Friday, September 30, 2005

Antibiotic Reverses Airflow Obstruction in Lung Transplant Recipients

News from Medscape Pulmonary Medicine

NEW YORK (Reuters Health) Sept 15 - The long-term survival of lung transplant recipients is limited by the development of bronchiolitis obliterans syndrome (BOS), a condition thought to be irreversible, but UK researchers suggest that the drop in lung function can, in fact, be reversed through treatment with azithromycin (Zithromax).

Encouraging findings from a pilot study, led Dr. Paul A. Corris, from The Freeman Hospital in Newcastle upon Tyne, and colleagues to retrospectively evaluate the effects of azithromycin on lung function in 20 lung allograft recipients with established BOS.

Azithromycin was introduced at a mean of 82 months after transplantation, according to the report in the September issue of the American Journal of Respiratory and Critical Care Medicine. All of the subjects were treated with immunosuppressive regimens that included a cell-cycle inhibitor, oral corticosteroids, and a calcineurin inhibitor.

After 3 months of treatment, azithromycin therapy was tied to a 110 mL median increase in FEV1 (p = 0.002), the authors point out. Moreover, the majority of patients who experienced an early benefit showed sustained improvements at up to 11 months.

"This case series," the authors observe, "confirms the benefit of azithromycin in not only halting, but reversing the declining lung function seen in patients with BOS."

"Low-dose macrolides," they conclude, "offer a new and exciting therapeutic strategy for the treatment of progressive BOS, and further clinical and translational mechanistic studies are required."

Am J Respir Crit Care Med 2005;172:772-775.

Thursday, September 29, 2005

Drug Firms Launch Web Site to Disclose Trials Data

LONDON (Reuters) Sept 21 - The global pharmaceutical industry launched a new Web site Wednesday, Sept 21 giving details of clinical trials on new medicines in a bid to allay patient fears over drug safety.

The new portal Clinical Trials established by the International Federation of Pharmaceutical Manufacturers and Associations, links available online information about clinical trials worldwide

The pharmaceutical industry recognizes that a broader access to clinical trial information can be of significant benefit to patients as well as to the medical community in that it can help to facilitate medical decisions about potential therapies.

In a joint EFPIA/IFPMA/JPMA/PhRMA position on the disclosure of clinical trial information via clinical trial registries and databases that industry issued in January 2005, it committed to make information available on ongoing clinical trials (Clinical Trials Registries) as well as on results of clinical trials (Clinical Trials Results Databases).

By providing a single user-friendly entry site, the IFPMA portal aims to facilitate patients' and doctors' searches for comprehensive information on clinical trials.

(For example I entered a search for "pulmonary fibrosis" and received hundreds of results. Merv)

What information can you find by using this portal?

The new internet search portal establishes links to IFPMA member company websites as well as other commercial and government-sponsored websites containing information on clinical trials provided by pharmaceutical companies.

Firstly, the portal can be used to search the mentioned websites for information on newly initiated clinical trials that are performed to determine the therapeutic benefit of a given medicinal product. Here, patients (in conjunction with their healthcare providers) will find as well information on how to enquire about enrolling in the ongoing trial they are interested in.

Secondly, the portal enables the user to find results of clinical trials conducted on medicinal products that have been approved for marketing. Industry committed to disclose these results in a non-promotional summary, regardless of the trial outcome.

Wednesday, September 28, 2005

Inheritance, Smoking Spawn Mysterious and Deadly Lung Disease

DURHAM, N.C. – An incurable, deadly lung disorder, "idiopathic interstitial pneumonia" (IIP), whose causes were mysterious, arises from a combination of a genetic predisposition and damage due to inhaled chemicals, notably from cigarette smoking, Duke University Medical Center researchers have found.

They said their findings could lead to a treatment, but more immediately represent a warning to people with the genetic predisposition, not to smoke.

