There is good news making its way slowly, slowly into the medical world: little by little allopathic medicine is finally noticing how effective nutrients are in diseases and clinical conditions. Too slowly for most of us, but, still, there are creeping changes.
Instead of antibiotics, for example, pediatricians have noticed that pediatric diarrhea responds to zinc. Why? Because immune systems need zinc to do their job. So give the child zinc and it can fix the problem by itself without dangerous, expensive drugs. Well, well!
And even better, infection yields to silver. Well, of course it does. Burn centers have know that for decades and so has every natural doctor and naturopath for the last how many decades? But the derision and scorn heaped on us when we tried to talk about these and a thousand other ways of treating people when they come to us for cheap, simple, effective and safe means of getting well or staying that way is profound.
It is, however, the derision and anger born of fear.
Laibow’s First Law of Human Psychology is “Anger Drives Out Fear, Or At Least It’s Supposed To!” And conventional medicine is very, very afraid of the natural competitors to its expensive, dangerous and very limited drugs.
Oh, yes, one more thing: Codex Alimentarius makes the international trade of supplements very difficult since supplements may only be sold at doses so low that they have no clinical impact. Codex copmpliance in Europe through the European Food Supplements Directive is, in fact, stripping the shelves of stores of the nutrients previously avaialbe which might have allowed people to use the information in this article. Just ask any one you know, for example, in the UK, what is happening to their supplements: they are vanishing like the morning mist. Poof! Just like that.
If you don’t want the same thing to happen to you, it is imperative that you take action now, join the Natural Solutions Foundation’s distribution list for the free and secure Health Freedom eAlerts and take the action steps therein. I can assure you that legislators are not going to protect your health freedom without an effective outcry from us, the consumers who make our own choices about our own health paths.

Yours in health and freedom,
Dr. Rima
Rima E. Laibow, MD
Medical Director
Natural Solutions Foundation
www.HealthFreedomUSA.org
www.GlobalHealthFreedom.org
www.NaturalSolutionsFoundation.org
www.Organics4U.org
www.NaturalSolutionsMedia.tv
www.NaturalSolutionsMarketPlace.org

Changes in Folate and Homocysteine Linked to Incident Dementia
http://www.medscape.com/viewarticle/579216?sssdmh=dm1.378114&src=nldne

NEW YORK (Reuters Health) Aug 18 – Onset of dementia is associated with decreasing folate and increasing vitamin B12 and homocysteine, results of a study published in the August issue of the Journal of Neurology, Neurosurgery, and Psychiatry indicate.

“Several cross-sectional studies have found significant associations of lower folate and hyperhomocysteinemia with dementia or cognitive impairment, but the direction of cause and effect is not known,” Dr. Jin-Sang Yoon, of University Medical School, Kwangiu, Republic of Korea, and colleagues write. “Results from prospective studies have been controversial.”

In their study, the researchers examined both baseline levels and changes in folate, vitamin B12, and homocysteine as predictors of incident dementia in 625 elderly patients free of dementia at baseline; 518 (83%) were followed over 2.4 years.

Incident dementia occurred in 45 of the 518 (8.7%). The only baseline factor that predicted incident dementia was lower folate concentrations

However, “The onset of dementia was significantly associated with an exaggerated decline in folate, a weaker increase in vitamin B12 concentrations and an exaggerated increase in homocysteine concentrations over the follow-up period,” the team reports.

After adjustment for weight change, these associations were reduced.

“Further research is required to clarify these complex longitudinal interrelationships,” Dr. Yoon and colleagues conclude. “In the meantime, attention needs to be paid to the nutritional status of people with dementia from the time of diagnosis onwards, regardless of whether this is a cause or effect of their condition.”

J Neurol Neurosurg Psychiatry 2008;79:864-868.Silver-Coated Endotracheal Tube Reduces Risk for Ventilator-Associated Pneumonia CME

News Author: Laurie Barclay, MD
CME Author: Penny Murata, MD
Disclosures
Release Date: August 19, 2008; Valid for credit through August 19, 2009
Credits Available

Physicians – maximum of 0.25 AMA PRA Category 1 Credit(s)â„¢ for physicians;
Family Physicians – up to 0.25 AAFP Prescribed credit(s) for physicians

To participate in this internet activity: (1) review the target audience, learning objectives, and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation; (4) view/print certificate View details.

