Fish oil may protect preemies eyesight
Mon, 09 Jul 2007 18:11:35 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Perhaps nowhere in the body is the adage "you are what you eat" so true as in your eyes, a link scientists are banking on in a novel bid to save premature babies' vision.
Doctors are about to begin testing whether fish oils could prevent a disease that can silently attack behind preemies' tiny eyelids, one that strikes about 16,000 U.S. infants a year and blinds hundreds.
It's part of research into a trio of apparently eye-healthy compounds that babies born too early miss absorbing from their mothers — research gaining increasing attention as more and babies are born premature and at risk.
"We're trying to mimic what would happen in utero," explains Dr. Lois Smith, an opthalmologist at Children's Hospital Boston who is leading the work. "Rather than give drugs, we're doing replacement treatment."
Preventing the disease — called retinopathy of prematurity, or ROP — is a major goal, because there's no sure way to save vision once it strikes. Laser therapy decreases but doesn't eliminate the chance of blindness, and many babies who don't go blind still suffer serious damage.
It's not just an issue for preemies. The same abnormal growth of blood vessels behind ROP triggers two leading causes of blindness in adults: diabetic retinopathy and age-related macular degeneration. Already, scientists are studying if these omega-3 fatty acids — the same kind touted for heart health — could protect adult eyes, too.
Why might they? These diseases destroy the retina, the eye's innermost layer, which harbors a higher percentage of certain fats than other organs. Eat lots of salmon, rich in omega-3s, and your retina will show it. Eat mostly hamburgers, and your retina will harbor more of a different fatty acid, omega-6s. The retina's composition actually changes with diet.
Mothers pass omega-3s to their unborn children mostly during the third trimester, when the eyes develop most rapidly. Preemies not only miss out on some or all of that transfer, but omega-3s aren't added to the intravenous feeding that many require, either.
Premature babies have still forming retinas; blood vessels necessary to nourish them haven't finished growing. ROP forms when something spurs those blood vessels to grow abnormally — too many form, and they leak.
But do omega-3s play a role? Smith and colleagues at Harvard and the National Eye Institute first turned to mice to find out.
They harmed the mice retinas in a way that mimics ROP, and then fed them different foods: Half ate the rodent version of a typical Western diet, high in omega-6s and low in omega-3s. Half ate the equivalent of a Japanese diet, with a 2 percent higher omega-3 content.
That simple change cut in half the retinal disease among the omega-3-nibbling mice, Smith reported last month in the journal Nature Medicine.
More intriguing, the omega-3s didn't just block bad blood vessels from forming. They also helped normal, healthy blood vessels grow. They appeared to work by blocking well-known inflammation-causing pathways in the body — while mice fed more of the omega-6s experienced extra inflammation.
Now, Smith is about to begin a study in premature babies at her Boston hospital to see if adding omega-3s to their IV feedings — feedings that today contain omega-6s instead — decreases their risk of eye damage.
"This could be a very simple and safe treatment," says Dr. Rafael Ufret-Vincenty, a retina specialist at the University of Texas Southwestern Medical Center.
Indeed, omega-3s have long been known to be important for newborn brain development; they're in breast milk and are added to some formulas for older babies. When it comes to preemies' IV feeding, a version rich in omega-3s is available in Germany but hasn't spread to North America, says Dr. Sylvain Chemtob, an ROP specialist at Sainte-Justine University Health Centre in Montreal.
"It makes a lot of biological sense," he says.
These are the same fish oils sold as over-the-counter dietary supplements for heart health, and a nationwide study already is recruiting adults with macular degeneration to test if high doses could slow their vision loss.
For preemies, omega-3s aren't the only missing-from-mom player generating attention. A drug combination sold to treat hormone-deficient children grow taller is being studied, too — a growth hormone called IGF-1 and a "binding protein" that helps regulate it.
