Medical Articles by Dr. Ray

Oct

2018

Health Risks After Hurricanes

By Ray Schilling | Infectious Disease, Lung Disease, Mortality, Prevention

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Sep

2018

No Amount Of Alcohol Is Good

By Ray Schilling | alcohol, Cancer, Cardiovascular disease, Dementia, Diabetes, heart attack, Heart Disease, High Blood Pressure, immune system, Obesity, Stroke

New research, more extensive than previous research has shown that no amount of alcohol is good.

This is completely against the widespread belief that moderate consumption of alcohol would prevent heart disease.

Specifically, previous research had shown the following: one glass of alcohol per day for women and 2 glasses of alcohol for men was reportedly make us live longer.

New research with larger population numbers

But a new study involving much larger population groups, all ages, and drinkers versus non-drinkers came to a different conclusion. It concluded that the previous recommendation was based on only heart attack rates, but excluded other causes of sudden death like heart failure, a rupture of the aorta (aneurysm), high blood pressure that kills (fatal hypertensive disease) and strokes. With the compilation of all these cardiovascular diseases, the statistics suddenly started to look different. Now even small amounts of alcohol killed. What is worse, there was clear evidence that binge drinkers have much worse survival statistics than moderate drinkers. When you drink according to the American Heart Association’s recommendation, you drink smaller amounts of alcohol daily.

Binge drinking

But many of us like to live it up on weekends or whenever there are friends over who also like a few drinks. This binge drinking habit lowers the life expectancy by an average of 10 years. It does so because the list of complications I mentioned above. In addition there are alcoholic liver cirrhosis, pancreatitis and various cancers that shorten your life.

Global health study

The funders of this global health study was the Bill and Melinda Gates Foundation, and it looked at the burden that alcohol puts on 195 countries. The original study appeared in the Lancet. The combined study population was 28 million individuals. There were 649,000 cases of various deaths due to alcohol. Here is a summary of the abbreviated outcome of the global health study. As you can see from this, there is no safe level of alcohol consumption as even small amounts of alcohol over a long period of time lead to significant damage in the body. You can prevent heart attacks to a certain extent. But instead people die from a ruptured aorta, from strokes or from heart failure. The leading cause of death for men and women age 15 to 49 worldwide was alcohol. It accounted for almost 1 in 10 deaths.

Some alcohol-related statistics

The following were the observations in the study.

Over 300 disabilities and diseases were directly related to alcohol consumption. The findings were collected in 195 countries, classified by age and sex. The data was gathered between 1990 and 2016.
Globally, 2.4 billion people drink alcohol. 25% are women who consume 0.73 drinks on average each day, 39% are men drinking 1.7 drinks a day.
Denmark, Norway and Germany drank the most alcohol globally.
For ages 50 and up the leading causes of death were: road injuries, suicides and tuberculosis.

More statistics

Most deaths caused by alcohol came from cardiovascular disease and cancer for all countries.
When you look only at drinkers, the standard recommendation of the American Heart Association regarding low alcohol consumption seems true. But the new study compared non-drinkers with drinkers. From this it is clear that even one drink a day has a risk of premature death.
At the age of 40 cutting down long-term alcohol use will add 1 to 2 years of life expectancy.
For all ages 2.8 million people die globally every year from alcohol related diseases.
Half of the world does not drink at all. This means that the ones, who drink, consume double as much as the statistics show.
Americans prefer beer. They drink about 27 gallons of beer, 2.6 gallons of wine and 2.2 gallons of spirits per adult/year.

Common clinical conditions from alcohol consumption

Binge drinking is the consumption of 5 drinks or more in an evening for men or 4 drinks for women. The CDC is concerned about binge drinking, because of its association with significant organ damages. There are 4 major concerns regarding these effects. Heart disease and cancer; diabetes; memory loss and appearance. In the following I will zero in on these alcohol-related conditions.

Heart disease

As this article pointed out above, there is a very limited protective effect, but mostly in above 55-year-old women who drink in moderation (1 glass of alcohol; per day). They have some protection from developing heart attacks, because their LDL cholesterol gets lowered and their clotting system is influenced in positive ways. But 6% of breast cancer in women is due to the effect of alcohol consumption, which is a downfall. For both men and women binge drinking is what kills. Binge drinkers who drink more than 100 grams of alcohol per week (more than 7 drinks in the US) experience increased deaths. The causes are heart failure, strokes, fatal hypertensive disease and fatal aortic aneurysm, where the main artery bursts. Apart from that alcohol-related pancreatitis and liver cirrhosis can kill as well.

Cancer

A relatively new finding is that alcohol has a close relationship to causing various cancers. Alcohol weakens the immune system. Also, alcohol has a negative influence on the bacterial composition, the microbiome in our digestive tract. This can be a cause for colon cancer. Liver cancer, mouth cancer and breast cancer also has a direct relationship to increased alcohol consumption. Esophageal cancer and laryngeal cancer are also related to alcohol consumption.

Diabetes

Alcohol can stimulate the pancreas to release insulin, which may give you hypoglycemic attacks. As alcohol contains empty calories, over the course of several years alcohol consumption can add to your weight, causing obesity and type 2 diabetes. As diabetes has detrimental effects on the heart and blood vessels, this mixed with alcohol consumption, can worsen cardiovascular disease thus increasing the risk for heart attacks and strokes.

Memory loss

In the beginning of chronic alcohol consumption you may enjoy the relaxing effect of alcohol. This is merely the toxic effect of alcohol on brain cells. Alcohol has the effect of inhibiting brain cells, which makes you feel relaxed, super-sociable and even silly. In reality you are starting to loose control. After several years of this effect you are left with feelings of anxiety, depression and anger. This is when trouble starts to occur. People out of control are more likely to get into fights and get injured or killed. People can develop blackouts where they do not remember parts of the evening or an entire event. Memory loss is starting. The hippocampus is an important part of the brain that is involved in processing short- term memory into long-term memory. A form of dementia can occur that was brought on by chronic alcohol overconsumption.