Learning Objectives

Upon completion of this activity, participants will be able to:

1. Compare the incidence of ventilator-associated pneumonia in patients intubated for at least 24 hours with a silver-coated endotracheal tube vs an uncoated endotracheal tube.
2. Report whether use of a silver-coated endotracheal tube affects duration of intubation, length of stay in the intensive care unit or hospital, mortality rates, and adverse events.

Authors and Disclosures

Laurie Barclay, MD
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Penny Murata, MD
Disclosure: Penny Murata, MD, has disclosed no relevant financial relationships.

Brande Nicole Martin
Disclosure: Brande Nicole Martin has disclosed no relevant financial information.

August 19, 2008 — Use of a silver-coated endotracheal tube significantly reduces the incidence of microbiologically confirmed ventilator-associated pneumonia (VAP), according to the results of a large, randomized, multicenter study reported in the August 20 issue of the Journal of the American Medical Association.

“VAP causes substantial morbidity,” write Marin H. Kollef, MD, from the Washington University School of Medicine in St. Louis, Missouri, and colleagues from the North American Silver-Coated Endotracheal Tube Investigation Group. “A silver-coated endotracheal tube has been designed to reduce VAP incidence by preventing bacterial colonization and biofilm formation.”

The goal of this prospective, single-blind study conducted in 54 centers in North America was to evaluate whether use of a silver-coated endotracheal tube would reduce the incidence of microbiologically confirmed VAP.

Of 9417 adult patients aged 18 years or older who were screened between 2002 and 2006, a total of 2003 patients who were expected to need mechanical ventilation for at least 24 hours were randomly assigned to undergo intubation with 1 of 2 high-volume, low-pressure endotracheal tubes. These tubes were similar except that the experimental tube had a silver coating.

The main endpoint was incidence of VAP, diagnosed from quantitative bronchoalveolar lavage fluid culture with at least 104 colony-forming units/mL in patients intubated for at least 24 hours. Secondary endpoints were VAP incidence in all intubated patients, time to VAP onset, length of intubation and duration of intensive care unit and hospital stay, mortality rates, and adverse events.

Rates of microbiologically confirmed VAP in patients intubated for at least 24 hours were 4.8% (37/766 patients; 95% confidence interval [CI], 3.4% – 6.6%) in the group receiving the silver-coated tube and 7.5% (56/743; 95% CI, 5.7% – 9.7%; P = .03) in the group receiving the uncoated tube (relative risk reduction, 35.9%; 95% CI, 3.6% – 69.0%).

Rates of microbiologically confirmed VAP in all intubated patients were 3.8% (37/968; 95% CI, 2.7% – 5.2%) in the experimental group and 5.8% (56/964; 95% CI, 4.4% – 7.5%; P = .04) in the control group (relative risk reduction, 34.2%; 95% CI, 1.2% – 67.9%).

Use of the silver-coated endotracheal tube was associated with delayed occurrence of VAP (P = .005), but there were no statistically significant between-group differences in durations of intubation, intensive care unit stay, and hospital stay. Mortality rates and frequency and severity of adverse events were also similar in both groups.

“Patients receiving a silver-coated endotracheal tube had a statistically significant reduction in the incidence of VAP and delayed time to VAP occurrence compared with those receiving a similar, uncoated tube,” the study authors write. “The silver-coated endotracheal tube appears to offer a unique approach because it is the first intervention that becomes user-independent after intubation, requiring no further action by the clinician.”

Limitations of this study include single blinding rather than double blinding; use of a small, fixed block size stratified by center; other factors possibly contributing to between-group differences in VAP rates; study protocol not standardizing prevention strategies; and a protective effect of higher severity-of-illness scores against development of VAP.

In an accompanying editorial, Jean Chastre, MD, from Institut de Cardiologie, Groupe Hospitalier Pitié-Salpê trière in Paris, France, discusses the study limitations.

“Important uncertainties exist regarding the exact benefit of silver-coated endotracheal tubes,” Dr. Chastre writes. “Consequently, silver coated tubes should not be viewed as the definitive answer for VAP prevention, and, until additional data confirm the clinical effectiveness and cost benefit of these devices, their use should be restricted to high-risk patients treated in ICUs [intensive care units] with benchmark value-based infection rates that remain above institutional goals despite implementation of a comprehensive strategy of usual preventive measures to prevent VAP.”

