A Chinese herbal preparation prevents death from Sepsis

Where I grew up in tropical Australia, if you were sick, you went to the doctor but if you were really sick you went to the Chinese herbalist. I have myself benefited from that in my youth. I had persistent test-confirmed glandular fever (mononucleosis) but a Chinese herbal preparation sent it into rapid remission. So I am probably less surprised by the findings below than most. I note that the study was a methodologically strong one, not another useless observational one

Question Is Xuebijing injection (XBJ) effective in reducing mortality in patients with sepsis?

Findings In this randomized clinical trial that included 1817 patients with sepsis, the 28-day mortality rate was 18.8% in the XBJ group vs 26.1% in the placebo group, a significant difference.

Meaning Among patients with sepsis, treatment with XBJ, compared with the placebo group, resulted in lower 28-day mortality.

Abstract
Importance Previous research has suggested that Xuebijing injection (XBJ), an herbal-based intravenous preparation, may reduce mortality among patients with sepsis.

Objective To determine the effect of XBJ vs placebo on 28-day mortality among patients with sepsis.

Design, Setting, and Participants The Efficacy of Xuebijing Injection in Patients With Sepsis (EXIT-SEP) trial was a multicenter, randomized double-blind, placebo-controlled trial conducted in intensive care units at 45 sites and included 1817 randomized patients with sepsis (sepsis 3.0) present for less than 48 hours. Patients aged 18 to 75 years with a Sequential Organ Failure Assessment score of 2 to 13 were enrolled. The study was conducted from October 2017 to June 2019. The final date of follow-up was July 26, 2019. Data analysis was performed from January 2020 to August 2022.

Interventions The patients were randomized to receive either intravenous infusion of XBJ (100 mL, n = 911) or volume-matched saline placebo (n = 906) every 12 hours for 5 days.

Main Outcomes and Measures The primary outcome was 28-day mortality.

Results Among the 1817 patients who were randomized (mean [SD] age, 56.5 [13.5] years; 1199 [66.0%] men), 1760 (96.9%) completed the trial. In these patients, the 28-day mortality rate was significantly different between the placebo group and the XBJ group (230 of 882 patients [26.1%] vs 165 of 878 patients [18.8%], respectively; P < .001). The absolute risk difference was 7.3 (95% CI, 3.4-11.2) percentage points. The incidence of adverse events was 222 of 878 patients (25.3%) in the placebo group and 200 of 872 patients (22.9%) in the XBJ group.

Conclusions and Relevance In this randomized clinical trial among patients with sepsis, the administration of XBJ reduced 28-day mortality compared with placebo.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804120

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Aspartame to be declared 'possible carcinogen' by WHO

This is just the latest in a long line of do-gooder attempts to "get" artificial sweeteners. Sugar is bad for you too, of course, so you can't win. And fruit sugar (fructose) is the worst of all, allegedly

I once took on the Aspartame evangelists at some length, linking to many studies that debunked the scare. You can find my posts here. Plus ça change, plus c'est la même chose

Sources told Reuters that the International Agency for Research on Cancer, an arm of the World Health Organization, will soon name aspartame a "possible carcinogen." But historically, the agency's decisions have been controversial and confusing.

Reuters reported that an arm of the World Health Organization will soon name aspartame a "possible carcinogen." (Image credit: Steve Russell / Contributor via Getty Images)
An agency within the World Health Organization (WHO) will soon name the widely used artificial sweetener aspartame a "possible carcinogen," based on a review of 1,300 studies, Reuters reported, citing information from two sources who are knowledgeable about the process.

But don't panic: The arm of the WHO that did the review, the International Agency for Research on Cancer (IARC), uses a classification system for possible and known carcinogens that is notoriously confusing and often misleading, Reuters noted. Science writer Ed Yong summed it up well in a 2015 Atlantic article, in which he wrote, "Perhaps we need a separate classification scheme for scientific organizations that are 'confusogenic to humans.'"

Here's what you need to know.

The IARC doesn't analyze how much of a product a person can safely consume before it poses a health risk, according to Reuters. When it comes to aspartame, the answer is a lot: Past assessments suggest that a typical, 150-pound (68 kilograms) person could safely consume the equivalent of the aspartame contained in more than 13 cans of Diet Coke a day.

The arm of the WHO that handles such assessments — the Joint WHO and Food and Agriculture Organization's Expert Committee on Food Additives, or JECFA — has ruled on aspartame many times before. In its most recent review, the agency again held that the sweetener is safe to consume and set the acceptable daily intake at zero to 40 milligrams per 2.2 pounds (1 kilogram) of body weight. That translates to about 2,730 milligrams per day for a 150-pound person.

Again, this recommendation reflects how much aspartame can be consumed before it poses any health risk — not specifically cancer. Various agencies, including the European Food Safety Authority and U.S. Food and Drug Administration, have not found any definitive link between aspartame consumption and an increased risk of cancer, the American Cancer Society states.

Interestingly, JECFA is also reviewing the available data on aspartame and will announce its findings July 14, the same day the IARC is expected to rule on the artificial sweetener.

The IARC ranks substances as carcinogenic, probably carcinogenic, possibly carcinogenic or not classifiable. These classifications serve as a rough way to rank the strength of the evidence linking a substance to cancer in humans; this evidence includes studies of humans, human cells and tissues and lab animals, as well as studies of the substances' similarity to known or probable carcinogens. The rankings aren't related to how much a substance might increase cancer risk, but how conclusively the IARC can say it causes cancer at all.

Tobacco, asbestos and processed meat are all classified as carcinogenic, meaning the IARC determined there's conclusive evidence that they can cause cancer in humans, even though the degree of risk differs among these substances.

The IARC considers glyphosate, the active ingredient in the weed killer Roundup, a "probable" carcinogen, meaning there's inconclusive or inadequate evidence that it can cause cancer in humans and either sufficient evidence showing it causes cancer in animals or strong evidence that it has similar characteristics to known or probable human carcinogens. (Regulatory agencies have contested the IARC's ruling on glyphosate, Reuters noted.)

For "possible" carcinogens, there's inconclusive or inadequate evidence they can cause cancer in humans but sufficient evidence that they cause cancer in animals or strong evidence that they have carcinogen-like characteristics. In some cases, something can rank as a possible carcinogen if there's "strong" evidence from cell and chemical studies but inadequate evidence in animals and humans.

Sources told Reuters that aspartame will fall into this category, alongside the radiofrequency electromagnetic fields associated with cellphones. (Note that non-IARC authorities have said there's no or insufficient evidence linking cancer to cellphone use.)

Listing aspartame as a possible carcinogen is intended to motivate more research, sources close to the IARC told Reuters. Read more about the IARC's upcoming decision in Reuters.

https://www.livescience.com/health/food-diet/aspartame-to-be-declared-possible-carcinogen-by-who-dont-panic

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