Friday, July 8, 2011
One of the biggest problems we have with chemotherapy to treat cancer is the fact that there can be devastating side-effects. The simplest way I can explain chemo is the drugs can be given to kill the cancer cells, but in doing so, the drugs actually harm the healthy cells. In other words, we are sending invaders into the body to kill cancer cells, but there are casualties everywhere else. Now, a new report in the journal Nature Biotechnology suggests there could be some new developments. It all has to do with tumor-targeted antibodies. They're highly efficient at recognizing cancer cells while ignoring normal cells. This feature has been exploited for targeted drug therapy. There are drugs like this out there being used right now, but the next generation, that's the next generation to be tested, they are much more effective and there is a lot more optimism.
Monday, June 13, 2011
Call me a realist rather than an eternal optimist. When I tell my patients to do certain things or make certain lifestyle changes, I try to look inward and see if I could do it myself. Rather than make a blanket statement with unrealistic expectations, I try to work with my patients to find a plan that's acceptable for both sides. Let's use dieting as an example. If someone is 20 pounds overweight, it's obvious that there is a need to lose lots of weight, but most people find it easier to lose 3 to 5 pounds over several months than 20 all at once. And, it's important that the weight goes away and doesn't come back. If you look at the big picture, weight-loss is a lifetime process and a person who makes real lifestyle changes is the ultimate winner. When you approach your own health challenges, be realistic and don't set the bar too high. We all like success and little victories can be as good as major ones.
Monday, May 9, 2011
Could being breast-fed as a baby have a long-term impact on behavior as an adult? According to a new report in the Archives of Disease in Childhood it just might. The new report finds that babies who are breast-fed for at least four months are less likely to have behavioral problems as five year olds. We know that breast-feeding has other advantages including help with fighting infections because of antibodies transferred in mother's milk and with bonding between mother and child. Obviously this is excellent news for breast-feeding mothers. However I'm always concerned about studies like this. Many women have difficulty breast-feeding and it is important they don't feel guilty if they can't. Today we have infant formula that closely matches breastmilk. Mothers who spend quality time feeding their baby with the bottle certainly can bond with the child as well. Nevertheless this is a very interesting study and one that no doubt will be followed up with further studies in time
Monday, May 2, 2011
Posttraumatic stress disorder or PTSD is a major complication for soldiers fighting wars. There are obvious reasons for this. Stress, the concern over life or death, and fear of the unknown often contribute. But when soldiers witness death and destruction directly they can have long-term effects. But what soldiers are at greater risk to develop PTSD. Are there certain characteristics? Are there certain ways to find out? According to a new study in the archives of Gen. Psychiatry, military service members who screened positive for signs of PTSD before they were deployed were five times more likely to develop the condition. There were other risk factors. Those who took psychiatric drugs before deployment were to two and a half more times more likely. Experts say that early intervention is necessary for people at risk
Monday, April 25, 2011
High blood pressure is a very common condition in men over 40. There is no doubt that regular exercise, watching your weight and trying to reduce stress are all good ideas when you are trying to lower your blood pressure. But , according to a new study out of the University of South Carolina there may be one way to reduce your risk by as much as 34%… It is a way many people have not really thought about. Their study finds that men who build muscle strength can reduce their risk dramatically. According to the findings reported in the Journal of the American College of Cardiology, men over age 40 with high blood pressure were followed for about 18 years. Those with the highest muscular strength had the greatest life expectancy. If you think about it makes a lot of sense. Regular exercise is necessary to build strength and once muscle mass is developed it can help burn calories even when people are at rest.
Wednesday, April 20, 2011
The term is meaningful use. The vast majority of people words the meaningful use don't really mean all that much, but in medical circles these two words will dramatically affect the way you receive care. Meaningful use is the way the government has chosen to describe a series of rules and regulations that will help determine how computers and technology will affect the care you are given. The good news is that there are all sorts of regulations put in place that will be used to measure the quality of your care and the way records are kept. The bad news is that many of these regulations were written by politicians or people who have very little to do with the practice of medicine. Overall I believe we are definitely heading into a time where care will be improved especially from an organizational standpoint and consistency of decision-making. My fear is that a great deal of the art of medicine may be left behind with the clicks on a keyboard. The best way to achieve success and we can accept nothing but success is to involve healthcare providers and patients in the process
Sunday, April 17, 2011
There have been many tremendous breakthroughs in the field of genetic research. As a result of greater understanding of the genetic code we understand the origin of many illnesses and conditions some of which can be life-threatening. But a new report in the Journal Pediatrics takes a look and a very interesting study which is based on the information we have learned from genetic research. Do the majority of parents who have young children want to know what conditions their children may develop when they are older. In other words would you as a parent wants to know if your young child was someday going to suffer from a certain form of cancer or genetic disease. According to the new study a majority of parents would want their children to be tested and know the results. The American Academy of pediatrics advises against this type of testing. This is an interesting study that at one time would have been a hypothetical discussion. But it is becoming more realistic everyday.
