نبدا بجريدة النيويورك التايمز
دراسه تربط بين بعض المضادات الحيويه وتشوهات وعيوب الولادة
Study Ties Some Antibiotics to Birth Defects
CHICAGO (AP) -- Researchers studying antibiotics in pregnancy have found a surprising link between common drugs used to treat urinary infections and birth defects. Reassuringly, the most-used antibiotics in early pregnancy -- penicillins -- appear to be the safest.
Bacterial infections themselves can cause problems for the fetus if left unchecked, experts said, so pregnant women shouldn't avoid antibiotics entirely. Instead, women should discuss antibiotics choices with their doctors.
The new study is the first large analysis of antibiotic use in pregnancy. It found that mothers of babies with birth defects were more likely than mothers with healthy babies to report taking two types of antibiotics during pregnancy: sulfa drugs (brand names include Thiosulfil Forte and Bactrim) and urinary germicides called nitrofurantoins (brand names include Furadantin and Macrobid).
It was the first time an association had been seen between urinary tract treatments and birth defects, said lead author Krista Crider, a geneticist with the Centers for Disease Control and Prevention, which funded the research. ''Additional studies are going to need to be done to confirm these findings.''
Used for many decades, the antibiotics in question predate the Food and Drug Administration and its requirements for rigorous safety testing. The FDA now grades all drugs for safety to the fetus based on available research, but rigorous studies are so lacking in many cases, that no antibiotics get the highest grade of ''A.''
Sulfa drugs are the oldest antibiotics and some animal studies have found harm during pregnancy. Nitrofurantoins previously have been viewed by doctors as safe to treat urinary tract infections during pregnancy.
The study, appearing in November's Archives of Pediatrics and Adolescent Medicine, may cause doctors to change the drugs they choose to treat pregnant women with infections. The findings were released Monday.
Dr. Susan Mehnert-Kay, a family practice doctor in Tulsa, Okla., who has written about diagnosing and managing urinary tract infections, said the research is ''very interesting'' and would cause her to reconsider antibiotic choices in early pregnancy.
The study is important because it looked at drugs that have been used for decades without large studies of their safety in pregnant women, said Dr. Michael Katz of the March of Dimes.
''Some physicians are not as attuned to this as they ought to be, so patients have the right to ask questions,'' Katz said.
The researchers analyzed data from more than 13,000 mothers whose infants had birth defects and nearly 5,000 women who lived in the same regions with healthy babies.
The women were interviewed by phone from six weeks to two years after their pregnancies. Those who remembered taking antibiotics during the month before conception through the first three months of pregnancy were identified as exposed to antibiotics.
The women's memories could have been faulty, a substantial weakness of the study, which the authors acknowledged. About one-third of the women who took antibiotics couldn't remember the specific type of drug they took.
It's also unclear whether the birth defects were caused by the drugs or by the underlying infections being treated, Crider said.
Birth defects linked to sulfa drugs included rare brain and heart problems, and shortened limbs. Those linked to nitrofurantoins (ny-troh-fyoor-AN'-toyns) included heart problems and cleft palate. The drugs seemed to double or triple the risk, depending on the defect.
''These defects are rare. Even with a threefold increase in risk, the risk for the individual is still quite low,'' Crider said.
Katz of the March of Dimes said anencephaly, a fatal brain problem linked to sulfas, affects about 1 in 10,000 births in the United States. Cleft palate occurs about 20 per 10,000 births.
Crider said the findings give doctors another opportunity to caution against overuse of antibiotics. Viral illnesses like colds and flus shouldn't be treated with antibiotics, she said.
Women in 10 states, including California, Texas and New York, were interviewed as part of the National Birth Defects Prevention Study.
The FDA recommends that pregnant women discuss medications with their doctors, said FDA spokeswoman Sandy Walsh. The agency has proposed changes to prescription drug labeling that would require more complete information for women of childbearing age, pregnant women and those who breastfeed, Walsh said.
Sign in to Recommend More Articles in Health »
جريدة النيويورك تايمز
http://www.nytimes.com/aponline/2009...s.html?_r=1&hp.................................................. ...........................................
نروح لجريدة الواشنطن بوسط
39
بليون دولار
للقضاء علي الالتهاب الرئوى
$39 billion needed for pneumonia
TOOLBOX
Resize
Print
E-mail
COMMENT
0 Comments
Your browser's settings may be preventing you from commenting on and viewing comments about this item. See instructions for fixing the problem.
Discussion Policy
CLOSE
Comments that include profanity or personal attacks or other inappropriate comments or material will be removed from the site. Additionally, entries that are unsigned or contain "signatures" by someone other than the actual author will be removed. Finally, we will take steps to block users who violate any of our posting standards, terms of use or privacy policies or any other policies governing this site. Please review the full rules governing commentaries and discussions. You are fully responsible for the content that you post.
