Jan
01
2007

Prevent Type 2 Diabetes With Diet And Moderate Exercise

By | Diabetes, Hormones, Nutrition, Prevention

The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are overweight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.

Prevent Type 2 Diabetes With Diet And Moderate Exercise

Diabetics need exercise and a proper diet

It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

More information about:

1. Diabetes type 2: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

2. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Last edited November 2, 2014

Dec
01
2006

Vaccine Can Protect Against Bird Flu

By | Infectious Disease, Lung Disease, Prevention

To take the flu shot or not to take it becomes an issue as the northern winter and with it the flu season is approaching.
It has to be stressed that the influenza vaccine not only limits flu epidemics and saves lives. It is the only reliable protection available to protect all age groups. Of course it does not offer protection against the common cold, but it is a preventative weapon against many influenza strains that cause serious illness and death.

Dr. Robert Webster, a virologist and internationally recognized influenza expert recently quoted data from his laboratory at St. Jude’s Children’s Research Hospital in Memphis. He noted that the currently recommended seasonal influenza vaccines contain A/New Caledonia 20/99 that is an H1N1 virus. Its composition is very similar to the bird flu virus H5N1.

In animal experiments this immunization was given, after which the test animals were exposed to the highly lethal Vietnam 1203/04 strain of H5N1. The treated animals had a survival rate of 50%. Controls without the vaccination prior to exposure had a death rate of 100 %. There is indeed a basic cross-protection and people who take the current influenza vaccine 2006/2007 will have this partial protection against the bird flu should it suddenly become an epidemic. The bird flu (H5N1) has not made its appearance in the Americas.

Vaccine Can Protect Against Bird Flu

Vaccine Can Protect Against Bird Flu

Dr. Webster pointed out that the greatest concern is its entry through the illegal trade of animals. After drug smuggling, the smuggling of animals is probably the greatest illegal trade in the world and at the same time the most likely way in which the virus could come into the country and spread. The other concern is the entry of the virus through migratory birds.

References: The Medical Post, November 3, 2006, page 19

Last edited December 5, 2012

Dec
01
2006

Cold Virus Lurks In Hotel Rooms

By | Infectious Disease, Lung Disease, Prevention

It seems to be a bit overdone to wash your hands after touching a light switch or clicking the remote control, but researchers from the University of Virginia do not think that it is such a far-fetched idea during cold and flu season.
They found that rhinovirus that was live and capable to infect, typically found in people who have a cold and a runny nose, could still be transferred to a fingertip 24 hours after a person with a cold stayed in the room. Dr. Owen Hendley and his colleagues recruited 15 adults who had just come down with a rhinovirus cold to stay overnight in a hotel room. They were not to have visitors, get all their meals from room service and do hand washing only after using the washroom. They spent five hours in the evening, the night and two hours in the morning in their room before checking out. After checkout they were asked to name the 10 to 12 objects they touched most frequently, when they were in the room. Those were door handles, the hotel pen, light switches, TV remote control and the phone. All of those were sampled for residual virus, and on average on 40% of them rhinovirus was found. In the second part of the study, a group returned to the hotel several months later, but only after researchers had placed a drop of the subjects’ own stored rhinovirus-containing mucus on the sites most frequently touched. The test persons were asked to touch the contaminated sites by flipping light switches or using the phone. After each contact they rubbed their fingertip in a collecting fluid, after which they washed their hands. If the site had been contaminated 30 minutes earlier, viral transfer to the fingertip occurred 60% of the time. If the contamination was done the night before viral transfer still occurred in 33%.

Cold Virus Lurks In Hotel Rooms

Cold Virus Lurks In Hotel Rooms

It is still a step from picking up the virus on a fingertip to developing a cold: it requires self-inoculation. Dr. Hendley points out that it is as prosaic as keeping fingers away from eyes, nose or mouth and do frequent hand washing. While transmission of rhinovirus through dried nasal mucus is not efficient, it is still important to understand that the virus remains transferable at least one day.

Reference: The Medical Post, November 3, 2006, page 19

Last edited December 5, 2012

Dec
01
2006

Asthma Medication May Not Be Enough

By | Allergies, Asthma, Prevention

Doctors at an asthma clinic in New York were puzzled as to why their patients were not getting better even after continued medical care. Even though the patients were compliant with their medications, they needed oral steroids and presented with more severe asthma attacks at the emergency department. Looking into the living conditions of the patient group that continued having problems provided some insight: they lived in housing units that were dilapidated. In a program in which St. Luke’s-Roosevelt Hospital and other clinics participated, with the help of legal services of an attorney law firm the hospital was getting help for patients, who lived in substandard housing. When a patient lived in a building with dust, mold, roaches or rodents, any amount of treatment for asthma was almost futile. Even though there were letters and phone calls from social workers to landlords, unacceptable conditions in these housing units were not corrected. One letter from the New York Legal Assistance Group finally did the job. In plain English the notice to the negligent landlord said: Clean the place up or see me in court.

