World News: Aspirin: A miracle drug?

World News: Aspirin: A miracle drug? – thestar.com.

Lorianna De Giorgio
Toronto Star
April 15, 2012

Is Aspirin a miracle drug?

Aspirin-3D-vdW

Aspirin-3D

More and more research is emerging on the benefits of taking a low daily dose of the cheap painkiller — from preventing heart attacks and strokes to possibly preventing different forms of cancer.

Why, more than 100 years after it was discovered, is Aspirin still surprising the medical community?

“(It’s) a combination of factors: it’s been around a long time, a lot of people use it, a lot of people are studying it, and there’s a lot of information on its use in the laboratory setting, which provides us with a lot of data to really understand its potential uses,” says Dr. Andrew Chan, an associate professor of medicine at Harvard Medical School and assistant professor of medicine, gastroenterology at Massachusetts General Hospital.

HISTORY

German chemist Felix Hoffman, working for eventual international pharmaceutical giant Bayer, created acetylsalicylic acid (ASA) in 1897 in chemical form. Two years later, Bayer began selling the drug under the trade name Aspirin.

It has been used for decades to relieve headaches, muscle aches and fever.

In the 1970s, British pharmacologist John Vane discovered the science behind Aspirin’s anti-inflammatory properties — the pain reliever stops the production of hormone-like substances called prostaglandins by blocking an enzyme in the body known as cyclooxygenase.

Vane was awarded the Nobel Prize in medicine in 1982 for his research.

A daily low dose (around 75 milligrams) of the anti-inflammatory has also been said to reduce the risk of cardiovascular disease, ease arthritis pain and stop the formation of blood clots, since it acts as a blood thinner.

Aspirin’s image as a “preventive agent” got a boost last month with a series of studies in medical journals The Lancet and The Lancet Oncology focusing on how the pain reliever can reduce the risk of cancer deaths.

Oncologists already know that a long-term, low daily dosage of Aspirin may reduce cancer-related deaths, specifically colon cancer. But the latest studies, led by Dr. Peter Rothwell, professor of clinical neurology at the University of Oxford, found that daily Aspirin also has the potential to prevent and to stop the spread of certain forms of cancer when taken in short — three- to five-year — periods.

In one study Rothwell and his team found that after taking Aspirin daily for three years the threat of developing cancer was cut to about 25 per cent compared to those not taking the drug; after five years of taking the painkiller, the risk of dying from cancer was cut to 37 per cent.

TRANSFORMATIVE DRUG

“Aspirin clearly has benefits beyond what we previously considered,” says Chan, who wrote a commentary in The Lancet on Rothwell’s studies.

Due to Aspirin’s potential to fight two leading causes of death in the developed world — cancer and cardiovascular disease — plus the ongoing research around it, it’s fair to call it “a transformative drug” in terms of disease prevention, he says.

Next may be discovering if Aspirin can prevent dementia, Chan says.

SIDE EFFECTS

Despite the discoveries, Aspirin’s side effects pose serious concerns.

Chan says it’s too early for the drug to be recommended on a daily basis for the general public as side effects include gastrointestinal bleeding, bleeding strokes and brain hemorrhaging.

More data needs to be collected before it becomes a general recommendation, Chan says.

“At this point . . . I think people need to individualize their use of Aspirin and discuss it with their doctors to determine whether the potential benefits . . . outweigh the risks,” he says.

Researchers losing sleep over prescription of antipsychotics for insomnia

Researchers losing sleep over prescription of antipsychotics for insomnia.

English: Zyprexa

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Canadian researchers are sounding an alarm over the prescribing of antipsychotics — drugs once reserved for schizophrenia and mania — for the treatment of insomnia.

So-called “atypical,” or newer antipsychotics — a class that includes quetiapine (Seroquel) and olanzapine (Zyprexa) — are being prescribed “off label,” meaning for unapproved uses, in low doses for insomnia.

Yet their side-effects can be serious and include dramatic weight gain, elevated blood fats and possibly an increased risk of death, especially in the elderly, researchers from Laval University write in a report appearing this week in the world’s leading general medical journal, The Lancet.

The drugs may increase “parasomnias,” such as sleepwalking and night eating, they say. They also have been linked with an increased risk of “tardive dyskinesia” — abnormal and uncontrollable muscle movements, mostly of the mouth, face and tongue.

