Benzac Benzoyl Peroxide

Paraffin wax candles, used mainly for romantic ambiance, fragrance and light, may also contribute to air pollution inside your home.

The candles, which are made from petroleum, are a source of known human carcinogens and indoor pollution, researchers said in a study to be presented Wednesday at the American Chemical Society’s national meeting in Washington, D.C.

In the study, R. Massoudi and Amid Hamidi found that candles made from beeswax or soy, although more expensive, apparently are safer because they do not release potentially harmful pollutants.

“An occasional paraffin candle and its emissions will not likely affect you,” Hamidi said in a news release. “But lighting many paraffin candles every day for years or lighting them frequently in an unventilated bathroom around a tub, for example, may cause problems.”

Ventilation can help reduce the level of pollutants in closed rooms, the researchers said.

Besides the more serious risks, Hamidi also said that some people who believe they have an indoor allergy or respiratory irritation may actually be reacting to pollutants from burning candles.

The type 2 diabetes drug Avandia (rosiglitazone) increases the risk of heart failure and death more than another drug in the same class, Actos (pioglitazone), new Canadian research contends.

Avandia has been the subject of controversy since 2007, when it was linked to an increased risk for heart attack and death, although those claims have become clouded as other studies have discounted that risk to some degree. But taken together, many believe that the drug should not be used, especially since there appears to be a safer choice.

“It is difficult for making a case for using rosiglitazone in anybody, because we have an alternative,” said lead researcher Dr. David Juurlink, division head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.

In 2007, Dr. Steven Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, published a study that found Avandia showed a 43 percent greater risk of heart attack among diabetes patients, and he remains convinced that the drug should not be used.

“I agree with the authors’ conclusions,” Nissen said. “Rosiglitazone should not be used in patients with diabetes. Pioglitazone is a safer alternative.”

There is increasing evidence that Actos is safer than Avandia, Juurlink said. “Not a single study has suggested that pioglitazone might be less safe than rosiglitazone,” he said. “And rosiglitazone doesn’t have a single advantage — not even a theoretical one.”

Both Avandia and Actos belong to a class of drugs called thiazolidinediones, which are used widely to lower blood sugar in people with type 2 diabetes. In addition to an increased risk for heart failure, both drugs can also cause side effects that include weight gain and fluid retention. Both medications carry a U.S. Food and Drug Administration warning label about the risk of heart failure and heart attack.

The latest report on the safety of these drugs is published online Aug. 19 in the BMJ.

For the study, Juurlink’s team collected data on 39,736 patients treated with Avandia or Actos between April 2002 and March 2008. The researchers compared these data with hospital records of heart failure, heart attack and deaths.

The researchers found that patients taking Avandia were at greater risk of heart failure and death than those taking Actos. There was no significant difference between the drugs for the risk of heart attack, Juurlink’s group noted.

For every 93 patients treated with Avandia instead of Actos, there was one additional cardiovascular event or death per year, the researchers estimated.

“As a clinician, I cannot envision an instance in which I would recommend rosiglitazone,” Juurlink said.

However, Corinne de Vries, a professor of pharmacoepidemiology in the department of pharmacy and pharmacology at the University of Bath, England, and co-author of an accompanying journal editorial, is not convinced that Avandia is less safe than Actos.

“Nobody should stop taking their medication without consulting their doctor, because I don’t think rosiglitazone kills you,” de Vries said.

De Vries said the conclusions of this study are not supported by the data Juurlink’s group used. People taking Avandia were sicker than those taking Actos, so these patients were more likely to develop heart failure, she noted.

“The data presented by Juurlink do not support the suggestion that you should favor one drug over the other,” de Vries said. “There is no reason to believe yet that there is a difference.”

People who have a preexisting heart condition should not be started on either of these drugs, de Vries stressed. Patients who develop heart failure should have the drug discontinued, because the condition is usually reversible, she added.

Another expert, Dr. Carl J. Lavie, medical director for cardiac rehabilitation and prevention director of the Stress Testing Laboratory at the Ochsner Heart and Vascular Institute in New Orleans, thinks the study gives more reasons not to use Avandia.

“I believe that most clinicians have stopped using Avandia — some will use Actos instead or go to another class completely,” Lavie said.

Lavie noted that an ongoing study assessing Avandia and Actos in a head-to-head comparison should provide more answers about these drugs.

“Until then, this current study provides further ammunition against using Avandia or at least for trying Actos first, which is along the same lines as the current American Diabetes Association and European guidelines anyway,” Lavie said. “Most will, and should, avoid either agent in a patient with heart failure or high heart failure risk.”

“Both drugs have a place in treating diabetes, but not if you have a preexisting heart condition,” de Vries said.

One of the first steps toward managing your child’s asthma is to recognize the allergens or irritants that can trigger an attack. Frequently, these may include dust, pet dander, smoke, exercise or polluted air.

The American Academy of Family Physicians offers these suggestions:
During allergy seasons, run the air conditioner and keep the windows in your home and car closed. Regularly replace filters from your home’s cooling system.
Keep bathrooms, kitchens and basements clean and allow them to air out. Run a dehumidifier, if needed, in these areas.
Reduce dust and dust mites by frequently washing bed linens in hot water. Remove any carpets and rugs, if possible.
Keep pets out of your child’s bedroom.
Keep your child away from tobacco smoke.

The epidemic of home foreclosures is having a serious impact on Americans’ health, suggests a study that looked at 250 Philadelphia homeowners facing foreclosure.

More than half of them reported being depressed, and 37 percent of them had major depression. In addition, almost 60 percent reported skipping meals because they couldn’t afford food and 48 percent said they couldn’t afford prescription drugs.

The study also found that for 9 percent of participants, a medical condition in their family was the primary reason for the home foreclosure, and more than 25 percent said they had significant unpaid medical bills.

“The foreclosure crisis is also a health crisis. We need to do more to ensure that if people lose their homes, they don’t also lose their health,” the study’s lead author, Dr. Craig E. Pollack, who conducted the research while at the University of Pennsylvania School of Medicine, said in a news release.

The financial strain of foreclosure may cause people to reduce what they consider discretionary health care spending, for such things as preventive care visits, healthy foods and drugs for chronic conditions. This can have a serious effect on long-term health, Pollack said.

He and his colleagues also found that the stress of foreclosure may lead to an increase in unhealthy behaviors. For example, 65 percent of smokers in the study said they smoked more since receiving notice of foreclosure.

The findings from Philadelphia may represent only the tip of the iceberg when compared to some other cities, Pollack said. While foreclosure filings in Philadelphia almost doubled between 2007 and 2008, other large cities have higher unemployment and foreclosure rates.

In order to reduce foreclosure-related health effects, mortgage counseling agencies and health care workers need to coordinate their efforts to help people at risk of foreclosure access both housing and medical help, the researchers said.