whose concluding remark of his 1941 study on cancer rates vs. latitude stated: “A closer study of the action of solar radiation on the body might well reveal the nature of cancer immunity.”[5]

Ramagopalan and associates recently reported in Genome Research on their findings that vitamin D is involved in actions on some 229 genes with almost 2800 genomic positions affected on those genes.  The summary of their abstract findings states: “Initially thought to play a restricted role in calcium homeostasis, the pleiotropic actions of vitamin D in biology and their clinical significance are only now becoming apparent. However, the mode of action of vitamin D, through its cognate nuclear vitamin D receptor (VDR), and its contribution to diverse disorders, remain poorly understood. We determined VDR binding throughout the human genome using chromatin immunoprecipitation followed by massively parallel DNA sequencing (ChIP-seq). After calcitriol stimulation, we identified 2776 genomic positions occupied by the VDR and 229 genes with significant changes in expression in response to vitamin D. VDR binding sites were significantly enriched near autoimmune and cancer associated genes identified from genome-wide association (GWA) studies. Notable genes with VDR binding included IRF8, associated with MS, and PTPN2 associated with Crohn’s disease and T1D.” [11] Reports on this study have popped up in multiple media sources as well [6,7,8,9,10]

It is true that sunlight can cause basal cell and squamous cell cancers in susceptible persons.  However, a good correlation between sunlight exposure and lowered incidence of internal cancers exists. It has been shown that  cancer mortality increases with distance from the equator.  This finding was clearly demonstrated in a 1941 study by Dr. Frank Apperly and confirmed in other studies.[17]  He examined cancer deaths across North America and found that more northern latitudes had higher cancer death rates.  In his review he found that cities between 30-40 degrees latitude had an 85% higher overall cancer death rates than cities located between 10-30 degrees latitude.  Cities between 40-50 degrees latitude averaged 118% higher death rates from cancer and those between 50-60 degrees latitude had a 150% higher cancer mortality. Dr. Apperly also studied the relationship of sunlight and skin cancer.  Surprisingly, he found that sunlight produces an immunity to cancer in general. In locales with a mean temperature less than 42 degrees F this was even true with skin cancer.  At mean temperatures higher than 42 degrees F solar radiation appears to increase the incidence of skin cancer.  Upon reviewing the data, he postulated that the closer one is to the equator, the lesser the risk of developing internal cancers, but the higher the risk of developing. It appears that Dr. Apperly was among the first to investigate the relationship between temperature and skin cancer as well as how sunlight might reduce the risk of death from internal cancers.  He concluded his review by saying that “a closer study of the action of solar radiation on the body might well reveal the nature of cancer immunity.” [5,6,12,19]

Cancer has in some regions of the country, surpassed heart disease as the leading cause of death. The mortality rate for cancer is high (roughly 42%) and increases with increasing age.  This is particularly true for those aged 40 to 60 years. Despite discussion of cancer prevention, true efforts in this regard have been minimal. Drugs developed so far have been expensive and many have serious side effects. Most focus has been on early detection rather than prevention of cancer.  There are some 18 vitamin D-sensitive cancers. Ultraviolet light, and specifically ultraviolet B (UVB), could possibly reduce cancer by limited exposure of suitable skin areas to UVB of an intensity and duration insufficient to produce skin cancer. To date, the medical literature sites a great fear of development of skin cancer from overexposure to sunlight and UV rays.  To be sure, this is based on some degree of truth.  Though skin cancer incidence is significant, mortality from skin cancer is rare. Roughly 1,000,000 Americans will be affected by skin cancer but only 10,000 deaths were expected in 2005 (a 1% mortality rate). Skin cancer is easily detected and often cured by excisional biopsy alone. [6,12,13,14]

All of this points to the real issue which is the role of vitamin D in prevention of cancer and disease. [2,3,4,6,7,8,9,10,11]

Some have postulated that vitamin D deficiency is a major factor in the development and progression of autism. While still a theory, the idea of a significant role for vitamin D in the causation of autism is gaining momentum. More and more scientists are examining this possible link in the hopes that this theory will hold up against scientific scrutiny.  If true, it would be mean a relatively simple solution might exist for what has become a too frequent and often tragic condition. [15]

Determining vitamin D deficiency requires testing since there is no way to know for certain until a 25-hydroxyvitamin D test, also called a 25(OH)D, level is determined. It is felt that levels should be above 50 ng/ml (125 nmol/L) year-round, in both children and adults. Recent studies suggest that the minimal acceptable level is 50 ng/ml (125 nmol/L). A recent study analyzed five studies in which both the parent compound (cholecalciferol) and 25(OH)D levels were measured. Findings show that the body does not reliably begin storing cholecalciferol in fat and muscle tissue until 25(OH)D levels get above 50 ng/ml (125 nmol/L). The average person starts storing cholecalciferol at 40 ng/ml (100 nmol/L), but at 50 ng/ml (125 nmol/L) virtually everyone begins to store it for future use. Therefore, at levels below 50 ng/ml (125 nmol/L), the body uses up vitamin D as fast as you can make it, or take it, indicating chronic “starvation”  in regard to vitamin D which is clearly not a good thing. 25(OH)D levels should be between 50–80 ng/ml (125–200 nmol/L), year-round. [3,12,13,14,15,16]

