Oct
02
2003

Heart Scan Saves Lives In Diabetics

By | Diabetes, Heart Disease, Prevention

A simple new nuclear perfusion study of the heart when applied to healthy appearing diabetics (adult onset or “type 2 diabetics”) showed silent hardening of the coronary arteries in 21.6%. This large study of an American medical team was recently presented at the 18th Congress of the International Diabetes Federation in Paris/France. Dr. F. Wackers, professor of medicine from Yale University school of medicine and one of the lead investigators, explained that 1,124 patients with diabetes in the age range of 55 to 75 years who were all thought to not have any heart blood vessel disease, either had nuclear perfusion studies performed and a control group did not.

As indicated above to the surprise of the investigators 113 patients of 522 (=21.6%) had positive heart scans showing perfusion difficulties of the heart muscle. Further testing with other methods revealed that 73% indeed had perfusion defects and 27% had other heart disease, electrocardiogram abnormalities and other heart dysfunctions. Conventional assessment tools such as a smoking history, determination of degree of obesity, blood pressure,kidney disease , high blood lipid levels, high C-reactive protein levels, the diabetes test hemoglobin A1C or homocysteine levels in the blood were also assessed. However, these conventional tests did not help in predicting that these patients would have developed perfusion defects in their heart muscle. This was due to hidden narrowing of the heart blood vessels (=coronary arteries) and this affected the supply of nutrients and oxygen to the heart even though these patients were completely symptom free at the beginning of the trial.

Heart Scan Saves Lives In Diabetics

Heart vessels and nuclear scan

Dr. Vivian Fonsega, a professor of medicine and pharmacology at Tulane University in New Orleans and co-researcher of the team, added that after a follow-up of 1 year those who had normal initial nuclear perfusion studies of the heart only 1% developed serious heart disease. These control patients who have now been followed for 3 years overall remained very healthy. In other words a normal (called “negative”) nuclear perfusion test in diabetics predicts a better longterm outcome than a positive perfusion test.

With this heart scan the cardiologist can identfy the high risk group among diabetics and can subsequently concetrate on doing something actively about the identified diseased heart blood vessel(=”coronary artery”) disease. Identified narrowing in the coronary arteries (“stenotic arterial lesions”) can be overcome by prying them open and placing heart stents across the affected section utilizing catheters (angiography). In other cases heart bypass surgery can be done by the heart surgeon to improve the perfusion of the heart muscle. The researchers stressed that those diabetics at risk can be identified with this test and the life expectancy of this high risk group of patients can be significantly prolonged. The study will continue for several more years so that the longterm results of any intervention can be measured when compared to controls.

Based on The Medical Post (Sept. 23, 2003 ): p. 55.

Here is a link to a chapter on diabetes and here is a link to heart attacks.

Last edited December 9, 2012

Sep
01
2003

West Nile Virus (WNV) Vaccine Being Tested In Humans

By | Infectious Disease, Prevention

According to Dr. Tom Monath, the scientific officer of the Acambis pharmaceutical company, human trials on a new vaccine for West Nile virus (WNV) can begin as soon as the FDA will give the green light (likely in October of 2003).

At the 2003 World Vaccine Conference in Montreal/Canada this summer Dr. Monath explained that Acambis has been doing research for a new vaccine against WNV since 1999 when this virus arrived in New York. The virus belongs into the same group of flaviviruses as dengue fever, yellow fever and Japanese encephalitis.

Yellow fever has been successfully prevented by vaccination with a live vaccine that has been modified considerably (called 17D attenuated vaccine). This strain is basically a harmless virus, which will induce a strong immune response in 100% of vaccinated people. If this is repeated every 10 years, a vaccinated person would be safe to travel in yellow fever infested areas. Based on this knowledge the researchers of Acambis have created a chimera virus where the yellow fever vaccine (attenuated virus 17D) is used as a vehicle in the center while the surface has been modified by incorporating parts of the WNV into its envelope. As this new vaccine virus has qualities of both the yellow fever vaccine virus and the WNV, it is called a chimera virus. The same technology has already been successfully applied to two other flavivirus vaccines, namely the dengue fever vaccine and the Japanese encephalitis vaccine.