Thursday, April 14, 2011
There is a battle going on in medicine these days and as patients it is very important that you know what is happening. I don’t know if you saw the Seinfeld episode where Elaine wants to see what is on her doctor’s chart. It is actually very entertaining to watch the comedy surrounding what Elaine sees as her doctor’s ability to write anything he wants seemingly without her control. Fortunately, patients have access to their charts and have control. But the battle I am talking about has to do with hospital charts. Each day doctors, nurse and anyone involved with an in patient’s care writes notes as a way to communicate information to other healthcare providers –information that is crucial for your healthcare. But, long after discharge the government and other payers for care look at the notes and determine what they will pay for your hospitalization. The battle is that the notes are potentially being used to generate payments. We need to return to a time when the charts were used to help people get better ..not justify fees.
Tuesday, April 12, 2011
There is a concerning new study dealing with the herpes virus. According to a report in the Journal of the American Medical Association people with genital herpes can be contagious even when they don't have symptoms. We have known for many years that herpes is spread through sexual contact when people have source or what is called prodromal period in the days before the soars appear. Worldwide more than 530 million people at the herpes virus and according to this report people who harbor the virus can be shedding it as much as 10% of the time. This means they could infect sexual partners. Although use of condoms can reduce the spread of genital herpes, it does not provide 100% percent protection.
Sunday, April 10, 2011
Are you having a struggle with weight loss? Is it difficult to keep those extra pounds from attaching to your hips? Well now you have someone to blame. According to a study from University of Minnesota mothers of young children were heavier and ate more calories, fatty foods and sugary drinks than women without children. In addition both parents were less active than those of the same age without children. The study was not a small one. There were over 1500 adults with children younger than five. According to the report which is in today's journal pediatrics the mothers in this study with young children had a diet so poor that they would have to walk more than 3 miles a day to not gain a pound. The authors of this study suggest that parents with young children trying to take them outside and spend time exercising with them. Some ideas are going for walks with children in a stroller or playing games that increased levels of activity for both the child and parents. The hope is to reverse bad habits not only for mom and dad but for children as well
Wednesday, April 6, 2011
One of the major things that hospitals can do to ensure your safety as a patient is to keep careful track of possible errors. No one wants to make an error especially in a hospital setting with patient lives are on the line but if these errors can be measured and people can learn from them similar mistakes can be prevented. But according to a study from the University of Utah in the journal health affairs current tracking measures including a self reporting system are not catching the majority of errors. The University of Utah uses a technique called the global trigger tool which measures errors. Their system was able to identify 354 errors compared to only 39 with the other systems that are more traditional. This means that 90% of mistakes were missed. A review of the study shows that many of these mistakes were not major errors nor do they necessarily cause patients significant harm but the point is we need better ways to monitor errors across the board. It is hoped that as electronic medical records become more part of patient care many of these errors to be picked up earlier.
Monday, April 4, 2011
Let's face it we live in a society where people are working overtime in many cases just to make ends meet. But according to a report in the Annals of Internal Medicine there could be a stiff price to pay for this. Adults who work 11 hours or longer each day at a 67% higher risk of developing heart disease when compared to people who only work 7 to 8 hours per day. When you examine the study is quite clear that there is a price to pay for working extended hours. People working longer hours tend to exercise less and the work environment increase the amount of stress in a person's life. Both of these factors have been associated with an increased risk of heart disease. The study was conducted at the University of London.
Tuesday, March 29, 2011
We know that sleep is very important. But according to a new report when you combine a lack of sleep with stress it can lead to big problems especially when it comes to weight. The study in the International Journal of Obesity found that if you slept 6 to 8 hours a day and were under stress you lost less weight than if you slept the same amount and weren't under stress. This is particularly important because it could affect the way we treat obesity in the future. Obviously we look at things like diet and exercise but it is clear that we have to start looking at lifestyle. We need to include things like the stress a person feels that they are facing each day. Whether the stress is real or perceived the same when it comes to the person. In addition we need to be concerned about proper time and again to getting sleep as well as the issues that may prevent people from getting the sleep they need. This could include their environment, their mood and the foods they eat
Wednesday, March 23, 2011
Pancreatic cancer is one of the most difficult cancers to treat. It is extremely aggressive and very difficult to control. Researchers at the University of Pennsylvania believe they have made a major stride in the battle against pancreatic cancer. They studied 21 patients with surgically incurable pancreatic cancer. They gave them what is called an immune activating treatment in addition to their chemotherapy. Although they did not cure the cancer they were able to cause substantial shrinkage of the tumor. What they found is that their experimental drug stimulated immune system to produce cells that act the supporting tissue of the tumor. According to leading experts this type of attack on tumors has not been reported before. Adding many of these major breakthroughs we are not seeing immediate results but these critical steps are necessary to win the overall battle. Clearly this is a major step in the fight against pancreatic cancer