Dr. Luis Chug at St. Luke followed up on the patients one year later. Patients who needed 18 courses of oral steroids could reduce the treatment to just 2 the year after the cleanup. Patients who had made 14 trips to the emergency department because of asthma attacks the year before made only 2 after the conditions were corrected. The overall asthma of the patients also improved. Ten patients were afraid to go to a lawyer to seek help. A year later their living conditions predictably had remained the same. Their asthma had not improved either. The legal action was cost effective, reported Dr. Chug. Each emergency visit cost the hospital about $470 in services, and each course of prednisone cost about $345. The patients do not pay legal fees. Instead the service is funded by grants from participating hospitals. The study shows very clearly how practical public health measures can be used to correct health problems. The legal processes available in New York City are not unique in North America, as many local and regional governments have statutes requiring proper building maintenance.

Asthma Medication May Not Be Enough

Substandard housing bad for asthma

The results are also relevant to asthma patients who are not struggling with substandard housing. Patients with asthma simply cannot get better, when they live among irritants and allergy causing substances. Dust, cigarette smoke, perfumes, home fragrances, vapors from household cleansers, animal dander from house pets or feathers from a seemingly cozy down comforter can be the culprits for patients with asthma that does not improve despite treatment.

More information about:

1. asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. mold allergies: https://www.askdrray.com/mold-allergies-often-overlooked/

Reference: The Medical Post, November 14, 2006, page 23 and 25

Last edited November 2, 2014

Nov
01
2006

Think Feet With Diabetes

By | Diabetes, Prevention, Skin Disorders

This article is about “think feet with diabetes”. About 2 million Canadians are currently living with diabetes. It can be a “silent” disease, as patients may have few symptoms. Once diagnosed with diabetes it is of great importance to be vigilant of lifestyle and nutrition to keep the condition under control. A common problem for about 15% of diabetics is the development of a diabetic foot ulcer. Of those afflicted 14-24% will require an amputation of a lower extremity as a result. In addition to this the mortality rate of patients with below knee amputation due to the complications of a diabetic foot ulcer is 19-55% after three years.
Even though these statistics sound ominous, patients can do a lot in the way of prevention. According to the Canadian Diabetes Association guidelines, a diabetic patient should have a foot exam performed at least annually. Diabetic peripheral neuropathy is the leading cause of diabetic foot ulcers. The physician can examine the feet for loss of sensation. He will check for foot calluses and will debride those, which are pre-ulcer state. The physician also checks for poor circulation in the foot at that time.
If there is no loss of protective sensation, an annual exam will suffice, but if there is loss of sensation, several exams per year may be needed. A vascular surgeon may have to assess the patient to see if the foot circulation is sufficient. Infection is a warning sign and has to be treated promptly. Finally, any source of pressure to the foot needs to be removed or offloaded.
A proactive approach to keep the feet healthy starts at home.

Think Feet With Diabetes

Think Feet With Diabetes

The following points are important especially to the patient with diabetes:
-Inspect your feet on a daily basis. Check for sores, blisters or cracks that don’t heal.
-Check your footwear. If there is debris (sand, pebbles) remove promptly.
-Wash your feet daily with warm, not hot water and dry them well, especially between your toes.
-Trim your toenails. If you have difficulties doing that, seek out the help of a podiatrist. Also don’t use the homemade approach cutting corns and calluses.
-Keep the circulation to your feet going: put up your feet when you sit. Wiggle your toes, move your ankles, don’t cross your legs for long stretches of time.
-Shop for suitable footwear! Ask the sales clerk to measure both of your feet in order to determine the proper size. Shop in the afternoon, as your feet can swell during the day.
-Don’t break in a tight fitting new shoe! This may injure your feet. A new shoe should be comfortable right away.
-Don’t delay looking after problems. If a cut, sore, bruise or blister does not start to heal after a day, see a physician.

