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Jackson death ruled homicide

From the Detroit Free Press:

On Monday, the Los Angeles County Coroner's Office released an amended death certificate in which the cause of death is listed as homicide brought on by a lethal cocktail of drugs, specifically "acute propofol intoxication." The effects of benzodiazepine are listed as a contributing factor, according to

A host of other drugs is listed in the report.

Though there have been no official charges against Dr. Conrad Murray, who administered the propofol, manslaughter charges are expected.

Posted: 1/12/2010 12:22:00 PM

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Toxic Metal in Kids' Jewelry From China

From The New York Times:

Barred from using lead in children's jewelry because of its toxicity, some Chinese manufacturers have been substituting the more dangerous heavy metal cadmium in sparkling charm bracelets and shiny pendants being sold throughout the United States, an Associated Press investigation shows.

The most contaminated piece analyzed in lab testing performed for the AP contained a startling 91 percent cadmium by weight. The cadmium content of other contaminated trinkets, all purchased at national and regional chains or franchises, tested at 89 percent, 86 percent and 84 percent by weight. The testing also showed that some items easily shed the heavy metal, raising additional concerns about the levels of exposure to children.

Cadmium is a known carcinogen. Like lead, it can hinder brain development in the very young, according to recent research.

Children don't have to swallow an item to be exposed -- they can get persistent, low-level doses by regularly sucking or biting jewelry with a high cadmium content.

To gauge cadmium's prevalence in children's jewelry, the AP organized lab testing of 103 items bought in New York, Ohio, Texas and California. All but one were purchased in November or December.

The results: 12 percent of the pieces of jewelry contained at least 10 percent cadmium.

''There's nothing positive that you can say about this metal. It's a poison,'' said Bruce A. Fowler, a cadmium specialist and toxicologist with the U.S. Centers for Disease Control and Prevention. On the CDC's priority list of 275 most hazardous substances in the environment, cadmium ranks No. 7.

There is no definitive explanation for why children's jewelry manufacturers, virtually all from China in the items tested, are turning to cadmium. But a reasonable double whammy looms: With lead heavily regulated under the Consumer Product Safety Improvement Act of 2008, factories scrambled for substitutes, just as cadmium prices plummeted.

To determine how much cadmium a child could be exposed to, items are bathed in a solution that mimics stomach acid to see how much of the toxin would leach out after being swallowed.

The jewelry testing for AP was conducted by chemistry professor Jeff Weidenhamer of Ashland University in Ohio, who over the past few years has provided the CPSC with results showing high lead content in products that were later recalled. His lab work for AP assessed how much cadmium was in each item. Overall, 12 of the 103 items each contained at least 10 percent cadmium. Two others contained lower amounts, while the other 89 were clean.

Ten of the items with the highest cadmium content were then run through the stomach acid test to see how much would escape. Although that test is used only in regulation of toys, AP used it to see what hazard an item could pose because unlike the regulations, a child's body doesn't distinguish between cadmium leached from jewelry and cadmium leached from a toy.

An official at FAF's headquarters did not respond to multiple requests for comment when informed of Weidenhamer's results; a woman at the company's office in southern China who would not give her name said FAF products ''might naturally contain some very small amounts of cadmium. We measure it in parts per million because the content is so small, for instance one part per million.'' However, the tests conducted for AP showed the pendants contained between 246,000 and 346,000 parts per million of cadmium.

''It comes down to the following: Cadmium causes cancer. How much cadmium do you want your child eating?'' said Michael R. Harbut, a doctor who has treated adult victims of cadmium poisoning and is director of the environmental cancer program at the Karmanos Cancer Institute in Detroit. ''In my view, the answer should be none.''

Posted: 1/11/2010 10:17:00 AM

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Study: Antidepressant lift may be all in your head

From USA Today:

A small new study provides more evidence that, on average, antidepressants may be little more effective than a sugar pill in most patients who take them.

Antidepressants are among the most-prescribed drugs in the USA. More than 164 million prescriptions were dispensed in 2008, according to IMS Health.

Robert DeRubeis, a psychologist at the University of Pennsylvania, and his team pooled data from six trials in which a total of 718 depressed patients were randomly assigned to take either an antidepressant or a placebo. The authors obtained patient-specific data from scientists involved with each trial.

