The Changing Face of AIDS

AIDS first came to the medical scene and public attention in the 1970’s; then a diagnosis of AIDS was a death sentence. The life expectancy of anyone who had contracted the disease was very short making a study of the long term effects of the disease difficult.

The rapidly mutating virus developed resistance to the drugs that were used to suppress it. In the mid 1990’s drug “cocktails,” multi drug combinations of antiretroviral drugs were able to provide barriers to mutation. The number of deaths for AIDS patients dropped dramatically and long term aspects of the disease changed. Victims could expect longer life spans though they would require medication the rest of their lives.

The longer life expectancy of AIDS patients presented another set of problems. AIDS patients are living longer, but they are aging faster. Those in the 50 to 60 age group who suffer from AIDS, have the health issues that most people do not experience until they are a decade older.

The number of AIDS sufferers over the age of 50 has increased by 77% from 2001 to 2005, and now more than a quarter of the approximately one million active AIDS cases in this country are advanced in age. Of 5,049 patients who began AIDS therapy between 1995 and 2004, 997 were over the age of 50, 1,834 were 40-49 and the rest were between 18-39 years of age. AIDS presented new challenges to the medical community in the 70’s and 80’s and now the problems presented in the aging AIDS population is again challenging the medical community.

There is presently no data that specifically compares the onset of geriatric diseases between AIDS and non AIDS patients, but the medical community says that people in their mid-50’s, without AIDS, usually do not have heart disease or diabetes associated with lipodystrophy or oesteoporosis without additional risk factors.

Lipodystrophy is a side effect of the drugs that keeps HIV in check. It rearranges fat in the body and can lead to the sunken eyes and cheeks usually associated with advanced age. It can lead to insulin resistance and raise triglyceride levels. Individuals on AIDS therapy treatment are usually treated with corticosteroids to protect against other opportunistic infections that prey on HIV weakened immune systems. This can lead to a bone disease, vascular necrosis, and the necessity for hip replacement surgery. Other aging problems with HIV are the development of memory deficits and liver and kidney disease.

In a Jan 6, 2008 article in the International Herald Tribune, Jane Gross quotes Dr. Tom Barrett, medical director of Howard Brown, “All we can do right now is to make inferences from thing to thing to thing. They might have gotten some of these diseases anyway. But the rates and the timing, and the association with certain drugs, makes everyone feel that this is a different problem.”

Why is this happening? There haven’t been any studies to provide sound statistics of what problems are related to AIDS. Only recently have there been enough aging AIDS patients to study. The initial assumptions are that those who have survived with the AIDS infection, have immune systems and organs that first took a beating from the disease, and then were further damaged by the toxicity of the antiretroviral drugs which they took to survive the disease.

With lack of research, patient care suffers. Barrett says the incidence of osteoporosis warrants routine screening. However, in the United States, Medicare, Medicaid and most private insurers will not cover bone density tests for middle aged men.

The New York-based AIDS Community Research Initiative of America, in trying to provide help and assistance to older individuals with AIDS, found that depression, which is common to the elderly, is even higher among longtime AIDS survivors. They often grow despondent because of health issues and the deaths of friends and associates.

Mary Engel, writing in the Los Angeles Times on February 5, 2008 quotes Los Angeles resident and long time survivor Thomas Woolsey, 59, “Everybody I knew died in the late ‘80’s or early ‘90’s. It sounds like I’m the lucky one, but I don’t really think so. What good is a life without any friends?”

Healthy Holiday Eating Tips

The holidays pose a difficult time for those trying to maintain healthy eating habits. The sheer quantity of food favorites available from mid-November through the first of January is a challenge, even for those with the strongest willpower. So how do you strike a happy balance between the holiday smorgasbord and your desire to keep the pounds at bay?

Clearly, the holidays are not a time to diet. But you can take steps to lessen the impact on your waistline.

Never go to a holiday event on an empty stomach. Fasting ahead of time to leave room for that BIG MEAL or extra trips to the buffet is a no-no. Be sure to eat a snack or light meal before leaving home; foods like chicken or cottage cheese which are high in protein help you eat less later.