“The risks are significant,” says Dr. Charles Morin, a professor of psychology at Laval and first author of the Lancet paper.

While most of the side-effects have been linked with higher doses, Morin says there is not enough evidence to warrant using the drugs for sleep.

“Unless someone has a documented major psychiatric disorder, like a psychosis, there’s no place to use these drugs in the management of insomnia,” he said in an interview.

“I don’t think that you can take risks with patients who have insomnia if you haven’t tried all of the other options before.”

Atypical antipsychotics can cause rapid and substantial weight gain, as well as abnormal fat and glucose regulation, increasing the risk for diabetes and cardiovascular disease in the long-term.

Despite the heavy burden on a person’s psyche and physical functioning, insomnia is under-recognized and under-treated, the authors write. Studies suggest people with chronic insomnia are more than five times as likely to develop anxiety or depression, and more than twice as likely to suffer congestive heart failure as those without. They are seven times more likely to develop substance abuse.

Nearly 70 per cent of people with insomnia continue to report insomnia a year later; 50 per cent still have insomnia up to three years later.

“In view of the high prevalence and substantial morbidities of insomnia, patients should routinely be asked about sleep problems by health-care providers,” Morin and his co-author, Ruth Benca, from the University of Wisconsin, write in The Lancet.

“Sleep is so intimately related to physical and psychological health,” Morin, who holds a Canada Research Chair in sleep disorders, said.

“There are lots of public-health campaigns about the impact of smoking, and exercise and obesity. We should have the same about sleep. We’re spending a third of our lives sleeping. We should pay more attention to it.”

His research has shown that about 40 per cent of Canadians experience symptoms of insomnia — taking longer than 30 minutes to fall asleep, waking in the middle of the night or too early in the morning — at least three times a week.

Cognitive behavioural therapy should be the first-line approach to treatment, Morin said. CBT — therapy that includes changing the psychological problems that perpetuate insomnia, such as excessive worry — produces better sleep over the long term without the daytime “hangovers” and other side-effects of drug treatment, he said.

While face-to-face therapy needs to be made more widely available, Morin said group therapy, videos and Internet-based programs can also help.

Hypnotic drugs such as triazolam, zaleplon and zolpidem are effective in the short-term, he and his co-author write, but “the evidence of long-term efficacy is scarce and most hypnotic drugs are associated with potential adverse effects,” they caution.

Anxiety, depression, and pain can lead to insomnia. So, too, can “hyper arousal.” People who are more hypervigilant have a more difficult time letting go at bedtime, Morin said. Their bodies are physiologically different; their body temperature doesn’t drop as much at night as it does in good sleepers.

That may explain why insomniacs are at greater risk for hypertension, he said.

“Their hearts are working harder throughout the 24-hour cycle.”

“And their mind is working harder. It never stops. Even during sleep, people with insomnia feel their mind is still active,” Morin said — a phenomenon researchers have documented using EEG, or electroencephalography, a recording of the brain’s electrical activity.

Only a small proportion of people suffering significant insomnia ever receive treatment, Morin said. Instead, most self-medicate with over-the-counter drugs that carry more serious side-effects than prescribed pills, or, worse, with alcohol.

Booze is “readily available, it’s cheap, you don’t need a prescription,” Morin said. “But even if it can help a tense person to get to sleep faster, you’ll pay the price in the second half of the night.”

When the body metabolizes alcohol, sleep becomes more fitful, he said.

Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis : The Lancet Infectious Diseases

Modified version of File:CDC-11214-swine-flu.j...

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Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis : The Lancet Infectious Diseases.

Summary

Background

No published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza.

Methods

We searched Medline for randomised controlled trials assessing a relative reduction in influenza risk of all circulating influenza viruses during individual seasons after vaccination (efficacy) and observational studies meeting inclusion criteria (effectiveness). Eligible articles were published between Jan 1, 1967, and Feb 15, 2011, and used RT-PCR or culture for confirmation of influenza. We excluded some studies on the basis of study design and vaccine characteristics. We estimated random-effects pooled efficacy for trivalent inactivated vaccine (TIV) and live attenuated influenza vaccine (LAIV) when data were available for statistical analysis (eg, at least three studies that assessed comparable age groups).

