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To help customers have a safe and fun summer in the sun, Rite Aid and The Skin Cancer Foundation are partnering to raise awareness and offer free information on the importance of smart skin care practices. A free skin care guide aimed to encourage customers to protect their skin this summer will be available at nearly 4,900 Rite Aid stores nationwide and online at riteaid.com starting May 31.

The 12page skin care guide contains information from The Skin Cancer Foundation on being proactive in preventing skin cancer, guidelines on how to use and choose sunscreen, and tips to avoid burning. Theres a section on how to protect the eyes with the proper sunglasses, as well as information on how different kinds of recreation call for different kinds of sun protection, such as sweatresistant or waterresistant sunscreens and a lip balm of at least SPF 15.

The guide includes the signs of skin cancer, how diabetes affects the skin, how to use sunscreens and cosmetics together, and how to keep skin healthy yearround with the use of sunscreen, exfoliation and hydration both on the surface with moisturizers and internally by drinking plenty of water. A simple quiz at riteaid.com/health/skin/ is designed to determine skin type and offers advice based on answers.

Also online at riteaid.com/health/skin/ is an interactive body map to track skin changes on a regular basis, a section about the differences between harmless spots and unusual growths that need immediate medical attention, and the facts about UVA/UVB protection.

Customers also can learn online or in all Rite Aid stores about how to get a free gift bag valued at $40, filled with popular skin care samples and coupons, with the purchase of $20 of specially marked skin care products.

Rite Aid pharmacists are specially trained to offer helpful information on proper skin protection options and always are available to answer questions on maintaining healthy skin while enjoying the outdoors. They also can counsel customers about certain medications that cause skin to burn more easily, a side effect called photosensitivity. Some commonly used medications, such as antibiotics, antihistamines, birth control pills and oral diabetes medications, require additional precautions to avoid sunburn, hives, rashes or other skin irritations.

Rite Aid also is participating for the second year in the The Skin Cancer Foundations Road to Healthy Skin Tour presented by AVEENO® and Rite Aid, making 80 stops across the country many of them local Rite Aid stores to provide early detection services to thousands of people. At each stop, local boardcertified dermatologists will conduct free fullbody skin cancer screenings on a 38foot customized RV in one of two private rooms. Educational materials that explain how to perform monthly skin checks at home and the proper ways to protect the skin from the sun on a daily basis also are provided, along with sunscreen samples, coupons and other useful information.

In 2008, the Road to Healthy Skin Tour traveled 17,650 miles making 81 stops. It attracted almost 7,000 visitors and screened more than 3,000. More than 3,200 suspicious markings were detected and 39 suspected cases of melanoma. For the tour schedule and other interactive features, visit riteaid.com/skintour.

Customers can check their local Rite Aid store for the new Rx Suncare line available only at Rite Aid and at riteaidonlinestore.com. This exclusive line of suncare products is competitive with national brands or items found at highend specialty retailers in terms of quality but priced much lower. Seven products carry the prestigious Skin Cancer Foundation Seal of Recommendation as an effective UV sunscreen with a sun protection factor (SPF) of SPF 30 to SPF 50 and antiaging vitamins. Items in the RX Suncare line are priced from $2.49 to $9.99 and are fragrance free, noncomedogenic (does not block pores), supplemented by antioxidant vitamins and provide stabilized broad spectrum protection. Among the products are those specially designed for kids, sports, an advanced protection continuous spray, burn relief mask and a lip balm.

According to The Skin Cancer Foundation, there are more cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon; in fact, one in five Americans will develop skin cancer in the course of a lifetime. Despite these staggering statistics, 40 percent of people admit that they never use sunscreen and only 11 percent use an SPF 15 or higher daily. The Skin Cancer Foundation, the only global organization solely devoted to preventing, detecting and treating skin cancer, reports the incidence of melanoma is increasing faster than that of almost any other cancer. For more skin cancer information visit skincancer.org.

Rite Aids focus on skin care is part of its yearlong commitment to health and wellness. Each year Rite Aid offers free information, answers and education on health and wellness topics including allergies, oral health, diabetes, weight management and heart health.

