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Yoga is safe for pregnant women, as long as they approach the activity with reasonable caution and moderation, experts say.

“Women who are expecting can benefit greatly from exercise, especially yoga — they just need to be aware of their limitations,” orthopaedic surgeon and mom-to-be Dr. Rachel Rohde said in a news release issued by the American Academy of Orthopaedic Surgeons (AAOS).

“A pregnant woman’s body goes through a lot of changes that will alter the way she practices yoga, whether she is a veteran or a beginner,” Rohde added.

As a fitness alternative, yoga allows pregnant women to maintain an exercise program without harming their baby or their heart, according to the AAOS and, overall, the benefits of such a low-impact regimen outweigh the risks.

However, maintaining correct yoga positioning is critical to ensuring general safety and avoiding muscle or joint injury, the organization pointed out. The U.S. Consumer Product Safety Commission noted that more than 5,500 Americans were treated for yoga-related injuries in 2008.

Nevertheless, the AAOS says that if performed properly, yoga affords expectant mothers a good opportunity to build strength and flexibility, while achieving a measure of relaxation and breath control.

“One of the best aspects of yoga is being in control of your body and having the ability to do each movement at your own pace,” said Rodhe. “Poses like ‘downward dog’ that require a lot of pressure on the palm can increase carpal tunnel symptoms by pressing on a major nerve; if you get numbness in your fingers while in one of these positions, move so that the weight is not resting on your hands. If you are unable to move into a difficult position, you always have the option to get into a resting pose if experiencing pain.”

The AAOS recommends that those interested in practicing yoga should consult their physician first and make sure they work with a qualified instructor. Proper warm-ups and attire are important as well, and pregnant women should take care to remain properly hydrated and avoid forms of yoga such as Birkam — also called “hot” yoga — that can unduly raise their body temperature.

SOURCE: American Academy of Orthopaedic Surgeons, news release.

Large and deadly outbreaks of measles in 30 African countries threaten to reverse gains made against the viral disease in the past two decades, the World Health Organization (WHO) said on Friday.

More than 1,100 deaths from measles have been reported among 64,000 known cases in Africa the last year, it said. Chad, Nigeria and Zimbabwe have had the largest outbreaks.

“There is a widespread resurgence of measles with these outbreaks in over 30 African countries, some of which are seeing very high case fatality ratios,” WHO expert Peter Strebel told a news briefing.

Some 8,000 migrant children in Bulgaria also had the highly-contagious disease during the period, he said.

Measles deaths among children under five years old fell to 118,000 in 2008 from 733,000 in 2000, according to the United Nations agency’s latest figures.

But the WHO warned that a lack of funding and political commitment could result in a return to more than 500,000 cases measles deaths per year by 2012, wiping out the gains to date.

Health ministers from WHO’s 193 member states, holding their annual meeting in Geneva, agreed on Thursday to try to achieve at least 90 percent measles vaccination coverage nationally by 2015.

Britain also reported large numbers of measles cases over the past year, due to vaccination rates which had dropped below 90 percent following a scare that the measles, mumps and rubella (MMR) shot could lead to autism, Strebel said.

“In the past it was associated with the MMR autism threat which has now been proven not be present. In the U.K. in fact there have more recently been improvements in vaccination levels and transmission (disease spread) has come down to very low levels,” he said.

In February, the Lancet medical journal formally retracted a paper that caused a 12-year international battle over links between the three-in-one childhood MMR vaccine and autism.

The 1998 paper led to a steep drop in the number of vaccinations in the United States, Britain and other parts of Europe, prompting a rise in cases of measles.

Severe measles is more likely among poorly nourished young children. The most serious complications include blindness, encephalitis, severe diarrhea and dehydration, ear infections or severe respiratory infections such as pneumonia, WHO says.

It costs less than $1 to vaccinate a child against measles but two doses are required for full protection.

Scientists report that they’ve successfully used gene therapy to treat a small number of patients with the condition known as “bubble boy” disease, which robs children of the ability to fight off germs.

The research is preliminary, and another phase of testing is needed before the therapy can get federal approval. Also, the treatment only appears to work in patients with a particular strain of the disease.

Even so, the findings highlight the fact that the disease is becoming easier to treat and the prognosis is improving for these children, said lead investigator Dr. Donald B. Kohn.

“We’re talking about 70 to 90 percent surviving and doing well, and we’re hoping to get that even higher as gene therapy gets more effective,” said Kohn, a pediatric bone-marrow transplant doctor at the University of California at Los Angeles David Geffen School of Medicine.

When they’re born, babies have natural resistance to disease, thanks to immunity that they inherit from their mothers. Over time, if things go well, they develop immune systems of their own. But in some cases the immune systems don’t develop properly and the children become especially vulnerable to disease.

The condition is rare, but it became widely known in the 1980s because of the case of the “Bubble Boy,” a child named David Vetter who lived in a plastic bubble to avoid being infected by germs. He died at the age of 12, and his treatment remains controversial to this day.

Currently, children with the different types of the immune deficiency condition are treated with stem-cell transplants and gene therapy.

In the new study, researchers treated 10 children who had a form of the condition called adenosine deaminase severe combined immunodeficiency that affects 20 percent of those with bubble boy disease.

Researchers, who began the study in 2001, assigned four patients to receive regular treatment with enzyme replacement therapy. Another six stopped that therapy and received chemotherapy designed to create room in their bone marrow for transplanted cells.

“It would be like if you’re in a garden with a high density of plants, and you want to put some new plants in. The best chance for them to grow would be to remove some of the old plants,” explained Dr. Mark Kay, head of the gene therapy program at Stanford University School of Medicine.

