Advantages of supplements are still unclear

The dietary supplements glucosamine and chondroitin sulfate might slow joint damage for people with mild arthritis in their knees, according to a new study, Fox News reports.

Among more than 30 parts of the knee joint measured in the new study, a handful differed between people who took the supplements and those who didn't over the course of two years.

The results could also be seen as an indication the supplements do not make a significant difference in arthritis symptoms or severity, one researcher said.

"This is yet another set of data arguing against any disease-modifying benefit of glucosamine and chondroitin sulfate," said Daniel Solomon, a rheumatologist and pharmacoepidemiologist at Brigham and Women's Hospital in Boston who was not involved in the study.

But another researcher thought the study might indicate a possible role for glucosamine and chondroitin, if only for people with milder arthritis.

The report's authors, led by Johanne Martel-Pelletier of the Osteoarthritis Research Unit at the University of Montreal Hospital Research Centre, were unavailable for comment.

They looked at data on 600 participants in an ongoing osteoarthritis study sponsored by the U.S. National Institutes of Health Osteoarthritis Initiative. Some of the study participants were taking bone-building drugs, some were taking pain relievers such as ibuprofen and some were taking glucosamine and chondroitin supplements.

Researchers used magnetic resonance imaging (MRI) to examine the spaces between the joints and monitored the participants' arthritis symptoms and disease progression over 24 months.

The people who took both anti-inflammatory pain medications and glucosamine and chondroitin supplements had less pain and milder changes due to disease in one part of the knee joint than those who took the pain drugs but no supplements.

Yet among those who were not taking pain medication, there was no difference in pain between people taking the supplements and those who didn't.

And overall, the people who took supplements had similar disease progression to those who did not take them.

In general, Solomon says, the results do not change the bottom line for osteoarthritis patients: glucosamine and chondroitin don't help.

Krishna Chaganti, a rheumatologist at the University of California, San Francisco, who also was not involved in the study, thinks people with osteoarthritis can discuss the pros and cons of the supplements with their doctors. But she cautions that aside from questionable effectiveness, the downsides of glucosamine and chondroitin include a hefty price tag and possible safety risks, because supplements such as these are not regulated by the U.S. Food and Drug Administration.

Google Glass: What surgeons say about tech

BYE_2 Once upon a time in Macedonia

In the Stambul Ataturk Intl.Airport

This summer, in June and July, immediately  after the summer exam sessions, in Macedonia- at the  picturesque shores of Lake Ohrid, near the Ohrid city  by the International Union “The United young pharmacists” within the framework of the “Europe pharmacologist Students Association” was held '' Bike Your

EPSA Logo

Environment 2'' environmental program.

There were participating delegations from 7 Europe Council member  countries each by 5 members: Armenia, Macedonia, Serbia, Lithuania, Hungary, Spain, Croatia. Our country was represented by us – by the students of faculty pharmacy . There were organized  interactive games and lessons, which discussed the proper use of natural resources , environmentally-friendly transport and other environmental issues, as well as organized a bicycle parade – as a "green letter " for humanity. Though of all this, along with the heavy syllabus we have also relaxed  at the beach.

Presenting armenian national dishes

Group photo

     The town had a wonderful nature and ecological sustainability, which was not damaged by the intervention of human factor, and seems it was the evidence of our theoretical discussions. Each group was representing their country , their culture, the nature of their economical and political situations, regional issues. We were trying to understand the similarities and differences. Evenings were consecrated to present the national dishes, dances, songs, games and more. Europeans were shocked of our national dance "Fortress" (which was demonstrated through the video) and also they were pleased of the taste of  our dishes , they tried to sing our songs and expressed desire to visit to the country one day. We tried to present the best positive aspects and to do the possible  to generate interest to our country .

Bike Parade

  After recognizing all the participants , we realized, that despite of the many differences, we all have the same problems. Even though this was our first experience of  international communication, we did the possible to have successful overcome in each task. We had ten amazing days, when we had developed some skills , made new friends , acquainted with their lifestyle and culture. We also changed many things in our ideology and  began to love our country more.

                                                                                                         

                                By AReg Galstyan

Exchange Programs at YSMU for Parmacy student

IPSF (International Pharmaceutical Students’ Federation) and ArmPSA
(Armenian Pharmaceutical Students’ Association) present the exchange program for
pharmaceutical students
Yerevan State Medical University after M. Heratsi and Armenian Pharmaceutical Students’
Association (ArmPSA) grant exquisite opportunity to pharmaceutical students to participate in
the students’ exchange program. Due to this program students have the opportunity to have
summer or winter practice in various countries in the fields mentioned below:
• Community pharmacy
• Hospital pharmacy
• Industrial pharmacy
• University pharmacy
The program runs in English or the language of the chosen country. It’s a students’ program only
and no salary/scholarship is provided. Upon the completion of the program the students are
awarded the IPSF International Certificate.
Applicants: all students of Pharmacy faculty (preferably 2nd and higher year students)
Applicants should fill in the following documents in English at http://SEP.ipsf.org
• Application form
• Curriculum Vitae
• Motivation Letter
• Photo
Thorough information concerning the criteria and conditions of exchange programs in various
countries within different months is available at the above-mentioned website.
Duration: 1-2 months
Application deadline: 1st of March
Selection criteria:
• Knowledge of state language of the chosen country
• First time participation in this program
• Academic excellence
• IPSF membership
Financial terms
The following expenses are to be covered by the participant:
• Registration fee
• Hostel and accommodation*
• Two-way ticket
• Medical insurance
• Visa costs
* The amount of hostel and accommodation fee depends on the chosen country. 

