Pharmacy News For 2 Mar 2008

PharmD|Pharmacy Schools : 2008 : 2008_03_02

CDC to destroy oldest smallpox vaccine

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Sat, 01 Mar 2008 02:05:26 GMT
By MIKE STOBBE, AP Medical Writer

ATLANTA - The government announced Friday that it has said goodbye to one of the world's greatest lifesavers — the oldest smallpox vaccine. The U.S. Centers for Disease Control and Prevention this month made arrangements to dispose of the last of its 12 million doses of Dryvax, and notified other health departments and the military to do the same by Feb. 29.
Dryvax — produced by scraping virus off the skin of infected calves — is being replaced in federal vaccine stockpiles by a more modern product manufactured in laboratories.

Dryvax was unusually dangerous for a vaccine, blamed in recent years for triggering heart attacks and a painful heart inflammation in some patients.

Still, attention should be paid on the occasion of its demise, said Dr. William Schaffner, chairman of Vanderbilt University's department of preventive medicine.

It is a "historical moment, because it's our oldest vaccine," Schaffner said. "It was a vaccine that eliminated smallpox from the United States."

Smallpox is a deadly, infectious disease that plagued the world for centuries and killed nearly a third of the people it infected. Victims suffered scorching fever and body aches, then spots and blisters that would leave survivors with pitted scars.

Dryvax was created in the late 1800s, by the company that became Wyeth Laboratories. Wyeth was a primary U.S. manufacturer of smallpox vaccine by the mid-1940s, and was the only company left making it by the early 1960s, said Dr. D.A. Henderson, a University of Pittsburgh vaccine expert who played a key role in international smallpox eradication efforts.

The United States was able to end routine childhood vaccination against the disease by the early 1970s. World health authorities declared the disease was eradicated from nature in 1980.

Wyeth stopped making the vaccine in the 1980s. But government officials kept a stockpile of about 15 million doses. The Dryvax came in handy in 2003, when it was used to help contain an outbreak of monkeypox in the United States.

"There are situations where one does have to have a smallpox vaccine," said Dr. Neal Halsey, director of John Hopkins University's Institute for Vaccine Safety.

U.S. officials had also been worried that smallpox might resurface as a result of bioterrorism. Following the 9/11 attacks and the anthrax-containing letters that surfaced a month later, the government in 2002 ordered certain military personnel vaccinated and recommended shots for front-line health care workers.

The government also pushed for manufacture of a new vaccine. It hired a company named Acambis Inc., which had produced nearly 200 million doses by the end of 2003, Henderson said.

Last September, the U.S. Food and Drug Administration approved licensure of the company's ACAM2000 vaccine. That product is now the mainstay of the CDC stockpile, Henderson said.

Dryvax had problems. It was long suspected of triggering neurological complications, including encephalitis, in rare cases. Then, in 2003, three adults who received the vaccine died suddenly of heart attacks. As a precaution, health officials advised people with heart disease to skip the vaccination.

A study published in 2005 suggested that Dryvax triggered a painful heart inflammation in a small number of emergency workers vaccinated after Sept. 11.

"Times had changed, and our awareness, sensitivity and tolerance for adverse events associated with vaccines was much greater" than during the smallpox vaccination campaigns of the 20th century, Schaffner said.

ACAM2000 is created in laboratories, not on a farm, so there's much less possibility of bacterial contamination in the production process. However, it's derived from Dryvax, and it's not clear it will have fewer side effects than the old vaccine, some vaccine experts said.

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On the Net:
CDC: http://emergency.cdc.gov/agent/smallpox/vaccination/index.asp

Schwarzenegger kicks off fitness expo

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Sat, 01 Mar 2008 12:57:50 GMT

COLUMBUS, Ohio - California Gov. Arnold Schwarzenegger is in Ohio to help celebrate the 20th anniversary of his sports and fitness festival at the Veterans Memorial Auditorium.
Schwarzenegger received a loud round of applause Friday night when he presented a series of awards at a women's figure and fitness competition. He waved to the crowd, interviewed a few winners but did not make a speech.

The three-day Arnold Sports Festival features 17,000 competitors in 37 events, including 12 Olympic sports. Schwarzenegger has staged sports and fitness events in Columbus since 1989.

The Republican governor's visit comes days before a crucial presidential primary. He has endorsed likely GOP nominee John McCain.


