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Farmers are the Unhappiest Workers
Posted on: August 20, 2007
In a Finnish study involving 5000 workers farmers scored the lowest in job satisfaction. In questionnaires given in which personal productivity, health status and quality of life were evaluated farmers scored the lowest. Salaried workers came in second and entrepreneurs scored the highest.
Ovarian Cancer- Early
Posted on: August 19, 2007
More than 20,000 women are diagnosed with ovarian cancer every year in the U.S. Almost 80% of these will already have spread by the time they are diagnosed. Current early detection methods are a blood test called a CA125 and an intra-vaginal ultrasound. In several retrospective studies recently they determined that early detection was possible if the physicians asked the following questions to all women under going their annual pap smears.
1. Are you experiencing any pelvic pain?
2. Have you had any abdominal pain for more than 12 days per month?
3. Have you noticed any increase in the size of your abdomen?
4. Have you noticed more abdominal bloating lately?
5. Do you experience a rapid feeling of fullness when eating?
6. Have you had any difficulty in eating?
While these symptoms may sound vague they may be life saving if you bring them to the attention of your Doctor.
Death Risk from Air Pollution
Posted on: August 18, 2007
The College of London looked at death rates and compared them to black smoke and sulphur dioxide environmental exposure for the years 1982 through 1998. They found that black smoke and sulphur dioxide levels decreased by five and four times respectively during those years. However the death rates attributable to black smoke increased from 10% to 19% during the study and from 10% to 20% for sulphur dioxide. The study underwent critical statistical review and the results stood.
It is theorized that there may be other more potent pollutants that are not measured that could be causing the increase in death rates or they could be acting in synchrony with the existing pollutants thereby being more lethal.
Authors note: Whether you get second hand smoke from cigarettes or industrial pollution in the air, or increased ozone levels form global warming, or carcinogens in the water, each and everyone of us has a responsibility to try to change it for our children and grand-children.
Suicide Rates increase in Hotter Weather
Posted on: August 17, 2007
An analysis of 50,000 suicides in England and Wales between 1993 and 2003 found that as the temperature rises so does the suicide rate. In fact for each degree above 18C there was a four percent rise in suicides – and for violent suicides the rate was 5%. Some of the reasons put forth were that people become more irritable and aggressive in hot weather, serotonin levels decrease in the summer, and people tend to drink more alcohol in hotter weather. In fact in the 1995 heat wave the suicide rate increased by 46.9%. The highest day for suicides was January 1 and the Mondays were the worst day. As with all suicides 75% are by men and 25% by women.
Authors Note: I was always under the assumptions that since Oregon and Washington have about 220+ days of rain and the suicide rate is highest in those states, that rainy weather was the culprit. Maybe we should do some comparative studies here in the U.S.
Job stress leads to Depression
Posted on: August 16, 2007
In a study involving 1000 thirty two year olds 45% of new onset depression was attributable to job stress. These jobs involved lack of personal control, long hours, non-negotiable deadlines and too much work. The jobs ranged from surgeons, teachers, pilots, garbage men and policemen; the higher the pressure the higher the percentage of depression. They concluded that managers should lead by praise and reward rather than punishment and lack of control.
Changing views on Menopause
Posted on: August 14, 2007
In study done in San Francisco involving 53 Americans, Latinos and African American women aged 40-48 they found that menopause was a back burner issue. The women were more concerned with their current health and appearance than in a life event over which they had no control. The women tested were more about individual responsibility and control of their lives. They believed that staying younger physically, mentally and in their appearance was the most important aspects of their lives in their forties.
Botox® for Low Back Pain
Posted on: July 20, 2007
In a study out of Kuwait 8 patients with severe chronic low back pain were injected into the lumbar Para-spinal muscles (the low back muscles on either side of the spinal canal) three sites were injected. 63% had remarkable recovery in both muscle spasm and pain relief, and 25% had improvement only in muscle spasm. The effect was still working after 30 days. The conclusion was that this is an easy procedure, well tolerated, virtually no side effects and does not require either expensive or invasive procedures.