Antidepressants were more effective than a placebo only for patients with very severe depression, who made up 40% of trial participants but, according to a recent survey cited in DeRubeis' paper, represent fewer than 30% of depressed people who seek treatment in the real world.

In a statement, Food and Drug Administration spokeswoman Karen Riley called DeRubeis' paper "useful."

A larger study published in February 2008 reached conclusions similar to those in DeRubeis' paper. In the 2008 study, researchers pooled data from all clinical trials submitted to the FDA for the licensing of Prozac, Serzone (no longer on the market), Effexor and Paxil.

Posted: 1/7/2010 1:50:00 PM

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Pain Management Failing as Fears of Prescription Drug Abuse Rise

From ScienceDaily:

Millions of Americans with significant or chronic pain associated with their medical problems are being under-treated as physicians increasingly fail to provide comprehensive pain treatment -- either due to inadequate training, personal biases or fear of prescription drug abuse.

A pharmaceutical expert in pain management in the College of Pharmacy at Oregon State University says the issue is reaching crisis proportions, and in two new professional publications argues that health consumers must be aware of the problem and in many cases become more informed, persistent advocates for the care they need and deserve.

Adequate pain treatment has always been a concern, said Kathryn Hahn, a pharmacist, affiliate faculty member at OSU and chair of the Oregon Pain Management Commission, in part because it's not a major part of most physician's medical training. Even though they will often see a stream of patients with pain problems throughout their careers, they may only get a few hours of education on the use of opioids in medical school.

In recent years, the problems have dramatically increased due to concerns about prescription drug abuse, in which drugs such as oxycodone are often stolen from homes or otherwise misused. In a 2006 survey of teenagers, 62 percent said prescription pain relievers were easy to get from their parents' medicine cabinet. One analysis concluded that admissions to federally supported treatment programs for prescription opioid abuse increased 342 percent from 1996 to 2006 -- a comprehensive problem that is also estimated to cost insurance companies tens of billions of dollars a year.

"Surveys show that at least 30 percent of patients with moderate chronic pain and more than 50 percent of those with severe chronic pain fail to achieve adequate pain relief," she wrote in one article. "The economic impact of acute and chronic pain exceeds $100 billion per year in the U.S. alone."

Community pharmacists, she said, are often on the front lines of this issue and constantly see individuals with pain concerns and inadequate pain management by their health care providers. They can often help serve as advocates, improve lines of communication between patients and their doctors, and help patients manage their prescribed drug therapies.

Health insurers also have an important role to play in reducing prescription drug abuse, Hahn said. They can help educate physicians on appropriate use, advocate for universal precautions in use of pain medicines, restrict off-label uses of readily diverted opioids, pay for multidisciplinary pain management programs, and take other steps.

Posted: 1/6/2010 9:11:00 AM

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Bodegas, barbershops dealing sweet liquor punch 'Nutcrackers' to city teens

From the New York Daily News:

The city's bodegas and barbershops are secretly selling kids as young as 14 an illegal and potent mix of fruit punch and alcohol, a Daily News investigation found.

"Nutcrackers," and a frozen version called the "Nemo," sell for $5 or $10 a cup - an easy buzz for teens who like the sweet taste and the cheap price.

A News reporter was able to buy the blend of punch and vodka, white rum or tequila at five shops in upper Manhattan and the Bronx last week, including a Washington Heights natural juice spot.

"Kids like them. You don't need ID to get them. It is like your first step toward drinking liquor," said Shaquel, a 15-year-old who declined to give his last name.

To make the street cocktails even more appealing to teens, some sellers add liquor to piña colada mix or drop a Jolly Rancher candy at the bottom of the cup.

"It is a real phenomenon right now, and it needs a law enforcement response," said Dr. Peter Provet, head of the Odyssey House, a drug and alcohol rehabilitation clinic for teens. "Kids who start to abuse alcohol start to abuse things that are sweet."

Police brass said cracking down on nutcracker sales are a low priority for officers in high-crime precincts who are busy battling drug dealers and gangs.

If cops catch someone selling the drink, the punishment is a mere summons for illegal sale of alcohol, with fines ranging from several hundred dollars to, in the rare instance, more than $1,000.

Posted: 1/4/2010 8:35:00 AM

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