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Saturday, 29 August 2015

High use of alternative medicine in senior oncology patients

 Alternative medicines are widely thought to be at least harmless and very often helpful for a wide range of discomforts and illnesses. However, although they're marketed as "natural," they often contain active ingredients that can react chemically and biologically with other therapies. Researchers performed a comprehensive review of all of the medications taken by senior oncology patients and found that as 26 percent were using complementary or alternative medicines (CAM), in a report published August 12th, in the Journal of Geriatric Oncology.
"Currently, few oncologists are aware of the alternative medicines their patients take," says Ginah Nightingale, PharmD, an Assistant Professor in the Jefferson College of Pharmacy atThomas Jefferson University. "Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn't specifically ask."
There are a number of CAMs that are known to interfere with certain cancer treatments. For example, St. John's wart can make some cancer therapy less effective, according to theNational Institutes of Health. Others can interfere with anesthesia during surgery for cancer. But not all interactions have been studied. Because CAMs fall under the category of health supplements, they are not regulated by the Food and Drug Administration (FDA), which means that dose and potency (and therefore reaction in the body) can vary widely between products, and between patients.
In addition, in an elderly population of cancer patients, CAMs can simply add additional medications to an already long list of drugs taken for various ailments. "Numerous pills, or what we call polypharmacy in the field, can increase the risk for medication non-adherence, potential drug-drug interactions and increase the risk for drug-disease interactions in a population that has been reported to take several medications and have several medical conditions," says Dr. Nightingale, "The use of CAM in this subpopulation warrants substantial interest and concern on behalf of medical oncologists and allied health professionals because of the potential clinical implications associated with CAM use. Patients may be combining these agents while receiving concurrent systemic chemotherapy, radiation therapy and/or surgical interventions which have the potential to compromise the safety and efficacy of treatment interventions."
Dr. Nightingale and colleagues surveyed the senior oncology patients who came to Jefferson for consultations in the Senior Adult Oncology Multi-Disciplinary clinic. Over the course of one visit, patients were seen by professionals from five different areas crucial to maintaining a senior's health throughout oncology treatment, including a medical oncologist, geriatrician, clinical pharmacist, social worker and dietician. As part of this assessment, the patients brought in the contents of their medicine cabinets, and the medications that were actively used were reviewed and recorded.
The research team found that 26 percent of patients were taking CAMs at some point during the continuum of their cancer care, with the highest usage among women over the age of 80 - a population that hadn't been captured by previous studies. Among those taking complementary medicine, 68 percent were in the over-80-year-old range.
Some of the alternative medications that were commonly used in this population were alternative therapies for macular degeneration, stomach probiotics, joint health, and mega-dose vitamins or minerals. While the current study did not examine the potential adverse events caused by these medications, "we know that some can have a biochemical effect on the body and other drugs." says Nightingale.
"It is very important to do a comprehensive screen of all of the medications that older cancer patients take, including CAMs," says Dr. Nightingale. "Clear and transparent documentation of CAM use should be recorded in the patient's medical record. This documentation should indicate that patient-specific communication and/or education was provided so that shared and informed decisions by the patient can be made regarding the continued use of these medications."
"Oncology healthcare is undergoing significant transformation in the delivery of effective clinical services and is ripe for greater engagement of pharmacists to reduce drug-related problems and unnecessary medications, in order to optimize medication prescribing," says Dr. Nightingale.