Appearance

Alcohol dries out the skin cells and body cells. The face gets wrinkles. Your skin looks parched and gives you the appearance of a prematurely aged person. Alcohol can interfere with your sleep and when you have a lack of it you end up with dark circles around your eyes as well as puffy eyes. It does not make for a good picture, whether it happens inside the body or on your skin!

No Amount Of Alcohol Is Good

Conclusion

A new study that was larger and more comprehensive than any previous study has exposed the myth that one drink for women and two drinks for men would protect you from heart disease. It may protect you from heart attacks, but it definitely does nothing to protect you from other heart conditions. There is also sudden death from heart failure, a rupture of the aorta (aneurysm), high blood pressure that kills (fatal hypertensive disease) and stroke. When you factor all that in as well, even your low, moderate alcohol consumption has health risks. The global health study, funded by the Bill and Melinda Gates Foundation looked at the burden that alcohol puts on 195 countries. The combined study population was 28 million individuals.

Alcohol related deaths and diseases

649, 000 registered cases of various deaths occurred due to alcohol. This included deaths from traffic accidents, injuries, cancer, heart disease and suicide. This global study compared the life expectancy and disease frequencies of alcohol-consuming people with non-alcohol consuming people. It concluded that non-alcohol consuming people live on an average up to 10 years longer than their alcohol-consuming counterparts. No studies up to now have been that comprehensive. The results from twenty-eight million people speak for themselves, and the death statistics are clear. It is worthwhile to look at the details and draw your own conclusion.

Sep

2018

The Best Foods For Your Heart

By Ray Schilling | Cancer, Cardiovascular disease, cholesterol, coffee, diet, fiber, fish oil, Fitness, food, green tea, heart attack, Heart Disease, Nutrition, omega-3 fatty acids, Stroke, sugar, Vitamins and supplements

In the following I will describe 16 foods, which are the best foods for your heart. I will also comment as to why I believe they are best. This review is based on this article in “Medical News Today”.

But I have added many other comments to it.

Heart disease is still the number 1 killer. We need to change what we eat.

Vegetables

The regular intake of green leaf vegetables and cruciferous vegetables (broccoli, cauliflower and cabbage) has an association with the preservation of cognitive function. In the Nurses’ Health Study starting in 1984 women were asked about their usual intake of a specified portion of food items, including 15 fruits and 28 vegetables. At a later date, between 1995 and 2001, researchers decided to ask the oldest participants (70 years and older) to participate in a cognitive function study. Two years later researchers repeated these tests.The main finding of the study is that women with the highest intake of green, leafy vegetables had the least decline in their cognitive function. The vegetable lovers, who consumed five serving of cruciferous vegetables, like broccoli, cabbage and cauliflower had less decline in their cognitive function. On the other hand the highest decline showed up in the group that averaged only 2 servings per week.

Asparagus

Asparagus is a source of fiber, folate, multiple vitamins and chromium. Chromium enhances the function of insulin to transport sugar into cells. Asparagus contains glutathione, a powerful antioxidant that neutralizes free radicals and carcinogens. It is said to help prevent lung cancers, larynx cancer, and bone, breast and colon cancers.

Berries

Berries like strawberries, raspberries, blackberries and blueberries are full of bioflavonoids. These are antioxidants, which prevent cardiovascular disease.

It is the anthocyanines, which prevent oxidation of LDL cholesterol. Berries also have bioflavonoids and reduce lipid formation in the blood. Berries contain fiber, folate, iron, calcium, vitamin A, and vitamin C.

Broccoli

This fiber rich vegetable helps to prevent hardening of the arteries. Broccoli and kale likely have preventative effects against colon cancer.

Chickpeas, beans, peas and lentils

Legumes or pulses are a great way to consume plant-derived protein. People who are on vegan diets should be eating them for a protein source. They also contain lots of fiber, vitamins and minerals. We know that they lower cholesterol, which prevents heart disease. Other healthy nutrients they contain are bioflavonoids, which have antioxidant properties and help prevent cardiovascular disease.

Dark chocolate

This is a food rich in antioxidants. Dark chocolate is chocolate with more than 70% cocoa content. Please note: “milk chocolate” is nothing better than candy and devoid of any health benefits. Dark chocolate increases the protective HDL cholesterol and prevents oxidation of LDL cholesterol. It is said to prevent atherosclerosis (hardening of the arteries). Don’t exceed eating 1 to 2 oz. per day, as chocolate has some sugar in it and the fat content would be detrimental with higher consumption.

Chia seeds and flaxseeds

Chia seeds and flaxseeds are rich in omega-3 fatty acids in the form of α-linolenic acid (ALA). ALA reduces LDL cholesterol and it dissolves plaque in the arteries. ALA also reduces blood pressure to a certain degree. All of this helps reduce cardiovascular disease (heart attacks and strokes). Note that flaxseeds must be ground to powder to release the nutrients from its tough shell. Both chia and flaxseeds can be used as an egg replacement in vegan cooking.

Fish high in omega-3s

Omega-3 fatty acids are abundantly present in fish. It has plaque-reducing properties and also reduces the risk for abnormal heart beats. Overall this means less cardiovascular disease. The American Heart Association recommends a 3.5 oz. serving of fatty fish (salmon, mackerel, lake trout, herring or sardines) twice per week.

Coffee

A Brazilian study from 2018 showed that drinking 3 cups of coffee a day would stop coronary artery calcification. Many other studies have shown reduced mortality from heart attacks and strokes with increased coffee intake.

Green tea

Green tea is known to reduce blood pressure slightly and to reduce cholesterol. Both effects are beneficial for the cardiovascular system (prevents heart attacks and strokes). Green tea also prevents many cancers. Whatever we know about coffee consumption seems to also be true for green tea consumption.