Low Dose Aspirin – Finally Yes
Posted on: July 19, 2007
In 1976 the Nurses Health Study started and included 121,701 nurses. Evaluation of the people in the study after six years showed no improvement in the mortality rates, however in this study they looked almost 80,000 nurses at 24 years of taking low dose aspirin. What they found is that the incidence of deaths from heart disease was substantially reduced and those from cancer were also less but not as dramatic as those for heart disease. Further evaluation of the data allowed the researchers to say that at 24 years of taking low dose aspirin the risk of mortality from all causes was reduced (and this includes colorectal cancer the third leading cause of death). 80,000 people over 24 years that’s good enough for me, I think I’ll start taking low dose aspirin.
New Treatment for Women with hot flashes who have had Estrogen related cancers
Posted on: July 18, 2007
Gaba-pentin also known as Neurontin is usually used for seizure disorders, nerve pain and Trigeminal Neuralgia. It works by stabilizing the nerve membrane. When given to a group of women who had had breast cancer it appeared to work as well some of the antidepressants. In fact the drug cut the frequency of hot flashes in half. This is great news since this drug has very little side effects and does not change a person’s personality.
Mediterranean Diet Protects Against Asthma
Posted on: July 17, 2007
A very large study from the island of Crete found that children who adhered to a Mediterranean diet had less asthma and allergic rhinitis than a conventional western diet. There were 690 children involved and the Mediterranean consisted mostly of grapes, oranges, apples fresh tomatoes, essential fatty acids (mostly olive oil), vegetables, nuts and fish.
High nut intake, grape, oranges and kiwi consumption was inversely associated with wheezing but margarine proved to be a risk factor. The stricter the adherence to the diet the less asthma symptoms there were.
Since asthma is currently increasing at an alarming rate in the U.S this may be yet another natural way to combat this terrible disease. This study showed that those children which had the strictest adherence to the Mediterranean had the least amount of allergic symptoms. Maybe all of the preservatives that keep our food from turning rancid are having adverse reactions in our lungs?
Stockings after Venous Surgery
Posted on: July 16, 2007
There has always been amongst Physicians a wide diversity regarding how long someone after surgery should wear stocking. The French are probably the most laisser-faires with the English being the strictest and the Americans in between. A study recently reported out of the U.K. on 300 patients after venous surgery found that there was no benefit to wearing stocking for more than one week. The parameters looked at were post operative pain, complications, time to return to work and patient satisfaction. This is great news for all of my surgical patients.
Female Sexual Arousal Disorder
Posted on: July 15, 2007
A new central nervous system drug for female sexual desire disorder has just completed the first two clinical trials. The name of the drug is Bremelanotide. In the group taking the drug 67% reported feelings of desire vs. 22% of the placebo group (the most common placebo effect is about 20% no matter what is being tested). 72% of those taking the drug had genital sexual arousal vs. 39% in the placebo group. In summary 75% of the women taking the drug reported sexual arousal and 50% had increased sexual desire vs. 25% and 19% respectively.
Red Korean Ginseng
Posted on: July 14, 2007
It has long been known that there are a variety of Ginseng products from a multitude of countries – some have efficacy and some do not. In this study they used Korean Red Ginseng to men with erectile dysfunction. The study was double blinded and placebo controlled ( in other words neither the doctors doing the study or the recipients getting the product knew what they were getting until after the study was completed and the code given). Using the International Index of Erectile Function the Ginseng group reported a 66.6% improvement in erection and also improvement in rigidity, penetration and maintenance. Red Korean Ginseng is an effective alternative for men with erectile dysfunction.
A Smoke Free World?
Posted on: July 13, 2007
In 2004 Ireland become the first country in the world to ban smoking in the workplace, bars and restaurants – nationwide. Congratulations!!
There are many states in the U.S. that have similar laws, California being the first to enact it in the U.S.
There is now irrefutable evidence that second hand smoking causes premature death and disease, lung cancer, and heart disease. Tragically there are over 5 trillion cigarettes smoked annually and even though the World Health Organization has issued a Convention of Tobacco Control and 145 countries have ratified this treaty the United States of America has not!