There is some variation in the recommended dose of vitamin D on a daily basis. Recommendations from the National Institutes of Health are far lower than those advocated by many disease prevention groups. To be sure, one must account for the amount of vitamin D estimated to be obtained from one’s diet as well as exposure to sunlight overall.  Then, additional supplementation may be needed.  This is especially true if one has proven low levels on blood chemistry. [3,14]

The risk of vitamin D overdose, or toxicity, seems to be minimal and to date, very rare.  It is estimated that one would have to have an intake of between 600,000 and 1,680,000 IUs (International Units) per day for several days or months to develop this condition.  Most over the counter supplements come in dosages of 1000, 2000 or 5000 IU. Given this fact, reasonable supplementation, especially in light of confirmed deficiency makes perfect medical sense. [3,14,18]

Patients should consult their physician and may wish to suggest that 25(OH)D levels be measured on a routine basis in conjunction with their annual physical exam and laboratory testing . . . ben kazie md

1. Deaths and Mortality – http://www.cdc.gov/nchs/fastats/deaths.htm
2. Vitamin D – http://en.wikipedia.org/wiki/Vitamin_D
3. Dietary Supplement Fact Sheet: Vitamin D – http://ods.od.nih.gov/factsheets/vitamind.asp
4. Vitamin D – http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind
5. Vitamin D Quotes – http://www.vitamindcouncil.org/vitamin-d-quotes.shtml
6. Shedding Light on Vitamin D & Cancer – http://issuu.com/iwishart/docs/investigate_apr09_100dpi
7. Vitamin D linked to autoimmune and cancer disease genes, underscoring risks of deficiency – http://www.bionity.com/news/e/121670/?WT.mc_id=ca0068
8. Vitamin D linked to autoimmune and cancer disease genes, underscoring risks of deficiency – http://www.eurekalert.org/pub_releases/2010-08/cshl-vdl081710.php
9. Vitamin D Found to Influence Over 200 Genes, Highlighting Links to Disease – http://www.sciencedaily.com/releases/2010/08/100823172327.htm
10. Vitamin D found to influence over 200 genes, highlighting links to disease – http://www.physorg.com/news201791554.html
11. A ChIP-seq defined genome-wide map of vitamin D receptor binding: Associations with disease and evolution – (Ramagopalan SV, Heger A, Berlanga AJ, Maugeri NJ, Lincoln MR, Burrell A, Handunnetthi L, Handel AE, Disanto G, Orton S, Watson CT, Morahan JM, Giovannoni G, Ponting CP, Ebers GC, Knight JC.; Genome Res 2010 – http://genome.cshlp.org/content/early/2010/08/20/gr.107920.110.abstract?sid=7cd67983-f82c-469f-88df-d7a2e99a5fdf
12. Vitamin D and Your Health Deficiency – http://www.vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml?gclid=CPWii7P61KMCFZNg2godBH87ug
13. Vitamin D Deficiency Syndrome – http://www.vitamindcouncil.org/vdds.shtml
14. Treating Disease With Vitamin D – http://www.vitamindcouncil.org/treatment.shtml
15. Vitamin D Theory of Autism – http://www.vitamindcouncil.org/health/autism/vit-D-theory-autism.shtml
16. Am I Vitamin D Deficient? – http://www.vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml
17. An adjunctive preventive treatment for cancer: Ultraviolet light and ginkgo biloba, together with other antioxidants, are a safe and powerful, but largely ignored, treatment option for the prevention of cancer – http://www.medical-hypotheses.com/article/S0306-9877%2806%2900005-3/abstract
18. Hypervitaminosis D – http://en.wikipedia.org/wiki/Hypervitaminosis_D
19. Apperly FL; The relation of solar radiation to cancer mortality in North America. Cancer Research. 1941:1:191-195 – http://cancerres.aacrjournals.org/content/1/3.toc

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What is Salmonella?

Salmonellosis is an infection caused by the bacteria Salmonella. Those infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days.  Most recover without treatment. However, in some the diarrhea may be so severe that hospitalization is required. Sometimes fatal infections occur in young children, frail or elderly people, and others with weakened immune systems. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

Salmonella is actually a group of bacteria that can cause diarrheal illness in humans. They are microscopic living creatures that pass from the feces of people or animals to other people or other animals. There are many different kinds of Salmonella bacteria. Salmonella serotype Typhimurium (typhoid fever) and Salmonella serotype Enteritidis are the most common in the United States. Salmonella germs have been known to cause illness for over 100 years. They were discovered by an American scientist named Salmon, for whom they are named.

