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    Sunday, October 30, 2011

    Banned Herbal Ingredient Linked to Urinary Tract Cancer

    Natural does not equal safe, and any herb strong enough to have a potential benefit is strong enough to have potential to cause harm."
    Exposure to aristolochic acid, found in some Chinese herbal products such as Mu Tong and Fangchi, significantly increased the risk for urinary tract cancer, according to a retrospective study.Researchers in Taiwan found prescription of more than 60 grams of Mu Tong and consumption of more than 150 mg aristolochic acid were independently associated with an increased risk for urinary tract cancer.

    • Mu Tong, 61 to 100 g: OR 1.6, 95% CI 1.3 to 2.1
    • Mu Tong, >200 g: OR 2.1, 95% CI 1.3 to 3.4
    • Aristolochic acid, 151 to 250 mg: OR 1.4, 95% CI 1.1 to 1.8
    • Aristolochic acid, >500 mg: OR 2.0, 95% CI 1.4 to 2.9

    Used in Chinese herbal preparations taken for weight loss or urinary tract infections, aristolochic acid has been banned in several countries, including in Taiwan and in the U.S.The latest study found a linear, dose-dependent relationship between the amount of aristolochic acid consumed and an increased risk for urinary tract cancer (P<0.001). This was independent of arsenic exposure through drinking water, which has also been associated with bladder and urinary tract cancers.Among the more than 4,000 patients analyzed, 57% had bladder cancer and 43% had upper urinary tract cancer.
    The International Agency for Research on Cancer has classified herbal remedies containing high concentrations of aristolochic acid as carcinogenic. Traces of aristolochic acid may still be found in adulterated remedies currently on the market.
    Wang, et al "Population-based case-control study of chinese herbal products containing aristolochic acid and urinary tract cancer risk" J Nat Can Inst 2009; DOI:10.1093/jnci/djp467.

    Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    Tuesday, October 18, 2011

    About 2 million older adults undergo abdominal surgeries in the U.S. every year, a number that's expected to grow as the proportion of older adults increases rapidly: by 2020, one in six adults is expected to be older than 65, and 15% will be over 85.
    The patient records came from the Comprehensive Hospital Abstract Reporting System, a state-wide database that contains information on the age, sex, zip code, and billed charges of patients, as well as the codes for their diagnosis and procedures.
    The study focused on complications that occurred within 90 days of discharge and deaths within 90 days of hospital admission.

    After adjusting for various factors, including hospital volume and patient characteristics, the study found that the odds of early death after abdominal surgery increased considerably for each five-year increase in age beyond 65. These associations held for patients with cancer and other diagnoses, and for both elective and nonelective procedures (P<0.001).

    The likelihood of complications increased as patients aged beyond 65 years, with the researchers finding the following associations between age and complication frequency (trend test, P<0.001):

    • 65 to 69 years, 14.6%
    • 70 to 74 years, 16.1%
    • 75 to 79 years, 18.8%
    • 80 to 84 years, 19.9%
    • 85 to 89 years, 22.6%
    • 90 and older, 22.7%

    Similarly, older patients were at higher risk of mortality. Death rates by age group were (trend test, P<0.001):

    • 65 to 69 years, 2.5%
    • 70 to 74 years, 3.8%
    • 75 to 79 years, 6.0%
    • 80 to 84 years, 8.1%
    • 85 to 89 years, 12.6%
    • 90 and older, 16.7%

    Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Arch Surg 2009; 144: 1108-14.

    Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

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