Nuts

Nuts contain healthy fatty acids (omega-3). But they also contain fiber, protein, minerals, vitamins and antioxidants. Use them in desserts, in salads and as a quick food on the go. They are definitely healthier than protein bars.

Liver

Liver is one of the nutrient rich foods. It is rich in iron, phosphorus, vitamin A, folate, vitamin B12 and biotin.

Oatmeal

Oatmeal is rich in soluble fiber. It has been shown to lower LDL cholesterol and total cholesterol. This is important for prevention of heart disease.

Red wine (may be)

The bioflavonoids of red grapes have been the subject of much research. There is a dose-response curve showing a protective effect with regard to heart attacks and strokes with the consumption of 1 to 3 glasses of red wine per day. But unfortunately there is also a dose-response curve with respect to alcohol consumption and cancer causation. Personally, I take resveratrol from the health food store, 500 mg daily and consume white wine or red wine very rarely.

Tomatoes

There are a number of beneficial phytochemicals in tomatoes. Carotenoids like lycopene, lutein, zeaxanthine and beta-carotenes are helping to prevent prostate cancer and colon cancer. Potassium and folate are cardioprotective.

Spinach

Eating spinach regularly will provide you with magnesium, iron and bioflavonoids. Magnesium is good for a regular heart rhythm. The other nutrients are good for skin, bone and hair health.

Discussion

I have reviewed why these 16 foods are the best foods for your heart. We have seen that many foods that are rich in antioxidants are also cancer preventative. People who eat a Mediterranean diet will get these 16 foods, because their meals are balanced with nutrients. But if you eat a hamburger or a pizza you will not get balanced nutrients. The more one-sided your food intake, the more dangerous your lifestyle becomes. This is the problem with the Standard American diet (“SAD”). You need all of the components of the 16 foods described here. Junk food won’t do, as it consists only of empty calories.

The Best Foods For Your Heart

Conclusion

It is useful to review healthy foods as was done above. Now it is a matter of including them in your daily food intake. If this is overwhelming you, start with baby steps. One or two healthy foods here or there are a good start. Increase this until you cover all the 16 foods mentioned. The more balanced your food intake is, the more antioxidant vitamins you will get. And the more heart disease and cancer prevention you will experience.

Apart from good, balanced nutrition we also need regular exercise for heart disease and cancer prevention. Go to a gym, go for a walk, climb some stairs. Get away from the computer and television. Together with best foods for your heart this will keep you healthier for longer.

Sep

2018

Moderate Carb Intake Has The Lowest Mortality

By Ray Schilling | diet, exercise, heart attack, lifestyle, Mortality, Nutrition, Stroke

A 25-year long study has shown that a moderate carb intake has the lowest mortality. A comprehensive study from the US has followed more than 15,000 men and women for 25 years. They were between 45-64 years when they entered the study and they were from diverse socioeconomic backgrounds. The authors chose mortality as an end point. Dr. Sara Seidelmann is a clinical and research fellow in cardiovascular medicine from Brigham and Women’s Hospital in Boston. She was the lead author of this study. The research group used food questionnaires and analyzed the carb content in the food. They also determined what percentage of the food composition was of animal origin or plant origin.

Research study finds moderate carb intake has the lowest mortality

The main findings of the study were that less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. On the other hand, more than 70% of carbs in the diet also had increased mortality rates of 1.2-fold. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%. Dr. Seidelmann explained that in terms of life expectancy the result of the study could be summarized as follows. A 50-year-old person had another 33 years to live when carb intake was in the moderate range. The low-carb person had only another 29 years to live (4 years less than the moderate carb person). The high-carb person lived another 32 years, 1 year less than the moderate carb person.

Plant-derived versus animal-derived fat and protein

The study showed that there was increased longevity when carbohydrates were exchanged for proteins and fats from plant sources. Mortality was 18% less for this group. Conversely, when carbs were replaced for animal-derived fat or protein mortality was 18% more!

Dr. Seidelmann noted that this study was coming from a US based population. In the case of an Asian group they would consume much more carbs on average, but they would replace a lot of the animal fat and protein with fish. Fish is a healthier source of protein and fat than beef or pork.

A moderate carb intake group that used protein and fat from animal sources was compared to plant sources. When protein and fat had the origin from lamb, beef, pork, and chicken the mortality over 25 years was higher. When protein and fat came from vegetables, such as nuts, peanut butter, seeds and whole-grain breads there was a lower mortality rate.

Other studies comparing the effect of animal protein versus plant protein

A 2016 study that had gone on for 49 years was involving 131,342 participants. Animal protein intake showed an association with higher mortality from heart attacks and strokes. 3% of energy from processed red meat was now substituted by an equivalent amount of plant protein. This reduced the all-cause mortality by 34%, for unprocessed red meat by 12% and for egg by 19%.

Red meat is cancer-producing. Several studies have shown this. When red meat is digested, cancer-causing substances are released that can be the cause of cancer in the lining of the stomach and the colon. The above link says we should limit red meat consumption to 65 grams (2oz.) per day or 2 servings (130 grams or 4 oz.) 3 to 4 times per week. We should avoid eating more than 455 grams (1 pound) of lean red meat per week.

Triglycerides are an independent risk factor for heart attacks

In this publication evidence is also present that triglycerides are an independent risk factor that can cause heart attacks.

When you eat too many carbs, the body produces the excess you don’t need into triglycerides, and it deposits its subsequently as fat in fatty tissue. Physical activity burns up some of the triglycerides. But when we eat too much refined sugar and starchy foods, there will be an excess of triglycerides putting our blood vessels and our hearts at risk.

Regular exercise prevents disease and premature deaths

Many studies have shown that regular exercise prevents heart attacks and premature deaths. We even know the mechanism of why this is so. Exercise releases nitric oxide ((NO) from our blood vessels, which widens the arteries. This also prevents high blood pressure. Exercise elevates the protective HDL cholesterol. When regular exercisers were compared to a non-active group they had a 41% lower risk of death. All-cause hospitalizations were down by 21% and cardiac hospitalizations were down 32%.