Healthy persons infected with Salmonella often experience fever, diarrhea, nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections, endocarditis, or arthritis.

What Eggs Are Affected?

Eggs affected by this recall were distributed to grocery distribution centers, retail grocery stores and food service companies which service or are located in fourteen states, including the following: Arkansas, California, Iowa, Illinois, Indiana, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Texas, and Wisconsin. Eggs are distributed under the following brand names: Hillandale Farms, Sunny Farms, and Sunny Meadow in 6-egg cartons, dozen-egg cartons, 18-egg cartons, 30-egg package, and 5-dozen cases. Loose eggs are packaged under the following brand names: Wholesome Farms and West Creek in 15 and 30-dozen tray packs. The loose eggs may also be repackaged by customers.

The only eggs effected by this recall have plant numbers P1860 or P1663 and Julian dates as follows:

• P1860 – Julian dates ranging from 099 to 230
• P1663 – Julian dates ranging from 137 to 230

Only eggs with these plant numbers are effected – even though the brand name may be the same

How Do Eggs Become Infected?

Unlike eggborne salmonellosis of past decades, the current epidemic is due to intact and disinfected grade A eggs. Salmonella enteritidis silently infects the ovaries of healthy appearing hens and contaminates the eggs before the shells are formed.

Most types of Salmonella live in the intestinal tracts of animals and birds and are transmitted to humans by contaminated foods of animal origin. Stringent procedures for cleaning and inspecting eggs were implemented in the 1970s and have made salmonellosis caused by external fecal contamination of egg shells extremely rare. However, unlike egg-borne salmonellosis of past decades, the current epidemic is due to intact and disinfected grade A eggs. The reason for this is that Salmonella enteritidis silently infects the ovaries of healthy appearing hens and contaminates the eggs before the shells are formed.

Although most infected hens have been found in the northeastern United States, the infection also occurs in hens in other areas of the country. In the Northeast, approximately one in 10,000 eggs may be internally contaminated. In other parts of the United States, contaminated eggs appear less common. Only a small number of hens seem to be infected at any given time, and an infected hen can lay many normal eggs while only occasionally laying an egg contaminated with the Salmonella bacterium.

How Does One Reduce Risk?

Eggs, like meat, poultry, milk, and other foods, are safe when handled properly. Shell eggs are safest when stored in the refrigerator, individually and thoroughly cooked, and promptly consumed. The larger the number of Salmonella present in the egg, the more likely it is to cause illness. Keeping eggs adequately refrigerated prevents any Salmonella present in the eggs from growing to higher numbers, so eggs should be held refrigerated until they are needed. Cooking reduces the number of bacteria present in an egg; however, an egg with a runny yolk still poses a greater risk than a completely cooked egg. Undercooked egg whites and yolks have been associated with outbreaks of Salmonella enteritidis infections. Both should be consumed promptly and not be held in the temperature range of 40 to 140 for more than 2 hours.

Is There Treatment If Infected?

Nontyphoid Salmonella infection is generally self-limited. Treatment for enteritis or food poisoning is controversial. Some doctors recommend no antibiotics since the disease is self-limited, while others suggest using antibiotics such as ciprofloxacin for 10-14 days. A review of 12 clinical trials showed no significant change in the overall length of the illness or the related symptoms in otherwise healthy children and adults treated with a course of antibiotics for nontyphoid Salmonella disease. Antibiotics tend to increase adverse effects and prolong Salmonella detection in stools. Patients identified as immunosuppressed (for example, patients with AIDS or undergoing cancer chemotherapy) should receive antibiotics. Some investigators believe antibiotics prolong the carrier state.  Antibiotics usually chosen to treat Salmonella infections are fluoroquinolones and third-generation cephalosporins (used in children because fluoroquinolones are not indicated for use in children). Resistance to these drugs is a potential problem for those individuals that become infected with Salmonella as drug treatment options become limited.

Clearly, common sense, attention to cleanliness, thorough cooking of eggs and general public health measures are the best protection from infection.  Once infection occurs, prompt treatment with supportive measures and medications as medically indicated is essential.  Careful attention to hand washing and personal hygiene is critical to reduce the risk of spreading infection to care givers and other family members . . . ben kazie md

No evidence that tainted eggs go beyond 2 farms – http://enews.earthlink.net/article/hea?guid=20100823/b67576dd-7b7d-4d05-a524-e98ac055c671

FDA: No evidence yet that millions of eggs tainted by salmonella extend beyond 2 Iowa farms – http://www.startribune.com/business/101287334.html?elr=KArks4OiP:DiiU1OiP:Dii_47cQiU47cQUU

Investigation Update: Multistate Outbreak of Human Salmonella Enteritidis Infections Associated with Shell Eggs – http://www.cdc.gov/salmonella/enteritidis/

