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Three companies advertising cures:

1. Young Living claims their Young Living Essential Oil Products cure conditions such as, but not limited to, viral infections (including ebola), Parkinson’s disease, autism, diabetes, hypertension, cancer, insomnia, heart disease, post-traumatic stress disorder (PTSD), dementia, and multiple sclerosis.

2.Natural Solutions Foundation claims their products such as "The Silver Solution", "CBD Organic Dark Chocolate Bars(High Potency CBD Hemp Oil)" prevent disease.

3. dōTERRA International, LLC is claiming dōTERRA Essential Oil products help or cure conditions including, but not limited to, viral infections (including ebola), bacterial infections, cancer, brain injury, autism, endometriosis, Grave’s Disease, Alzheimer’s Disease, tumor reduction & ADD/ADHD.

These companies have not been approved by the FDA therefore, the FDA has issued warnings to all three companies: on 9/23/14 FDA issued a warning letter to Natural Solutions Foundation: FDA Warning letter to Natural Solutions Foundation. On 9/22/14 FDA issued a warning letter to Young Living: FDA Warning to Young Living. On 9/22/14 FDA issued a warning letter to dōTERRA International, LLC: FDA Warning letter to dōTERRA International, LLC. Apparently the companies products are not approved by the FDA. Leads me to believe these products actually work!

Antiepileptic Drug Use in Pregnancy Likely Not Associated with Spontaneous Abortion

Use of antiepileptic drugs in pregnancy does not appear to increase the risk for spontaneous abortion, according to an observational study in The BMJ.

Using Danish registries, researchers examined over 980,000 pregnancies from 1997 through 2008; 11% resulted in spontaneous abortion and 0.3% in stillbirth. Overall, 0.5% of pregnancies were exposed to antiepileptic drugs.

After multivariable adjustment, antiepileptic exposure was associated with a 13% increased risk for spontaneous abortion relative to nonexposure; however, the increased risk was significant only among women without epilepsy. In addition, when consecutive pregnancies discordant for antiepileptic use within the same woman were examined, antiepileptics were not associated with spontaneous abortion. The researchers conclude, therefore, that residual confounding may explain the increased risk observed in the main analysis.

Antiepileptics were not significantly associated with risk for stillbirth, although the researchers call the finding "imprecise."

Eleanor Bimla Schwarz of NEJM Journal Watch Women's Health commented, "This study highlights that the risks associated with untreated maternal disease in pregnancy are generally worse than those associated with maternal use of medication, especially for women with epilepsy."

Author: Amy Orciari Herman
Dated: August 25, 2014
Source: NEJM
Edited: Susan Sadoughi, MD & André Sofair, MD, MPH

Consumer Reports: Pregnant Women Should Avoid All Tuna

Pregnant women should avoid eating tuna altogether because of the risk for mercury exposure, says Consumer Reports. The recommendation is at odds with the FDA and EPA, which recently proposed that pregnant women eat 8-12 oz. of low-mercury seafood, including canned light tuna, weekly.

The agencies recommended limiting consumption of albacore tuna to 6 oz. per week. But Consumer Reports' analysis of FDA data found that a 125-pound woman could exceed the EPA's recommended mercury consumption limit by eating just 4 oz. weekly. Canned light tuna does, on average, contain less mercury than albacore, but FDA data indicate that 20% of canned light tuna samples contained double the average level of mercury.

In addition, Consumer Reports recommends that young children, women of childbearing age, and people who eat 24 oz. of fish per week or more should not eat yellowfin and big eye tuna in sushi since these are high-mercury fish.

Author: Kelly Young
Dated: August 22, 2014
Source: NEJM
Edited: André Sofair, MD, MPH
Additional Info: Consumer Reports

Hydrocodone Products to Get More Severe, Schedule II Classification

Combination hydrocodone products, currently considered Schedule III drugs, will be reclassified as Schedule II because of their high risk for abuse. The new regulation from the Drug Enforcement Administration will take effect in 45 days.

"Schedule II drugs ... are defined as drugs with a high potential for abuse, less abuse potential than Schedule I drugs, with use potentially leading to severe psychological or physical dependence," according to the DEA's definition. "These drugs are also considered dangerous."