Discussion

Barry Sears is the inventor of the Zone Diet. I attended a lecture in 2001 at an Anti-Aging Conference in San Diego. Dr. Sears was the keynote speaker at this conference. He stressed that a diet with 55% of complex carbs would be the best diet. It is interesting that Dr. Seidelmann in the study mentioned in beginning of this blog found the same thing. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%.
The second point that is important to note is that it matters whether we eat protein derived from animals or from plants. Even small steps help. When we reduce our animal protein intake by only 3% of the energy intake, and replace it by plant protein, there is a significant reduction in mortality.
Exercise is rarely mentioned in relation to diets. But exercise needs to be included every day and you will experience a reduction of cardiac hospitalizations of 32% as mentioned above.

Moderate Carb Intake Has The Lowest Mortality

Conclusion

A moderate carb intake, as is the case in the Mediterranean diet and in the Zone Diet of Barry Sears, has the lowest mortality rate. Complex carbs (in vegetables) are absorbed much slower. As a result the risk for heart attacks is much lower. The opposite is true for refined carbs from sugar. They cause heart attacks and strokes with premature mortality. Dr. Sara Seidelmann led a study at the Brigham and Women’s Hospital in Boston that lasted 25 years. Less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. These diets are paleo-type diets, the Atkins diet and the ketogenic diet. More than 70% of carbs in the diet also had increased mortality rates of 1.2-fold.

The healthiest diet

People who consumed a diet where carbs were between 50% and 55% had the lowest mortality rate (Zone Diet). Another finding of this study, which was confirmed by others is that animal-based protein is unhealthier than plant-based protein. Even replacing 3% of energy from an animal-based diet with plant-derived protein delayed mortality significantly.

If you want to live longer and stay healthy you need to critically evaluate what you eat.

Sep

2018

Two Proteins Responsible For Getting Epilepsy

By Ray Schilling | epilepsy, neurological disease, seizure disorder

Epilepsy is sometimes difficult to control, but research has now identified two proteins responsible for getting epilepsy. According to the researchers this finding has the potential of turning our current knowledge about epilepsy upside down.

How the brain works and seizures originate

The brain is an accumulation of a myriad of nerve cells that are connected with an equal number of nerve fibers.

The communication from one end of the brain to the other end occurs via electrical signals. They have their origin in the nerve cells and travel through the nerve fibers at an astonishingly fast rate.

The nerve cells of the brain also have a connection to the muscles, organs and skin. This is achieved with the help of nerve fibers. They travel through the spinal cord and peripheral nerves to reach the end organs. Again the transmission of these communication signals are through electrical impulses. Usually these signals are perfectly balanced by inhibitory nerve cells, whose job it is in the spinal cord and throughout the brain to keep these electrical signals under control.

Unfortunately some people are not so lucky. They have a “low seizure threshold” and a fever or stress can trigger a seizure or epilepsy. This is a state of the brain where activated parts are overruling the inhibitory parts and an epileptic seizure or partial seizure results. In the case of a grand mal seizure the person may be unconscious for a brief period of time while the muscles have shaking spells. It may start with involuntary muscle twitching around the eyes, the patient becomes unconscious and may fall down onto the ground. The patient may bite the tongue, stop breathing, shake arms, then the trunk muscles and finally both legs. Around 1 in 100 people get epilepsy, and it is mostly children and people above the age of 65 who get it.

New research regarding two proteins responsible for getting epilepsy

Rochelle Hines led a team of neuroscientists from the University of Nevada, Las Vegas in this research. They investigated two proteins involved in inhibiting the central nervous system. In the past it was thought that an overstimulation of nerve cells would have caused electrical overstimulation of the central nervous system causing epilepsy. Now this new research showed that it is two proteins that are missing. Normally these proteins suppress the electrical nerve activity that leads to epilepsy.

First of all, gephyrin is a protein that regulates GABA receptors. GABA is a brain hormone that calms the brain. Another protein, called collybistin is a regulator of the localization of gephyrin.

Different approach to study epilepsy will find better medications

Rochelle Hines and her team found two key proteins, gephyrin and another protein, the alpha-2 subunit of the GABA receptor. They found that they have to interact with each other in order to calm the brain. If this does not occur, seizures (epilepsy) can occur. The emphasis of this research was on finding ways to stimulate the inhibition of the GABA receptor system. In the past the emphasis was to generally calm down the entire brain with medications. This caused a lot of side effects because the traditional anti-seizure medications do not target a specific area of the brain. Now scientists can work with the two key inhibitory proteins, gephyrin and the alpha-2 subunit of the GABA receptor. At this point a new medication is not yet available, but certainly when the development of it is complete, it will be more specific and have fewer side effects.

Some citations from the lead researcher, Rochelle Hines

“Regulating this ‘compartment’ of proteins in the brain that controls cell signalling may lead to better therapies for stopping or preventing seizures. If we can better understand the activity of the brain pattern, we can understand how it might go wrong in a disorder like epilepsy, where brain activity becomes uncontrolled. And if we can understand what is important for this control, we can come up with better strategies for treating and improving the quality of life for people with epileptic seizures and maybe other types of disorders as well, such as anxiety or sleep disorders.”

It is interesting to me that seizures and anxiety maybe the same process in the brain. While with anxiety the brain is irritated, it is still controlled. In contrast in the case of epilepsy the control of the GABA system is gone and the brain excitation is uncontrolled. Medication that will increase the proteins gephyrin and the alpha-2 subunit of the GABA receptor is badly needed.

