FAA bans the anti-smoking drug Chantix

The Federal Aviation Administration (FAA) has banned pilots and air traffic controllers from using the prescription anti-smoking drug CHANTIX® (varenicline), manufactured by Pfizer, after new information became available about possible side effects that could impact aviation safety. The action was taken after a medical safety group, the Institute for Safe Medication Practices, released the results of a study that found evidence for the occurrence of seizures, loss of consciousness, heart attacks, vision problems, and various psychiatric instabilities in individuals who use the drug.

An announcement about the FAA ban on Chantix explained:

Approximately 150 pilots and 30 controllers are known to use the medication, although the exact number isn't known. To make sure all pilots and controllers got the word, FAA sent a notice to all registered pilots and controllers. It also alerted all aviation medication examiners across the country and notified major pilot associations and the air traffic controllers union, NATCA. An estimated 6.5 million people worldwide have used Chantix.

The Food and Drug Administration (FDA) approved the Pfizer-made drug for sale in 2006, and the FAA first approved Chantix for pilot and controller use in July 2007. Employees who reached the maximum dose at that time were required to wait 72 hours before working, and had to have a letter from their physician.

In November 2007, the FDA began to receive reports of psychiatric problems associated with the medication. The FAA’s Federal Air Surgeon Fred Tilton said he was aware of the anecdotal information circulating about Chantix, but chose to rely on hard data as it became available. “There were indications, but no clear data,” he said. “We don't just act indiscriminately.”

When more conclusive data was published this week, Tilton's Office of Aerospace Medicine moved quickly in response.

Medications approved for pilot and controller use must undergo a rigorous review process before being considered acceptable. When a new class of drug comes on the market, members of FAA’s Office of Aerospace Medicine require at least a year for data to emerge regarding its effects, at which point a review board can then be convened. If any red flags are detected by the board during evaluation, the medication will be prohibited.

Nicotine replacement products such as the nicotine patch, gum and lozenges are still allowed.

If you are interested in having a look at the report that prompted the FAA to ban Chantix, here is the link to the full document:

Strong Safety Signal Seen for New Varenicline Risks - The Institute for Safe Medication Practices, May, 2008

Zinc acetate lozenges can reduce cold symptoms

There is still no cure for the common cold, but some medical researchers in Michigan have carried out a study that demonstrated one way to reduce the severity of a cold. I'll cut right to the chase: Zinc acetate lozenges taken within 24 hours of developing symptoms of the common cold reduce the duration and severity of symptoms.

Now for the details. Researchers at Wayne State University of Medicine in Detroit carried out a clinical trial with volunteers who had cold symptoms for 24 hours or less at the outset of the study. They gave half the volunteers cherry-flavored lozenges that contained 13.3 mg of zinc acetate. The other half of the volunteers were given a placebo in the form of cherry-flavored lozenges that were identical except for the presence of zinc acetate. The participants in the study were asked to dissolve one lozenge in their mouth every 2-3 hrs while awake, for as long as they had cold symptoms.

The participants in the study kept track of the severity of their symptoms, and the number of lozenges they took, in a log. The participants also answered a questionnaire about any side effects they noticed while taking the lozenges.

The results of the study, reported in a recent issue of the Journal of Infectious Diseases, showed that "the durations of cough, nasal discharge, and muscle ache were significantly shorter in the zinc group than in the placebo group." The average duration of symptoms for the group who took the zinc lozenges was four days, while the the group that took the placebo lozenges had symptoms lasting for an average of seven days. For more than half of the participants who took the zinc, the cold was completely resolved on day 4, but no one who took the placebo lozenge was free of cold symptoms on day 4. Volunteers who took the zinc also rated their symptoms as less severe than those who took the placebo lozenges.

Side effects were generally mild, consisting of things like bitter aftertaste, dry mouth or other mouth irritations, and were essentially same for both the zinc group and the placebo group. No one complained of side effects such as abdominal pain or vomiting.

So, still no cure for the common cold, but if you feel a cold coming on, it might be a good idea to try zinc lozenges to lessen the severity and duration of your symptoms. There are plenty of brands of zinc lozenge on the market, and they are available without prescription. Remember that the zinc formulation used in this study was zinc acetate. Some lozenges contain a different form of zinc, such as zinc gluconate. While other forms of zinc also may work, it might be worth your while to read the package, and look for a lozenge that has zinc acetate, in an amount similar to that used in the study.