CDC Investigation Announcement: Multistate Outbreaks of Human Salmonella Hartford and Salmonella Baildon Infections – http://www.cdc.gov/salmonella/baildon-hartford/index.html

Hillandale Farms of Iowa Conducts Nationwide Voluntary Recall of Shell Eggs Because of Possible Health Risk – http://www.fda.gov/Safety/Recalls/ucm223452.htm

Investigation Update: Multistate Outbreak of Human Typhoid Fever Infections Associated with Frozen Mamey Fruit Pulp – http://www.cdc.gov/salmonella/baildon-hartford/index.html

How can I tell if my eggs have been recalled? – http://www.fda.gov/Food/NewsEvents/WhatsNewinFood/ucm223536.htm

How are Salmonella infections treated? -http://www.medicinenet.com/salmonella/page3.htm#treated

Antibiotics for treating salmonella gut infections – http://www.ncbi.nlm.nih.gov/pubmed/10796610 (Sirinavin S, Garner P. Antibiotics for treating salmonella gut infections. Cochrane Database Syst Rev. 2000;CD001167)

Salmonellosis – http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/

Salmonella enteritidis – http://www.cdc.gov/ncidod/dbmd/diseaseinfo/salment_g.htm

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Medical and clinical experts now agree that AD starts a decade or more before people have symptoms. By the time there are symptoms, it may already be far too late to save the brain. The goal then is to find ways to identify people who are getting the disease, and use those people as subjects in studies to see how long it takes for symptoms to occur and in studies of drugs that may slow or stop the disease.  Most recently, a paper just published in the Archives of Neurology, outlines a signature in spinal fluid, which very accurately predicts which patients will develop onset of AD within about 5  years. Researchers are finding a number of simple and accurate ways of detecting AD long before there are definite symptoms. In addition to work on genetic tests and spinal fluid tests they also have new PET scans of the brain that show the telltale amyloid plaques that are a unique feature of the disease. Hundreds of new drugs are undergoing testing and trials in the hope that one or more might change the course of the relentless brain cell death that robs people of their memories and abilities to think and reason. The latest PET scans for AD are not commercially available, but the spinal fluid tests are.

These new tests bring with them new questions and concerns.  Should patients and doctors use the commercially available spinal tap tests to find a disease that is yet untreatable? In research studies patients are often not told they may have the disease, but in the real world, many, if not most will be told. Many feel this should be left up to doctors and their patients. Others feel that doctors should not use the spinal fluid tests at all.  The concern is that the spinal fluid tests are not reliable enough and there can be variation in results between labs.  Finally, this type of testing has only been studied in the research settings where patients are carefully selected to have no other conditions, like strokes or depression, that could affect their memories. Some patients with severe memory loss do not have the AD. Doctors may choose to use the spinal tap test in cases where they want to be sure of the diagnosis. Also, they may wish to offer the test to people with milder symptoms who want to know whether they are developing AD.

One negative is that spinal fluid can only be obtained with a spinal tap, and that procedure, with its reputation for pain and headaches, makes some doctors and many patients nervous. The procedure involves putting a needle in the spinal space and withdrawing a small amount of fluid.  It is well-known however that spinal taps are safe and not particularly painful for most people. Still, a program of education is needed to make people feel more comfortable about having them. Since most family doctors and internists are not experienced in performing the test, there could be special spinal tap centers where they could send patients.

The new study included more than 300 patients in their 70s, 114 with normal memories, 200 with memory problems and 102 with Alzheimer’s disease. Their spinal fluid was analyzed for amyloid beta, a protein fragment that forms plaques in the brain, and for tau, a protein that accumulates in dead and dying nerve cells in the brain. To avoid bias, the researchers analyzing the data did not know anything about the clinical status of the subjects. Also, the subjects were not told what the tests showed. Nearly every person with Alzheimer’s had the characteristic spinal fluid protein levels. Nearly three-quarters of people with mild cognitive impairment, a memory impediment that can precede Alzheimer’s, had Alzheimer’s-like spinal fluid proteins. All of those with the proteins developed Alzheimer’s within five years. Nearly one-third of people with normal memories had spinal fluid indicating Alzheimer’s. Researchers suspect that those people will develop memory problems.

The prevailing hypothesis about Alzheimer’s says that amyloid and tau accumulation are necessary for the disease and that stopping the proteins could stop the disease. It is not yet known what happens when these proteins accumulate in the brains of people with normal memories. They might be a risk factor like high cholesterol levels, yet as we know, many people with high cholesterol levels never have heart attacks. Alternatively, it could mean that AD has already started and if the person lives long enough he or she will with absolute certainty get symptoms like memory loss. Many believe that when PET scans for amyloid become available, they will be used instead of spinal taps, in part because doctors and patients are more comfortable with brain scans.