Smith already knew babies with ROP lacked the growth hormone, but last month she and colleagues at Sweden's University of Goteborg reported they also have less binding protein than healthy babies. Studies in mice suggest that protein helps ROP-stricken retinas develop more normally, the Swedish team and University of Florida researchers reported, apparently by calling on stem cells to help build strong blood vessels.
Stay tuned: the Swedish scientists have begun a pilot study of the drug combo, Insmed Inc.'s Iplex, in preemies.
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EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Unhealthy truckers try to shape up
Mon, 09 Jul 2007 18:01:18 GMTBy EMILY FREDRIX, AP Business Writer
GREEN BAY, Wis. - Truck drivers — the people who deliver our food, cars and clothing — have one of the most dangerous jobs in America — accounting for nearly 15 percent of U.S. work-related deaths. And that's only counting the accidents.
They are also more at risk than average Americans for a number of health problems. Obesity is rampant. Many don't bother to wear seatbelts because their stomachs get in the way. About one in four have sleep apnea. Half of them smoke.
The latest research in an upcoming report drives home those points and may help influence government regulations for truck drivers' health, which are under review. The Federal Motor Carrier Safety Administration is considering tightening its rules for conditions including diabetes and high blood pressure. And many companies are stepping up their own efforts at improving health.
"It takes a while to undo years and years and years of unhealthy behavior," said Christie Cullinan of the American Trucking Associations, which represents about 2,000 companies and suppliers. "But I think companies are having to look at this because of the skyrocketing health care costs and related workers compensation costs."
Drivers are tested every two years to maintain their licenses, which are issued by states. Waivers can be granted, but generally commercial drivers can't be licensed if they have severe high blood pressure or severe heart conditions. Other aspects of drivers' health, like weight and smoking, aren't regulated.
"They can't say, 'You can't be obese' and they can't force you to stop smoking,'" said Gerald P. Krueger, a psychologist who compiled the latest research by the Transportation Research Board. "The government shouldn't regulate that. But we've been trying to educate people to the linkage between being a healthy person and a safe driver."
Krueger said trucking companies need to do more to foster better health among their employees, whether it's to reduce health care costs or hang onto employees in an industry where turnover is high and shortages growing.
It's not clear how many companies are making efforts. The trucking associations group says it is planning a survey. The group estimates there are 1.3 million long-haul drivers nationwide.
An Associated Press spot check of companies revealed these initiatives:
_Celadon Group Inc. has stationed nurses at its main facility in Indianapolis and encourages its 3,200 drivers in the U.S. and Canada to get blood pressure and cholesterol checks. Doctors are on call if needed, and Celadon pays all expenses. The company says it's helped trim its $10 million annual health care bill.
_Melton Truck Lines Inc. replaced sodas in the Tulsa, Okla., headquarters vending machines with green tea, water and diet drinks. The company also offered a 12-week weight-loss series.
_Con-way Freight of Ann Arbor, Mich., saw annual workers compensation claims plunge 80 percent and lost work days drop 75 percent in Los Angeles after its trial of a wellness program two years ago. Now leaders of such programs are being hired at other hub offices.
_Schneider National Inc. of Green Bay, Wis., screened 10,000 of its 15,000 drivers for apnea, a disorder that interferes with breathing during sleep and can leave the sufferer groggy and exhausted. The company provided the 10 percent who had the disorder with special air masks to help them sleep.
Some drivers are responding to all the health campaigns, working out at loading stations, cooking for themselves and even walking laps around their rigs.
Sammy Belvin, a driver for Oklahoma-based Melton Truck Lines, has been getting advice from a wellness coordinator with the company. He carries weights in his truck, and for meals, he eats cereal and cooks chicken breasts on an electric grill in his cab.
A driver for 23 years, Belvin says these days he's not the only one jogging around in the mornings before he drives off for the day.
Lisa Miles, an independent driver based in Fort Wayne, Ind., lifts weights in the cabin of her semi, too, while her partner driver takes the wheel. She gave up smoking three years ago and now is trying to lose 30 pounds.
"It's real easy to let your personal health be the last of your priorities," she said.
