Yin Qiao San was shown to be more effective than ribavarin (Rebetol) to inhibit Influenza-A

Posted on July 25, 2010 by wngai
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The widespread outbreak of avian influenza throughout East Asia in the past few years have raised concerns that such infections could lead to another pandemic in the near future.

Current antiviral drugs are effective in controlling the virus, but some influenza virus is prone to mutate and develop resistance.  Furthermore, the use of current antiviral drugs is limited by its supply and cost.

In the search of new antiviral drugs to treat influenza, some researchers are investigating drugs that have been used in Traditional Chinese Medicine (TCM).

The classical formula of Yin Qiao San (YQS) was first documented in the book “Wen Bing Tiao Bian (温病条辨),” which records the theoretical research on warm-heat disease.  YQS consists of nine herbal components (Flos lonicerae (Jinyinhua), Fructus forsythiae (Lian Qiao), Fructus arctii (Niubangzi), Herba schizonepetae (Jingjie), Herba menthae (Bohe), Semen sojae praeparatum (Dandochi), Herba lophatheri (Zhuye), Rhizoma phragmitis (Lugen), and Radix glycyrrhizae (Gan cao)) and has been used in China for thousands of years to treat common cold, fever, coughing, and other respiratory diseases.

In the recent publication of KaoShiung J Med Sci, investigator Wang Xf demonstrated that Yingqiasn extracted in 50% ethanol was more effective than ribavrin in inhibiting influenza-A virus in infected embryonated hen eggs.

Even though the result is encouraging, it is still a study done in test tubes.  Further clinical studies conducted in human are required to demonstrate the efficacy of Yin Qiao San.

Source:  Kaoshiung J Med Sci 2010; 26:182-91

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Low level of Vitamin D might cause Headache and Migraine

Posted on July 25, 2010 by wngai
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If you constantly experience headache or migraine, you might like to check your level of vitamin D level.  A presentation at the 52nd Annual Scientific Meeting of the American Headache Society (AHS) suggested patients with headache and migraine have low level of vitamin D levels. 

In his presentation, Dr. Krusz measured serum vitamin D levels in 100 patients.  About half of these patients had new migraine or headache (n = 55) and the remaining patients had chronic pain disorders, including fibromyalgia, rheumatic, and neuropathic pain disorders (n = 45). 

The average vitamin D level in patients with predominantly headache and migraine was 26.3 ng/mL. This level was much lower than the vitamin D level of 50.0 ng/ml recommended by the Vitamin D council.

The results of this study add to the current evidence that Vitamin D has beneficial effects to our central nervous system (CNS).

Vitamin D deficiency is more common among people with dark skin, elderly individuals, and those who avoid the sun.  However, vitamin D hypersensitivity can occur in patients with primary hyperparathyroidism and occult cancers.  In those situations, treatment of vitamin D deficiency should be done under the care of a physician.

Source: American Headache Society (AHS) 52nd Annual Scientific Meeting: Poster 51. Presented June 26, 2010

Vitamin D council.  http://www.vitamindcouncil.org/

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Gefitinib (Iressa) is better than Standard Therapy in Lung Cancer with EGFR Mutations

Posted on July 25, 2010 by wngai
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Gefitinib (Iressa) is more effective than first-line therapy in improving survival without disease in patients with advanced nonsmall-cell lung cancer (NSCLC) and epidermal growth-factor receptor (EGFR) mutations. 

The current study was conducted in 230 patients from 43 centers in Japan, all of whom were treatment naive and had advanced NSCLC with EGFR mutations. Patients were randomized to receive either gefitinib or standard chemotherapy of paclitaxel and carboplatin. 

After the interim analysis of the first 200 patients, the safety monitoring committee decided to terminate the study after a significant difference in survival without disease was seen between the 2 treatment groups (P < .001). 

The geiftinib group had a significantly longer median survival without disease (10.8 vs. 5.4 months, P<0.001) and a higher complete response rate (73.7% vs. 30.7%, P<0.001) than the standard chemotherapy group. 

Median overall survival was also better for the gefitinib group, but the difference was not significant (30.5 vs 23.6 months).  This might be due to the fact that patients who failed first-line chemotherapy were given gefitinib as their second line treatment. 