Monday, March 21, 2011
There is a disturbing new report that says some sports fans can take winning and losing too far. Fans of the Carolina Panthers, Detroit Lions, New England Patriots, Denver Broncos, Kansas City Chiefs, and Tennessee Titans were studied. According to scientists at the University of California at Berkeley there was a 10% increase in the rate of domestic abuse by men against their wives and girlfriends when their own football team lost a game they were expected to win. However when teams were expected to lose the violence was not as great. The researchers discovered this by cross checking the time of police calls with game times. Quite alarmingly increasing domestic violence occurred in the final hour of the game till two hours thereafter. The NFL cannot be blamed for this but the study shows how those who are prone to violence are more likely to act out after a negative experience in their life
Tuesday, March 15, 2011
You might be wondering why people in Japan are taking iodine after the tsunami. Damage to the nuclear power plant has led to the release of radioactive iodine. Radioactive iodine can lead to thyroid cancer. Taking iodine pills saturates the thyroid gland and can prevent the radioactive iodine from entering the body. Certainly no one can argue that taking iodine tablets in such a potentially dangerous situation is not a good idea. But people many miles away in places like Toronto and San Diego are buying iodine tablets as well with the thought that radiation might travel to them. As radiation travels the concentration decreases and experts say there is little chance of problems so far away. But does taking iodine cause any risks. If iodine is taken in extremely high amounts --- a dosage of many grams-- it can cause acute iodine poisoning with burning in the mouth throat and stomach diarrhea weak pulse and ultimately coma. But these are extremely high amounts. People who abuse iodine can impair the production of thyroid hormone but once again were talking about abuse. So in reasonable doses iodine does not present a significant risk but without a real chance for exposure to radioactive iodine people should save their money and not rush to the store to buy it.
Monday, March 14, 2011
The Alzheimer's Association has just released 2011 statistics surrounding the disease. Much like the American Heart Association and the American Cancer Society does with their results, the Alzheimer's Association provides a snapshot into this devastating illness. Alzheimer's is now the sixth leading cause of death in the United States. Perhaps most concerning is that it is the only one in the top 10 diseases that cannot be prevented or cured. 5.4 million Americans are living with the disease but by the year 2050 is estimated that number will reach 16 million. To try and put those numbers in perspective, every 69 seconds one person develops Alzheimer's in this country. Of course the greatest toll both physical and mental is often on the caregivers. 15 million Alzheimer's and dementia caregivers provide unpaid care valued at over $200 billion dollars
Saturday, March 12, 2011
There is good news in the world of preventive medicine. Top medical experts from the United States and Europe have reached a consensus. They both believe that pre-hypertension needs to be addressed and aggressively treated. Now, as you know, I believe the prevention of disease is far more effective than treating health problems later on. Pre-hypertension is a newly recognized diagnoses that focuses on people who are on the road to high blood pressure. Most treatments center around lifestyle issues like changing diet and increasing exercise. The fact it’s becoming an international issue is a major help in control. I truly believe that if we’re going to deal with pre-hypertension, we need to understand what the risk factors are and then slowly but surely find ways to attack them to reduce it so those problems won’t be as bad.
Sunday, March 6, 2011
The deaths of teenage basketball Star West Leonard closely followed by 17-year-old rugby player Matthew Hammerdorfer have raised a very reasonable question, "just how often do tragedies like this strike". According to the journal Circulation, the Journal of the American Heart Association, the rate of sudden cardiac deaths in young athletes was similar to that of deaths from lightning. But even though they are rare they are hard-hitting and have tremendous impact. The two primary causes of sudden death from heart conditions in which there were no previous symptoms are hypertrophic cardiomyopathy and a genetic condition called long QT syndrome. Hypertrophic cardiomyopathy is a thickening of the heart muscle and can cause cardiac arrest during exertion. The QT syndrome is a problem with electrical regulation of the heart. It is very difficult to detect these underlying heart conditions but a physical examination. EKGs can help but in the United States they are not recommended because testing is costly and can lead to false positive results which would mean unnecessary additional testing. There are many cardiologists who believe the EKGs should be standard. The European Society of cardiology recommends routine EKGs. One of the best ways to screen is through pointed questions for instance does the child have heart palpitations, a racing heart or passes out. Sadly the first warning in many of these cases is the sudden cardiac event while participating in a sports related activity.
Down syndrome is a chromosomal disorder that results in cognitive delays. It is caused by having an extra copy of chromosome. Down syndrome can be diagnosed with a procedure called an amniocentesis where amniotic fluid is taken from the pregnant mother. This procedure does carry a small risk of miscarriage. Now there is news out of the journal nature medicine that a simple blood test could help detect a baby with down syndrome. The study which was performed in Greece involved 40 cases. The scientists were successful in detecting down syndrome however the authors believe that more cases are necessary and more studies need to be completed before the test can be approved for use. According to the article the scientists believe they can spot down syndrome through fetal DNA that has been shed into the mother's bloodstream. Once again this is not approved for use in United States