Human growth hormone use seen as risky.
The New York Times (12/20, SP2, Austen) reported that "physicians and medical researchers who have studied people with medical conditions that lead to growth hormone overproduction said that available evidence suggested that athletes who cheat by using costly" human growth hormone (HGH) as a performance-enhancing drug may "simply wind up" exposing themselves to "cardiovascular problems, an increased risk of diabetes, arthritis, carpal tunnel syndrome, glucose intolerance, colon polyps, skin growths, excessive sweating," and "serious headaches," as well as "abnormal bone growth in the face, head, hands, and feet," and possibly even cancer.
Tuesday, December 22, 2009
Calorie Counting = Less Food
Calorie counts on menus led to diners eating less in study.
USA Today (12/21, Hellmich) reports, "Diners consume far fewer calories at dinner and afterward when the calorie content of entrees is listed on the menus along with information on how many calories they should consume in a day," according to a study from the Rudd Center for Food Policy and Obesity at Yale University. In the American Journal of Public Health, the researcher said that diners who saw a notice of recommended daily caloric intake and calorie counts on the menu ate about 250 fewer calories than diners who did not. Rudd Center director Kelly Brownell said that "it's 'crystal clear' that menus should include both the calories and the 2,000-reference number to make it easier for consumers to make healthful choices."
USA Today (12/21, Hellmich) reports, "Diners consume far fewer calories at dinner and afterward when the calorie content of entrees is listed on the menus along with information on how many calories they should consume in a day," according to a study from the Rudd Center for Food Policy and Obesity at Yale University. In the American Journal of Public Health, the researcher said that diners who saw a notice of recommended daily caloric intake and calorie counts on the menu ate about 250 fewer calories than diners who did not. Rudd Center director Kelly Brownell said that "it's 'crystal clear' that menus should include both the calories and the 2,000-reference number to make it easier for consumers to make healthful choices."
Computerized Prosthetic Limb Update
New computer program assists with prosthetic limb adjustments.
The New York Times (12/20, BU4, Eisenberg) reported a new computer-based alignment system for prosthetics is providing "quantitative information" for patients seeking to make adjustments to their prosthetic limbs without the help of a clinician. The system, called Compas -- short for Computerized Prosthesis Alignment System -- "interprets data collected as a patient walks," and then "suggests adjustments." The program "was developed in part with financing from the National Center for Medical Rehabilitation Research of the National Institutes of Health."
The New York Times (12/20, BU4, Eisenberg) reported a new computer-based alignment system for prosthetics is providing "quantitative information" for patients seeking to make adjustments to their prosthetic limbs without the help of a clinician. The system, called Compas -- short for Computerized Prosthesis Alignment System -- "interprets data collected as a patient walks," and then "suggests adjustments." The program "was developed in part with financing from the National Center for Medical Rehabilitation Research of the National Institutes of Health."
Head Injury in the NFL
NFL concedes long-term effects of concussion damage.
On the front of its Sports Monday section, the New York Times (12/21, D1, Schwarz) reports that the National Football League "conceded publicly for the first time that concussions can have lasting consequences" on Sunday, adding that it would support any research efforts into the long-term effects on NFL players. The admission follows an Oct. 28th hearing before the House Judiciary Committee, after which the NFL "accepted the resignations of the co-chairmen of its concussion committee and overhauled its policies toward concussion management." The CBS Evening News (12/20, story 4, 0:25, Mitchell) reported that the League "says it will encourage current and former players to donate their brains to researchers at Boston University for study."
On the front of its Sports Monday section, the New York Times (12/21, D1, Schwarz) reports that the National Football League "conceded publicly for the first time that concussions can have lasting consequences" on Sunday, adding that it would support any research efforts into the long-term effects on NFL players. The admission follows an Oct. 28th hearing before the House Judiciary Committee, after which the NFL "accepted the resignations of the co-chairmen of its concussion committee and overhauled its policies toward concussion management." The CBS Evening News (12/20, story 4, 0:25, Mitchell) reported that the League "says it will encourage current and former players to donate their brains to researchers at Boston University for study."
Spirituality and Cancer Care
Increased spiritual support may be linked to higher quality of life in cancer patients.
HealthDay (12/18, Gordon) reported, "Addressing the spiritual needs of someone with advanced cancer could be just as important as taking care of their medical needs," according to a study appearing Dec. 14 in the Journal of Clinical Oncology. The study of 670 patients showed that 60 percent "said that their spiritual needs either hadn't been met or were minimally supported," even though patients ranked "pain control and being at peace with God" as the two most important factors "at the end of their lives." Patients who received "greater spiritual support from their medical team" said they had "a higher quality of life as they neared death." The study also showed that "highly religious" patients who received greater spiritual support were less likely to be treated with "aggressive medical care."
HealthDay (12/18, Gordon) reported, "Addressing the spiritual needs of someone with advanced cancer could be just as important as taking care of their medical needs," according to a study appearing Dec. 14 in the Journal of Clinical Oncology. The study of 670 patients showed that 60 percent "said that their spiritual needs either hadn't been met or were minimally supported," even though patients ranked "pain control and being at peace with God" as the two most important factors "at the end of their lives." Patients who received "greater spiritual support from their medical team" said they had "a higher quality of life as they neared death." The study also showed that "highly religious" patients who received greater spiritual support were less likely to be treated with "aggressive medical care."
New Mammogram Update
Federal mammogram recommendations defended.
In an op-ed appearing in the New York Times (12/20, BU5), economics professor Richard H. Thaler wrote that the recent recommendation from a federal advisory panel regarding mammograms has "been called a rash misjudgment and an example of ostrich-like thinking." Thaler argued that this criticism is "unfair," noting that the new report "makes some good arguments," and that "when you add up a decade of false positives, hundreds of these women will have received false alarms -- and about half of these will have received biopsies." He concluded that when it comes to the cost/benefit analysis of conducting breast cancer screenings, "one can make a good case that we don't want the government making these choices," although few people "want those decisions made by private insurance companies, either."
Patients seeking mammogram advice from their physicians. American Medical News (12/21, Moyer) reports that in response to new federal guidelines recommending against annual mammograms for "women age 40 to 49," patients are "going to their doctors with questions and concerns about what to do," but "the discussions mean explaining the recommendations to patients, separating fact from fiction, and determining the best course of action." Len Lichtenfeld, MD, deputy chief medical officer of the American Cancer Society, noted that although physicians can have such conversations with their patients, "in no way can a physician look at a particular woman with average risk and say, 'You should be screened, or you should not be screened.'"
In an op-ed appearing in the New York Times (12/20, BU5), economics professor Richard H. Thaler wrote that the recent recommendation from a federal advisory panel regarding mammograms has "been called a rash misjudgment and an example of ostrich-like thinking." Thaler argued that this criticism is "unfair," noting that the new report "makes some good arguments," and that "when you add up a decade of false positives, hundreds of these women will have received false alarms -- and about half of these will have received biopsies." He concluded that when it comes to the cost/benefit analysis of conducting breast cancer screenings, "one can make a good case that we don't want the government making these choices," although few people "want those decisions made by private insurance companies, either."
Patients seeking mammogram advice from their physicians. American Medical News (12/21, Moyer) reports that in response to new federal guidelines recommending against annual mammograms for "women age 40 to 49," patients are "going to their doctors with questions and concerns about what to do," but "the discussions mean explaining the recommendations to patients, separating fact from fiction, and determining the best course of action." Len Lichtenfeld, MD, deputy chief medical officer of the American Cancer Society, noted that although physicians can have such conversations with their patients, "in no way can a physician look at a particular woman with average risk and say, 'You should be screened, or you should not be screened.'"
Video Office Visits Possible in 2010
Insurer plans to offer online health exams next year.
The New York Times (12/21, B4, Miller) reports that "OptumHealth, a division of UnitedHealth Group...plans to offer NowClinic, a service that connects patients and doctors using video chat, nationwide next year." NowClinic is expected to "improve healthcare by ameliorating some of the stresses on the system today, like wasted time dealing with appointments and insurance claims, a shortage of primary care physicians and limited access to care for many patients," according to OptumHealth. The online exams have drawn opposition, the Times adds, as "some doctors worry that the quality of care that patients receive will suffer if physicians neglect one of the most basic elements of healthcare: a physical exam."
