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Flu Treatment News: Which treatments should I take for flu symptoms?

Which treatments should I take for flu symptoms?

The flu treatment you should take depends on your symptoms. For example, if you have nasal or sinus congestion, then a decongestant can be helpful.

Decongestants come oral or nasal spray forms. Decongestants are used to reduce swelling in the nasal passageways. However, nasal spray decongestants should not be used for more than a few days because, if they are used too long and then stopped, they can cause rebound symptoms.

If you have a runny nose, postnasal drip, or itchy, watery eyes — then an antihistamine may be helpful for your flu symptoms. Antihistamines block the effect of “histamine,” and help relieve such annoying symptoms as sneezing, itching, and nasal discharge.

Over-the-counter antihistamines often make people drowsy, whereas decongestants can make people hyper or keep them awake. Keep in mind that both decongestants and antihistamines can interact with other drugs you may be taking, and they may aggravate some conditions. Talk to your doctor or pharmacist about which flu symptom treatment is best for you.
Which treatment should I use for nasal congestion?

If you need immediate relief for swollen, congested nasal passages, you may get relief with an over-the-counter decongestant nasal spray. It is important to stop using decongestant nasal sprays after three to five days to avoid the development of rebound congestion.

Some doctors suggest using a saline spray instead of a medicated spray. Saline sprays loosen thick mucus in the nasal passageways but have no rebound effect. It may be used for extended periods of time without significant side effects.
Is it safe to take a decongestant if I have high blood pressure?

Decongestants can increase blood pressure and heart rate. Pseudoephedrine and phenylephrine are oral decongestants commonly available in over-the-counter products. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn’t be a problem as long as you monitor your blood pressure. This may not be true, however, with certain types of blood pressure medications. Check with your doctor or pharmacist about safety.
Which flu treatment works best for my cough?

An occasional cough may clear the lung of pollutants and excess phlegm. A persistent cough should be diagnosed and treated specifically. On the pharmacy shelf, you’ll find numerous cough medicines with various combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which combination, if any, would be appropriate for your cough.

Popular anti-flu drug may be no better than aspirin

The most widely used drug in the world prescribed to fight the flu may prove ineffective for many this year, researchers say.
Tamiflu, the mainstay of flu treatment in the US, now may not work to prevent the flu if you’ve been exposed to someone who already has the flu (such as a sick coworker) or if there is a flu outbreak in your community or in reducing secondary complications such as pneumonia, according to a report published online January 18 in the British Medical Journal (BMJ).
“The Cochrane researchers set out to test Roche’s claim that Tamiflu prevented complications and reduced the number of people needing hospital treatment,”read a BMJ press release. “But their investigation was hampered by Roche’s refusal to provide all of its trial data for analysis.”
Every year, about 25 to 50 million Americans suffer from the flu, WebMD News reports. Symptoms come on rapidly which often result in absences from work and school.
If these symptoms are caught early, usually within first 24-48 hours, doctors can prescribe Tamiflu to treat the stuffy nose, cough, sore throat, fever/chills, aches, tiredness; making them less severe and shortens the recovery time so that people feel better faster.
But the flu can have serious complications ranging from ear and sinus infections to life-threatening pneumonia that may require hospitalization.
ABC news reports that the flu virus usually causes about 36,000 deaths in the United States each year. Pneumonia resulting from flu is usually the fatal complication.
Rome-based physician and epidemiologist Tom Jefferson, MD, along with colleagues at the Cochrane Collaboration pored over nearly 30,000 pages of clinical studies to examine the company’s claims only to be stonewalled.
Tara Iannuccillo, a Roche spokesperson denies Cochrane’s allegations, saying that Roche stands behind the “robustness and integrity of our data supporting the efficacy and safety of Tamiflu.
“Roche provided the Cochrane group with access to 3,200 pages of very detailed information, enabling their questions to be answered.”
But their questions weren’t answered. They were just beginning. Indeed, Roche did send them 3,195 pages of information covering 10 treatment trials of Tamiflu, but the table of contents suggested that there was more to the story.
“What we’re seeing is largely Chapter One and Chapter Two of reports that usually have four or five chapters,” Peter Doshi from Johns Hopkins University and the BMJ article’s lead author told Medpage Today.
Added Dr. Doshi: “We are no longer sure that oseltamivir (Tamiflu) offers a therapeutic and public health policy advantage over cheap, over the counter drugs such as aspirin.”
“The authors have been unable to obtain the full set of clinical study reports or obtain verification of data from the manufacturer of oseltamivir (Roche) despite five requests between June 2010 and February 2011,” Cochrane Collaboration researchers report.
Roche, based in Switzerland, added some $3.4 billion to the company’s bottom line in 2009 alone, according to Deborah Cohen, investigations editor of BMJ; much of it spurred by retail sales and the stockpiling of the drug by governments and corporations.
Since 2005, federal and state governments in the United States have spent more than $1.5 billion to stockpile Tamiflu and another antiflu drug, Relenza which has to be inhaled,the New York Time reports.
Fiona Godlee, MD, Editor-in-Chief of BMJ writes that the decisions to stockpile the drug and made it widely available have been based on the flawed evidence.
Scientists at the Cochrane Collaboration recommend that until more is known about the Tamiflu from clinical studies in preventing complications of the flu ” health professionals, patients and other decision makers need to reflect on the findings of this review before making any decision about the use of the drug.”

Review renews questions about oseltamivir benefits

A lengthy new analysis of unpublished clinical trial data is renewing questions about the effectiveness of the influenza drug oseltamivir (Tamiflu), saying that although the drug shortens flu symptoms by about a day, there is no evidence that it reduces hospital admissions.

The report by Tom Jefferson and colleagues, members of the Cochrane Collaboration, also says that, despite sifting thousands of pages of documents, the team couldn’t gather enough data to determine whether oseltamivir reduces flu complications and transmission. The 200-page report was published yesterday by The Cochrane Library.

The report also raises some questions about the safety of oseltamivir, saying some reports of adverse events possibly related to the drug were not included in published reports of clinical trials.

Roche, manufacturer of Tamiflu, said numerous clinical trials and medical experience have shown that oseltamivir is effective and usually well-tolerated. The company said it supplied 3,200 pages of data to Jefferson’s team, though the researchers say in the report that the company withheld some data they requested.

European and US health officials said they had not had time to study the report, but they noted that it ignores a significant body of observational data supporting the effectiveness of oseltamivir against both seasonal flu and the 2009 pandemic virus.

The analysis was sponsored by the UK National Institute for Health Research Health Technology Assessment program. The Cochrane Collaboration is an international network of researchers who study the quality of evidence for healthcare interventions. Jefferson is an independent epidemiologist based in Rome.

Targeting publication bias
The report is the latest of several reviews of the neuraminidase inhibitors (NIs, including oseltamivir and zanamivir [Relenza]) from Cochrane researchers. The authors say their aim was to eliminate publication bias—the fact that studies with positive findings about an intervention are more likely to be published than those with negative or inconclusive findings.

During the 2009 pandemic, the Australian and British governments asked for an update of the previous Cochrane review of NIs, according to the report. That update ended up being inconclusive, because the researchers could not verify the data behind manufacturer and government claims about oseltamivir. The authors point in particular to a meta-analysis of 10 clinical trials, eight of which have never been published.

“We identified that a large number of studies, including data from 60% of the people who have been involved in randomised, placebo-controlled phase III treatment trials of oseltamivir have never been published,” Jefferson said in a press release from Wiley-Blackwell, publisher of the Cochrane Library. “We are concerned that these data remain unavailable for scrutiny by the scientific community.”

Accordingly, the researchers decided to try “to get to the bottom of the issue of the effects of NIs by appraising evidence from unpublished clinical study reports . . . and regulatory documents containing comments and reviews,” the report says. The authors eventually collected 16,000 pages of data from the drug manufacturers and US, European, and Japanese regulatory agencies, according to the press release.

The team identified 67 clinical trials of oseltamivir and zanamivir, most of them in adults, but 42 of these were unusable because of insufficient information or unresolved discrepancies in the data. Of the 25 trials included in the analysis, 15 were of oseltamivir and 10 of zanamivir, and all were sponsored by the drug manufacturers.

The analysis focused mainly on oseltamivir because it is much more widely used and stockpiled and is on the World Health Organization list of essential drugs. In the end, the researchers decided to postpone its analysis of zanamivir, awaiting receipt of individual patient data promised by GlaxoSmithKline, its manufacturer.

After sifting all the oseltamivir data, the researchers concluded that the drug shortens the time to alleviation of symptoms by an average of about 21 hours, from the average of 160 hours of symptoms in placebo-group patients. But from seven studies that examined the question, they found no effect on the rate of hospitalizations.

The report adds, “Due to limitations in the design, conduct and reporting of the trial programme, the data available to us lacked sufficient detail to credibly assess a possible effect of oseltamivir on complications and viral transmission.”

The researchers say they found some inconsistencies between published trial reports and the unpublished trial records. The press release says some of these had to do with oseltamivir safety. The unpublished reports mentioned “serious adverse events,” some of them possibly related to the drug, but one of the two most cited publications does not mention those events, while the other says there were “no drug-related serious adverse events,” according to the release.

Another finding is that subjects randomly assigned to receive oseltamivir were less likely to be diagnosed as having flu than were control subjects (odds ratio based on eight studies, 0.83; 95% confidence interval, 0.73 to 0.94). The authors assert that oseltamivir probably interfered with the antibody response and that therefore the placebo and treatment arms of the flu-infected subgroup in trials—defined in part by a rise in antibody titers—are not comparable.

They further suggest that this raises doubts about the proposed effects of oseltamivir. One possibility, they say, is that by interfering with antibody production, oseltamivir “has the effect of selecting the strongest antibody responders,” who are probably the healthiest people and those least likely to experience flu complications.

Jefferson and colleagues conclude with a prediction that the full clinical study reports from the trials could clarify the outstanding questions about oseltamivir. “These full clinical study reports are at present unavailable to us,” they write.

ECDC expert weighs in
Dr Angus Nicoll, head of the influenza program at the European Centre for Disease Prevention and Control (ECDC) and honorary professor at the London School of Hygiene and Tropical Medicine, said it was difficult to comment definitively on a 200-page document that has only just gone public, but it did not seem to be saying much that the Jefferson group had not said before.

“What is important now is that independent scientists comment on the document and ask questions through the ‘Submit Comments’ field at the manuscript,” he said (see link below). “As I understand it, these comments will be responded to—and that is the Cochrane process for reviews like this so they now undergo open peer review.”