CR Bard Inc supported this study and provided grant support to all of the study authors. Some of the study authors have disclosed various financial relationships with Kimberly Clark, Elan, Merck, Pfizer, Bayer, GlaxoSmithKline, Boehringer Ingelheim, KCI, sanofi-aventis, Johnson & Johnson, Easi, Hospira, Nomir Medical Technologies, Arpida, Cubist, Elan, Ortho-McNeil, Sanofi Pasteur, Wyeth, Bayer-Nektar, Nestle Clinical Nutrition, Lilly, Corbett Accel Healthcare, National Institutes of Health, Novartis, and/or Maquet. Dr. Chastre has received consulting and lecture fees from Pfizer, Brahms, Wyeth, Johnson & Johnson, Bayer-Nektar, and Arpida.

JAMA. 2008.300:805-813, 842-844.
Clinical Context

Rello and colleagues reported in the December 2002 issue of Chest that VAP is linked with increased morbidity rates and generally occurs in the first 10 days after endotracheal intubation. Probable causes of VAP include colonization with pathogenic bacteria and aspiration, as noted by Kollef in the June 2005 issue of Respiratory Care. In the November 2006 issue of Critical Care Medicine, Rello and colleagues found that a silver-coated endotracheal tube decreased bacterial colonization of the airway. The silver ions in a polymer on the inner and outer lumen migrate to the surface of the tube to potentially reduce bacterial adhesion, impede biofilm formation, and promote antimicrobial activity.

This prospective, randomized, controlled, multicenter, single-blind study assesses the efficacy of a silver-coated endotracheal tube in reducing the incidence of VAP in patients needing mechanical ventilation for at least 24 hours.
Study Highlights

* 2003 adults aged at least 18 years and expected to need at least 24 hours of mechanical ventilation were randomly assigned to use of a silver-coated endotracheal tube vs an uncoated endotracheal tube.
* Exclusion criteria were enrollment in a conflicting study, bronchiectasis, severe hemoptysis, cystic fibrosis, pregnancy, silver sensitivity, and more than 12 hours of endotracheal intubation in the previous 30 days.
* 1932 subjects were intubated: 968 in the silver-coated tube group and 964 in the uncoated tube group.
* 1509 subjects were intubated for at least 24 hours: 766 in the silver-coated tube group and 743 in the uncoated tube group.
* Baseline characteristics for both groups were similar for age (mean age, 60.9 – 62.2 years; range, 18 – 102 years), sex, Acute Physiology and Chronic Health Evaluation II score, immunocompetency, enteral nutrition use, and endotracheal tube size.
* Both groups had similar VAP risk factors, except chronic obstructive pulmonary disease was less common in the silver-coated tube group vs the uncoated tube group (24-hour intubation subjects, 11.6% vs 16.4%; P = .007; all intubated subjects, 9.2% vs 12.7%; P = .02).
* The primary outcome measure was VAP incidence, defined by at least 104 colony-forming units/mL in bronchoalveolar lavage fluid culture, in patients intubated for at least 24 hours.
* VAP incidence in patients intubated for at least 24 hours was lower in the silver-coated tube group vs the uncoated tube group (4.8% [37/766 patients] vs 7.5% [56/743 patients]; P = .03; relative risk reduction, 35.9%).
* VAP incidence in all intubated patients was lower in the silver-coated tube group vs the uncoated tube group (3.8% vs 5.8%; P = .04; relative risk reduction, 34.2%).
* Bronchoalveolar lavage fluid culture was also obtained in those with suspected VAP or with new radiographic infiltrate and at least 2 qualifying signs (fever or hypothermia, leukocytosis or leukopenia, or purulent tracheal aspirate).
* Of 220 patients who underwent bronchoalveolar lavage for suspected VAP, the most common pathogens for the silver-coated tube group vs the uncoated tube group were Staphylococcus aureus (9 vs 16), Pseudomonas aeruginosa (8 vs 11), Enterobacteriaceae (10 vs 5), and polymicrobial infections (7 vs 13).
* VAP incidence within 10 days of intubation in patients intubated for at least 24 hours was less common in the silver-coated tube group (relative risk reduction, 47.6%; 95% CI, 14.6% – 81.9%; P = .005).
* Delayed occurrence of VAP was linked to silver-coated tube use (P = .005).
* There was no difference between groups in median duration of intubation, intensive care unit stay, hospital stay, and mortality rates.
* Regression analysis showed that silver-coated tube use was associated with decreased risk for VAP at any time, VAP within 10 days of intubation, and delayed time to occurrence.
* Adverse events occurred with similar frequency and severity for both groups.
* 59 endotracheal tube–related adverse events occurred: 21 in the silver-coated tube group vs 38 in the uncoated tube group.
* 74 intubation procedure–related adverse events occurred: 39 in the silver-coated tube group vs 35 in the uncoated tube group.
* Post hoc analysis showed that VAP in patients intubated for at least 24 hours was linked with longer duration of intubation and longer length of stay in the intensive care unit or hospital but not with mortality rate.
* Limitations of the study included lower than expected VAP incidence in the uncoated tube group, more subjects with chronic obstructive pulmonary disease in the uncoated tube group, and lack of blinding of investigators.