Indoor smoking bans have cut cigarette smoking by almost 4% and doubling the taxes has cut new young smokers from starting by almost 30% in Canada. We still have no national consensus (or will) to do the same throughout America. There are only 17 States that that have adopted comprehensive anti smoking legislation.
Over 100 million deaths have been attributed to smoking in the 20th Century and yet the manufacturers continue to target the adolescents, minority groups, women and the young in developing countries. This translates in to over 1.3 Billion people still smoking in the world. Congratulations to the Buddhist country of Bhutan which is the only country in the world to ban the sale of tobacco. We have the knowledge and resources to win this battle in our country so is it our lack of will or are the manufacturers smarter and stronger than our will and resources?
Bird Flu Vaccine
Posted on: July 12, 2007
The FDA has just awarded the French drug company Sanofi the approval to make the first H5N1 flu virus vaccine. But before you get too complacent this is not going to totally protect you from the bird Flu. If the H5N1 mutates to become virulent for human to human transmission it will not be ‘exactly’ the current form of the existing virus. This one will have some immunity and maybe bide you some time until the virulent form has a specific vaccine against it. It will also not be available to the public because the Federal Government will buy all of the vaccine for the U.S. Strategic National Stockpile. This of course means the military, federal employees, first line medical personnel, police and National Guard will get the vaccine and it will be unlikely that it will filter down to us
Chocolate
Posted on: July 11, 2007
There has been a lot of publicity regarding chocolate as a neutraceutical lately. It does contain anthocyanadins which is a type of flavenoid, and this mainly applies to dark chocolate. In several studies it has been shown that those people who consume the largest amount of dark chocolate tend to have less heart disease and lower blood pressure. I mean let’s face it would you like to take your beta blocker daily or two ounces of dark chocolate. Maybe the drug industry could make their beta blockers in chocolate instead of pill form?
Both chocolate and initial love produce a chemical in the brain called phenyl ethylamine. This has been found to affect many of the ‘feel good’ neuro-transmitters in the brain. The flavenoids in chocolate have also been shown to inhibit platelet aggregation – so is it a chocolate a day or a baby aspirin? You guess who is going to win.
EXERCISE – TO DO OR NOT TO DO?
Posted on: June 26, 2007
WARTS AND FIG JUICE?
In a study out of Iran 25 patients with warts on both hands were recruited into a study using the white latex juice from a fig tree and standard cryotherapy (freezing of the wart). The fig tree latex cured 44% of the warts while the cryotherapy cured 56%. Conclusion was that fig tree juice is slightly less effective than standard therapy, and therefore a good alternative, but the latter had more side effects such as blanching of the skin and scars.
Author’s comments: It has been well known that most warts disappear within three to five years anyway with no treatment and that if you irritate them with anything (frog juice, WD-40, pepper, window cleaner etc – you get the point) about another fifty percent will also go away.
EXERCISE – TO DO OR NOT TO DO?
It is estimated that more than 50% of Americans are now overweight and the number is rising. Obesity leads to decreased life expectancy, heart disease, stroke, elevated blood fats, high blood pressure, diabetes, arthritis and gall-bladder disease. Obviously losing weight reduces the above as well as improving high blood pressure and mood.
The rebound rate for people who do “fad dieting” is almost 98% and some have surmised that this might be due to not incorporating exercise along with their reduced caloric intake. The usual barriers elicited by patients are that exercise consumes too much of their time and gyms require both time and money.
Studies have shown that exercise alone is an excellent weight reducer but when combined with caloric restriction the effect is greater. This study showed that the higher the exercise intensity the greater the weight loss. The following types of exercise all caused weight loss: walking, jogging, bicycling, swimming, weight training, calisthenics and group ball sports. (The list is obviously bigger but were not measured in this study).
Bottom line, adding exercise to your weight reduction program will improve your results!
NEW DRUG MAY CURE MUSCULAR DYSTROPHY
Within our DNA are certain mutations called ‘premature termination codons’ or (PTC’s) which tell the cells protein making machinery to stop making crucial proteins before they are completely made. Now from the University of Pennsylvania come trials with a drug PTC124 that shows promise in mice and humans to reverse the effects of muscular wasting in Muscular Dystrophy using this new drug. In muce studies it actually was able to produce normal muscle tissue.