In the gefitinib group, the most common adverse events were rash and elevated levels of liver enzyme.  In the standard chemotherapy, they were appetite loss, neutropenia, anemia, and sensory neuropathy.  Overall incidence of severe toxic effects was significantly higher among patients receiving chemotherapy than among those receiving gefitinib (71.7% vs 41.2%; P < .001). 

The study showed that treatment with gefitinib resulted in longer survival without disease in patients with mutated–EGFR nonsmall-cell lung cancer but with better tolerable profile, including less hematologic toxicity and neurotoxicity. 

While this is great news patients with NSCLC, it is important to note that only 15% of American lung cancer patients have an EGFR mutation and not all lung cancer patients can benefit from this treatment. 

Source: N Engl J Med. 2010;362:2380-2388

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Vitamin B6, Methionine Linked to Lower Risk for Lung Cancer

Posted on July 25, 2010 by wngai
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According to a new study published in the Journal of the American Medical Association, serum levels of vitamin B6 and amino acid, methionine, were inversely associated with risk for lung cancer. 

The study was conducted among ~400,000 participants in 10 European countries.  Between 1992 and 2000, 385,747 EPIC participants donated blood samples to measure the serum levels for 4 B vitamins (B2, B6, folate, and B12), methionine, and homocysteine.  By 2006, 899 patients were identified with lung cancer. 

When investigators analyzed the serum levels of these cancer patients, they found that the level of B6 and methionine were lower than that of the participants without cancers.   

Participants who have high level of B6 had a 36% lower likelihood of developing lung cancer.  Similarly, participants whose serum methionine level was high had a 48% lower likelihood of getting lung cancer.  Continue reading →

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Coffee Drinking Lowers Risk for Head and Neck Cancers

Posted on July 25, 2010 by wngai
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Good news for coffee drinkers.  A new study found that drinking caffeinated coffee is associated with lower risk for head and neck cancers.  The study was published in June 22 online issue of the Cancer Epidemiology, Biomarkers & Prevention. 

Tobacco smoking and alcohol drinking are the major risk factors for head and neck cancers (cancers of the oral cavity, pharynx and larynx).  These 2 risk factors are responsible for approximately 75% of cases diagnosed in North America and Europe. 

Using 9 case-control studies of head and neck cancers, the investigators pooled individual-level data from 5,139 patients with cancer and 9,028 controls. 

The investigator found that drinking caffeinated coffee was inversely associated with risk for oral cavity or pharyngeal cancer. Compared with no coffee intake, the risk of developing head and neck cancer were reduced by 4% for an increment of 1 cup of coffee per day or by 39% for consumption of more than 4 cups per day. 

There is, however, no relationship between tea drinking and head and neck cancer risk. 

This pooled analysis of studies suggests a relationship between caffeinated coffee drinking and risk of cancer of the oral cavity and pharynx. 

Source: Cancer Epidemiol Biomarkers Prev. Published online June 22, 2010

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Modest Tea and Coffee Consumption Cuts Cardiovascular Disease

Posted on July 25, 2010 by wngai
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The latest look at the effects of tea and coffee consumption on cardiovascular morbidity and mortality suggests that moderate intake of either beverages reduces coronary heart disease risk (CHD).  The findings were reported in the June 18, 2010 issue of Arteriosclerosis, Thrombosis, and Vascular Biology.

The Dutch researchers evaluated tea and coffee consumption in food-frequency questionnaire among 37,514 participants and observed the incidence of CVD morbidity and mortality for 13 years.

The researchers discovered that the consumption of 2.1 to 3.0 cups of coffee per day reduced the risk of CHD by 21% while the consumption of 6 or more cups of tea per day can reduce the risk of CHD by 36%.  Consumption of tea and coffee, however, has no effect on the reduction of stroke.

Even though the underlying mechanisms of their effects are not entirely clearly, it is possible that the flavonoids, which are antioxidant, and other biologically active substances contained in coffee, can have favorable effect on conoary heart disease. 

In conclusion, this large prospective study indicated that tea and coffee consumptions are associated with reduced lower risk of coronary heart disease

Source: Arterioscler Thromb Vasc Biol 2010

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Vitamins B6, B12 May Protect Against Depression in Older Adults

Posted on July 25, 2010 by wngai
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A recently published study showed that high intakes of vitamins B6 and B12 might reduce the risk of depressive symptoms in older adults. 

The study evaluated the dietary intakes and the incidence of depression in 3503 adults who are at least 65 years old.  