Reference: Parkhurst Exchange, October 2006 Edition, page 26

Last edited November 1, 2014

Oct
01
2006

Antiviral Drugs Not For Flu Prevention

By | Infectious Disease, Lung Disease, Prevention

With the arrival of the fall and winter season concerns about viral illnesses crop up. The most common ailment is the flu, which occurs seasonally. Prevention measures come in the forefront, and over-the-counter remedies and herbal supplements make their appearance.
Yet at this point the most effective measures remain very basic: good hygiene, hand washing, non-exposure to people who have the flu and non-sharing of personal items that could carry the virus. Flu shots for flu prevention remain the single most effective way to prevent widespread epidemics.
Antiviral agents zanamivir (also known as Relenza) and oseltamivir (Tamiflu) have come under discussion. They have been very effective in the treatment of influenza symptoms. It is not too late to treat with oseltamivir after the patient has been infected with the flu, as the drug prevents lower respiratory tract complications. For the symptomatic relief of influenza 75 mg per day were 61% effective, and 150 mg were 73% effective. Using the drugs strictly as a prophylaxis proved to be a fallacy. Results showed that neither zanamivir nor oseltamivir prevented influenza-like illnesses.

Antiviral Drugs Not For Flu Prevention

Antiviral Drugs Not For Flu Prevention

Even though both antiviral agents are not 100 % effective, they still can be useful in the setting of a flu pandemic. They are also of help in population groups with chronic health problems or immunocompromised persons to whom any viral infection can be serious.

More info about the flu: http://nethealthbook.com/infectious-disease/respiratory-infections/flu/

Reference: The Medical Post, September 1, 2006, page 61

Last edited November 1, 2014

Oct
01
2006

Good Nutrition Is Gender Specific

By | Cancer, Health, Heart Disease, Nutrition, Prevention, Stroke

It is well known that various health concerns are related to the gender of a person, but there are findings that suggest that even nutrition has to be tailored to the needs of males or females.
Calcium is known to be beneficial to bone health, and while high calcium diet may protect a woman from osteoporosis, it does not have the same evidence for men. As a matter of fact, high calcium intake in males may increase their risk of prostate cancer. For the male it means that calcium should be used in moderation and vitamin D intake could help to offset some risks.
Fat choices, mostly sources of monounsaturated fats in the form of olive oil are important for both, men and women, and for both the omega-3 fatty acids that are found in fish are excellent. Men, especially those with a risk of prostate cancer, should be cautious about loading up on flaxseed and canola oil. Alpha-linolenic acid in these two oils may be a problem for the prostate.
Iron is also emphasized in healthy nutrition, but men need less than women. In the presence of an abnormal gene, excessive iron can accumulate to harmful deposits in various organs.
Social habits, for example the drinking of alcohol seem to have more grave implication to women than to men. The glass of wine that may help reduce the risk of heart attacks and certain strokes may seem harmless enough, and average men don’t seem to develop health problems, as long as the alcohol intake is low. Larger amounts will increase the risk of many ills for males and females alike, but even low doses of alcohol may increase a woman’s risk of breast cancer.
“Super Foods” have made headlines, and all of them are known because of their high content in antioxidants. A recent study from the University of Oslo, Norway, under Dr. Bente Halverson examined, which of them are ranking highest. At the top are, in the order of strength: blackberries, grape juice from Concord grapes, artichoke hearts, walnuts and strawberries. The researchers came up with a list of high oxidant foods on the basis of typical serving sizes.

Good Nutrition Is Gender Specific

Everybody needs to find healthy food

These are the winners among the super foods and spices: blackberries, walnuts, strawberries, artichokes, cranberries, brewed coffee, raspberries, pecans, blueberries, ground cloves, grape juice and unsweetened baking chocolate. Males as well as females of all age groups will benefit from those.
Dr H. Simon, associate professor of medicine at Harvard Medical School points out that there are fundamental facts in nutrition that apply to everyone. But there is also a fine print, which varies according to gender, age and medical conditions.

More information about nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Reference: The Medical Post, September 19, 2006, page 25

Last edited November 1, 2014

Sep
01
2006

Food Choices Can Boost Good Cholesterol

By | Health, Nutrition, Obesity, Prevention

Dr. Andrew Pipe, a cardiologist at the University of Ottawa Heart Institute, sees a lot of people with cardiovascular problems. He also has found that telling patients to “reduce their cholesterol and get the triglycerides down” is not very helpful. Dr. Pipe is aware that we are living in a world where people are constantly tempted by junk food, and it is not surprising that obesity is one of the consequences.
It sounds daunting to a person with a lifetime of poor food habits and poor lifestyle choices to make changes. He believes that simplifying advice for healthy living can be brought down to 5 F’s for healthy living:

-Fruit and vegetables, 3-4 each day
-Fish, 3-4 per week
-Fibre, 5 per day
-Fat, 3-6 per day. Monounsaturated fats are best
-Fast food: avoid it!