This to me is science at its best.
ASPIRIN USE AND CANCER PREVENTION
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ASPIRIN USE AND CANCER PREVENTION
Long term use of daily aspirin and incidence of Cancer from the Cancer Prevention Study II Nutrition Cohort Study shows ten different types of cancer were evaluated among 69,810 men and 76,303 women from 1992 to 2003. After exhaustive statistical analysis the bottom line is that one full aspirin a day for greater than five years that the overall incidence of colorectal, prostate, and breast cancers ‘may be modestly reduced’.
HORMONES AND CAROTID ARTERY BLOCKAGE
They measured 56 women who had severe carotid artery blockages and then age matched an equal amount of controls. They then measured the testosterone, lipid levels, and all of the other sex hormonal levels. The results were that those who had blockages had significantly lower levels of testosterone and androstenedione (another male hormone) than their controls. Their conclusions were that physiological levels of androgens play a protective role in the development of atherosclerosis of the internal carotid artery.
DOES FOLIC ACID PREVENT COLORECTAL CANCERS
In a study that lasted 10 years and involved 9 clinical centers and 1021 men, there were 516 men that were put on 1 mg of Folic acid and 505 that were given a placebo. The end result was that 1 mg of Folic acid did not reduce colon cancers and there is some suggestion that it might actually increase your risk for the cancer.
SENATE PASSES DRUG SAFETY BILL
By a 93 to 1 margin the Senate passed legislation that would greatly the FDA’s safety office. There are currently 90 people in that office and this would double their office and fund it by 2012 to nearly 1 billion dollars. It is estimated that nearly one in two people today take a prescription drug and this bill will allow for extensive computerized reviews and association of any side effects that might not show up until it is too late. It goes to the House where amendments are likely to be attached.
GINGER: FOR TASTE, SEA-SICKNESS OR POST OP NAUSEA?
The pungent smell of ginger comes from the ketone gingerol and is in the family of cardamom and turmeric. And although not actually a root its culinary delights rate it extremely effective. In most studies that were double blinded ginger proved to be better than placebo for post operative nausea. In the sea sickness studies there are mixed results. In one study it was superior to Dramamine and in others it did not reduce the vertigo associated with sea sickness. Although it has been proposed for arthritis the results were mixed. Since it is safe and free of most side effects it is great for pregnancy caused nausea.
Deaths from Heart Attacks – Good News
Posted on: May 19, 2007
In a very encouraging report involving 44,373 patients, spanning 7 years, and involving England, Germany, Canada, France and Spain they found that the death rates fell from 8.4% to 4.5%. Even in Mild heart attacks the death rate was reduced from 2.9% to 2%. These improvements have been attributable to angioplasty (putting a catheter into the artery of the heart and opening up the blockage), and anti clotting medicines. The risk of heart failure brought on by a severe heart attack was also reduced from 7.1% to 4.7%. All of this points to coordinated efforts from the Emergency Room to the operating room in record time. Time to treatment seems to be the critical factor in heart attack survival.
Face masks – if you need them, it might be a good idea
Posted on: May 18, 2007
From the CDC’s Clinician’s Terrorism Update comes the question of facemasks to prevent spread of the disease. Of course first line treatment should included hand washing, anti-viral medications, avoiding crowded places, stay at home as much as possible, and the use of facemasks.
The standard facemasks that you see a surgeon wearing is essentially useless in a pandemic situation. The ones you should be looking at are termed N-95 which means that it eliminates 95% of particulate matter which goes down to .3 microns. This is great for bacteria but viruses are thousands of times smaller. What they are good at is preventing you from inhaling someone’s sneeze droplets or coughing spray. Stay at least 6 feet away from infected persons, and make sure that your N-95 mask is tightly fitted.
Better Looks? Better Pay?
Posted on: May 17, 2007
Here is a study from the U of Texas that tells us once again that if you’re good looking you’re going to make more money – about 5%.