Two Proteins Responsible For Getting Epilepsy

Conclusion

Epilepsy and seizure disorders appear to now be due to a lack of inhibition in the central nervous system. Two proteins that work on the inhibitory GABA receptors hold the key. They are gephyrin and the alpha-2 subunit of the GABA receptor. There are mouse strains that are deficient for these proteins, and they come down with epilepsy. The human brain has the same proteins that are necessary to inhibit the brain. In anxiety disorders it seems like there is a mild loss of these inhibitory proteins. In contrast with epilepsy the deficiency of these hormones is more severe. Researchers are now concentrating on developing new drugs or modifying existing drugs to stimulate the production of these inhibitory proteins. The hope is that these medications will have fewer side effects, because they will be more receptor specific.

Sep

2018

Cell Phones Can Cause Cancer After All

By Ray Schilling | Cancer, leukemia

Re-investigation of whether or not cell phones can cause cancer revealed that cell phones can cause cancer after all. This publication comes from the Journal “The Guardian”. It turned out that for 25 years the cell phone industry managed to suppress scientific evidence of cancer. In many experiments scientists found brain cancer and adrenal gland cancer in rats from exposure to electromagnetic fields. Regulatory authorities based their statements on fake experiments that showed no apparent effect of EMF (electro-magnetic fields) on animals. There were never any human trials. But 25 years ago cell phones received a “clear signal” though in retrospect that was wrong. Now it turns out that this is one of the biggest human mass experiments.

Human cancer statistics

Exposure to radiation from an atom bomb can indeed bring on brain tumors. This Australian study investigated brain cancer rates in the 1980’s and in the early 2000’s. The conclusion was that cell phone exposure was about the same in the 1980’s and the early 2000’s. Brain tumors were also the same. But at the bottom of this review the authors show some interesting statistics about Hiroshima. Brain cancers are shown as bar graphs in people who suffered exposure to the radiation of Hiroshima. The bar graphs compared brain cancer statistics between 31 years after Hiroshima and 41 to 50 years after Hiroshima. There still was a clear increase of brain tumors in the population 41 to 50 years after Hiroshima.

Long lag time

This is because brain cancer has a long lag time between radiation exposure and actual brain cancer occurrence. The prominent Sydney neurosurgeon, Dr. Charlie Teo said that there can be a long lag period of 10 to 20 years for electromagnetic frequencies (EMF) to cause brain cancer. EMF also has the name EMR (electromagnetic radiation). If one takes into account that EMF is much weaker than radiation from an atom bomb, the lag period of causing brain cancer could be much longer than what Dr. Teo assumed.

An international study found that gliomas were 40% more common in high cell phone users than in low cell phone users. For meningiomas the high cell phone users had 15% more meningiomas than low cell phone users. A previous British study assuming a lag period of 10 years found no gliomas in children and young persons as I reported 12 years ago. But this data might change with a lag period of 20 or 30 years or longer.

Political manoeuvres

The cigarette industry did not want to admit that cigarette smoke was causing lung cancer. In a similar vein the cell phone producers attempted to suppress any negative information about their products. They have been suppressing information that found any biological effect of EMF on tissues. And they funded studies that showed no effect by EMF.

The Guardian states: “The key strategic insight animating corporate propaganda campaigns is that a given industry doesn’t have to win the scientific argument about safety to prevail – it only has to keep the argument going. Keeping the argument going amounts to a win for industry, because the apparent lack of certainty helps to reassure customers, fend off government regulations and deter lawsuits that might pinch profits.” By pursuing this strategy over 30 years the industry has been very successful to undermine any scientist who found that cancer of the brain and cancer of the adrenal glands can occur after prolonged exposure to EMF.

What is the truth about EMF?

The National Cancer Institute

The findings of the National Cancer Institute review are that there is no evidence that the exposure rate or intensity of EMF is strong enough to pose any risks to children or adults. It did acknowledge that exposure to living within 1 kilometer of high voltage power lines could cause leukemia in children. But EMF exposure is not comparable to EMF from these high power lines. The problem with the attitude of the National Cancer institute is that they don’t mention how the lag period can delay the occurrence of cancer by several decades. In other words, their observation time was cut short, and they simply concluded prematurely that EMF could not cause cancer.

World Health Organization

The WHO has done a thorough review of the world literature on the topic of EMF and possible effects on humans. It did acknowledge that the top 10% of heavy cell phone users are at a higher risk of gliomas and meningiomas as mentioned above. EMF exposure has to last for at least 10 years for this to occur. But the vast majority of cell phone users show no effect on the brain or elsewhere. The WHO makes the point that brain cancers may be more common, if EMF exposure to a person is 10 years or longer. The International Agency for Research on Cancer has classified EMF as “possibly carcinogenic to humans”. It means that more exposure, longer duration of exposure, and closer tissue contact with EMF could cause cancer.

Cancer literature supports that cell phones can cause cancer after all

In a website by Prof. Keith Scott-Mumby several factors come up that support the notion that EMG is capable of causing DNA damage to cells given the right circumstances.

Children are much more vulnerable in their brains than adults to get brain cancer. As a result, when children play with cell phones and other gadgets that emit EMF they will be more likely to develop brain cancer later in life.
Acoustic neuromas in the auditory nerve are 5-fold more likely to develop in children than in adults.
Swedish researcher, Prof. Lennart Hardell presented a talk at a cancer conference, which stated the following: People who started to use cell phones before the age of 20 had a 5-fold risk to get gliomas, which is a brain cancer type.
Other research showed that exposure of children to EMF from cordless phones in a household caused a 4-fold higher risk of developing gliomas later in life than controls who did not have EMF exposure.
Keith Scott-Mumby also stated that brain tissue of children absorbed EMF twice as much as adults do, and similarly, bone marrow of children absorbed EMF 10 times as much as adults do.
An Indian study in 2005 was comparing people who had no EMF exposure with people who used a cell phone for 1 to 15 hours per day. DNA damage was measured from buccal scrapings (the lining inside the cheek). The controls had only 4% of DNA damage. The frequent cell phone users had DNA damage in 39.75% of their buccal scrapings. We know from other literature that the first step to developing cancer is a mutation of the DNA. After a certain lag period cancer can develop in tissue with mutated DNA.