Hypertensive patients benefit from acupuncture treatments, UCI study finds

Patients with hypertension treated with acupuncture experienced drops in their blood pressure that lasted up to a month and a half, researchers with the Susan Samueli Center for Integrative Medicine have found.
Their work is the first to scientifically confirm that this ancient Chinese practice is beneficial in treating mild to moderate hypertension, and it indicates that regular use could help people control their blood pressure and lessen their risk of stroke and heart disease.
"This clinical study is the culmination of more than a decade of bench research in this area," said Dr. John Longhurst, a University of California, Irvine cardiologist and former director of the Samueli Center. "By using Western scientific rigor to validate an ancient Eastern therapy, we feel we have integrated Chinese and Western medicine and provided a beneficial guideline for treating a disease that affects millions in the U.S."
Longhurst and his UCI colleagues Dr. Peng Li and Stephanie Tjen-A-Looi conducted tests on 65 hypertensive patients who were not receiving any hypertension medication. Separated randomly into two groups, the subjects were treated with electroacupuncture - a form of the practice that employs low-intensity electrical stimulation - at different acupoints on the body.
In one group of 33 receiving electroacupuncture on both sides of the inner wrists and slightly below each knee, the researchers found a noticeable drop in blood pressure rates in 70 percent of participants - an average of 6 to 8 mmHg for systolic blood pressure (the high number) and 4 mmHg for diastolic blood pressure (the low number). These improvements persisted for a month and a half.
Also in this group, the team identified significant declines in blood concentration levels of norepinephrine (41 percent), which constricts blood vessels and increases blood pressure and glucose levels; and renin (67 percent), an enzyme produced in the kidneys that helps control blood pressure. In addition, the electroacupuncture decreased aldosterone (22 percent), a hormone that regulates electrolytes.
No consequential blood pressure changes were found in the group of 32 who received electroacupuncture at other acupoints along the forearm and lower leg.
Although the blood pressure reductions in the first cohort were relatively small - mostly in the 4-to-13-mmHg range - the researchers noted that they were clinically meaningful and that the technique could be especially useful in treating systolic hypertension in patients over 60.
"Because electroacupuncture decreases both peak and average systolic blood pressure over 24 hours, this therapy may decrease the risk for stroke, peripheral artery disease, heart failure and myocardial infarction in hypertensive patients," Longhurst said.

Botanists conduct first large-scale genetic study of marijuana, hemp

A study by Canadian researchers is providing a clearer picture of the evolutionary history and genetic organization of cannabis, a step that could have agricultural, medical and legal implications for this valuable crop.
"Even though hemp and marijuana are important crops, knowledge about cannabis is lacking because of its status as a controlled drug," said Jonathan Page, a University of British Columbia botanist who co-led the first large-scale study of the genetic diversity of cannabis. The research was conducted together with Sean Myles, a population geneticist at Dalhousie University.
Researchers looked at the genotypes of 81 marijuana and 43 hemp samples. Using the DNA variants in the cannabis genome, they were able to search for relationships between different plants. They found that cannabis plants, which consist of three species (C. sativaC. indica and C. ruderalis), are often incorrectly labeled.
IMAGEPopular lore assigns different characteristics to marijuana plants. For example, Indica-type plants are believed to produce relaxing and sedative effects as opposed to more stimulating Sativa-type plants. The researchers found only a moderate correlation between the ancestry of marijuana strains reported by breeders and the ancestry inferred from their DNA. For example, a sample of Jamaican Lambs Bread, which is classified as C. sativa, was almost identical at a genetic level to a C. indica strain from Afghanistan.
"Cannabis breeders and growers often indicate the percentage of Sativa or Indica in a cannabis strain, but they are not very accurate," Page explained.
While hemp plants also go by the latin name C. sativa, researchers discovered that hemp showed a high amount of genetic separation from marijuana, likely due to the breeding of the plants for radically different uses.
Canada is a global leader in hemp production, with more than 80,000 acres devoted to seed and fibre production. A licence from Health Canada is required to grow marijuana for medical purposes, and there are now 25 licensed producers supplying about 21,000 Canadian patients. Understanding cannabis genetics and evolution could assist in better breeding efforts for both crops.
"The genetic difference between marijuana and hemp has legal implications in many countries," said Page. "Right now, the genetic identity of a marijuana strain cannot be accurately determined by its name or reported ancestry. Ultimately we require a practical, accurate and more reliable classification system of this plant."
The findings were published today in PLOS ONE.

Chestnut Leaves Extract Disarms Deadly Staph Bacteria

Ingredients from the leaves of the European chestnut tree contain the power to disarm dangerous staph bacteria without boosting its drug resistance, researchers have discovered. The study is published in PLOS ONE

The use of chestnut leaves in traditional folk remedies inspired the research, led by Cassandra Quave, an ethnobotanist at Emory University. 