The better looking you are the greater your chances of promotion. You’ll be perceived to be smarter, and have more confidence. These studies have been done for the past 50 years – all with the same results. In the past they related this to the fact that you would be more likely to mate and have better offspring. Lets face it who isn’t attracted more to a beautiful person of the opposite sex (or same sex depending on your orientation)? So for the rest of us – well we’ll just have to work harder.
Pediatric Flu Deaths – what’s going on here?
Posted on: May 16, 2007
The CDC reported that from October 2006 through may 2007 there have been 55 children that have died from the flu. This is data from 23 states. Bacterial secondary infections are a complication of the flu and the most lethal of these is usually Staphylococcus Aureus. In 2004-5 there was one such lethal case, in 2005-6 there were 3 cases and now 55? I do not have the answers but as a physician the following questions come to mind. Were these children in the hospital and are these hospital acquired infections? Were more of these children immuno-compromized to begin with? Are physicians beginning to become less vigilant knowing it’s “just the flu”?
To Take or Not to take Estrogen – That is the question
Posted on: May 15, 2007
In 1991 the Women’s Health Initiative was begun to see if post menopausal women were befitting from taking estrogen. This was a $725 million dollar project involving 27,000 women. Abruptly in 2002 the NIH (National Institutes of Health) stopped the study and announced that estrogen hormones were increasing the rates of heart attacks. Millions of women abruptly stopped their estrogen therapy and looked for another means to control their symptoms. Now in a major flip flop new analysis has emerged showing that estrogen may be beneficial for people early in menopause, that is the first ten years of menopause. The new data shows that women aged 50-59 who took estrogen had a 30% lower risk of dying, 10-19 years into menopause had a 22% increased risk, but if you were over 20 years into menopause and continued to take estrogen you had a 71% increased risk of death .
The problem with this entire study appears to be that the average age was 63 and only about 10% of the women were in their first ten years of menopause. Before this data can be widely disseminated it has to get the approval of the AMA and its publication JAMA (Journal of the American Medical Association). And herein lies the problem. Apparently JAMA has tightened up the statistical requirements for the data to be “statistically significant”. In technical jargon they are now requiring a P value of .01 not the usual .05. And to put that in layman’s terms for every 10,000 women aged 50-59 who use hormones there would be 10 fewer deaths and in women aged 70-79 there would be 16 additional deaths. Now you don’t have to be a statistician to realize that someone here has a vested interest to get this published and therefore into mainstream medicine as “evidence based medicine”, the new jargon to justify prescription filling. My personal take is if you have to take hormones make sure they are human bio-identical and be judicious – you should not substitute a pill for proper diet and life style.
Human Pappilloma Viral Infections (HPV)
Posted on: May 14, 2007
The highest incidence and deaths from HPV occur in the Southeastern U.S. The FDA has just released a vaccine for four of the most common sub-types of HPV that cause both the genital warts and cervical cancer. The vaccine is intended for use in all females ages 9-26 but routine usage is now recommended to start at 11 or 12 years of age and consists of three injections. The second dose should be given two months after the first and the third 6 months after the second.
The vaccine covers HPV subtypes 6 and 11 which are the ones primarily responsible for 90% of genital warts and subtypes 16 and 18 which are the most common ones responsible for about 76% of cervical cancers.
Why should I get the vaccine and just how prevalent is this disease? The answers are alarming! The more sex partners you have the more likely you are to get it. HPV was detected in 14.3 % of women ages 18-25 with one sex partner. Two partners increased your risk to 22% and 31% with more than two partners. The following data will probably shock you as much as it did me. According to the National Survey of Family Growth 24% of girls are sexually active by age 15. Nope that’s not a typo. 40% by the age of 16 and 70% by age 18. HPV is associated with about 50% of vulvar squamous cell cancers and most vaginal cancers are positive for HPV. Almost 90% of anal squamous cell cancers are associated with HPV.
Current treatments include freezing the virus, burning it electrically, laser therapy, surgical excision and blotting the lesions with Podophyllin all of which only control the lesions and none are curative. Condoms help but early abstinence cures. In my opinion every woman should get screened with her annual next PAP smear and continue to get annual PAP smears. The vaccine has been established to be effective for about 5 years and long term studies are underway.
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