Cell Phones Can Cause Cancer After All

Conclusion

EMF, the low-grade radiation of electronic gadgets like i-phones, cell phones in general and cordless phones, has an effect on our body cells. We are not aware of this effect. But the body knows on a cellular level that part of our DNA has been damaged. Fortunately, we do have protective mechanisms in place that safe us from most of these damages. But children who are not fully developed yet are at a disadvantage. Their bone marrow and brains are much more prone to develop various types of leukemia and brain cancers. This is why it makes sense to limit their exposure to EMF emitting devices.

At this point the government institutions have not developed recommendations what to do about this problem. The industry has no interest in providing guidelines, as they want to sell more gadgets and increase their market share.

Add to this that even the wiring in a house is sending out weak signals of EMF, which is added to all of the other effects of EMF from cell phones, TV and computer use. We need to rethink our exposure to EMF and balance our lifestyle with other activities where we are not subject to this exposure.

We also need to eat an anti-cancer diet, like a Mediterranean diet. This diet has shown to be an anti-inflammatory and antioxidant diet preventing cancer. All of this can balance our exposure to EMF and offer us preventative measures to stay healthy.

Aug

2018

The Downside Of Living To 100

By Ray Schilling | Alzheimer’s disease, Arthritis, back pain, Cancer, Cardiovascular disease, chronic pain, Dementia, depression, Diabetes, diet, Drugs, exercise, Fitness, fractures, heart attack, High Blood Pressure, Infectious Disease, mitochondria, Mortality, Obesity, osteoarthritis, Osteoporosis

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

Aug

2018

Poor Diet Habits Can Cause Alzheimer’s

By Ray Schilling | Alzheimer’s disease, Dementia, diet, exercise, food, Heart Disease, High Blood Pressure, Inflammation, Nutrition, Obesity, Smoking

A new study from the Brock University in St. Catharine’s, Ont. showed that poor diet habits can cause Alzheimer’s. Specifically the risk for Alzheimer’s was a combination of high saturated fats in the diet in combination with too much sugar.

The third triggering factor was the normal aging process that also contributed to the development of Alzheimer’s.

The study showing that poor diet habits can cause Alzheimer’s

Master student Bradley Baranowski and PhD student Kirsten Bott conducted the experiments under the supervision of Assistant Professor of Health Sciences Rebecca MacPherson. The experimental group consisted of middle-aged mice that were observed for 13 weeks. They received a high-fat/high-sugar diet. The control group received a normal diet.

The experimental group with the high fat/high sugar diet was aging prematurely. They also showed elevated inflammatory markers, elevated insulin levels and cellular stress. Dr.MacPherson mentioned that the middle-aged mice would be comparable to humans aged 40 to 60. “[We’re] trying to see what the initiating signals are that can lead to progression of Alzheimer’s disease,” MacPherson said.

Lifestyle choices matter

“People often view Alzheimer’s disease as a genetic disease when in fact, genetic mutations leading to Alzheimer’s accounts for less than five per cent of cases,” Baranowski said in the press release. “This study highlights that our lifestyle choices matter and can potentially put us at risk of developing or progressing neurodegenerative diseases such as Alzheimer’s.”

Other studies that support the concept that lifestyles matter

Over the years many other researchers have analyzed what factors contribute to getting Alzheimer’s. It probably is a combination of several factors.

Age

Age is one of the major risk factors. Most Alzheimer’s patients are above the age of 65. Above 65 the risk doubles every 5 years. By the time we are 85 our risk is 1/3 to get it.

Family history

If you have a parent, brother or sister who came down with Alzheimer’s, you have a higher risk of getting it.

Environmental factors

Often environmental factors like eating too much sugar or too much saturated fat are confused with family history factors. Nutritional habits in a family can be like a tradition. It may appear as if this is a family history of Alzheimer’s when in reality poor eating habits were passed on from generation to generation. A lot more research is necessary in this area.

History of Head injury

A history of a closed head injury carries with it a higher risk of Alzheimer’s later in life. We need to use seat belts in cars and helmets when bicycling. Avoid risky sports activities where you would sustain a traumatic brain injury.

Heart disease

There is a link between heart disease, diabetes, stroke, high blood pressure, high cholesterol and Alzheimer’s. When brain arteries get clogged, the brain deposits more beta-amyloid protein as plaques. This is a sign of early Alzheimer’s disease.

Older Latinos and older African Americans

Older Latinos have a 1 ½-times higher risk than older whites to get Alzheimer’s and dementia. On the other hand older African-Americans are 2-times more likely than older whites to come down with Alzheimer’s. The reason for this is not entirely clear. But a big factor likely is the cardiovascular risk that is higher in Latinos and African Americans. This translates into a higher risk for Alzheimer’s.

Prevention of Alzheimer’s disease

There are more publications that point out that Alzheimer’s disease is largely preventable by cutting out those factors that contribute to its development.

Here is a list of steps to follow in order to prevent Alzheimer’s disease.

First of all treat diabetes, high blood pressure and obesity aggressively. This eliminates cardiovascular risk factors, which keeps the brain vessels open.
Furthermore quit smoking. By preserving the cardiovascular system the brain stabilizes.
Another important factor is physical activity: exercise daily! This maintains cardiopulmonary fitness. It also keeps your brain vessels open.
Also, take care of your diet: eat balanced meals and avoid junk food. A Mediterranean diet or the MIND diet are examples of diets that help prevent Alzheimer’s. Note that these are low sugar and low saturated fat diets. This fits the initial observation that you read in the beginning of this blog. Mice on a high fat/high sugar diet showed premature aging and developed Alzheimer’s. Knowing this, it is good to do the opposite: cut out excessive saturated fats and sugar. Sugar increase LDL cholesterol and triglycerides, which leads to hardening of arteries.
Mental stimulation is another important factor for preventing Alzheimer’s. With lifelong bilingualism there was a delay of about 4.5 years in onset of dementia. The ACTIVE study is in the link above. It showed that mental stimulation could indeed delay the onset of Alzheimer’s over a 10-year period.