However, Nicoll felt that a fundamental design problem of the review is that it excludes all observational data, commenting, “Jefferson has a very pure approach not considering observational data.” He said the disadvantage of this approach is that it lacks power to detect uncommon but important effects—either good results like the prevention of severe flu complications or rare adverse effects of drugs.

“Our reading of the observational data, like that published in the BMJ by China CDC recently from the pandemic [see link below], is that early oseltamivir use is associated with less severe complications,” he said. “The observational data are weak, but they are mostly pointing towards a protective effect. That particularly came out in the pandemic, but is also the case with seasonal flu. Just relying on trial data can lead to the old trap of thinking that absence of evidence of effectiveness (protection against complications) equals evidence of no effect.”

Nicoll also said that there are two or three evidence-based reviews of observational data coming and they should be awaited so that the trial and observational data can both be considered.

He also took issue with the Cochrane team’s conclusion that there is no clinical trial evidence that NIs reduce severe outcomes in flu patients. He said they discounted analyses by Miguel Hernan and Marc Lipsitch of Harvard University.

In an earlier report, according to Nicoll, the Jefferson group examined a meta-analysis of clinical trials of oseltamivir by Kaiser and others. (The new report says the meta-analysis included 10 manufacturer-funded trials, eight of which have never been published.) When Jefferson and colleagues tried to reanalyze the data in the Kaiser paper they couldn’t reproduce the findings, Nicoll said.

But subsequently Hernan and Lipsitch asked for more primary data from the 10 trials and reanalyzed them along with additional data, producing results consistent with oseltamivir reducing flu complications. Their report was published in Clinical Infectious Diseases last year (see link below).

“Lipsitch and Hernan are a very well respected independent group, so when we saw their findings we realized there was evidence of reduced complications from trials in seasonal flu,” Nicoll said.

Finally, Nicoll commented that the bottom line of the Jefferson reviews is always that there should be more large, randomized trials, independent of industry and now, even independent of governments. Clearly those could not include people at higher risk from flu, such as older people, young children, and those with other conditions, he said, noting that the sample sizes needed for such trials would be impossibly large.

“There are some questions that you have to answer without relying on trials alone,” he concluded.

CDC official notes observational data
Tim Uyeki, MD, MPH, a flu expert at the US Centers for Disease Control and Prevention (CDC), said he had not read the report, but, like Nicoll, he commented that the Cochrane review did not consider the observational data supporting oseltamivir. Uyeki is deputy chief for science in the Epidemiology and Prevention Branch of the CDC’s Influenza Division.

“There is a substantial amount of data from observational studies of oseltamivir treatment of seasonal flu and pandemic flu to suggest clinical benefit when treatment is initiated early,” and even some benefit when treatment is begun more than 2 days (but less than 5 day) after illness onset,” Uyeki said. “There are some limited studies that have also suggested a reduction in risk of admission to ICU or death.”

He added that the observational studies all point in the direction of clinical benefits. “When the ACIP [Advisory Committee on Immunization Practices] and CDC and other groups are making clinical recommendations and recommendations for public health, it’s important to look at all of the evidence that’s available, including evidence from randomized placebo-controlled trials as well as observational data,” he added.

Roche’s response
In a statement released yesterday, Roche officials defended oseltamivir’s track record and the company’s openness in supplying data to Jefferson’s team.

“Numerous clinical trials and real-life medical experience show Tamiflu is effective in reducing the severity and duration of influenza symptoms as well as specified secondary complications,” the company said. “Analyses by health authorities and independent research groups show that, during the 2009 H1N1 pandemic, Tamiflu saved lives and reduced hospitalization. Similar benefits have also been reported for seasonal influenza.”

The company said the drug has been used to treat and prevent influenza in 90 million people, including nearly 20 million children, in 80 countries. In addition, “clinical studies show that Tamiflu is well tolerated in the overwhelming majority of cases. Like all medicines, Tamiflu can have side effects and these are listed in the Summary of Product Characteristics.”

Roche also said it provided the Cochrane group “3,200 pages of very detailed information, enabling their questions to be answered.”

“All completed Roche sponsored clinical studies on the safety and efficacy of Tamiflu are available as peer-reviewed publications or in summary form on www.roche-trials.com,” the statement said. “More detailed clinical trial reports are available for use by investigators on a password-protected site, enabling researchers to verify the findings of these studies and publications relating to them.”

Health News Online: Bellco Health staying put, expanding in Amityville

Joint Juice Announces the State of America’s Joint Health

Today Joint Juice, Inc., a leading San Francisco-based nutrition company, announces the latest results from its online joint health assessment[1], revealing the U.S. states with the best – and worst – joint health. As people across America recently made New Year’s resolutions to improve their fitness, Joint Juice encourages them to remember take care of their joints as they get in shape. According to findings, Hawaii came out on top as the state with the best joint health, tied with Washington D.C. and Arkansas. Maine was at the bottom of the list, earning the distinction of the state with the worst joint health.

“Joints are the foundation of an active and healthy lifestyle, yet are often overlooked,” said David Ritterbush, Chief Executive Officer of Joint Juice, Inc. “We are on a mission to educate Americans about the importance of joint care by continuing to provide educational tools such as our joint health assessment, and offering innovative products to help people continue to do their favorite activities.”

Since the launch of the joint health assessment in 2010 on the Joint Juice website nearly 10,000 people have taken the test to evaluate their personal joint health. The results incorporated data from participants in all 50 states. The illustrative joint health assessment created by Kevin R. Stone, M.D., renowned orthopaedic surgeon and Joint Juice, Inc. founder evaluates the condition of an individual’s joints based on a series of 15 questions regarding diet, exercise, lifestyle, Body Mass Index (BMI), and joint health history. Interspersed throughout the assessment are tips from legendary quarterback Joe Montana, who shares his story about how Joint Juice combined with a healthy lifestyle has helped him stay active. Results were collected from June 2010 through December 2011, and summarized in five categories: Excellent, Good, Average, Below Average, and Poor.

In 2012, Joint Juice, Inc. will continue their partnership with Joe Montana for the second consecutive year to encourage Americans to focus on their joint health so they can get back to doing the activities that they love to do. The nationwide campaign will offer tips, tricks, and exercises to help people get on a path to healthier joints.

To learn more about joint health or to take the Joint Juice® joint health assessment, please visit jointjuice.com.

Supermarkets accused of exploiting loopholes to undermine alcohol pricing laws

MSPs have accused supermarkets of “undermining the spirit” of alcohol discounting laws by slashing their prices and encouraging online purchasing.

Legislation came into force in October last year banning volume sales of alcohol, with the aim of stopping “irresponsible promotions” such as two for one deals and group discounts on wine.

However loopholes in the law mean retailers are still able to offer such discounts on internet sales made in England, and have been able to sell the same bottles of alcohol for whatever the combined discount price was to begin with.

Members of Holyrood’s Health Committee raised the issue with representatives from Asda and Tesco today during a session on the Scottish Government’s proposals for minimum alcohol pricing.

SNP MSP Jim Eadie asked: “Do you accept that there are many people who feel that you are not abiding by the spirit of the legislation that was introduced by the Parliament?

“The one thing that you did almost immediately when certain promotions were banned was to introduce bottles of wine for £3.33.”

Mr Eadie said the supermarkets had been accused of “undermining the spirit of the legislation” by “slashing prices and encouraging online purchasing”.

He continued: “It does leave the impression with the wider health community in Scotland who are widely focused on what is the biggest public health challenge facing this country, that your companies are putting their profits before the health of the people of Scotland.”

David Paterson, head of regional affairs at Asda, replied: “The clear intention of the quantity discount ban was to reduce any incentive for a customer to buy a larger amount of alcohol than they had intended to.

“That was the clear and unequivocal objective.

“We made it very clear particularly in the last Alcohol Bill that when you intervene in a market which is part of a wider UK single market, there are a number of unintended consequences and they cannot be wished away.

“So in the same sense that I have seen attacks on other retailers about the use of online, it seems a bizarre situation to me that there are companies based solely in England that can continue to sell alcohol at whatever price they want but that in some sense companies that are in Scotland and invest here shouldn’t also be able to do that. There has to be a level playing field.”

He added: “I think it’s worth saying that we didn’t slash our prices and we haven’t driven customers online. We don’t have an online alcohol offering.”

Labour MSP Dr Richard Simpson continued to press the supermarkets on the issue.

He said: “We may not have written the legislation correctly and I am not saying you are incorrect in terms of the law. I think we failed to understand fully when we passed that Bill that it would not end volume discounting.

“The spirit of the law was quite clear, that we wanted to ban discounting for volume, and yet the supermarkets particularly – and also the small stores – are still selling on a volume discounting basis.”

Dr Simpson asked the supermarkets how they would respond to minimum pricing.

Emma Reynolds, government affairs director for Tesco, said: “In a competitive market, if you do want action on price, it needs to be government-led and through legislation because we are in the business of competing for the best possible offers for customers.

“That is why we have said we’ll be constructive in government-led discussions on price.”

Mr Paterson said there were already rules about when and where retailers can sell alcohol, alongside the ban on quantity discounts.

He added: “When you get to a point where the price is set, we will have one of the most restrictive alcohol retailing regimes in the world, and it will be quite clear how you deal with that.”

Mr Paterson said Asda would abide by any laws passed by Holyrood.

The session also took evidence from a number of other representatives from the drinks industry including the Scotch Whisky Association, Diageo, Tennent Caledonian Breweries (UK) Limited, the National Association of Cider Makers, the Scottish Beer and Pub Association and the Scottish Licensed Trade Association.

Health Care News: Court schedules week of health care arguments

Court schedules week of health care arguments

The Supreme Court has announced that it will use an entire week’s worth of argument time to decide the constitutionality of President Barack Obama’s historic health care overhaul.

The high court announced Monday that it will hear health care arguments on March 26th, 27th and 28th..

The Patient Protection and Affordable Care Act aims to provide health insurance to more than 30 million previously uninsured Americans

Justices will hear arguments on Monday the 26th over whether court action is premature because no one yet has paid a fine for not participating in the overhaul. Tuesday’s arguments will be over whether Congress overstepped its authority with the law. Finally, on Wednesday justices will hear whether the rest of the law can take effect even if the health insurance mandate is unconstitutional.

