Using Singulair Treatment for Capsular Contracture

by jfrentzen 8/24/2010 12:53:00 PM

From the May/June 2010 of the Aesthetic Surgery Journal: Blogger Ramona Bates points out an article on the use of Singulair for capsular contracture (CC). More on Using Singulair Treatment for Capsular Contracture:

The article reviews the literature, noting some articles I missed.  Their study is a small (17 patients, 4 with bilateral CC for a total of 21breasts treated with Baker’s Grade II or greater CC).  All of their patients were informed of possible risks associated with the off-label application of Singulair before being prescribed 10 mg of Singulair for 90 days and instructed to massage their breasts twice daily.

[From the study:] "Unlike Accolate, the adverse event profile of Singulair is comparable to placebo, with the most common side effects being headache (18.4% vs 18.1%), influenza-like symptoms (4.2% vs 3.9%), abdominal pain (2.9% vs 2.5%), cough (2.7% vs 2.4%), and dyspepsia (2.1% vs 1.1%)."

Follow-up of patient compliance and treatment results was obtained by a combination of chart review and a standardized telephone questionnaire.  Telephone interviews were used to determine the actual duration and dose of Singulair taken by the patient and whether the patient noted improvement, no change, or worsening of contracture.

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Are Sunscreens with Nanoparticles of Zinc Oxide Safe?

by jfrentzen 6/4/2010 11:08:00 AM

One of our favorite plastic surgeon bloggers, Ramona Bates, MD, submitted a news/opinion item to the Emax Health Web site that covers zinc oxide content in sunscreens. A group called Friends of the Earth (FOTE) feels that sunscreens with nanoparticles are a risk to your health and urge you not to use them. Friends of the Earth is self-described as "progressive environmental advocates." Bates responds eloquently with a "Well, maybe but maybe not" position on the matter.

Are Sunscreens with Nanoparticles of Zinc Oxide Safe?

While the FOTE quote a recent Australian study by Macquarie University's Professor Brian Gulson as evidence that sunscreens using nano-ZnO are potentially hazardous due to absorption into the blood stream through the skin, Gulson in an interview notes that his study doesn't shed any light on the question of whether the nano-particles themselves played a part in the zinc absorption. “That was the most critical thing. This isotope technique cannot tell whether or not it's a zinc oxide nano-particle that got through skin or whether it's just zinc that was dissolved up in contact with the skin and then forms zinc ions or so-called soluble ions. So that's one major deficiency of our study.”

Other studies not mentioned by FOTE suggest the case for safe, non-penetrating, transparent, topical ZnO sunscreen formulations appears to be strengthening as the one by Sheree Cross and colleagues.

Another concern in the use of nanoparticles in sunscreens is the exposure of the body due to oral and nasal uptake due to application to the lips and mouth area, around the nose, and via contact with sunscreened hands and food.

Philip Moos and colleagues looked at the effects of nanomaterials in the colon. Their experiments used cell cultures of colon cells to compare the effects of zinc oxide nanoparticles to zinc oxide sold as a conventional powder. They found that the nanoparticles were twice as toxic to the cells as the larger particles. This is a study of cell cultures which now needs to be looked at again in living gut before getting too concerned. The scientist also not that the concentration of nanoparticles that was toxic to the colon cells was equivalent to eating 2 grams of sunscreen - about 0.1 ounce.

While the final word may not be out on the safety of nanoparticles in sunscreens at this point I feel safe in using them and recommending their use to family, friends, and patients. No sunscreen is recommended for oral consumption, so care should always be used in washing your hands prior to eating.

Read it all.

AOL News has covered the issue as well here. Unlike Bates, the AOL news reporter apparently has fallen for the FOTE's conclusions like a trout looking for the hook.

France, Germany, the U.K. and the European Parliament have moved rapidly to require everything from safety testing and mandatory labeling of nanoparticles to even the outright ban of these engineered chemical creations in many sunscreen and cosmetic products. Nothing of the kind is happening in the United States, Friends of the Earth says in a report issued today. .

"Nanosunscreens have the potential to cause serious human and environmental harm, but there is nothing stopping companies from selling them," says the report by the international environmental and public health advocates.

And consumers are pretty much on their own when it comes to determining what's safe to slather on their skin. Labeling is often inadequate or inaccurate. And not even the Consumer Safety Protection Commission, which ensures the safety of the items that Americans buy, is stepping up for sunscreen shoppers.

"It's not our responsibility. Sunscreen safety is FDA's job," says Alexander Filip, deputy director of public affairs for the commission. But, he added: "Our chairman has publicly addressed industry groups warning them about use of nanomaterials without notifying us or their customers."

It is amusing when governmental agencies freely and openly blame one another for the failings of the entire bureaucracy. Moving along, the AOL news report finally gets around to admitting that all this worry is based on inconclusive studies.

[The FOTE] report calls the use of nanoparticles of titanium dioxide and zinc oxide a "risk without benefit." It examines six studies on the health implications of manufactured nanomaterials used in sunscreens.

The studies, which raised some concerns in the public health community, are all peer-reviewed and have been published in international scientific journals. But the authors of almost all the work stress that their studies are preliminary and that more research is needed.

Perhaps the mainstream news media will pick up on this story, slice out the "science talk" and mumbo jumbo about inconclusive research studies, and use the sunscreen nanoparticples topic as yet another avenue for sowing FUD (fear, uncertainty, and doubt).

 

One PhD-in-Organic-Chemistry's View on Aging Research

by jfrentzen 3/25/2010 3:10:00 PM
In a true "we have met the enemy and it is we" moment, blogger and PhD in organic chemistry Derek Lowe comments succinctly on the The Problem With Research on Aging:

Nature has a review of a new book on the anti-aging field, Eternity Soup by Greg Critser, and I found this part very instructive. The same things apply to several other therapeutic areas where people see fast money to be made:

"Critser's methodical portrayal of a host of anti-ageing practitioners reveals some fascinating people who seek to convince others that they can purchase longer and healthier lives like any other commodity. He makes clear that many anti-ageing treatments are based more on faith healing than on science, and that the industry defends them and presents them to the public with evangelical zeal. Scientific gerontologists who point out the lack of empirical evidence behind the claims are shouted down, sued for libel or made fun of as lab technicians or statisticians with no experience in treating patients.

"Critser became aware during his research of why the ridiculed scientific gerontologists find the anti-ageing industry so aggravating. The industry closely monitors the field for any advances, and when it spots something that might be turned into a commercial enterprise, the product is repackaged, branded and sold to the public as the next great breakthrough of its own invention. . ."

It's interesting, though, that the cancer-cure quacks tend not to ride so much on the current research. A lot of that stuff seems just to be completely made up, without even a connection to something in the scientific literature. Perhaps that's because there are occasional spontaneous remissions from cancer, but none from old age. . .

The above is just the beginning. Wait until you get to the feedback comments beneath Lowe's post.

Read it all.

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