IIP is a form of pulmonary fibrosis, a group of diseases characterized by scarring of the lungs. The condition, for which no treatment exists, typically kills its victims within five years. While the prevalence of the disease is unknown according the National Institutes of Health, estimates indicate the numbers are rising with as many as 15,000 new cases of idiopathic pulmonary fibrosis -- a form of the disease having unknown causes -- diagnosed yearly in the U.S.

Read the complete report: Pulmonary Fibrosis

Tuesday, September 27, 2005

Health consequences of smoking 1–4 cigarettes per day

This study, published in Tobacco Control, adds to the mountain of evidence about the health risks of smoking.

Objectives: To determine the risk in men and women smoking 1–4 cigarettes per day of dying from specified smoking related diseases and from any cause.

Design: Prospective study.

Setting: Oslo city and three counties in Norway.

Participants: 23,521 men and 19,201 women, aged 35–49 years, screened for cardiovascular disease risk factors in the mid 1970s and followed throughout 2002.

Conclusions: In both sexes, smoking 1–4 cigarettes per day was associated with a significantly higher risk of dying from ischaemic heart disease and from all causes, and from lung cancer in women. Smoking control policymakers and health educators should emphasise more strongly that light smokers also endanger their health.

Read the full abstract: Tobacco Control

Sunday, September 25, 2005

Dark chocolate may reduce blood pressure, improve insulin resistance

For chocloate lovers who've been told their favorite treat was "unhealthy" there is now a suggestion that dark chocolate may reduce blood pressure and improve insulin resistance, according to a report in Hypertension: Journal of the American Heart Association.

Researchers report in this article that if you have high blood pressure, a daily bar-sized serving of flavonol-rich dark chocolate might lower your blood pressure and improve insulin resistance.

Previous studies suggest flavonoid-rich foods, including fruits, vegetables, tea, red wine and chocolate, might offer cardiovascular benefits, but this is one of the first clinical trials to look specifically at dark chocolate's effect on lowering blood pressure among people with hypertension, said study author Jeffrey B. Blumberg, Ph.D.

Read the full report: Dark Chocolate

Thursday, September 22, 2005

Fund Raising For Lung Transplant Research

Merv Sheppard, Dr. Lianne Singer, Dr. Shaf Keshavjee, Kim Cassar, Peter Laurence

Lung transplant recipients Kim Cassar, Peter Laurence and Merv Sheppard organized the Transplant Open Golf Tournament, with the support of Toronto General & Western Hospital Foundation and other volunteers, to raise funds for the Lung Transplant Team at Toronto General Hospital. Golf Photos

At a lung transplant support group meeting September 21, 2005 Kim, Merv and Peter proudly presented a check for $13,184 to Dr. Shaf Keshavjee, Director of the Lung Transplant Program and Dr. Lianne Singer, Lung Transplant Program Medical Director, in support of lung transplant research. Next year's tournment is June 7, 2006 at Castlemore Golf & Country Club in Brampton, Ontario. We hope to double the above amount next year. Mark your calendars!

Check presentation photos: Presentation

Wednesday, September 21, 2005

New Relief From Postherpetic Neuralgia (PHN)

One of the most debilitating experiences I ever had in my life was with the pain caused by postherpetic neuralgia (PHN) that followed my bout of shingles. Many immune-suppressed patients who have had chicken pox as a child suddenly now find themselves overcome by shingles and the ensuing pain. So these announcements from Pfizer bode well for the future management of PHN.

This is the U.S. announcement. The Canadian announcement is similar.
NEW YORK, September 21 -- Pfizer Inc announced today that Lyrica® (pregabalin) capsules c-v, a new prescription medication for the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN), postherpetic neuralgia (PHN) and adjunctive treatment of partial onset seizures in adults with epilepsy, is now available in U.S. pharmacies.

Neuropathic pain, one of the most debilitating forms of pain, is caused by nerve damage that can result from underlying conditions, such as diabetes or shingles. Nearly half of the 18 million Americans with diabetes will develop some form of diabetic neuropathy over the course of their disease. Some will develop painful DPN which is often described as burning, tingling, sharp, stabbing, or pins and needles in the feet, legs, hands or arms.