Rotech Healthcare Inc. Announces Acquisition of Home Medical Businesses

Rotech Healthcare Inc. ROHI
+5.17% , one of the largest
providers of home medical equipment and related products and services, announced today its acquisition of three home medical entities. The acquired businesses are Best Care HHC Acquisition Company LLC, NeighborCare Home Medical Equipment of Maryland, LLC and NeighborCare Home Medical Equipment, LLC.

Rotech anticipates that these acquisitions will contribute approximately $11 million in projected annual revenue in 2012.

“We expect the acquisition of these NeighborCare home medical entities to have a positive impact on Rotech’s financial performance in 2012 and beyond, as well as to expand our presence in the Philadelphia, Baltimore and other East Coast markets,” said President and Chief Executive Officer Philip Carter.

About Rotech Healthcare Inc.

Rotech Healthcare Inc. is one of the largest providers of home medical equipment and related products and services in the United States, with a comprehensive offering of respiratory therapy and durable home medical equipment and related services. The Company provides home medical equipment and related products and services principally to older patients with breathing disorders, such as chronic obstructive pulmonary diseases (COPD), which include chronic bronchitis, emphysema, obstructive sleep apnea and other cardiopulmonary disorders. The Company provides equipment and services in 48 states through approximately 425 operating locations located primarily in non-urban markets.

CMS selects 32 final Pioneer ACOs

The Centers for Medicare & Medicaid Services (CMS) today announced the final list of 32 Pioneer Accountable Care Organizations (ACO) to start in the new year. CMS estimates that care coordination between hospitals, physicians and other care givers under the Pioneer ACO model could save Medicare up to $1.1 billion.

Among the list are Banner Health Network in Arizona, Dartmouth-Hitchcock ACO in New Hampshire and Eastern Vermont, Monarch Healthcare in Orange County, Calif., as well as Beth Israel Deaconess Physician Organization, Partners Healthcare and Steward Health Care System, all in Massachusetts. CMS chose 32 out of a pool of competitive applicants through a lengthy and open process, according to CMS.

“Pioneer ACOs are leaders in our work to provide better care and reduce health care costs,” said Health & Human Services Secretary Kathleen Sebelius. “We are excited that so many innovative systems are participating in this exciting initiative – and there are many other ways that health care providers can get involved and help improve care for patients.”

As the forerunner to the Medicare Shared Savings Program, the Pioneer ACO model will allow those organizations and individual providers that already are experienced in coordinating care to reap the benefits earlier and more of them. These groups will move more rapidly from a Shared Savings model to a population-based payment model, according to the press release. Differing from the Medicare Shared Savings Program, starting in year three of the initiative, those organizations that have earned savings during the first two years will be eligible to move to a population-based payment arrangement and full risk arrangement that can continue through an optional fourth and fifth year.

“We know that health care providers are at different stages in their work to improve care and reduce costs,” said Marilyn Tavenner, acting Administrator of CMS. “That’s why we’ve developed a menu of options for Medicare to meet doctors, hospitals, and other healthcare providers where they are, and begin the conversation of how to enhance the care they are offering to people with Medicare.”

The first performance period of the Pioneer ACO model will start Jan. 1, 2012.

Arthritis Treatment News: Novartis’ childhood arthritis drug study achieves primary goal

Novartis’ childhood arthritis drug study achieves primary goal

Novartis (NYSE:NVS) announced Friday its phase 3 trial for its ACZ885 drug for the treatment of systemic juvenile idiopathic arthritis (SJIA) has achieved its primary endpoint.

The phase 3, four-week, randomized, double-blind, placebo-controlled study enrolled 84 children and young adults suffering from SJIA. Each patient was treated with either a single dose of ACZ885, or a placebo.

At the end of the four-week study, 83.7% of patients in the ACZ885 drug group experienced at least a 30% improvement in symptoms, versus 9.8% of patients in the placebo group. Meanwhile, 32.6% of patients in the drug group experienced 100% improvement in symptoms, versus none in the placebo group.

The primary endpoint was a 30% improvement in at least three of the following six variables, the company said: physician’s assessment of disease activity, parent/patient assessment of overall well-being, functional ability, number of joints with active arthritis, number of joints with limited range of motion, and a laboratory measure of the C-reactive protein, an inflammatory agent.

“These data suggest that ACZ885 could become an important treatment option for children living with SJIA, the most difficult-to-treat and severe form of juvenile arthritis, potentially transforming their lives,” said one of the study’s investigators, Professor Pierre Quartier.

“ACZ885 provided rapid and long-lasting symptom relief by targeting interleukin-1 beta, a key inflammatory mediator of the disease.”

Affecting one in every 100,000 children, SJIA is characterized by inflammation affecting the whole body, including most joints. Other symptoms include potentially life-long and recurrent arthritis flares, which can involve skin rash, daily spiking fevers, joint pain, and swelling.

The ACZ885 drug works by inhibiting IL-1 beta, the excessive production of which causes certain inflammatory diseases, like SJIA.

Novartis said its second phase 3 trial of ACZ885, which will determine if the drug can extend the time between arthritic flares and reduce or eliminate corticosteroid use, is ongoing, with results expected to be presented later this year.

Arthritis: What’s truth and what’s myth?

Cracking your knuckles causes arthritis — you probably know that’s an old wives’ tale. Though it could injure ligaments around the joints and lead to weaker grips, there’s no proof every pop puts you one step closer to arthritis — specifically osteoarthritis. Osteoarthritis (OA) develops when the cartilage that cushions the ends of the bones in your joints breaks down. The bones then begin to rub against one another, causing pain. OA is the most common form of arthritis, but there’s no cure, so the more you know, the better. Here are three more misconceptions about OA:
Myth: Arthritis is a natural part of aging.
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Yes, it usually appears after age 45. And yes, the older you are, the more wear and tear you have. But not every older adult develops osteoarthritis. Obesity is also a major risk factor — more weight means more stress on lower body joints.
Myth: Meds should be your first line of treatment.

Reduce pain and improve joint function — that’s the goal of osteoarthritis treatment, and medications (from over-the-counter acetaminophen to prescription pain pills) certainly help. But according to the Arthritis Foundation, simply moving your body is the best medicine for OA, and it’s an effective first step. Gentle exercises, such as walking or swimming, help strengthen muscles and bones, increase flexibility and make joints more stable. That’ll also help you lose weight, which will further reduce joint strain.

Myth: Supplements cure joint pain.

Glucosamine and chondroitin are two that are reputed to battle osteoarthritis, but an analysis of 10 studies showed these supplements don’t do much to relieve pain associated with knee and hip OA. Another supplement that probably doesn’t work: vitamin D. It has been suggested it can help treat knee OA, but it does not appear to lessen the symptoms or slow its progression.

TNF Treatment for Rheumatoid Arthritis Boosts Skin Cancer Risk

Treating rheumatoid arthritis (RA) patients with tumor necrosis factor (TNF) inhibitors appears to increase their risk of developing skin cancer, a new review of prior research indicates.

However, TNF inhibitors, which include infliximab (Remicade), adalimunab (Humira), and etanercept (Enbrel), do not appear to boost the risk for developing other forms of cancer, the researchers added.

The findings stem from an analysis of 21 previous studies conducted between 1998 and 2010, as well as eight study summaries that had been presented at research conferences during the same timeframe. All the studies had focused on the potential for cancer risk in association with the use of standard TNF inhibitors.

“This systematic review and meta analysis provides reassurance to physicians and patients that the treatment of [rheumatoid arthritis] with TNF inhibitors does not increase the risk of malignancy, particularly lymphoma,” the French study team said in a news release from Annals of the Rheumatic Diseases, which published the report in its current online issue.

“However, it does appear to increase the risk of skin cancer, including melanoma,” added the French team, led by Prof. Xavier Mariette from Paris-Sud University’s rheumatology service in Ile de France.

The authors noted that RA has previously been shown to increase the risk for developing certain types of cancer, including both lung cancer and lymphoma, while decreasing the risk for other cancers, including bowel and breast.

However, the question of TNF inhibitor treatments as a cancer risk has remained a subject of debate.

All told, the current review looked at a collection of studies involving more than 40,000 patients who had been exposed to nearly 150,000 years of TNF inhibitor drugs.

Seven of the studies indicated no notable risk increase for any type of cancer associated with the use of TNF meds. Another two long-term studies similarly suggested that while RA patients who had previously had cancer faced a higher likelihood for a second bout, TNF treatments alone posed no additional cancer risk.

But four other studies collectively demonstrated that TNF inhibitors boosted the risk for non-melanoma skin cancer by 45 percent. And another two studies suggested that the RA treatment raised the specific risk for developing melanoma by nearly 80 percent.

Dr. W. Hayes Wilson, chief of rheumatology at Piedmont Hospital in Atlanta, said the findings should help guide physicians on potential RA treatment complications.

“I don’t think this is particularly surprising, given that there’s long been a concern about cancer risk in the back of our minds,” he noted. “And, in fac,t this is somewhat reassuring on the front of solid cancers that there’s nothing to be alarmed about.”

“But while we can perhaps now put aside our worries about other types of cancers, this does give us some indication that we need to be vigilant when it comes to skin cancer,” Wilson added. “And we certainly need to have a high index of suspicion if a patient has a skin abnormality, and make certain that they see their dermatologist.”

Dr. Gott: Ancient treatment uses bees to control pain

Dear Dr. Gott: Do you have any information on “bee sting therapy” for the chronic pain of fibromyalgia?

Dear Reader: This therapy dates back more than 3,000 years in China and involves placing live bees on strategic pressure points of a patient’s body. It is similar to the needles used in acupuncture, but in this instance, the therapy uses stingers to control the pain of diseases such as rheumatism, arthritis, shingles, lupus, herniated discs, MS, diabetes and fibromyalgia. The treatment relies mainly on the poison of the bees, which can help blood circulation, ease pain and reduce inflammation.

Following a sting, adrenal glands produce cortisol, a natural hormone with anti-inflammatory properties. Supposedly the therapy jump-starts the immune system to trigger the production of endorphins, the body’s natural painkiller. Some specialists think a characteristic of the venom is the presence of dopamine, serotonin and norepinephrine, which help heal conditions involving nerve disorders.

Most research and studies have been directed toward managing multiple sclerosis, but that field is expanding to include arthritis and numerous arthritis-related disorders. Of importance is that up to 5 percent of our population is allergic to bees; therefore, patients seeking to use this therapy must always be tested first.

One downside is that some patients simply can’t endure the injections because of the pain involved.

This therapy that has been around for more than 3,000 years is still in its infancy in the United States, and because insufficient research has been documented, the jury is out on whether it is the answer to a more pain-free existence for fibromyalgia and arthritis sufferers.