Offer to bring a dish to holiday parties. Make it a low-calorie version of a favorite, insuring at least one safe choice. Don’t stand near the buffet where you might be tempted to fill your plate again, and again.

If the event is at your house, do yourself and your guests a favor by including healthier items such as salad, fruit and vegetables on the menu. Provide low-calorie and fat-free salad dressings, dips and condiments. When preparing dishes, look for healthy ingredient substitutions such as low-fat or skim milk instead of whole milk and swap applesauce for oil in baked goods. The dishes can be just as tasty without all the added fat and calories.

Watch your portion sizes. This becomes especially important at a buffet, where there are so many choices, each looking so inviting. You can still have a large variety of food; just eat a small portion of each.

Slow down. Don’t eat as if you’re at an eating competition. Choose your food carefully and then eat slowly, savoring the flavor of each bite. Most people eat so quickly, their stomach is full long before the signal reaches their brain; which usually leads to overeating and that bloated, miserable feeling.

Do your best to stick with an exercise program. Exercise not only helps keep away the pounds but also helps to reduce the stress which often accompanies family get-togethers and social events. After the meal, take the socializing outdoors for a nice walk around the neighborhood or to a nearby park.

Don’t fall into the fast food trap. The holiday season can be hectic and leave you with little time to prepare healthy meals. Plan ahead; prepare meals ahead of time and freeze them so they are handy when you need them.

Be realistic. Holidays are a time for fun and you will want to join in. Instead of dieting, try aiming for maintaining your present weight by making smart eating choices and staying active. Pat yourself on the back for all of your efforts!

Traditional Chinese Medicine may reduce the side-effects of chemotherapy

Traditional Chinese Medicine (TCM) may help in reducing the side-effects for breast cancer patients undergoing chemotherapy, according to a recent study conducted by the Cochran Collaboration. The Cochran Library is an independent evidence based research group that provides evidence to inform healthcare decision-making.

Although chemotherapy is still considered the best treatment for breast cancer, the side effects can be very unpleasant. Side-effects include nausea and vomiting, decrease in bone marrow density, mouth soreness, lower resistance to infections, hair loss, and weakness and fatigue. More than half of the women that undergo chemotherapy suffer from one or more of these side-effects.

The purpose of the review was to evaluate the safety and effectiveness of using traditional Chinese Medicinal Herbs to reduce the side effects of chemotherapy. The study followed 542 women with breast cancer undergoing chemotherapy, and concluded while there was no statistical evidence to suggest that Chinese Medicinal Herbs could be harmful, the use of Medicinal Herbs may offer some benefit to those breast cancer patients undergoing chemotherapy in terms of bone marrow improvement and quality of life. There are approximately 50 fundamental herbs used in Chinese medicine and combinations of these herbs make up herbal remedies. For this study, six common herbal remedies were tested.

Despite widespread use of alternative medicine, such as Traditional Chinese Medicine, historically, there have been very few clinical trials to measure the health outcomes from their use. The Cochran study is a welcomed step forward in this direction. The authors admit that more well designed trials are required and that the evidence in this study it too limited to provide confident conclusions.

Consumers: Beware of Counterfeit Colgate Toothpaste

Consumers should be on the look-out for illegally manufactured counterfeit toothpaste falsely labeled as “Colgate” and imported from South Africa. Updated information shows this product contains harmful bacteria, but authorities did not elaborate as to what the bacteria are. This update comes from additional developments included in a report by Canadian health authorities as well as Colgate’s own investigation.

In the initial recall announcement, the importer, MS USA Trading, Inc. of North Bergen, N.J., said the toothpaste may contain diethylene glycol, a chemical found in antifreeze. The trading company said the problem was discovered in routine testing by the Food and Drug Administration.

Colgate-Palmolive assures customers that “counterfeit toothpaste is not manufactured or distributed by Colgate and has no connection with the company whatsoever”. They also add that diethylene glycol is not now and has never been an ingredient in Colgate toothpaste anywhere in the world.