PHN is a complication of shingles, a painful outbreak of rash or blisters on the skin caused by a reactivation of the same virus that causes chicken pox (the herpes zoster virus). Each year, about 150,000 Americans develop PHN, which is often characterized as constant stabbing, burning, or electric shock-like sensation.

Full U.S. press release: Lyrica Now Available in U.S.

Full Canadian press release:Lyrica Now Available in Canada

Tuesday, September 20, 2005

Hospital Cafeteria Food a Recipe for Illness?

We are starting to see more and more articles and news items claiming that hospital cafeteria food is a recipe for illness, and this new report by the Physicians Committee for Responsible Medicine (PCRM) indicates that high-fat, high-cholesterol meals increase the risk of heart disease and cancer for hospital staff and visitors.

But I think there's more than meets the eye here. Read on and see what you think about the pros and cons of what's being advocated.

I've excerpted the report below with a link to the full news release.

Thursday, September 15, 2005
WASHINGTON—Nutrition scientists with the Physicians Committee for Responsible Medicine (PCRM) have conducted a nationwide survey to determine if hospital cafeterias and restaurants are meeting the need for low-fat, cholesterol-free foods that can help people maintain a healthy weight and prevent heart disease, diabetes, and some cancers. While there are some promising trends, such as the wide availability of whole-grain products and fresh fruit, there is an urgent need for improvement. The survey reveals that fewer than one-third of hospitals offer either a daily salad bar or a daily low-fat, cholesterol-free entrée. Moreover, a nutritional analysis reveals that many entrées described as healthful by hospitals are actually very high in artery-clogging fat. Sixty-two percent of these “healthiest entrée” offerings derived more than 30 percent of calories from fat, and a few derived more than 50 percent of calories from fat.

For the full news release go to: PCRM

Contact: Jeanne S. McVey at 202-686-2210, ext. 316, or cell 415-509-1833;

At first the above article caught my attention and I said yes, some hospital food is unhealthy, with so many burger and pizza fast food restaurants springing up in hospitals all over the country.

But when I dug into this more deeply PCRM seems to be an organization advocating a total vegetarian diet with only about five percent of it's members being actual physicians.

Here's what had to say recently:
The Physicians Committee for Responsible Medicine (PCRM) is a wolf in sheep’s clothing. PCRM is a fanatical animal rights group that seeks to remove eggs, milk, meat, and seafood from the American diet, and to eliminate the use of animals in scientific research. Despite its operational and financial ties to other animal activist groups and its close relationship with violent zealots, PCRM has successfully duped the media and much of the general public into believing that its pronouncements about the superiority of vegetarian-only diets represent the opinion of the medical community.
“Less than 5 percent of PCRM’s members are physicians,” Newsweek wrote in February 2004. The respected news magazine continued:

[PCRM president Neal] Barnard has co-signed letters, on PCRM letterhead, with the leader of Stop Huntingdon Animal Cruelty, an animal-rights group the Department of Justice calls a “domestic terrorist threat.” PCRM also has ties to People for the Ethical Treatment of Animals. An agency called the Foundation to Support Animal Protection has distributed money from PETA to PCRM in the past and, until very recently, did both groups’ books. Barnard and PETA head Ingrid Newkirk are both on the foundation’s board. is part of the network, and is committed to providing detailed and up-to-date information about the funding source of radical anti-consumer organizations and activists. They have analyzed over 410,000 pages of IRS documents to create their database, and new information will be added every month.

go to this link for the full article:
A Wolf in Sheep's Clothing

So what's right and what's wrong here? I would be interested in you comments. Merv.

Monday, September 19, 2005

Freedom from eye glasses for cataract patients?

This looks like good news for transplant recipients that develop cataracts.

After being on high doses of Prednisone before and after my lung transplant, I developed cataracts and was starting to go slowly blind. Thanks to the miracle of an intraocular lens implant in both eyes I now have perfect 20/20 vision as far as distance goes, but need glasses for reading. Now, there is news that a lens has been developed that provides correction for both near and far sightedness.