Poor Diet Habits Can Cause Alzheimer’s

Conclusion

Above all, I cannot emphasize enough how important a healthy diet is for a healthy mind. The combination of an overabundance of saturated fats and refined sugar was found to be the cause of premature aging in mice. But likewise, we know from human trials that this also causes premature aging in humans and higher incidence of Alzheimer’s. As a result, it is logical to recommend a lower intake of saturated fat and to reduce sugar intake. It will prevent hardening of the arteries and slow down the development of Alzheimer’s.

But there are many other recommendations to avoid getting Alzheimer’s: quit smoking. Stay physically active by exercising daily. Use a Mediterranean diet or the MIND diet to prevent Alzheimer’s. Clinical trials with these diets have shown them to be effective. Treat diabetes, high blood pressure and obesity aggressively as this will stabilize your metabolism. As a result it also prevents Alzheimer’s. Finally, stimulate your brain every day by doing various activities. This forms new synaptic connections inside your brain and postpones Alzheimer’s from setting in as you age.

Aug

2018

HPV Testing For Cervical Cancer

By Ray Schilling | Cancer, cervical cancer, Prevention, Women’s Diseases

HPV testing for cervical cancer is more sensitive than the traditional Pap test. For years physicians recommended the traditional Pap test once a year to prevent cancer of the cervix. But a few years ago a new cervical cancer screening test, namely the HPV test made the news. It stems from the observation that cancer of the cervix develops in 99.7% of women who test positive for the HPV virus. There are many types of HPV, here we are interested in the few subtypes that produce cancer (carcinogenic HPV virus).

Transmission of the HPV virus between men and women

The human papilloma virus transmits from males to females through bisexual contact. The problem starts when he develops HPV lesions on his penis. Without him wearing a condom, the contact with her cervix during sex can transmit HPV to her cervix. Both partners are not aware of the transmission of that virus, as it does not cause any symptoms. HPV invades the superficial skin layer of the cervix in the woman. In the man HPV will invade the skin of the glans of the penis. After certain incubation time it causes transformation into cervical cancer in the woman. Strangely enough it does not cause cancer in the male. However, in both sexes HPV virus is in the mucous membranes and can contaminate the other sex’s genital.

A recent study comes from UBC Vancouver, British Columbia, which compared the Pap test with HPV testing.

Details of the Vancouver study on HPV testing for cervical cancer

On July 3, 2018 this study appeared in the medical journal JAMA.

19,009 women were part of this randomized clinical trial. With HPV testing only 2.3 cases per 1000 women of early cervical cancers were present four years later. Using the traditional Pap test this figure was 5.5 cases per 1000 women after 4 years. 224 clinicians participated in this study. Women were recruited for this study from January 2008 to May 2012. Follow-up took place till Dec. 2016. The participating women in this study were 25 to 65 years of age.

In 2017 in the US there were still 12,820 women in the United States who got cancer of the cervix. Approximately 4210 are dying from this disease every year. Many women do not like to take the Pap test or the HPV testing. There are compliance problems with either one of these tests.

Significance of this trial regarding HPV testing for cervical cancer

The newer HPV testing was superior to the regular Pap test. The HPV test was more sensitive and resulted in much lower cancer rates after 4 years of follow-up. Every woman would have an HPV test every 4 years. In this case we likely would see cervical cancer go to the bottom of cancers that kill women. The reason for that is that HPV testing and colposcopy pick up cancers much earlier. This leads to a more effective treatment of cervical cancer. After 4 years much less cancer of the cervix was found when the researchers tested again using HPV testing.

Implications of HPV testing for cervical cancer

In third world countries

Many 3^rd world countries do only the HPV testing. At the time when this decision was made, it was unknown that they had actually chosen the better method to test for cancer of the cervix. Now this trial reassures all the health care providers in 3^rd world countries that they should continue with the program, and they only have to do the test every 4 years, not every 2 years, which makes it even more cost effective.

Implications for the US

In the US so far the recommendation was to do both the regular Pap test and the HPV test simultaneously. This trial, however, says that this is not necessary. It would be better to use the more sensitive HPV test and abandon the more expensive and less sensitive PAP test. In 2012 a taskforce recommended to do the Pap smear in women age 21 to 65 every 3 years. The taskforce further recommended to women age 30 to 65 that they screen with a combo of cytology and HPV testing every 5 years. The lead investigator, Dr. Ogilvie said: “Offering women HPV [testing] for cervical cancer screening detects more precancerous lesions earlier, and also a negative HPV test offers more assurance that women will not develop precancerous conditions in the next four years,” she said. “This can mean that women may need less frequent screening but have more accurate results.”

What other doctors are saying about HPV testing for cervical cancer

Comments by Dr. Kathleen Schmeler

Dr. Kathleen Schmeler said that the study was “well-designed” and provided a much-needed comparison of Pap versus HPV testing. She is a gynecologic oncologist and at The University of Texas MD Anderson Cancer Center. She was part of the new research. Dr. Schmeler added: “The bottom line is that this could really potentially simplify how we screen women and have it be more effective and not quite as complicated and burdensome — and opens the door for doing just HPV testing, which is actually what’s currently recommended by the World Health Organization for countries that don’t have Pap testing capabilities,”

Comments by Dr. Stewart Massad

Dr. L. Stewart Massad Jr. is a professor of obstetrics and gynecology in the division of gynecologic oncology at Washington University School of Medicine. He wrote an editorial to the study in the JAMA. He wrote: “What will replace the Pap test? In 2012, the American Cancer Society endorsed co-testing with cervical cytology testing and HPV testing at 5-year intervals as the preferred strategy for screening women 30 to 65 years of age because this approach combines the sensitivity of HPV testing with the familiarity of traditional Pap testing,” He then went on to say: “However, the addition of cervical cytology testing adds little to the accuracy of HPV testing while increasing cost and false-positive results. In 2018, organizations that develop cancer screening guidelines are wrestling with whether to recommend replacing co-testing with primary HPV testing as the optimal screening strategy.”

