Pharmaceuticals

Debate on Thyroid Checks During Pregnancy

A debate is brewing in the physician community : Should all pregnant women should be screened for thyroid function? And  should women with milder cases of hypothyroidism be diagnosed and treated? The problem is that there is little evidence regarding the effectiveness of treatment for milder cases. Scientists are unsure whether diagnoses and subsequent treatment sufficiently help pregnant patients or, instead, waste money on blood testing and thyroid medication.

I was first reviewer for a HNR review on a recent Quest Diagnostics study that looked at records and surveys from half a million pregnant women. The AP ran the story.

Overall, the story does an excellent job weighing the pros and cons of thyroid screening and treatment in pregnant women.

Our Review Summary

The article gives extensive context to the recent Journal of Clinical Endocrinology & Metabolism study and refers to other research done in the field.

Why This Matters

The article effectively breaks down and explains a complex debate in the physician community – whether all pregnant women should be screened for thyroid function and whether women with milder cases of hypothyroidism should be diagnosed and treated. The story says this will “add pressure” for science to settle this issue, but that pressure already exists from endocrinologists and obstetricians – with, as the study shows, about 1 in 5 pregnant women being tested from 2005-8. [HealthNewsReview.org]

You can see the full reviews on my site at Journalism -> Review and also at HealthNewsReview.org.

How to Ward Off Dementia and Alzheimer’s

While the Alzheimer’s Association estimates the costs of treating Alzheimer’s to rise five-fold to $1.08 trillion by 2050, some researchers believe these costs can be lowered if people behaved healthier. “What’s good for your brain is good for your heart, and vice versa,” said Alzheimer’s researcher Huntington Potter of the University of South Florida. “Cardiovascular disease works with Alzheimer’s disease to cause even worse dementia.”

Meanwhile, Mark Underwood, a researcher for Quincy Bioscience, suggests people can be more proactive in safeguarding their health.

He has simple tips for keeping the brain healthy to help fight the onset of dementia :

  • Eat your veggies – A 2006 study of more than 3,700 older adults found that those who ate plenty of vegetables slowed the decline of their mental abilities by 40%, compared with those who skimped on their greens.
  • Get outdoors – Your skin makes vitamin D when it’s exposed to sunlight. In one study among volunteers 65-years and older, those with the lowest levels of the vitamin were more than twice as likely to have cognitive impairment as those whose levels were optimal.
  • Use your brainSome studies found that people who had spent more years in school or had worked in mentally demanding jobs stayed sharper, even when their brains were damaged by the plaques and tangles of Alzheimer’s disease. Lifelong hobbies, such as playing cards or doing crossword puzzles, might also help protect against the symptoms of Alzheimer’s disease.
  • Talk to people – A Harvard study found that socially connected people kept more of their memory intact as they aged – up to twice as much, according to one measure.

Underwood also suggests regulating brain calcium, which he says can be controlled with Prevagen – a dietary supplement made by his biotech company. According to the product’s website, the supplement lowers calcium levels, thereby restoring brain function.

But USF's Potter isn’t convinced by that claim.

“The calcium-binding protein may bind calcium as it goes through your digestive tract for awhile until it gets digested,” Potter said, “but whether it’s going to reduce calcium in the brain or not is highly unlikely. And even if it did, it isn’t necessarily something you want to do.”

Calcium supplements are often prescribed to older people because they need to boost their levels, Potter added. He also advises monitoring blood pressure and cholesterol levels.

Otherwise, he says Underwood’s other four tips hold some truth, since these behaviors have shown to delay dementia in some studies.

Consumers, "be aware" : talk to your doctor before taking any dietary supplements. [HealthyState.org]

An Epicenter of HIV Infection

The U.S. South has become an epicenter of HIV infection, according to Dr. John Bartlett of Duke University. He says the South accounted for 46 percent of all new AIDS diagnoses in the U.S. in 2005. Other regions saw a 6 percent decrease in AIDS cases.

How does Florida fare in all this? Well, the Sunshine State has the second highest number of AIDS diagnoses in the country.

The reasons for high HIV and AIDS rates are numerous – and complicated. One CDC study looked at 20 counties with the largest increases in AIDS cases. The characteristics common in these communities were single-mother households, low educational attainment and poverty.

In addition, African-Americans are disproportionately affected by the epidemic. Not only do they deal with higher rates of HIV infection compared to other racial groups, but they are also more likely to spend time in prison, where HIV and AIDS rates are often higher than the general population. According to Bureau of Justice Statistics, black males are incarcerated 6.5 times more than white males.

Dr. Bartlett presented this data today at Orlando Regional Medical Center. In a study at Duke University, his colleagues found that people were more likely to take their HIV medication if they hadn’t experienced any traumatic events in their lives. To these researchers, “trauma” included childhood abuse and neglect, being sent to reform school or prison, death of a spouse and witnessing violence. The people who took their HIV pills every day were more likely to lead longer and healthier lives. For those who didn’t, they risked becoming resistant to HIV medications and developing full-blown AIDS.