Emory Eye Center is the first to offer a newly FDA-approved intraocular lens (IOL) for cataract patients. The lens provides them with a new option for post-surgery vision correction -- that of freedom from glasses. The lens provides near, intermediate, and far vision capabilities.

Alcon Corporation's new AcrySof ReSTOR Apodized Diffractive IOL provides those with or without presbyopia a quality range of vision. Presbyopia ('old age vision') is a refractive condition with a diminished power of accommodation due to a loss of elasticity of the crystalline lens. Typically, those over 40 have this condition.

The new lens allows those patients freedom from glasses following their IOL implant(s). Older IOLs, typically implanted after cataract removal, normally require patients to use reading glasses or bifocals for near vision. In clinical trials with patients who have bilateral cataract removal, 80 percent of them used no glasses following their surgery.

The ReSTOR lens is a foldable IOL that replaces the diseased cataract lens. The complementary technologies of apodization, diffraction and refraction allow patients to experience a full-range of vision without the need for glasses.
'This device is an exciting opportunity for patients and physicians,' says J. Bradley Randleman, MD, a cornea specialist at Emory Eye Center. 'We now have a lens option that may provide high-quality distance and near vision for our cataract patients, and significantly reduce their dependence on glasses for their everyday lives,' he says. "

Full press release: Intraocular Lens

Wednesday, September 14, 2005


Regular posts will resume next week. I'm away on Organ Donation Awareness business for the next few days. Meanwhile please browse my previous posts and links. Thanks, Merv.

Saturday, September 10, 2005

Lung Transplant Support Group Meetings September and October, 2005

Support Group Meetings in Toronto and Kitchener are on-going as noted. Please read below for location and directions.

TORONTO SUPPORT GROUP MEETINGS – Wednesdays at 11am – Pre & Post Transplant patients please read:

The support group has a pre-transplant focus and is intended for pre-transplant patients/families and those who are up to about 3 months post-transplant. All post lung transplant patients are invited to attend any meeting where a physician is speaking.
Support persons may attend all meetings.

Cepacia negative patients may attend from the 1st to the 15th of the month. Cepacia positive patients may attend either meeting from the 16th to the end of the month.

Out of town patients who have the opportunity to attend only during occasional visits to the hospital should feel welcome to come at any time.

Meeting Schedule - September and October, 2005 (subject to change without notice.)

  • September 7th Sarah Greenwood – relaxation techniques

  • September 14th - General Meeting

  • September 21st - Special Event: Dr. Shaf Keshavjee, Director, Toronto Lung Transplant Program , will attend and be presented a check by post-transplant patients, Kim Cassar, Peter Laurence and Merv Sheppard, who, along with other volunteers, organized a very successful golf tournament to raise funds for transplant research. This is an open meeting and everyone is invited. Let's have a good turnout in support of Dr. Keshavjee and his team.

  • September 28th - Speaker: Post transplant coordinators, Debbie Zogalo and Josie Dorosz

  • October 5th - Speaker: Transplant Pharmacist will discuss transplant medications and answer questions

  • October 12th - General Meeting

  • October 19th - Sarah Greenwood – relaxation techniques

  • October 26th - Speaker: Lung transplant Civitan members will update us on their work and their goals designed to assist lung transplant patients

Meetings are at 11am, 11th floor west, Room 1135 NCSB
(NCSB - New Clinical Services Building, Toronto General Hospital - take elevators from University lobby)

Maureen O'Dell MSW RSW
Social Worker, Multi Organ Transplant Program
Toronto General Hospital, University Health Network
200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4
Tel: (416) 340-4800 ext 4612
Email Maureen!