Findings

We screened 5707 articles and identified 31 eligible studies (17 randomised controlled trials and 14 observational studies). Efficacy of TIV was shown in eight (67%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 59% [95% CI 51—67] in adults aged 18—65 years). No such trials met inclusion criteria for children aged 2—17 years or adults aged 65 years or older. Efficacy of LAIV was shown in nine (75%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 83% [69—91]) in children aged 6 months to 7 years. No such trials met inclusion criteria for children aged 8—17 years. Vaccine effectiveness was variable for seasonal influenza: six (35%) of 17 analyses in nine studies showed significant protection against medically attended influenza in the outpatient or inpatient setting. Median monovalent pandemic H1N1 vaccine effectiveness in five observational studies was 69% (range 60—93).

Interpretation

Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality.

Funding

Alfred P Sloan Foundation.

Greeks pay for economic crisis with their health

Greeks pay for economic crisis with their health | World news | The Guardian.

Rising demand and cost-cutting put services at breaking point, while drug addiction, HIV and suicide rates increase

Ambulance crews join doctors and health workers to protest against cuts outside the Greek parliament

Ambulance crews join doctors and health workers to protest against service cuts outside the Greek parliament in Athens. Photograph: Aris Messinis/AFP/Getty Images

It is 4am on the emergency ward of Evangelismos general hospital – the biggest in Greece – and the stream of patients is relentless. Dr Michalis Samarkos has not stopped working since he started his shift some 14 hours earlier, and he has been besieged by patients unable to afford the tests or the drugs they need.

Many, like the unemployed diabetic man he has just examined, have gone without treatment for several days. “When you see a diabetic unable to afford his insulin you know he is going to die,” says Samarkos. “There is no infrastructure to help these people. On every front the system has failed the people it was meant to serve.”

Greeks are paying for their economic disaster with their health, according to a new study.

In a letter to the Lancet medical journal, a team lead by Dr Alexander Kentikelenis and Dr David Stuckler from Cambridge University and Professor Martin McKee from the London School of Hygiene and Tropical Medicine warns of a potential “Greek tragedy“. They point to signs of a dramatic decline in the health of the population and a deterioration of services at hospitals under financial pressure.

Many Greeks have lost access to healthcare coverage through work and social security plans, and rising poverty levels mean growing numbers who would previously have used the private sector are now flocking to state hospitals. Alongside savage spending cuts, the rise has put an immense strain on a chaotic and corrupt system that was already in decline.

Hospital budgets dropped by 40% between 2007 and 2009, say the Lancet authors. There are reports of understaffing, shortages of medical supplies and patients paying bribes to medical staff to jump queues.

“There are signs that health outcomes have worsened, especially in vulnerable groups,” write the experts. There was a 14% rise in the number of Greeks reporting their health as “bad” or “very bad” between 2007 and 2009.

Suicides rose by 17% during the same period, and unofficial 2010 data quoted in parliament mention a 25% rise compared with 2009. The health minister reported a 40% rise in the first half of 2011 compared with the same period in 2010.

“The national suicide helpline reported that 25% of callers faced financial difficulties in 2010 and reports in the media indicate that the inability to repay high levels of personal debt might be a key factor in the increase in suicides,” the Lancet authors write. “Violence has also risen, and homicide and theft rates nearly doubled between 2007 and 2009.”

Their analysis is based on data from the EU Statistics on Income and Living Conditions. The pressure that the health services are under may account for a rise of 15% between 2007 and 2009 in the numbers who say they did not go to the doctor even though they thought they should. Long waiting times and travel distances to clinics were among the reasons cited.

GP and hospital out-patient care is virtually free, but many Greeks cannot even afford the €5 (£4.30) fee they are required to pay when visiting public out-patient clinics, and doctors say they are often forced to haggle over fees.

Meanwhile, there has been a marked rise in the number of people admitted to hospital – up 24% between 2009 and 2010 and up another 8% in the first half of 2011 compared with the same period last year.