As many as half of drivers are regular smokers, compared to about one-fifth of all Americans. Many truckers are obese, and only about one in 10 get regular aerobic exercise. More details will be available in a soon-to-be-published study for the Transportation Research Board, an arm of the National Academy of Sciences. All those bad habits can fuel high blood pressure and chronic conditions like heart disease and diabetes.
Sleep apnea, which is linked to obesity, is rampant too. An industry study a few years ago found 28 percent of drivers had it; that compares with about 4 percent in the general population who have the disorder.
Government numbers say the trucking industry has the most fatalities of all occupations. The Bureau of Labor Statistics says truck drivers account for nearly 15 percent of all worker deaths in the most recent data available, from 2005. Of those trucker deaths, 80 percent involved traffic accidents, the bureau said.
Truck drivers also report more injuries, such as sprains, than workers in any other category, according to the Occupational Safety and Health Administration. Many of them unload the goods they carry, risking back injuries.
The medical review board of the Federal Motor Carrier Safety Administration will discuss updating medical guidelines at a meeting this month, but any changes are at least a year away, officials said.
Meanwhile, the Teamsters union wants to ensure that truckers don't lose their jobs if health rules are tightened, said Lamont Byrd, director of safety and health for the union.
"We see some real changes coming down the pipe that suggests the bar may be raised," he said.
Truckers pose unique challenges when it comes to improving health, said Ilene Masser, director of such a program for faculty and staff at New York University Medical Center. They sit for long periods, are out on their own, eat a lot of fast food and most of them are men, who often need more prodding than women to make changes, she said.
Changes are worth it. About three-quarters of employers with at least 1,000 workers have a wellness program, she said. And for every dollar invested, they get about $3.14 back, including savings on health care costs and added productivity.
William Rundle is one of the drivers for Schneider National who benefited from his company's aggressive effort to treat sleep apnea.
"It's wonderful to be able to function during the day now," he said, adding that he has more energy and makes his deliveries on time. He said his company has also persuaded him to quit smoking and eat better.
In the past year he's trimmed 15 pounds from his formerly 300-pound, 5-foot-7 frame. It's difficult, he said. He wants to eat salads but they often come with hard-to-resist cheese and bacon. He wants to exercise but counts few safe places to walk close to the highway.
"You don't see very many truck drivers that look like they're in good shape. We're just like anybody else," said Rundle, 43, who lives in Woodbourne, N.Y.
For at least seven years, Schneider has worked to improve drivers' health. Twice a year, the company takes a "discomfort" survey on driving ergonomics and aches and pains. Physical therapists follow up with drivers to address problems before they become severe.
Krueger, the Transportation Research Board psychologist, said younger drivers know more about healthy behaviors because they've heard it in school. But the problem lies in convincing the drivers already on the road that they need to exercise, see a doctor regularly and eat better. He has spent decades researching occupational medicine and he's heard all sorts of excuses, especially from drivers.
"My favorite line is, 'Dr. Krueger, I get off work at 3 in the morning. You want me to go to Gold's Gym and do what?'"
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On the Net:
American Trucking Associations: http://www.truckline.com
FMCSA: http://www.fmcsa.dot.gov
FDA approves patch to treat dementia
Mon, 09 Jul 2007 14:36:53 GMTWASHINGTON - The first skin patch to treat the dementia that can plague Alzheimer's patients gained federal approval, a drug company said Monday.
The drug in the patch, called Exelon or rivastigmine, is the same as that now available in capsule form but provides a regular and continuous dose throughout the day, according to Novartis Pharmaceuticals Corp. Since the drug enters the bloodstream directly, the patch also eliminates some of the gastrointestinal side effects associated with the drug when swallowed.
The drug is meant to treat the symptoms of mild to moderate dementia in patients with Alzheimer's disease. It also won Food and Drug Administration approval to treat patients with mild to moderate Parkinson's disease dementia, Novartis said.