West Nile Virus (WNV) Vaccine Being Tested In Humans

West Nile Virus (WNV) Vaccine Being Tested In Humans

The new WNV vaccine has been tested extensively in mice and monkeys and has been found sofar to be very safe and it is mounting a very good immune response. It is timely that human trials are being done now starting this fall as WNV seems to be expanding rapidly throughout the United States and Canada. The vaccine would be needed particularly for older people as in them the WNV disease presents much more violently with a higher death rate. However, visitors from Europe to the US and Canada will likely want to protect themselves as well before they travel.

Comment in July 2012: A vaccine for humans is still not available, for horses it is.

Last edited December 9, 2012

Sep
01
2003

Asthma And Wheezing Influenced By Family Lifestyle (Swedish Study)

By | Asthma, Prevention

A new study from Sweden was published by Dr. Magnus Wickman and colleagues,from the Karolinska Hospital in Stockholm, in the medical journal Allergy 2003;58:730-731,742-747. The authors of this study were analyzing data of a prospective birth cohort study of 4089 children who were born in Sweden between 1994 and 1996.

The families were given health questionaires at the age of 2 months to assess whether the family was adhering to the allergy prevention guidelines (see below). Questionaires were again given at the age of 1 year and 2 years of these children. Specific questions were asked regarding environmental conditions in the house where the children lived. In the mid 1990’s allergy prevention guidelines were strongly recommended to the public in Sweden regarding the value of breast feeding, the avoidance of smoking inside the house in the presence of children, also that a house should be kept well ventilated and without dampness. All of these factors, as was stressed by the allergists in Sweden who organized the campaign, would protect the immune system from allergies against molds, dust mites as well as cigarette smoke and should reduce the rates of asthma.
Here are the results in tabular form.

Asthma And Wheezing Influenced By Family Lifestyle (Swedish Study)

Asthma And Wheezing Influenced By Family Lifestyle (Swedish Study)

As can be seen from this table, which is based on families without allergic parents, a two-fold drop of asthma and wheezing occured when the allergy prevention guidelines were followed in the house. With allergic parents the children had an even greater benefit as the reduction of asthma and wheezing was three-fold when compared to controls who did not follow the guidelines. This is one of the few studies, which shows conclusively that allergy prevention works!

Link to asthma chapter of Dr. Schilling’s Net Health Book: http://nethealthbook.com/lung-disease/asthma-introduction/

Swedish Family Lifestyle Study
Agreement with
allergy guidelines		 % of asthma and wheezing at ages 1 and 2 of child:
1
year		 2
years
Yes (all three measures followed) 6.8% 12.6%
No (one or none of measures followed) 17.9% 24.1%

Last edited October 26, 2014

Aug
01
2003

Reduction Of Complications After A Stroke

By | Prevention, Stroke

Following an acute stroke, it used to be taught in medical school that lowering the blood pressure would be something to avoid for fear that this would lower circulation to the brain and could make a stroke worse. A new study, called ACCESS (Acute Candesartan Cilexitil Therapy in Stroke Survivors), is proving this teaching wrong and demands a 180° turnaround.

Dr. Joachim Schrader has pablished this landmark study recently in the Medical Journal “Stroke” (Stroke – 01-JUL-2003; 34(7): 1699-703). This study followed 339 stroke patients after an initial angiotensin type 1 receptor blocker was given right away versus a control group who got it only 1 week later. In other words, the test here was to see what would happen, if treatment would be started right away during the acute phase of the stroke. Up to now this was only done in the stable period after 1 or 2 weeks (the conventional approach). The 1 year follow-up data showed that the overal death rate from all causes (summing up all complications) was 47.5% less in the treatment group than in the control group. In other words by using intervention with this newer type of blood pressure lowering medication, such as the angiotensin type 1 receptor blocker candesartan (Atacand), complications such as extension of the stroke or heart problems and other complications were averted. The end result were fewer deaths and better quality of life in those who survived.