It is clear that for a sensible treatment rationale to develop concerning AD, more knowledge is necessary. It may well be that drugs that are currently used to treat AD, almost always AFTER symptoms have developed, may be more useful if initiated at the first sign of development, just as statin drugs are used to lower cholesterol in patients with high levels, even if they have yet to have a stroke or heart attack.  In any event, early detection is ALWAYS a key to disease treatment and potential successful treatment outcome.  We hope that PET scans will become widely available and soon, so that more patients can be screened in a less invasive manner.  Hopefully, this and as yet to be discovered techniques and medications will finally put a halt to the expanding scourge of Alzheimer’s . . . ben kazie md

New Test Predicts Onset of Alzheimer’s by as Much as a Decade – http://www.associatedcontent.com/article/5674310/new_test_predicts_onset_of_alzheimers.html?cat=12

Spinal-Fluid Test Is Found to Predict Alzheimer’s – http://www.nytimes.com/2010/08/10/health/research/10spinal.html?_r=1&th&emc=th

Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People – http://archneur.ama-assn.org/cgi/content/abstract/67/8/949

Meta-analysis Confirms CR1, CLU, and PICALM as Alzheimer Disease Risk Loci and Reveals Interactions With APOE Genotypes – http://archneur.ama-assn.org/cgi/content/full/archneurol.2010.201

What is Alzheimer’s – http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

Tau protein – http://en.wikipedia.org/wiki/Tau_protein

Beta amyloid – http://en.wikipedia.org/wiki/Amyloid_beta

10 Signs of Alzheimer’s – http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

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This action is part of the follow-up mandated by the rapid approval process.  Rapid approval allows promising drugs to enter the market faster with the requirement that companies continue to do research on the effectiveness.  In  this case, it appears that in terms of breast cancer, there does not appear to be a major advantage in the additional use of Avastin (it is almost always used in conjunction with chemotherapy).  In this case, the system seems to be working as it should on both ends, by getting a promising product to the market quickly and then following up to be sure that the early promise is indeed realized . . . ben kazie md

F.D.A. Panel Urges Limits for Avastin – http://www.nytimes.com/2010/07/21/health/policy/21avastin.html?_r=1&hpw

FDA panel says Avastin should not be marketed for breast cancer treatment – http://www.latimes.com/news/health/la-sci-avastin-20100721,0,4084979.story

Roche May Lose $1 Billion a Year on Avastin Change – http://www.bloomberg.com/news/2010-07-20/roche-s-avastin-fails-to-win-u-s-advisory-panel-backing-for-breast-cancer.html

FDA Panel Says Avastin’s Breast Cancer Indication Should Be Removed – http://online.wsj.com/article/SB10001424052748703724104575379392504495872.html

Panel wants Avastin withdrawn for breast cancer – http://www.google.com/hostednews/ap/article/ALeqM5hsrSyNbgEjEv8fRvLyR0cVzoJQrQD9H2VIP81

Briefing Information for the July 20, 2010 Meeting of the Oncologic Drugs Advisory Committee – http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/OncologicDrugsAdvisoryCommittee/ucm219223.htm

FDA Briefing Document Oncology Drug Advisory Committee Meeting July 20, 2010 BLA STN 125085/191 and 192 Avastin® (bevacizumab) Applicant: Genentech Inc – http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/OncologicDrugsAdvisoryCommittee/UCM219224.pdf

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Filed under: Breast, cancer, guidelines, Medications, medicine, public health, research, Uncategorized, women Tagged: AMA, American, American Academy of Family Practice, American Cancer Society, American College of Obstetrics and Gynecology, American College of Radiology, American College of Surgeons, American Dietetic Association, American Medical Association, angiogenesis, anti-angiogenisis, Bloomberg, Bloomberg News, breast, breast cancer, Breast Cancer Action, cancer, cancer cells, cancer deaths, cancer of the breast, cancer research, cancer treatment, carcinoma of the breast, CBS News, chemotherapy, Dana-Farber Cancer Institute, delayed drug effects, disease causation, disease prevention, disease treatment, doctors, drug approval, drugs, early death, FDA, Food and Drug Administration, Genentech, health, health news, illness, Journal of the American Medical Association, Los Angeles Times, medical news, Medical News Today, medicine news, National Breast Cancer Coalition, national news, new drugs, New York Daily News, news, NY Times, Oncology, pharma industry, pharmaceutical agent, pharmaceuticals, prevention, public health news, research, research news, Roche, surgery news, The American Geriatrics Society, Wall Street Journal, WHO news, women, women's health news, world news, WSJ ]]> http://benkazie.wordpress.com/2010/07/21/quick-post-fda-panel-says-revoke-approval-of-avastin-bevacizumab-for-breast-cancer/feed/ 1 benkaziebenkazie http://benkazie.wordpress.com/2010/07/02/libido-pill-for-women-on-hold/ http://benkazie.wordpress.com/2010/07/02/libido-pill-for-women-on-hold/#comments Fri, 02 Jul 2010 19:20:40 +0000 benkaziebenkazie http://benkazie.wordpress.com/?p=802 ]]>

Flibanserin (proposed trade name Girosa) is a drug developed by and under investigation via Boehringer Ingelheim pharmaceuticals.  It is considered a novel, non-hormonal treatment for pre-menopausal women with Hypoactive Sexual Desire Disorder (HSDD). HSDD has been a recognized distinct sexual function disorder for more than 30 years.

