“This is a major stride in migraine science,” said David W. Dodick, president of the American Headache Society, and professor of neurology at the Mayo Clinic College of Medicine, and the director of the Headache Program in Phoenix, Arizona. Underscoring the significance of the findings, Dr. Dodick said, “It is the first study to identify a genetic risk factor for the common subtypes of migraine, and provides some support for the general concept of migraine as a state of brain hyperexcitability. It also supports previous research findings on the potential role of glutamate in migraine , as well novel glutamate modulating drugs that are currently being tested in migraine. Further work may provide insight into the precise molecular mechanism(s) of migraine as well as future targets for novel therapies.”

The team found that patients with a particular DNA variant on Chromosome 8 between two genes — PGCP and MTDH/AEG-1 — have a significantly greater risk for developing migraine. It appears that the associated DNA variant regulates levels of glutamate — a chemical, known as a neurotransmitter, which transports messages between nerve cells in the brain. Prevention of the build up of glutamate at the synapse (space between nerve endings) may provide a promising target for novel therapeutics to ease the burden of the disease, according to Dr. Dodick. Although researchers have in the past described genetic mutations giving rise to rare and extreme forms of migraine, this is the first time a team has identified a genetic variant giving rise to the common forms of the condition.

Why keep food cold? Harmful bacteria multiply rapidly in the “Danger Zone” — the temperatures between 40 and 140 °F. So, perishable food transported without an ice source won’t stay safe long. Here are safe handling recommendations to prevent foodborne illness from “bag” lunches.

Begin with Safe Food
Perishable food, such as raw or cooked meat and poultry, must be kept cold or frozen at the store and at home. Eggs should be purchased cold at the store and kept cold at home. In between, transport perishable food as fast as possible when no ice source is available. At the destination, it must be kept cold. Food should not be left out at room temperature more than 2 hours (1 hour if the temperature is above 90 °F).

Prepackaged combos that contain luncheon meats along with crackers, cheese, and condiments must also be kept refrigerated. This includes luncheon meats and smoked ham which are cured or contain preservatives.

Keep Everything Clean
Wash your hands before you prepare or eat food. Wash cutting boards, dishes, utensils, and countertops with hot, soapy water after preparing each food item and before you go on to the next item. A solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water may be used to sanitize surfaces and utensils. Keep family pets away from kitchen counters.

Don’t Cross-Contaminate
Harmful bacteria can spread throughout the kitchen and get onto cutting boards, utensils, and countertops. Always use a clean cutting board. When using a cutting board for food that will not be cooked, such as bread, lettuce, and tomatoes, be sure to wash the board after using it to cut raw meat and poultry. Use one cutting board for fresh produce and a separate one for meat and poultry.

At lunchtime, discard all used food packaging and paper bags. Do not reuse packaging because it could contaminate other food and cause foodborne illness.

Packing Lunches
Pack just the amount of perishable food that can be eaten at lunch. That way, there won’t be a problem about the storage or safety of leftovers.

It’s fine to prepare the food the night before and store the packed lunch in the refrigerator. Freezing sandwiches helps them stay cold. However, for best quality, don’t freeze sandwiches containing mayonnaise, lettuce, or tomatoes. Add these later.

Insulated, soft-sided lunch boxes or bags are best for keeping food cold, but metal or plastic lunch boxes and paper bags can also be used. If using paper lunch bags, create layers by double bagging to help insulate the food. An ice source should be packed with perishable food in any type of lunch bag or box.

Keeping Cold Lunches Cold
Prepare cooked food, such as turkey, ham, chicken, and vegetable or pasta salads, ahead of time to allow for thorough chilling in the refrigerator. Divide large amounts of food into shallow containers for fast chilling and easier use. Keep cooked food refrigerated until time to leave home.

To keep lunches cold away from home, include a small frozen gel pack or frozen juice box. Of course, if there’s a refrigerator available, store perishable items there upon arrival.

Some food is safe without a cold source. Items that don’t require refrigeration include whole fruits and vegetables, hard cheese, canned meat and fish, chips, breads, crackers, peanut butter, jelly, mustard, and pickles.

Keeping Hot Lunches Hot
Use an insulated container to keep food like soup, chili, and stew hot. Fill the container with boiling water, let stand for a few minutes, empty, and then put in the piping hot food. Keep the insulated container closed until lunchtime to keep the food hot — 140 °F or above.

Microwave Cooking/Reheating
When using the microwave oven to reheat lunches, cover food to hold in moisture and promote safe, even heating. Reheat leftovers to at least 165 °F. Food should be steaming hot. Cook frozen convenience meals according to package instructions.

