December 2007 Health in the News Archive

[ Monthly Index of New Briefs ]

Unpublished Results of Cholesterol-Drug Studies

December 2007

The New York Times reports, "New evidence shows that the drugmakers Merck and Schering-Plough have conducted several studies of their popular cholesterol medicine Zetia (ezetimibe) that raise questions about its risks to the liver," but the results of these studies have yet to be published. According to the Times, some "results of the studies, alluded to in documents on the Food and Drug Administration's (FDA) website, raise questions about whether Zetia can cause liver damage when used long term with other...statins."

One Schering executive, Dr. Robert J. Spiegel, has confirmed the studies' existence, but "said the companies had not considered the studies scientifically important enough to publish their findings," although "[s]ome may eventually be published." Schering claims that the FDA "had reviewed the data from the unpublished studies, and had approved Zetia for use alongside statins." But, prior to the drug's 2002 approval, an "FDA reviewer said it should not be cleared for use with statins because the combination had caused liver damage in animals."

Dr. Grout's Comment:

Once again we realize that nutritional therapy, supplements and appropriate exercise do not harm the liver, AND lower cholesterol. Why go any further? It seems like a no-brainer.

Pfizer Sued Over Lipitor Promotions

December 2007

The Wall Street Journal reports that in a lawsuit, a former Pfizer Inc. official, Jesse Polansky, M.D., M.P.H., who was Pfizer's director of outcomes management strategies, "accused the company of illegally boosting sales of its top-selling drug Lipitor (atorvastatin) through an elaborate campaign of misleading educational programs for" physicians.

According to Dr. Polansky, the "educational campaign was a key part of a marketing strategy that 'led thousands of physicians to prescribe Lipitor for millions of patients who did not need medication', and could be harmed by overly aggressive treatment." Dr. Polansky claims that the company "wanted to extend Lipitor use beyond the indications found on the drug's label by targeting people at moderate risk of developing heart disease, or having a heart attack." In the suit, Dr. Polansky also alleges that the "Pfizer programs included deliberate misinformation promoting the idea that kidney-disease patients may need to be treated with statins."

Dr. Grout's Comment:

The use of "statin" cholesterol-lowering drugs has become increasingly controversial. Many cardiologists have stated that virtually everyone over age 40 should be on a statin drug. Others said they were, well, nuts. In any event, doctors who followed the urging of Pfizer will need to rethink the risk-benefit ratio of their recommendations. Who has more to gain in taking statins – you or Pfizer's piggy-bank? Consumer beware.

Drugs' Side Effects Fodder for Lawsuits

December 2007

The Washington Times reports that a "Massachusetts Supreme Judicial Court ruling that holds doctors responsible for failing to warn patients about the side effects of the drugs they prescribe exposes medical professionals nationwide to a new and costly wave of lawsuits." Medical law experts predict that last week's ruling "will increase malpractice insurance costs for doctors, which will likely decrease access to care for patients."

The court decision came after a case involving "a 75-year-old man, David Sacca, who lost consciousness while driving, and fatally struck a 10-year-old boy." The boy's mother sued the man's physician, Roland Florio, M.D., for not warning his patient "about drowsiness and other possible side effects of the eight prescription drugs he was taking." In a 4 to 2 decision, the "high court ruled...on Dec. 10 that Dr. Florio's responsibility as a physician extended to anyone who could be put at risk by his failure to warn a patient about the side effects of drugs."

Dr. Grout's Comment:

Supplements don't generally have these side effects, now, do they?

Biophosphonates Not So Good for Osteoporosis

December 2007

According to an analysis published online Monday in the journal Annals of Internal Medicine, "widely used bisphosphonate drugs are" not "more effective than other treatments at preventing fractures in people with osteoporosis." Researchers with U.S. Agency for Healthcare Research and Quality (AHRQ) "analyzed 101 published studies in order to compare the effectiveness and risks of six bisphosphonates -- alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), and zoledronic acid (Zometa) -- along with estrogen, calcitonin (a man-made hormone), calcium, vitamin D, testosterone, parathyroid hormone, and selective estrogen receptor modulators (SERMs)." They found that "there's not enough scientific evidence to determine whether bisphosphonates are better at preventing fractures than estrogen, calcitonin, or raloxifene (a SERM)."

According to Jean Slutsky, of AHRQ, the findings are important "because so many elderly people are at risk for osteoporosis, and frequently life-altering fractures related to bone weakening." The study "helps shed light on what is known, and not known, about the effectiveness and safety of osteoporosis treatments," and "while it isn't clear which medications work best, it is clear that most treatments do help reduce fracture risk when taken regularly," she noted.

Dr. Grout's Comment:

You've probably seen actress Sally Fields in TV ads promoting once-a-month "Boniva" for osteoporosis. That is a bisphosphonate drug. Once again, we see an attempt to fix nutrient deficiencies with a prescription pill which has significant side effects.