The New York Times (12/21, B4, Miller) reports that "OptumHealth, a division of UnitedHealth Group...plans to offer NowClinic, a service that connects patients and doctors using video chat, nationwide next year." NowClinic is expected to "improve healthcare by ameliorating some of the stresses on the system today, like wasted time dealing with appointments and insurance claims, a shortage of primary care physicians and limited access to care for many patients," according to OptumHealth. The online exams have drawn opposition, the Times adds, as "some doctors worry that the quality of care that patients receive will suffer if physicians neglect one of the most basic elements of healthcare: a physical exam."
Wednesday, December 16, 2009
Chicken Pox and Shingles
Varicella vaccine may protect against shingles.
HealthDay (12/4, Preidt) reported, "Children who are vaccinated against chicken pox may also have increased protection against shingles," according to data in the Pediatric Infectious Disease Journal. Investigators at the Kaiser Permanente Department of Research "looked at the health records of 172,163 children in southern California who were vaccinated with the varicella (chicken pox) vaccine between 2002 and 2008." They noted that "over an average of 2.5 years after receiving the chicken pox vaccine, only 122 cases of shingles (Herpes zoster) occurred among the children, an estimated incidence of one case per 3,700 children per year."
Citation: AMA
HealthDay (12/4, Preidt) reported, "Children who are vaccinated against chicken pox may also have increased protection against shingles," according to data in the Pediatric Infectious Disease Journal. Investigators at the Kaiser Permanente Department of Research "looked at the health records of 172,163 children in southern California who were vaccinated with the varicella (chicken pox) vaccine between 2002 and 2008." They noted that "over an average of 2.5 years after receiving the chicken pox vaccine, only 122 cases of shingles (Herpes zoster) occurred among the children, an estimated incidence of one case per 3,700 children per year."
Citation: AMA
Hand Sanitizer Update
Germ fighting claims said to often be exaggerated.
The Wall Street Journal (12/16, Bialik) reports that the numerous claims found on products touting a 99.9% success rate in killing germs and bacteria are typically based on lab results as opposed to real-world usage. Jason Tetro, a microbiologist at the University of Ottawa, says that the laboratory in which many of hand-sanitizers are tested is "the optimal environment for the hand sanitizer to work." In addition, current regulations only require companies to prove that the products are effective against a handful of microbes. The Journal points out that the FDA forbids companies making claims on over-the-counter products, and notes the agency's recent crackdown on companies making false claims relating to the H1N1 virus.
Citation: AMA
The Wall Street Journal (12/16, Bialik) reports that the numerous claims found on products touting a 99.9% success rate in killing germs and bacteria are typically based on lab results as opposed to real-world usage. Jason Tetro, a microbiologist at the University of Ottawa, says that the laboratory in which many of hand-sanitizers are tested is "the optimal environment for the hand sanitizer to work." In addition, current regulations only require companies to prove that the products are effective against a handful of microbes. The Journal points out that the FDA forbids companies making claims on over-the-counter products, and notes the agency's recent crackdown on companies making false claims relating to the H1N1 virus.
Citation: AMA
Coffee May Lower Prostate Cancer Risk
Coffee consumption, exercise may lower prostate cancer risk.
Bloomberg News (12/8, Bennett) reported that Harvard scientists have discovered that "drinking coffee may lower the risk of developing the deadliest form of prostate cancer." In fact, "the five percent of" study participants "who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any." The work, Bloomberg notes, "is the first to associate coffee with prostate cancer, contradicting previous research that's found no link."
The team is quick to point out, however, that "it's too early to start recommending that men start drinking coffee to help prevent prostate cancer, but the results are encouraging," WebMD (12/7, Warner) reported.
Research explores role exercise could play in fight against prostate cancer. A presentation made "at the Frontiers in Cancer Prevention Research conference" touched on the "role that exercise...could play in the fight against prostate cancer," the Time (12/7, O'Callaghan) "Wellness" blog reported. "An analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all." As for walking, those who did so "for four or more hours per week" had "overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week."
Citation: AMA
Bloomberg News (12/8, Bennett) reported that Harvard scientists have discovered that "drinking coffee may lower the risk of developing the deadliest form of prostate cancer." In fact, "the five percent of" study participants "who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any." The work, Bloomberg notes, "is the first to associate coffee with prostate cancer, contradicting previous research that's found no link."
The team is quick to point out, however, that "it's too early to start recommending that men start drinking coffee to help prevent prostate cancer, but the results are encouraging," WebMD (12/7, Warner) reported.
Research explores role exercise could play in fight against prostate cancer. A presentation made "at the Frontiers in Cancer Prevention Research conference" touched on the "role that exercise...could play in the fight against prostate cancer," the Time (12/7, O'Callaghan) "Wellness" blog reported. "An analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all." As for walking, those who did so "for four or more hours per week" had "overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week."
Citation: AMA
Postpartum Depression in Fathers
Postpartum depression may also affect fathers.
In the New York Times (12/8, D6) "Mind" column, psychiatrist Richard A. Friedman, MD, writes that about "10 percent" of women "plummet into severe postpartum depression" after giving birth. Now, "it turns out that men can also have postpartum depression." But, although a study conducted by psychiatrist Paul G. Ramchandani, of the UK's Oxford University, found that "four percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children," postpartum depression in fathers "isn't something most people, including physicians, have ever heard of." Notably, "the strongest predictor of paternal postpartum depression is having a depressed partner," with "fathers whose partners were also depressed" having "nearly two and a half times the normal risk for depression."
Citation: AMA
In the New York Times (12/8, D6) "Mind" column, psychiatrist Richard A. Friedman, MD, writes that about "10 percent" of women "plummet into severe postpartum depression" after giving birth. Now, "it turns out that men can also have postpartum depression." But, although a study conducted by psychiatrist Paul G. Ramchandani, of the UK's Oxford University, found that "four percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children," postpartum depression in fathers "isn't something most people, including physicians, have ever heard of." Notably, "the strongest predictor of paternal postpartum depression is having a depressed partner," with "fathers whose partners were also depressed" having "nearly two and a half times the normal risk for depression."
Citation: AMA
Early STD Testing for Women
Women urged to seek STD testing within 12 months of first intercourse.
The Los Angeles Times (12/7, Roan) "Booster Shots" blog reported, "Young women should be screened for sexually transmitted diseases within a year of first intercourse and should be retested every three to four months if an infection is found, according to a study published...in the Archives of Pediatrics and Adolescent Medicine." Indeed, the "US Preventive Services Task Force and Centers for Disease Control and Prevention have recommendations for STD screening, but those documents are somewhat vaguely worded." The work conducted by researchers at Indiana University, however, "suggests that starting at a young age and conducting regular screening may prevent many health problems," such as pelvic inflammatory disease and ectopic pregnancy, in the years to come.
Citation; AMA
The Los Angeles Times (12/7, Roan) "Booster Shots" blog reported, "Young women should be screened for sexually transmitted diseases within a year of first intercourse and should be retested every three to four months if an infection is found, according to a study published...in the Archives of Pediatrics and Adolescent Medicine." Indeed, the "US Preventive Services Task Force and Centers for Disease Control and Prevention have recommendations for STD screening, but those documents are somewhat vaguely worded." The work conducted by researchers at Indiana University, however, "suggests that starting at a young age and conducting regular screening may prevent many health problems," such as pelvic inflammatory disease and ectopic pregnancy, in the years to come.
Citation; AMA
Soy and Cancer Survival
Soy foods may be safe, beneficial for breast cancer survivors.
USA Today (12/9, Szabo) reports that, according to a study published Dec. 9 in the Journal of the American Medical Association, "soy foods may be safe, and possibly even beneficial, for breast cancer survivors." Until now, "many breast cancer doctors have been cautious about recommending soy products -- such as soy milk, tofu, edamame, or miso soup -- because they contain plant estrogens. Most breast cancers are fueled by estrogen, which can make it risky to take additional hormones, such as for menopausal symptoms."
The Los Angeles Times (12/9, Roan) reports that researchers at Vanderbilt University "analyzed data from the Shanghai Breast Cancer Survival Study of 5,042" Chinese women "ages 20 to 75." The investigators found that "patients with the highest intake had a 29% lower risk of death during the study period and a 32% lower risk of breast cancer recurrence compared to patients with the lowest intake of soy foods," which "was measured by either soy protein or soy isoflavone intake."
Bloomberg News (12/9, Ostrow) reports, "The study, which followed women for an average of about four years, is the largest to examine the influence of soy intake on breast cancer survival and recurrence, the authors said. More than 192,000 women in the US will be diagnosed with breast cancer this year, according to the National Cancer Institute."