The impact of cuts on drugs services appears particularly troubling. HIV infections rose significantly in 2010, with injecting drug users accounting for half of the rise. The numbers are on course to rise by 52% this year. Many new infections are also linked to rises in prostitution and unsafe sex. Heroin use reportedly rose by 20% in 2009, according to estimates from the Greek Documentation and Monitoring Centre for Drugs. Budget cuts in 2009 and 2010 have meant the loss of a third of the country’s outreach programmes.

Health workers in Athens say the economic crisis has contributed to a surge in intravenous drug use in the city. “Since January 2011 we have seen a more than 1000% rise of HIV among intravenous drug users,” says Eleni Kokalou who works in the infectious diseases department of Evangelismos Hospital. “Lack of preventive services at community and primary level and funding cuts for the few existing ones, like the syringes exchange program for IDUs, has contributed greatly to the rise,” she said.

“Overall, the picture of health in Greece is concerning,” write the Lancet authors. “In an effort to finance debts, ordinary people are paying the ultimate price: losing access to care and preventive services, facing higher risks of HIV and sexually transmitted diseases, and in the worst cases losing their lives. Greater attention to health and healthcare access is needed to ensure that the Greek crisis does not undermine the ultimate source of the country’s wealth – its people.”

Economic slump linked with soaring suicide rates in Europe

 8th July 2011

The financial crisis that swept Europe almost certainly led to an increase in suicides, according to health experts’ research.

Researchers say that when the rate of unemployment rose, suicide rates immediately increased in nine of the ten countries they studied between 2007 and 2009.

The analysts say that countries facing the most severe cuts and debts including Greece and Ireland, had greater rises in suicide, medical journal The Lancet reported.

At risk: The severe financial crisis in Greece is linked with the country's soaring suicide rates

At risk: The severe financial crisis in Greece is linked with the country’s soaring suicide rates

The team of researchers, who took their mortality rate data from the World Health Organisation, say that the key to combating the rise is investment in welfare systems, efforts to improve labour opportunities and strong social support networks.

U.S. and UK experts used complete data from ‘new’ EU states – ones that joined after 2004 – Czech Republic, Hungary, Lithuania, and Romania.

They also took data from old EU states – ones that were members before 2004 – Austria, Finland, Greece, Ireland, the Netherlands, and the UK.

Dr David Stuckler, who worked on the report, wrote in The Lancet: ‘These findings reveal the rapidity of the health consequences of financial crises.’

The researcher says previous figures backed their findings: ‘In the pre-2004 EU, we see that suicides increased both before and during periods when unemployment rose, at a time of significant economic insecurity across Europe,’ he said in The Lancet.

‘This is also consistent with historical studies that show immediate rises in suicides associated with ‘early indicators’ of crisis, such as turmoil in the banking sector, which precipitates later unemployment.’

Tough times: Those who live in countries with severe financial woes have a higher suicide rate

Tough times: Those who live in countries with severe financial woes have a higher suicide rate

The countries facing the most severe financial crises, such as Greece and Ireland, had greater rises in suicides.

The increases varied between 5 per cent and 17 per cent for under 65s after a period of falling suicide rates, which had been dropping until 2007.

Greece saw a staggering 17 per cent incline, while Ireland’s suicide rate soared by 13 per cent.

In Latvia suicides increased by more than 17 per cent between 2007 and 2008.

Of the risers, Finland, also with strong social protection systems, had an increase in suicides of just over 5 per cent in the same period.

The researchers say out of all the countries Austria, which provides a strong social support network, had a slight decline in suicides despite an increase in unemployment of 0·6 percentage points between 2007 and 2009.

Economic slump linked with soaring suicide rates in Europe | Mail Online.

Europe ‘losing’ superbugs battle

Klebsiella pneumoniae NDM-1 is carried by Gram-negative bacteria like Klebsiella

Antibiotic-resistant infections have reached unprecedented levels and now outstrip our ability to fight them with existing drugs, European health experts are warning.

Each year in the EU over 25,000 people die of bacterial infections that are able to outsmart even the newest antibiotics.

The World Health Organization says the situation has reached a critical point.

A united push to make new drugs is urgently needed, it says.

Without a concerted effort, people could be dealing with the “nightmare scenario” of a worldwide spread of untreatable infections, says the WHO.

One example is the New Delhi or NDM-1 superbug recently found in UK patients.