Lipsticks Containing Mercury Get Fined

December 2007

AP reports that Minnesota will ban products which contain mercury as of January 1, 2008. In a nationwide first, the state will fine retailers who knowingly sell mercury-containing cosmetics. The "provision is part of a larger ban targeting better-known sources of mercury, such as thermostats, barometers...and medical devices." The also applies to over-the-counter drugs such as eye drops, nasal sprays, hemorrhoid treatments, and antiseptics.

State Sen. John Marty (D-Roseville), who sponsored the legislation, said: "Mercury does cause neurological damage to people even in tiny quantities," and it can also "retard brain development in children and fetuses, who are most vulnerable to the metal's toxic effects."

Dr. Grout's Comment:

Good for Minnesota! Now if we can just get the rest of our states to follow suit, we might start a healthy trend… And if the state of Minnesota's elected officials are willing to safeguard people from mercury toxicity, does it make sense that the CDC continues to support the use of mercury in vaccines and flu shots?

Smarter Use of Chemo and Radiation

December 2007

Three key pieces of news came out of the December 12th meeting of breast cancer specialists in San Antonio:

1 - High-dose chemotherapy has only a minimal effect on survival in breast cancer patients with node-positive disease, new research shows. "It's pretty clearly established that [high-dose chemotherapy] is a false hope," said study author Donald Berry, head of the Division of Quantitative Sciences at the University of Texas M.D. Anderson Cancer Center in Houston. "There's a disease-free survival benefit but not much of a survival benefit. There may be a subset which would benefit, but we looked and couldn't find it."
2 - Researchers report a more convenient three-week course of radiation works just as well as the five-week schedule that is typically given to women after breast-conserving surgery for breast cancer. In a study of more than 1,000 women, only 6.2% of those who got the short course of radiation had cancer recur in the same breast over the next 10 years, compared with 6.7% of those who got the conventional five weeks of radiation. The difference was so small, however, that it could have been due to chance.
3 - A gene test called Oncotype DX can predict whether some cancer patients could benefit from chemotherapy, or do without it. Researchers at Chicago's Loyola University examined whether Oncotype DX accurately predicted chemo's benefit in 367 women whose hormone-driven cancer had spread to lymph nodes. Ten years "after these women were treated, those who had low scores on the gene test were found to have had no benefit from chemo." In contrast, the researchers found that "chemo did a lot of good for those with high scores." But, the "test is expensive -- $3,400 -- though many insurers are paying for it because it can avoid even more costly chemo."

Dr. Grout's Comment:

The Chicago research group suggests a more sensible use of chemotherapy – to benefit those whose tumors are susceptible. Still to come on the mainstream radar is the concept of insulin-potentiated chemotherapy, which makes cancer cells especially receptive to the chemo cocktail so that only one-tenth the normal amount of drugs need to be used. This lower-dose chemo treats the cancers without severely maiming the patients.

Waist-to-hip ratio may predict heart disease

December 2007

According to a study reported in Circulation, researchers found that male participants "who had the highest waist-hip ratio were 55 percent more likely to have coronary artery disease than men in the lowest quintile." The research team also discovered that among "women in the top quintile, there was a 91 percent increase in risk versus women in the lowest fifth."

Researchers looked at measurements of the height, weight, hips, and waist of 24,500 participants.

Dr. Grout's Comment:

We measure this ratio routinely on all our new patients, and on those who choose to participate in the FirstLine Therapy program for better nutrition and reduction of heart disease risks.

New Jersey recommends mandatory vaccinations

December 2007

New Jersey may become the first state to mandate flu vaccines for any child entering day care or preschool. The New York Times reports that by a vote of 5 to 2, with two abstentions, the New Jersey Public Health Council recommended approval of the flu shot requirement for school children. The Council also agreed that three other new vaccines should become a requirement. Moreover, officials from the state's department of health said "they expected the health commissioner, Dr. Fred M. Jacobs, to sign the measure by Dec. 18," making the vaccines mandatory on Sept. 1 of 2008.

The other vaccines are: one for pneumonia, and two others that would be given to those entering sixth grade. The first of those would be to guard against meningococcal disease, a fast-killing strain of meningitis, and the other an additional booster of the vaccine for diphtheria, tetanus, and pertussis.

The vaccines will be available for free for low-income families through the federal Vaccines for Children program, and private insurers generally will cover the cost. Still, a number of "concerned parents said they will keep urging support for a bill that would give parents a right to a 'philosophical objection' to vaccine mandates, as many other states have."

The Wall Street Journal also reports that "federal health officials are still imploring people to get immunized -- even healthy adults who have been asked in the past to forgo vaccine to save limited stocks for those at greatest risk of complications from the flu." The agency is also "trying to convince flu-shot providers to offer shots throughout the entire flu season, rather than just in October and November."

Yet, many are still wary about the shots, because "89 percent of the anticipated flu-vaccine supply in the U.S. this year contains thimerosal, a preservative consisting of about 50 percent mercury," which some say may pose a health hazard. Although "manufacturers are producing more" thimerosal-free vaccines, the Centers for Disease Control and Prevention still "insists there is no evidence of harm from thimerosal in vaccines." Over "108 million doses of flu vaccine have been distributed so far this season, out of approximately 134 million pledged by five manufacturers."