HealthDay (12/8, Gordon) reported, "What's more, the association between soy and a reduced risk of death held true even for women with estrogen receptor-positive cancers and women taking tamoxifen," the investigators found. In fact, the research team "found that soy actually reduces the availability of naturally occurring estrogen by binding to its receptors," having "a very similar effect to tamoxifen."
MedPage Today (12/8, Phend) noted that "the study was done in China, where soy intake tends to be higher than in the US and eaten in less processed forms." But, "while American women typically eat less than one-tenth as much soy as their counterparts in China, the results should be reassuring regardless of consumption, according to an accompanying editorial." The editorialists also "cautioned that any potential benefits cannot be extrapolated to dietary supplements containing soy," but said that "patients with breast cancer can be assured that enjoying a soy latte or indulging in pad thai with tofu causes no harm and, when consumed in plentiful amounts, may reduce risk of disease recurrence."
Citation: AMA
USA Today (12/9, Szabo) reports that, according to a study published Dec. 9 in the Journal of the American Medical Association, "soy foods may be safe, and possibly even beneficial, for breast cancer survivors." Until now, "many breast cancer doctors have been cautious about recommending soy products -- such as soy milk, tofu, edamame, or miso soup -- because they contain plant estrogens. Most breast cancers are fueled by estrogen, which can make it risky to take additional hormones, such as for menopausal symptoms."
The Los Angeles Times (12/9, Roan) reports that researchers at Vanderbilt University "analyzed data from the Shanghai Breast Cancer Survival Study of 5,042" Chinese women "ages 20 to 75." The investigators found that "patients with the highest intake had a 29% lower risk of death during the study period and a 32% lower risk of breast cancer recurrence compared to patients with the lowest intake of soy foods," which "was measured by either soy protein or soy isoflavone intake."
Bloomberg News (12/9, Ostrow) reports, "The study, which followed women for an average of about four years, is the largest to examine the influence of soy intake on breast cancer survival and recurrence, the authors said. More than 192,000 women in the US will be diagnosed with breast cancer this year, according to the National Cancer Institute."
HealthDay (12/8, Gordon) reported, "What's more, the association between soy and a reduced risk of death held true even for women with estrogen receptor-positive cancers and women taking tamoxifen," the investigators found. In fact, the research team "found that soy actually reduces the availability of naturally occurring estrogen by binding to its receptors," having "a very similar effect to tamoxifen."
MedPage Today (12/8, Phend) noted that "the study was done in China, where soy intake tends to be higher than in the US and eaten in less processed forms." But, "while American women typically eat less than one-tenth as much soy as their counterparts in China, the results should be reassuring regardless of consumption, according to an accompanying editorial." The editorialists also "cautioned that any potential benefits cannot be extrapolated to dietary supplements containing soy," but said that "patients with breast cancer can be assured that enjoying a soy latte or indulging in pad thai with tofu causes no harm and, when consumed in plentiful amounts, may reduce risk of disease recurrence."
Citation: AMA
Tamiflu Update from AMA
Researchers find little evidence Tamiflu reduces flu complications in otherwise healthy people.
The AP (12/9, Cheng) reports, "British researchers say there is little evidence Tamiflu [oseltamivir] stops complications in healthy people who catch the flu, though public health officials contend the swine flu drug reduces flu hospitalizations and deaths." In a review of "previously published papers on Tamiflu as used for seasonal flu," researchers "found insufficient data to prove whether the antiviral reduces complications...but concluded the drug shortens flu symptoms by about a day."
The review, appearing online in BMJ, notes that researchers were "unable to conclude that the drug is effective at reducing complications...because they do not have access to key data from eight clinical trials sponsored by the drug's manufacturer, Roche Laboratories Inc.," the Los Angeles Times (12/8, Maugh) "Booster Shots" blog reported. For its part, Roche "said that the data...simply duplicated the results from published trials and did not provide enough information to justify publication."
Bloomberg News (12/9, Cortez) reports that the finding challenges results from a previous study in which researchers concluded "that Tamiflu protects against complications." In an accompanying editorial, BMJ editor in chief Fiona Godlee noted that "the studies originally used to establish the benefits of Tamiflu were written by Roche employees and paid consultants," which "raises questions about how drugs are reviewed, approved, and distributed."
Godlee stated, "Governments around the world have spent billions of dollars on a drug that the scientific community now finds itself unable to judge," HealthDay (12/8, Preidt) reported. Study author Chris Del Marr, a professor at Bond University in Australia, wrote that "governments should establish studies to monitor the safety of Tamiflu" as "previous evidence about" its "effects on flu complications may be unreliable."
But, on its website, CBS News (12/8) reported that the World Health Organization "said data from countries around the world show that when given early, Tamiflu can reduce the severity of swine flu symptoms, though the agency recommends the drug be saved for people at risk of complications." Meanwhile, Godlee called for "new global legislation to ensure...'ready access to the raw data behind any analyses used to license and market a drug.'"
MedPage Today (12/8, Smith) reported that the editorial also "raised a series of issues...including who had access to data from Roche-funded trials, whether ghost writers were used to prepare journal manuscripts, and why some authors were not listed while -- in at least one case -- an author was cited who later said he can't recall performing the study."
Citation: AMA
The AP (12/9, Cheng) reports, "British researchers say there is little evidence Tamiflu [oseltamivir] stops complications in healthy people who catch the flu, though public health officials contend the swine flu drug reduces flu hospitalizations and deaths." In a review of "previously published papers on Tamiflu as used for seasonal flu," researchers "found insufficient data to prove whether the antiviral reduces complications...but concluded the drug shortens flu symptoms by about a day."
The review, appearing online in BMJ, notes that researchers were "unable to conclude that the drug is effective at reducing complications...because they do not have access to key data from eight clinical trials sponsored by the drug's manufacturer, Roche Laboratories Inc.," the Los Angeles Times (12/8, Maugh) "Booster Shots" blog reported. For its part, Roche "said that the data...simply duplicated the results from published trials and did not provide enough information to justify publication."
Bloomberg News (12/9, Cortez) reports that the finding challenges results from a previous study in which researchers concluded "that Tamiflu protects against complications." In an accompanying editorial, BMJ editor in chief Fiona Godlee noted that "the studies originally used to establish the benefits of Tamiflu were written by Roche employees and paid consultants," which "raises questions about how drugs are reviewed, approved, and distributed."
Godlee stated, "Governments around the world have spent billions of dollars on a drug that the scientific community now finds itself unable to judge," HealthDay (12/8, Preidt) reported. Study author Chris Del Marr, a professor at Bond University in Australia, wrote that "governments should establish studies to monitor the safety of Tamiflu" as "previous evidence about" its "effects on flu complications may be unreliable."
But, on its website, CBS News (12/8) reported that the World Health Organization "said data from countries around the world show that when given early, Tamiflu can reduce the severity of swine flu symptoms, though the agency recommends the drug be saved for people at risk of complications." Meanwhile, Godlee called for "new global legislation to ensure...'ready access to the raw data behind any analyses used to license and market a drug.'"
MedPage Today (12/8, Smith) reported that the editorial also "raised a series of issues...including who had access to data from Roche-funded trials, whether ghost writers were used to prepare journal manuscripts, and why some authors were not listed while -- in at least one case -- an author was cited who later said he can't recall performing the study."
Citation: AMA
TV Time and Calories
Reducing TV time may spur calorie burn.
HealthDay (12/14, Gardner) reported that researchers have found a correlation between "turning off the TV" and "lifestyle habits," according to the paper in the Archives of Internal Medicine. Indeed, the fact that "less time watching TV means more calories burned" is "hardly surprising," but investigators say it "may provide clinicians with a new tool to stem the tide of overweight and obesity." In fact, "participants burned 120 more calories a day and spent about 50 percent less time plunked in front of the TV than they had before starting the study" when their viewing habits went unchecked.
There was, however, "no significant difference between the intervention and control groups in energy intake, energy balance, or body mass index," MedPage Today (12/14, Walsh) noted. Still, previous studies have shown that "TV couch potatoes expend even less energy than people engaged in other sedentary behaviors such as reading, writing, or talking on the telephone, and US adults currently average five hours of TV a day."
Citation: AMA
HealthDay (12/14, Gardner) reported that researchers have found a correlation between "turning off the TV" and "lifestyle habits," according to the paper in the Archives of Internal Medicine. Indeed, the fact that "less time watching TV means more calories burned" is "hardly surprising," but investigators say it "may provide clinicians with a new tool to stem the tide of overweight and obesity." In fact, "participants burned 120 more calories a day and spent about 50 percent less time plunked in front of the TV than they had before starting the study" when their viewing habits went unchecked.
