Minum Mei

According to a study in the Archives of Neurology, limited alcohol, said to be good for heart, may shrink the brain. Researchers have found that alcohol consumption even in moderation may be less medicinal than earlier believed to be and people who drink alcohol have smaller brain volume than those who do not. Though there is natural shrinkage of up to 2 % in brain volume as people age, scientists felt that alcohol in moderation could slow this natural shrinkage by improving blood flow and heart function.

Carol Ann Paul, an instructor in the neuroscience program at Wellesley College conducted the study when she was at the Boston University School of Public Health, said she had hoped to find that alcohol might protect against such brain shrinkage. "Decline in brain volume -- estimated at 2 percent per decade -- is a natural part of aging. However, we did not find the protective effect," says Paul. "In fact, any level of alcohol consumption resulted in a decline in brain volume."

A study on 1839 adults with an average age of 61 years was conducted based on an analysis of drinking habits and brain volume. The patients underwent magnetic resonance imaging (MRI) of the brain and the researchers found that the more alcohol was consumed the smaller was the brain volume. Non drinker’s brains occupied 78.6 % of the cranial space while in former drinker’s case it dropped to 78.2 % and went to 77.8 % for moderate drinkers and 77.2 for heavy drinkers.

Although men were more likely to be heavier drinkers than women, brain shrinkage in the women was more. The researchers feel it could be due to women's smaller stature and greater tendency to feel alcohol's effects. It's not clear why even modest amounts of alcohol may shrink the brain, although alcohol is "known to dehydrate tissues, and constant dehydration can have negative effects on any sensitive tissue," says Paul.

James Garbutt, M.D., professor of psychiatry at the University of North Carolina at Chapel Hill notes that the study did not show that the reduced brain volume impaired memory or mental function. "We're talking very small differences here," says Dr. Garbutt, who was not involved in the study. "We're not seeing 10 to 20 percent shrinkage." The reduction in brain mass is an interesting finding. "But we have a long way to go to figure out the implications of it."

"The public health effect of this study gives a clear message about the possible dangers of drinking alcohol. This study suggests that, unlike the associations with cardiovascular disease, alcohol consumption does not have any protective effect on brain volume." the authors concluded

Key Test often Skipped before Angioplasty by Doctors

U.S. researchers said on Tuesday that people on Medicare who elect for non-emergency artery-opening procedures for heart disease do not get the recommended cardiac stress test beforehand. The surgery, known as PCI or percutaneous coronary intervention, costs Medicare, the U.S. government's health insurance program $10,000 to $15,000 per procedure for people aged 65 and older.

Dr. Grace Lin of the University of California, San Francisco, whose study appears in the Journal of the American Medical Association said, "It's important to document that patients are receiving PCI for appropriate indications to ensure the optimal use of Medicare resources."

More than 800,000 PCI procedures are performed each year and each procedure has contributed significantly to increase in Medicare spending since the mid-1990s. The research showed the number that received the procedure to be just 44 %. "We didn't expect to find 100 percent, but we expected a much higher percentage than 44," said Dr. Rita F. Redberg, professor of medicine at the University of California, San Francisco.

Typically done on a treadmill, stress tests, can show whether a person has ischemia, or inadequate supply of blood to the heart caused by a blocked artery. "What really matters is whether or not that blockage is affecting blood flow to the heart. That is why the stress test is important," Lin said.

Earlier studies have said that many stable patients with chest pain can get similar relief with standard drug therapy at far lower cost. Lin and colleagues studied insurance claims in 2004 from Medicare beneficiaries and found only 44 % took a stress test 90 days prior to elective surgery. "There was a tremendous amount of variation in the amount of stress testing that was done," Lin said. The Society for Cardiovascular Angiography and Interventions said the results though important were not accurate as stress tests are not always appropriate, especially for patients who are too sick or immobile to take them.

Stress tests should be done regularly, not just when angioplasty is being considered, said Dr. Eric Topol, director of the Scripps Translational Science Institute in La Jolla, Calif. "Then you have a way to follow a patient," he said. "You can do a stress test every year to be sure things are normal. That is an important baseline that is being ignored all too frequently."

Study: Caffeine Intake Can Increase Breast Cancer Risk

According to a new study, more than four cups of coffee can increase the risk of breast cancer. The researchers found that caffeinated drinks are responsible for one third of the breast cancer cases. The study also highlights an increase in developing large tumours with high intake of caffeinated drinks.