FDA Dont swallow inhaler capsules

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Sat, 01 Mar 2008 01:09:44 GMT
By The Associated Press

WASHINGTON - Respiratory disease medications Spiriva and Foradil capsules should be used with the intended inhalation devices and not swallowed, federal health officials warned on Friday.
These drugs were developed to facilitate breathing in patients with asthma and chronic obstructive lung disease, including chronic bronchitis and emphysema.

But the Food and Drug Administration said it has received several reports of the capsules being swallowed. The agency warned that these products will only properly assist breathing if inhaled through the Spiriva HandiHaler or Foradil Aerolizer, which were designed to deliver these drugs.

The agency indicated that not many of the patients who swallowed the capsules reported side effects.

Spiriva was developed by Boehringer Ingelheim Pharmaceuticals Inc., which co-markets it with Pfizer Inc. Foradil is manufactured by Novartis AG and marketed in the United States by Schering-Plough Corp.


Study Spanking can bring problems later

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Sat, 01 Mar 2008 01:15:59 GMT

DURHAM, N.H. - New research by a University of New Hampshire domestic abuse expert says spanking children affects their sex lives as adults. Professor Murray Straus concludes that children who are spanked are more likely as adults to coerce partners to have sex, to have unprotected sex and to have masochistic sex.
Other studies have shown the link between spanking and physical violence, but Straus said his research is the first to show a link between corporal punishment and sexual behavior.

"My underlying motive was to bring this to the attention of parents and of more people," Straus said, "in the hope it will help continue the decrease in the use of corporal punishment."

Straus, co-director of UNH's Family Research Laboratory, conducted a study in the mid-1990s in which he asked 207 students at three colleges whether they'd ever been aroused by masochistic sex. He also asked them if they'd been spanked as children. He found that students who were spanked were nearly twice as likely to like masochistic sex.

He has bundled that study with three new ones that explore the connections between corporal punishment, coerced sex and risky sex. He presented all four studies this week at the American Psychological Association's Summit on Violence and Abuse in Relationships in Bethesda, Md.

Straus said his study found adults who were spanked as children are more likely to coerce their partners to have sex.

Straus asked 14,000 college students in 32 different countries whether they strongly disagreed, disagreed, agreed or strongly agreed with this statement: "I was spanked or hit a lot before age 12." He also asked whether they had ever verbally or physically coerced an uninterested partner to have sex.

He found a big difference between students who said they'd been hit a lot before age 12 and those who said they hadn't. For every increased step on Straus's four-step scale of agreement, men were 10 percent more likely to have verbally coerced sex from a partner by insisting on sex or threatening to end the relationship if the partner refused. Women were 12 percent more likely to have done that.

Previous studies have shown that 90 percent of parents strike their toddlers, a statistic that's held steady throughout the 30 years Straus has researched corporal punishment. Meanwhile, the number of parents who hit older children has drastically decreased. Straus said it's unclear why, though he has some theories. One is that 2- and 3-year-olds are less likely to respond to repeated verbal warnings.

Straus said he would like more pediatricians and child-rearing experts to warn against spanking. He'd also like lawmakers to take a stand by dedicating state money to teaching parents about the dangers of corporal punishment.

"The best-kept secret in child psychology is that children who were never spanked are among the best behaved," Straus said.

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Information from: Concord Monitor, http://www.cmonitor.com


Carb Intake Obesity Tied to Rise in Esophageal Cancers

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Sat, 01 Mar 2008 04:47:26 GMT

FRIDAY, Feb. 29 -- There may be a link between rising rates of carbohydrate intake and obesity and the increasing number of esophageal cancer cases in the United States, a new study says.

Researchers noted that cases of esophageal cancer increased from 300,000 in 1973 to 2.1 million in 2001, which closely mirrors increases in carbohydrate intake and obesity over the same time.


Obesity is a major risk factor for many types of cancer, and a diet high in calories from refined carbohydrates is a common contributor to obesity, the researchers noted. They also said no other studied nutrients were found to correlate with esophageal cancer rates.


"If we can reverse the trends in refined carbohydrate intake and obesity in the U.S., we may be able to reduce the incidence of esophageal cancer," study senior author Dr. Li Li, an assistant professor in the department of family medicine and the Case Comprehensive Cancer Center at Case Western Reserve University/University Hospitals Health System, said in a prepared statement.