To help you out, I did a quick search and found several brands of zinc acetate lozenges similar to those used in the study:

• Eby’s ColdCure™ Zinc Acetate Lozenges (Eby Pharma)
• Fast Dry™ Zinc Lozenges (F&F Foods)
• ZinxLozenges® (Auriga Laboratories)

While all of these fill the bill, there may be others, including so-called store brands, so read the ingredients on the package.

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Source: Prasad, A., Beck, F., Bao, B., et al. (2008). Duration and Severity of Symptoms and Levels of Plasma Interleukin-1 Receptor Antagonist, Soluble Tumor Necrosis Factor Receptor, and Adhesion Molecules in Patients with Common Cold Treated with Zinc Acetate. Journal of Infectious Diseases, Vol. 197, pp. 795–802, doi:10.1086/528803

Video: Dirty hotel secrets caught on camera

Crews spend a lot of time in hotels, and often have concerns about the cleanliness of various objects in their rooms, if not the room itself. This video clip from Atlanta TV station Fox 5 is about an 'undercover investigation' regarding the glasses in hotel guest rooms.



(If the video does not play or display properly above, click here to view it on YouTube.)

Hmmm. It might be a really good idea to bring your own cup to use on layovers. Then take it home and run it through your own dishwasher!

Have a happy, healthy 2008!

Cataracts in pilots: A double whammy?

Recently I wrote a piece about the health hazards that pilots face from sun exposure on the flight deck. One of the hazards I mentioned was the risk of developing cataracts, a condition in which the lens of the eye becomes opaque, leading to diminished vision. (The photo at right is a scene as it might be viewed by a person with cataract.)

Exposure to UV rays from the sun is not the only risk factor for cataracts encountered by professional pilots. Research has shown that airline pilots also are at risk for developing cataracts as a result of occupational exposure to cosmic radiation. The results of this research appear in the Archives of Ophthalmology, a specialty medical journal published by the American Medical Association.

A research team at the University of Iceland studied a sample of 445 men over the age of 50. Among the men in the sample were 79 airline pilots. The researchers performed detailed eye examinations on the men in the study. Cataracts were found in 71 of the men, including 15 of the pilots.

In addition to undergoing the eye examination, the study participants also were interviewed about previous diseases, medications, and lifestyle factors such as smoking status and sunbathing habits. This enabled the researchers to control for these additional risk factors in their analysis.

The results of the analysis showed that the pilots had roughly triple the risk for cataracts as the other men in the sample.

The authors had this to say about the results for pilots in the study:

Our calculations show a significant association between length of employment (measured in years), cumulative radiation dose (measured in millisieverts), and cumulative radiation dose sustained before the ages of 50 and 40 years and risk of nuclear cataracts, adjusted for age, smoking status, and sunbathing habits among commercial airline pilots.

The kind of cataracts found in the pilots, called 'nuclear cataracts,' are characterized by clouding that begins near the center of the lens and then spreads. Although nuclear cataracts can be age-related, the pilots appeared to be getting the cataracts at a younger age than the non-pilots in the study.

Source: Rafnsson, V., Olafsdottir, E., Hrafnkelsson, J., Sasaki, H., Arnarsson, A., & Jonasson, F. (2005, August). Cosmic radiation increases the risk of nuclear cataract in airline pilots. Archives of Ophthalmology, Vol. 123, pp. 1102-1105.

Related Information: Aircrew Exposure to Cosmic Radiation.

Photo Source: National Eye Institute, National Institutes of Health, Ref#: EDS03

How to prevent heat-related illness

Summer weather seems to be unusually hot in many areas this year. The U.S. Centers for Disease Control & Prevention (CDC) provides these tips for preventing heat-related illness.