There was, however, "no significant difference between the intervention and control groups in energy intake, energy balance, or body mass index," MedPage Today (12/14, Walsh) noted. Still, previous studies have shown that "TV couch potatoes expend even less energy than people engaged in other sedentary behaviors such as reading, writing, or talking on the telephone, and US adults currently average five hours of TV a day."
Citation: AMA
Good News about Coffee!
High coffee, tea intake may reduce chances of developing type 2 diabetes.
Bloomberg News (12/15, Gibson) reports that, according to a study published in the Archives of Internal Medicine, "drinking four cups of coffee, decaf, or tea daily can reduce the chances of getting type 2 diabetes by about 25 percent to 35 percent." Harvard University "researchers reviewed 18 studies of almost 500,000 people" and discovered that "for each cup of coffee people drank, their likelihood of getting diabetes dropped by seven percent."
"Even better results were found for bigger coffee and tea consumers -- drinking three to four cups a day was associated with about a 25% reduced diabetes risk, compared with those who drank between none and two cups day," the Los Angeles Times (12/15, Stein) reports. In addition, investigators found "positive results with decaf coffee and tea." Specifically, those "who drank more than three to four cups of decaf a day had about a one-third lower risk than those who didn't drink any," while "tea drinkers who consumed more than three to four cups a day had about a one-fifth lower diabetes risk than non-tea drinkers."
HealthDay (12/14, Gordon) and MedPage Today (12/14, Fiore) also covered the story.
Citation: AMA
Bloomberg News (12/15, Gibson) reports that, according to a study published in the Archives of Internal Medicine, "drinking four cups of coffee, decaf, or tea daily can reduce the chances of getting type 2 diabetes by about 25 percent to 35 percent." Harvard University "researchers reviewed 18 studies of almost 500,000 people" and discovered that "for each cup of coffee people drank, their likelihood of getting diabetes dropped by seven percent."
"Even better results were found for bigger coffee and tea consumers -- drinking three to four cups a day was associated with about a 25% reduced diabetes risk, compared with those who drank between none and two cups day," the Los Angeles Times (12/15, Stein) reports. In addition, investigators found "positive results with decaf coffee and tea." Specifically, those "who drank more than three to four cups of decaf a day had about a one-third lower risk than those who didn't drink any," while "tea drinkers who consumed more than three to four cups a day had about a one-fifth lower diabetes risk than non-tea drinkers."
HealthDay (12/14, Gordon) and MedPage Today (12/14, Fiore) also covered the story.
Citation: AMA
Teens and Prescription Drugs
Study finds teens less wary of prescription drugs.
The AP (12/15, Goodman) reports the National Institute on Drug Abuse released a study on Monday which determined that marijuana usage has become "even more popular" among US teens in recent years. Researchers said the increase could be partly attributable to "the national debate over medical use of marijuana" which can "make the drugs seem safer to teenagers." The study also found that "in addition to marijuana, fewer teens also view prescription drugs and Ecstasy as dangerous." National Institute on Drug Abuse Director Nora Volkow, MD, warned that teens "falsely reason it's less dangerous to get high on prescription drugs 'because they're endorsed by the medical community.'" The Christian Science Monitor (12/15, Wood) reports the study determined that "seven of the 10 drugs most abused by high school seniors are prescription or over-the-counter drugs acquired primarily from teens' friends or relatives."
The Oregonian (12/15, Dworkin) reports that the study also found methamphetamine use by teens "has dropped to its lowest level in at least a decade," while "cigarette smoking has also fallen to low rates, with just one in nine high-school seniors smoking daily." The Wall Street Journal (12/15, Dooren) reports alcohol consumption remained consistent with previous years, with nearly two-thirds of seniors reporting abuse in the past year. The Los Angeles Times (12/15, Healy) reports, "Although fewer kids reported taking Ritalin [methylphenidate], much of that decline was because kids had merely shifted to Adderall [amphetamine/dextroamphetamine], a newer AD/HD drug." The Washington Times (12/15, Billups) also covers the story.
Citation: AMA
The AP (12/15, Goodman) reports the National Institute on Drug Abuse released a study on Monday which determined that marijuana usage has become "even more popular" among US teens in recent years. Researchers said the increase could be partly attributable to "the national debate over medical use of marijuana" which can "make the drugs seem safer to teenagers." The study also found that "in addition to marijuana, fewer teens also view prescription drugs and Ecstasy as dangerous." National Institute on Drug Abuse Director Nora Volkow, MD, warned that teens "falsely reason it's less dangerous to get high on prescription drugs 'because they're endorsed by the medical community.'" The Christian Science Monitor (12/15, Wood) reports the study determined that "seven of the 10 drugs most abused by high school seniors are prescription or over-the-counter drugs acquired primarily from teens' friends or relatives."
The Oregonian (12/15, Dworkin) reports that the study also found methamphetamine use by teens "has dropped to its lowest level in at least a decade," while "cigarette smoking has also fallen to low rates, with just one in nine high-school seniors smoking daily." The Wall Street Journal (12/15, Dooren) reports alcohol consumption remained consistent with previous years, with nearly two-thirds of seniors reporting abuse in the past year. The Los Angeles Times (12/15, Healy) reports, "Although fewer kids reported taking Ritalin [methylphenidate], much of that decline was because kids had merely shifted to Adderall [amphetamine/dextroamphetamine], a newer AD/HD drug." The Washington Times (12/15, Billups) also covers the story.
Citation: AMA
H1N1 Update 12/16/09 from the AMA
CDC estimates 15% of Americans have been infected with H1N1.
The CDC released new H1N1 statistics on Thursday, garnering coverage in most major papers and two network newscasts. Coverage largely focused on the number and distribution of the infections, and noted worries about another wave of infections in January. The CBS Evening News (12/10, story 7, 2:20, Couric) reported, "The H1N1 flu began hitting Americans last spring, and now we're getting a clearer picture of the impact. The CDC estimated today that nearly 50 million of us have come down with the flu, nearly 10,000 have died, including 1,100 children." Dr. Thomas Frieden, CDC director, is shown saying, "Many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than occurs during a usual flu season."
ABC World News (12/10, story 7, 0:25, Gibson) reported that "even more worrisome" is that "the flu has caused 10,000 deaths, three-fourths of those among young adults, though that is still less than the normal death rate from the seasonal flu."
USA Today (12/11) reports that up to "Nov. 17, 200,000 people have been hospitalized," which USA Today notes is "about the same number of people hospitalized during the entire flu season, which usually lasts until May."
The New York Times (12/11, A26, McNeil) points out that a month ago, the CDC "estimated that only about 4,000 had died." But "several flu experts said they were not shocked by the sudden jump because the new figures were as of Nov. 14, when this fall's wave of swine flu cases was reaching its peak." The number of people who "will ultimately die of the H1N1 flu depends heavily on whether there is a third wave in January...and on whether the virus changes to be more lethal or drug-resistant."
With 15% of Americans having been infected, Dr. Frieden said, "That still leaves most people not having been infected and still susceptible," the Los Angeles Times (12/11, Maugh) reports. "Frieden said the 200,000 hospitalizations since the beginning of the pandemic seven months ago is about the same as in a usual flu season. The deaths are lower than the 35,000 associated with seasonal flu in a typical year, but the breakdown is sharply different." The deaths "include 1,100 children and 7,500 adults 18 to 64."
Frieden noted that "many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than during a regular flu season," the Wall Street Journal (12/11, A6, McKay) reports.
But, according to the AP (12/11, Stobbe), CDC officials acknowledged that "it's likely the new estimate is conservative, and undercounts elderly deaths" because "the new CDC swine flu estimates do not include heart attacks and strokes, mainly because there hasn't been time to collect that kind of data."
Still, the Washington Times (12/11, Geracimos) notes that "the seasonal flu itself is still to come, meaning the number of flu deaths and hospitalizations hasn't come close to its final figure." But "as of this week, 85 million doses of vaccine are available, [Frieden] noted, with more providers giving the vaccine in increasing numbers to the high priority groups." When "asked how receptive Americans have been to the H1N1 vaccine," Frieden "said that half of those polled 'wants to and plans to be vaccinated.'"
Frieden added that "many states are expanding the vaccination programs from the high-risk groups such as children and pregnant women to include healthy adults," Bloomberg News (12/11, Randall) reports.
Time (12/11, Park) reports that experts said the new data was "not surprising," as the current wave is thought to have peaked in early November. Marc Lipsitch, an epidemiologist at the Harvard School of Public Health, said that concern over the possibility of another wave "is all the more reason ... to continue aggressive antiflu efforts." Reuters (12/11, Steenhuysen) and AFP (12/11) also cover the story.