The researchers, however, were unable to give a safe caffeine intake for women. But they did indicate that more than four cups of coffee a day can increase the breast cancer risk by 68%. The risk further aggravates with advancement ion age.

Dr Ken Ishitani, from Harvard University, who led the study with colleagues from Tokyo Women's Medical University, said:

"These findings indicate that caffeine consumption may affect breast cancer progression, and such an effect may be independent of the (sex hormone) oestrogen."

Further research would confirm reasons for the relationship between breast cancer and caffeine.

But according to another research published in Archives of Internal Medicine journal, caffeinated drinks did not seem to have any major impact on other diseases. At the same time, previous studies indicate palpitations and increase in miscarriages. These drinks also cause chest pain and headaches in school children.

Senators Question Cardiologists’ Ties to Stent Makers

Charles E. Grassley, Republican of Iowa, and Herb Kohl, Democrat of Wisconsin, have sent letters to Columbia University and the Cardiovascular Research Foundation to question financial ties between high profile doctors and device and drug institutions.

Dr. Martin B. Leon, founder and former chairman of CRF, a nonprofit group and Dr. Gregg W. Stone, its current chairman, both stent specialists affiliated with Columbia, are among the doctors listed by name in the letter. The letters have also questioned ties to a few companies which include Abbott, Medtronic, Boston Scientific and Johnson & Johnson, the four shops that sell stents in the U.S.

The foundation receives funding from device makers, among other sources, and conducts research and it’s most recent tax filing listed its revenue in 2005 to be $ 47.2 million. In a statement the foundation said “CRF welcomes the inquiry from Senators Kohl and Grassley and intends to comply fully with their request for information.” It went on to say, “C.R.F. is committed to maintaining the highest standards of integrity in all of its research and educational activities and ensuring independence, objectivity and scientific rigor in all of its programs.”

In a statement issued by Columbia University Medical Center it said it would respond to the request for information. “It is important to note that Columbia University and its Medical Center have conflict of interest policies and procedures in place, and we expect that they are followed by all members of the faculty," the statement said.

The letter to the CRF asked the group to disclose all financing it had received since 2003 from the five device manufacturers named in the letter and also to provide documentation of any payments and benefits the foundation had provided to 22 researchers including Dr. Stone, Dr. Leon and Dr. Moses. Kohl and Grassley have also written directly to drug and device makers asking them about their payments to doctors.

Grassley and Kohl back a bill that would require drug and device makers to report payments to doctors and earlier this month they sent a letter to Emory questioning payment of more than $500,000 to a high profile psychiatrist from GlaxoSmithKline over a few years when he reported receiving payments of less than $10,000 per year from the company.

Senators Question Cardiologists’ Ties to Stent Makers

Charles E. Grassley, Republican of Iowa, and Herb Kohl, Democrat of Wisconsin, have sent letters to Columbia University and the Cardiovascular Research Foundation to question financial ties between high profile doctors and device and drug institutions.

Dr. Martin B. Leon, founder and former chairman of CRF, a nonprofit group and Dr. Gregg W. Stone, its current chairman, both stent specialists affiliated with Columbia, are among the doctors listed by name in the letter. The letters have also questioned ties to a few companies which include Abbott, Medtronic, Boston Scientific and Johnson & Johnson, the four shops that sell stents in the U.S.

The foundation receives funding from device makers, among other sources, and conducts research and it’s most recent tax filing listed its revenue in 2005 to be $ 47.2 million. In a statement the foundation said “CRF welcomes the inquiry from Senators Kohl and Grassley and intends to comply fully with their request for information.” It went on to say, “C.R.F. is committed to maintaining the highest standards of integrity in all of its research and educational activities and ensuring independence, objectivity and scientific rigor in all of its programs.”

In a statement issued by Columbia University Medical Center it said it would respond to the request for information. “It is important to note that Columbia University and its Medical Center have conflict of interest policies and procedures in place, and we expect that they are followed by all members of the faculty," the statement said.

The letter to the CRF asked the group to disclose all financing it had received since 2003 from the five device manufacturers named in the letter and also to provide documentation of any payments and benefits the foundation had provided to 22 researchers including Dr. Stone, Dr. Leon and Dr. Moses. Kohl and Grassley have also written directly to drug and device makers asking them about their payments to doctors.