According to a Colgate-Palmolive news release, the counterfeit products were found in several ‘dollar-type discount stores’ in Maryland, New Jersey, New York, and Pennsylvania. Updated information also includes small discount retailers in Canada.

Colgate-Palmolive, in cooperation with government health and law enforcement authorities, continues to remove counterfeit toothpaste from the shelves of retail stores. Here are some indicators to look for to identify the counterfeit product:

• The counterfeit toothpaste is labeled as a five ounce or 100 ml tube, a size not made or sold by Colgate in the United States.
• Includes regular, gel, triple and herbal versions.
• There are words on the package, “Manufactured by: COLGATE-PALMOLIVE (PTV) LTD., SOUTH AFRICA-52 Commissioner Street, Boksburg, 1460”
• There may be several misspelled words on the product carton including: “isclinically”, “SOUTH AFRLCA” and “South African Dental Assoxiation”.

Colgate products are sold in a wide variety of retail outlets including supermarkets, pharmacies, general merchandise stores, large dollar stores and club stores. To help you identify genuine Colgate toothpaste made for sale in the United States, look for:

• The words “Distr. by Colgate-Palmolive, New York, NY 10022” appear in the lower right-hand corner of the panel on the box.
• In the white box that contains the UPC bar code genuine Colgate products for sale in the U.S. begin with the code number 35000.

Colgate says it is working closely with the FDA to help identify those responsible for the counterfeit product.

If you suspect that you have counterfeit product, do not use it. Visit the FDA’s web site (www.fda.gov) for more information or call Colgate’s customer service line (1-800-468-6502)

Key To Long Life

A study has shown that men who exercise, are the right weight and do not smoke during retirement increase their chances of living for another 25 years, reported The Daily Telegraph. The Guardian also covered the story and said the chances of reaching 90 were surprisingly dependent on behaviour from age 70 onwards.

Both newspapers gave a list of adverse factors and their estimated effect on the odds of a 70 year old man reaching 90. These included high blood pressure, lack of exercise, smoking, obesity, diabetes, and a sedentary lifestyle.

This study adds to the body of knowledge on what contributes to exceptional longevity in this age group: that smoking is bad and exercise and a healthy weight are good. However, the study did not look at all the factors that can affect lifespan. Also, the study was carried out in mainly white, middle class men in the US so the findings may not apply to all 70 year olds.

What were the results of the study?

The researchers found that of the 2,357 men aged around 70 when they enrolled in the study, 970 (41%) men survived to age 90.

Those men who did not have high blood pressure, were not sedentary, did not smoke, and were not obese or diabetic at the start of the study had a 54% chance of living to 90 years old.

Men who smoked at the start of the study had only a 25% chance of living to 90 years old. Having a combination of different adverse effects at enrolment reduced the probability of survival even further, e.g. someone who was sedentary, with high blood pressure and diabetes had a 19% chance of surviving to 90 years old, while someone with all five risk factors had only a 4% chance of still being alive 20 years later.

This was a large study and there were other relevant findings: smoking or being overweight was associated with worse physical ability, while moderate, vigorous exercise was associated with better physical ability. Not surprisingly, the men who lived to 90 or older were less likely to have cancer, heart disease, or other diseases associated with high mortality.

Blood test detects ovarian cancer early

Researchers have developed what they believe is the first blood test that accurately detects ovarian cancer at an early stage.“The ability to recognize almost 100% of new tumours will have a major impact on the high death rates of this cancer,” senior author Dr. Gil Mor, from Yale University School of Medicine in New Haven, Connecticut, said in a statement. “We hope this test will become the standard of care for women having routine examinations.”

In 2005, Mor’s team first described a panel of biomarkers that can detect stage I and II ovarian cancer.

In the present trial, reported in the medical journal Clinical Cancer Research, the researchers expanded the panel from four proteins to six, and used a sophisticated assay system to measure protein levels in 362 healthy women and 156 patients newly diagnosed with ovarian cancer.

Alone, none of the biomarkers could distinguish the cancer patients from the healthy comparison group, the researchers report. When all six biomarkers were measured, however, the test identified 95 percent of the cancer patients.

A larger evaluation of the biomarker assay is currently underway.