Monthly Archives: June 2009

Pain Relievers and Alcohol — A Potentially Risky Combination

You probably don’t think twice about taking an over-the-counter pain reliever or having a glass of wine or two with dinner. But the combination of pain relievers and alcohol can pose health risks.

When taken as directed, pain medications are generally considered safe. However, problems can arise when they are taken more frequently or in larger doses than recommended or taken in combination with other drugs — including alcohol.

The May issue of Mayo Clinic Health Letter recommends you consider these factors before deciding if it’s safe to drink an alcoholic beverage while taking pain medications.

Do you take pain relievers or drink alcohol often? The risk of side effects from combining pain relievers and alcohol is greater if you take medication frequently or drink alcohol frequently.

Do you take high doses of pain medication? The risk of serious side effects from alcohol use increases when you take a high dose of a pain reliever.

Does the medication cause side effects? If you’re already experiencing side effects from pain medication, such as stomach upset or drowsiness, alcohol will only make these side effects worse.

What’s your age? People over age 65 are at increased risk of adverse side effects from pain relievers. Plus, with age, your body processes alcohol more slowly, prolonging its effects.

Can you stop at one drink? It’s probably best to avoid alcohol altogether if you have difficulty stopping after one drink. The more you drink, the greater the risk.

Being cautious doesn’t necessarily mean you can never have alcohol while you take pain medications. The amount you can safely drink varies. For example, the Food and Drug Administration (FDA) reports adults who take more acetaminophen than recommended — more then 4,000 milligrams a day (eight 500-milligram tablets) — and who drink three or more alcoholic drinks a day may be at increased risk of liver damage. The FDA also reports that people who take nonsteroidal anti-inflammatory drugs and drink more than three alcoholic drinks a day may be at increased risk of gastrointestinal bleeding.

The best advice is caution. The less you combine a pain reliever and alcohol, the better. Because prescription pain relievers contain more potent medication than do nonprescription pain relievers, it’s generally recommended that you avoid alcohol when taking prescription pain medication.

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Why Ecuador and South America despise the USA’s “War on Drugs”

PepsiCo is trialing a new refrigeration system in its vending machines with one that contains carbon dioxide instead of hydrofluorocarbons (HFCs).

“This field test will help us evaluate the performance and reliability of these new machines in a real-world environment,” said PepsiCo’s vice president of packaging and equipment development, Robert Lewis.

HFCs are greenhouse gases more potent at trapping solar radiation than carbon dioxide, and are now considered responsible for 17 percent of human-caused global warming.

Only 5 percent of a vending machine’s greenhouse gas emissions come from the coolant that it uses. The other 95 percent of the machine’s emissions come from the electricity that it uses.

Pepsi is trialing 30 different vending machines in the Washington, D.C. area, all of them featuring a special green label. The company said that it has also been working to improve the energy efficiency of its machines, with 2008 models using 44 percent less energy than 2004 models and 52 percent less energy than 2003 models.

The cola company is not the first to experiment with non-HFC-based refrigeration. Coca-Cola and Unilever have also trialed the technology in the United States, while Unilever has already put two million Ben & Jerry’s ice creams vending freezers into circulation around the world. Wal-Mart uses non-HFC refrigeration in one of its Canadian stores.

China’s largest maker of refrigerators has started making fridges without HFCs, as have one Japanese company and Western companies Whirlpool and Miele. A total of 300 million home refrigerators around the world currently operate without using HFCs.

In the United States, however, such devices have not been approved for commercial use by the Environmental Protection Agency. Before companies such as Pepsi, Unilever or Whirlpool can start putting HFC-free freezers or vending machines into wide circulation, the agency must certify the technology as both safe and effective.

Sources for this story include:

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Action To Reduce Risk Of Measles Epidemic

The Health Protection Agency welcomes the Chief Medical Officer’s (CMO) MMR catch up programme, which urges Primary Care Trusts and GPs to identify individuals not up to date with their MMR and offer catch-up immunisation to reduce the risk of a measles epidemic.

Latest modelling research carried out by the Agency, examining the potential for measles transmission in England, suggests that there is now a real risk of a large measles outbreak of between approximately 30,000 to 100,000 cases – the majority in London.

Professor Elizabeth Miller, Head of Immunisation at the Health Protection Agency, said:

“Public confidence in the MMR vaccine is now high with more than 8 out of 10 children receiving one dose of MMR by their second birthday.

“However, low vaccine uptake over the past decade means there is now a large group of children who either haven’t been vaccinated or who have received just one dose. These children are susceptible to not only measles but to mumps and rubella as well.

“2007 saw the highest number of measles cases recorded in England and Wales since the current method of monitoring the disease was introduced in 1995.

“Measles is a very serious infection as it can lead to pneumonia and encephalitis. It is not possible to tell who will be seriously affected by measles. This is why it’s incredibly important to continue to remind parents about the benefits of having their child vaccinated with two doses of MMR for optimum protection. It is never too late to get vaccinated.”