The move means the drugs will be subject to tighter government regulations, including more stringent prescribing practices. The most commonly prescribed combination product affected by the ruling is hydrocodone plus acetaminophen (marketed as Vicodin or Lortab).

Author: Amy Orciari Herman
Dated: August 22, 2014
Source: NEJM
Edited: André Sofair, MD, MPH

Study for Treatment of Autism in Adolescents. Nasal Oxytocin vs. Placebo!

No significant differences were noted on caregivers' or clinicians' observation measures, but parents who believed their child received oxytocin reported greater improvements.

Nasal oxytocin's popularity among consumers is evidenced by >200,000 Google hits, >46,000 Google scholar citations, and 175 products available on Amazon.com (accessed 8/9/14). The widespread interest, especially as a treatment for autism in children, contrasts with the paucity of repeated-dose trials in children, although single-dose studies had promising results (NEJM JW Psychiatry Dec 23 2013). In a randomized, double-blind, placebo-controlled study, researchers in Australia examined the efficacy of oxytocin nasal spray (18–24 IU) twice-daily for 8 weeks in 50 high-functioning autistic adolescent boys (age range, 12–18 years; active treatment, 26 boys; placebo, 24). Children were assessed by caregivers' and clinicians' observation measures at baseline, 4 and 8 weeks, and 3-month follow-up.

No significant differences were noted between groups on the primary outcome measures — change in caregiver-reported social responsiveness and clinician-rated global improvement — or on most secondary measures. Of note, parents who believed that their children were on active medication reported greater improvements, but most of these instances were in children who actually received oxytocin. The only serious adverse effect was in one placebo recipient.

Comment

This investigation did not include evaluation of oxytocin plasma levels or genetic polymorphisms. These are relevant because recent data suggest that heritable oxytocin plasma level and oxytocin gene variants affect social functioning in both healthy and autistic children (Proc Natl Acad Sci U S A 2014; 111:12258). Thus, future studies of nasal oxytocin that include plasma and genetic measures might help identify predictors of response.

Parents of autistic children frequently inquire about oxytocin treatment. They can now be informed that nasal oxytocin treatment is not yet scientifically based, but is not known to cause immediate serious adverse effects.

Dated: August 22, 2014
Source: NEJM
Reviewed by: Barbara Geller, MD

Experimental Treatment for Marburg Virus Shows Promise in Primates

An experimental treatment resulted in 100% survival in primates infected with Marburg virus, a filovirus — like Ebola — that causes hemorrhagic fever, according to a study in Science Translational Medicine. Currently, there are no Marburg vaccines or treatments approved for human use.

Twenty-one rhesus macaques were infected with lethal doses of Marburg-Angola virus. Sixteen were given 7 daily intravenous doses of the treatment, a lipid-encapsulated, small-interfering RNA that interferes with how the virus grows once it enters a cell.

By day 9, all monkeys given the control treatment had died, whereas all animals given the active treatment survived, even those who didn't start treatment until 72 hours after infection, when clinical symptoms tend to appear.

The researchers, some of whom hold a patent for the therapy studied, previously published research showing that a similar approach protected monkeys from Ebola virus.

Author: Kelly Young
Dated: August 21, 2014
Source: NEJM
Edited: Susan Sadoughi, MD

Low-Cost Intervention Helps Smokers Quit After Hospital Discharge

An intervention that combines free smoking cessation medication with automated telephone calls can help smokers quit after hospital discharge, a JAMA study finds.

Some 400 hospitalized smokers who wanted to quit were randomized to receive sustained care or standard care after discharge. With sustained care, patients received a free smoking cessation medication of their choice (up to 90 days' supply), plus five automated phone calls over 90 days that provided support and advice and allowed participants to request return calls from counselors as needed. With standard care, patients received a recommendation for a smoking cessation product plus encouragement to call a free quit line.

At 6 months post-discharge, biochemically validated abstinence was achieved by significantly more sustained-care versus standard-care patients (26% vs. 15%). For sustained care, the hospital's cost per quit was $4910 in year one (including costs for training and phone system development) and $2670 in later years.

The authors conclude: "These findings, if replicated, suggest a translatable, low-cost approach to achieving sustained smoking cessation after a hospital stay."

Author: Amy Orciari Herman
Dated: August 20, 2014
Source: NEJM
Edited: Lorenzo Di Francesco, MD, FACP