The study was published in a recent issue of The American Journal of Gastroenterology.


The causes of esophageal cancer are largely unknown, and despite recent advances, patients with this type of cancer have a poor prognosis. The five-year survival rate is less than 20 percent.


More information


The American Cancer Society has more about esophageal cancer.



Cultural practices buttress Sierra Leone poverty U.N.

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Sat, 01 Mar 2008 11:30:16 GMT
By Katrina Manson

FREETOWN - Harmful cultural practices such as female genital mutilation are hampering efforts to reduce poverty in Sierra Leone, which has the world's worst child and maternal mortality rates, a top U.N. official said.
Discrimination against women is also partly responsible for the social problems that have persisted since the 1991-2002 civil war, said Ann Veneman, executive director of child agency UNICEF, after a three-day visit to rural clinics and schools.

"Sierra Leone needs to change a number of the harmful traditional and cultural practices," Veneman told reporters late on Friday, citing female genital mutilation , child marriage and pregnancy, and under-age labor.

According to the United Nations, more than a quarter of children die before their fifth birthday in the former British colony, and one in eight women die in childbirth.

Seventy percent of the population live below the poverty line and fewer than 30 percent are literate.

Veneman criticized the high rates of sexual violence that have continued since the war when thousands of women were raped, kept as sex slaves and forced into marriage by rebels.

"A tremendous amount of sexual violence still goes on in this country," Veneman told Reuters after the news conference. "It has to be unacceptable in this society to allow sexual violence against women and children to continue."

Ignorance due to a tradition of not sending girls to school was contributing to problems such as feeding newborns with dirty water and rice milk instead of breast milk, which boosts the immune system, and the failure to use bednets against malaria.

"Poverty is the big problem," Veneman said. "But the young girls have a double problem: they are highly discriminated against and there is a total disregard for women and girls."

She also said girls were prey to secret societies -- closed traditional groups solely for women, that meet in the bush.

"They have secret societies where you learn how to be a woman and how to take care of a man and this is where you get your FGM," she said.

"These women who do this are running a business and have an economic interest in doing it. But it is a harmful practice: it can cause infection, bleeding and HIV/Aids."

UNICEF estimates 90-94 percent of women in Sierra Leone are cut and Veneman says attitudes are not changing quickly enough.

"There are still young people out there who have suffered in such terrible ways," said Veneman. "It's a special burden."




ADHD Drugs Won39t Raise Risk of Substance Abuse

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Sun, 02 Mar 2008 00:01:24 GMT
By Sherry Baker
HealthDay Reporter

SATURDAY, March 1 -- Parents of children who are prescribed psychostimulants for attention deficit-hyperactivity disorder might have one less thing to worry about now that a new study concludes these kids are no more likely than their peers to abuse drugs and alcohol as young adults.

The report, which was funded by the National Institutes of Health, is published in the March issue of the American Journal of Psychiatry.


"The results should reassure clinicians who might be hesitant to treat ADHD because of concerns about future substance abuse," said study co-author Michael C. Monuteaux, assistant director of research at the pediatric psychopharmacology program at Massachusetts General Hospital.


Past research looking for a link between ADHD medications and substance abuse has produced conflicting conclusions.


"Some previous studies showed an increased risk of substance abuse associated with stimulant treatment, and other studies showed both no association and also a protective effect from treatments," Monuteaux said. "But those studies had some methodological limitations, and not all of them followed their samples well into late adolescence and early adulthood."


The Massachusetts General Hospital investigators designed their study to overcome the shortcomings of previous studies. They followed their research subjects up to a median age of about 22, included an assessment for psychiatric problems such as conduct disorder that are associated with substance abuse, and applied rigorous methods to accurately analyze data.


The research study team interviewed 112 young men (ranging in age from 16 to 27) a decade after they had been diagnosed with ADHD about their use of alcohol, tobacco and a variety of psychoactive drugs. Seventy-three percent of the subjects had been treated with stimulants at some time, and 22 percent were currently taking the stimulant medications.


The study found no relationship between having ever received stimulant treatment and the risk of future alcohol or other substance abuse. The age at which stimulant treatment began and how long it continued also had no impact on substance use.