Using mathematical equation, the investigator found that higher total vitamin intakes including supplements were associated with a lower risk of depression during the 12 years follow-up. The risk of depressive symptoms was 2% lower per year for each additional 10 mg of vitamin B6 and an additional 10 μg of vitamin B12.

This study indicated that high total intakes of vitamins B-6 and B-12 are protective of depressive symptoms in community-residing older adults.

When assessing and treating older adults with depression, clinicians and other healthcare professionals should evaluate the nutritional status and whether patients are vitamin insufficiencies before treatment.

Source: Am J Clin Nutr. Published online June 2, 2010

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Efficacy and tolerability of Avastin plus Xeloda as first-line therapy in patients with advanced Liver Cancer

Posted on July 4, 2010 by wngai
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Liver cancer is the fifth most common cancer worldwide and the third most common cause of cancer mortality.  More than 80% of cases occur in East Asia and sub-Sharan Africa, and the incidence is increasing in Europe and the US.

Patients with locally advanced or metastatic HCC have dismal outcome.  Typically, the median survival for these patients diagnosed in Asia was typically 2-4 months with best supportive care.

Currently, Nexavar (sorafenib) is the only targeted agent indicated for advanced HCC.  A new study published indicated that Avastin (bevacizumab) plus Xeloda (capecitabine) might be another option for patients with advanced liver cancer.

Continue reading →

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Replacing White Rice with Brown Rice Reduce Risk of Type 2 Diabetes

Posted on July 4, 2010 by wngai
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Brown RiceIn Asian countries, rice has been a staple food for centuries.  In US, more than 70% of rice consumed is white rice.

Through the refining processes, the outer bran and germ portions of rice grains (ie.  Brown rice) are removed to produce white rice.  The removal of the outer bran and germ is supposed to make the rice more palatable when consumed and to improve its absorption.  However, this refinement might not be suitable to people who are at risk of developing diabetes (i.e. patients with family history or are obese).

In a study published in the June issue of Arch Intern Med, investigators reported that substituting brown rice may lower risk of type 2 diabetes.

The study evaluated the diet, lifestyle practices, and disease status among 39,765 mean and 157,463 women who have participated in the Health Professionals Follow-up Study and the Nurses’ Health Study I and II.

The analysis found that higher intake of white rice (>5 servings per weeks vs <1per month) was associated with a higher risk of type 2 diabetes; P<0.05).

Furthermore, the investigator estimated that replacing 50g/d (uncooked, equivalent to one-third serving per day) intake of white rice with the same amount of brown rice would reduced the risk of type 2 diabetes by 16%.

Besides lowering the risk of diabetes, brown rice also offer high content of multiple nutrients, such as fiber, vitamins, and minerals, most of which are lost during refining and milling g process.

Source: Arch Intern Med Vol. 170 (No. 11), June 14, 2010

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Tai Chi Increased Efficacy of Antidepressant Therapy in Older Adults

Posted on July 4, 2010 by wngai
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Tai ChiLike acupuncture(針灸), Tai Chi (太極拳) was known to improve blood circulation and stimulate the central nervous system.  A new study now reported that adding Tai Chi to antidepressant therapy (such as escitalopram, Lexapro) can improve resilience, quality of life, and cognitive function in seniors with major depression.

The study recruited 112 adults with major depression and treated them with an antidepressant (escitalopram) daily for 6 weeks.  After 6 weeks of therapy, 70 patients who partially responded to escitalopram were randomized to practice Tai Chi or receive health education, in addition to the antidepressant.

Both Tai Chi and health education patients showed similar improvement in the severity of depression.  However, subjects in the Tai Chi group showed significantly greater improvement in resilience than did subjects in the health education group (70.2% vs 65.0%; P < .05).

Also, patients who practiced Tai Chi also demonstrated greater improvement in health-related quality of life and cognitive functions (memory and executive function) scores when compared to the patients in the health education group (80 versus  66 on the 26-Item short Form Health Survey, P<0.05 and 0.03 versus 0.4 errors in Stroop mean error scores, P<0.05).  Lastly, C-reactive protein levels were also improved in the Tai Chi group.

Since fewer than half of elderly depressed patients respond to first-line antidepressant, this study offers new hope to elderly patients with depression disorder.

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Source: New Clinical Drug Evaluation Unit (NCDEU) 50th Anniversary Meeting: Abstract 5, Session II. Presented June 16, 2010.

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