Dear Dr. Gott: Ever since I was young, I’ve drunk more than others. I’m now in my mid-40s, and it’s not uncommon for me to drink more than a gallon of liquids a day. Almost all of it is water.

There are times now before I go to bed when my mouth gets dry, and I’m thirsty. I know some of my meds cause dry mouth. I have been tested for diabetes because doctors want to rule it out as soon as they hear how much I drink. My blood work is always good, and I wonder if my dry mouth is anything to be concerned about.

Dear Reader: The urge to drink excessive fluids has many potential possibilities other than the diabetes. Heart, liver or kidney failure, specific drugs such as diuretics and anticholinergics, psychogenic polydipsia (excessive thirst), diabetes insipidus (a condition in which the kidneys are unable to conserve water) are a few possibilities. You should eliminate salt from your diet and avoid foods high in sodium.

I recommend you make an appointment with your physician and request additional lab testing to possibly include a CBC with differential, serum calcium level and perhaps more based on your medical history.

Bad Breath Treatment Today: Can supplements cause body odors?

Can supplements cause body odors?

Overview
Certain supplements can affect the way your body smells and give off a distinct, unpleasant odor. Sometimes taking a normal dose of a particular supplement can cause you to have body odor, but other times body odor only occurs if you’ve taken too much of a particular supplement. If you notice that your supplement is causing you to smell bad, talk to your doctor about discontinuing that particular supplement.

Garlic
Fresh garlic can cause body odor and bad breath, and the same is true for garlic supplements. These supplements often are made with fresh or dried garlic powder, which causes the supplements to have a similar effect to the real deal. Garlic supplements are sometimes used to help treat high blood pressure, prevent atherosclerosis and to reduce the risk of developing certain cancers, such as rectal, colon and stomach cancers. Garlic supplements, however, should not be substituted or used in place of traditional medications. Talk to your doctor before you begin taking any supplements to treat medical conditions.

Omega-3 fatty acids
Omega-3 fatty acid supplements are sometimes used to help prevent the spread of solid tumors and to inhibit the growth of certain cancers, such as colon, pancreatic and prostate cancers. Omega-3 fatty acids also are used to help ward off cardiovascular disease and prevent fatal heart attacks. These supplements contain anti-inflammatory properties, making them useful in the treatment of inflammation associated with arthritis, eczema and other health conditions. They’re often made from fish oils and oils extracted from beans, such as navy beans, soybeans and great northern beans. These supplements can cause your breath and body to have a fishy smell, even when taken at the correct dosage.

Carnitine
Your body produces carnitine on its own, via the liver and kidneys, and it is stored in the brain, heart, skeletal muscles and sperm. Typically, your body can make all the carnitine it needs, but certain medical conditions can inhibit the production and storage of carnitine. Certain medications also cause this to happen, which might make it necessary to take a carnitine supplement. A rare side effect of taking carnitine supplements is body odor; other rare side effects include increased appetite and body rash. Do not take these supplements without your doctor’s approval, because they can interfere with some medical conditions.

Choline
Your body can manufacture choline on its own, notes the Linus Pauling Institute, but certain conditions and medications can make it difficult for your body to produce this nutrient. Choline is required for the body to remain healthy. Consuming high doses of this supplement, typically 10 to 16 grams a day, can cause a fishy body odor and increased sweating. Adults only require 3.5 grams of choline per day.

Alternatively Speaking: Self-awareness brings confidence

Alternative medicine enthusiast Natalie Marx answers your questions: Are there any natural remedies for toothache? How can I deal with bad breath?
Talkbacks (2)

I have witnessed many wonderful recoveries through the usage of natural medicine. These include some of the most intense and complex combinations of problems that people face — depression, anxiety, insomnia, OCD, every kind chronic pain and addiction, chronic fatigue, eating disorders, and the list goes on.

Each person who was healed embarked on a journey of self discovery learning new ideas and healthy practices. Ultimately, each of us is responsible for our own health. We create it or destroy it, both through our own actions and our actions as a society. While we cannot control everything that could make us ill, we can control enough to make a difference. Often a huge difference. Natural therapy aims to heal the whole person, not just to relieve an annoying symptom. New knowledge and self-awareness brings with it confidence and personal insight. In the end, your own self-care practice not only consolidates the healing, but also results in a life full of harmony.

Q. Dear Natalie, my youngest daughter is ten years old and has been suffering from terrible tooth ache. Do you have any natural remedies since she is terrified of visiting the dentist!

A. Toothache can be one of the most unbearable conditions experienced by a person. There can be throbbing, consistent pain that can be very hard to deal with on a day to day basis. The best solution is of course to visit a dentist and get a professional opinion. However, in cases where this might not be immediately possible, or in the case with your daughter’s fear, it may be necessary to try a few herbal remedies for temporary relief.

Clove oil is a well known and favored home treatment for tooth ache. Dab a small amount of clove oil on a cotton swab and hold the oil directly to the painful tooth or gum area until the oil has had time to absorb into the affected area. Clove oil has an unpleasant flavor, so it’s probably wise to keep the oil from touching your daughters tongue.

You can alternatively try dipping a cotton swab in vanilla essence and press it against the affected tooth. Do make sure you target the correct tooth, referral pain can sometimes make identification difficult. Try a little Turmeric powder mixed with mustard oil onto a cotton bud and press into the affected tooth. This can also provide relief without any ill effects.

A calendula based toothpaste such as Weleda brand is very preventive in nature. Calendula has a long history of being used for the gums and teeth.

Another easy to use remedy is to peel a clove of garlic and press it against the tooth for relief. The juice of the garlic is an effective natural anesthetic and will provide immediate relief. Make sure your daughter is getting a good amount of vitamin C and calcium in her diet as they help maintain strong teeth.

Alcohol can lead to bad breath, or worse

SUMMARY: There are plenty of health issues associated with excessive alcohol consumption, and while halitosis is not the worst of them, it can signal the presence of major dental problems. So say Japanese researchers from the Fukuoka Dental College’s Department of General Dentistry.

There are plenty of health issues associated with excessive alcohol consumption, and while halitosis is not the worst of them, it can signal the presence of major dental problems. So say Japanese researchers from the Fukuoka Dental College’s Department of General Dentistry.

In a study published in the International Dental Journal, the team associated heavy daily drinking with powerful bad breath and an increased risk of periodontal disease.

The group began by recruiting 235 adults, all of whom complained of chronic oral odor. Scientists then used a halimeter to measure each volunteer’s level of halitosis, confirming the presence of an odor by using an organoleptic (or nose-based) test.

Researchers then interviewed participants to determine how often they consumed alcohol.

Among those who drank daily, many were found to have severe halitosis. These subjects also tended to have deep pockets of infection under their gumlines, indicating the presence of periodontitis, a serious infection of the gums and dental roots that can lead to tooth loss.

Specialty breath fresheners can reduce the smell of bad breath caused by alcohol-related tooth decay. Incidentally, such products are often alcohol-free, which may be a boon for individuals who are seeking treatment for chronic drinking.

Gout Treatment News: Gout drug may help some with few treatment options

Gout drug may help some with few treatment options

A new drug that’s injected intravenously may help some very sick gout patients who don’t get better with usual treatment, according to a new study.

The research was designed and funded by the pharmaceutical company Savient, which markets the drug, called Krystexxa, or pegloticase.

Patients taking the drug had fewer gout symptoms a few months after starting treatment than those who got a sham treatment — but they were also more likely to have a serious reaction to the injections.

The researchers say most gout patients don’t have very severe disease and should not be using the drug.

“The progression in these individuals is extreme,” study author Dr. Michael Becker, from the University of Chicago, told Reuters Health. The patients in the study had “gone on to have really severe — on average disabling — (gout), poor quality of life (and) lots of pain.”

“This is not a medication to be undertaken in a much larger group of patients,” he added.

Of 5 or 6 million people in the U.S. with gout, about three percent do not get better with typical gout drugs, such as Lopurin and Zyloprim, or they can’t take the medication for another reason, Becker and colleagues note in the Journal of the American Medical Association. Last year, the U.S. Food and Drug Administration approved Krystexxa — given by injection every other week — for use in those patients.

Gout is a form of arthritis that occurs when uric acid — generally passed out of the body in the urine — accumulates in joints and forms crystals, causing swelling and pain. Krystexxa works by breaking that uric acid down into a form that’s more easily passed through the body.

The current report combines data from two drug trials involving 212 patients with chronic gout. Study participants who got the drug injection every two weeks for six months were compared to a group that received injections once a month and a group that got only drug-free placebo injections.

The majority of patients were men — in their fifties, on average.

Krystexxa caused uric acid levels to fall quickly — but that response didn’t always last. Forty-two percent of patients in the biweekly group and 35 percent in the monthly group still had lowered uric acid six months after starting treatment.

On average, patients who received the drug had a bigger improvement in their general physical function and quality of life compared to those who only got the drug-free injections. And those who got the most frequent drug injections also reported the least pain.

However, more than nine out of ten patients reported at least one “adverse event” — including painful gout flare-ups or reactions to the injections, including a few cases of breathing problems. Those reactions were more common in patients taking Krystexxa.

Some patients also reported headaches and nausea.

Becker said doctors could test which patients had stopped responding to the drug and halt treatment to avoid unnecessary risks in people whose gout isn’t getting any better.

Krystexxa costs about $5,000 per month. Becker said patients whose symptoms improved with the injections could probably go back on cheaper medications — but it’s not clear yet how long most patients would have to get the injections first.

Most patients in the study also had heart conditions, or at least the risk factors for heart disease. Gout often occurs together with obesity and high blood pressure.

Becker said patients who don’t respond to Lopurin and Zyloprim have a couple of other medication options (including Uloric, approved by the FDA in 2009), but gout drugs can take up to several years to really kick in — and some patients with severe disease can’t wait that long. For a number of those patients, Krystexxa may be worth the risks and cost.

“When you have seriously ill people who have no options, 40 percent (of patients getting better) is pretty good,” he said. “Gout can be a really serious and disabling disease. With this and other (drugs) that are coming into line for treatment, we can do a good job in virtually all these people, including the sickest.”

Pegloticase an Option in Patients With Refractory Gout

Adults with severe chronic gout refractory to conventional urate-lowering therapy may respond to treatment with pegloticase (Krystexxa; Savient Pharmaceuticals, Inc), with reductions in uric acid levels, as well as improved physical function and quality of life.

The findings were based on 2 company-sponsored studies published in the August 17 issue of the Journal of the American Medical Association.