Future dilemma

In view of all those comments the regulatory agents will have to come up with solutions for what is in the best interest of women for testing for cervical cancer.

HPV Testing For Cervical Cancer

Conclusion

A large randomized clinical trial in Vancouver, BC, Canada has compared screening methods for cancer of the cervix in women. Half of the subjects underwent screening by the newer HPV tests that checks for the presence of HPV virus. The other half received conventional screening by the Pap test (a cytological screening test.) The result was that the HPV test was more sensitive and resulted in less early cancer tests 4 years down the road. With the conventional Pap test there were more than double the amount of abnormal cells present 4 years down the road, which makes the Pap test less safe compared to the HPV test.

It appears from this trial that the Pap test is no longer a choice, except for colposcopy procedures that take care of early cervical cancers. But for screening in general HPV testing every 4 years is all what every women needs for her protection.

Phage Therapy Against Superbugs

By Ray Schilling | Infectious Disease

Introduction

Phage therapy against superbugs is the latest concept in treating infections. Antibiotic resistance has developed into a huge clinical problem. Every year in the US about 2 million people have infections from antibiotic resistant bacteria, and 23,000 people die as result of it. Certainly, there is a desperate need to find alternative treatment options to treat antibiotic resistant infections. One such option is to use phages, a specific form of viruses to treat antibiotic resistant bacteria. Here is a scientific overview regarding the use of phages for the treatment of antibiotic resistant infections.

History of phages

The observation of phages attacking bacteria goes back more than 100 years. The French Canadian microbiologist, Félix Hubert d’Herelle (1873–1949) described in 1917 what bacteriophages are. He also coined the term of “phage therapy” for the treatment of bacteria with phages. Dr. d’Herelle recognized phages to be virus-like organisms that attacked bacteria and could kill them. When Fleming detected antibiotics, phage research came to a halt. Drug companies invented more and more antibiotics, as it was easier to kill bacteria this way. But now with emerging resistances of bacteria to antibiotics, there is a sudden revival of the 100-year old research on phages. The problem is that there has not been much clinical experience with phage therapy against super bugs until lately. In 1923 Dr. d’Herelle co-founded the Eliava Institute in what is now Tbilisi, Georgia. This institute has the world’s most comprehensive database on phage therapy in man.

Two clinical examples of phage therapy against superbugs

Chronic prostatitis due to superbug

Pranav Johri, a Canadian of Indian descent was suffering of a chronic prostate infection. Physicians had used five different antibiotics, but all to no avail. His doctor told him that he had a chronic prostatitis problem for which there was no cure. But Pranav saw another specialist who determined that Pranav had a prostatitis due to a superbug, which was resistant against all the common antibiotics. Pranav traveled to the Eliava Institute in Tbilisi, Georgia. He paid 6000.00 CAD and had three treatments. After the first treatment his temperature became normal for the first time in months, and his chronic pain subsided. He and his wife were so excited that they felt like celebrating. They did sightseeing, went out to restaurants and enjoyed their travels, all things he was unable to do for months. Pranav had finally received a cure with phage therapy to his chronic prostate infection.

Enteric infection due to superbug

Tom Patterson who had visited Egypt in 2015 together with his wife fell ill on the last night of his holiday. Eventually he went into a hospital in his hometown, San Diego. The doctors told him that he would likely die. He had acquired a multi-antibiotic resistant infection. He was slipping in and out of consciousness. His wife, Steffanie Strathdee, an infectious disease epidemiologist, remembered having heard about phage therapy during a virology class during her training in Toronto. Tom received two separate phage cocktails that two separate research teams in the US had prepared for his condition. He received the first dosage into his abdomen.

Intravenous phage therapy

The second administration was intravenously. There are only a handful of patients who had received treatment with phage therapy in the US; he is probably the first one who received phage therapy intravenously. A few days later he woke up. He had to relearn basic life skills like swallowing and speaking. But he made a full recovery from a serious disease with multi-antibiotic resistant bacteria. The University of California San Diego School of Medicine had helped Tom to recover from his illness. They announced at the end of June 2018 that they would be opening the Center for Innovative Phage Applications and Therapeutics in San Diego.

Modern phage technology

Basically phages are viruses that specialize in killing bacteria. They exist in nature wherever bacteria grow and help that they do not over-proliferate. But they can be useful in fighting difficult to treat bacterial infections as well, like pseudomonas ear infections, Clostridium difficile gut infections or Methicillin-resistant Staphylococcus aureus infections in skin wounds. In the former Soviet Union and in the Eliava Institute in Tbilisi, Georgia, extensive phage research has accumulated valuable data over decades. In the West physicians relied on the power of antibiotics, and phages stayed on the back-burner of the research lab.

Genetic engineering of phages and toxins produced by phages

Combining phage research and genetic engineering research we are entering a new era of manufacturing biological compounds that can kill bacteria similar to antibiotics. Here is a review article of this new exciting field. I only include this link to show that researchers are now getting a handle on phages. They can be genetically modified to specifically attack one kind of bacterium. The DNA of the phage can be isolated and injected into bacteria. I do not expect you to understand all of what is discussed in this link.

Phage Therapy Against Superbugs

Conclusion

As a result phages are more and more in use to treat difficult chronic infections where bacteria have become resistant to multiple antibiotics. It requires a team of experts who are familiar with phage cocktails. The cocktail is a careful combination of various phages that will fight the antibiotic resistant infection.The composition of it has to be according to the bacteria present in the patient’s bacterial flora. As shown with two clinical examples very sick patients can recover relatively quickly from their chronic infections. After this breakthrough more and more centers for phage therapy will open and this should help reduce the death rate from antibiotic-resistant infections.