In a July 22 letter, the Food and Drug Administration (FDA) reminds health professionals that using unapproved IUDs raises concerns about effectiveness and safety—as well as the potential for fraud and counterfeiting.

“Federal law requires that IUD/IUSs (intrauterine systems) be FDA-approved prior to marketing. This law is designed to protect patients from products that are unsafe and ineffective,” Theresa Toigo, FDA’s liaison with health professionals, says in the letter. “The recent issue with patients in Rhode Island unknowingly receiving imported, unapproved IUD/IUSs highlights the unacceptable risk patients may be exposed to when a product’s identity, purity, source, handling, and storage cannot be verified.”

Still, patients can use their FDA-approved IUDs with confidence, Toigo says.

FDA experts say women who received unapproved IUDs from practitioners in Rhode Island, Massachusetts, and Kentucky could be at an increased risk for unwanted pregnancy.

The small, T-shaped devices—often made of flexible plastic or copper wire—are inserted into a woman’s uterus to prevent pregnancy. Some IUDs also deliver small amounts of hormone as added protection from pregnancy.

FDA says women should not try to remove IUDs by themselves. The agency is advising women who think they may have an unapproved IUD to use another form of birth control—such as condoms, birth control pills, or the patch—and contact their health care professional. Women may want to ask:

• What advantages are there for keeping my IUD in?
• Should I think about having my IUD removed?
• If I keep my IUD in, how long should I use another form of birth control?
• If I want my IUD removed, can I get a new, FDA-approved one?
• I don’t want to use condoms. Will other birth control products, such as the pill, patch, or ring, be equally effective?
• Will this affect my ability to get pregnant in the future?
• What should I do if I think I’m pregnant?

Nationwide Problem

What started out as a Rhode Island investigation has spread beyond the state’s borders. The FDA is aware of the use of these unapproved products in several states and is continuing to investigate.

FDA says doctors, nurses, midwives—and possibly patients themselves—might buy unapproved products from what appear to be Canadian or other foreign websites in a bid to save money. Purchasing medical products from websites that are outside of the U.S. may be illegal and may increase the risk of receiving a potentially harmful product, since many websites sell products that are not FDA-approved and could be manufactured in other countries.

“Unapproved products bring a lot of unknowns into the equation,” says FDA compliance officer Kathleen Anderson. “An Internet ad may claim to sell IUDs made in Canada, but there’s no way to be sure. They might have been made anywhere in the world and in unsanitary or undesirable conditions.”

Advice for Consumers

FDA investigators routinely monitor the Internet for the sale of unapproved drugs and devices in an effort to protect the public, but the rapidly growing number of websites trafficking in fraudulent medical products means consumers must remain alert.

Experts advise consumers to learn how to buy health-related products safely over the Internet. Legitimate Internet pharmacies are licensed by the appropriate state board of pharmacy and follow laws and regulations of the state where they operate.

Legitimate Internet pharmacies will also display a seal from the National Association of Boards of Pharmacy—known as VIPPS seal or Verified Internet Pharmacy Practice Sites. VIPPS pharmacies are listed at vipps.nabp.net/verify.asp⁴.

FDA is also asking the public to report information about the distribution of unapproved IUDs. To contact the agency’s criminal investigators visit www.fda.gov/oci⁵.

This article appears on FDA’s Consumer Updates page⁶, which features the latest on all FDA-regulated products.

Chili peppers contain an ingredient that may cause weight loss and fight fat.

Capsaicin, the stuff that gives chili peppers their kick, may cause weight loss and fight fat buildup by triggering certain beneficial protein changes in the body, according to a new study on the topic. The report, which could lead to new treatments for obesity, appears in ACS’ monthly Journal of Proteome Research.

Jong Won Yun and colleagues point out that obesity is a major public health threat worldwide, linked to diabetes, high blood pressure, heart disease, and other health problems. Laboratory studies have hinted that capsaicin may help fight obesity by decreasing calorie intake, shrinking fat tissue, and lowering fat levels in the blood. Nobody, however, knows exactly how capsaicin might trigger such beneficial effects.

In an effort to find out, the scientists fed high-fat diets with or without capsaicin to lab rats used to study obesity. The capsaicin-treated rats lost 8 percent of their body weight and showed changes in levels of at least 20 key proteins found in fat. The altered proteins work to break down fats. “These changes provide valuable new molecular insights into the mechanism of the antiobesity effects of capsaicin,” the scientists say.

via Using Malaria Medication for Leg Cramps is Risky.

In this report …

Chapters are in Adobe Acrobat PDF format.

• Report summary, 197 kb.

• Entire Report, 800 kb.

BACKGROUND: The product is distributed on Internet sites and online auctions by multiple independent distributors participating in an online multi-level marketing scheme. It is sold in a 2-serving box and a 12-serving carton containing six 2-serving boxes.