Grassley and Kohl back a bill that would require drug and device makers to report payments to doctors and earlier this month they sent a letter to Emory questioning payment of more than $500,000 to a high profile psychiatrist from GlaxoSmithKline over a few years when he reported receiving payments of less than $10,000 per year from the company.

Psoriasis Drug Raptiva gets FDA Warning

The Food and Drug Administration is giving a "black box" warning to Raptiva, the psoriasis drug, about the risk of life-threatening infections including a rare brain infection and meningitis.

Genentech Inc.'s drug Raptiva will now have a Boxed Warning highlighting the risk of bacterial sepsis, viral meningitis, invasive fungal disease, PML and other opportunistic infections. The label will also include data from juvenile animal studies in mice, which indicate a potential risk for the permanent suppression of the immune system with repeat administration of Raptiva juveniles.

The warning follows Genentech's announcement that the drug Raptiva may have resulted in a 70 year old chronic plaque psoriasis patient taking Raptiva for four years getting progressive multifocal leukoencephalopathy, or PML, which causes swelling of the brain and dying.

Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research, said in a news release that the FDA ordered Raptiva's "black box" warning and other label changes after receiving reports of serious infections in some patients taking the drug. The FDA though is not stopping patients from taking Raptiva and acknowledges that one case of PML does not establish that the drug causes any illness. "Doctors and other prescribers should carefully evaluate and weigh the risk/benefit profile of Raptiva for patients who would be more susceptible to the risks," Woodcock says.

Raptiva is given by injection once a week and the drug is not approved for children under 18. The FDA recommends that patients taking Raptiva should be alert for signs of infection and seek immediate medical attention if they have any medical problems like confusion, dizziness, bleeding gums or numbness or weakness in arms and legs. Patients are also urged to get up to date on their vaccinations before starting the drug and not get vaccinated while on the drug as they may develop immunity to the vaccination virus.

Genentech spokeswoman Krysta Pellegrino said they will issue a letter to doctors and other health care providers detailing the label changes. "We feel it's important that patients and doctors are educated about the signs and symptoms of infections and the other information included in the boxed warning."

Former Director of UCLA Willed Body Program Pleads Guilty to Body Trafficking

Henry Reid, the former director of UCLA’s willed body program, pleaded guilty for his role in selling donated body parts to drug companies. The years long investigation into the body-for-parts profit scheme culminated when Reid pleaded guilty to conspiracy to commit grand theft, said Nancy Greenstein, a university police spokeswoman.

Reid, 58, was hired in May 1997 as the director and from May 1999 to February 2004, he allegedly sold body parts to businessman Ernest Nelson, another defendant in the case, who resold them to “more than 20 private, medical, pharmaceutical and hospital research companies,” in a conspiracy to defraud UCLA of its donor bodies for financial gain in a scheme that netted up to $1 million, prosecutors said.

An Anaheim resident, Reid pleaded guilty in Los Angeles County Superior Court to one count of conspiracy to commit grand theft, a count shared by both individuals. In addition each received one count of grand theft of personal property allegedly worth more than $1 million, according to the statement.

There was a special allegation that he damaged or destroyed more than $1 million worth of school property, referring to the donated bodies.

Reid could be sentenced to four years and four months in a state prison and is to pay a restitution amount between $100,000 and $1 million to UCLA’s willed body program with a judge deciding on the final amount. Reid also agreed to cooperate in Nelson’s case. If he had been convicted at trial he could have faced up to 11 years in prison.

Melvyn Sacks, his attorney said after the hearing, "My client accepted responsibility for the mistake he made concerning his activities as director of the Willed Body Program at UCLA and is extremely remorseful about the situation. He deeply regrets the outcome of his actions."

UCLA police Chief Karl Ross said the investigation involved more than 100 search warrants and took three years in what he called "an extremely complicated case."

Nelson said he believed he was acting under the university’s authorization and he cut the donated torsos and kept the frozen parts in a rented warehouse until they were sold. In 2003 a state health investigator became concerned about a sale and contacted the university which unraveled the scheme.

Reid and Nelson were arrested in 2004 and then released while the investigation concluded. Nelson pleaded not guilty to the charges and no trial date has been set for him. Reid is scheduled for sentencing on Jan. 30, 2009.

UCLA suspended its cadaver program in 2004 for a year and has instituted new procedures to prevent future abuses, including new donor forms and security and tracking systems for the bodies.