Babies in the womb benefit from second dose of steroids

According to a recent research, administering a second dose of steroids to babies, still in the womb, could be beneficial to reduce the chances of post-birth respiratory problems in the future without posing any concerns in terms of baby growth.

It was revealed by study author Dr. James Kurtzman, an associate clinical professor in the division of maternal-fetal medicine in the department of obstetrics and gynecology at the University of California, Irvine, that a reduction of 31 percent was noticed in terms of overall composite neonatal morbidity when a second steroid dose was administered to babies who are born before 34 weeks.

From Health.discovery.com:

When doctors first started giving steroids to mothers who appeared to be going into pre-term labor, they discovered that, for the babies' health, it was best if the steroid dose was given no more than seven days before delivery.
But it's not always easy to tell exactly when a woman will deliver. So, if a woman passed the seven-day mark and still had not delivered, doctors would repeat the steroid dose. However, doctors soon learned that multiple courses of steroids led to growth restriction and smaller head circumferences in the babies.
"Then the pendulum swung the other way, and doctors were holding out on giving the first dose" until they were sure the woman was going to deliver, Kurtzman explained. That resulted in some women never getting treated before delivery.
"So, we developed this study for patients that remained pregnant for more than two weeks after receiving their first course," he said.
The study included 437 women from 18 medical facilities -- both community hospitals and academic medical centers. The women were randomly assigned to receive either a second, so-called "rescue," dose of steroids closer to delivery or a placebo.
The researchers found a significant reduction in respiratory problems for babies who received the second dose of steroids. Plus, they found no evidence of growth restriction or smaller head circumferences.

The results of this study reveal that we are faring better in terms of prevention and management of premature births, as per Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center in New York City.

Shoaib Akhtar banned for five years

Shoaib Akhtar, Pakistan's fast bowler and popularly known as the Rawalpindi Express, was handed over a ban of five years after repeated incidents of disciplinary breaches. This could mean an end to the maverick paceman's controversial career.

The paceman who was previously handed over a ban of two years after hitting a teammate with the bat appeared before a disciplinary committee that imposed a ban of two years after Akhtar was found publicly criticizing the country's cricket board.

From Foxsports.com.au:

Akhtar last played for Pakistan in the third and final Test against India at Bangalore in December last year. He broke down with back trouble and was blamed for Pakistan's 1-0 series defeat.

The “Rawalpindi Express” was not selected for Pakistan's five-match series against Zimbabwe in February and was omitted from next month's first two limited-overs fixtures against Bangladesh.

In 2006, Akhtar and Asif tested positive for the banned steroid nandrolone and were expelled from Pakistan's Champions Trophy team for India. Akhtar was banned for two years and Asif for one year, but the bans were lifted on appeal.

Separately spinner Danish Kaneria, who also faced a charge of criticising the PCB, was severely reprimanded, Ashraf said.

Kaneria had hit out at his demotion from category “B” to “C” in the central contract in an online column. He later blamed a newspaper for publishing his words out of context.

“Since this was Kaneria's first offense on discipline, he has been severely reprimanded and barred from issuing any press statements,” Ashraf said.

The Pakistan cricket team is all about issues, which is evident from the incidents when and Inzamam-ul-Haq's team forfeited a Test in 2006 after being accused of ball-tampering and coach Bob Woolmer died at last year's World Cup.

Olympic coach distributed drugs

Former Olympic weightlifter Christos Konstantinidis has accused the suspended Greece Coach Christos Iacovou of giving banned substances to athletes, according to a Court official.

Konstantinidis represented Greece at the 1988 Seoul Olympics and provided evidence to a judicial investigation set up to enquire into a doping scandal in which 11 out of the 14-member national weightlifting team tested positive for the anabolic steroid, methyltrienolone.

From Foxsports.com.au:

He told prosecutor Andreas Karaflos that Iacovou, who has been suspended by the Greek Weightlifting Federation pending the outcome of the case, had pressed him to take banned substances in 1997.

"The former athlete told the prosecutor that Iacovou had urged him to take banned substances and that when he refused he found himself off the national team," the official said on condition of anonymity.

Konstantinidis made identical claims in 1997 but was then forced to sign an apology for fear of losing his job with the police.

The court official said Konstantinidis told the prosecutor that despite signing the apology 11 years ago, he had never retracted his comments.

"He stood by what he had said in 1997 and he repeated those claims today again," the official said.

Iacovou would not have given steroids to his athletes, as per Nikos Kourtidis, one of the three weightlifters who didn't test positive.

Multiple myeloma patients can live for long with steroid pills

Multiple myeloma, which is a cancer of the plasma cells in the region of bone marrow, can be effectively treated with steroid pills and help patients live for long.