"This study is a continuing effort to explicate the factors that mediate risk. It is methodologically sound and suggests that, as always, things are more complicated than we want them to be. The study demonstrates that the use psychostimulants for ADHD children do not increase the risk for substance abuse in adulthood, but it also suggests there is no protective effect, said Dr. Jon A. Shaw, director of the Division of Child and Adolescent Psychiatry and Behavioral Science at the University of Miami.


Symptoms of ADHD include impulsiveness, hyperactivity and inattention. According to a study published last fall in the Archives of Pediatrics & Adolescent Medicine, almost 9 percent of American children have ADHD, but only 32 percent of them are getting the medication they need.


"There is sufficient evidence that parents should be reassured that the use of psychostimulant medication for the treatment of ADHD in children and adolescents does not increase the risk for substance abuse in later life and remains the most effective treatment for this condition," Shaw said.


More information


For more on ADHD, visit the National Institute for Mental Health.



UK lawmakers urge action to cut childbirth deaths

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Sun, 02 Mar 2008 01:28:53 GMT

LONDON - Hundreds of thousands of women in poor countries die each year during pregnancy or childbirth from largely avoidable causes, British lawmakers said on Sunday.
The International Development Committee said there had been little progress in reducing maternal deaths in developing countries in the last 20 years and it criticised a lack of political will to improve women's health.

One in seven women in Niger dies in childbirth, compared to one in 8,200 in Britain, it said.

Of the Millennium Development Goals set by the United Nations in 2000, there had been least progress on the target of reducing maternal mortality by 75 percent, the committee said.

On current trends, the goal will not be met by the 2015 deadline.

"A key factor in this collective failure has been insufficient political will to drive actions to improve the health of women, both at the international and national levels," it said in a report to coincide with Mothers' Day in Britain.

Studies estimated maternal deaths worldwide in 2005 at 536,000 although the true figure could be as high as 872,000, because of a tendency to under-report such deaths and poor data, said committee chairman Malcolm Bruce, an opposition Liberal Democrat.

"It has ... been estimated that for each woman who dies, 30 further women will become disabled, injured or ill owing to pregnancy, so it is reasonable to assume that millions of women suffer in some way due to childbirth," he said.

Only two in five women in sub-Saharan Africa deliver their babies with the help of skilled medical staff, the report said.

Addressing a huge shortage of midwives worldwide and increasing the availability of emergency obstetric care to all women must remain the main focus of the British government's overseas aid department, the committee recommended.

Increasing access to basic drugs and equipment including family planning supplies was vital, as was tackling gender inequalities that prevented women gaining access to health care.




Study finds dogs robots cheer elderly

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Sat, 01 Mar 2008 09:26:34 GMT
By CHERYL WITTENAUER, Associated Press Writer

ST. LOUIS - Dogs may have a hard time wrapping their paws around this one: Robotic competition is nipping at their heels in the man's-best-friend department. A study by Saint Louis University found that a lovable pooch named Sparky and a robotic dog, AIBO, were about equally effective at relieving the loneliness of nursing home residents and fostering attachments.
The study, which appears in the March issue of the Journal of The American Medical Directors Association, builds on previous findings by the researchers that frequent dog visits decreased loneliness of nursing home residents.

Andrew Ng, who leads Stanford University's team in building a home-assistance robot and was not involved in the study, said the strength of the research is very encouraging.

If humans can feel an emotional bond with robots, even fairly simple ones, some day they could "not just be our assistants, but also our companions," he said.

To test whether residents responded better to Sparky, a trained therapy dog, or the Sony-made robot dog, researchers divided 38 nursing home residents into three groups at a trio of long-term care facilities in St. Louis.

One group had weekly, 30-minute one-on-one visits with Sparky; another group had similar visits with AIBO; a control group did not visit with either dog. Their level of loneliness — determined by residents' answers to several questions — was tested at the beginning and near the end of eight weeks of visits.

Investigator Marian Banks delivered the dogs, but did not interact with the residents. In the end, both groups were less lonely and more attached.

Most of the elderly used Sparky, a 9-year-old, reddish-brown mutt with a white muzzle and floppy ears, as a confidant, telling him "their life story," Marian Banks said.

"He listened attentively, wagged his tail, and allowed them to pet him," said Banks, who adopted and trained Sparky after finding him in an alley behind her home seven years ago.

Those who visited with AIBO took a little longer — about a week — to warm up to the metallic creature. Over time, they grew more comfortable with AIBO, and petted and talked to him. He responded by wagging his tail, vocalizing and blinking his lights.