The Medical Post in its July 29, 2003 edition (p. 1 and 54) interviewed Dr.Ashfak Shuaib, professor of neurology of the University of Alberta in Edmonton, regarding the significance of this study. He felt that there likely would be a new hormonal effect on the brain from the lining of the arteries in the brain that gets blocked and that leads to an increase of blood supply to the brain.

Reduction Of Complications After A Stroke

Reduction Of Complications After A Stroke

This in turn would rescue the brain tissue around the stroke preventing the late complications. He said that this line of research would be very solid data, but that it would have to be confirmed by an independent study from other investigators. Dr. Shuaib’s group of researchers are planning an imaging study where they will study the blood flow following strokes under the same conditions using candesartan (Atacand).

Link to a chapter on stroke of the Net Health Book.

Last edited October 26, 2014

 

Aug
01
2003

Parkinsons Disease From Too Much Meat And Too Little Vitamin B2

By | Nutrition, Parkinson’s disease, Prevention, Vitamins and supplements

Parkinsons disease (correct medical spelling is ” Parkinson’s disease”) is a degenerative disease of the brain stem that presents with symptoms of shaking, tremor and gait problems.

It is a neurological disease of the elderly and often is a cause of disability leading to institutionilisation. New research at the University of Sao Paulo (UNIFESP) in Brazil has found that a diet rich in vitamin B2 and low in meat has helped to improve patients with Parkinsons disease.

It appears that it may not only be useful in alleviating symptoms of existing disease, but even more importantly to prevent this neurological disorder from developinlg. Dr. Cicero Galli Coimbra stated that in Buenos Aires (where the study was done) the consumption of meat is one of the highest in the world as is the rate of Parkinsons disease. Under his guidance a research team found that about 15% of the population do not absorb vitamin B2 adequately. In combination with excessive red meat intake a significant proportion of the population does not absorb enough of this vitamin resulting in Parkinsons disease.

In this study a group of patients with advanced Parkinsons disease were put on a special diet that included milk (which is a good source of vitamin B2). Other sources of vitman B2 as shown here were cereal, nuts, milk, eggs, green leafy vegetables and lean meat. Within one month 18% of their motor function had returned to normal. After the third month of this diet 60% of the motor function had returned.

Parkinsons Disease From Too Much Meat And Too Little Vitamin B2

Parkinsons Disease From Too Much Meat And Too Little Vitamin B2

Many had improved so much that they were able to drive a car safely again. Riboflavin (=vitamin B2) is an important ingredient in a number of metabolic processes in brain cells that result in the production of dopamine, a brain hormone that is required for regulating muscle coordination in various parts of the brain. This translates into a stable gait, normal muscle strength, good balance and normal cognitive functioning.

These findings were reported in the July 15, 2003 issue of The Medical Post, page 31.

Link to Dr. Schilling’s Net Health Book regarding Parkinsons disease.

Last edited December 9, 2012

Jul
01
2003

High Blood Pressure On The Increase In The US

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

High blood pressure on the rise

Dr. Hajjar, of the University of South Carolina in Columbia and Dr. Kotchen, of the Medical College of Wisconsin in Milwaukee have compared a large group of people in the US in the years 1999-2000 with prior studies in 1988-1991and 1991-1994 where peoples’ blood pressures were measured.

The latest study involved more than 5000 people, the prior studies more than 9000 people each. Almost 29% of the population has a blood pressure of 140/90 or higher in the latest study.