Long-term urate-lowering therapy is the mainstay of treatment of gout, John S. Sundy, MD, PhD, of Duke University Medical Center, Durham, North Carolina, and colleagues note in their study.

In roughly 3% of patients, conventional oral urate–lowering agents fail to achieve target uric acid levels of less than 6.0 mg/dL. Pegloticase was developed for this group of patients.

The drug was approved by the US Food and Drug Administration in September 2010 based in part on the results of the 2 randomized controlled trials reported in the Journal of the American Medical Association.

In comments to Medscape Medical News, Daniel Furst, MD, professor of rheumatology at the University of California, Los Angeles, and member of the American College of Rheumatology, said that pegloticase “clearly has a place as second- or third-line” therapy for refractory gout.

It fulfills an unmet need, but one that “is not yet fully characterized,” said Dr. Furst, who was not involved in these studies of pegloticase.

Parallel Randomized Controlled Trials With Similar Results

The 2 studies, known as C0405 and C0406, were conducted between June 2006 and October 2007 at 56 rheumatology practices in the United States, Canada, and Mexico. The studies lasted 6 months and involved a total of 225 patients: 109 in trial C0405 and 116 in trial C0406.

Study participants received 12 biweekly intravenous infusions of either pegloticase 8 mg at each infusion (biweekly treatment group), pegloticase alternating with placebo at successive infusions (monthly treatment group), or placebo.

One week before the first infusion and throughout the study, all participants received prophylaxis for gout flare with either colchicine (0.6 mg once or twice daily) or a nonsteroidal anti-inflammatory drug.

The primary endpoint was a plasma uric acid level of less than 6.0 mg/dL measured at months 3 and 6. A responder was defined as a patient with a plasma uric acid level of less than 6.0 mg/dL for 80% of the time or longer during months 3 and 6.

The investigators say plasma uric acid levels normalized within 24 hours of the first infusion in all patients receiving pegloticase. Some patients subsequently lost the urate-lowering response, whereas others maintained uric acid levels of less than 6.0 mg/dL throughout the trial.

When analyzed separately by dose, patients treated with biweekly pegloticase experienced response rates of 47% (20/43; 95% confidence interval [CI], 31% – 62%) and 38% (16/42; 95% CI, 24% – 54%) in the 2 trials.

Patients treated with monthly pegloticase had response rates of 20% (8/41; 95% CI, 9% – 35%) and 49% (21/43; 95% CI, 33% – 65%) in the 2 trials. Response rates were 0% in both placebo groups in the 2 trials.

When data from the 2 trials were pooled, response rates were 42% in the biweekly pegloticase group (36/85; 95% CI, 32% – 54%), 35% in the monthly pegloticase group (29/84; 95% CI, 24% – 46%), and 0% the placebo group.

The proportion of responders in both pegloticase treatment groups was significantly greater vs the placebo group in the pooled analysis (P < .001 for both), the investigators report.

They also note that average plasma uric acid levels were substantially below the 6.0-mg/dL target for the entire 6-month study period.

Forty percent of patients in the biweekly pegloticase group and 21% in the weekly pegloticase group had complete resolution of 1 or more tophi (a secondary endpoint) by the final visit vs 7% of patients in the placebo group (P = .002 and P = .20, respectively). Compared with placebo, both pegloticase doses were associated with significant improvements in physical function, quality of life, and pain on standard instruments.

Potential Adverse Events With Pegloticase

One or more adverse events occurred in more than 90% of participants in each treatment group. Serious adverse events were more common in patients treated with biweekly pegloticase (24%) and monthly pegloticase (23%) vs patients treated with placebo (12%).

Despite gout flare prophylaxis, roughly 80% of patients across the 3 pooled study groups experienced gout flare; it was the most common adverse event.

Infusion-related reaction was the second most common adverse event, occurring in 26% and 42% of patients receiving pegloticase biweekly and monthly, respectively, and in 5% of those receiving placebo. Ten percent of patients receiving pegloticase biweekly and 13% receiving it monthly dropped out of the study because of infusion-related reactions.

“Infusion-related reactions, including some cases fulfilling criteria for anaphylaxis, were the most common adverse events causing withdrawal from these trials,” the study authors note.

Although all of these reactions resolved “promptly and without sequelae, minimizing the risk for infusion-related reactions is important for the safe administration of pegloticase in clinical practice,” they advise.

Seven deaths occurred between randomization and the end of the study (4 in the pegloticase group and 3 in the placebo group).

Summing up, Dr. Sundy and colleagues say that these parallel, 6-month, placebo-controlled trials of pegloticase treatment indicate sustained uric acid reductions and significant clinical improvements in “a substantial proportion of patients with chronic gout and refractoriness to, or intolerance of, conventional urate-lowering therapy.”

Dr. Furst commented that the 2 studies have several limitations, including, but not limited to, the “small numbers, short duration and no cost effectiveness analysis.” He also said that the “generalizability” of the results “needs further work.”

The 2 studies were sponsored by Savient Pharmaceuticals. Four study authors were employees of Savient at the time of conception and performance of the studies. A complete description of disclosures can be found in the original article.

Dr. Furst discloses that he is an investigator in a trial of febuxostat (Uloric) and serves on a task force panel that is developing guidelines for treatment of gout. He has been on a number of national committees concerned with rheumatic therapeutics, including being a member and fellow in the American College of Rheumatology and the American Society of Clinical Pharmacology and Therapeutics.

Eisenhower Rheumatology Clinic uses new diagnostic tools, treatments to tackle rising gout incidences

Gout, a painful form of arthritis, has become an increasingly common problem in the United States. Gout is now the most common inflammatory joint disease in men of all ages, and in older women. Gout is caused by high levels of the chemical uric acid in the body, which is deposited into the joints as microscopic crystals. The crystals cause episodes of intense joint swelling and pain as the body’s immune system attempts to attack and break them down. Large studies in the United States indicate that the prevalence of gout nearly doubled from 2.9 to 5.2 cases per 1000 people from 1990 to 1999.

This significant increase in gout is generally attributed to negative lifestyle trends in the U.S. population. Obesity, diabetes, high blood pressure, and the consumption of red meat, alcohol and foods sweetened with fructose have been identified as risk factors for gout. Certain medications, medical conditions such as chronic kidney disease, and genetic factors influence an individual’s risk of gout as well. Pre-menopausal women have a low rate of gout due to the protective effects of estrogen. However, after menopause the rate of gout rises and is influenced by the same risk factors affecting men.

Fortunately, new diagnostic tools and treatments are being deployed to fight the growing epidemic. The traditional diagnosis of gout requires identifying gout crystals by removing them from an affected joint with a needle and syringe. This approach is not only painful, but is technically difficult in certain joints. Eisenhower’s Rheumatology Clinic is employing a new diagnostic tool in the form of high-frequency ultrasound scanning to identify gout crystals within the joint. The scan is quick and painless and can be performed during a routine office visit. In addition, blood testing and X-rays are often performed to determine the severity of gout and to guide treatment.

Once diagnosed, many patients require a medication to treat their gout. Failure to treat gout typically results in progressive disease severity over time and may lead to irreversible joint damage. Some severe gout flares mimic serious infections and may result in unnecessary hospitalizations and antiobiotic treatments. Until recently, treatment options were limited due to a relative dearth of clinical and research interest in gout. Allopurinol, an oral medication that lowers blood levels of uric acid, has long been the mainstay of gout treatment. However, for patients allergic or intolerant to this medication, until recently there was no equally effective alternative.

Physicians now have two additional treatment options. Febuxostat, an oral medication similar to allopurinol, is available for patients who fail or cannot tolerate allopurinol. Pegloticase, an intravenous medication given as an outpatient infusion, is available for cases that fail oral treatment. For many, gout treatment is managed by a primary care physician such as an Internal Medicine or Family Medicine physician. Complicated cases may be referred to a Rheumatologist.

The importance of modifying lifestyle-related risk factors to reduce gout cannot be over-emphasized. Reducing consumption of red meats, alcohol, and fructose-sweetened foods such as soft-drinks is recommended. Consumption of low-fat dairy products has been found to reduce the risk of gout, and therefore is encouraged. Finally, maintaining an ideal body weight through healthy diet and regular aerobic exercise directly reduces the risk of gout, with the added indirect benefit of reducing high blood pressure and kidney disease. A strategy that encompasses nutritional education and lifestyle changes as well as medication management offers the best chance of success in treating and preventing gout.

Heart Disease News: Technique Stimulates Growth of New Blood Vessels of Heart Disease Patients

Technique Stimulates Growth of New Blood Vessels of Heart Disease Patients

New method could be used to treat heart disease

University of Pittsburgh researchers have developed a new method for regrowing blood vessels with growth factor, which could be used to treat heart disease.

Yadong Wang, study leader and University of Pittsburgh professor, along with co-authors Johnny Huard, Hunghao Chu and Chien-Wen Chen, have found a minimally invasive technique for transferring growth factor into mice via injection, which stimulates the growth of new blood vessels.

The human body has growth factors that control activities like cell proliferation, differentiation and migration. These potent molecules can even cause cell suicide and promote cell growth. The problem is that the body strictly controls growth factor, and the body will destroy “free-floating” growth factor.

But now, Wang and his team have created a method that overcame this problem. Despite the half-life for most growth factor (injected under the skin) being a half hour or less, researchers decided to inject the growth factor under the skin of mice directly onto a molecule called heparin, which bonds growth factor to its receptor on the cell’s surface. As the receptor and the growth factor bind to heparin, the activity of growth factor is increased and stabilized.

This may have solved the problem associated with growth factor duration, but it also caused another road block: bonding heparin to growth factor results in a water-soluble substance, which is a problem because a majority of the human body is made up of water.

But this issue didn’t stop the University of Pittsburgh team for long. They found a positively charged molecule, called polycation, which possesses many positive charges to counter heparin’s many negative charges. This neutralized the heparin and brought it out of solution into a coacervate, which is an aggregate of small oil droplets.

The team was able to successfully deliver fibroblast growth factor-2 as a result of the conversion of heparin/growth factor complexes into coacervates. Using only one growth factor, the researchers injected the compound under the skin of mice, which caused new blood vessels to grow. In addition, the blood vessels were still in place over a month later.

“We had structures that resembled arterioles — small arteries that lead to a network of capillaries,” said Wang.

The procedure is minimally invasive because the coacervate is not very viscous, meaning that you can use a thin needle to inject the growth factor through tissue and the damage created in small. It could also be used through a catheter, meaning that the chest wouldn’t need to be opened up for open-heart surgery.