HSDD is the most commonly reported female sexual complaint.  It is characterized by a decrease in sexual desire that causes marked personal distress and/or personal difficulties. Studies show that about 1 in 10 women reported low sexual desire with associated distress, which may be HSDD. The neurobiology and neurochemistry of female sexual desire is complicated.  It involves interactions among multiple neurotransmitters, sex hormones and various psychosocial factors. Sexual desire is controlled in a distinct brain area.  This control involves a balance between inhibitory and excitatory neurotransmitters. Serotonine acts as an inhibitor while dopamine and norepinephrine act as stimulators of sexual desire.

Flibanserin is a 5-HT1A receptor agonist (meaning that it binds to a receptor of a cell and triggers a response by the cell) and 5-HT2A receptor antagonist (meaning it acts against and blocks an action) that had initially been investigated as an antidepressant. Early research suggests that flibanserin targets these receptors preferentially in selective brain areas. It acts to help restore a balance between inhibitory and excitatory effects.

Phase III clinical trial data presented at the 58th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in San Francisco (May 2010), included data from two major North American trials (DAISY® and VIOLET®) which assessed flibanserin 100mg in pre-menopausal women suffering from HSDD. Initially over 1,300 women were enrolled in the 24 week trial with some 971 available for final analysis and review. The data demonstrated that a higher proportion of pre-menopausal women with HSDD reported improvement in their condition and a meaningful benefit from their treatment, compared to placebo.

Pre-menopausal women with HSDD report feeling an improvement in their symptoms of low desire and associated distress when taking flibanserin.  They also reported that this change had a meaningful benefit to them. These findings add to earlier data that showed positive outcomes. Women who completed 24 weeks of treatment showed statistically significant improved measures of sexual desire, overall sexual functioning, distress associated with low sexual desire, and the number of satisfying sexual events (SSE), compared with placebo.

The most common adverse events (AEs) reported in the study with flibanserin 100 mg were mild to moderate and were noted during the first 14 days of treatment. AEs reported by more women on flibanserin than on placebo included somnolence (daytime sleepiness), dizziness, fatigue, anxiety, dry mouth, nausea and insomnia. The majority of these AEs resolved with continued treatment. About 15% of women on flibanserin 100mg and 7% of women on placebo discontinued treatment due to AEs.

The US Food and Drug Administration’s (FDA) Reproductive Health Drugs Advisory Committee voted 10 to 1 on June 18 that flibanserin, 100 mg was not significantly better than placebo for HSDD. They also voted unanimously that the benefits did not compensate for its adverse effects. Although the FDA does not have to follow the advice of the advisory panel, the ruling means that approval is now unlikely in the United States unless additional data can be presented supporting the drug’s clinical benefit. Flibanserin is not as of yet approved in any country. No treatments directed toward HSDD in women are currently approved for use in the United States.  It is not clear at this time if the manufacturer will pursue additional studies or approvals outside of the US market.  HSDD remains a real and problematic issue for many women and couples.  In the era of Viagra, we can only hope that the FDA will seek to move to market medications which may have value for women seeking improved sexual function as well . . . ben kazie md

Sex and the Single Drug – http://www.nytimes.com/2010/06/27/business/27stream.html

No Sex Please, We’re Middle Class – http://www.nytimes.com/2010/06/27/opinion/27Paglia.html?ref=food_and_drug_administration

Drug for Sexual Desire Disorder Opposed by Panel – http://www.nytimes.com/2010/06/19/business/19sexpill.html

Sex, Brain, Body: Make the Connection – http://www.sexbrainbody.com/

Boehringer Ingelheim Comments on June 18th FDA Advisory Committee Meeting – http://us.boehringer-ingelheim.com/newsroom/2010/06-18-10_flibanserin_statement.html

Flibanserin – http://en.wikipedia.org/wiki/Flibanserin

Hypoactive sexual desire disorder – http://en.wikipedia.org/wiki/Hypoactive_Sexual_Desire_Disorder

FDA Advisory Committee Votes Against Flibanserin for Hypoactive Sexual Disorder – http://www.medscape.com/viewarticle/723896

Boehringer Ingelheim announces new data on flibanserin in pre-menopausal women with HSDD – http://www.eurekalert.org/pub_releases/2010-05/opr-bia051710.php

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As women seek to advance their sexual satisfaction, in the shadow of the craze started for men with the introduction of Viagra and continued by Levitra and Cialis, now comes a new technique designed to enhance the G spot.  The G spot was described by Graffenberg (hence the name).  It is area of tissue just below the urethra in the female in the distal anterior wall of the vagina.  There has been debate in the scientific literature regarding the reality of the G spot but increasingly there seems to be consensus that in fact it does exist.  Some have referred to the G spot as the “female prostate” alluding to it’s location, association with Skene’s glands in women and possible relation to the area which in a male would develop into the prostate gland.