The Agency has reported year on year increases in cases of measles due to outbreaks in areas of the country where MMR uptake has dipped or been low for longer periods of time with some children becoming seriously ill. In June the Agency reported the second death from measles in the last two years.

Immunisation leads in the Agency’s local Health Protection Units will be working closely with their partners in the NHS to increase the number of children immunised and so head off the dangers of an epidemic.

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Sex During Adolescence Doesn’t Predict Future HPV Infection

Predicting a child’s future is a near impossible task – today’s straight-A student may not become tomorrow’s doctor, and the school-yard bully may actually grow up to become a member of the Peace Corps.

So why should an adolescent’s sexual behavior – or lack thereof – determine whether or not she gets vaccinated against the human papillomavirus, to protect against future HPV infection? It shouldn’t, say researchers at the University of Michigan C.S. Mott Children’s Hospital’s Child Health Evaluation and Research (CHEAR) Unit.

The study, set to appear in the July issue of the journal Pediatrics, finds women who were sexually active as adolescents were just as likely as women who were not sexually active during their youth to get HPV as adults.

“Using risk factors as a means to determine who should get the HPV vaccine is not a good strategy. In our study, all women who eventually became sexually active at some point had an equivalent risk of getting HPV,” says study lead author Amanda F. Dempsey, M.D., Ph.D., MPH, a member of the CHEAR Unit in the U-M Division of General Pediatrics.

These findings, Dempsey says, support the Centers for Disease Control and Prevention’s Advisory Committee on Immunizations Practices recommendation for universal vaccination for all women ages 11 to 26, regardless of sexual experience.

Much of the confusion over whether or not to vaccinate a patient stems from conflicting recommendations. While the ACIP advocates for universal vaccination, the American Cancer Society recommends vaccinating all females younger than 18, and selectively vaccinating women ages 19 to 26 based on an informed discussion between the patient and her doctor about sexual history.

The price of the vaccine is also a factor. With each dose costing approximately $120 – along with high up-front costs to stock the vaccine, inconsistent coverage from government programs and low levels of reimbursement from private insurance – many states are struggling to provide the vaccine to all eligible girls and women.

For those reasons, many clinicians are targeting the HPV catch-up vaccination to only girls and women they deem to be at the greatest risk for acquiring HPV. Previous studies of sexually active adolescents and young adults identified specific sexual partnerships, behavioral and sociodemogrpahic characteristics associated with increased risk for HPV infection.

The problem, Dempsey says, is that those studies only looked at women currently infected with HPV, and retrospectively analyzed potential risk factors for infection.

“Few studies have evaluated the ability of specific risk factors to predict future HPV infection prospectively,” says Dempsey. “This is an important distinction, given that, to be effective, the HPV vaccine must be provided before vaccine type-specific infection occurs.”

For their study, Dempsey and her colleagues selected six high-risk behaviors that have been shown in other studies to be associated for sexually active women with a higher risk of HPV – the number of sexual partners, history of having an older male sexual partners and/or a new sex partner with the past year, illegal drug use, history of sex while impaired by drinking, and regular use of cigarettes/alcohol. For virgins the team also assessed risk factors found in other studies to be associated with the acquisition of other sexually transmitted diseases, and early sexual activity.

Of the risk factors evaluated during adolescence, none were found to be associated with future HPV infection. Among sexually active adolescents, only a history of having sex while impaired by alcohol was associated with increased odds of testing positive for vaccine-type HPV as a young adult.

“Whether or not an adolescent was sexually active did not have an association with future HPV infection,” says Dempsey. “Essentially all individuals who become sexually active are at risk for acquiring HPV, which is due to the high prevalence of HPV in society. So targeting particular groups for vaccination would prevent many at-risk women from being protected.”

In fact, estimates suggest that more than 80 percent of the U.S. population will have had an HPV infection by the time they reach the age of 50.

The study also found:

* Of the 3,181 study participants, 43 percent reported being sexually active in the first wave of the study. The first wave included girls ages 11-17.

* Virgins with a history of illegal drug were at a decreased risk for young-adult HPV infection.

* Sexually active adolescents tended to be older, in a higher grade and were more likely to be African American.

* 53 percent of study participants, who tested positive for HPV in the third wave of the study (ages 18 and older), were virgins in the first wave of the study.

HPV infection generally occurs shortly after a woman becomes sexually active. Most women never know they have the virus because it usually goes away on its own and may not cause any symptoms. There are more than 100 types of HPV, but only some types of HPV lead to cervical cancer or genital warts. The vaccine guards against four types of HPV: two that cause 70 out of 100 cases of cervical cancer and two that cause 90 out of 100 cases of genital warts.

In addition to Dempsey, study co-authors were Achamyeleh Gebremariam, with the CHEAR Unit in the Department of Pediatrics at the U-M Health System; and from the Department of Epidemiology at the University of Washington, Laura A. Koutsky and Lisa Manhart.

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