Compared to the 1988-1991study this is a significant increase of 3.7%. More than half of this was explained on the basis that the population’s weight (measured by body mass index calculation) had increased. The sub groups who had the largest increase in blood pressure were as follows:

1. diabetics with high blood pressure. In this high risk group only about 25% had a blood pressure readings of less than 130/85, which is the target value.

2. Mexican Americans had a significantly poorer awareness and control of their elevated blood pressures than the non-Hispanic whites and non-Hispanic blacks.

3. Women as a group were poorer in blood pressure controlling than men.

4. People above the age of 60 had a much higher rate of uncontrolled blood pressure as well.

The study concluded that by concentrating campaigns and efforts on these four target groups significant gains could be made in terms of control of blood pressure, reduction of strokes, heart attacks and kidney damage.

Here are some links regarding high blood pressure, prevention of strokes and heart attacks to various chapters of my nethealthbook.com:

High blood pressure link

Heart attack link

Stroke link

Last edited October 26, 2014

Jun
01
2003

Genetic Link Found For Bipolar Disorder

By | Diabetes, Mental Health, Prevention, Women’s Diseases

A staff psychiatrist at the Dalhousie Medical School in Halifax (Novia Scotia, Canada) has gathered 1100 DNA samples and psychiatric histories from patients with bipolar disorder and family members who do not have this psychiatric disease. Dr. Martin Alda, The Medical Post reports on page 46 of the May 20, 2003 edition, and his medical team were able to identify 4 areas of interest on chromosomes 15, 7, 6 and 21 where molecular markers for bipolar disease were located.

Two additional tools, namely responders to lithium (common bipolar disease stabilizer) and certain ethnic group differences, are being utilized as well. Dr. Alda has already found that unstable genes can be stabilized in the presence of lithium. By studying the genes involved in the expression of bipolar disorder and defining what triggers a depressive response and what triggers a manic episode, the researchers hope to unravel the mysteries that still surround this intriguing disease. Dr. Alda is also studying the connection of diabetes and biploar disease. Patients with biploar disease are 3 times more prone to diabetes than the general population. As these patients (bipolar patients with diabetes) are poor responders to lithium, there is a suggestion that perhaps the newly defined genetic loci are blocked in some way by the hormone changes in diabetics. Further investigations in this direction are planned by the research group.

Genetic Link Found For Bipolar Disorder

Genetic Link Found For Bipolar Disorder

Link to bipolar disorder: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/bipolar-disorder/

Link to diabetes:

http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 26, 2014

Jun
01
2003

Effect Of Smallpox Vaccination Lasts Much Longer

By | Infectious Disease, Prevention, Skin Disorders

Introduction

A study found that the effect of smallpox vaccination lasts much longer than previously thought. In the age of bioterrorism Americans worry about what would happen in the case of an attack with smallpox. Due to concentrated efforts worldwide through the WHO for many years, smallpox could be declared eradicated in the US in 1949 and worldwide in 1972. American children since then did not receive a smallpox vaccination. However, 95% of Americans over the age of 35 have been vaccinated and according to a recent study have been shown to still have a very good immune response that likely would make them immune to a bioterrorism attack with smallpox virus.

Review article in the British Medical Journal 

A review article in the British Medical Journal (BMJ 2003;326:1164) on May 31, 2003 reports about a study by Oregon researchers from the Departments of Molecular Microbiology and Immunology in Portland. Dr. Mark Slifka and Dr. Erika Hammarlund (Oregon Health Sciences University) collected blood samples from 306 previously smallpox vaccinated volunteers to check for antibody levels as well as T cell responses against smallpox antigens. The volunteers were of different ages and included people who were vaccinated against smallpox as recently as last year and as long as 75 years ago. All of them showed a very good response due to high antibody levels and their serum was able to neutralize the smallpox vaccinia virus in Petri dishes.