It was remarked by James Berenson, M.D., lead author of the Southwest Oncology Group sponsored study and Director of the Multiple Myeloma and Bone Metastasis Program at Cedars-Sinai Medical Center that use of Prednisone in response to an upfront chemotherapy can be hailed as a safe and effective treatment option for prolonging lives.

From News.Bio-Medicine.Org:

Multiple myeloma occurs when the body makes an abnormally high number of cancerous plasma cells. When healthy, plasma cells help to protect the body from infection and disease by forming antibodies that attack foreign substances. But when the body makes too many plasma cells that all make the same type of antibody, this leads to multiple myeloma, causing damage to bones, severe bone pain, an overabundance of calcium in the blood, anemia, and a weakening of the immune system. Today, most patients with multiple myeloma receive initial treatment with chemotherapy or with high-dose chemotherapy followed by a stem cell transplant and many respond to treatment and achieve remission. However, all patients ultimately relapse with incurable disease, leading physicians to search for ways to prolong remission for as long as possible by using some type of maintenance therapy.

This finding was disclosed by researchers at the Cedars-Sinai Medical Center.

Daily Pirfenidone doses helpful for treating Idiopathic pulmonary fibrosis

According to researchers from Japan, a daily dose of Pirfenidone is effective to treat individuals afflicted with idiopathic pulmonary fibrosis.

As per the Phase III, double-blind, placebo-controlled clinical trial, daily doses of this drug can prove to be an effective option for slowing down the progression of idiopathic pulmonary fibrosis and reducing the loss of lung capacity.

From News-Medical.Net:

"The most common treatment for IPF is anti-inflammatory agents such as steroids," said lead researcher Takashi Ogura, M.D., of Kanagawa Cardiovascular and Respiratory Center in Yokohama, Japan. "However our study confirmed that pirfenidone, the main action of which is thought to be antifibrotic, achieved a therapeutic effect on IPF. I expect that our study will serve as a guide to develop a new therapy for IPF in the future."

The researchers recruited a total of 275 Japanese patients with mild to moderate IPF and randomized them to a high dose pirfenidone (1,800 mg/day) group, a low dose pirfenidone group (1,200 mg/day) and a placebo group. They measured lung capacity (vital capacity or VC) and progression-free survival, defined as a period without death or a greater than 10 percent decrease in VC, to determine the effectiveness of the regimens.

At the end of one year, they found that patients who had been randomized to the high dose regimen had significantly lower loss of VC than the placebo group. Furthermore, pirfenidone slowed the overall deterioration of IPF compared to the placebo.

"Taken altogether, our study demonstrated positive clinical effects of pirfenidone that suppresses the progress of IPF and potentially contributes to improving the outcomes of patients with IPF," said Dr. Ogura.

The trial results were presented at the American Thoracic Society's International Conference in Toronto.

Global initiatives formulated for tackling supply of illegal drugs

A joint operation was recently exercised to curb the supply of dangerous and illegal medicines.

This operation was made to demonstrate the dangers of buying drugs online and received significant support from the Permanent Forum on International Pharmaceutical Crime (PFIPC) the World Customs Organization, the UK's Medicines and Health Care products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA) and Immigration and Customs Enforcement (ICE), the Royal Canadian Mounted Police, and Health Canada.

From News-Medical.Net:

During the operation, Internet monitoring revealed 751 websites engaged in illegal activity, including offering controlled or prescription only drugs, 72 of which have now been taken down. In addition, more than 16,000 packages were inspected by regulators and customs, 995 packages were seized and nearly 167,000 illicit and counterfeit pills - including antibiotics, steroids and slimming pills, confiscated.

Twenty-two individuals are currently under investigation for a range of crimes including illegally selling and supplying unlicensed or prescription-only medicines.

"As the very positive results of this global effort are made public, INTERPOL and its member countries will prove again that the Internet is not an anonymous safe haven for those who use it for criminal purposes. We hope that by raising public awareness about the dangers of illegal internet pharmacies, consumers will exercise greater care when purchasing medicines on the Internet," added Secretary General Noble.

"Our thanks go to the police, customs and regulatory officials in the 24 participating countries as well as to our partner international organizations such as the World Health Organization's IMPACT, the World Customs Organization and Universal Postal Union whose tireless efforts and dedication have made Operation Pangea II such a success," Noble concluded.

Operation Pangea II was coordinated by INTERPOL and the World Health Organization's International Medical Products Anti-Counterfeiting Taskforce (IMPACT). The week-long initiative was highlighted by a series of arrests and seizure of thousands of potentially harmful medical products.

Identification of breast cancer type without lump

Lumps in the breast region are possible signs of breast cancer but most of us are caught unaware about a breast cancer type, inflammatory breast cancer, which is not characterized by a lump.

This cancer type warrants urgent diagnosis so that life of afflicted patients could be saved, according to Sofia Merajver, M.D., Ph.D., co-director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center.