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FDA on Tuesday posted on its Web site advertising guidelines for drugmakers and medical device manufacturers, offering suggestions on how to present risk information to health care professionals and consumers, the Wall Street Journal reports. Agency officials said the industry had asked for guidance on how to comply with its rules, which require a balanced presentation of a products risk and effectiveness. Exclusion or minimization of risk information is the most commonly cited violation each year in FDAissued warnings or enforcement letters. The new guidelines include detailed information on how aspects such as font, types of contrast and white space in print materials can appropriately present risk information. According to the Journal, the 24page document is not binding. FDA will accept public comments for 90 days prior to issuing final guidelines (Corbett Dooren, Wall Street Journal, 5/27).

Reprinted with kind permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Immigration officials held a cancer patient for four hours before they allowed him to enter the USA because one of his cancer drugs caused his fingerprints to disappear. His oncologist is now advising all cancer patients who are being treated with the commonly used drug, capecitabine, to carry a doctors letter with them if they want to travel to the USA.

The incident is highlighted in a letter to the cancer journal, Annals of Oncology [1], published online 27 May. According to the oncologist, several other cancer patients have reported loss of fingerprints on their blog sites, and some have also commented on similar problems entering the USA.

Dr EngHuat Tan, a senior consultant in the medical oncology department at the National Cancer Centre, Singapore, described how his patient, a 62yearold man, had head and neck cancer that had spread (metastatic nasopharyngeal carcinoma), but which had responded well to chemotherapy. To help prevent a recurrence of the cancer the patient was put on a maintenance dose of capecitabine, an antimetabolite drug.

Capecitabine is a common anticancer drug used in the treatment of a number of cancers such as head and neck cancers, breast, stomach and colorectal cancers. One of its adverse sideeffects can be handfoot syndrome; this is chronic inflammation of the palms or soles of the feet and the skin can peel, bleed and develop ulcers or blisters. “This can give rise to eradication of finger prints with time,” said Dr Tan.

The patient, Mr S, developed a mild case of handfoot syndrome, and because it was not affecting his daily life he was kept on a low dose of the drug.

“In December 2008, after more than three years of capecitabine, he went to the United States to visit his relatives,” wrote Dr Tan. “He was detained at the airport customs for four hours because the immigration officers could not detect his fingerprints. He was allowed to enter after the custom officers were satisfied that he was not a security threat. He was advised to travel with a letter from his oncologist stating his condition and the treatment he was receiving to account for his lack of fingerprints to facilitate his entry in future.”

Foreign visitors have been asked to provide fingerprints at USA airports for several years now, and the images are matched with millions of visa holders to detect whether the new visa applicant has a visa under a different name. “These fingerprints are also matched to a list of suspected criminals,” wrote Dr Tan.

Mr S was not aware that he had lost his fingerprints before he travelled.

Dr Tan concludes “In summary, patients taking longterm capecitabine may have problems with regards to fingerprint identification when they enter United States ports or other countries that require fingerprint identification and should be warned about this. It is uncertain when the onset of fingerprint loss will take place in susceptible patients who are taking capecitabine. However, it is possible that there may be a growing number of such patients as Mr S who may benefit from maintenance capecitabine for disseminated malignancy. These patients should prepare adequately before travelling to avert the inconvenience that Mr S was put through.”

Dr Tan said that he would recommend patients on capecitabine to carry a doctors letter with them. “My patient subsequently travelled again with a letter from us and he had fewer problems getting through.”

[1] Travel warning with capecitabine. Annals of Oncology. doi10.1093/annonc/mdp278
[2] Due to patient confidentiality it is not possible to identify Mr S.

Emma Mason Emma Mason

A drug currently FDAapproved for use in diabetes shows some protective effects in the brains of patients with relapsing remitting multiple sclerosis, researchers at the University of Illinois at Chicago College of Medicine report in a study currently available online in the Journal of Neuroimmunology.

In a small, doubleblinded clinical trial, patients with relapsing remitting multiple sclerosis were assigned to take pioglitazone (a drug commercially known as Actos used to treat type2 diabetes) or a placebo. Patients continued their normal course of therapy during the trial.

Standard neurological tests were done initially, as were MRI scans to provide baseline values for lesions typically seen in MS patients. The patients were evaluated every two months, and blood samples were taken. Repeat MRI scans were done after five months and again after one year.