The increased use of injections for plastic surgery and cosmetics has led some to investigate the concept of “G spot amplification”.  The idea being to inject a suitable material into the G spot to increase its size and prominence, thus making it more accessible, easier to find and more susceptible to stimulation during foreplay or intercourse.  Although extensive randomized trials are lacking, published data from certain series suggests that as many as 80% of women find G spot amplification very satisfying.  Most say they would be willing to repeat the procedure.   All of the substances currently being used, off label, are adsorbed by the body in 3 to 12 months, so treatments would have to be repeated to remain effective.  The effects of multiple repeat injections over time are as of yet not really known.

The currently used substances, none of which is FDA approved for this use, are mainly injections intended for cosmetic enhancement to reduce wrinkles and age lines, primarily on the face.  These substances include Juvederm^®, Restylane^®and Perlane^®.  Restylane and Perlane are both composed of hyaluronic acid, the main difference being that Perlane has larger particle size and is intended for deeper injections into the skin.  Juvederm is also a hyaluronic acid based product which acts as a smooth gel filler to smooth away wrinkles around the mouth and nose. It is infused with lidocaine to improve comfort during treatment.

The American College of Obstetrics and Gynecology has raised a red flag warning that these injections and other types of “cosmetic vaginal procedures” have not been proven safe and efficacious and therefore advise women against these procedures.  If they do choose to proceed, they should obtain full information and be aware of all potential risks and benefits, realizing that some risks may not, as of yet, be known.  Off label use of various medications is not new.  However, whenever the use is for a cosmetic or similar purpose the tolerance for side-effects, complications and bad outcomes diminishes. Concern has also been raised by the cavalier attitude some have taken toward these procedures, such as the so called “G Spot Parties“, where women come together as a group and go to a clinic to have the injections.

Another worrisome aspect to this latest cosmetic procedure is the attempt by some to apply patent law to the technique of injection.  In medicine and surgery it has generally been a standard in the profession to teach colleagues techniques that advance patient care. The American Medical Association (AMA) House of Delegates voted in 1994 to oppose the practice of medical and surgical procedure patents as unethical. The patent system, to the extent it keeps new procedures secret for long periods of time and limits free access to information that improves patient care,conflicts with the principles of the Hippocratic Oath, which calls upon physicians to share their expertise freely and to teach their colleagues for the benefit of patients. The House of Delegates viewed the method patent trend as contrary to the medical tradition of an open exchange of information without the expectation of financial reward and expressed concern that it might have a chilling effect on medical practice and education according to the AMA Board of Trustees.

In the end, the old adage, let the buyer beware, should rule.  These procedures are costing on average around $1,200 – a cost as  you might suspect that is not covered by health insurance. So ladies, as interesting as it sounds, the best advice is to proceed with caution as with all things in sex and life . . . ben kazie md

G-spot amplification – http://en.wikipedia.org/wiki/G-spot_amplification

G-Spot – http://en.wikipedia.org/wiki/Gr%C3%A4fenberg_spot

The Role of the Urethra in Female Orgasm (published in the International Journal of Sexology in 1950) – http://www.landman-psychology.com/284/sexuality/grafenberg-gspot.htm

Who’s afraid of the G-spot? - J Sex Med. 2010 Jan;7(1 Pt 1):25-34 -http://www.ncbi.nlm.nih.gov/pubmed/20092462

Cosmetic vulvovaginal surgery – http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B8CY0-4TDBMKS-1&_user=10&_coverDate=10%2F31%2F2008&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=e9efb1f4971260cf067f694ad7dd2ef0

G-Shot Parties: A Shot at Better Sex? – http://abcnews.go.com/print?id=4312986

ACOG Advises Against Cosmetic Vaginal Procedures Due to Lack of Safety and Efficacy Data – http://www.acog.org/from_home/publications/press_releases/nr09-01-07-1.cfm

Welcome to G-Spot Amplification^{™ –} http://www.thegshot.com/

Patents on Medical Procedures and The Physician Profiteer – http://library.findlaw.com/2004/Sep/19/133572.html

Enhanced romance / The G-Shot — Is it the latest panacea to improve your love life? – http://articles.sfgate.com/2007-06-03/living/17250812_1_plastic-surgeon-orgasms-gynecologist

Juvederm Injectable Gel – http://www.juvederm.com/about_safety/about_safety.aspx

Restylane and Perlane – http://www.restylaneusa.com/about-restylane.html

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Metabolic Syndrome may play a major role in predisposing to the development of Alzheimer’s Disease (AD) and related dementia. What is dementia? Dementia is a broad diagnostic label given to people whose memory is impaired to the point that it affects daily functioning. Not all dementia is due to Alzheimer’s Disease, but everyone who has Alzheimer’s Disease also has a form of dementia.