"AIBO is charismatic if you start to interact with him," said the study's author, Dr. William Banks, a professor of geriatric medicine at Saint Louis University. "He's an engaging sort of guy."

The research could mean that a world is possible where robots could substitute for living dogs and help people, William Banks said.

"They could be personal, not an intrusive crazy inanimate object," he said.

Sara Kiesler, professor of computer science and human-computer interaction at Carnegie Mellon University who was not involved in the study, said the results of the study are encouraging but not completely convincing.

The problem is inferring it was the robotic dog that reduced the loneliness, and not the human who brought him into the room, she said. She said another study could compare a visit from AIBO with someone stopping by with a stuffed animal or even just a candy bar.

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Journal of The American Medical Directors Association: http://www.jamda.com/


Vitamin E Supplements May Raise Lung Cancer Risk

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Sat, 01 Mar 2008 04:47:38 GMT
By Ed Edelson
HealthDay Reporter

FRIDAY, Feb. 28 -- Vitamin supplements won't protect people against lung cancer and taking vitamin E may even heighten the risk, a new study finds.

The survey covered the supplement-taking habits and lung cancer incidence of almost 78,000 adults in the state of Washington over a four-year period.


"Our study of supplemental multivitamins, vitamin C, vitamin E and folate did not show any evidence for a decreased risk of lung cancer," study author Dr. Christopher G. Slatore, a fellow in the division of pulmonary and critical care medicine at the University of Washington, said in a statement. "Indeed, increasing intake of supplemental vitamin E was associated with a slightly increased risk of lung cancer."


As reported in the March issue of the American Journal of Respiratory and Critical Care Medicine, the research focused on men and women aged 50 to 76 taking part in the four-year VITAmins and Lifestyle study. Lung cancer was diagnosed in 521 participants surveyed.


In addition to the expected association with smoking, family history and other lung cancer risk factors, there was a slight but statistically significant association with vitamin E supplementation and incidence of the disease, the researchers found.


Every increase in vitamin E of 100 milligrams per day was associated with a 7 percent rise in lung cancer risk -- translating into a 28 percent increase in risk over 10 years for someone taking 400 milligrams of vitamin E daily.


"This provides additional evidence that taking vitamin supplements does not help prevent lung cancer," said Eric Jacobs, strategic director of pharmacoepidemiology at the American Cancer Society.


The society does not currently recommend use of any vitamin supplement to prevent malignancy, Jacobs said. However, "our dietary guidelines do recommend eating five or more servings of a variety of vegetables each day," he noted.


A representative of the supplements industry called the study results "not all that surprising."


"Vitamins are essential nutrients that act to maintain health and prevent vitamin deficiency," Pamela Mason, spokeswoman for the London-based Health Supplements Information Service, said in a statement. "They were never intended to be used to prevent chronic disease such as cancer. Indeed, it would be asking a lot of a vitamin pill to expect it to prevent cancer."


Since the primary cause of lung cancer is smoking, the best preventive measure is simply not to smoke, Jacobs said. Nutrients can play an auxiliary role, he noted. Anyone who cannot quit should avoid taking beta-carotene supplements, because studies have linked them to an increased risk of lung cancer, Jacobs said.


On the other hand, "for former smokers, there is some evidence that vegetables high in carotinoids, such as carrots and sweet peas, decrease the risk," he said.


Some vitamins have been linked to a reduced risk of other cancers, added Edward Gorham, an associate professor of family and preventive medicine at the University of California at San Diego.


"We have worked with vitamin D, and we found a protective effect of vitamin D on colon cancer, breast cancer and ovarian cancer, and recently a modest effect on lung cancer," Gorham said.


But that effect came not from supplements but from sunlight, which causes vitamin D to be formed in the human body, he said.


"These results with multivitamins dont surprise me because there is so little vitamin D in multi-supplements, 100 or 200 International Units," Gorham said. "To achieve the effect, it takes 2,000 IU. If youre in the tropics, that amounts to 10 or 15 minutes in the sun. In southern California, it takes 10 or 15 minutes in the summer and longer in the winter because the sun angle is so low."


One study has also associated vitamin D supplements with a decreased risk of colon and breast cancer in women, Gorham said.


More information

There's more on nutrition and cancer prevention at the American Cancer Society.

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