Pearls for Practice

* The incidence of VAP in patients intubated for at least 24 hours is reduced and delayed with use of a silver-coated endotracheal tube vs an uncoated endotracheal tube.
* Use of a silver-coated endotracheal tube does not affect duration of intubation, length of stay in the intensive care unit or hospital, mortality rates, or adverse events.
http://www.medscape.com/viewarticle/579239?sssdmh=dm1.378114&src=nldne

Oral zinc for treating diarrhoea in children.

Cochrane Database Syst Rev. 2008; (3):CD005436 (ISSN: 1469-493X)

Lazzerini M; Ronfani L
Unit of Research on Health Services and International Health, WHO Collaborating Centre for Maternal and Child Health, Via dei Burlo 1,34123, Trieste, Italy.

BACKGROUND: Diarrhoea causes around two million child deaths annually. Zinc supplementation could help reduce the duration and severity of diarrhoea, and is recommended by the World Health Organization and UNICEF. OBJECTIVES: To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea. SEARCH STRATEGY: In November 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 4), MEDLINE, EMBASE, LILACS, CINAHL, mRCT, and reference lists. We also contacted researchers. SELECTION CRITERIA: Randomized controlled trials comparing oral zinc supplementation (>/= 5 mg/day for any duration) with placebo in children aged one month to five years with acute or persistent diarrhoea, including dysentery. DATA COLLECTION AND ANALYSIS: Both authors assessed trial eligibility and methodological quality, extracted and analysed data, and drafted the review. Diarrhoea duration and severity were the primary outcomes. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses (using the fixed- or random-effects model) and assessed heterogeneity. MAIN RESULTS: Eighteen trials enrolling 6165 participants met our inclusion criteria. In acute diarrhoea, zinc resulted in a shorter diarrhoea duration (MD -12.27 h, 95% CI -23.02 to -1.52 h; 2741 children, 9 trials), and less diarrhoea at day three (RR 0.69, 95% CI 0.59 to 0.81; 1073 children, 2 trials), day five (RR 0.55, 95% CI 0.32 to 0.95; 346 children, 2 trials), and day seven (RR 0.71, 95% CI 0.52 to 0.98; 4087 children, 7 trials). The four trials (1458 children) that reported on diarrhoea severity used different units and time points, and the effect of zinc was less clear. Subgroup analyses by age (trials with only children aged less than six months) showed no benefit with zinc. Subgroup analyses by nutritional status, geographical region, background zinc deficiency, zinc type, and study setting did not affect the results’ significance. Zinc also reduced the duration of persistent diarrhoea (MD -15.84 h, 95% CI -25.43 to -6.24 h; 529 children, 5 trials). Few trials reported on severity, and results were inconsistent. No trial reported serious adverse events, but vomiting was more common in zinc-treated children with acute diarrhoea (RR 1.71, 95% 1.27 to 2.30; 4727 children, 8 trials). AUTHORS’ CONCLUSIONS: In areas where diarrhoea is an important cause of child mortality, research evidence shows zinc is clearly of benefit in children aged six months or more.
Subject Headings
Major Subject Heading(s) Minor Subject Heading(s)

* PreMedline Identifier: 18646129