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Stillbirth linked directly to mother's oral bacteria
by Kate Melville

Confirming long-held suspicions, a Case Western Reserve University researcher has for the first time established a direct link between a mother's oral bacteria and the death of her fetus.

Researcher Yiping Han's revelations about Fusobacterium nucleatum and its likely role in pre-term labor and stillbirths appear in the February issue of Obstetrics & Gynecology.

     The mother in question carried the baby fullterm, but during the 35-year-old's pregnancy she reported excessive gum bleeding, a symptom of pregnancy-associated gingivitis. Around 75 percent of pregnant women experience gum bleeding due to the hormonal changes during pregnancy.

The bleeding associated with the gingivitis allowed the bacteria - normally contained to the mouth because of the body's defense system - to enter the blood and work its way to the placenta. Even though the amniotic fluid was not available for testing, Han suspects that the bacteria entered the immune-free amniotic fluid and eventually were ingested by the baby.

         Han explained that normally a mother's immune system takes care of the bacteria in the blood before it reaches the placenta. But in this case, the mother also experienced an upper respiratory infection just a few days before the stillbirth. "The timing is important here because it fits the time frame of hematogenous [through the blood] spreading," Han said.

      Postmortem microbial studies of the baby found the presence of F. nucleatum in the lungs and stomach. The baby had died from a septic infection and inflammation caused by bacteria. After questioning the mother about her health during the pregnancy, Han arranged for her to visit a periodontist, who collected plaque samples from her teeth.

      Using DNA cloning technologies, Han found a match in the bacterium in the mother's mouth with the bacterium in the baby's infected lungs and stomach. "The testing strongly suggested the bacteria were delivered through the blood," Han said.

         Happily, with preventative periodontal treatment and oral health care, the mother has now given birth to a healthy baby. Han suggests women who are considering a pregnancy seek dental care to take care of any oral health problems before conceiving.

 


GSK Consumer Healthcare warns consumers of potential health risks associated with long-term excessive use of zinc-containing denture adhesives

Because the safety and health of our consumers is our primary concern, GlaxoSmithKline (GSK) Consumer Healthcare is issuing a Consumer Advisory warning consumers about the potential health risks associated with long-term excessive use of zinc-containing denture adhesives.

GSK has taken voluntary, precautionary action to end the manufacture and supply of its zinc-containing denture adhesives marketed across many countries.

We are taking these actions because we have become aware of potential health problems associated with the long-term excessive use of our zinc-containing denture adhesive products. However, it is important for consumers to know that these products remain safe to use as directed on the product label.

GSK will transition to zinc-free versions of all affected variants. Zinc Free will be clearly shown on the new packaging.


    

Adverse neurological effects

Some forms of Super PoliGrip and Fixodent (Procter & Gamble) contain a form of zinc, which is bonded to an unknown formulation. While a small amount of zinc is necessary for a balanced diet, exposure to an excessive amount can result in copper depletion and serious negative adverse neurological effects.


 

In 2008, the peer-reviewed journal Neurology reported on four patients suffering from neuropathy and other neurological symptoms typical of zinc poisoning and copper depletion (August 2008, Vol. 71:9, pp. 639-643). The article specifically linked excess zinc in Super PoliGrip to "profound neurologic disease" in the patients reviewed.

"While zinc is an essential part of the diet, recent publications suggest that an excessive intake of zinc-containing denture adhesives over several years may lead to the development of neurological symptoms and blood problems such as anemia," the GSK consumer advisory states. "Neurological symptoms may include numbness, tingling, or weakness in the arms and legs, and difficulties with walking and balance."

GSK contends that the products are safe when used as directed, but that some consumers apply more adhesive than directed and use it more than once per day.

The acceptable daily zinc intake is 8 mg for women and 11 mg for men, and more than 40 mg constitutes zinc poisoning, according to the U.S. National Academy of Sciences.

A 2.4-oz (68-gram) tube of Super PoliGrip contains 38 mg of zinc per gram of product, and GSK recommends that a single tube should last approximately six weeks.

"This really is about consumer health and safety," Malesia Dunn, a GSK spokesperson, told DrBicuspid.com. "That is what led us to the decision to issue this advisory. We do know that some people have been using denture adhesives in excess over the long term, and we wanted to issue this advisory as a precautionary measure to minimize any potential risk."

GSK said it will transition to zinc-free versions of its Super PoliGrip products, with "Zinc Free" clearly shown on the new packaging. Dunn said she did not know when the new formulations would become available to consumers.