H1N1 rates higher for American Indians, Alaska natives. The Washington Post (12/11, A11, Brown) reports that epidemiologists at the CDC announced that "the death rate from pandemic H1N1 influenza is four times higher in American Indians and Alaska natives than in the rest of the US population." An analysis released Thursday "of flu deaths in 12 states found that Indians and Alaska natives suffered 3.7 deaths per 100,000 people, compared with 0.9 deaths per 100,000 for all other ethnic groups." While CDC Director Thomas Frieden explained that the "cause of this difference in mortality is not known," he said the findings may reflect "environmental factors and underlying conditions...[and] access to healthcare rather than genetics or ethnicity."
New flu-tracking model indicates swine flu is on the decline. The Chicago Tribune (12/11, Wernau) reports that three University of Chicago professors have determined that the H1N1 virus "is on track to bottom out by the end of the year, returning to levels seen nine months ago, before the first case of H1N1 hit the US" The consensus was reached by applying a mathematical model to data from Google Flu Trends. According to the researchers, "the flu seems to have hit its peak nationwide in mid- to late October and has been trending downward since."
Health officials using new media outlets in swine flu education effort. The Boston Globe (12/11, Smith) reports that the H1N1 pandemic has forced health officials to go "where the young audience is," and embrace a series of new media outlets such as blogs, tweets, YouTube videos and Facebook. The approach seems to be working, as preliminary evidence suggests that "despite flinty budgets and a culture of caution, public health's embrace of social media is resonating with consumers." According to the Globe, swine flu videos posted by the CDC on YouTube "have attracted 3 million views since late April." However, "whether the tweets and text messages are translating into better health remains unclear."
The CDC released new H1N1 statistics on Thursday, garnering coverage in most major papers and two network newscasts. Coverage largely focused on the number and distribution of the infections, and noted worries about another wave of infections in January. The CBS Evening News (12/10, story 7, 2:20, Couric) reported, "The H1N1 flu began hitting Americans last spring, and now we're getting a clearer picture of the impact. The CDC estimated today that nearly 50 million of us have come down with the flu, nearly 10,000 have died, including 1,100 children." Dr. Thomas Frieden, CDC director, is shown saying, "Many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than occurs during a usual flu season."
ABC World News (12/10, story 7, 0:25, Gibson) reported that "even more worrisome" is that "the flu has caused 10,000 deaths, three-fourths of those among young adults, though that is still less than the normal death rate from the seasonal flu."
USA Today (12/11) reports that up to "Nov. 17, 200,000 people have been hospitalized," which USA Today notes is "about the same number of people hospitalized during the entire flu season, which usually lasts until May."
The New York Times (12/11, A26, McNeil) points out that a month ago, the CDC "estimated that only about 4,000 had died." But "several flu experts said they were not shocked by the sudden jump because the new figures were as of Nov. 14, when this fall's wave of swine flu cases was reaching its peak." The number of people who "will ultimately die of the H1N1 flu depends heavily on whether there is a third wave in January...and on whether the virus changes to be more lethal or drug-resistant."
With 15% of Americans having been infected, Dr. Frieden said, "That still leaves most people not having been infected and still susceptible," the Los Angeles Times (12/11, Maugh) reports. "Frieden said the 200,000 hospitalizations since the beginning of the pandemic seven months ago is about the same as in a usual flu season. The deaths are lower than the 35,000 associated with seasonal flu in a typical year, but the breakdown is sharply different." The deaths "include 1,100 children and 7,500 adults 18 to 64."
Frieden noted that "many times more children and younger adults, unfortunately, have been hospitalized or killed by H1N1 influenza than during a regular flu season," the Wall Street Journal (12/11, A6, McKay) reports.
But, according to the AP (12/11, Stobbe), CDC officials acknowledged that "it's likely the new estimate is conservative, and undercounts elderly deaths" because "the new CDC swine flu estimates do not include heart attacks and strokes, mainly because there hasn't been time to collect that kind of data."
Still, the Washington Times (12/11, Geracimos) notes that "the seasonal flu itself is still to come, meaning the number of flu deaths and hospitalizations hasn't come close to its final figure." But "as of this week, 85 million doses of vaccine are available, [Frieden] noted, with more providers giving the vaccine in increasing numbers to the high priority groups." When "asked how receptive Americans have been to the H1N1 vaccine," Frieden "said that half of those polled 'wants to and plans to be vaccinated.'"
Frieden added that "many states are expanding the vaccination programs from the high-risk groups such as children and pregnant women to include healthy adults," Bloomberg News (12/11, Randall) reports.
Time (12/11, Park) reports that experts said the new data was "not surprising," as the current wave is thought to have peaked in early November. Marc Lipsitch, an epidemiologist at the Harvard School of Public Health, said that concern over the possibility of another wave "is all the more reason ... to continue aggressive antiflu efforts." Reuters (12/11, Steenhuysen) and AFP (12/11) also cover the story.
H1N1 rates higher for American Indians, Alaska natives. The Washington Post (12/11, A11, Brown) reports that epidemiologists at the CDC announced that "the death rate from pandemic H1N1 influenza is four times higher in American Indians and Alaska natives than in the rest of the US population." An analysis released Thursday "of flu deaths in 12 states found that Indians and Alaska natives suffered 3.7 deaths per 100,000 people, compared with 0.9 deaths per 100,000 for all other ethnic groups." While CDC Director Thomas Frieden explained that the "cause of this difference in mortality is not known," he said the findings may reflect "environmental factors and underlying conditions...[and] access to healthcare rather than genetics or ethnicity."
New flu-tracking model indicates swine flu is on the decline. The Chicago Tribune (12/11, Wernau) reports that three University of Chicago professors have determined that the H1N1 virus "is on track to bottom out by the end of the year, returning to levels seen nine months ago, before the first case of H1N1 hit the US" The consensus was reached by applying a mathematical model to data from Google Flu Trends. According to the researchers, "the flu seems to have hit its peak nationwide in mid- to late October and has been trending downward since."
Health officials using new media outlets in swine flu education effort. The Boston Globe (12/11, Smith) reports that the H1N1 pandemic has forced health officials to go "where the young audience is," and embrace a series of new media outlets such as blogs, tweets, YouTube videos and Facebook. The approach seems to be working, as preliminary evidence suggests that "despite flinty budgets and a culture of caution, public health's embrace of social media is resonating with consumers." According to the Globe, swine flu videos posted by the CDC on YouTube "have attracted 3 million views since late April." However, "whether the tweets and text messages are translating into better health remains unclear."
Cluster Headache Update
Pure oxygen may effectively treat cluster headaches.
The Los Angeles Times (12/10, Kaplan) "Booster Shots" blog reports that according to a study published this week in the Journal of the American Medical Association, cluster headaches "can be treated by inhaling pure 100% oxygen. Cluster headaches affect about 0.3% of the general population, according to the study. The National Institutes of Health says the debilitating headaches can strike daily for weeks at a time. Other sources say the bouts can last for months before patients go into remission." The piece notes that after a limited study indicated pure oxygen brought relief to some patients, "a trio of researchers from the National Hospital for Neurology and Neurosurgery in London decided to test the therapy more rigorously."
Wednesday, December 9, 2009
Our Favorite Exercise Machine!
The recumbent stationary cycle is our favorite exercise machine. In many ways this machine is superior to treadmills and elliptical machines for the following reasons;
1. You can sit down and exercise.
2. You can read, talk on the phone, watch TV and even have a snack while you are exercising.
3: This machine works your hips and thighs.
4: The recumbent cycle is easy on the knees and back.
5: You do not have to swing your arms so all the work is being done by the legs.
6: You can stay on this machine for 60 minutes easily and get that valuable exercise done!
These machines are made by a variety of manufacturers and they last forever.
Have fun and enjoy your new machine!
