Raw milk is milk that has not been pasteurized or homogenized and Pennsylvania farms selling raw milk must be permitted and inspected to reduce health risks associated with such products. Another case of Listeria monocytogenes was found at Piney Ridge dairy last year. "During routine testing, samples taken at the dairies tested positive for Listeria monocytogenes," said Wolff. "If consumers have raw milk from these farms, they should discard it immediately." The Department of Agriculture has suspended sales of raw milk at the dairies and is requiring corrective action be taken. Samples were taken from the farms on March 31 and tested positive for Listeria monocytogenes April 4. Multiple laboratory samples must test negative before sales can resume.
Listeriosis is a type of food poisoning generated by the Listeria monocytogenes bacteria and is dangerous to the elderly, pregnant women, newborns, and those with chronic medical conditions. Most people experience only mild flu like symptoms—fever, muscle aches, nausea, or diarrhea. In serious cases, the disease spreads to the nervous system, causing headaches, stiff neck, and convulsions. In pregnant women, Listeriosis can result in miscarriage or stillbirth. Listeria lives in soil and water and can easily contaminate dairy and beef products; because listeria thrives in cold, milk is an ideal environment.
Last month the US Food and Drug Administration (FDA) announced a new draft compliance policy for control of Listeria monocytogenes (Lm) in ready-to-eat foods. This is a groundbreaking policy in that this is the first time different policies have been created for foods that do and do not support growth of the toxic organism. For foods that do not support the growth of the listeria bacteria, the FDA will revise its tolerance level; the “zero tolerance” standard for ready-to-eat foods that do support the growth of the bacteria will not change.
In recent months, listeria has been the focus of a number of outbreaks, including three cases in North Carolina linked to soft cheeses and an outbreak at Massachusetts’ Whittier Farms dairy where four people died and more were sickened from consuming products produced at the dairy. In January, in Olympia, Washington, the Ca Rem #1 Ice Cream, SeaTac voluntarily recalled its coconut-flavored popsicles when routine sampling and analysis revealed the presence of Listeria. In February, the Minnesota Department of Agriculture (MDA) alerted the public to avoid consuming smoked pork and beef bratwurst produced by J&B Meats, of Barnesville, Minnesota when a routine sampling revealed listeria contamination. In March, Meijer Inc. of Grand Rapids, Michigan, pulled 2,184 pounds of frozen entrees after the US Department of Agriculture (USDA) testing showed the food could be tainted with listeria. Most recently, Stop and Shop recalled four types of prepared chicken due to possible listeria contamination.
All of these medications were found to increase the risk of gastrointestinal (GI) bleeding especially when taken with aspirin or when taken in high doses.
One study, done at the University of Utah College of Pharmacy in Salt Lake City, showed that patients, who took aspirin and OTC NSAIDs together, were two to three times more likely to develop stomach ulcers, perforations and bleeding compared to individuals who took the NSAIDs alone.
The findings were presented yesterday at the American College of Gastroenterology annual meeting in Honolulu.
Another study, conducted by Dr. Barry Bowen of McMaster University in Hamilton, Ontario and published in the November issue of Clinical Gastroenterology and Hepatology, reports that those on an ibuprofen regimen suffered four times as much blood loss from stomach ulcers and gastro intestinal problems than those individuals not taking the medication.
The researchers conducted an analysis of two random studies that considered 68 healthy subjects who were given either four weeks of an ibuprofen regimen at 800 mg, three times daily for 28 days (twice the daily recommended dosage) or a placebo.
Healthy individuals, who took the ibuprofen, had blood loss that was 3.64-fold greater than the placebo group. The bleeding started as little as three days into the study and lasted for the entire course of treatment in many individuals.
Joe Biskupiak, study author at the University of Utah College of Pharmacy, stated that the risks documented in the recent studies were not unexpected: "We know that the prescription NSAIDs increase risk. Over-the-counter NSAIDs are a little harder to pin down because it's harder to get data on patients using them. Everybody suspected it, but there hasn't been a lot out there."
He also remarked that both doctors and patients need to be educated about the gastrointestinal problems associated with the drugs. Recent findings suggest that most of the people taking pain relievers, who were at risk for bleeding, were not taking medication to prevent it. Many were also unaware of the possible negative side effects.
Several other experts also regard the new studies as “confirmatory” of the link between high-dosage, frequent, and multiple NSAID use and gastrointestinal problems. In addition, regulating OTC NSAID use “remains the most substantial modifiable risk factor to reduce gastrointestinal complications from NSAIDs," according to Dr. Mark Fendrick, professor of internal medicine at the University of Michigan School of Medicine at Ann Arbor.
The NSAID family of drugs includes Cox-2 inhibitors such as Vioxx and Bextra (now off the market) and Celebrex (still available). Those versions of NSAIDs were successful because of their less serious GI effects.
Since Cox-2 inhibitors have now been associated with an increased risk of serious cardiovascular problems, however, many patients have returned to the “non-specific” OTC NSAIDs for relief thereby significantly increasing the number of people exposed to the GI problems associated with either high-dosage, frequent, or multiple OTC NSAID use.
As Biskupiak put it: “Just because it’s over-the-counter doesn’t mean it’s devoid of risk.”
Results of the study were published online Monday in the American Heart Association journal Hypertension.
Ibuprofen and naproxen are classified as non-steroidal anti-inflammatory drugs or NSAID and have previously been linked to high blood pressure. The federal government has just been required to carry stricter warning labels on NSAIDs because of an elevated risk of heart-related problems. Acetaminophen, however, had been largely considered risk free.
It is also significant to note that many arthritis pain sufferers turned to these alternative OTC painkillers in desperation when it was disclosed that the widely prescribed class of drugs known as COX-2 inhibitors (Vioxx, Bextra, Celebrex) posed an increased of heart attack.
Although Harvard researchers have found a connection between high blood pressure and painkillers in the past, the recent study was the first to rule out the possibility that patients taking the painkillers under consideration were already suffering from hypertension.
The study, considered 5,123 women participating in the Nurses Health Study at Harvard Medical School and Brigham and Women's Hospital in Boston. The women, who were between 34 and 77 did not have high blood pressure at the beginning of the study and were monitored for up to eight years.
Results showed that women 51 to 77 who took an average of 400 milligrams of ibuprofen a day were 80% more likely to develop high blood pressure than older women who did not take the drug.
Women in the same age group who took an average daily dose of more than 500 milligrams of acetaminophen (one extra-strength Tylenol) almost doubled their risk of developing high blood pressure within about three years.
Those who took more than 400 milligrams of ibuprofen daily (about two Advil) had a 78% grater risk of developing high blood pressure.
Younger women (aged 34 to 53) who took those daily doses of 400 milligrams of ibuprofen or NSAIDs were 60% more likely to develop high blood pressure and those who took an average of more than 500 milligrams acetaminophen a day had a two-fold higher risk of developing high blood pressure.
The risk of developing high blood pressure, for women who did not take OTC painkillers is approximately 1% to 3% a year.
Dr. John Phillip Forman, of the Harvard Medical School and an associate physician at Brigham and Women's Hospital in Boston, said the findings did not indicate that women should stop taking pain medication. “We are by no means suggesting that women with chronic pain conditions not receive treatment for their pain. By pointing out risks associated with these drugs, more informed choices can be made by women and their clinicians.''
Currently aspirin remains the safest pain reliever for women. In the study it was not shown to effect blood pressure. This is probably because aspirin has a different effect on blood vessels in comparison with ibuprofen, which may increase sodium and effect levels of nitric oxide triggering blood pressure changes.
Future studies will consider what relationship, if any, OTC pain medications have on increased hypertension in men.