About 4.5 million Americans have Alzheimer's. As the disease progresses, it robs patients of their memories and changes how they both think and behave. It's ultimately fatal.
Rivastigmine isn't a cure. It inhibits the breakdown of a chemical in the brain called acetylcholine, thought important for both learning and memory.
Novartis said the prescription patch would be available soon. The patch is made by Germany's LTS Lohmann Therapie-Systeme AG and distributed by Novartis Pharmaceuticals, part of Switzerland's Novartis AG.
China battles shoddy food drugs
Mon, 09 Jul 2007 15:43:30 GMTBy ALEXA OLESEN, Associated Press Writer
BEIJING - China must step up its fight against shoddy food and drugs and the corrupt officials who have let them flourish, or it faces social unrest and a further tarnished image abroad, senior party and regulatory officials said.
The comments came at a State Food and Drug Administration seminar where officials were warned to learn from the example set by their former boss, who was sentenced to death for taking bribes from drug companies.
Food and Drug Commissioner Shao Mingli likened the overhaul of his agency and the fight against China's substandard — and sometimes deadly — food and drugs to a pitched battle.
"We must face the fact that there are still some problems which cannot be ignored," Shao was ed as saying at the weekend seminar in a transcript posted on the agency's Web site. "Some areas are not fully aware of the importance, hardship and complexity of this work. They fear the difficulties and suffer battle fatigue."
China's pharmaceutical industry is lucrative but poorly regulated. Some companies try to cash in by substituting fake or substandard ingredients.
Fears abroad over Chinese-made products were sparked last year by the deaths of dozens of people in Panama who took medicine contaminated with diethylene glycol imported from China. It was passed off as harmless glycerin.
A Panamanian prosecutor has said that tests show at least 94 people died after taking medicine contaminated with diethylene glycol since July 2006, with 293 additional deaths under investigation.
In North America, pet food containing Chinese wheat gluten tainted with the chemical melamine was blamed for the deaths of dogs and cats.
Since then, U.S. authorities have turned away or recalled toxic fish, juice containing unsafe color additives, and popular toy trains decorated with lead paint.
"Food security problems have impeded Chinese agri-products and food many times in international trade and damaged our national credibility and image," Sun Xianze, a food supervision officer with the State Food and Drug Administration, told the conference in Beijing.
He cited a list of domestic food scares from the past year, including drug-tainted fish, banned Sudan dye used to color egg yolks red, and pork tainted with clenbuterol, a banned feed additive.
More such cases were likely to occur and would "not only affect the healthy development of the industry but could also impact local economies and social stability," Sun said.
Seminar attendees were told to "draw profound lessons" from the former agency director, Zheng Xiaoyu, who was sentenced to death in May for taking bribes to approve substandard medicines, including an antibiotic blamed for at least 10 fatalities in China.
Qu Wanxiang, the vice minister of supervision for the Communist Party's Central Commission for Discipline and Inspection, said corruption like Zheng's "shook the government's regulatory foundation and damaged the government's image." His comments were posted Monday to the State Food and Drug Administration Web site.
"The impact is extremely bad and the consequences extremely serious," Qu said.
Under Zheng's 1998-2005 tenure, his agency approved six medicines that turned out to be fake, and the drug makers used falsified documents to apply for approvals, state media reported.
His death sentence was unusually severe even for China, which is believed to carry out more court-ordered executions than all other nations combined, and likely indicates the leadership's determination to confront the country's dire product safety record.
On Friday, China sentenced another official, one of Zheng's former subordinates, to death for taking bribes.
Cao Wenzhuang, the State Food and Drug Administration's pharmaceutical registration department director, was given a death sentence with a two-year reprieve for accepting bribes and dereliction of duty. Such suspended death sentences usually are commuted to life in prison if the convict is deemed to have reformed.
Cao said he took no bribes. His lawyer, Gao Zicheng, said Cao plans to appeal.
Authorities said last week that they had withdrawn the production licenses of five drug makers in the last year and penalized 128 others.