• Drink more fluids (nonalcoholic), regardless of your activity level. Don't wait until you're thirsty to drink. Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask him how much you should drink while the weather is hot.
• Don't drink liquids that contain caffeine, alcohol, or large amounts of sugar -- –these actually cause you to lose more body fluid. Also, avoid very cold drinks, because they can cause stomach cramps.
• Stay indoors and, if at all possible, stay in an air-conditioned place. If your home does not have air conditioning, go to the shopping mall or public library -- –even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. Call your local health department to see if there are any heat-relief shelters in your area.
• Electric fans may provide comfort, but when the temperature is in the high 90s, fans will not prevent heat-related illness. Taking a cool shower or bath, or moving to an air-conditioned place is a much better way to cool off.
• Wear lightweight, light-colored, loose-fitting clothing.
• NEVER leave anyone in a closed, parked vehicle.
• Although any one at any time can suffer from heat-related illness, some people are at greater risk than others. Check regularly on:

Infants and young children

People aged 65 or older

People who have a mental illness

Those who are physically ill, especially with heart disease or high blood pressure

• Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.

If you really must be out in the heat, the CDC suggests the following:

• Limit your outdoor activity to morning and evening hours.
• Cut down on exercise. If you must exercise, drink two to four glasses of cool, nonalcoholic fluids each hour. A sports beverage can replace the salt and minerals you lose in sweat. Warning: If you are on a low-salt diet, talk with your doctor before drinking a sports beverage. Remember the warning in the first "tip" (above), too.
• Try to rest often in shady areas.
• Protect yourself from the sun by wearing a wide-brimmed hat (also keeps you cooler) and sunglasses and by putting on sunscreen of SPF 15 or higher (the most effective products say "broad spectrum" or "UVA/UVB protection" on their labels).

Source: Tips for Preventing Heat-Related Illness - U.S. Centers for Disease Control & Prevention

[Photo Source]

Herbal supplement safety

Millions of people take herbal supplements every day. Do you?

Do you have any idea about which ones really are safe and which are not? Do you know how you can find out?

One good source of information about herbal supplements is the Herbal Safety website, run by the UTEP-UT Austin Cooperative Pharmacy Program. The website has a wealth of reliable information for consumers of herbal products. The information on the website is offered in both English and Spanish.

In addition to fact sheets on all the most commonly used herbs, the website features articles aimed at 'special populations.' For example, reports in this section give guidance on which herbal supplements should be avoided by pregnant and lactating women, or by those about to have surgery.

The website also provides a search feature that you can use to quickly find information on a specific herb.

If you are a consumer of herbal supplements, do visit the Herbal Safety website. You may be surprised at how much you didn't know about the herbal products you take as supplements.

For lots more information you can trust about herbal supplements and vitamins:

• Dietary Supplements - MedlinePlus
• Dietary and Herbal Supplements - National Center for Complementary and Alternative Medicine

Our AircrewHealth.com website also has a frequently updated page with the latest news stories about Vitamins & Nutritional Supplements.

Sun exposure on the flight deck

On an aviation forum, a pilot asked if it might be a good idea to use sunscreen while working on the flight deck. I wrote an answer to the question. The answer is: Yes it is a very good idea for pilots to use sun screen!

Here's the scoop on sun exposure for pilots:

The concentration of ultraviolet (UV) rays -- the ones that can cause sunburn, skin cancer, and other problems -- is greater at altitude than on the ground. The higher up you go, the less of the Earth's atmosphere you have between you and the sun. The atmosphere normally acts to filter out some of the sun's rays before they reach the ground.

Pilots are exposed to substantial doses of UV rays through the flight deck windscreen while flying. This can lead to skin damage of several varieties, ranging from premature aging and wrinkles to skin cancer.

UV rays also can do serious damage to the damage the eyes, causing cataracts, a disorder that clouds the lens of the eye and may ultimately result in partial or full blindness. UV exposure also can cause inflammation of the corneas, the irises, and the membranes that line the eyelids.

What to do?

Keep your arms covered while flying, if possible. Use a sunscreen product on your face, neck, arms and lips. What brand you choose is a matter of personal preference, but according to the American Academy of Dermatology, you would be wise to choose one that's waterproof, so that it doesn't come off if you sweat.

Suncreen products now come labeled with 'SPF' numbers. SPF stands for Sun Protection Factor. Products with higher SPF numbers -- SPF 15 or greater -- offer the most protection against UVB rays.

By the way, there is no approved rating system for protection against UVA rays.

