GARLIC CAN CAUSE INCREASED BLEEDING. RISKS OF “NATURAL” MEDICINES

Herbal medicines are not always the harmless nostrums that many patients and even some physicians think, but may actually contribute to cardiovascular morbidity and mortality, researchers warned in a review published in the Journal of the American College of Cardiology[JACC].
Many such products, including aloe vera, ginkgo biloba, ginseng, and green tea, can interact with conventional cardiovascular drugs and lead to serious adverse reactions, according to the Mayo Clinic.

The JACC article also listed 15 common herbal medicines known to interact adversely with conventional cardiovascular drugs.In many cases, the herbal products compete with the regular medicines for the same drug-metabolizing cytochrome P450 enzymes, potentiating the latter's effects. In other cases, the herbal products have their own cardiovascular effects.

Many physicians already know that even “natural” grapefruit juice occupies the CYP3A4 enzyme, leading to slower-than-expected metabolism and, therefore, higher blood levels of a host of pharmaceuticals.These include the statins, calcium channel antagonists, several common anti-arrhythmic drugs, and the angiotensin receptor blocker irbesartan (Avapro), Jahangir and colleagues noted.

Garlic is one of several common herbal remedies with specific cardiovascular effects in its own right (others include ginkgo biloba, ginseng, and saw palmetto). Garlic inhibits platelet aggregation and thus can lead to increased bleeding risks when combined with aspirin, clopidogrel (Plavix), or warfarin (Coumadin), the researchers noted.

The Mayo group identified 10 herbal products that increase bleeding risks with anticoagulant and antiplatelet drugs, and listed 27 herbal products that patients with cardiovascular diseases would do well to avoid. These include such common and harmless-seeming products as green tea, capsicum pepper, licorice, and kelp, as well as grapefruit juice and garlic.

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.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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Boxed Warning Added to Clopidogrel [PLAVIX] Label

Prescribing information for clopidogrel (Plavix) will now include a boxed warning that the drug can be less effective in poor metabolizers, the FDA indicated. The new warning suggests that many if not all patients on clopidogrel should undergo genetic testing to determine whether they have variants of the CYP2C19 gene associated with poor metabolism of the antiplatelet drug. Clopidogrel is actually a prodrug that requires metabolic activation by the CYP2C19 enzyme to become effective. Poor metabolizers get little or no benefit from the drug at standard doses, and therefore are at increased risk for thrombotic events and death, the FDA said. The drug's label has carried a similar warning since May 2009, but the FDA said today that "it was important to highlight this risk in a boxed warning" in light of a subsequent review of data. Seven different variants of the CYP2C19 gene are associated with poor metabolism of clopidogrel. According to the FDA, patients with two loss-of-function alleles, which do not have to be identical, will be poor metabolizers. The agency estimated that 2% to 14% of patients are poor metabolizers, with some racial-ethnic groups more likely to be affected than others. Whites have the lowest prevalence of poor metabolism and Asians have the highest. The boxed warning also includes this advice to healthcare providers: "Tests are available to identify a patient's CYP2C19 genotype and can be used as an aid in determining therapeutic strategy." A Cardiologist at Brigham and Women's Hospital and Harvard Medical School in Boston, claims the warning effectively means every patient on clopidogrel needs to be tested, although the new label does not say so directly. Some 25 million prescriptions for clopidogrel were written in 2008, according to Drugs.com. The FDA also recommended that physicians "consider alternative dosing" if patients are found to be poor metabolizers. The FDA urged patients currently taking clopidogrel not to stop the drug unless told to do so by their physician. Concerned patients should discuss the new information with their doctors before making any change. 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.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. Deepen your understanding of "medical malpractice"... www.MedMalBook.com For more health info and links visit the author's web site www.hookman.com

40,000 Former Clinic Patients Notified About Possible Exposure To Blood-Borne Diseases Because Of Unsafe Injection Practices.

Nurse anesthetists reusing single-dose medicine vials among different patients led to as many as 115 people who contracted hepatitis C because of these unsafe injection practices at two Endoscopy centers. Officials notified 40,000 former clinic patients about possible exposure to blood-borne diseases because of unsafe injection practices. The Clinic’s staff told health investigators they were ordered by administrators, principally the physician owner, to reuse supplies and medications to save money, according to a Las Vegas letter suspending the center’s business license The police investigation ended late last year. Hundreds of former patients have sued the physician, his clinics and the manufacturers of the anesthetic, propofol, that was used during their colonoscopies. 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.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. Deepen your understanding of "medical malpractice"... www.MedMalBook.com For more health info and links visit the author's web site www.hookman.com

HOW ACCURATE ARE NUTRITION PACKAGE LABELS?

According to a study published in the Journal of the American Dietetic Association, "prepared foods may contain an average of 8% more calories than their package labels own up to, and restaurant meals may contain a whopping 18% more." The misleading labels are also said to be "perfectly o.k." with the Food and Drug Administration, which "plays no role in checking the calorie claims in restaurants." Without federal regulation, "it's up to the states to handle the job - with the predictable patchwork results." Susan Roberts, who conducted the study, described the unregulated menu counts as "the Wild West when it comes to this."

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.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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Sharing hospital room may increase infection risk during stay

Sharing a hospital room increases your risk of picking up an infection during your stay, a new study shows." The work, by researchers from Queen's University in Kingston, Ont., "found that each new roommate raised a patient's risk of picking up an infection in hospital by about 10 percent." The study's senior author, Dr. Dick Zoutman, said in a statement, "That's a substantial risk, particularly for longer hospital stays when you can expect to have many different roommates."

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.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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Autism increases in the US

Almost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."

Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.

Among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said. Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls.

From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both).

The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old which is especially important, as early recognition and treatment improves outcomes.

ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3. 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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Abdominal surgeries riskier for older adults than previously thought

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%
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Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Archttp://www.blogger.com/img/blank.gifh 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.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.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com