They brought the infection back with them from countries like India and Pakistan, which they had visited for medical treatment and cosmetic surgery.

Powerful weapons

These superbugs are resistant to carbapenem antibiotics, which is concerning for experts because they are some of our most powerful weapons and are used for hard-to-treat infections that evade other drugs.

“Given the growth of travel and trade in Europe and across the world, people should be aware that until all countries tackle this, no country alone can be safe”

Zsuzsanna Jakab WHO regional director for Europe

The Cardiff University researchers, who made the discovery last August, now say bacteria with this new genetic resistance to antibiotics have contaminated Delhi’s drinking water supply, meaning millions of people there could be carriers.

Dr Timothy Walsh and his team collected 171 swabs of seepage water and 50 public tap water samples from sites within a 12km radius of central New Delhi between September and October 2010.

The NDM-1 gene was found in two of the 50 drinking-water samples and 51 of 171 seepage samples.

Worryingly, the gene had spread to bacteria that cause dysentery and cholera, which can be easily passed from person to person via sewage-contaminated drinking water.

“Oral-faecal transmission of bacteria is a problem worldwide, but its potential risk varies with the standards of sanitation.

“In India, this transmission represents a serious problem… 650 million citizens do not have access to a flush toilet and even more probably do not have access to clean water,” the researchers warn in the journal Lancet Infectious Diseases.

The scientists are calling for urgent action by health authorities worldwide to tackle the new strains and prevent their global spread.

Zsuzsanna Jakab, WHO regional director for Europe, said: “Antibiotics are a precious discovery, but we take them for granted, overuse and misuse them: there are now superbugs that do not respond to any drugs.

“Given the growth of travel and trade in Europe and across the world, people should be aware that until all countries tackle this, no country alone can be safe.”

The UK’s Health Protection Agency said it was monitoring the spread of NDM-1 closely.

“The first case of a bacterial infection with this resistance was identified in January 2008. Monitoring of this resistance began in 2009 as more cases were identified.”

So far, there have been around 70 cases of the infection recorded in the UK.

The HPA insists that the risk of infection to travellers to the Asian subcontinent who are not treated in hospital is minimal.

“If members of the public are travelling for surgery overseas they should satisfy themselves that appropriate infection control measures are in place,” says the HPA.

BBC News – Europe ‘losing’ superbugs battle.

Daily aspirin dose ‘for everyone over 45′

Generic regular strength enteric coated 325mg ...

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Evidence is building that the benefits for many healthy middle-aged and older people “far outweigh” the side effects, according to the academics.

In particular, individuals at higher risk from the country’s two biggest killers would be helped by taking the painkiller as a preventive medicine, they added.

The experts were speaking at the Royal Society of Medicine a month after research from Oxford University published in The Lancet showed that taking 75mg of aspirin daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third. A 75mg dose is a quarter of the standard over-the-counter pill.

Earlier studies had already shown that a low daily dose could reduce the risk of developing heart disease.

Members of the panel said that the recent research was potentially of “enormous importance” to public health.

Bowel, or colorectal, cancer is the third most common form of the disease in Britain, with 39,000 diagnoses annually and 16,000 deaths.

The Lancet study suggests greater aspirin use could potentially save thousands of lives a year in relation to this one cancer alone.

But research is also looking into whether aspirin could have a preventive effect on other types of cancer as well.

Combined, all cancers claim more than 150,000 lives in Britain every year, while cardiovascular disease accounts for some 200,000 deaths.

Prof Peter Rothwell, the Oxford neurologist who led the bowel cancer study and was part of yesterday’s panel, has started taking a daily dose of aspirin himself. He said: “I suspect that in five to 10 years’ time we will be prescribing aspirin to middle-aged people, not only for the known vascular benefits.”

But members of the public might take matters into their own hands before then, he predicted.

“If it becomes clear that there are benefits for other cancers, then the balance of risk and benefit will become so clear that people may take the decision to take it for themselves,” he said. “It seems implausible that this effect on colorectal cancer is going to be a completely isolated phenomenon in relation to other cancers, given that we know that there are similarities between how cancers develop.”

Prof Rothwell said that he thought it would be “sensible” for people to start taking aspirin at about 45, when the chance of developing bowel and other cancers began to rise. “The risk of cancer goes up substantially between the age of 40 and 55,” he said.