Have a look at Facts About Sunscreens on the American Academy of Dermatology's website for more help in how to choose and use suncreens.

Select sunglasses carefully. It may surprise you to learn that polarized and mirror-coated lenses are not necessarily the best. Look for a label or hang-tag that indicates that the sunglasses block both UVA and UVB rays. Choose sunglasses that block 99% - 100% of UV light (both UVA and UVB).

The World Health Organization (WHO) recommends sunglasses with wrap-around lenses or side panels, to prevent damaging rays from sneaking in at the sides. Even if this style is not your usual preference, it might be a good idea to have a pair like this for use on the flight deck. You can always change to another style that you prefer once you are back on the ground!

A final note: Given that professional pilots have greater occupational exposure to UV rays, it would be a good idea for them to get checked regularly for early signs of skin cancer. Skin cancer screening takes only a few minutes, and is non-invasive. No needles, no Xrays, no blood tests: all it takes is a visual examination of the skin by a qualified person.

The American Academy of Dermatology sponsors FREE skin cancer screening in communities around the US. The exams are done by volunteer dermatologists. You can use the Skin Cancer Screening Map on the AAD website to locate a skin cancer screening center in a community near you. The listings are updated regularly.

Pilots, protect yourselves!!

[Photo Source]

Frequent hand washing for in-flight infection control

Colds, flu, measles, mumps, and tuberculosis are just a few of the communicable diseases that can be transmitted from one person to another aboard an aircraft. This is worrisome to flight attendants, in particular, since they spend so much time in close quarters with passengers who may be infected.

Infectious diseases are transmitted aboard aircraft primarily through touching items and surfaces that infected persons may have coughed or sneezed on. The simple act of hand-washing may be the best defense against catching one of these diseases. A study carried out by researchers at the University of North Carolina has shown that washing with ordinary soap, and then rinsing with tap water, is actually the most effective way to rid hands of both bacteria and viruses at the same time.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that you follow these steps for proper hand washing:

1. Wet your hands with warm water.
2. Apply a generous amount of soap
3. Rub your hands together for a full 20 seconds.
4. Rinse your hands.
5. Dry your hands with a paper towel.
6. Use the paper towel to turn off the faucet and open the door.

If water and soap are NOT available, the CDC recommends that you use an alcohol-based hand sanitizer. Look for a product with 62% ethanol based hand-sanitizer, preferably in a gel form.

For more information: Aircrew Exposure to Infectious Diseases.

[Photo Source]

Generic version of Ambien approved by FDA

This week the U.S. Food and Drug Administration (FDA) approved the first generic version of zolpidem tartrate immediate release tablets. Zolpidem tartrate is the active ingredient in the well-known brand of sleeping tablets called Ambien®.

An FDA news release about the newly approved generic product says:

Zolpidem tartrate tablets in formulations of five milligrams and 10 milligrams are manufactured by multiple generic drug companies in the United States.

The following 13 manufacturers have received FDA approval for zolpidem tartrate tablets: Mylan Pharmaceuticals Inc., TEVA Pharmaceuticals USA, Roxane Laboratories Inc., Watson Laboratories Inc., Ranbaxy Laboratories Ltd., Dr. Reddy’s Laboratories Ltd., Apotex Inc., Synthon Pharmaceuticals Inc., Genpharm Inc., Mutual Pharmaceutical Company Inc., Caraco Pharmaceutical Laboratories Ltd., Carlsbad Technology Inc., and Lek Pharmaceuticals.

This is particularly good news for those who do not have health insurance plans that cover the cost of prescription drugs. If you take Ambien, you may want to ask your doctor to consider writing a prescription for the new generic version. Generic drugs are less expensive than equivalent brand name drugs.

For more information about generic drugs, have a look at this FDA information sheet for consumers: Generic Drugs: What You Need to Know.

For more news and information about sleep, visit the Sleep News page on the AircrewHealth.com website.

Cell phone use and risk of brain cancer

Most people who fly for a living are heavy users of mobile phones. Every once in awhile we hear someone suggest that cell phones might cause cancer, especially in heavy users. Now some Scandinavian researchers have shown with a large-scale study that the risk is very small.