Routine Basic Health Maintenance
Blood Pressure 120/80 or lower is optimal
Total Cholesterol less than 200
Triglycerides less than 120
HDL 50-60
LDL 110 or lower if possible
Blood glucose 100 or less when fasting
Basal Metabolic Index 18.5-24.9 is optimal
Waist Measurement 35 inches for females, 40 inches for males
Lifestyle
Do not smoke or use tobacco products
Limit alcohol to 2 drinks a day
Exercise for 30-60 minutes a day increasing your heart rate
Reduce stress and practice relaxation
Low fat diet high in fruits and vegetables
Prevention
Annual flu vaccine (if indicated)
Pneumonia vaccine at least once as an adult
Vision exam yearly
Perform some type of weight training three times a week
Vitamin E 600-800 units a day (possible benefit)
Fish Oil (Omega 3) tablet three times a day (possible benefit)
Screening
Colonoscopy or stool testing Over 50 years old (guidelines based on risk)
Skin cancer screening Every 3 years ages 20-39, annually after this
TB testing All patients at high risk
HIV All patients at high risk
Cholesterol Every 5 years of low risk, yearly if high risk
Diabetes Every 3 years age 45+ unless risk factors
Glaucoma Every 2-4 years 40+ years of age
Annually in people with diabetes
Women
Bone density 65+ years of age
Breast exam Physician exam 40+ years of age, self exam monthly
Mammogram Age 40-49 baseline and every 1-2 years after this
Age 50-69 annually
Pap and Pelvic At three years after first intercourse or age 21
Annually until age 65
Men
Testicular examination Self exam monthly
Prostate exam Rectal exam yearly over 40 years of age
PSA (prostate blood test) Yearly after age 50
Total Cholesterol less than 200
Triglycerides less than 120
HDL 50-60
LDL 110 or lower if possible
Blood glucose 100 or less when fasting
Basal Metabolic Index 18.5-24.9 is optimal
Waist Measurement 35 inches for females, 40 inches for males
Lifestyle
Do not smoke or use tobacco products
Limit alcohol to 2 drinks a day
Exercise for 30-60 minutes a day increasing your heart rate
Reduce stress and practice relaxation
Low fat diet high in fruits and vegetables
Prevention
Annual flu vaccine (if indicated)
Pneumonia vaccine at least once as an adult
Vision exam yearly
Perform some type of weight training three times a week
Vitamin E 600-800 units a day (possible benefit)
Fish Oil (Omega 3) tablet three times a day (possible benefit)
Screening
Colonoscopy or stool testing Over 50 years old (guidelines based on risk)
Skin cancer screening Every 3 years ages 20-39, annually after this
TB testing All patients at high risk
HIV All patients at high risk
Cholesterol Every 5 years of low risk, yearly if high risk
Diabetes Every 3 years age 45+ unless risk factors
Glaucoma Every 2-4 years 40+ years of age
Annually in people with diabetes
Women
Bone density 65+ years of age
Breast exam Physician exam 40+ years of age, self exam monthly
Mammogram Age 40-49 baseline and every 1-2 years after this
Age 50-69 annually
Pap and Pelvic At three years after first intercourse or age 21
Annually until age 65
Men
Testicular examination Self exam monthly
Prostate exam Rectal exam yearly over 40 years of age
PSA (prostate blood test) Yearly after age 50
MRSA Treatment
For successful treatment of a MRSA outbreak take the following steps. Remember that the MRSA organism exists in the pus that comes out of the boil so treat this discharge with respect and keep the area covered.
#1 Take your oral antibiotic as directed.
#2 Wash in the shower head to toe with Phisoderm or Hibiclens antibacterial soap (available over the counter at the pharmacy). All members of the household should do this twice a day.
#3 Bactroban nasal ointment applied inside the nose on both sides twice a day for 14 days. (Again, all household members should do this). Apply this using a Q-tip and then discard.
#4 HANDWASHING! This is the best way to prevent spreading this infection. If any other household members develop any symptoms of infection such as boils, etc. they should be seen by a doctor immediately.
#5 Keep bed linen and clothing clean throughout the time of treatment and perform a routine house cleaning with a good disinfectant spray on all surfaces.
MRSA (Methicillin resistant staph aureus) is a particularly resistant staphylococcal infection which is spread from skin to skin and may be picked up on surfaces or on clothing. It is found in the community and the origin of the infection may not be easily detected. The fluid that leaks out of the blisters and boils on the skin is the contagious agent and this is how it is spread. You do not need to quarantine yourself or your family but please take precautions to keep the surfaces of your skin and clothing as clean as possible.
#1 Take your oral antibiotic as directed.
#2 Wash in the shower head to toe with Phisoderm or Hibiclens antibacterial soap (available over the counter at the pharmacy). All members of the household should do this twice a day.
#3 Bactroban nasal ointment applied inside the nose on both sides twice a day for 14 days. (Again, all household members should do this). Apply this using a Q-tip and then discard.
#4 HANDWASHING! This is the best way to prevent spreading this infection. If any other household members develop any symptoms of infection such as boils, etc. they should be seen by a doctor immediately.
#5 Keep bed linen and clothing clean throughout the time of treatment and perform a routine house cleaning with a good disinfectant spray on all surfaces.
MRSA (Methicillin resistant staph aureus) is a particularly resistant staphylococcal infection which is spread from skin to skin and may be picked up on surfaces or on clothing. It is found in the community and the origin of the infection may not be easily detected. The fluid that leaks out of the blisters and boils on the skin is the contagious agent and this is how it is spread. You do not need to quarantine yourself or your family but please take precautions to keep the surfaces of your skin and clothing as clean as possible.
Kidney Stone Advice
What are the types of kidney stones?
Calcium oxalate stones are the most common. They tend to form when the urine is acidic, meaning it has a low pH. Some of the oxalate in urine is produced by the body. Calcium and oxalate in the diet play a part but are not the only factors that affect the formation of calcium oxalate stones. Dietary oxalate is an organic molecule found in many vegetables, fruits, and nuts. Calcium from bone may also play a role in kidney stone formation.
Calcium phosphate stones are less common. Calcium phosphate stones tend to form when the urine is alkaline, meaning it has a high pH.
Uric acid stones are more likely to form when the urine is persistently acidic, which may result from a diet rich in animal proteins and purines—substances found naturally in all food but especially in organ meats, fish, and shellfish.
Struvite stones result from infections in the kidney. Preventing struvite stones depends on staying infection free. Diet has not been shown to affect struvite stone formation.
Cystine stones result from a rare genetic disorder that causes cystine—an amino acid, one of the building blocks of protein—to leak through the kidneys and into the urine to form crystals.
How much fluid should a person drink to prevent stone formation?
The amount of fluid a person needs to drink depends on the weather and the person’s activity level. People who have had a kidney stone should drink enough water and other fluids to produce at least 2 quarts of urine a day. Some doctors have their patients collect urine for 24 hours so the volume can be measured. The doctor can then advise the patient about increasing fluid intake, if necessary. People who work or exercise in hot weather need more fluid to replace the fluid they lose through sweat. Drinking enough water helps keep urine diluted and flushes away materials that might form stones and is the most important thing a person can do to prevent kidney stones.
A person at risk for cystine stones should drink enough water each day to dilute the concentration of cystine that escapes into the urine, which may be difficult. More than a gallon of water may be needed every 24 hours.
What fluids protect against kidney stone formation?
Water is an inexpensive and calorie-free protection against kidney stones.
Some studies suggest citrus drinks like lemonade and orange juice protect against stones because they contain citrate, which stops crystals from growing into stones. But no large-scale trials have been conducted to confirm these findings. While citrus drinks may be helpful in preventing calcium oxalate stones and uric acid stones, they might be harmful for people who form calcium phosphate stones.
Coffee and tea can add to a person’s total fluid intake and have been shown to reduce the risk of stone formation, but they do contain oxalate. Moderate intake of beer and wine may also protect against stone formation.
What fluids should be avoided?
Grapefruit juice and dark colas have been found to increase the risk of stone formation and should be avoided by people who are prone to calcium oxalate stone formation. Although cranberry juice is often promoted as useful for preventing urinary tract infections, it contains oxalate and may be harmful to stone formers.
Citation from American Family Physician
Calcium oxalate stones are the most common. They tend to form when the urine is acidic, meaning it has a low pH. Some of the oxalate in urine is produced by the body. Calcium and oxalate in the diet play a part but are not the only factors that affect the formation of calcium oxalate stones. Dietary oxalate is an organic molecule found in many vegetables, fruits, and nuts. Calcium from bone may also play a role in kidney stone formation.
Calcium phosphate stones are less common. Calcium phosphate stones tend to form when the urine is alkaline, meaning it has a high pH.
Uric acid stones are more likely to form when the urine is persistently acidic, which may result from a diet rich in animal proteins and purines—substances found naturally in all food but especially in organ meats, fish, and shellfish.
Struvite stones result from infections in the kidney. Preventing struvite stones depends on staying infection free. Diet has not been shown to affect struvite stone formation.
Cystine stones result from a rare genetic disorder that causes cystine—an amino acid, one of the building blocks of protein—to leak through the kidneys and into the urine to form crystals.