As aspirin had a preventive effect, it was advisable to start taking it daily towards the beginning of that period, he explained. However, he said it was ultimately up to individuals to decide whether to take the drug, “rather than us making definitive statements”.

Prof Peter Elwood, of Cardiff University’s School of Medicine, who conducted the first trial into the effect of aspirin on heart disease in the 1970s, said: “I think we are on the brink of another breakthrough of enormous importance to the community in general.”

Prof Gordon McVie, a leading cancer specialist, from the European Institute of Oncology, said the discussion among the experts was whether this was metaphorically a “put-it-in-the-water moment”.

Opinion on the subject varies however. Experts are divided particularly over the question of to whom aspirin should be recommended as a daily preventive medicine.

The drug was formulated as a painkiller more than a century ago but researchers are finding that it can help in diseases ranging from heart disease to dementia.

Advocates believe that its active ingredient is akin to a vitamin that almost everybody should take, as our modern diet does not provide it. Others point out that taking the drug is known to double the incidence of intestinal bleeding, from about one in 1,000 people per year to about two.

The question is how much of the population – in terms of their age and their risk of developing serious diseases – should be recommended to take aspirin on a daily basis.

Prof McVie said: “I think there’s a frankly conservative feeling in this group, that for [colorectal] cancer, it should be targeted for people at higher risk.”

Prof Sir John Burn, a geneticist at Newcastle University, said: “The problem is, if we recommend something to the whole population, then we will see side effects.

“We know aspirin can cause gastrointestinal bleeding. That is to some extent holding back the situation.” Prof Dion Morton, a colorectal surgeon at University Hospital Birmingham, was another of those attending yesterday’s meeting, which was convened by the Aspirin Foundation.

He said that medicine was increasingly using a “stratified approach, where we target the right drugs at the right patients”.

He thought regulatory approval should be sought for doctors to prescribe aspirin as a preventive medicine for those at a higher risk of bowel cancer. “If they have not been told in writing they should be advocating it, they won’t advocate it,” Prof Morton said.

While intestinal bleeding was serious, research suggested that aspirin increased the risk only of less serious cases, said Prof Elwood. He said there was some evidence that the intestines adjusted to aspirin over the long term.

Daily aspirin dose ‘for everyone over 45′ – Telegraph.

Alcohol the most lethal drug: study

Alcohol is more dangerous than illegal drugs like heroin and crack cocaine, according to a new study.

British experts evaluated substances including alcohol, cocaine, heroin, ecstasy and marijuana, ranking them based on how destructive they are to the individual who takes them and to society as a whole.

Researchers analyzed how addictive a drug is and how it harms the human body, in addition to other criteria like environmental damage caused by the drug, its role in breaking up families and its economic costs, such as health care, social services, and prison.

Heroin, crack cocaine and methamphetamine, or crystal meth, were the most lethal to individuals. When considering their wider social effects, alcohol, heroin and crack cocaine were the deadliest. But overall, alcohol outranked all other substances, followed by heroin and crack cocaine. Marijuana, ecstasy and LSD scored far lower.

The study was paid for by Britain’s Centre for Crime and Justice Studies and was published online Monday in the medical journal, Lancet.

Experts said alcohol scored so high because it is so widely used and has devastating consequences not only for drinkers but for those around them.

“Just think about what happens (with alcohol) at every football game,” said Wim van den Brink, a professor of psychiatry and addiction at the University of Amsterdam. He was not linked to the study and co-authored a commentary in the Lancet.

When drunk in excess, alcohol damages nearly all organ systems. It is also connected to higher death rates and is involved in a greater percentage of crime than most other drugs, including heroin.

But experts said it would be impractical and incorrect to outlaw alcohol.

“We cannot return to the days of prohibition,” said Leslie King, an adviser to the European Monitoring Centre for Drugs and one of the study’s authors. “Alcohol is too embedded in our culture and it won’t go away.”

Mr. King said countries should target problem drinkers, not the vast majority of people who indulge in a drink or two. He said governments should consider more education programs and raising the price of alcohol so it isn’t as widely available.