The idea behind this discovery is to use growth factor to help the heart heal itself after a heart attack without negative results, like dilating ventricles until they become too large. The growth factor would be injected right after the heart attack to help the heart repair itself.

“Our hope would be to reduce scarring, keep as much of the muscle alive as possible, and induce quick blood vessel formation to bring as many nutrients as possible in order to reestablish an environment for muscle growth,” said Wang.

The team will use a disease model next to test this method before moving on to human clinical trials. If all goes well, the final step will be to commercialize the treatment.

Study: Heart procedures driven by profit, not science

Heart disease kills more Americans than anything else. While the statistics cause great concern, some providers see this is as an opportunity to cash in by marketing expensive, unnecessary heart procedures to healthy patients.

A recent investigation by Consumer Reports Health indicates that the practice of healing hearts has become a money-making machine that too often favors profits over science.

“We’re concerned that some people are having too many tests and too many treatments as a result, and some of that’s driven by profits, not good science,” reiterated Dr. John Santa, director of the Consumer Reports Health Ratings Center.

Most patients would say that my heart is very important and there’s no amount of money that would preclude me from getting some type of test to make sure that my heart is healthy, “Early Show” co-anchor Chris Wragge points out.

While Dr. Santa recognizes this concern, he says, “There are good and inexpensive tests and many of those aren’t being used as often. It’s frustrating because many tests that are expensive potentially dangerous and aren’t effective are being used.”

What are some of the tests that indicate people are overdoing it?

“We did a survey of almost 1,200 healthy (people) 40 to 60 years old, no disease, no symptoms and no risk factors and found 44 percent were getting ineffective tests, like EKGs, stress tests or ultrasound of the carotid arteries,” he adds.

According to Santa, there are negative effects, aside from the costs. “These tests aren’t precise when it comes to detecting early disease so they can be false positives, you get a cascade of additional tests and sometimes treatment including angioplasty, you could end up with a metal stent in your coronary artery for the rest of your life and may not need it,” he explains.

Are doctors giving bad advice?
“In some cases, unfortunately they are,” he said. “Most doctors are emphasizing the big five tests: blood pressure, cholesterol, diabetes, taking small doses of aspirin and stopping smoking. Those are the big five, but obviously doctors are, in some cases, recommending tests that aren’t very effective, and in some cases treatment that isn’t.”

What advice can Dr. Santa offer to patients who trust their doctor for the most part?

“They need to do research and use tools like we’re offering that offer ratings of these tests, also offering ratings of heart surgery groups, so that they can more easily sort out who are the best heart surgeons to have their surgery,” he said.

Exactly what goes into the whole ratings system?

“It’s a three-star system, 323 heart surgery groups across the country have released this data. Eighty-one of the groups are three-star, very good performance information, 238 are average and five below average,” he explained. “The important thing for patients to know, almost all heart surgeons have this information. Ask them for it. And if they aren’t willing to give it to you, maybe you should look for another surgeon. Do your research. Don’t just take the advice of your doctors.”

Sunshine Heart Appoints New US Board Member

Sunshine Heart, Inc. (asx:SHC), a global medical device company focused on innovative technologies for moderate heart failure, today announced the appointment of Gregory Waller as an independent non-executive director. Mr. Waller brings more than 30 years of financial management and industry experience to Sunshine Heart with an established history of serving on the boards of several successful medical device companies. He is the second US-based board member to be appointed this year following the appointment of Paul Buckman in January.

Mr. Waller was with the public company, Sybron Dental Specialties, for 25 years until he retired as Chief Financial Officer in 2005. During his career with Sybron, Mr. Waller contributed to the company’s growth from $10 million to $750 million in sales. Serving in a variety of operational and financial management positions, he was instrumental in closing multiple rounds of financing for the company. In addition, he oversaw Sybron’s initial public offering and its acquisition of more than 30 companies worldwide until its eventual sale to Danaher Corporation in 2006 for $2.6 billion (representing a $2.1 billion gain to shareholders).

“Few industry veterans have taken a company to the success that Gregory Waller has and we are honored to welcome him onto our board,” said Nick Callinan, Sunshine Heart’s Chairman. “Mr. Waller has an outstanding track record on the boards of fast growing medical technology businesses, many of which have now become established public companies. His vast experience with the cardiovascular market will also be extremely valuable to us.”

Mr. Waller currently serves on the board of Endologix Inc., which develops and manufactures minimally invasive treatments for vascular disease. He helped develop the strategic direction for Endologix, assisted in the development of the audit committee procedures and processes and helped raise substantial capital, taking Endologix’s market cap from $175M to $470M.

In addition, he has previously held board positions with Alsius, Inc., Cardiogenesis Inc., Clarient, Inc., and SenoRx, Inc., where he played an instrumental role in each company’s acquisition or IPO.

“It is a privilege to join the board of Sunshine Heart as I believe the Company has an exciting future ahead of it,” said Mr. Waller. “The unique C-Pulse system has the potential to become a leading treatment for Class III heart failure, representing a tremendous opportunity in the cardiovascular heart failure market. I am particularly looking forward to working with Dave Rosa, CEO of Sunshine Heart, to help navigate the continued financial success of the Company.”

Mr. Waller has been a featured speaker for the Center of Corporate Governance as well as a panelist at the Forum for Corporate Directors meetings.

“The diversified expertise that Mr. Waller brings in financial management, corporate governance, auditing and fundraising will support Sunshine Heart’s growth and the continued achievement of our corporate goals,” Mr. Callinan added. “These include securing additional capital to complete a U.S. FDA pivotal trial for our C-Pulse Heart Assist system, to support regulatory approvals outside the U.S., as well as to fund continued enhancements to the C-Pulse system.”

This press release does not and shall not constitute an offer to sell or the solicitation of any offer to buy any of the securities. The shares of Sunshine Heart have not been registered under the Securities Act of 1993 (US Securities Act) and may not be offered, sold or delivered in the United States, or to, or for the account or benefit of, any US Person, as such term is defined in Regulation S of the US Securities Act. In addition, hedging transactions with regard to the shares may not be conducted unless in accordance with the US Securities Act.

About the C-Pulse(R) Heart Assist System The C-Pulse Heart Assist System utilizes the proven scientific principles of intra-aortic balloon counter-pulsation applied in an extra-aortic approach to assist the left ventricle by reducing the workload required to pump blood throughout the body, while increasing blood flow to the coronary arteries. Operating outside the patient’s bloodstream, the novel extra-aortic approach of the C-Pulse technology offers greater flexibility allowing patients to disconnect as necessary or desired. The C-Pulse system’s potential benefits may help reverse the heart failure process or maintain the patient’s current condition, thereby preventing the need for later stage heart failure therapies, such as left ventricular assist devices (LVADs), artificial hearts or transplants.

About Sunshine Heart(R) Sunshine Heart is a global medical device company committed to the commercialization of the C-Pulse Heart Assist System, a minimally invasive, implantable, non-blood contacting, heart assist therapy for the treatment of moderate heart failure. C-Pulse relieves the symptoms of heart failure through the use of counter-pulsation technology which enables an increase in cardiac output, an increase in coronary blood flow and a reduction in the heart’s pumping load. The Company has completed enrolment of an approved US Food and Drug Administration (FDA) 20patient U.S. clinical trial with the C-Pulse System. Sunshine Heart is a Delaware-based Corporation headquartered in Minneapolis with a subsidiary presence in Australia. The Company has been listed on the ASX since September 2004.
Forward-Looking Statements

This announcement contains forward-looking statements that are based on management’s beliefs, assumptions and expectations and on information currently available to management. All statements that address operating performance, events or developments that we expect or anticipate will occur in the future are forward-looking statements, including without limitation, our expectations with respect to the progress of, and presentation of data related to, product development and commercialization efforts, results of clinical trials, expected timing of FDA regulatory filings, FDA acceptance of our filings and research and development activities, ultimate clinical outcomes and benefit of the Company’s products to patients, market and physician acceptance of the products, intellectual property protection and competitive product offerings could cause actual events to adversely differ from the expectations indicated in these forward looking statements. Management believes that these forward-looking statements are reasonable as and when made. However, you should not place undue reliance on forward-looking statements because they speak only as of the date when made. Sunshine Heart does not assume any obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. Sunshine Heart may not actually achieve the plans, projections or expectations disclosed in forward-looking statements, and actual results, developments or events could differ materially from those disclosed in the forward-looking statements. Forward-looking statements are subject to a number of risks and uncertainties, including without limitation, the possibility the FDA does not accept our regulatory application or approve the marketing of the C-Pulse(R) Heart Assist System in the U.S., the possibility the Company may be unable to raise the funds necessary for the development and commercialization of its products, the possibility the Company may be unable to successfully list its securities on a U.S. securities exchange, and those described in our filings with the ASX. We may update our risk factors from time to time in our filings with the ASX.

Arthritis Treatment News: FDA Nixes Expanded Golimumab Use

FDA Nixes Expanded Golimumab Use

July 27, 2011 — The US Food and Drug Administration (FDA) did not approve an application for a proposed label expansion for golimumab (Simponi, Janssen Biotech, Inc.), which would include stopping the progression of joint damage. Janssen Biotech, Inc., which is part of Johnson & Johnson, announced Friday that it received a “complete response” letter from the agency.

The “complete response” letter signifies that the FDA has completed its initial review of the application but that changes must be made before the application can be approved.

Brian Kenney, a company spokesperson, would not reveal what additional information the FDA has requested. He also declined to comment on the FDA’s safety concerns.

FDA spokesperson Morgan Liscinsky told Medscape Medical News that federal regulations prevent the FDA from disclosing any information from a new drug application that has not been approved by the agency.

“We look forward to collaborating with the FDA to fully understand the requirements needed to support this proposed label expansion,” Jerome A. Boscia, MD, vice president and head of immunology development at Centocor Research & Development, a division of Johnson & Johnson Pharmaceutical Research & Development, LLC, said in a statement.

Janssen Biotech, Inc., plans to request an end-of-review meeting with the FDA to thoroughly understand the details of the complete response letter and discuss future steps to achieve approval, according to a statement.

The expanded approval application for Simponi sought to expand the physician label to include inhibiting the progression of structural damage, such as joint damage; inducing major clinical response and maintenance of reduction of signs and symptoms; and maintenance of improved physical function in the treatment of moderately to severely active rheumatoid arthritis.