RECOMMENDATION: Consumers who have Magic Power Coffee should stop using it immediately. The FDA advises consumers who have experienced any negative side effects from sexual enhancement products to consult a health care professional and to safely discard the product.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

• Online: www.fda.gov/MedWatch/report.htm
• Phone: 1-800-332-1088
• Mail: return the postage-paid FDA form 3500, which may be downloaded from the MedWatch “Download Forms” page, to address on the pre-addressed form
• Fax: 1-800-FDA-0178

“This is the first study with a sufficient sample size to evaluate the association between PBDE flame retardants and thyroid function in pregnant women,” said the study’s lead author, Jonathan Chevrier, a UC Berkeley researcher in epidemiology and in environmental health sciences. “Normal maternal thyroid hormone levels are essential for normal fetal growth and brain development, so our findings could have significant public health implications. These results suggest that a closer examination between PBDEs and these outcomes is needed.”

PBDEs, or polybrominated diphenyl ethers, are a class of organobromine compounds found in common household items such as carpets, textiles, foam furnishings, electronics and plastics. U.S. fire safety standards implemented in the 1970s led to increased use of PBDEs, which can leach out into the environment and accumulate in human fat cells.

Studies suggest that PBDEs can be found in the blood of up to 97 percent of U.S. residents, and at levels 20 times higher than those of people in Europe. Because of California’s flammability laws, residents in this state have some of the highest exposures to PBDEs in the world.

“Despite the prevalence of these flame retardants, there are few studies that have examined their impact on human health,” said the study’s principal investigator, Brenda Eskenazi, UC Berkeley professor of epidemiology and of maternal and child health. “Our results suggest that exposure to PBDE flame retardants may have unanticipated human health risks.”

The new study, to be published June 21 in the journal Environmental Health Perspectives, is the second study to come out this year from Eskenazi’s research group linking PBDEs to human health effects. Eskenazi was the principal investigator on the earlier study that found that women with higher exposures to flame retardants took longer to get pregnant.

In the new study, the researchers analyzed blood samples from 270 women taken around the end of their second trimester of pregnancy. The women in the study were part of a larger longitudinal study from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) that examines environmental exposures and reproductive health.

The researchers measured concentrations of 10 PBDE chemicals, two types of thyroxine (T4) and thyroid-stimulating hormone (TSH). They controlled for such factors as maternal smoking, alcohol and drug use, and exposure to lead and pesticides.

Analysis focused on the five PBDE chemicals that were detected most frequently and are components of a mixture called pentaBDE. The researchers found that a 10-fold increase in each of the PBDE chemicals was associated with decreases in TSH ranging from 10.9 percent to 18.7 percent. When the five PBDEs were analyzed together, a tenfold increase was linked to a 16.8 percent decrease in TSH.

The study did not find a statistically significant effect of PBDE concentrations on levels of T4. With one exception, all the women in the study with low TSH levels had normal free T4 levels, which corresponds to the definition of subclinical hyperthyroidism. The study found that odds of subclinical hyperthyroidism were increased 1.9 times for each tenfold increase in PBDE concentrations.

“Low TSH and normal T4 levels are an indication of subclinical hyperthyroidism, which is often the first step leading toward clinical hyperthyroidism,” said Chevrier. “Though the health effect of subclinical hyperthyroidism during pregnancy is not well understood, maternal clinical hyperthyroidism is linked to altered fetal neurodevelopment, increased risk of miscarriage, premature birth and intrauterine growth retardation.”

Exactly how flame retardants influence TSH levels is unclear, the researchers said, but animal studies have shown that certain PBDEs can mimic thyroid hormones.

In addition to the commercial mixture pentaBDE, octaBDE and decaBDE have been developed for use as commercial flame retardants. PentaBDE and octaBDE have both been banned for use by the Stockholm Convention on Persistent Organic Pollutants, the European Union and eight U.S. states, including California, but they are still present in products made before 2004.

The production of decaBDE by major manufacturers is scheduled to be phased out in the United States by 2013. However, pentaBDE and decaBDE are being replaced by new brominated and chlorinated compounds whose impact on human health is not yet clear, the researchers noted.

The survey asked if they’d ever taken a prescription drug such as OxyContin, Percocet, Vicodin, Adderall, Ritalin, or Xanax, without a doctor’s prescription.  Prescription drug abuse was most common among white students (23 percent), followed by Hispanic students (17 percent) and then black students (12 percent).  Prescription drug abuse was most common among 12th grade students (26 percent) and lowest among 9th grade students (15 percent). There was no difference in prescription drug abuse by gender (20 percent for both male and female students).