From News-Medical.Net:

Inflammatory breast cancer is a very aggressive type of cancer in which the cancerous cells move rapidly throughout the breast and clog the lymph vessels in the skin, causing the breast to look swollen, red, itchy or inflamed. It's often mistaken for a rash or infection and many women are initially treated with antibiotics or steroids.
“There are many options for treating this disease. In many cases, the treatment is going to be on and off for life. There will be times of remission, but this is a serious disease that has a high chance of recurring,” says Merajver, a professor of internal medicine at the U-M Medical School.
About inflammatory breast cancer
* Represents 3 percent to 6 percent of the 180,000 women diagnosed with breast cancer each year.
* With treatment, 20 percent to 40 percent of patients survive 10 years. This is up from 5 percent to 10 percent 20 years ago.
* Characterized by redness, warmth or an orange-skin appearance on the skin of the breast. A persistent red breast should be biopsied promptly.
* May or may not cause a lump or mass.
* Treatment includes aggressive chemotherapy, followed by surgery and radiation therapy.

Merajver said that the U-M Inflammatory Breast Cancer Clinic would be turning into a clearinghouse for passing information related to tertiary care and advice.

Pregnant women can use steroids without side effects

According to a study, pregnant women suffering from asthma can continue using steroids without affecting growth of their unborn babies.

It was disclosed by the involved researchers that unborn babies are in far more danger from lack of oxygen than the mother making use of inhaled steroids.

From MedicalNewsToday.com:

The researchers looked at 396 pregnant women who took inhaled steroids. It did not have an effect on the growth of the fetus. There was no effect on the baby's birth weight either.
They also found that inhaled steroids are safer for pregnant women to take than steroid pills. Oral steroids have been shown to slow the fetus' growth. Oral steroids are also used to treat asthma.
The study was carried out at the Kaiser-Permanente Medical Center in San Diego. The team leader was Michael Schatz.
Schatz said 'Now, women don't have to make a choice between their health and the health of the baby. They don't have to think that making that choice is going to somehow harm the baby.'
You can read about the study in the Journal of Allergy and Clinical Immunology.
7% of pregnant women get asthma to some degree. Some of these women use inhaled steroids. The National Asthma Education and Prevention Program, (part of the Department of Health and Human Services), supports the use of steroids in pregnant women with serious asthma.
The worry asthmatic women have when they are pregnant is that the fetus is deprived of oxygen. This can sometimes lead to retardation, premature birth, low birth weight and even stillbirth.

The study results appeared in the Journal of Allergy and Clinical Immunology.

Glue ears can be treated with topical steroid use

In order to inhibit unnecessary secondary referral and expensive surgery, many non-surgical treatment options are being used these days for otitis media with effusion (OME).

The cost efficacy of topical intranasal steroids for treating otitis media with effusion (OME) in primary care was recently evaluated by a recent study from the perspective of the UK National Health Service.

From MedicalNewsToday.com:

Epidemiological studies of OME reveal that it affects 50-80% of children by the age of five. Without effective intervention, severe OME can cause significant hearing loss, which may result in linguistic, developmental, behavioural, motor and social impairment. Although many OME cases resolve spontaneously, referral rates from primary care remain high, with approximately 1-5 per 1000 children in the general population undergoing surgery (grommets) each year.
The study was led by Dr. Stavros Petrou from the University of Oxford.
Says Dr. Petrou: "This study demonstrates that the current use of topical steroids for OME is unlikely to represent an efficient use of scare public resources."
This will be discussed in detail in Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 5,000 clinicians, decision-makers, and researchers worldwide.

The study was led by Dr. Stavros Petrou from the University of Oxford and demonstrated that topical steroids cannot be considered as a cost-effective treatment option for OME in general practice.

Some children might be 'unlucky' with asthma medications

Children and girls exposed to tobacco smoke could derive more benefit from one of the most widely prescribed medications for asthma and allergies, Montelukast.

The finding was revealed by researchers at National Jewish Medical and Research Center and appeared in an issue of the Journal of Allergy and Clinical Immunology.

From Sciencedaily.com:

Inhaled corticosteroids are considered the first-line treatment for cases of persistent asthma. However, steroids alone do not effectively control asthma in 30 percent to 40 percent of patients and they may have some side effects, especially in children. In those cases, a secondary medication is often used. Montelukast is one such medication.
Montelukast, one of the most widely prescribed medications for asthma and allergies, blocks the action of chemicals called leukotrienes, which contribute to inflammation. However, physicians have found that montelukast is quite variable in its effectiveness, helping some patients but not others. Dr. Rabinovitch and his colleagues set out to better understand its variable effectiveness.

Two biomarkers were discovered by Associate Professor of Pediatrics Nathan Rabinovitch, MD, and his colleagues that can prove helpful to physicians in accurately determining as to which all of their asthmatic patients can benefit from montelukast.