“HIV infection is less about infectious diseases and more about healing,” Bartlett said. He proposes to address HIV disparities in the South by increasing awareness of HIV among African-American communities, better treating mental illness and substance abuse, lowering barriers to expert HIV care and better understanding trauma. [HealthyState.org]

New Drug Stops Multiple Sclerosis in Mice

JUPITER - Researchers in South Florida have developed a drug that treats multiple sclerosis in mice, without suppressing their entire immune systems. They think the compound could also fight other autoimmune disorders, like rheumatoid arthritis and lupus. [audio:http://eunalhee.com/wp-content/uploads/Lhee_MSdrug.mp3|artists=Lhee|titles=MSdrug]

Researchers at Scripps Florida in Jupiter don't think they've found a cure for MS, but they believe their new drug could keep patients who have the disease from getting any worse.

They also think the drug could have two main advantages over existing therapies, if it works in humans. For one, it could be swallowed as a pill, instead of being injected into the bloodstream.

Also, lead researcher Tom Burris said the drug would target specific cells instead of attacking the whole immune system.

"So we see it more as a magic bullet to target the source of the disease rather than a carpet bombing to destroy the entire or suppress the entire immune system, which, of course, carries a lot of side effects," Burris said.

Burris would like to test the drug in mice with other autoimmune disorders. He thinks the pill could be in human clinical trials in several years.

The study was published last week in the journal Nature. [HealthyState.org | FPR Spot]

The Two Sides of Prozac

One of the toughest challenges I face when reporting about medical research comes at the very beginning – when I determine whether to even cover the study. The science may be solid, the researchers reputable. But often, the findings are contradicted in other studies.

Take for example Prozac.

I heard neurologist Russell Fernald from Stanford University talk about brain science today. When he was talking about neurotransmitters, he mentioned Prozac – a drug commonly used to treat depression. He said that a lot of doctors are still unaware that Prozac could cause bone loss, leading to bone injuries and even osteoporosis in children and adolescents.

Intrigued, I found a study linking Prozac to bone loss: Antidepressants Linked To Bone Loss, Study Suggests.

But I also found this: Commonly Used Antidepressants May Prevent Bone Loss.

The possible side effect of bone loss is not mentioned on the NIH website for Prozac.

So which is it?

Science, I am often told, is a process. And uncertainty is an inherent quality in medical research.

But is it the duty of journalists to report new medical research, even if it’s refuted elsewhere? [HealthyState.org]

New Drug Therapy for Women Suffering From LAM

GAINESVILLE – Researchers think they've found the first effective therapy for women suffering from a rare and often fatal lung disease. It's a drug that's normally used for organ transplant patients. [audio:http://eunalhee.com/wp-content/uploads/Lhee_LAM.mp3|titles=LAM|artists=Lhee]

The lung disease is called Lymphangioleiomyomatosis -- LAM for short. It's similar to a slow-growing cancer.

LAM affects only women, but scientists aren’t sure why. They used to treat it with hormone therapy or by removing the patients' ovaries. But many of the women still died.

Researchers decided to treat LAM with the drug rapamycin - it's usually used to keep transplant patients from rejecting their new organs. Dr. Mark Brantly of the University of Florida co-authored the study. He said the drug stopped and even reversed the progression of LAM in study participants.

"That’s a dream for me to be able to take a disease, crack it… develop a therapy so that, you know, we can actually make people better," Brantly said.

He said the next step is to expand the study and see if the drug helps LAM patients live longer.

The findings were published this month in The New England Journal of Medicine. [HealthyState.org | FPR Spot]

To Treat or Not To Treat

Currently, neurologists are testing preventative therapies on patients who are in the advanced stages of Alzheimer’s. Here’s the problem: These strategies weren’t designed to be effective in these patients.

Here’s another way to think of it : Would you test statins – drugs commonly used to prevent heart disease – in patients who have already suffered massive heart attacks?

Even if a preventative therapy were effective, it probably wouldn’t show in the volunteers currently in the trials.

In a recent “Perspective” article in the journal Neuron, University of Florida researcher Todd Golde points out the discontinuity between studies in humans, which look at treatment, and preliminary laboratory studies, which concentrate on prevention.

He told me there are ethical issues with giving experimental preventative drugs to human patients with no sign of disease.

“When we consider prevention, a drug or a therapy has to be deemed ‘safe,’” Golde says. “The bar for that is set pretty high, especially if you’re dealing with asymptomatic people.”

He says Alzheimer’s research should focus on identifying substances in the body that could signal the likelihood people would develop the disease. This may resolve the ethical issue, since scientists could then identify volunteers before they show symptoms. [HealthyState.org]

Drug Push for Mosquito-Borne Diseases

ORLANDO - Florida university researchers are starting a special push to create new drugs for mosquito-borne diseases, like dengue fever, West Nile virus and equine encephalitis. They'll be meeting with pharmaceutical industry representatives in Orlando today to kick off the year-long initiative. [audio:http://eunalhee.com/wp-content/uploads/Lhee_mosquitopharm.mp3|titles=mosquitopharm|artists=Lhee]

The University of Florida and the University of South Florida got more than half a million dollars for the project from the state last year. They plan to work with pharmaceutical companies for drug development in emerging diseases.

USF chemistry professor Bill Baker said the project is focusing on mosquito-borne illnesses, like dengue fever and West Nile virus, because of recent outbreaks in the state.

"It’s an integrative approach to try to make sure that vector-borne diseases don’t become an epidemic, for example, in the state of Florida," Baker said.

In addition to drug research, Baker said the collaboration will look into preventative measures, like mosquito control, disease surveillance and vaccines. [HealthyState.org | FPR Spot]