So, how do we know if we have metabolic syndrome.  Well, not all researchers agree on a simple definition.  However, we generally do know what makes it up. Some scientists even argue that metabolic syndrome isn’t a true condition at all, stating that it is simply a combination of different risk factors. Regardless, the evidence suggests that any of the following problems can increase your risk for developing AD and other diseases.

The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:

• Abdominal obesity (excessive fat tissue in and around the abdomen)
  • A waistline measuring > 35 inches for women and > 40 inches for men. If you’re at high risk for diabetes, the measurement is 31 to 35 inches for women and 37 to 39 inches for men. Remember, this is NOT your pant size, but what the tape measure shows when you actually measure your waistline.

• Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
  • High triglycerides: Levels of 150 mg/dL or higher, or taking medication for high triglycerides.
  • Low HDL: Levels below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL.

• Elevated blood pressure (high blood pressure)
  • At or about 130/85, or taking medication for high blood pressure.

• Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
  • High blood sugar: Fasting blood sugar (blood glucose) of 100 mg/dL or higher, or receiving treatment for high blood sugar.

• Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)

• Proinflammatory state (e.g., elevated C-reactive protein in the blood)

Abdominal fat matters.  In fact, most abdominal fat is not the fat you can pinch under your skin, that is subcutaneous fat.  Most abdominal fat is in fact, visceral fat.  The kind that wraps around your internal organs deep inside.  The more of this you carry around the higher your chances of developing insulin resistance which can lead to type two diabetes, heart disease and other metabolic syndromes.

Visceral fat or belly fat, is deposited slightly differently in men and women, but the end result is the same.  The main defense against visceral fat, aside from proper diet and portion control, is exercise.  Without a doubt, the most effective overall exercise is a simple one, walking.  Swimming, jogging or other types of aerobic exercise are also ideal.  However, even moderate amounts of exercise, like a daily walk, can have a positive impact.

Some experts believe there are two possibilities as to why mid-life metabolic syndrome is an important risk factor for later-life dementia. One is that diabetes and hypertension are directly responsible for the underlying pathology of Alzheimer’s disease, which involves toxic levels of proteins that build up in the brain. The proteins form plaques and tangles that destroys cerebral tissue. Two, diabetes and hypertension cause cerebrovascular disease (in which blood vessels supplying the brain are damaged), and this contributes to dementia by leading to strokes and mini-strokes.

However, the definitive cause remains unknown.  Clearly, metabolic syndrome is a combination of things that may or may not equal the sum of its parts. It includes diabetes and hypertension, and to be sure those two things by themselves are very important. Yet, it also includes cholesterol, and cholesterol levels may in the end have nothing at all to do with dementia or brain aging. Research is ongoing to try and answer these very questions.

In the meantime, neurologists suggest that treating metabolic syndrome could prevent dementia. No single study has as of this date shown that by successfully treating metabolic syndrome you can cut your risk of vascular dementia. Vascular dementia is an umbrella term used for cognitive impairments caused by problems in blood vessels that feed the brain, what most of us would call strokes, large and small. Doctors say that common sense dictates that controlling your risk of metabolic syndrome will cut your risk of vascular dementia, because it reduces your risk of stroke, which is the cause of vascular dementia.

There are many things you can do to reduce your risk of developing AD, including not waiting until you are in your 60s and 70s. You need to take action in mid-life, which means NOW . . . ben kazie md

Your Heart, Your Belly and Alzheimer’s – http://patients.aan.com/resources/neurologynow/index.cfm?event=home.showArticle&id=ovid.com%3A%2Fbib%2Fovftdb%2F01222928-200905040-00015

What is the metabolic syndrome? – http://www.americanheart.org/presenter.jhtml?identifier=4756

What Is Metabolic Syndrome? – http://www.nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html

Dementia – http://www.mayoclinic.com/health/dementia/ds01131

What is Alzheimer’s – http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

Belly fat in men: Why weight loss matters – http://www.mayoclinic.com/health/belly-fat/mc00054

Belly fat in women: How to keep it off – http://www.mayoclinic.com/health/belly-fat/wo00128

Abdominal obesity – http://en.wikipedia.org/wiki/Abdominal_obesity

Visceral Fat: A major health concern in Postmenopausal Women – http://www.womenfitness.net/visceral_fat.htm

How to Lose Visceral Fat – http://ezinearticles.com/?How-to-Lose-Visceral-Fat&id=657916

Dangerous visceral fat builds up if you don’t exercise, can go down if you do – http://www.medicalnewstoday.com/articles/30641.php

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