Food Choices Can Boost Good Cholesterol

Food Choices Can Boost Good Cholesterol

To this list Dr. Pipe added two more Fs:
– “Fysical” activity, 30-40 minutes per day. This may be a misspell, but it is the best way to increase your good cholesterol (HDL)
-Fun, unlimited. Your food choices and exercise need to be enjoyable and appealing or the plan does not work in the long run.

Here is a blog about slowing aging and avoiding disabilities: https://www.askdrray.com/slow-down-aging-and-prevent-disabilities/

Reference: National Review of Medicine, August 30,2006, page 10

Last edited November 1, 2014

Sep
01
2006

Moral Preaching Is Not Enough In AIDS Intervention

By | Infectious Disease, Men's Health, Prevention, Women’s Diseases

At a recent conference of the International AIDS Society in Toronto the full spectrum of the disease was covered: science, community, activism, and people with AIDS.
News Canada data released before the conference suggests that HIV infection remains a serious problem. There were somewhere between 2,300 and 4,500 new cases of HIV in Canada. The numbers are up from the estimated 2,100-4,000 cases that came up in 2002.
There is one statistic that can be a source of hope: the number of deaths from the infection has shown a steep decline in the mid-90’s. This effect is largely due to the discovery and application of three-drug antiretroviral therapy. The widespread use of this therapy has also reduced the viral load, and as a result infectiousness may be reduced.
UBC epidemiologist Dr. Evan Wood sees the encouraging development, but he emphatically spoke of the horrendous effect of AIDS. He stated, ” HIV remains the biggest threat to humanity globally.” He feels that the threat of terrorism pales in comparison to the carnage HIV results in every day. In this light it is short sighted and non-supportive of Canada’s PM, not to appear at this conference, as he had other commitments.
This year also marks the 25th anniversary of AIDS’ discovery, but it is known that the disease was ravaging Africa at least 25 years before it first appeared in the West.
The diagnosis of HIV infection does no longer sound like a death sentence. Things have been improving, but not fast enough, says Dr. Wood. Also one of the speakers, Bill Gates, spoke against naïve insistence on abstinence as a primary weapon in the battle against AIDS.

 

Moral Preaching Is Not Enough In AIDS Intervention

Moral Preaching Is Not Enough In AIDS Intervention

Dr. Wood shared this sentiment. He stated that while the whole idea is well intended, sexuality is part of normal human behavior, and everybody knows that abstinence cannot exist forever.

More information about AIDS: http://nethealthbook.com/infectious-disease/sexually-transmitted-disease/aids-introduction/

Reference: National Review of Medicine, August 30,2006, page 14

Last edited November 1, 2014

Jul
01
2006

Better Blood Pressure Control With New Drug

By | Heart Disease, High Blood Pressure, Prevention, Stroke

Numerous medications for blood pressure control are in circulation. Treatment of high blood pressure patients is crucial in the prevention of strokes, but despite the multitude of drugs that are on the market, the treatment has its challenges. Some of the drugs have side effects, like an irritating cough, and a suitable medication has to be tried out first. Even, when all is well and there are no unpleasant side effects, many patients have a problem with compliance. Pills that have to be taken several times per day are forgotten. As a result, the patient will have poor blood pressure control.
Blood pressures must be controlled on an ongoing basis. Ideally there are no big fluctuations, whether it is day or night. For this purpose, a medication has to stay in the system of the patient long enough. This time stretch is called the half-life of a drug.
The first drug in a new class of agents for the treatment of high blood pressure does exactly that: it has a long half-life, so blood pressure control is smooth and continuous, day or night. The oral direct renin inhibitor aliskiren has the potential to protect the heart and other organs with a once-daily dosage of 150 mg or 300 mg. The drug is being developed by Novartis, and clinical trials are on their way.
The medication in combination with a diuretic provides significant additional blood pressure reduction. The agent at work is a renin inhibitor (also known medically as “renin antagonist” as it blocks the effects of renin). In the past, renin inhibitors for treatment of hypertension (high blood pressure) could only be used as intravenous solution and this was only effective for a short time.

Better Blood Pressure Control With New Drug

Better Blood Pressure Control With New Drug

The new development is a breakthrough, as the medication is taken by mouth and it continues to work even when the drug is gone from the blood stream. It is ideal for daily dosing, and there is no apparent buildup in the body.

More information about hypertension (high blood pressure): http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

Reference: The Medical Post, June 13, 2006, page 38

Comment on Nov. 13, 2012: Aliskiren  (brand name “Tekturna”) was approved by the FDA in March of 2007. However, as all drugs, it does have some side-effects like headaches, cough, angioedema, skin rash, elevated uric acid with gout etc. (see this Wikipedia link).

Last edited Nov. 1, 2014