Simponi is a human monoclonal antibody that targets and neutralizes excess anti-tumor necrosis factor (TNF)-α, a protein that can cause inflammation and damage to bones, cartilage, and tissue. It is an FDA-approved treatment for reducing signs and symptoms of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It is 1 of 5 TNF blockers on the market.

According to David S. Pisetsky, MD, PhD, professor of medicine and immunology in the Division of Rheumatology and Immunology at Duke University Medical Center and director of Duke University Arthritis Center in Chapel Hill, North Carolina, TNF blockers generally do everything listed under Simponi’s proposed label expansion.

“TNF blockers in general fulfill all those criteria,” he told Medscape Medical News after hearing about the application. “But did they have enough data in those particular studies to support those claims?”

The FDA’s initial thumbs down probably relates to a shortage of data from clinical trials to support the claims, he said. It usually relates to the number of patients and duration of the study. “That’s my guess,” he said.

Psoriatic Arthritis

Psoriatic arthritis affects about 25 percent of those with psoriasis and early diagnosis is critical to reduce the risk for joint destruction. Researchers are trying to identify potential markers that may be useful for determining which patients are at greatest risk for the condition.

Psoriatic Arthritis
Psoriasis is a chronic skin condition characterized by red, scaly patches on the skin, typically over the scalp, knees, elbows, and torso. According to the National Psoriasis Foundation, the condition affects about 7.5 million Americans.

Psoriatic arthritis is an inflammatory condition that is sometimes associated with psoriasis. It occurs when the body’s immune system mistakenly attacks the joints. This leads to a breakdown of joint cartilage and bone damage. Christopher Ritchlin, M.D., Rheumatologist with the University of Rochester Medical Center in Rochester, NY, says in addition to bone destruction, psoriatic arthritis patients can have abnormal bone growth, which can cause the joints to fuse and become immobile.

Roughly 25 percent of psoriasis patients develop psoriatic arthritis. Some signs include: painful and swollen joints, back pain, morning stiffness, fatigue, loss of range of motion in the joints, nail changes and redness and pain around the eyes. Most patients develop the condition about ten years after the first signs of psoriasis. However, Ritchlin says about 15 percent of patients develop joint symptoms before the onset of the skin disease and another 15 percent develop the skin and joint symptoms at about the same time.

Getting Treatment
Initial treatment for psoriatic arthritis tends to be conservative. Doctors may start with nonsteroidal anti-inflammatory medications to reduce pain, swelling and inflammation. If these drugs cause too many side effects or fail to reduce symptoms, the next step is to use disease modifying antirheumatic medications, then biologic response modifiers. Exercise is important to keep joints strong and flexible. Patients may also use heat and cold treatments to soothe joint pain.

Ritchlin says patients with psoriatic arthritis often see a dermatologist, rheumatologist and family health care provider. It’s important for all physicians involved in the patient’s care to work together to provide the safest and simplest forms of treatment.

Early diagnosis of psoriatic arthritis is critical to reduce the risk for joint destruction. However, in patients who develop the joint symptoms before the skin disease, Ritchlin says the diagnosis can be tricky because the joint signs may be mistaken for rheumatoid arthritis. Since there are no specific diagnostic tests for psoriatic arthritis, doctors must rely on medical and family history, physical exams, diagnostic X-rays and blood tests (that rule out rheumatoid arthritis). Ritchlin is also looking at potential markers that may be useful for identifying patients at greatest risk for developing psoriatic arthritis.

Shock Wave Therapy and PSGAGs: Effects on Arthritis

We know osteoarthritis (OA) is a painful, degenerative condition that can result in lost training days, poor performance, and early retirement in equine athletes. We also know that there are many different treatments for OA. What we don’t know, and what a team of researchers recently investigated, is how certain arthritic joint tissues–such as the subchondral bone (the layer of bone that lies directly underneath the layer of articular cartilage that lines the ends of the bones and lends support to the joint)–respond to treatments such as extracorporeal shock wave therapy (ESWT) and polysulfated glycosaminoglycans (PSGAGs, a common joint therapy).

“Previous studies have shown that both extracorporeal shock wave therapy and intramuscular administration of polysulfated glycosaminoglycans have a beneficial effect in some horses with OA, and these therapies are widely used in equine practice,” said Chris Kawcak, DVM, PhD, Dipl. ACVS, professor and equine surgeon at the Gail Holmes Equine Orthopaedic Research Center at Colorado State University.

“The subchondral bone is commonly involved in joint disease and is therefore a potential site of action for ESWT and PSGAGs,” relayed Kawcak.

To determine if ESWT or PSGAGs “targeted” the subchondral bone, Kawcak and colleagues created a chip in the middle carpal joint (the lower joint in the knee) in one knee of 24 healthy horses. Three groups of horses were then either treated with ESWT, PSGAGs, or neither. The team evaluated the treatment results by measuring the levels of various markers of cartilage and bone turnover (i.e., synthesis and degradation) in blood and synovial (joint) fluid samples; evaluating bone density; and assessing the structure and composition of the bone.

Key findings of the study were:
PSGAG had no significant effect on any bone variables; and
ESWT also did not affect the subchondral bone itself, but increased levels of the bone marker called osteocalcin in the blood were significantly higher in horses treated with ESWT than in the control group.

“Unlike other published studies, we did not find any physical evidence of subchondral bone remodeling, and, thus, healing following either ESWT or PSGAG administration,” relayed Kawcak.

Dental Care News: Kool Smiles Expands Access in South Carolina

Kool Smiles Expands Access in South Carolina; New Greenville Location Marks Third South Carolina Office Opening In Six Months

Kool Smiles, a leading dental health provider for children and adults, announced the opening of a new office in the K-Mart Plaza by Mills Avenue in Greenville. The company’s second office in Greenville opened May 23, offering residents convenient new options for affordable dental care. The new location is the third new office opened in South Carolina during the last six months, with other new openings in North Charleston and Columbia.

The Centers for Disease Control and Prevention (CDC) reports that tooth decay currently affects more than 19 percent of U.S. children aged 2-19-more than any other chronic infectious disease. Untreated pain and infections may lead to developmental problems, such as eating, speaking, playing and learning.

Senator Joel Lourie of Columbia feels the new offices come at a great time for South Carolina residents. “We are pleased to have Kool Smiles in our communities and appreciate the valuable services they will provide to children and families. At a time when more and more people are struggling to meet their medical and dental expenses, it is encouraging to see an organization like Kool Smiles open their doors for service.”

Representative Bruce Bannister of Greenville shares Lourie’s enthusiasm. “The community is delighted Kool Smiles has opened a second facility in Greenville, SC,” Bannister says. “Nothing is more important to a child’s health than receiving quality preventative dental care.”

The newest location was opened in response to a strong need in the Greenville area. “This expansion reflects the depth of our commitment to this community,” explains Dr. Polly Buckey, DDS, MS, a board certified Pediatric Dentist who serves as spokesperson for Kool Smiles. “With these additional dentists, we’re positioned to better meet the needs of our patients for preventative and restorative care.”

The new Kool Smiles office, which accepts most types of insurance, boasts a sophisticated electronic medical records system. But what most patients will notice first is the cheerful, family-friendly decor. There’s an indoor playground where kids can relax before and after treatment, and a large observation window so parents can keep a close eye on their children.

“The upbeat atmosphere of our offices puts patients of all ages at ease,” explains Dr. Buckey. “Children especially are more relaxed, so they have a more positive experience and are more likely to return for recommended preventative care. It’s all part of our effort to transform the way people feel about and care for their teeth.”

“This expansion is further proof of the sea change we’re affecting in South Carolina dental care,” Dr. Buckey said. “Between 1999 and 2006, South Carolina’s number of licensed dentists enrolled in Medicaid nearly doubled, making it easier for children to find care. We’re thrilled to be part of this important advancement in accessible dentistry.”

Kool Smiles of Greenville Mills Avenue office at #3 K-Mart Plaza, approximately three miles from the other Greenville Kool Smiles at 3227 West Blue Ridge Drive, is within easy reach of most Greenville area residents. It’s just the latest of numerous locations Kool Smiles has opened in 2011, including new offices in North Charleston and Columbia, SC, Takoma Park, MD, New Orleans and Gretna, LA, San Angelo, TX, and Midwest City, OK.

To tour the new Greenville Mills Avenue Kool Smiles office or to book an appointment, please call (864) 438-0939. Those interested in employment opportunities may visit the Kool Smiles Jobs website.

About Kool Smiles

Kool Smiles is a leading dental health provider dedicated to expanding access to quality dental care for children and families in underserved communities. Kool Smiles dentists are proud to offer care to kids and adults with almost any insurance plan, including State Children’s Health Insurance Program (SCHIP), Medicaid and Tricare. Nationally, 97% of Kool Smiles patients plan to return and refer their friends and family. Kool Smiles also provides oral health education programs through partnerships with community schools and organizations.

The alarming state of oral health today is the foundation upon which Kool Smiles has built its mission and vision. Despite the United States’ status as the wealthiest country, the former U.S. Surgeon General concluded that oral care is the #1 unmet healthcare need for children. Over 50 percent of 5- to 9-year-old children have at least one cavity or filling, and that proportion increases to 78 percent among 17-year-olds. Oral health is essential to the general health and well-being of children and plays a critical role in their ability to succeed in school and acquire positive self-esteem.

Dental care pays dividends in overall health

While the economic crisis may have many necessities vying for scarce funds, skipping dental visits may be more costly in the long run. Difficult economic times often find people delaying or avoiding trips to the dentist, according to Deborah Locke, a licensed dental hygienist in New Jersey and New York with national board certification.

Downsized employees not only have lost medical benefits, but dental coverage, too, said Locke, who received her dental hygiene certificate from the University of Pennsylvania School of Dental Medicine in Philadelphia.

“People may not be aware of many subtle dental changes, because they don’t feel them or recognize them. This can result in delayed or skipped dental visits,” said Locke, a Marlboro resident who has been an active dental hygienist for 30 years. “It takes a trained dental professional to see small changes that if left untreated may develop into major costly dental problems or even medical diseases.”

The key to good dental health, she said, is education and knowledge.

“One of my key roles as a dental hygienist is to explain to patients the etiology of dental diseases and what individuals can do to prevent dental problems. These dental ‘issues’ if left unchecked could affect a person’s ability to eat properly, compromising one’s ability to maintain proper nutrition, which in turn may negatively impact one’s general health.

“Bleeding of the gums and inflammation [puffiness] in the gums is not a normal dental state,” said Locke, who has a Bachelor of Science degree in health education from New York University. “It is estimated that more than 90 percent of the population is afflicted with some level of gum disease, which is a slow, relatively painless process that, if left untreated, can result in bone degradation and eventual tooth loss.”

