Tuesday, December 29, 2009

NostrumDamus

BrooklynDodger(s) comment: Gingko extract contains flavenoids and terpenoids, thought to be anti oxidant. 3000+ subjects followed over a median of 6 years because of some people think it's a folk remedy. Think of what that cost. The anti-oxidant mechanism hasn't hardly worked.

JAMA 2009;302 2663-2670
Ginkgo biloba for Preventing Cognitive Decline in Older Adults

A Randomized Trial

Beth E. Snitz, PhD; Ellen S. O’Meara, PhD; Michelle C. Carlson, PhD; Alice M. Arnold, PhD; Diane G. Ives, MPH; Stephen R. Rapp, PhD; Judith Saxton, PhD; Oscar L. Lopez, MD; Leslie O. Dunn, MPH; Kaycee M. Sink, MD; Steven T. DeKosky, MD; for the Ginkgo Evaluation of Memory (GEM) Study Investigators

JAMA. 2009;302(24):2663-2670.

Context The herbal product Ginkgo biloba is taken frequently with the intention of improving cognitive health in aging. However, evidence from adequately powered clinical trials is lacking regarding its effect on long-term cognitive functioning.

Objective To determine whether G biloba slows the rates of global or domain-specific cognitive decline in older adults.

Design, Setting, and Participants The Ginkgo Evaluation of Memory (GEM) study, a randomized, double-blind, placebo-controlled clinical trial of 3069 community-dwelling participants aged 72 to 96 years, conducted in 6 academic medical centers in the United States between 2000 and 2008, with a median follow-up of 6.1 years.

Intervention Twice-daily dose of 120-mg extract of G biloba (n = 1545) or identical-appearing placebo (n = 1524).

Main Outcome Measures Rates of change over time in the Modified Mini-Mental State Examination (3MSE), in the cognitive subscale of the Alzheimer Disease Assessment Scale (ADAS-Cog), and in neuropsychological domains of memory, attention, visual-spatial construction, language, and executive functions, based on sums of z scores of individual tests.

Results Annual rates of decline in z scores did not differ between G biloba and placebo groups in any domains, including memory (0.043; 95% confidence interval [CI], 0.034-0.051 vs 0.041; 95% CI, 0.032-0.050), attention (0.043; 95% CI, 0.037-0.050 vs 0.048; 95% CI, 0.041-0.054), visuospatial abilities (0.107; 95% CI, 0.097-0.117 vs 0.118; 95% CI, 0.108-0.128), language (0.045; 95% CI, 0.037-0.054 vs 0.041; 95% CI, 0.033-0.048), and executive functions (0.092; 95% CI, 0.086-0.099 vs 0.089; 95% CI, 0.082-0.096). For the 3MSE and ADAS-Cog, rates of change varied by baseline cognitive status (mild cognitive impairment), but there were no differences in rates of change between treatment groups (for 3MSE, P = .71; for ADAS-Cog, P = .97). There was no significant effect modification of treatment on rate of decline by age, sex, race, education, APOE*E4 allele, or baseline mild cognitive impairment (P > .05).

Conclusion Compared with placebo, the use of G biloba, 120 mg twice daily, did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment.

Wednesday, December 02, 2009

Hairdressers: Another Non-Industrial Population at Increased Risk Due to Chemical Exposure

BrooklynDodger(s) comment: IARC lists occupation of hairdresser as Group 2A. Volume 57.

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International Journal of Epidemiology 2009 38(6):1512-1531; doi:10.1093/ije/dyp283















































Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Risk of cancer among hairdressers and related workers: a meta-analysis

Bahi Takkouche1,2,*, Carlos Regueira-Méndez1,2 and Agustín Montes-Martínez1,2

1 Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
2 CIBER en Epidemiología y Salud Pública (CIBER-ESP), Spain.

* Corresponding author. Department of Preventive Medicine, Faculty of Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain. E-mail: bahi.takkouche@usc.es


 Abstract

Background Hairdressers and allied occupations represent a large and fast growing group of professionals. The fact that these professionals are chronically exposed to a large number of chemicals present in their work environment, including potential carcinogens contained in hair dyes, makes it necessary to carry out a systematic evaluation of the risk of cancer in this group.

Methods We retrieved studies by systematically searching Medline and other computerized databases, and by manually examining the references of the original articles and monographs retrieved. We also contacted international researchers working on this or similar topics to complete our search. We included 247 studies reporting relative risk (RR) estimates of hairdresser occupation and cancer of different sites.

Results Study-specific RRs were weighted by the inverse of their variance to obtain fixed and random effects pooled estimates. The pooled RR of occupational exposure as a hairdresser was 1.27 (95% CI 1.15–1.41) for lung cancer, 1.52 [95% confidence interval (CI) 1.11–2.08] for larynx cancer, 1.30 (95% CI 1.20–1.42) for bladder cancer and 1.62 (95% CI 1.22–2.14) for multiple myeloma. Data for other anatomic sites showed increases of smaller magnitude. The results restricted to those studies carried out before the ban of two major carcinogens from hair dyes in the mid-1970s were similar to the general results.

Conclusions Hairdressers have a higher risk of cancer than the general population. Improvement of the ventilation system in the hairdresser salons and implementation of hygiene measures aimed at mitigating exposure to potential carcinogens at work may reduce the risk.

Tuesday, December 01, 2009