Dr. Grout's Comment:

So, not only do we have a "flu shot" which has been shown not to prevent infection with the influenza virus, but now we want to make it mandatory? Who is in control here? It feels as though the tail is wagging the dog. I am NOT in favor of requiring injections with medications without my consent or without significant demonstration of either effectiveness, or need, or both.

Fruits and Veggies in WIC

December 2007

Associated Press reports that low-income "women and their children will see fruits, vegetables, and whole grains, but less dairy and egg products in the Women, Infants and Children (WIC) program, under a change the Agriculture Department plans to adopt Thursday." According to Agriculture Secretary Chuck Conner, this change "better reflect[s] the needs of over eight million low-income mothers and children in the WIC program," and it "will 'greatly improve dietary quality.'" Anti-hunger advocates celebrated the change, but "milk and egg producers" were "disappointed," because sales of their products will decline as a result of this change.

Dr. Grout's Comment:

Hallelujah! This certainly will improve dietary quality, and hopefully all these children will learn to actually like eating what is good for them. Diets high in fruits, vegetables and whole grains deliver the calcium and fiber that help maintain a healthy weight and can reduce the risk of disease.

Old fashioned farm raised eggs are an excellent complete protein, but so often what can be found in the grocery store or federal food programs today come from "factory chickens" which never see the light of day and are fed a grain and soy-based chicken feed laced with hormones and antibiotics. Old fashioned farm milk has also been changed for the worse by factory farming. Last month, the Pennsylvania Department of Agriculture ruled that dairies selling milk in that state no longer can use labels touting the product as being free of certain substances, such as recombinant bovine somatotropin. The ban of so-called "absence labeling" means that companies cannot make milk-labeling claims such as "antibiotic-free," "hormone-free" or "pesticide-free." Such labels mislead consumers, telling them what is not present in the milk vs. what's there.

Cleaner Air Improves Lung Function

December 2007

According to two studies published in today's issue of the New England Journal of Medicine, improving air quality can produce "measurable benefits in lung function for adults as they" get older.

A British study enrolled 60 adults with mild or moderate asthma and asked them to "walk for two hours along either the exhaust-filled sidewalks of Oxford Street, or the more bucolic Hyde Park. Researchers found that those who walked along Oxford Street had "a five to six percent reduction in lung function," which was "significantly larger" than the levels measured among participants who walked in Hyde Park. In addition, the Oxford Street participants had "an increase in biomarkers of lung inflammation."

Meanwhile a Switzerland study focused on 4,742 adults who had complete lung function assessments in 1990 and 1991, and then again in 2002, and whose residential history was documented at both points in time. Researchers found that "relatively small reductions in exposure to PM10 [particulate matter] have measurable benefits for lung function, suggesting that a decline in air pollution, even from low levels, may have positive consequences for public health." The decline in lung function slowed with the decline in air pollution."

An editorial accompanying the studies called them "a 'remarkable' look at air pollution's effects in the real world."

Dr. Grout's Comment:

I continue to be amazed at what is reported as research, although I guess I am glad that someone in the medical publishing world is finally looking at this issue. Of course the lung function improves when air pollution decreases. Now the next step is to decrease the air pollution all over the globe. The Kyoto agreements are a step in the right direction, although pollution really begins at home. Are we recycling when possible? Are we encouraging our work-places to recycle? Are we using "green" chemicals when we clean our houses? Do we drive gas-guzzlers or cars with better gas mileage? Every little bit helps to clean up our environment.

Employers Say "Get Healthy or Pay Up"

December 2007

The Wall Street Journal reports that in an effort to motivate workers to kick unhealthy habits, U.S. companies are hitting them where it hurts: in their wallets.

Employees at some companies who are overweight, smoke, or have high cholesterol for instance, and don't participate in supplementary wellness programs, will pay more for health insurance. In extreme cases, employees' deductibles could rise by $2,000.

Starting in 2008, the Kellogg Co., of Battle Creek, Michigan, will raise premiums for salaried and non-union employees who take a voluntary health risk assessment and participate in wellness programs. Employees who opt out will face higher insurance premiums.

Dr. Grout's Comment:

This initially sounds good, but it may cause more problems than it solves.

You could get a lot of agreement for penalizing the smoker. But how do you penalize the person who eats French fries and chips laden with trans fatty acids? What about the diet soda pop drinker who is oblivious to the growing research that shows diet sodas actually contribute to weight gain and that synthetic sweeteners have even caused seizures in some people? If your cholesterol level is deemed "too high," will your insurance premiums go up if you refuse to take statin drugs? What if your company's wellness program advocates eating margarine instead of butter and you don't agree margarine is better?

This is an interesting battle of the conflicted marketplace forces. On one hand, it makes sense to reward those who take care of their health. On the other hand, messages in the mainstream media about how to create and maintain health are as clear as mud. On one hand, your workplace is likely sprayed every month for pests. On the other hand, growing research links pesticides to breast cancer and other diseases. The possibility for conflicts is endless, and the desire for vested interests to take control, such as pharmaceutical companies, is great.