Patients taking pioglitazone showed significantly less loss of gray matter over the course of the oneyear trial than patients taking placebo. Of the 21 patients who finished the study, patients taking pioglitazone had no adverse reactions and, further, found taking pioglitazone, which is administered in an oral tablet, easy.

“This is very encouraging,” said Douglas Feinstein, research professor of anesthesiology at UIC. “Gray matter in the brain is the part that is rich in neurons. These preliminary results suggest that the drug has important effects on neuronal survival.”

Feinsteins lab has been interested in the class of drugs called thiazolidinediones, or TZDs. Several TZDs have been approved for use in the treatment of type2 diabetes because of the drugs effect on the bodys response to insulin.

The researchers focused on pioglitazone because of its known antiinflammatory effects, Feinstein said. They used primary cultures of brain cells to show that pioglitazone reduced the production of toxic chemicals called cytokines and reactive oxygen species. These molecules are believed to be important in the development of symptoms in MS.

Feinsteins lab proceeded to test pioglitazone in an animal model of MS. They and others showed that pioglitazone and other TZDs “can significantly reduce the clinical signs in mice with an MStype disease,” said Feinstein.

“More importantly, when mice who are already ill are treated with pioglitazone, the clinical signs of the disease go away,” he said. “We were able to induce almost complete remissions in a number of mice.”

“We are now working to determine the mechanisms to explain the protective effect on neurons that we see in our studies,” said Feinstein. “We hope to expand into a larger trial to confirm these preliminary results.”

Claudia C. Kaiser, who was a postdoctoral student at UIC, is first author on the paper. Other authors are Dinesh Shukla and Demetrios Shias of UIC; Glen Stebbins, Dusan Stefoski and George Katsamakis of Rush University Medical Center; and Douglas Jeffrey of Wake Forest University School of Medicine. Takeda Pharmaceuticals funded the study and provided the drug but had no other involvement in the study.

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Jeanne GalatzerLevy

The Royal College of Obstetricians and Gynaecologists (RCOG) has released a new model for medical revalidation this week.

The Working Party Report on Recertification outlines recommendations for the recertification of obstetricians and gynaecologists working in the UK. The RCOG has also released an enhanced Continuing Professional Development (CPD) Programme. This programme has been revised to meet the new challenges of recertification in the UK, and to ensure that clinicians stay uptodate in their areas of practice.

Medical revalidation is being developed in the UK in order to ensure a nationwide process for robust professional regulation. Revalidation will involve both a relicensure and recertification component. The recertification process will be based on annual enhanced appraisal, multisource feedback from patients and colleagues, and the CPD programme. All doctors will be required to participate in the CPD programme.

Dr. Tahir Mahmood, RCOG Vice President Standards, said “The RCOG has played a full part in national discussions with the General Medical Council, Department of Health and the Academy of Medical Royal Colleges to promote a robust but simple system and to keep bureaucracy to a minimum. We believe that our voice has been heard as the RCOG Revalidation Model is being upheld as an example to follow.

“The Working Party Report on Recertification demonstrates the RCOGs commitment to ensuring quality care and the highest standards in obstetrics and gynaecology. Lifelong learning and continuous improvement remain important hallmarks of our profession. The revalidation process will promote these goals, and will help doctors to remain uptodate and to progress in new areas.”

There is more medical evidence that pregnant women should steer clear of advice to “eat for two.”

Alison Stuebe, M.D., assistant professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill School of Medicine, reviewed data for more than 1,300 women and found that those who consumed extra calories, as well as fried foods and dairy products, were more likely to gain more than is recommended during pregnancy thats 35 pounds or more for a woman with a normal body mass index, or BMI.

Stuebe found that eating an extra 500 calories a day increased the odds of gaining too much by 10 percent. “Thats the number of calories in a muffin or a bagel with cream cheese at Dunkin Donuts,” Stuebe says. “It doesnt take much for the calories to add up.”

Gaining too much weight is linked with complications at birth, such as preeclampsia or requiring a Csection, as well as higher odds that both mom and child will be obese later in life.

But the study results are good news theres something women can do to reduce risks for themselves and their babies. “Its a twofer,” Stuebe says. “If you take care of yourself, its good for you and for your baby.”

Several eating habits reduced moms risk of gaining too much. Women with vegetarian diets in early pregnancy were half as likely to gain an unhealthy amount of weight, and those who exercised vigorously for a half hour a day reduced their risk by 20 percent. The researchers also found that consuming more monounsaturated fat, found in olive oil and nuts, was linked with a lower risk of excessive weight gain.

