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🔗 Medicine 🔗 Food and drink 🔗 Medicine/Toxicology 🔗 Pharmacology 🔗 Medicine/Society and Medicine

Some fruit juices and fruits can interact with numerous drugs, in many cases causing adverse effects. The effect was first discovered accidentally, when a test of drug interactions with alcohol used grapefruit juice to hide the taste of the ethanol.

The effect is most studied with grapefruit and grapefruit juice, but similar effects have been observed with certain other citrus fruits. One medical review advises patients to avoid all citrus juices until further research clarifies the risks. Effects have been observed with apple juice, but their clinical significance is not yet known.

One whole grapefruit, or a small glass (200 mL (6.8 US fl oz)) of grapefruit juice, can cause drug overdose toxicity. Fruit consumed three days before the medicine can still have an effect. The relative risks of different types of citrus fruit have not been systematically studied. Affected drugs typically have an auxiliary label saying “Do not take with grapefruit” on the container, and the interaction is elaborated upon in the package insert. People are also advised to ask their physician or pharmacist about drug interactions.

The effects are caused by furanocoumarins (and, to a lesser extent, flavonoids). These chemicals inhibit key drug metabolizing enzymes, such as cytochrome P450 3A4 (CYP3A4). CYP3A4 is a metabolizing enzyme for almost 50% of drugs, and is found in the liver and small intestinal epithelial cells. As a result, many drugs are affected. Inhibition of enzymes can have two different effects, depending on whether the drug is either

1. metabolized by the enzyme to an inactive metabolite, or
2. activated by the enzyme to an active metabolite.

In the first instance, inhibition of drug-metabolizing enzymes results in elevated concentrations of an active drug in the body, which may cause adverse effects. Conversely, if the medication is a prodrug, it needs to be metabolised to be converted to the active drug. Compromising its metabolism lowers concentrations of the active drug, reducing its therapeutic effect, and risking therapeutic failure.

Low drug concentrations can also be caused when the fruit suppresses drug absorption from the intestine.

🔗 Medicine 🔗 Sociology 🔗 Physiology 🔗 Medicine/Cardiology 🔗 Medicine/Society and Medicine

The Roseto effect is the phenomenon by which a close-knit community experiences a reduced rate of heart disease. The effect is named for Roseto, Pennsylvania. The Roseto effect was first noticed in 1961 when the local Roseto doctor encountered Dr. Stewart Wolf, then head of Medicine of the University of Oklahoma, and they discussed, over a couple of beers, the unusually low rate of myocardial infarction in the Italian American community of Roseto compared with other locations. Many studies followed, including a 50-year study comparing Roseto to nearby Bangor. As the original authors had predicted, as the Roseto cohort shed their Italian social structure and became more Americanized in the years following the initial study, heart disease rates increased, becoming similar to those of neighboring towns.

From 1954 to 1961, Roseto had nearly no heart attacks for the otherwise high-risk group of men 55 to 64, and men over 65 had a death rate of 1% while the national average was 2%. Widowers outnumbered widows, as well.

These statistics were at odds with a number of other factors observed in the community. They smoked unfiltered stogies, drank wine "with seeming abandon" in lieu of milk and soft drinks, skipped the Mediterranean diet in favor of meatballs and sausages fried in lard with hard and soft cheeses. The men worked in the slate quarries where they contracted illnesses from gases and dust. Roseto also had no crime, and very few applications for public assistance.

Wolf attributed Rosetans' lower heart disease rate to lower stress. "'The community,' Wolf says, 'was very cohesive. There was no keeping up with the Joneses. Houses were very close together, and everyone lived more or less alike.'" Elders were revered and incorporated into community life. Housewives were respected, and fathers ran the families.

🔗 Biography 🔗 Medicine 🔗 Women's History 🔗 Medicine/Society and Medicine

Henrietta Lacks (born Loretta Pleasant; August 1, 1920 – October 4, 1951) was an African-American woman whose cancer cells are the source of the HeLa cell line, the first immortalized human cell line and one of the most important cell lines in medical research. An immortalized cell line reproduces indefinitely under specific conditions, and the HeLa cell line continues to be a source of invaluable medical data to the present day.

Lacks was the unwitting source of these cells from a tumor biopsied during treatment for cervical cancer at Johns Hopkins Hospital in Baltimore, Maryland, U.S., in 1951. These cells were then cultured by George Otto Gey who created the cell line known as HeLa, which is still used for medical research. As was then the practice, no consent was obtained to culture her cells, nor were she or her family compensated for their extraction or use.

Lacks grew up in rural Virginia. After giving birth to two of their children, she married her cousin David "Day" Lacks. In 1941 the young family moved to Turner Station, near Dundalk, Maryland, in Baltimore County, so Day could work in Bethlehem Steel at Sparrows Point. After Lacks had given birth to their fifth child, Joseph, she was diagnosed with cancer. Tissue samples from her tumors were taken without consent during treatment and these samples were then subsequently cultured into the HeLa cell line.

Even though some information about the origins of HeLa's immortalized cell lines was known to researchers after 1970, the Lacks family was not made aware of the line's existence until 1975. With knowledge of the cell line's genetic provenance becoming public, its use for medical research and for commercial purposes continues to raise concerns about privacy and patients' rights.