Who's Blogging
» Links to this article
By MARIA CHENG
The Associated Press
Sunday, November 1, 2009; 7:01 PM
LONDON -- To fight pneumonia, the world's top killer of children, United Nations officials say they need $39 billion (euro26.35 billion) over the next six years.
On the first World Pneumonia Day on Monday, the World Health Organization and UNICEF are releasing a global plan aiming to save more than 5 million children from dying of pneumonia by 2015.
The plea for money is less than what has been spent on more high-profile diseases like AIDS, despite the fact pneumonia kills more children than AIDS, malaria and measles combined.
"This is very simply the biggest killer people never hear about," said Orin Levine, a public health expert at Johns Hopkins Bloomberg School of Health, who has advised WHO and UNICEF. Pneumonia accounts for about 20 percent of all child deaths every year; AIDS causes about 2 percent.
ad_icon
Some experts say the neglect of pneumonia is the health community's own fault. "While public health experts have long known the scope and severity of the scourge, they haven't effectively mobilized the backers to put pneumonia on the map," said Mary Beth Powers, a child health expert at Save the Children.
To change that, the U.N. is promoting a variety of strategies from vaccination to generalized interventions that address economic development. Pneumonia deaths are strongly linked to malnutrition and poverty.
While officials agree pneumonia deserves a much larger share of the global health budget, not all are convinced the U.N. plan is on target.
"Trillions of dollars have been spent on promoting economic development over the last 50 years, with very little evidence such spending has made any difference," said Philip Stevens, of the International Policy Network, a London-based think tank. "Much of the U.N's nearly $40 billion will be wasted unless they stick to vaccination."
Buying vaccines to protect children from pneumonia is precisely what GAVI, a global alliance of U.N. agencies and private partners like the Bill & Melinda Gates Foundation, plans to do. GAVI hopes to raise $4 billion to vaccinate about 130 million children in 42 poor countries by 2015.
Since 2000, a vaccine to protect children from pneumonia has existed, but is only available in rich countries. "Children in poor countries have the same right to health, the same right to be immunized as children in rich nations," said Julian Lob-Levyt, GAVI's CEO in a statement.
With renewed attention and resources on pneumonia, health officials hope to slash the number of deaths in half in the next few years. "Until now, pneumonia has been off the radar," Levine said. "But this is a big problem that can be solved."
المصدر جريدة الواشنطن بوسط
http://www.washingtonpost.com/wp-dyn...pid=sec-health.................................................. ..................................
الرومان يقي من سرطان البروستاتا
Effects of Pomegranate Chemical Constituents/Intestinal Microbial Metabolites on CYP1B1 in 22Rv1 Prostate Cancer Cells
The cytochrome P450 enzyme, CYP1B1, is an established target in prostate cancer chemoprevention. Compounds inhibiting CYP1B1 activity are contemplated to exert beneficial effects at three stages of prostate cancer development, that is, initiation, progression, and development of drug resistance. Pomegranate ellagitannins/microbial metabolites were examined for their CYP1B1 inhibitory activity in a recombinant CYP1B1-mediated ethoxyresorufin-O- deethylase (EROD) assay. Urolithin A, a microbial metabolite, was the most potent uncompetitive inhibitor of CYP1B1-mediated EROD activity, exhibiting 2-fold selectivity over CYP1A1, while urolithin B was a noncompetitive inhibitor with 3-fold selectivity. The punicalins and punicalagins exhibited potent CYP1A1 inhibition with 5−10-fold selectivity over CYP1B1. Urolithins, punicalins, and punicalagins were tested for their 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced CYP1 inhibitory activity in the 22Rv1 prostate cancer cell line. Urolithins A and B showed a decrease in their CYP1-mediated EROD inhibitory IC50 values upon increasing their treatment times from 30 min to 24 h. Urolithin C, 8-O-methylurolithin A, and 8,9-di-O-methylurolithin C caused a potent CYP1-mediated EROD inhibition in 22Rv1 cells upon 24 h of incubation. Neutral red uptake assay results indicated that urolithin C, 8-O-methylurolithin A, and 8,9-di-O-methylurolithin C induced profound cytotoxicity in the proximity of their CYP1 inhibitory IC50 values. Urolithins A and B were studied for their cellular uptake and inhibition of TCDD-induced CYP1B1 expression. Cellular uptake experiments demonstrated a 5-fold increase in urolithin uptake by 22Rv1 cells. Western blots of the CYP1B1 protein indicated that the urolithins interfered with the expression of CYP1B1 protein. Thus, urolithins were found to display a dual mode mechanism by decreasing CYP1B1 activity and expression
الجمعيه الامريكيه لعلوم الكميا
http://pubs.acs.org/stoken/campaign/...1021/jf902716r
الثلاثاء نوفمبر 17, 2009 10:44 am