Stuebe did the research while at Brigham and Womens Hospital in Boston. The results were published May 19, 2009, in the online version of the American Journal of Obstetrics and Gynecology (available to subscribers).

It might be obvious that a healthy diet and exercise reduce the odds of gaining too much weight during pregnancy, but more and more women are doing just that. Part of the problem is that providers dont counsel moms on weight gain, Stuebe says. Other studies have shown that moms who get advice from their doctor or midwife are more likely to gain in a healthy range.

Stuebes study offers some guidelines to share with expecting moms. Eating fried foods “was a huge predictor of excessive weight gain,” she says. Women who ate one serving a day were fourtimes as likely to gain too much weight.

Some study results were surprising. For example, dairy products, including those made with lowfat milk, were associated with more weight gain. More studies are needed to sort out why milk products were associated with extra gain.

The study used data from Project Viva, a prospective cohort of mothers and babies in the Boston, Mass., area. The study is ongoing, and researchers are currently following up the children at age seven.

For now, Stuebe says, her study results offer guidelines for moms to make healthy choices during pregnancy. “The next step is to study whether moms who get this advice have healthier weight gain than those who do not,” she says.

In the meantime, moms should follow existing guidelines to get regular exercise, and avoid fried foods and highcalorie snacks. Otherwise, after childbirth, they may find themselves struggling to unload extra pounds.

“And losing for two is a lot of work,” Stuebe says.

There is more medical evidence that pregnant women should steer clear of advice to “eat for two.”

Alison Stuebe, M.D., assistant professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill School of Medicine, reviewed data for more than 1,300 women and found that those who consumed extra calories, as well as fried foods and dairy products, were more likely to gain more than is recommended during pregnancy thats 35 pounds or more for a woman with a normal body mass index, or BMI.

Stuebe found that eating an extra 500 calories a day increased the odds of gaining too much by 10 percent. “Thats the number of calories in a muffin or a bagel with cream cheese at Dunkin Donuts,” Stuebe says. “It doesnt take much for the calories to add up.”

Gaining too much weight is linked with complications at birth, such as preeclampsia or requiring a Csection, as well as higher odds that both mom and child will be obese later in life.

But the study results are good news theres something women can do to reduce risks for themselves and their babies. “Its a twofer,” Stuebe says. “If you take care of yourself, its good for you and for your baby.”

Several eating habits reduced moms risk of gaining too much. Women with vegetarian diets in early pregnancy were half as likely to gain an unhealthy amount of weight, and those who exercised vigorously for a half hour a day reduced their risk by 20 percent. The researchers also found that consuming more monounsaturated fat, found in olive oil and nuts, was linked with a lower risk of excessive weight gain.

Stuebe did the research while at Brigham and Womens Hospital in Boston. The results were published May 19, 2009, in the online version of the American Journal of Obstetrics and Gynecology (available to subscribers).

It might be obvious that a healthy diet and exercise reduce the odds of gaining too much weight during pregnancy, but more and more women are doing just that. Part of the problem is that providers dont counsel moms on weight gain, Stuebe says. Other studies have shown that moms who get advice from their doctor or midwife are more likely to gain in a healthy range.

Stuebes study offers some guidelines to share with expecting moms. Eating fried foods “was a huge predictor of excessive weight gain,” she says. Women who ate one serving a day were fourtimes as likely to gain too much weight.

Some study results were surprising. For example, dairy products, including those made with lowfat milk, were associated with more weight gain. More studies are needed to sort out why milk products were associated with extra gain.

The study used data from Project Viva, a prospective cohort of mothers and babies in the Boston, Mass., area. The study is ongoing, and researchers are currently following up the children at age seven.

For now, Stuebe says, her study results offer guidelines for moms to make healthy choices during pregnancy. “The next step is to study whether moms who get this advice have healthier weight gain than those who do not,” she says.

In the meantime, moms should follow existing guidelines to get regular exercise, and avoid fried foods and highcalorie snacks. Otherwise, after childbirth, they may find themselves struggling to unload extra pounds.

“And losing for two is a lot of work,” Stuebe says.

