Kids’ liquid cold, allergy drugs recalled

Versions of Tylenol, Motrin, Zyrtec and Benadryl are affected

WASHINGTON - More than 40 over-the-counter infant's and children's liquid medications are being recalled in the United States and 11 other countries because they don't meet quality standards.

McNeil Consumer Healthcare issued the recall for children's versions of Tylenol, Tylenol Plus, Motrin, Zyrtec and Benadryl after consulting with the Food and Drug Administration.

The company is recalling the products because some did not meet required quality standards, the company said in a statement Friday. Some of the products recalled may have a higher concentration of active ingredient than is specified on the bottle. Others may contain particles, while still others may contain inactive ingredients that do not meet internal testing requirements. 

The company is advising consumers to stop giving the products to their children as a precautionary measure. The recall was not undertaken because of any adverse effects, the company said.

The medicines were made and distributed in the United States, and exported to Canada, the Dominican Republic, Dubai, Fiji, Guam, Guatemala, Jamaica, Puerto Rico, Panama, Trinidad and Tobago and Kuwait.

 

Diabetes sugar 'can go too low'

Intense treatment to lower blood sugar in patients with diabetes could prove nearly as harmful as allowing glucose levels to remain high, a study says.

Cardiff researchers looked at nearly 50,000 patients with type 2 diabetes and found the lowest glucose levels linked to a heightened risk of death.

Significant differences in death rates between patients on insulin and those taking tablets are also flagged up.

But there could be various explanations for this, experts noted.

Patients taking insulin-based treatments have been urged not to stop taking their medication as a result of the Cardiff University study, which is published in The Lancet.

Changing treatments

Using data from GPs, the team identified 27,965 patients with type 2 diabetes whose treatment had been intensified to include two oral blood glucose lowering agents - metformin and sulphonylurea.

A further 20,005 patients who had been moved on to treatment which included insulin were added to the study.

Patients whose HbA1c levels - the proportion of red blood cells with glucose attached to them - were around 7.5%, ran the lowest risk of dying from any cause.

For both groups this risk went up by more than half if levels dropped to 6.4%, the lowest levels recorded. For those with the highest levels the risk of death increased by nearly 80%.

But the risks appeared to be particularly pronounced among those on the insulin-based regimen than those on the combined treatment.

Irrespective of whether their HbA1c levels were low or high, there were 2,834 deaths in the insulin-taking group between 1986 and 2008, nearly 50% more than in the combined group.

'Don't stop'

The authors acknowledged there could be various factors associated with this, such as these being older patients with more health problems, who perhaps had had diabetes for a longer period of time. They also make reference to a possible link between use of insulin and cancer progression that had been reported in a different study.

"Whether intensification of glucose control with insulin therapy alone further heightens risk of death in patients with diabetes needs further investigation and assessment of the overall risk balance," wrote lead author Dr Craig Currie.

"Low and high mean HbA1c values were associated with increased all-cause mortality and cardiac events. If confirmed, diabetes guidelines might need revision to include a minimum HbA1c value."

Dr Iain Frame, head of research at Diabetes UK, described the study as "potentially important" but stressed it had limitations.

"It is not clear what the causes of death were from the results reported. Furthermore, when it comes to the suggestion made in this research that insulin could increase the risk of death, we must consider important factors such as age, the duration of their diabetes and how the participants managed their condition.

"It is crucial to remember that blood glucose targets should always be agreed by the person with diabetes and their healthcare team according to individual needs and not according to a blanket set of rules."

While people would be able to manage their condition for a period with diet, exercise and even tablets, many would eventually have to move on to insulin, he noted.

"We would advise people with type 2 diabetes who use insulin not to stop taking their medication. However, if they are worried about blood glucose targets, they should discuss this with their healthcare team."

Giving up smoking 'raises diabetes risk'

Giving up smoking sharply increases the risk of developing type-two diabetes, a US study suggests.

Researchers found quitters had a 70% increased risk of developing type-two diabetes in the first six years without cigarettes compared with non-smokers.

This is because they tend to put on weight.

However, the Annals of Internal Medicine study stressed that this should not be used as an excuse to carry on smoking.

The Johns Hopkins team also stress that smoking is a well known risk factor for type-two diabetes - as well as many other health problems, such as heart disease, stroke and cancer.

Researcher Dr Jessica Yeh said: "If you smoke, give it up. That's the right thing to do.

"But people have to also watch their weight."

The study, based on 10,892 middle aged adults who were followed for up to 17 years, found the risk of developing type-two diabetes was highest in the first three years after giving up smoking.

Around 1.8% of people giving up smoking developed type 2 diabetes each year during that period.

If quitters avoided developing the condition for 10 years, then their long-term risk returned to normal.

People who made no effort to give up smoking had a constant 30% increased risk of type-two diabetes compared with non-smokers.

Blood sugar

Type-two diabetes means the body either fails to make enough of the hormone insulin, or cannot make proper use of it, leading to uncontrolled blood sugar levels.

Untreated this can cause serious disease, and complications such as blindness, kidney failure and nerve damage.

One of the major risk factors for the condition is being overweight, and the rise in obesity across the developed world has been blamed for a big increase in type-two diabetes.

The researchers found those who smoked the most and those who gained the most weight had the highest likelihood for developing diabetes after they quit.

On average, during the first three years of the study, quitters gained about 8.4lb (3.8kg).

The researchers said doctors should keep in mind the importance of weight control when counselling people about giving up smoking.

Quitters tend to put on weight because smoking acts to suppress appetite.

The use of nicotine replacement therapy has been shown to blunt the weight gain associated with giving up smoking.

Martin Dockrell, of the anti-smoking charity Ash, said: "The researchers are clear that smokers should quit but - especially if you are a heavy smoker or are already overweight - you might want to gently increase your exercise when you quit.

"If you are a smoker who is also overweight you should talk to your doctor about how to get the best from quitting.

"A little more exercise could help improve your sense of well being, reduce weight gain and undo some of the harm done by smoking leading to a healthier, happier you."

Natasha Marsland, of the charity Diabetes UK, said: "On no account should people use the theoretical results of this study as an excuse not to give up smoking.

"The health benefits of giving up smoking far outweigh the risk of developing type-two diabetes from modest, short-term weight gain."

What does the future hold for US healthcare?

US senators have passed the final Senate version of a historic healthcare reform bill. What is your reaction?

The legislation aims to cover 31m uninsured Americans and the bill's passage, after months of political wrangling, could lead to the biggest change in US health-care in decades.

The bill has been a priority for President Barack Obama, who rejects claims that compromise has left it weakened. Opposition Republicans say the bill is expensive, authoritarian and a threat to civil liberties.

What do you think of the healthcare reform bill? How will this legislation affect you or your company? Are you a doctor in America with concerns about the bill?