This research team looked specifically at the risk for glioma, the most common kind of brain cancer. They studied the mobile phone usage patterns of 1,522 patients already diagnosed with glioma, and compared them with 3,301 controls -- that is, people who were free of glioma. They found no evidence of increased risk of glioma related to regular mobile phone use.

Writing about their research in the April 15, 2007 issue of the International Journal of Cancer, they concluded that "no significant association was found across categories with duration of use, years since first use, cumulative number of calls or cumulative hours of use." They also analyzed their data separately for analogue and digital phone use, and still found no significant differences between the glioma patients and the healthy controls.

The researchers did find a slightly increased risk for glioma of "borderline statistical significance" in people who used a cell phone for more than 10 years exclusively on one side of the head -- on the same side as the tumor. Since the difference was so small, the scientists said that they were unsure if this was due to chance or was indeed a causal effect. It could even have been what researchers call "information bias," that is, over-reporting of mobile phone use on the affected side by the brain tumor patients. To be on the cautious side, they said, "the possible risk in the most heavily exposed part of the brain with long-term use needs to be explored further before firm conclusions can be drawn."

The practical take-home message? Cell phone users -- even heavy users -- are probably not at great risk for glioma. But, to be on the safe side, don't always use your phone on the same side of your head!

Source: Lahkola, A., Auvinen, A., Raitanen, J., et al. (2007). Mobile phone use and risk of glioma in 5 North European countries. International Journal of Cancer, Vol. 120, pp. 1769-1775, doi:10.1002/ijc.22503

Job stress, relationship quality, and blood pressure

It has been known for quite awhile that chronic stress often is associated with a rise in blood pressure. Chronic stress at work has been identified as one kind of stress that can have this effect.

Now medical researchers at the University of Toronto have shown that the effects of job stress on blood pressure may be mitigated for those who have cohesive, mutually supportive relationships with their spouses or significant others.

Dr. Sheldon Tobe and his colleagues followed 229 men and women for a year. All had blood pressure that was in the normal range at the outset of the study. All were employed and living with spouses or 'significant others.'

They found that, over the course of a year, people in stressful jobs who had a poor relationship with their spouse or significant other had a rise in their blood pressure. In contrast, blood pressure actually fell for people who had a good marital relationship, even if they also had a stressful job.

The relationship aspect that was evaluated in this study was 'marital cohesion' -- that is, how much couples support each other. Writing about their research results in the February, 2007 issue of the American Journal of Hypertension, Dr. Tobe and his colleagues concluded, "Low marital cohesion exacerbated the effect of job strain to elevate blood pressure, and high marital cohesion ameliorated it."

Ready for the kicker? "This interaction may be gender specific in that it was demonstrated separately in women but not in men."

Source: Tobe, S., Kiss, A., Sainsbury, S., Jessin, M., Geerts, R., & Bajer, B. (2007). The Impact of Job Strain and Marital Cohesion on Ambulatory Blood Pressure During 1 Year: The Double Exposure Study. American Journal of Hypertension, doi:10.1016/j.amjhyper.2006.07.011

New information about how flu is transmitted

This article has been updated and revised. The new version of this article can be found on AircrewBuzz.com:

How flu is transmitted aboard passenger airliners (Not the way you may think!)

FDA: New label warnings required for sleep drugs

The U.S. Food and Drug Administration (FDA) has asked manufacturers of sleeping pills to strengthen their product labeling to include stronger language concerning potential risks.

This action came about after the FDA determined that these medications -- including popular brands such as Ambien®, Lunesta®, and Sonata® -- can cause strange and possibly dangerous side effects that consumers may not be aware of.

One type of side effect that the FDA is most concerned about is a kind of allergic reaction called anaphylaxis, a severe systemic response that is potentially life-threatening. Another serious type of allergic reaction that is possible is called angioedema, which causes severe swelling of the face, mouth, throat and tongue. While only a small number of people are likely to experience these severe reactions, they can occur without warning, as early the first time of the drug is taken.

The FDA also wants labels on sleeping pills to warn consumers about peculiar sleep-related behaviors that have been reported in some people who took these drugs. These include 'sleep-driving,' making phone calls, and preparing and eating food (while asleep) -- and not remembering afterward.