BioAlliance Pharma SA (ParisBIO), a company dedicated to therapies and supportive care for cancer and AIDS patients, announced its scientific communications at upcoming international conferences on infectious diseases and oncology

Loramyc®, indicated for fungal infections in immunecompromised patients with HIV or cancer

The 2009 American Society of Clinical Oncology (ASCO) Annual Meeting

May 29 to June 2, 2009 Orlando, Florida, USA.

Abstract “Prevalence and management of oropharyngeal candidiasis (OPC) by medical and radiation oncologists in cancer patients”.

At the American Conference for the Treatment of HIV (ACTHIV) that took place on May 1517, 2009 in Denver, Colorado, USA, BioAlliance Pharma presented the poster “OnceDaily Miconazole Mucoadhesive Buccal Tablet is an Effective and Safe Treatment for Oropharyngeal Candidiasis”.

Amep™, a biotherapy for Metastatic Melanoma treatment

American Society of Gene Therapy (ASGT) 12th Annual Meeting

May 2730, 2009 San Diego, California, USA

Poster “Complete Melanoma Regressions after Electrotransfer of the pAMEP™ Plasmid Coding for an AntiAngiogenic and AntiMetastatic Peptide”, May 28.

Antiintegrases new antiretroviral drugs for the treatment of resistant HIV1

XVIII International HIV Drug Resistance Workshop

June 913, 2009 Fort Myers, Florida, USA

Oral communication and poster “New integrase binding inhibitors acting in synergy with Raltegravir”, June 12.

Irinotecan SRN oral formulation for the treatment of advanced colorectal cancer

2nd Pharmaceutical Sciences Fair and Exhibition (PharmSciFair)

June 812, 2009, Nice, France

Oral communication “Sustained Release Nanoparticles (SRN) for oral administration of Irinotecan”, June 10.

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“Although the number of mentally ill immigration detainees” at the La Mesa, Calif.based private psychiatric hospital Alvarado Parkway Institute “at any one time seems to range from as few as two to only five or so, their situation needs to be addressed quickly,” a San Diego Tribune editorial states (San Diego Tribune, 5/19). Some disability rights lawyers and advocates for the mentally ill say that conditions at many of the private facilities, including API, violate state and federal laws governing treatment of mentally ill people. Ann Menasche, a lawyer with the legal advocacy group Disability Rights California, last month sent a letter to the U.S. Immigration and Customs Enforcement claiming that after visiting API and interviewing detainees, she found that the conditions are “excessive, unjustifiable and punitive” (

A new study conducted by SANE Australia finds almost half of all Australians still have a very limited understanding of schizophrenia and the everyday reality of living with the illness.

The study (conducted in conjunction with Virtual Medical Centre), surveyed nearly 900 people with 49 per cent admitting to having a poor understanding of schizophrenia and its impact.

The findings are disappointing but not surprising, says SANE Australias Executive Director Barbara Hocking. A lot of education is still needed about the realities of schizophrenia the fact is, with treatment, the majority of those affected lead full lives and participate in the community.

Unfortunately there is still a lot of stigma and discrimination towards those with schizophrenia, which is not helped by persistent myths about the illness. The most common myth confuses schizophrenia with socalled split personality, which is not the case.

Another myth is that people affected by schizophrenia are violent, when in fact research shows that they are more likely to be victims of violence than to commit violent acts themselves.

One in a hundred people will develop schizophrenia during their lives. More males than females are affected and 75% develop the illness between 16 and 25 years.

Schizophrenia is an illness which influences the normal functioning of the brain, affecting its ability to interpret information and make sense of the world. Symptoms can include confused thinking, delusions, hallucinations, difficulty expressing emotions and withdrawal from others. There is no cure for schizophrenia but treatment, which includes medication, psychological therapy and community support and accommodation programs, can do much to reduce and even eliminate the symptoms.

Through events such as Schizophrenia Awareness Week we can hope to break down the stigma surrounding the illness by encouraging conversation and helpseeking behaviour, says Ms Hocking.

SANE produces a number of education resources about schizophrenia to help people understand and make sense of the illness, as a first step to coping with its effects. SANE also operates a StigmaWatch program, which works with the community to monitor media portrayals of mental illness and suicide, advocating for an end to misrepresentations of schizophrenia.

Schizophrenia Awareness Week runs from May 17 23 2009.