"We've identified a family of compounds from this plant that have an interesting medicinal mechanism," Quave says. "Rather than killing staph, this botanical extract works by taking away staph's weapons, essentially shutting off the ability of the bacteria to create toxins that cause tissue damage. In other words, it takes the teeth out of the bacteria's bite." 

The discovery holds potential for new ways to both treat and prevent infections of methicillin-resistant S. aureus, or MRSA, without fueling the growing problem of drug-resistant pathogens. 

Antibiotic-resistant bacteria annually cause at least two million illnesses and 23,000 deaths in the United States, according to the Centers for Disease Control and Prevention. MRSA infections lead to everything from mild skin irritations to fatalities. Evolving strains of this "super bug" bacterium pose threats to both hospital patients with compromised immune systems and young, healthy athletes and others who are in close physical contact. 

"We've demonstrated in the lab that our extract disarms even the hyper-virulent MRSA strains capable of causing serious infections in healthy athletes," Quave says. "At the same time, the extract doesn't disturb the normal, healthy bacteria on human skin. It's all about restoring balance." 

Quave, who researches the interactions of people and plants - a specialty known as ethnobotany - is on the faculty of Emory's Center for the Study of Human Health and Emory School of Medicine's Department of Dermatology. She became interested in ethnobotany as an undergraduate at Emory. 

For years, she and her colleagues have researched the traditional remedies of rural people in Southern Italy and other parts of the Mediterranean. "I felt strongly that people who dismissed traditional healing plants as medicine because the plants don't kill a pathogen were not asking the right questions," she says. "What if these plants play some other role in fighting a disease?" 

Hundreds of field interviews guided her to the European chestnut tree, Castanea sativa. "Local people and healers repeatedly told us how they would make a tea from the leaves of the chestnut tree and wash their skin with it to treat skin infections and inflammations," Quave says. 

For the current study, Quave teamed up with Alexander Horswill, a microbiologist at the University of Iowa whose lab focuses on creating tools for use in drug discovery, such as glow-in-the-dark staph strains. 

The researchers steeped chestnut leaves in solvents to extract their chemical ingredients. "You separate the complex mixture of chemicals found in the extract into smaller batches with fewer chemical ingredients, test the results, and keep honing in on the ingredients that are the most active," Quave explains. "It's a methodical process and takes a lot of hours at the bench. Emory undergraduates did much of the work to gain experience in chemical separation techniques." 

The work produced an extract of 94 chemicals, of which ursene and oleanene based compounds are the most active. 

Tests showed that this extract inhibits the ability of staph bacteria to communicate with one another, a process known as quorum sensing. MRSA uses this quorum-sensing signaling system to manufacture toxins and ramp up its virulence. 

"We were able to trace out the pathways in the lab, showing how our botanical extract blocks quorum sensing and turns off toxin production entirely," Quave says. "Many pharmaceutical companies are working on the development of monoclonal antibodies that target just one toxin. This is more exciting because we've shown that with this extract, we can turn off an entire cascade responsible for producing a variety of different toxins." 

A single dose of the extract, at 50 micrograms, cleared up MRSA skin lesions in lab mice, stopping tissue damage and red blood cell damage. The extract does not lose activity, or become resistant, even after two weeks of repeated exposure. And tests on human skin cells in a lab dish showed that the botanical extract does not harm the skin cells, or the normal skin micro-flora. 

The Emory Office of Technology Transfer has filed a patent for the discovery of the unique properties of the botanical extract. The researchers are doing further testing on individual components of the extract to determine if they work best in combination or alone. 

"We now have a mixture that works," Quave says. "Our goal is to further refine it into a simpler compound that would be eligible for FDA consideration as a therapeutic agent." 

Potential uses include a preventative spray for football pads or other athletic equipment; preventative coatings for medical devices and products such as tampons that offer favorable environments for the growth of MRSA; and as a treatment for MRSA infections, perhaps in combination with antibiotics. 