"WAITING IN HOPE” Mondays 11am to 12 Noon in NCSB 12C Room 1202, Toronto General Hospital - "Waiting in Hope" offers a place for patients and/or support persons to gather together and share their experience and how it impacts their sense of spirituality, faith and understanding of life.
Info: Maureen O'Dell (see above)

KITCHENER-WATERLOO AREA SUPPORT GROUP MEETINGS start at 7:30 P.M. the first Tuesday of every month and are held at the Lions Arena, (corner of Rittenhouse & Block Line Rd.) in Kitchener, Ontario. For more info please call Denise Secours at 519 578-0288.

Thursday, September 01, 2005

Another Brief Intermission

Because of my wife Joan's diagnosis of breast cancer and the subsequent surgery, etc. my posts to this blog have been a bit sporadic and will probably be so for the next little while. Thanks for your understanding and patience. Merv.

September 1st, 2005
Here’s the latest on Joan.
The surgeon had a meeting late last week with his committee (microbiology, oncology and surgery) to discuss Joan’s case. The consensus was that rather than proceed with further surgery (which would delay radiation treatment by several weeks or a month) they recommended that Joan start radiation therapy now, 5 days a week for 6 to 8 weeks plus systemic therapy. The committee felt this should eradicate the remaining cancer cells. Meanwhile, Joan has been having a lot of pain with the huge hematoma and the surgeon drained 90cc’s of fluid Wednesday. Joan has now been referred to an oncologist and we are waiting for a call from the Cancer Clinic, which should be next week. The last couple of days have been rough for Joan but she seems to be much better today and hopefully this bodes well for the days to come. We hope you have a great Labor Day weekend. More updates later. Merv.

August 22, 2005
We met with the surgeon today and he reviewed the pathology report from Joan's surgery. The sentinal lymph node contained cancer cells and was an indication that the cancer had spread away from the original tumor site and he felt further surgery will be required; but he wanted to discuss Joan's case with the breast cancer specialists at a meeting this Thursday, Aug. 25th and will call us to confirm the next steps after that meeting. The surgeon also said that Joan will definitely require at least six weeks of radiation, five days a week and undergo systemic therapy such as tamoxafen. Thanks to all for your wonderful support. Merv.

August 17, 2005
Joan had a clinic appointment with the surgeon today, Aug. 17th. He removed the drainage tube that has been causing a lot of pain, but unfortunately he still did not have the pathology report back; however he called us a short while ago to say he had a “verbal” confirmation that she has Ductal Carcinoma with only one of the lymph nodes involved. (A condition called "atypical hyperplasia" occurs when abnormal cells of the breast cluster. As these cells continue to divide rapidly, changes or mutations can occur in the cells and they can form what is known as "intraductal cancer" or "ductal carcinoma in-situ " (DCIS). Carcinoma in-situ stays "in place" from where it started and has not spread to other areas of the body).

Joan’s cancer has been classed as stage two.

We have another clinic appointment next Monday, Aug. 22nd. The physician will review the pathology report with us and confirm the type of Ductal Carcinoma (there are several types) and the initial treatment. At the very least Joan will have to go on a course of radiation plus systemic therapy and the Cancer Clinic has already been called to arrange this.

It looks as if the cancer has not spread beyond the right breast area which is certainly hopeful news.

I’ll update this post after our next clinic appointment.

Email me at: Merv Sheppard

August 15, 2005
Joan is resting comfortably at home now. During the surgery for a partial mastectomy of her right breast the surgical team also removed the relavent lymph nodes. A drainige tube was sutured into her armpit area and this will probably be removed early this week. We still do not know the type or extent of her cancer and hope to learn more during our appointment with the surgeon scheduled for Wednesday, August 17th. I'll update this post regularly. Merv.

Email me at: Merv Sheppard

Joan, Myrtle Beach, 7-9-05
August 8, 2005
I haven't been able to publish regular posts here for the past week or so and probably won't be doing much this week either. A little over a month ago my wife Joan received a report that her yearly mammogram showed a suspicious mass. She then had a biopsy and we learned last Thursday that she has breast cancer. She's been fast-tracked for surgery; the pre-surgery clinic was today and she will have the operation tomorrow, August 9th. So as you can see I'll be busy and away from the blog. Thanks for your patience.