Lawsuits still pending

"It is satisfying to see GSK finally act responsibly by pulling Super PoliGrip from store shelves, which is something we think they should have done a long time ago," said Eric Chaffin, a partner at law firm Chaffin Luhana, which represents dozens of denture cream users who claim they suffered injury from the zinc-containing products, in a press release. "We think there are clearly safer alternatives on the market and are glad to see that GSK will be putting out more zinc-free formulations and moving away from this dangerous product line."

As for the pending lawsuits, "we still have a lot of work to do," he added. "In the near term, I'd like to see Procter & Gamble wake up and act responsibly by following GSK's lead to change this industry and withdraw Fixodent from the market. Then and only then will all denture cream consumers be safe in our view."

Attorneys at Parker Waichman Alonso, which also has filed numerous lawsuits on behalf of alleged victims of Super PoliGrip and Fixodent, said they applaud GSK for its decision to voluntarily stop the manufacture, distribution, and advertising of all Super PoliGrip denture adhesive products made with zinc.

"It is the firm's hope that GlaxoSmithKline will ultimately issue a full recall of all zinc-containing Super PoliGrip products, and it strongly urges Proctor & Gamble to act in a similar fashion to protect the public from the risks posed by Fixodent, the other zinc-containing denture cream on the market," the firm stated in a press release.

Tricia Gottlieb, a spokesperson for Procter & Gamble's Fixodent products, told DrBicuspid.com that the company is sticking by its statement that its products are safe and effective when used as directed.

"As with all consumer products, it is important to follow all label directions," she said. "Fixodent contains ingredients that are recognized as safe in the amounts used, and all Fixodent products are made, packaged, and labeled in accord with FDA manufacturing practices. We are recommending that denture wearers see their dentists regularly to ensure their dentures are fitting properly."

Dozens of denture cream zinc-poisoning lawsuits have been consolidated in the Denture Cream Products Liability Multidistrict Litigation currently pending in the U.S. District Court for the Southern District of Florida, Miami Division. The lawsuits allege that the manufacturers of these denture creams misled consumers about their risks and failed to provide adequate warnings and instructions to prevent deviation from accepted use.

Copyright © 2010 DrBicuspid.com





Exercise reduces falls in older people

Exercise programmes are an effective option for preventing falls among older people living in the community. There is less evidence at present for the effectiveness of other interventions, such as home safety improvements and vitamin D supplements, according to Cochrane Researchers who carried out a systematic review of the available evidence.

Although few falls result in serious injuries, they may have many
additional impacts on an older person's quality of life. For example,
after a fall, they may feel less confident and decide to restrict their
own activities to avoid further accidents. It is therefore important to
consider how falls can be prevented in order to provide peace of mind for those at risk, as well as family members.

Exercise may help to prevent falls by improving strength, flexibility,
balance, and endurance. "Programmes that contain a combination of these components reduce falls. These include exercising in supervised groups, participating in Tai Chi, and carrying out individually prescribed exercise programmes at home," says lead researcher Lesley Gillespie, who is based at Dunedin School of Medicine at the University of Otago in New Zealand. "What remains less clear is whether some other interventions really do reduce falls. Some may be of more benefit to those at higher risk of falling. There also seem to be differences in the effectiveness of some kinds of interventions when carried out in different health care settings."

Researchers reviewed data from 111 trials that included 55,303 older people altogether. As well as trials focused on group and individual
home-based exercise programmes, they considered interventions such as vitamin D for reducing muscle weakness, home safety improvements, cataract surgery for improving vision, and combination interventions based on individual assessments.

Those who took part in exercise programmes were less likely to suffer a fall and individuals fell less frequently than those who did not.
Combination interventions based on individual assessments also reduce falls. There was evidence from single trials that falls are reduced by some other interventions: gradual withdrawal from some types of drugs taken to improve sleep, reduce anxiety and treat depression; bringing forward cataract surgery on the first affected eye, and anti-slip shoes for icy conditions. Vitamin D showed potential for reducing the risk of falls only in those with vitamin D deficiencies. Home interventions were relatively unsuccessful, except in high-risk groups.
Gillespie says further research may help to determine which components are crucial to an effective exercise programme. "We need more research to see which components of an exercise programme are most important, but the trials would need to be large trials to discern any differences, " she says.

A further Cochrane review focusing on prevention of falls among older people living in residential care facilities and hospitals is nearing completion.



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