If you take any kind of prescription sleeping aid, click here to see if your brand is on the FDA warning list.

"There are a number of prescription sleep aids available that are well-tolerated and effective for many people," said Steven Galson, M.D., MPH, director of FDA’s Center for Drug Evaluation and Research. "However, after reviewing the available post-marketing adverse event information for these products, FDA concluded that labeling changes are necessary to inform health care providers and consumers about risks."

For more information and news about sleep, visit the Sleep News page on the AircrewHealth.com website.

Genes and migraine

Why do some people get migraine headaches while others do not? Researchers at the University of Iowa have discovered a particular genetic variation in people that may play an important role in susceptibility to migraines.

It has been suspected for quite some time that there are genetic reasons for who gets migraines and who does not, but the particular mechanisms were not clear. Based on their research findings, the University of Iowa research team believe that people who have migraines may have a subtle difference in the gene that is responsible for producing a certain small protein. That small protein is called RAMP1.

Don't be put off by the unfamiliar biochemical terminology here. The idea is actually quite straightforward.

RAMP1 appears to "turn up the volume" of a nerve cell receptor's response to another substance called CGRP. CGRP is thought to cause migraines. In fact, if it is injected into people who are susceptible to migraines, they get a severe headache or a full migraine.

CGRP levels are elevated in the blood during migraine, and drugs that either reduce the levels of CGRP or block its action significantly reduce the pain of migraine headaches.

RAMP1 is a key regulator of CGRP. Thus, people who have more RAMP1, also tend to be more sensitive to CGRP, which in turn causes them to have migraine headaches.

The University of Iowa team identified this link between RAMP1 and CGRP, and showed how a genetic variation in the amount of RAMP1 produced was related to sensitivity to CGRP, and ultimately to susceptibility to migraine.

Iowa researcher Dr. Andrew Russo said, "There is clearly a genetic difference between people who get migraines and those who do not, and we think that difference could be RAMP1. Our studies provide a reason to look for variations in the DNA that encodes RAMP1 in humans."

The UI team investigated CGRP receptors in the trigeminal nerve, which is responsible for relaying almost all sensory perception, including pain and touch, for the front of the head. The UI findings reinforce the emerging view that CGRP receptors in the trigeminal nerve play a key role in migraine headache.

However, there are other CGRP receptors throughout the body, and elevated CGRP levels are implicated in other types of pain, including arthritis. Russo predicts that his group's findings about RAMP1 will have implications for pain research beyond migraine headaches.[University of Iowa News Service]

The University of Iowa study was funded by the National Institutes of Health. The findings were published in the most recent issue of the Journal of Neuroscience.

Source: Zhang, Z., Winborn, C., Marquez de Prado, B., & Russo, A. (2007). Sensitization of Calcitonin Gene-Related Peptide Receptors by Receptor Activity-Modifying Protein-1 in the Trigeminal Ganglion. Journal of Neuroscience, Vol. 27, pp. 2693-2703.

Calcium and Vitamin D prevent stress fractures

A study carried out with women Navy recruits in the United States has shown that taking calcium and vitamin D supplements can reduce the risk of stress fractures (overuse injuries to the bone).

The study participants were more than 5,200 female U.S. Navy recruits, ages 17 to 35, doing eight weeks of basic training. They were divided into two groups -- one group received daily pill supplements of 2,000 mg of calcium and 800 IU of vitamin D, while the other group received placebo pills.

Results of the study were presented recently at the annual meeting of the Orthopaedic Research Society. HealthDay News reports on the findings:

During the study, 170 of the recruits in the placebo group suffered stress fractures, 25 percent more than the group taking the supplements. The researchers also noted that a history of exercise decreased risk among women in the study, while cigarette smoking increased the risk.

"What really surprised us is that calcium/vitamin D supplements made a significant difference in such a short period of time. Frankly, we were not sure we would see any statistically significant results in only eight weeks," principal investigator Joan Lappe, a professor of nursing and medicine at Creighton University in Omaha, Neb., said in a prepared statement.

Calcium and vitamin D supplementation has long been recommended to prevent osteoporosis. This new study shows another benefit to taking these supplements. It is important to choose a calcium supplement that includes vitamin D in the formulation, since vitamin D helps the body absorb the calcium.