Good T cell responses after 35 years of smallpox vaccination

The T cell mediated cellular immune response showed some slowing down in the older age group. However, another study done by a North Carolina research group and also presented at a meeting from the American Society for Microbiology in Washington, DC. and published recently (New England Journal of Medicine 2002;347:689-90) found that T cell responses lasted a very long time. A group of people vaccinated 35 years earlier, so the North Carolina group reported, had perfect T cell responses to the smallpox vaccinia virus. The conclusion of these studies is that the effect of smallpox vaccination lasts much longer.

Effect Of Smallpox Vaccination Lasts Much Longer

Effect Of Smallpox Vaccination Lasts Much Longer

Conclusion

There is no point of vaccinating more often than two times in a lifetime.  Even one-time vaccinated people often have good immunity against smallpox. People born after 1972 and never  vaccinated against smallpox should consider vaccination and discuss this with their doctors. There are, however, some known complications of the vaccine such as a myopericarditis (a heart condition). Next, generalized vaccinia can occur, a skin condition common in people with skin problems like acne or psoriasis. 1 in 10,000 immunizations will get viral encephalitis, which often leads to brain damage. There is presently a campaign to vaccinate 500,000 frontline healthcare workers in the US against smallpox. This is a government plan to prepare for a smallpox bioterrorism attack. Due to the possible complications so far only 35 000 healthcare workers have volunteered for vaccinations. Link to overview regarding history of smallpox from the CDC.

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Jun
01
2003

Hormones After Menopause (HRT) Not For Everybody

By | Hormones, Prevention, Women’s Diseases

Lately there have been several review articles published in the medical literature about hormone replacement therapy (HRT) after menopause for women. A number of longterm follow-up studies have shown that HRT with a combination of estrogen and progesterone hormones is associated with a higher risk of stroke, heart attacks, blood clots and pulmonary embolism. The WAVE trial has recently shown that estrogen replacement does not lead to protection from heart disease or strokes, however exercise and weight loss (from calorie restriction) does.

Two more recent studies add to the story: the one is a study showing that urinary incontinence (=bladder leakage) is much worse on estrogen replacement (HRT) than without it. The other study showed that estrogen replacement leads to dementia of the Alzheimers type.

Here are the details: Dr. Jodi Steinauer (University of California at San Francisco) reported about the findings during the American College of Obstetrics and Gynecology meeting at New Orleans. The study was designed to see whether estrogen/progestin hormone replacement would improve bladder function with aging. Episodes of urine loss when coughing, sneezing or running (urinary incontinence) were observed by the 1208 women from the HERS trial (Heart and Estrogen/Progestin Replacement Study) who were followed along for 4 years. The women were either given a hormone tablet (estrogen/progestin) or a “fake” pill with no hormones (placebo pill). To the surprise of the investigators the opposite of what was expected happened: The HRT group did much worse than the placebo group.

Hormones After Menopause (HRT) Not For Everybody

Hormones After Menopause (HRT) Not For Everybody

After one year urinary incontinence was up 2 to 3-fold in the HRT group and after 4 years this number was up 3 to 5-fold. Of the women who did not have stress incontinence in the beginning, only 38% of the placebo group developed it over 4 years, whereas in the HRT group 54% developed it. The authors concluded that HRT replacement therapy in menopause should be avoided (reported in The Medical Post, page 1 and 86, May 13, 2003).

Recently a new study (JAMA 2203;289:2651-62) showed that dementia was double the rate in older postmenopausal women on HRT than in the placebo group. 4532 postmenopausal women aged 65 years or older from the Women’s Health Initiative’s memory study (“WHIMS”) were followed by researchers for 4 years. The HRT therapy consisted of Prempro (Premarin and Provera). None of the women had dementia in the beginning of the study. After 4 years 21 of the placebo group had developed it (age related), the Prempro group developed 40 dementia cases. It is unclear why the HRT group had developed dementia, but the authors of the study theorize that perhaps a series of mini-strokes would be responsible for this.