How much fluid should a person drink to prevent stone formation?
The amount of fluid a person needs to drink depends on the weather and the person’s activity level. People who have had a kidney stone should drink enough water and other fluids to produce at least 2 quarts of urine a day. Some doctors have their patients collect urine for 24 hours so the volume can be measured. The doctor can then advise the patient about increasing fluid intake, if necessary. People who work or exercise in hot weather need more fluid to replace the fluid they lose through sweat. Drinking enough water helps keep urine diluted and flushes away materials that might form stones and is the most important thing a person can do to prevent kidney stones.
A person at risk for cystine stones should drink enough water each day to dilute the concentration of cystine that escapes into the urine, which may be difficult. More than a gallon of water may be needed every 24 hours.
What fluids protect against kidney stone formation?
Water is an inexpensive and calorie-free protection against kidney stones.
Some studies suggest citrus drinks like lemonade and orange juice protect against stones because they contain citrate, which stops crystals from growing into stones. But no large-scale trials have been conducted to confirm these findings. While citrus drinks may be helpful in preventing calcium oxalate stones and uric acid stones, they might be harmful for people who form calcium phosphate stones.
Coffee and tea can add to a person’s total fluid intake and have been shown to reduce the risk of stone formation, but they do contain oxalate. Moderate intake of beer and wine may also protect against stone formation.
What fluids should be avoided?
Grapefruit juice and dark colas have been found to increase the risk of stone formation and should be avoided by people who are prone to calcium oxalate stone formation. Although cranberry juice is often promoted as useful for preventing urinary tract infections, it contains oxalate and may be harmful to stone formers.
Citation from American Family Physician
High Blood Pressure Overview
High blood pressure (hypertension) is also known as “the Silent Killer” since people rarely have any symptoms of this disease. If left untreated, hypertension may cause heart attacks, strokes or injury to the kidneys. The safest level for your blood pressure to be at each day is about 120/80 mmHg. There are times when it may be elevated such as in times of stress or just after a big cup of coffee or taking many over the counter medications. You are being treated with a medication and advice about your lifestyle because your body has developed hypertension.
Lifestyle changes:
Quit smoking
Exercise 30-60 minutes a day getting your heart rate up
Limit your alcohol to 2 drinks a day or less
Use as little salt on your food as possible and eat foods which are low in salt
Limit your coffee, tea or soda intake to 2 cups a day
Learn to relax and manage your daily stress
Drink water and fluids each day
Eat a diet rich in fruits, vegetables and fiber
Physician Follow Up
Every 3 months – physician visit
Yearly physical exam
Yearly EKG
Lifestyle changes:
Quit smoking
Exercise 30-60 minutes a day getting your heart rate up
Limit your alcohol to 2 drinks a day or less
Use as little salt on your food as possible and eat foods which are low in salt
Limit your coffee, tea or soda intake to 2 cups a day
Learn to relax and manage your daily stress
Drink water and fluids each day
Eat a diet rich in fruits, vegetables and fiber
Physician Follow Up
Every 3 months – physician visit
Yearly physical exam
Yearly EKG
Vertigo Treatment You Can Do At Home
Cawthorne Exercises: for Benign Positional Vertigo
For the best results to limit the severity of positional vertigo, perform these exercises twice a day for 15 minutes each session. Gradually increase to 30 minutes per session.
Eye Exercises: Do each one 20 times
Looking up then down – slowly at first then quickly
Looking from one side to the other – slowly at first then quickly
Focus on finger at arms length move your finger one foot closer then away again.
Head Exercises: Do each one 20 times
Bend head forward and back again with eyes open slowly then quickly
Turn head from side to side, slowly then quickly
*As dizziness decreases these exercises should be done with eyes closed.
Sitting Exercises: Do each one 20 times
While sitting, shrug your shoulders
Turn shoulders to the right and then left
Bend forward and pick up objects from the ground and then sit up
Standing Exercises:
Change from standing to sitting and back again 20 times with eyes open
Repeat this with eyes shut
Throw a small rubber ball from hand to hand above eye level
Throw a small ball from hand to hand under one knee
Moving Around: Do each one 10 times.
Walk across the room with eyes open then with eyes shut
Walk up and down a slope with eyes open then with eyes shut
Walk up and down steps with eyes open then eyes shut
For the best results to limit the severity of positional vertigo, perform these exercises twice a day for 15 minutes each session. Gradually increase to 30 minutes per session.
Eye Exercises: Do each one 20 times
Looking up then down – slowly at first then quickly
Looking from one side to the other – slowly at first then quickly
Focus on finger at arms length move your finger one foot closer then away again.
Head Exercises: Do each one 20 times
Bend head forward and back again with eyes open slowly then quickly
Turn head from side to side, slowly then quickly
*As dizziness decreases these exercises should be done with eyes closed.
Sitting Exercises: Do each one 20 times
While sitting, shrug your shoulders
Turn shoulders to the right and then left
Bend forward and pick up objects from the ground and then sit up
Standing Exercises:
Change from standing to sitting and back again 20 times with eyes open
Repeat this with eyes shut
Throw a small rubber ball from hand to hand above eye level
Throw a small ball from hand to hand under one knee
Moving Around: Do each one 10 times.
Walk across the room with eyes open then with eyes shut
Walk up and down a slope with eyes open then with eyes shut
Walk up and down steps with eyes open then eyes shut
Osteoporosis Advice
What is osteoporosis?
In osteoporosis, the inside of the bones becomes porous from a loss of calcium. This is called losing bone mass. Over time, this weakens the bones and makes them more likely to break.Osteoporosis is much more common in women than in men. This is because women have less bone mass than men, tend to live longer and take in less calcium, and need the female hormone estrogen to keep their bones strong. If men live long enough, they are also at risk of getting osteoporosis later in life.
Recommended Calcium Intake for Adult Men and Women
19 to 50 years of age: 1000mg per day
50 years and older: 1200mg per day
Vitamin D
The body needs vitamin D to absorb calcium. You can get vitamin D in three ways: through the skin, from the diet, and from supplements. Experts recommend a daily intake of between 400 and 600 IU (International Units) of vitamin D, which also can be obtained from supplements or vitamin D-rich foods such as egg yolks, saltwater fish, liver, and fortified milk. The Institute of Medicine recommends no more than 2,000 IU per day.
In osteoporosis, the inside of the bones becomes porous from a loss of calcium. This is called losing bone mass. Over time, this weakens the bones and makes them more likely to break.Osteoporosis is much more common in women than in men. This is because women have less bone mass than men, tend to live longer and take in less calcium, and need the female hormone estrogen to keep their bones strong. If men live long enough, they are also at risk of getting osteoporosis later in life.
Recommended Calcium Intake for Adult Men and Women
19 to 50 years of age: 1000mg per day
50 years and older: 1200mg per day
Vitamin D
The body needs vitamin D to absorb calcium. You can get vitamin D in three ways: through the skin, from the diet, and from supplements. Experts recommend a daily intake of between 400 and 600 IU (International Units) of vitamin D, which also can be obtained from supplements or vitamin D-rich foods such as egg yolks, saltwater fish, liver, and fortified milk. The Institute of Medicine recommends no more than 2,000 IU per day.
Tips for Staying Healthy During Influenza Season
What You Can Do to Stay Healthy
· Get vaccinated. Vaccination is the best protection we have against flu. 2009 H1N1 flu vaccine will become available later this year.
· Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
· Take everyday actions to stay healthy.
o Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
o Irrigate your nose each evening with a sterile saline rinse.
o Take a shower and wash your hair twice each day to limit your contact with infectious virus.
o Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
o Avoid touching your eyes, nose and mouth. Germs spread that way.
o Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
o
· Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
· Find healthy ways to deal with stress and anxiety.
· Stay informed.
Visit www.GoToDartmouthMed.com and click on the
‘Flu Information’ link on the home page. This link is updated daily by the CDC and the Massachusetts Department of Public Health.
· Call 1-800-CDC-INFO for more information.
Centers for Disease Control and Prevention1600 Clifton RdAtlanta, GA 30333
800-CDC-INFO(800-232-4636)TTY: (888) 232-634824 Hours/Every Day
cdcinfo@cdc.gov
· Get vaccinated. Vaccination is the best protection we have against flu. 2009 H1N1 flu vaccine will become available later this year.
· Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
· Take everyday actions to stay healthy.
o Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
o Irrigate your nose each evening with a sterile saline rinse.
o Take a shower and wash your hair twice each day to limit your contact with infectious virus.
o Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
o Avoid touching your eyes, nose and mouth. Germs spread that way.
o Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
o
· Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
· Find healthy ways to deal with stress and anxiety.