"It's easy to dismiss traditional remedies as old wives' tales, just because they don't attack and kill pathogens," Quave says. "But there are many more ways to help cure infections, and we need to focus on them in the era of drug-resistant bacteria." 

Source: Eurekalert


Seaweed Pill May Help Treat Arthritis

Scientists have found that chemical compounds found in 'nuisance' seaweed could one day help to treat arthritis. 

This special type of seaweed, which is found in Hawaii, may also be able to help treat other chronic diseases, from Alzheimer's to cancer and even heart trouble.

The organisms, called 'Cyanobac-teria', produce chemical compounds that have been found promising as an anti-inflammatory agent and in tackling bacterial infection. 

The lives of at least 10 million -people in Britain are blighted by arthritis, which is not only a painful experience, but also an incurable condition, which is caused by inflammation of the joints. 

Researchers at the Scripps Institution of Oceanography began investigating the seaweed as it was killing off Hawaii's coral reefs, reported the Daily Express. 

To their surprise they discovered the chemicals damaging the coral could be used to treat human disease. 

"In different arenas these compounds could be helpful, such as treating chronic inflammatory conditions for which we currently don't have really good medicines," said the institution's William Gerwick, professor of oceanography and pharmaceutical sciences. 

Scientists identified the "nuisance" organism for the first time in 2008 threatening the reefs next to a national park off the Kona coast of Hawaii. 

The 'Cyanobacterium' is believed to be native to the islands and is usually not noticeable. 

Researchers found that the seaweed was 'smothering' the reefs at popular dive sites. 

It also appeared that the 'Cyanobacteria' were releasing a chemical that was bleaching the coral. 

Samples were retrieved in 2009 and transferred to the University for further analysis. 

Various laboratory tests were carried out and the research team discovered that the seaweed called "Leptolyngbya Crosbyana' - generates natural products known as 'Honaucins' with potent anti-inflammation and bacteria-controlling properties.he substances were found to obstruct bacteria's ability to "swarm" over surfaces. 

"It's a long road to go from this early-stage discovery to application in the clinic but it's the only road if we want new and more efficacious medicines," said Gerwick 

"I think this finding is a nice illustration of how we need to look more deeply in our environment because even nuisance pests, as it turns out, are not just pests 

"Several species of 'Cyanobacteria' and algae are known to produce novel compounds, many that have promising use in drug development for human and other uses. These organisms have been on the planet for millions of years and so it is not surprising that they have evolved numerous strategies for competing with neighboring species, including chemical warfare," Assistant Professor Jennifer Smith added. 

Prior research has revealed that seaweed is packed with vital micronutrients. It has been developed into anti-obesity treatments because consuming it makes people feel full and seaweed granules have also been hailed as a healthier alternative to salt. 

The latest study, which has been published in the journal Chemistry and Biology, will bring hope to the millions of people left in constant agony by arthritis.


Seaweeds To Be Used To Produce New Generation of Antibiotics: University of Exeter

In a bid to fight the growing threat of resistant superbugs British researchers are trying to use the antimicrobial properties of seaweeds from the country's coastline to develop a new generation of antibiotics, said researchers from the University of Exeter.s the number of multidrug-resistant bacteria, also known as superbug, rises, there is an urgent need for new drugs that can be used to treat infections when others fail. Natural environments can be a rich source of antibiotics. 

A research team from the University of Exeter are trying to uncover properties that could form the basis for a new generation of antibiotics that can curb infections caused by superbugs, such as MRSA, Xinhua reported. 

"Our early experiments have confirmed that seaweeds hold a diverse array of antimicrobial properties. Excitingly, some of these extracts are most effective against some of the more resistant and problematic bacteria and we're hoping our work will help to make the discovery of new drugs quicker and cheaper," said Michiel Vos, who led the study. 

With its rich abundance of coastline and seaweed species, Cornwall, a coastal area in southwest Britain, is the perfect place for this kind of research. To take these ideas further, Vos said the team would create a dedicated research project that can really shed light on the potential they were seeing. 

Antibiotic resistance is a serious and growing global problem. A previous World Health Organization (WHO) report stated that it is "now a major threat to public health".

Source: IANS



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