“We are concerned to learn that so many high school students are taking prescription drugs that were not prescribed to them,” said Howell Wechsler, EdD, MPH, director of CDC’s Division of Adolescent and School Health.  “Some people may falsely believe that prescription drugs are safer than illegal drugs, yet their misuse can cause serious adverse health effects, including addiction and death.”

The YRBS also asks several questions related to alcohol and drug use.  The 2009 survey found that about 72 percent of high school students ever used alcohol, about 37 percent ever used marijuana, 6.4 percent ever used cocaine, 4.1 percent ever used methamphetamine, and 6.7 percent ever used ecstasy.  These percentages are similar to those found in the 2007 survey.

Further analysis of National YRBS data showed encouraging trends in nutrition-related behaviors in recent years:

• A decrease in the percentage of students who drank soda at least once per day (34 percent in 2007; 29 percent in 2009)
• An increase in the percentage of students who ate fruit or drank 100 percent fruit juice two or more times per day (30 percent in 2005; 34 percent in 2009)
• Decreases in the percentages of students who engaged in the following unhealthy behaviors  to lose or keep from gaining weight: not eating for 24 or more hours (13 percent in 2001; 11 percent in 2009); taking diet pills, powders, or liquids (9 percent in 2001; 5 percent in 2009); and vomiting or taking laxatives (6 percent in 2003; 4 percent in 2009)

The 2009 National YRBS results also show that many high school students engage in other risk behaviors, which are harmful to their overall health and increase their risk of disease and injury. For example, during the seven days before the survey, 78 percent of high school students had not eaten fruits and vegetables five or more times per day, and 82 percent were not physically active for at least 60 minutes daily.  Also, during the 30 days before the survey, 19 percent of high school students smoked cigarettes, 28 percent rode in a car or other vehicle driven by someone who had been drinking alcohol, and 39 percent of currently sexually active students reported that they did not use a condom the last time they had sexual intercourse.  This information is similar to the 2007 YRBS findings.

About YRBS
National, state, and local YRBS studies are conducted every two years among high school students throughout the United States.  These surveys monitor health risk behaviors including unintentional injuries and violence; tobacco, alcohol, and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection; unhealthy dietary behaviors; and physical inactivity. These surveys also monitor the prevalence of obesity and asthma.

More than 16,000 U.S. high school students participated in the 2009 National YRBS.  Data are presented only for black, Hispanic, and white students because the sample size of students from other racial/ethnic populations was too small for meaningful analysis. Parental permission was obtained for students to participate in the survey.  Student participation was voluntary, and responses were anonymous. States and cities could modify the questionnaire to meet their needs. The 2009 report includes national data and data from surveys conducted in 42 states and 20 large urban school districts.

The National YRBS is one of three HHS-sponsored surveys that provide data on substance abuse among youth.  The others are the National Survey on Drug Use and Health (NSDUH), sponsored by the Substance Abuse and Mental Health Services Administration and a primary source of statistics on substance use among Americans age 12 and over (www.oas.samhsa.gov/nhsda.htm), and the Monitoring the Future (MTF) Study funded by the National Institute on Drug Abuse and conducted by the University of Michigan’s Institute for Social Research (http://monitoringthefuture.org). MTF tracks substance use and related attitudes among students in the 8th, 10th and 12th grades.

The 2009 Youth Risk Behavior Survey data are available at www.cdc.gov/yrbs.

Certification signifies that the services provided by the hospital have the critical elements to achieve long-term success in improving outcomes. It also shows the community that the quality care provided by the hospital is effectively managed to meet the specialized needs of stroke patients.

“Stroke patients require immediate and specialized care to lessen the long-term effects of a stroke,” said Barbara Doyle, CEO, Inova Mount Vernon Hospital. “This certification is a reminder to our community that we have dedicated resources and highly trained staff needed to effectively treat a stroke patient during an emergency.”

As part of the Joint Commission certification review, clinical experts reviewed the hospital’s standard practices and outcomes. Inova Mount Vernon Hospital earned the certification by demonstrating compliance with the Joint Commission’s national standards for stroke care, quality and safety.

Inova Mount Vernon joins Inova Alexandria, Inova Fairfax, and Inova Loudoun hospitals as designated Primary Stroke Centers.

The Joint Commission, an independent, not-for-profit organization, is the nation’s predominant standards-setting and accrediting body in healthcare. Its Primary Stroke Center Certification program was developed through a collaboration with the American Stroke Association.

According to the American Heart Association, about 795,000 Americans suffer a new or recurrent stroke each year. Stroke kills more than 143,000 people per year and is the third-leading cause of death in the United States. Visit inova.org/stroke for additional information about stroke and its warning signs.