Help For Stella Araqelyan

Four days before her prom in Yerevan, 17 year old Stella Araqelyan was diagnosed with acute lymphoblastic leukemia. Preliminary treatment was started immediately but her doctors’ decision was that her only hope was a prompt transfer to an advanced western medical center. Her parents’ requests were rejected by some medical centers, however Cleveland Clinic accepted to start her treatment with a preliminary estimated payment.

Her parents Irena and Levon gathered whatever they could to send Stella and her mother to Cleveland and the treatments were started just a few days ago. New diagnostic measures have shown that her treatment costs would be several times more than what was anticipated even with the discount the Cleveland Clinic has offered.

This has left Irena and Levon shocked and devastated. We are in the process of initiating a campaign to gather some funds from charitable organizations, however Stella and her mother who are now living in the St. Gregory of Narek parish house are trying to cut even on their daily expenses to save for the treatment.

Their needs are not only monetary but spiritual. Please contact Father Hratch Sargsyan to see how you can help at 440-264-3541, fr.hrach@yahoo.com. St. Gregory of Narek set up an account for online tax deductible donations. you can also send checks to our church address at 678 Richmond Rd. Richmond Heights OH 44143. Make checks payable to St. Gregory of Narek, memo line: Stella Arakelyan.

DONATE NOW and remember, any amount is good!

Paypal Link - https://www.paypal.com/us/cgi-bin/webscr?cmd=_flow&SESSION=r_YgVz1wGHUHINH3p3Gd51mxRbiuRFtLtBhrgmMyR8eck2vgwkLvOuaCYW0&dispatch=5885d80a13c0db1f8e263663d3faee8d4e181b3aff599f99e8c17bd6c7fe2f56

Popular Pain Relievers Trigger Heart Attacks!

Miners used to take a canary with them into the coal mine because if the bird died, the air had gone bad and it was time to get out of the mine. Heart attack patients are like those canaries. They are more vulnerable than healthy people to cardiac events, so they serve as an early warning system for heart risks. These heart attack survivors have just sent out a big alert about the dangers of pain relievers!

Danish researchers identified nearly 100,000 patients over the age of 30 who had experienced a first-time heart attack sometime between 1997 and 2009. They were followed for up to 5 years after their initial heart attacks (Circulation, online, Sept 10, 2012). The scientists were especially interested in the post-heart attack use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as:

• Celecoxib (Celebrex)

• Ibuprofen (Advil, Motrin, etc)

• Diclofenac (Cataflam, Voltaren)

• Naproxen (Aleve, Naprosyn)

• Rofecoxib (Vioxx)

It should come as no surprise that heart attack patients, like the general population, take a lot of pain relievers. Because the Danish health care system reimburses medication expenses, all pharmacies keep records of dispensed prescriptions. That enabled these investigators to track prescribed NSAID use. Of the 99,187 patients in the study, nearly half (44%) filled a prescription for one of the pain relievers above.

And the envelope, please: It turns out that the heart attack survivors who took an NSAID-type pain reliever were at a substantially higher risk of having another heart attack or dying than those patients who did not take such drugs. In their first year following a heart attack, about one-fifth of the NSAID users died, compared to 12 percent of those not taking an NSAID-type pain reliever. Over the five years of the study, NSAID users were about twice as likely to die as non-users. They were also at increased risk for another heart attack. The investigators concluded:

"It would seem prudent to limit NSAID use among patients with cardiovascular disease and to get the message out to clinicians taking care of these patients that NSAIDs are potentially harmful, even 5 years after MI [myocardial infarction or heart attack]."

We would take this warning a step farther. As we stated at the beginning, heart attack patients are like canaries in the coal mine because they are more susceptible to repeat heart attacks. They also serve as a warning to the rest of us. Heart attack survivors may be more vulnerable, but we're all at risk and they have just put up a huge red flag.

Ever since the great Vioxx scandal, there has been a growing recognition that most NSAIDs (except for aspirin) may pose a risk of heart attacks and strokes for the population at large--not just heart attack survivors. That's because these drugs can increase blood pressure, affect blood vessel physiology and alter blood clotting. All these factors could be responsible for a greater susceptibility to blood clots that could cause heart attacks and strokes. This discovery has pretty much disappeared without a trace, however. Most people (including doctors) have ignored the warning.

The authors of the new article in Circulation note that doctors are prescribing NSAIDs to a vulnerable population in worrisome amounts (44% of the heart attack victims got a prescription for such drugs). The investigators also expressed concern that despite widespread knowledge about the risks of such drugs, some NSAIDs (ibuprofen and naproxen) are available without a prescription. By the way, naproxen (Aleve) appears to be a little less likely than other NSAIDs to cause cardiovascular complications but it has been associated with gastrointestinal bleeding, a complication of all NSAIDs.