She said the dental office is the starting point for dental education.

“Ask questions about your mouth, the proper way to floss and brush, and what dental aids or rinses really work,” said Locke, who also earned a Master of Business Administration degree in health care administration from the Bernard M. Baruch College and Mount Sinai School of Medicine joint program in New York. “Education empowers you to take ownership of your dental and general health.”

Proper flossing and brushing of teeth, she said, are preventive actions that can be done at home. “We recommend brushing teeth with a soft toothbrush a minimum of twice a day, preferably after meals,” said Locke. “Daily flossing is critical to remove bacterial plaque between the teeth that, if not removed, forms calculus, or tartar, which can destroy the fibers that hold the teeth in place.”

Locke pointed out the benefits of daily flossing and the use of certain devices such as oral irrigators or water flossers. One of her patients who is in her 90s describes herself as an avid flosser. When Locke checked the woman’s teeth, she was very impressed. “Therewas no evidence of gum disease, no active infections, no mobility of the teeth. ‘What’s your secret?’ I asked her. She said that she flossed every day, even as a youngster before dental floss was readily available. She didn’t like the feeling of anything stuck to her teeth, so she used thread from her mother’s sewing kit,” Locke explained.

Locke states that good nutrition is key to good dental and overall health.

“Learn how to balance your intake of acidic and alkaline foods. Ingesting highacidic foods and drinks as well as improper tooth-brushing technique are the two main reasons for tooth sensitivity. Certain drinks like red wine, soda, and even ‘seemingly healthy’ fruit juice, can erode enamel, which is the outer layer of the tooth,” she said. “Moderate intake of these items and drinking more water, the wonder drink, are recommended.”

Achild’s primary or deciduous teeth, also called baby teeth, are very important, Locke said. “The deciduous teeth help the child speak and chew and are as important as the permanent adult teeth,” she said. “Check with your dentist or pediatric dentist to determine when you should bring your toddler in for his/her first dental visit.”

It may be recommended to start dental checkups when the deciduous teeth appear but not later thanwhen all the primary teeth have appeared, usually between 2½ to 3 years old, she said.

Locke, who is passionate about dental education, said that preventive care cannot be overestimated.

“If we, the dental professionals, educate, instruct and motivate our patients to take good care of their mouths, and to reduce the burden of infections, then we will be helping them to control their overall health as well,” she said, adding that poor dental health and hygiene cuts across socioeconomic lines.

Internet websites, such as the American Dental Association and the American Dental Hygiene Association, offer information on various dental topics. “Discuss these topics with your dental professional,” she said. “It’s another way to empower yourself.”

If lack of dental insurance or sudden loss of income prevents proper professional dental care, Locke suggests speaking with your dentist. “Honestly explain your financial situation and try to negotiate a financial plan,” she said. “Also, speak with friends and relatives about where they receive their dental care.

“Optimal dental health is a great investment,” she added.

For those with financial concerns, she suggested looking into low-cost dental clinics that are associated with hospitals or medical schools.

Cosmetic Dentistry El Monte – Angel Dental Care

Los Angeles, California – 07/19/2011 Let your smile shine as brightly as the warm summer sun during this beautiful summer season Angel Dental Care wants to promote healthy teeth as well as meeting your cosmetic dentistry needs. There is nothing more important to us than insuring that you and your family are cared for with the utmost professionalism and state of the art techniques and procedures currently available. We treat all of our clients with honesty and integrity providing services at exceptional prices with impeccable customer service. Angel Dentistry is located in El Monte which is centrally located near Los Angeles.

At Angel Dentistry we offer full mouth reconstruction as well as tooth reconstruction. Many times a patient will need to see multiple specialists to perform a full mouth reconstruction, however at Angel Dentistry we will provide all of the services in our full service office. In the event that another specialist is needed we will help you through every step of the process providing superior customer care. Seeing multiple specialists can really become costly to the patient so seeing one dentist is not only more affordable, but you receive one on one treatment from our professionals. If you are looking for the best family dental care in Los Angeles look no further. We are here to answer any and all of your questions whether it be about a particular procedure or making a payment plan.

Angel Dental care is a full service dental office that is able to help patients with a comprehensive list of procedures. Weather you just need a checkup or a root canal we offer many procedures and unbeatable prices. We have you and your entire family in mind and provide services for adolescents and adults. Here at Angel Dental care we want to show you how to properly care for your teeth. We want to promote healthy gums and teeth as well as care for more severe dental issues that may arise. Whatever it is you need we will provide you with outstanding care.

Dental Care News: Free dental care gives uninsured a reason to smile

Eastman Dental Celebrates Completion of $5.9 Million Renovations

Eastman Dental today celebrated the completion of a two-year, $5.9 million renovation and re-engineering project that allows a major increase in access to care in both downtown Rochester and at its main clinic site on the University of Rochester Medical Center campus.

Rochester Mayor Tom Richards, and representatives from the offices of Senator Kirsten Gillibrand, Representative Tom Reed, Representative Ann Marie Buerkle, Assemblyman Sean Hanna, and Assemblyman Mark Johns, and County Executive Maggie Brooks were present to help celebrate this new chapter for Eastman Dental, which for nearly 100 years, has been Rochester’s largest oral health care provider to the underserved.

Since the late 1990’s, patient demand each year increasingly exceeded capacity at both locations. The number of patients who came in for dental emergencies increased 100 percent over five years, placing significant strain on Eastman’s facilities and its ability to provide comprehensive care to all patients. In late 2008, Eastman Dental was awarded a $3.9 million New York State HEAL (Health Care Efficiency and Affordability Law) grant to enhance emergency services for the underserved, while creating a gateway to regular oral health and medical care, and to increase access and capacity for the underserved.
Diflucan Canada pharmacy
With those funds, Eastman Dental built at its main site on Elmwood Ave. a first-of-its-kind urgent care dental clinic, added six new treatment rooms in its General Dentistry and Orthodontic clinics, expanded and reconfigured its check-in and check-out process to provide better quality care, and more efficient service for all patients. Eastman Dental Downtown added four new treatment rooms, allowing twice as many patient visits as before in this high poverty area of Rochester, as well as a much needed makeover to the waiting room and clinic areas. In both locations, aging equipment was replaced, new technology was incorporated to increase scheduling and treatment efficiency, and ongoing training for staff and streamlining operations was put in place.

Cyril Meyerowitz, D.D.S., M.S., director, Eastman Institute for Oral Health, announced that U of R and Eastman Dental alumnus and Midland Management President Jack W. Howitt, AB, DDS, made one of the largest individual gifts in Eastman Dental’s history, and dedicated the newly named Howitt Urgent Dental Care clinic during the ceremony.

“I’ve always had a firm connection to dentistry and watching Eastman Dental morph into the Eastman Institute for Oral Health has been exciting,” Howitt said. “For me, the new urgent care portion of Eastman Institute was a logical place to direct my commitment. This gift marks my 55th reunion year from the U of R, and honors my two late uncles, Dr. Nathan G. Howitt and Dr. S. Michael Howitt, who were both in the dental profession.”

In addition, major functional and cosmetic renovations to the atrium and all the waiting rooms improve patient flow and customer service.

On display are beautiful glassware, Inuit and African sculptures, and other artwork donated by Stanley Handelman, D.D.S., former chair of the Advanced Education in General Dentistry Division and highly regarded professor, researcher and mentor for 40 years. Together, the artwork and new furniture provide a tranquil, comfortable, and inviting space in the newly designed atrium, where coffee and refreshments are available for purchase, and a patient ambassador is always available to answer any questions.

“We are extremely grateful for Jack Howitt’s generosity and commitment to our patients,” Meyerowitz said. “The new urgent care clinic and the renovations and updates are allowing us to provide substantially better quality, patient-centered care more cost effectively.”

Free dental care gives uninsured a reason to smile

Felecia Haywood bounded out of the dental chair, still numb but giddy after getting three fillings and having her chipped front tooth repaired.

“I’ve got my smile back!” said Haywood, 50, who had not been to a dentist since the fifth grade. She chipped her tooth about 10 years ago while eating.

Haywood and dozens of homeless and very-low-income patients of the nonprofit Glide Health Services in San Francisco received two weeks of free dental cleaning and treatments at Tooth Travelers, a mobile dental program stationed in the parking lot of Glide Memorial Church’s parking lot at 330 Ellis St. through today.

A dentist and assistants extracted more than 45 teeth and filled at least 50 cavities during 140 appointments in the 40-foot dental van since setting up at Glide on June 6. Many of the patients had been waiting for months for the chance to see a dentist.

“As health care reform is happening, there’s really nothing for people 18 and over when it comes to dental services,” said Karen Hill, clinic manager of Glide Health Services, a nurse-run health program at the church’s foundation for the needy and homeless.

Because of budget constraints, the state eliminated virtually all adult Medi-Cal dental services, known as Denti-Cal, in July 2009. The decision has left indigent and uninsured people with few options, so they often show up at emergency rooms in pain to have their teeth pulled and abscesses treated.

Services in the van are limited to dental screening, teeth cleaning, fillings, simple extractions, fluoride treatments and X-rays. Patients with more serious dental problems are referred to UCSF and University of the Pacific dental schools and community clinics for low-cost care.

The last time James Jones needed dental treatment, he had to go to San Francisco General Hospital for an abscess and a broken tooth. But the 60-year-old retired AC Transit worker, who has been without dental coverage since 1996, said through a mouth of cotton that his experience at the mobile clinic was more comfortable and completely painless.

“I hate dentists, but they were very pleasant,” said Jones, referring to the dental assistant and Dr. Monte Cooper, who removed five of Jones’ teeth during two visits to the trailer.

Tooth Travelers, based in Placerville (El Dorado County), was founded by Julie Day in 2009 after she was laid off from her job after 23 years in the dental insurance industry.

The mobile unit typically visits affordable housing developments and is funded by those property owners. The van’s visit to Glide was funded through a $25,000 donation from Wells Fargo.

“These people have challenges most of us will never experience or even comprehend,” Day said of the patients at Glide. “They are truly gracious and grateful.”

James Inglis, 47, had 18 teeth pulled about 12 years ago when he quit using drugs. Inglis, who has an upper and lower dental partial, was grateful to receive free dental services at the mobile unit because he has been laid off from his job and is homeless.

“Of course, I only have six teeth left, but that’s OK,” he said “They’re healthy.”