single pill might be able to reduce heart attacks and strokes by more than 80%, concludes a study from England. Heart attacks, stroke, and other pre­ventable cardiovascular diseases kill or seriously affect 50% of people in Britain.

Professor Nicholas Wald and Malcolm Law propose a “polypill” that would contain six active components—aspirin, a cholesterol-lowering drug, three blood pressure-lowering drugs at half the standard dose, and folic acid. The pill would be taken daily by all people aged 55 and over and is expected to have a huge effect on preventing disease in the Western world.
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Their radical strategy is based on evidence from more than 750 trials involving 400,000 participants.

These medications are well tolerated, and new problems are unlikely because they have been studied extensively and have often been used in combination.

The U.S. Food and Drug Administration (FDA) has approved Stalevo™ (carbidopa, levodopa, and entacapone) tablets for the treatment of patients with idio-pathic Parkinson’s disease who experience diminished benefits as the effects of levodopa wear off. Novartis plans to market the drug, and Orion Pharma will manufacture it in the U.S.

Parkinson’s disease affects more than 1% of people over age 65. Its cause is unknown, but symptoms result primarily from the degeneration of neurons in a part of the brain that controls movement. Patients experience trembling limbs, slowness of movement, stiffness and rigidity of the limbs, and gait or balance problems.

Levodopa is currently the most widely used agent for treating Parkinson’s disease. Carbidopa canadian reduces the side effects of levodopa, and entacapone optimizes its benefits, providing patients with an improved ability to perform everyday tasks and a reduction in disease-related symptoms.

Within one to two years, almost 50% of patients receiving levodopa therapy begin to notice that the effect lasts for shorter periods of time. In 15% to 20% of patients, the wearing-off effect becomes extreme and disabling. It is anticipated that Stalevo™ will be able to provide levodopa to the brain for a longer time.

Nursing women can safely take selective serotonin reuptake inhibitors (SSRIs), according to Norwegian investigators. This is good news for women who are at risk for postpartum depression, say the researchers, whose findings were reported at the 156^th annual meeting of the American Psychiatric Association in San Francisco.

Five different SSRIs were tested in 23 nursing women and their infants: generic citalopram (Celexa drug, Forest), tablet sertraline (Zoloft medication, Pfizer), paroxetine generic (Paxil medication, GlaxoSmithKline), venlafaxine drug (Effexor generic, Wyeth-Ayerst), and fluoxetine tablet (e.g., Drug Prozac,®, Eli Lilly, Dista). Although the women took doses of 20 to 130 mg/day and their serum drug levels were in the therapeutic range, the drugs did not enter the mothers’ milk in significant amounts. Drug levels in the infants ranged from 0 to 10% of those in the mother’s blood.

It’s about a hundred times more expensive, but it may be the better choice anyway. In phase III studies for the treatment of gram-positive hospital-acquired (nosocomial) pneumonia, Linezolid (Zyvox canadian, Pharmacia & Upjohn) was superior to vancomycin (Vancocin® HCl, Eli Lilly), report researchers from Methodist University Hospital. Their findings were presented at an American Thoracic Society meeting in Seattle in May 2003.

Linezolid was particularly efficacious in treating methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, and patients receiving linezolid were twice as likely to survive as patients who received vancomycin. The researchers explained that vancomycin is associated with renal toxicity, and patients at risk for renal problems might therefore be receiving underdoses. Linezolid is not associated with renal toxicity, and it seems to offer greater lung penetration.

Linezolid generic, which was approved in 2000, is the first FDA-approved oxazolidinone, a new class of antibiotics.

Cutting back on third-generation cephalosporins might reduce the number of infection-related deaths in critically ill patients, according to a study at a tertiary-care hospital in Beijing, China.

In phase 1, patients with confirmed or suspected gram-negative bacterial infections were treated primarily with third-generation cephalosporins, such as ceftazidim (Fortaz®, GlaxoSmithKline) and ceftriaxone sodium (Rocephalin®, Roche). In phase 2, they received other antibiotics, such as fourth-generation cephalosporins and carbapenems.
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Phase 2 clinical outcomes were better than those in phase 1. Patients’ stays in the intensive-care unit were shorter (17.6 days versus 29.3 days), and they were more likely to survive (16 of 83 [19.3%] vs. 29 of 80 [36.3%]). Mortality rates dropped significantly in patients with pseudomonal and lower respiratory infections.

Interferon alfa (IFN-a) therapy can have adverse psychiatric effects. Although symptoms, such as hallucinations, usually improve shortly after the drug is stopped, they may occasionally persist. Turkish researchers who treated a man with chronic hepatitis B advise monitoring the mental status of patients receiving IFN-a during all stages of therapy.
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A new study gives Americans over age 50 one more reason not to put off having a colonoscopy to check for colon cancer and its forerunners. The screening technique not only is excellent at detecting problems but also appears to be far more cost-effective for most people than new cancer-preventing drugs will probably ever be.

Researchers at the University of California, San Francisco, and the University of Michigan Health System used a computer model to compare the cost-effectiveness of colonoscopy and other screening procedures for colon cancer with that of COX-2 inhibitors, a class of drugs used to treat arthritis but also considered promising in preventing colon cancer.

The data suggest that the drugs are unlikely to be as effective—dollar for dollar—as colonoscopy in cutting cancer death risk for those with average colon cancer risk. Screening plus drugs was most effective but was even more costly.

Two other studies reportedly found that even aspirin had only a modest effect on preventing colon polyps and predicted that aspirin’s effectiveness in reducing colorectal cancer risk would never be superior to the life-saving effect of colon-oscopy.

For an average-risk person, it would cost $20,200 to save one life-year through colonoscopy screening but $233,300 to save the same life-year through COX-2 inhibitors. Even for a person with a higher risk of colon cancer, a colon-oscopy once every five years would still cost less and save more years of life than a daily drug. But the difference was smaller: $3,900 per life-year saved through screening every 10 years or $6,200 for screening every five years, versus $80,300 for drug therapy.