In summary, it appears now with more evidence from the literature that HRT should only be given to postmenopausal women in a few selected patients under close medical supervision, but that the majority of women likely should not take it. Osteoporosis can be prevented by regular brisk walks, dietary changes with fat reduction and avoidance of refined sugar etc. as another powerful tool to achieve longevity. Keep in mind that these “hormone” replacement trials were regarding Premarine and Provera, both products of the drug industry. The body reads these hormone-like susbstances as estrogen-like substances and gets an overdose with the regular dosaging. Only bio-identical hormones in the right mix will be heart and brain protective and will work against osteoporosis. In short, the study described above was done with the wrong “hormones” and should have been done with bio-identical hormones. In menopause there are all kinds of reasons why a woman should use bioidentical hormones to return to her previous hormone balance, but it needs to be supervised by a knowledgeable physician with experience in this.

Read the truth about bio-identical hormone replacement under the “menopause” link below.

Here is a link to “menopause”: http://www.nethealthbook.com/articles/menopause.php

Last edited December 9, 2012

Jun
01
2003

Vitamin B-6, Vitamin B-12, Folic Acid To Control Hardening Of Arteries

By | Heart Disease, Nutrition, Prevention, Vitamins and supplements

The May 2003 issue of the medical journal “Clinical Practice” contains an article by the dietician Andrea Miller (pages 46 to 49) about supplementation with these vitamins in relation to hardening of the arteries from too much of the amino acid homocysteine.

Homocysteine is an amino acid that contains sulfur, which is formed from the metabolism of methionine, an essential amino acid that we depend on in our food for maintaining a normal metabolism. There are complex metabolic pathways that involve several enzymes to function normally, which involve the three vitamins B-6, B-12 and folic acid (folate) to balance everything.

If one of these vitamins or any of the enzymes involved malfunction, a surplus of homocysteine results with an accelerated hardening of the arteries throughout the body. A certain percentage of the population does not have the full concentration of one or more of the metabolic enzymes in their system. If the food we eat is also relatively deficient in the above named vitamins, the body runs out of alternative metabolic options and produces dangerous levels of homocysteine. A normal blood level of homocysteine is between about 5 and 10 micro-mol per liter. This is not routinely measured by screening tests unless the doctor suspects a genetic trait in the family where family members tend to get heart attacks at an early age (mid 30’s to early 40’s). When the level of homocysteine is elevated to 12 micro-mols per liter, a supplement with folic acid of 1 mg per day would reduce this by 25% to safe levels of 9 micro-mols per liter. This results in a 15% decrease of the death rate from heart attacks.

Vitamin B-6, Vitamin B-12, Folic Acid To Control Hardening Of Arteries

Vitamin B-6, Vitamin B-12, Folic Acid To Control Hardening Of Arteries

Vitamin B-12 is found in animal products such as meat, poultry and dairy products. Vegetarians may not get enough Vit. B-12 and should supplement as should persons above the age of 50. A lack of B-12 vitamin leads to pernicious anemia.

Vitamin B-6 is found widely distributed in meat, fortified grains and poultry and usually is in our food supply to a satisfactory degree.

Folate (folic acid) is contained in orange fruits, beans, lentils and green vegetables. However, not everybody eats well banced meals and the food supply could be marginally deficient in folate.

Recommendation: The take home message is that a good multivitamin tablet containing about 400 to 600 micrograms (=0.4 to 0.6 mg) of folate (folic acid), 5 mg of vitamin B-6 and 20 micrograms of vitamin B-12 would be providing an adequate amount of these vitamins and reduce homocysteine levels in most people to safe levels. It is not recommended to take single vitamin supplements of these vitamins as this could lead to toxicity. Also, there is no point in taking higher doses of the vitamins as this also would lead to toxic reactions.

Link to information about balanced nutrition: http://www.nethealthbook.com/articles/nutrition.php

Last edited December 9, 2012

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