Researchers hoped the transplanted cells would create a new immune system and, in half of the six patients, they did just that.

The treatment gives the patients a “key missing piece of genetic information” so their bodies can create a normal immune system, Kohn said. And the cells come from the patient’s own body so there should be less risk that the body will reject the cells or vice versa, he explained.

The study results came in a phase 1 trial, the first of three study phases that treatments must undergo to get federal approval. The second phase of research has already begun.

The treatment is costly, Kohn noted, requiring months of hospitalization.

Kay said the gene therapy treatment may become the standard way to treat bubble boy disease. It could, he said, allow children to undergo just one treatment — a “lifelong cure” — instead of repeatedly taking the enzyme treatment.

The study is scheduled to be released Friday at the annual meeting of the American Society of Gene & Cell Therapy, in Washington D.C.

SOURCES: Donald B. Kohn, M.D., professor, department of microbiology, immunology and molecular genetics and department of pediatrics, University of California at Los Angeles David Geffen School of Medicine; Mark Kay, M.D., Ph.D., professor, pediatrics and genetics, Stanford University, Palo Alto, Calif.;

Two new drugs — both oral, rather than injected — may soon be available to combat multiple sclerosis.

Three studies, all being published early online Jan. 20 in the New England Journal of Medicine, find that the new drugs — fingolimod and cladribine — reduce relapse rates in people with relapsing-remitting multiple sclerosis (MS). Both drugs work by altering the immune system response.

However, as is often the case with immune-suppressing medications, there are concerns about side effects, including an increased risk of serious infections and possibly, cancer.

“Oral drugs are what people with MS have been wishing for a long time. This is wonderful news for people with MS,” said Dr. John Richert, executive vice president of research and clinical programs for the National Multiple Sclerosis Society (NMSS). “The drugs appear to be quite effective, and at the moment, appear to have a reasonable risk-benefit ratio. However, it will be very important for people with MS and their physicians to remain vigilant and be on the lookout for side effects.”

All three studies were funded by the drug’s manufacturers — Novartis for fingolimod and Merck Serono for cladribine. Both manufacturers are currently pursuing U.S. Food and Drug Administration approval for their medications.

Multiple sclerosis is a chronic, potentially disabling illness that’s believed to be an autoimmune disorder. In MS, the body’s natural defense system mistakenly attacks the fatty substance that protects the nerves (myelin). About 400,000 Americans have multiple sclerosis, according to the NMSS.

The current treatments for MS are all injectable medications, which Richert said is sometimes a barrier for people to start early treatment. He said that treatments may be more successful if they’re started early in the course of the disease, so he’s hoping that having oral medications will help people start treatment sooner.

Two of the new studies focused on the oral medication called fingolimod. Both were phase 3 studies. One study included more than 1,000 people with relapsing-remitting MS. The study participants were randomly selected to receive a daily dose of 0.5 milligrams (mg), 1.25 mg or a placebo.

Annual relapse rates were less than 1 percent each year, but were 54 percent less for the lower dose of fingolimod and 60 percent for the higher dose. The study also found slower disease activity and progression.

In the second study on fingolimod, 1,153 people with relapsing-remitting MS were randomly assigned to receive a daily dose of 0.5 mg or 1.25 mg of fingolimod or a weekly dose of 30 micrograms of interferon beta-1a (Avonex) for one year. The annual relapse rate on either drug was less than 1 percent in this study as well. However, the people on fingolimod had up to a 52 percent lower relapse rate. This study found no significant differences in disease progression between the two treatments.

Both studies found that the lower dose of the drug was better tolerated. A small number of serious infections occurred, including two deaths from herpes infections in these studies. And, there appeared to be a higher incidence of cancer in people taking fingolimod.

Still, “the fact that fingolimod is given orally is a huge advantage,” said the lead author of the yearlong study, Dr. Jeffrey Cohen, director of experimental therapeutics at the Mellen MS Center at the Cleveland Clinic in Ohio. “It appears to be effective and is generally well-tolerated.”

The third study, also a phase 3 study, looked at the oral medication cladribine in comparison to placebo. In this study, more than 1,300 people with relapsing-remitting MS were randomly assigned to receive a cladribine dose of either 3.5 mg or 5.25 mg per kilogram of body weight or a placebo. During the second year of the study, those on cladribine were all given the lower dose.

As in the fingolimod studies, annual relapse rates were less than 1 percent. However, those on cladribine had relapse rates that were up to 58 percent lower. Disease activity and disability scores were also lower in the treatment groups.

Although the drug appeared to be generally well-tolerated, there were some serious side effects with cladribine as well, including serious herpes zoster infections. Herpes zoster is the virus that causes shingles, and there is a vaccine available for this virus. Whether getting the vaccine prior to treatment would lessen the risk of infection isn’t clear because it hasn’t been studied, said Richert. Cladribine was also associated with a potentially increased risk of cancer.

Another question that remains to be answered for both medications is whether or not they will increase the risk of a very serious brain infection known as progressive multifocal leukoencephalopathy (PML). It wasn’t discovered that the MS medication, natalizumab (Tysabri), caused a slight increase in the rate of these infections until the drug came to market. That’s because it’s such a rare side effect.

SOURCES: Jeffrey Cohen, M.D., director, experimental therapeutics, Mellen MS Center, Cleveland Clinic, Ohio; John Richert, M.D., executive vice president, research and clinical programs, National Multiple Sclerosis Society, New York City;