Click here for more information about calcium, from the American Academy of Orthopaedic Surgeons.

FDA update on peanut butter recall

The U.S. Food and Drug Administration (FDA) has released an update on the peanut butter recall that was first issued last month. Contamination of the peanut butter with Salmonella caused hundreds of people to become ill.

Today the FDA said that samples that were collected from a ConAgra Foods processing plant in Georgia showed contamination with Salmonella. This is now believed to be the source of the Salmonella that was found in jars in peanut butter.

The FDA update issued today extends the product recall to peanut butter toppings. Here's what the FDA said:

FDA has learned that the ConAgra plant in Sylvester, GA, sent bulk Peter Pan peanut butter to its plant in Humboldt, TN. The three brands described below are part of the original Peter Pan recall. These brands have been recalled and are no longer being sold. However, some consumers may still have these products in their home.

Consumers who have any of the products listed below should discard them. Individuals who are not sure if the purchased product contains the recalled peanut butter topping should contact the store where the product was purchased.

The bulk peanut butter was used to make the following toppings:

• Sonic Brand Ready-To-Use Peanut Butter Topping in 6 lb. 10.5 oz cans. Sonic outlets used the topping until 2/16/07, when the product was recalled.
  The topping was used in the following Sonic products:
  • Peanut Butter Shake
  • Peanut Butter Fudge Shake
  • Peanut Butter Sundae
  • Peanut Butter Fudge Sundae
• Carvel Peanut Butter Topping in 6 lb. 10 oz. cans. Carvel used the topping until 2/16/07, when the product was recalled.
  The topping was used in the following Carvel ice cream products:
  • Chocolate Peanut Butter
  • Peanut Butter Treasure
  • Peanut Butter & Jelly
  • Reese's Peanut Butter Cup Sundae Dasher
  • Any other customized products containing the Peanut Butter Topping, including peanut butter flavored ice cream in ice cream cakes
• J. Hungerford Smith Peanut Butter Dessert Topping in 6 lb. 10 oz. cans: This topping may be used by retail and restaurant outlets throughout the United States but is not available for direct purchase by the public.

Click here to read the full FDA Update on Peanut Butter Recall.

Urgent message for the sisters of breast cancer patients

An urgent call has been issued asking for more participants for a large-scale breast cancer research project called The Sister Study. Breast cancer is believed to be caused by a combination of genetic and environmental factors. The Sister Study hopes to shed more light on which factors affect which women, and the ways in which genes and environmental factors may interact to affect a woman's chances of developing breast cancer.

The Sister Study is seeking to enroll 50,000 women who are the sisters of breast cancer patients, ages 35-74, who have not had breast cancer themselves. The research team is looking for women from all races and ethnic groups, and from all walks of life.

Sisters of breast cancer patients who volunteer for the study will be sent a Sister Study Kit through the mail. The kit contains study information, questionnaires, and material to use to collect urine, toenail, and household dust samples. Participants will be followed for a period of ten years with questionnaire or telephone interview every other year. There is no cost for participation.

The only requirements for joining this study:

• Your sister, related to you by blood, had breast cancer.
• You are between the ages of 35 and 74.
• You have never had breast cancer yourself.
• You are a woman living in the U.S. or Puerto Rico.

To join the study, click here -- or phone this toll-free number: 1-877-4SISTER (1-877-474-7837).

The Sister Study is being led by Dr. Dale Sandler and her colleagues from the National Institute of Environmental Health Sciences, which is a unit of the National Institutes of Health. A number of well-known cancer research foundations are acting as partners for The Sister Study.

For more information, visit The Sister Study website. And please pass along information about this very important research project to anyone you know who is the sister of a breast cancer patient.

FDA warning: Salmonella in peanut butter

The U.S. Food and Drug Administration (FDA) has issued an alert that warns consumers not to eat certain batches of Peter Pan and Great Value peanut butter, because they may be contaminated with Salmonella bacteria.

The affected jars of Peter Pan and Great Value peanut butter have a product code located on the lid of the jar that begins with the number "2111."

Both the Peter Pan and Great Value brands are manufactured in a single facility in Georgia by ConAgra. Great Value peanut butter made by other manufacturers is not affected.