Experts said the study should prompt countries to reconsider how they classify drugs. For example, last year in Britain, the government increased its penalties for the possession of marijuana. One of its senior advisers, David Nutt – the lead author on the Lancet study – was fired after he criticized the British decision.

“What governments decide is illegal is not always based on science,” said Mr. van den Brink. He said considerations about revenue and taxation, like those garnered from the alcohol and tobacco industries, may influence decisions about which substances to regulate or outlaw.

“Drugs that are legal cause at least as much damage, if not more, than drugs that are illicit,” he said.

via Alcohol the most lethal drug: study – The Globe and Mail.

 

All over 40s should consider daily dose of aspirin: leading expert

Aspirin-3D-vdW

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Prof Peter Rothwell of Oxford University has found that taking the painkiller daily for five years can reduce the chance of developing colorectal cancer by a quarter and cut deaths from the disease by a third.He said these results are the ‘tip of the iceberg’ and are likely to be an underestimate of its benefit in colorectal cancer prevention.

In addition he believes a similar effect is likely in other cancers such as breast, ovarian, womb, stomach and small bowel.

Prof Rothwell who is 46 said he and his wife both started taking low-dose aspirin themselves in order to reduce the chance of cancer several years ago and others in their 40s and 50s should consider it.

“The whole approach to aspirin is likely to change over the next few years. Currently people take it to prevent vascular events (such as heart attacks and stroke) but it is likely that in five years people will be taking it to prevent non-vascular diseases like cancer as well.”

The drug, which is over 110 years old, was originally formulated as a painkiller but researchers are increasingly finding new benefits for it in diseases ranging from heart disease to dementia.

Prof Rothwell examined trials in which people took 75mg of aspirin a day for an average of five years and followed them up for 20 years.

The findings are published in The Lancet medical journal.

This is a lower dose than when used as a painkiller and costs the NHS just three pence per patient per day.

Colorectal cancer is the third most common cancer in Britain with around 39,000 people diagnosed each year and around 16,000 die annually.

Prof Rothwell, of the John Radcliffe Hospital and Oxford University, said the trials looked at the benefits of taking aspirin for five years but he suspects the effect of taking it for longer would ‘undoubtably be much larger’.

He said as colorectal cancers start to appear in the people aged 55 and older and take around ten years to develop, the ideal time to start taking aspirin would be in the 40s and continue with it until around the age of 75 when the side effects of aspirin start to outweigh the benefits. The effect of taking aspirin may continue for around ten years after stopping it, he said.

The major side effect of aspirin is internal bleeding because it can disturb the lining of the stomach but this is reduced at lower doses.

The Department of Health has announced that pilots of a new colorectal screening programme will start next year in people using a scope to look for changes in the bowel that could signal cancer.

Prof Rothwell said use of aspirin would dovetail perfectly with the new programme as the drug prevents more cancers at the top of the bowel which will not be detected by the screening test.

There was a 70 per cent reduction in cancers and deaths from cancers in the upper colon among those taking aspirin for five years, the analysis found.

Aspirin blocks the effects of substance called cyclo-oxygenase and is produced by some forms of cancer which is why Prof Rothwell believes other cancers will respond to aspirin.

Other experts have now called for guidelines to be drawn up on how aspirin should be used to prevent cancer.

Dr Robert Benamouzig and Dr Bernard Uzzan, of the Avicenne Hospital, in Bobigny, France, wrote in an accompanying editorial: “This interesting study could incite clinicians to turn to primary prevention of colorectal cancer by aspirin at least in high risk-populations. Specific guidelines for aspirin chemoprevention would be the next logical step.”

Mark Flannagan, Chief Executive of Beating Bowel Cancer said: “These are very positive results. This was a big study over a long period of time and reinforces the message that aspirin may be important in significantly reducing the number of cases and deaths from bowel cancer.

“The results suggest that taking aspirin in conjunction with a healthy diet and lifestyle might reduce your risk of developing bowel cancer. However, anyone considering starting a course of medication should first consult their GP.

“As Professor Rothwell suggests, a low dose of aspirin may fit well with the flexible sigmoidoscopy screening programme that will be launched by the Government next year. We will have to see how these results might be considered during the roll out of flexible sigmoidoscopy.”

via All over 40s should consider daily dose of aspirin: leading expert – Telegraph.