Here's the straight and skinny:

NSAIDs, whether prescription or over-the-counter, pose some serious risks, including heart attacks, strokes, bleeding ulcers or death. Other side effects include:

NSAID SIDE EFFECTS

• Heartburn, indigestion, abdominal pain, nausea, constipation

• Headache, dizziness, drowsiness, disorientation

• Skin rash, sensitivity to sunlight, itching (potentially serious, so notify the MD!)

• Fluid retention, edema, high blood pressure

• Heart failure

• Ringing in ears, hearing changes

• Visual disturbances

• Ulcers, bleeding ulcers, perforated ulcers

• Liver damage, kidney damage

• Blood disorders, anemia

• Worsening asthma symptoms

People swallow an extraordinary number of NSAIDs either because their doctor prescribes them or because they are readily available over-the-counter. Despite admonitions on the OTC label to take ibuprofen or naproxen for no longer than 10 days, many Americans take NSAIDs daily for weeks, months or years.

Only about one person out of five actually reads the directions on the label. Fewer than one in three checks out the dosing instructions. About one quarter take more than the recommended dose of OTC NSAIDs, and about half of the people in one survey did not realize that OTC pain relievers could cause any harm (Journal of Rheumatology, Nov. 2005).

Most people assume that if you can buy a drug without a prescription it must be safe. Nothing could be further from the truth, especially when it comes to NSAIDs. If you told people that the OTC pain reliever they are popping could cause a heart attack, stroke or death they would likely be surprised the FDA would permit such a thing. And if someone has a heart attack or dies while taking ibuprofen for a bad back, arthritis or a headache, chances are that the NSAID won't be considered a contributing cause of the tragedy.

What's a person to do if she has pain and does not want to risk the complications of an NSAID pain reliever? We offer dozens of non-drug options in our book, The People's Pharmacy Quick & Handy Home Remedies. Herbs such as boswellia (p. 149), spices such as cayenne (p. 150) or turmeric (p. 152), supplements such as fish oil (p.154) or vitamin D (p. 158) and foods such as grape juice with Certo (p. 157), honey and vinegar (p. 156), pineapple juice (p. 156) and tart cherries (p. 153) have all provided relief for some people with joint pain.

Incorporating anti-inflammatory foods into tasty recipes is another approach to managing pain relief while limiting side effects. In our book Recipes & Remedies From The People's Pharmacy, we offer instructions for remedies like cherry spritzer (p. 62), curcumin milk (p. 60), ginger pickle (p. 50), pineapple-cherry cocktail (p. 65), virgin raisins (p. 64) or anti-inflammatory curcumin scramble (p. 103). Adding fish to the diet in dishes such as favorite fish platter (p. 106), fish tacos with radish & lime (p. 120) horseradish-crusted salmon with cranberry catsup (p. 127), pescado al cilantro (p. 137) salmon with fava bean & spring pea mash (p. 141) or spicy fresh tuna salad (p. 143) puts anti-inflammatory power into everyday meals, and adds heart benefits rather than risks.

You can find all our books and guides in The People's Pharmacy Store. And please reconsider routine use of NSAIDs like ibuprofen, meloxicam, naproxen and diclofenac. Such drugs may ease pain a bit, but the list of side effects is scary. People who have had heart attacks are not the only ones at risk for serious, even life-threatening complications.

New DNA Mutations Discovered in Malignant Melanomas

The mutations, which may be the most common in melanoma cells, share genetic hallmarks with other ultraviolet light–induced mutations. Researchers at the Dana-Farber Cancer Institute and the Broad Institute of Harvard and MIT have found new genetic mutations that appear in a combined total of 71% of malignant melanomas. They reported their findings in the February 22, 2013, edition of Science.

 The mutations were found in the “dark matter” of the tumor—sometimes referred to as “junk” DNA—because this area does not encode for proteins. This is the first time scientists have found mutations in this area of the cancer genome. (Previously, cancer genes have only been discovered in the protein-encoding region of the genome.) However, researchers found that these might be the most common mutations in melanoma cells.

 The researchers discovered the mutations by sifting through whole-genome sequences of cells taken from malignant melanoma tumors. These mutations are present in other malignancies, especially hepatocellular and bladder cancers. The researchers noted that this result prompted them to look at cancer tumors’ entire genomes.

 Doing so in the melanoma tumors led the researchers to a region that regulates and controls telomerase reverse transcriptase (TERT), which signals to increase telomerase production. Telomerase, in turn, prolongs cell life by allowing indefinite cell division and circumventing apoptosis (programmed cell death). In melanoma, the researchers were also able to show that TERT mutations share genetic hallmarks with other ultraviolet light–induced mutations.

 TERT is expressed in 90% of cancers. The mechanism in other cancers may be the same as or similar to that identified in melanoma. TERT has been an elusive target for drug development, but this finding may renew interest and help researchers think outside the box and find new approaches.