· Stay informed.
Visit www.GoToDartmouthMed.com and click on the
‘Flu Information’ link on the home page. This link is updated daily by the CDC and the Massachusetts Department of Public Health.
· Call 1-800-CDC-INFO for more information.
Centers for Disease Control and Prevention1600 Clifton RdAtlanta, GA 30333
800-CDC-INFO(800-232-4636)TTY: (888) 232-634824 Hours/Every Day
cdcinfo@cdc.gov
Tips to Recover from Back and Neck Pain.
If you have been injured and are trying to recover from a back
or neck injury, follow these instructions to speed recovery.
1: Apply Ice
Apply ice to the injured area as quickly as you can and continue to apply ice as often as possible for the first 2-3 days and at least twice a day until you are well again. More ice is better because it limits the swelling immediately. Be sure to protect your skin with a dish towel or cloth because applying ice for several hours can irritate the skin. Do not rely on salves, sprays or ointments to take the place of ice and do not apply heat. Use ice, frozen vegetables in their plastic packets or use a gel pack. Athletes know the value of ice so think like an athlete!
2: Stay Active and Lose Weight
Walking around, stretching and moving are important in the early phases of recovery because this helps the fluid to move out of the injured area. Do not just lie on the couch trying to avoid the pain. Getting back to work even in a reduced capacity is strongly advised.
3: Take Your Anti Inflammatory Medications
Begin Advil/Ibuprofen/naproxyn as soon as possible and continue these through the early weeks of your injury. These medications help your body to heal from the inflammation. Be careful to take these medications with food and stop them if you have an upset stomach.
4: Other Medications
You may be given a muscle relaxant and/or a pain medication. These are to be taken as needed and only when you are in severe pain. Do not drive or operate heavy machinery if you are given a narcotic or a muscle relaxant.
5: Quit Smoking
If you are a smoker, QUIT! Smokers have poor circulation and nerve injuries heal very slowly due to the substances found in tobacco. Smoking will always prolong your recovery.
6: Precautions
We do not recommend chiropractic treatment or deep tissue massage during the acute phases of recovery within the first 2-3 weeks.
7. Attend All Appointments
If physical therapy, physiatrist, pain management or neurologist appointments have been made for you, be sure to go to these appointments.
or neck injury, follow these instructions to speed recovery.
1: Apply Ice
Apply ice to the injured area as quickly as you can and continue to apply ice as often as possible for the first 2-3 days and at least twice a day until you are well again. More ice is better because it limits the swelling immediately. Be sure to protect your skin with a dish towel or cloth because applying ice for several hours can irritate the skin. Do not rely on salves, sprays or ointments to take the place of ice and do not apply heat. Use ice, frozen vegetables in their plastic packets or use a gel pack. Athletes know the value of ice so think like an athlete!
2: Stay Active and Lose Weight
Walking around, stretching and moving are important in the early phases of recovery because this helps the fluid to move out of the injured area. Do not just lie on the couch trying to avoid the pain. Getting back to work even in a reduced capacity is strongly advised.
3: Take Your Anti Inflammatory Medications
Begin Advil/Ibuprofen/naproxyn as soon as possible and continue these through the early weeks of your injury. These medications help your body to heal from the inflammation. Be careful to take these medications with food and stop them if you have an upset stomach.
4: Other Medications
You may be given a muscle relaxant and/or a pain medication. These are to be taken as needed and only when you are in severe pain. Do not drive or operate heavy machinery if you are given a narcotic or a muscle relaxant.
5: Quit Smoking
If you are a smoker, QUIT! Smokers have poor circulation and nerve injuries heal very slowly due to the substances found in tobacco. Smoking will always prolong your recovery.
6: Precautions
We do not recommend chiropractic treatment or deep tissue massage during the acute phases of recovery within the first 2-3 weeks.
7. Attend All Appointments
If physical therapy, physiatrist, pain management or neurologist appointments have been made for you, be sure to go to these appointments.
Eat Frequently to Lose Weight
Dietary Lifestyle Changes: Frequent small meals, low fat food choices.
Make lifestyle changes that limit your calorie intake either by choosing low fat, low calorie foods or by paying close attention to your portion sizes. Choosing a low fat foods and watching portion sizes will get results quicker.
Eat 5 small servings of food each day and be sure to have fruits and vegetables along with low fat protein such as fish or chicken every day. Limit your sweets and deserts and do not eat a heavy meal at night. Drink at least 32oz of water each day. Use low fat milk in coffee and cereal. Avoid fried foods. Avoid sugar and butter when possible.
To accelerate your weight loss simply eliminate bread products (bread, pizza crust, donuts, bagels, muffins etc.) from your diet. You can still eat the contents of the sandwich or the topping on the pizza but discard the bread.
Make lifestyle changes that limit your calorie intake either by choosing low fat, low calorie foods or by paying close attention to your portion sizes. Choosing a low fat foods and watching portion sizes will get results quicker.
Eat 5 small servings of food each day and be sure to have fruits and vegetables along with low fat protein such as fish or chicken every day. Limit your sweets and deserts and do not eat a heavy meal at night. Drink at least 32oz of water each day. Use low fat milk in coffee and cereal. Avoid fried foods. Avoid sugar and butter when possible.
To accelerate your weight loss simply eliminate bread products (bread, pizza crust, donuts, bagels, muffins etc.) from your diet. You can still eat the contents of the sandwich or the topping on the pizza but discard the bread.
Fibromyalgia Tips You May Not Know!
Fibromyalgia Lifestyle Guidelines
1: Quality sleep is of paramount importance!
2: Reduce your stress whenever possible since the body interprets even emotional stress as an insult and this can result in physical pain.
3: Exercise by walking, riding a stationary cycle or doing activities in a warm pool every day even if only for a few minutes. Build up your strength and endurance to heal your muscles.
4: As you feel better begin to work on keeping your muscles strong by using light weights or stretch cords. Going to physical therapy or a personal trainer will help your workouts.
5: Help those around you to understand that this type of pain and fatigue are difficult to describe to others and difficult to control. You will need everyone’s cooperation to be successful.
6: Consider therapy especially cognitive behavioural therapy (CBT) which has been shown to reduce stress and limit the neurotransmitter reaction.
7: Medications such as Elavil, Lyrica and Savella can help reduce your pain by modifying the pain neurotransmitters.
8: Avoiding stimulants such as caffeine and soda and eating a vitamin rich diet can help your body remain calm and lower your pain.
Remember that fibromyalgia can be controlled with medication, close attention to limiting stress, family cooperation and a clear understanding of the triggers of emotional and physical pain.
1: Quality sleep is of paramount importance!
2: Reduce your stress whenever possible since the body interprets even emotional stress as an insult and this can result in physical pain.
3: Exercise by walking, riding a stationary cycle or doing activities in a warm pool every day even if only for a few minutes. Build up your strength and endurance to heal your muscles.
4: As you feel better begin to work on keeping your muscles strong by using light weights or stretch cords. Going to physical therapy or a personal trainer will help your workouts.
5: Help those around you to understand that this type of pain and fatigue are difficult to describe to others and difficult to control. You will need everyone’s cooperation to be successful.
6: Consider therapy especially cognitive behavioural therapy (CBT) which has been shown to reduce stress and limit the neurotransmitter reaction.
7: Medications such as Elavil, Lyrica and Savella can help reduce your pain by modifying the pain neurotransmitters.
8: Avoiding stimulants such as caffeine and soda and eating a vitamin rich diet can help your body remain calm and lower your pain.
Remember that fibromyalgia can be controlled with medication, close attention to limiting stress, family cooperation and a clear understanding of the triggers of emotional and physical pain.
How to Exercise the Right Way to Lose Weight
Exercise Lifestyle Changes: 60 minutes per day.
To lose weight you have to burn calories. If you just limit your calories you will lose weight very slowly and may get discouraged. Walk at a brisk pace for an hour every day. If you only exercise for 30 minutes even running or exercising at a high level you will still only be burning your carbohydrates for fuel. After 30 minutes your body will start to use fats for fuels so exercise at a modest, steady pace for 60 minutes.
To lose weight you have to burn calories. If you just limit your calories you will lose weight very slowly and may get discouraged. Walk at a brisk pace for an hour every day. If you only exercise for 30 minutes even running or exercising at a high level you will still only be burning your carbohydrates for fuel. After 30 minutes your body will start to use fats for fuels so exercise at a modest, steady pace for 60 minutes.
Subscribe to:
Posts (Atom)