More from the FDA news release:

If consumers have any of this Peter Pan or Great Value brand peanut butter in their home that has been purchased since May 2006, they should discard it.

Symptoms of foodborne illness caused by Salmonella include fever, diarrhea and abdominal cramps. In persons with poor underlying health or weakened immune systems, Salmonella can invade the bloodstream and cause life-threatening infections. Individuals who have recently eaten Peter Pan and Great Value brand peanut butter beginning with product code 2111 and have experienced any of these symptoms should contact their doctor or health care provider immediately. Any such illnesses should be reported to state or local health authorities.

FDA's warning is based on a just-completed epidemiological study by the Centers for Disease Control and Prevention (CDC), the states and local health agencies, which links 288 cases of foodborne illness in 39 states to consumption of varying types of Peter Pan peanut butter. This report was provided to FDA on February 13.

The outbreak appears to be ongoing and the first consumer may have become ill in August 2006. The cause of foodborne illnesses can be difficult to identify. As a result of extensive epidemiological testing and recent case control studies, CDC was recently able to identify Peter Pan peanut butter as the likely cause of illness. Great Value brand peanut butter beginning with product code 2111 is manufactured in the same plant as Peter Pan peanut butter and, thus, is believed to be at similar risk of contamination.

ConAgra is recalling all Peter Pan and Great Value peanut butter beginning with product code 2111 that already was distributed. The company also is destroying all affected products in their possession. The company will cease production until the exact cause of contamination can be identified and eliminated. ConAgra will advise consumers to destroy any Peter Pan and Great Value brand peanut butter beginning with product code 2111 in their possession. To assist in this endeavor, FDA has sent investigators to ConAgra's processing plant in Sylvester, Georgia where the products are made to review records, collect product samples and conduct tests for Salmonella Tennessee.

Consumers who have questions should contact ConAgra at 866-344-6970.

Click here for the FDA news release: FDA Warns Consumers Not to Eat Certain Jars of Peter Pan Peanut Butter and Great Value Peanut Butter

UPDATE Feb. 23, 2007: As of February 21, the U.S. Centers for Disease Control and Prevention (CDC) has recorded 329 cases in 41 states, of illness from Salmonella in peanut butter. Click here to read Questions and Answers Related to this Outbreak on the CDC website.

Easing chronic neck pain

Neck pain is a fairly common ailment with many causes, including injury, arthritis, and fibromyalgia. Usually it goes away on its own in a relatively short time, but sometimes it becomes chronic. Now some Canadian researchers have found that sleeping with a neck support pillow and doing neck exercises can help ease chronic neck pain.

Researchers from the University of Western Ontario carried out a study to investigate the effects of several different treatment methods on patients with chronic neck pain. They recruited 151 patients with chronic neck pain, and randomly assigned each to one of four treatment groups:

1. hot or cold packs and massage
2. sleeping with a neck support pillow, plus hot or cold packs and massage
3. active neck exercises, plus hot or cold packs and massage
4. combined exercise, plus sleeping neck with a support pillow, plus the placebo

Participants who did the neck exercises were taught how to do them correctly by physical therapists. Participants were treated by physical therapists over a 6 week period.

Their progress was assessed at 0, 3, 6, 12, 24 weeks, and 12 months, with the 12 week assessment being the primary target for evaluation. Those who assessed the patients didn't know which treatments they had been given.

By the 12th week of the study, only those who used the contour neck support pillow and the exercises reported that their neck pain was significantly improved. There was no significant improvement among the other three groups.

Writing about their study in the Journal of Rheumatology, the research team concluded that, "Treatment by physiotherapists trained to teach both exercises and the use of a neck support pillow achieved the most favorable benefit for participants with chronic neck pain; either strategy alone was not more effective than a control regimen."

So, if you suffer from chronic neck pain, you might want to consider seeing your doctor about getting into a physical therapy program -- and get a contour neck support pillow, too.

Source: Helewa, A., Goldsmith, C., Smythe, H., Lee, P., Obright, K., & Stitt, L. (2007). Effect of therapeutic exercise and sleeping neck support on patients with chronic neck pain: a randomized clinical trial. Journal of Rheumatology, Vol. 34, pp. 151-158.