Thursday, January 09, 2014

Sleeping pill Stilnoct (zolpidem/ambien) can increase the risk of heart attacks, scientists claim

This finding probably shows only that Taiwanese in poor health have more insomnia

A sleeping pill prescribed to thousands of patients can increase the risk of heart attacks by up to 50 per cent, according to scientists.

Research carried out among heart attack victims found that numbers were higher among those who had taken zolpidem tablets, prescribed in the UK under the name Stilnoct and in the US as Ambien.

Scientists have linked taking zolpidem to an increased threat of heart attacks, and believe that taking the equivalent of 60 of the pills can increase the risk by as much as 50per cent.

Even taking just four pills with a dose of 35 miligrams per year increases the risk of a life-threatening cardiac episode by 20per cent.

The study, which was carried out by experts at the China Medical University in Taiwan, is the first to link zolpidem with cardiovascular problems.

Drug manufacturers Sanofi Inc have refuted the finding and said there are no known adverse cardiac reactions to zolpidem.

Experts can not be completely sure that the pills are responsible for heart problems.

However, scientists, who presented their findings at the world’s biggest cardiology conference in Dallas, Texas, say further and wider-reaching investigations into possible side effects of the drug are required following the study of more than 5,000 people.

Scientists who compared 5,000 heart attack victims with 20,000 healthy adults claimed there was a higher rate of heart attacks among those who took zolpidem.

The findings, revealed at the annual meeting of the American Heart Association, showed that even taking the pills sporadically can increase the risk of suffering a heart attack.

'The risk of an acute myocardial infarction (heart attack) was greatly increased with zolpidem exposure,' the report said, according to the Daily Express.

As part of a separate study the China Medical University scientists found that taking the equivalent of a 10mg zolpidem tablet every week can double the risk of a patient suffering a damaged aorta blood vessel.

According to the scientists the medication can increase the threat of an aortic dissection, where the vital aorta blood vessel is torn with potentially fatal results as it can cause internal bleeding.

In a statement Sanofi Inc said that that known adverse reactions to the drug did not include acute myocardial infarction or aortic dissection.

It said: 'We stand behind the substantial body of clinical data demonstrating the safety and efficacy of zolpidem, which was first approved in France in June 1987, amounting to 26 years of real-world use and 24 billion nights of patient therapy worldwide.'

Around five million people in Britain are prescribed z-hypnotics, including zolpidem, for insomnia every year.

However, there have been an increasing number of fears over their safety and it is recommended that patients should take the lowest dose possible for no more than four weeks.

In 2012, the US Food and Drug Administration said that the recommended dosages of zolpidem should be halved to to five milligrams because of concerns that the medication can remain in the bloodstream for longer than initially thought.

An unrelated study carried out last year showed increased rates of cancer-related deaths among people taking all varieties of sleeping pills, not just z-hypnotics.


Sweets made of bacteria fight off tooth decay

This was an extremely small study so must be regarded as preliminary only

Sweets that slash levels of harmful bacteria in the mouth could be a new weapon against tooth decay. They are designed to stop the bugs that cause decay from sticking to the surface of teeth, where they trigger erosion.

Instead, the harmful bacteria are swallowed in saliva and then flushed out of the body.

The sugar-free sweets work by  using a type of 'friendly' probiotic bacteria (lactobacillus paracasei) to bind to the harmful type (streptococcus mutans).

As the sweet is sucked, the friendly bacteria are released into the saliva. They then lock on to the corrosive type, forming a clump, which reduces the harmful bacteria's ability to stick to the surface of teeth.

As a so-called 'friendly' bacterium, found in some probiotic yoghurt drinks, for example, lactobacillus is a group of organisms that helps break down food, absorb nutrients and fight off bugs that might cause diseases such as diarrhoea.

The boiled sweets, developed by German firm Organobalance GMBH, could be targeted at children to try to avoid the early onset of tooth decay.

Rotten teeth in British children costs around £45 million a year to treat and by the age of 15, teenagers have had an average of 2.5 teeth filled or removed due to decay.

A recent survey suggested one in four five-year-olds in England already has tooth decay.

Streptococcus mutans, the most harmful bacterium in the mouth, feeds on sugar in the diet, which it ferments into an acid that burns holes in the surface of a tooth.

At the moment the only effective way to reduce bacteria numbers is to brush and floss regularly to reduce plaque (because plaque is where harmful bacteria congregate).

The sweets were developed after laboratory tests on rats showed that lactobacillus paracasei reduced levels of harmful microbes in the mouth.

The lactobacillus paracasei were first treated with heat, which stops them multiplying in the mouth but means they can still be recognised by the harmful bacteria which bind to it. To test it on humans, researchers developed a range of flavours containing heat-treated strains of the friendly bug.

They recruited 60 adults and split them into groups. Some ate sweets containing lactobacillus paracasei, and others ate identical-looking sweets with no bacteria.

Over one-and-a-half days, all the volunteers ate five sweets. Each time, researchers tested saliva samples to measure levels of the tooth-eating organism.

The results, published in the journal Probiotics and Antimicrobial Proteins, showed 75 per cent of those given the bacteria-loaded sweets had significantly lower levels of streptococcus mutans after eating only one sweet and this reduction persisted throughout the experiment. Those on placebo sweets also saw a slight reduction in the 'bad' bacteria, but researchers think this might have been because they were more inclined to suck for longer - creating more saliva to flush the mouth out - because they knew they were taking part in an experiment.

The sweets could be available within the next year or two. Scientists are also developing toothpastes and mouthwashes containing the friendly bacteria.

Commenting on the findings, Dr Nigel Carter, chief executive of the British Dental Health Foundation, said: 'This adds to the growing belief that probiotics have an important role to play in improving oral health.'


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