Medical Articles by Dr. Ray

Mar

2008

Kids With Sleep Apnea May Need Surgery

Obstructive sleep apnea can have a significant impact on those who suffer from it. The condition is often ignored or dismissed with the comment that the sleeper is just “a bad snorer”. What will be alarming to a parent is the fact that children with the condition called “obstructive sleep apnea” stop breathing periodically throughout the night and snore very loudly. Another consequence may be a child who is chronically tired and as a result is doing poorly in school. Ron Mitchell, MD, professor of pediatric otolaryngology at St.Louis University likens the impact of obstructive sleep apnea on the quality of life to conditions similar to chronic asthma or rheumatoid arthritis. In normal weight children the condition stems from the enlargement of tonsils and adenoids, which can aggravate upper airway collapse during sleep. Obstructive sleep apnea affects boys and girls equally.

About 2% to 4% of children aged 4 to 6 have the condition, but Dr. Mitchell suspects that the number is probably higher, as parents don’t always recognize and report the problem.

Kids With Sleep Apnea May Need Surgery

For those children in whom sleep apnea is caused by the enlargement of tonsils and adenoids surgery, a tonsillectomy and adenoidectomy, provides dramatic relief. The study from St. Louis University found that it was successfully resolving sleep problems for 80% to 90% of affected children.

More information about adenoids: http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/nose-problems/adenoids/

Reference: February 13, 2008 issue of The Laryngoscope

Last edited November 3, 2014

Mar

2008

High Death Rate In India Due To Smoking

By Ray Schilling | Cancer, Heart Disease, Infectious Disease, Lung Disease

Dr. Prabhat Jha of the Centre for Global Health Research, Toronto has published research regarding the risk of mortality associated withs smoking in India, involving data from 1.1 million Indian homes. Data of deceased individuals, all of them in the age group between 30 and 69 years of age, showed that 37% of the men and 5% of the women had been smokers, and smoking doubled the risk for both sexes due to medical causes. Smoking did not only rate as a risk for lung and respiratory cancers but also for tuberculosis, vascular and respiratory disease. Smoking as a causal relationship was estimated to be responsible for 1 in 5 deaths in men and 1 in 20 deaths in women. With the population growth in India the number of death in the age group of 30 to 69 related to smoking is estimated to increase by 3% per year. Currently available data suggests that the rate of smoking is high especially among men in India. Data from other nations show, that smoking bans in public places are effective in turning these statistics around. Italy used to be one of the European nations, where smoking in public was common and as a result the exposure to second hand cigarette smoke was not only an inconvenience but a serious health risk. Cardiovascular events like heart attacks showed a decrease among men and women in Italy after the smoking ban in public places was put into effect in 2005. The findings were related to the improved indoor air quality.

High Death Rate In India Due To Smoking

There was an increase of sales in stop smoking aids like nicotine replacement products. Sales of cigarettes showed a decrease. Giulia Cesaroni from a local health unit in Rome remarked that even a small reduction in the incidence of cardiovascular disease can have enormous public health implications, as coronary artery disease is the leading cause of deaths in Italy. Compared to before the ban heart attack rates of middle aged (35- to 64-years) Italians dropped by 11%, 65- to 74-year-olds had a reduction of 8%, but those in the 75-84 year age group showed no benefit (as coronary artery disease in them likely was irreversible).

More information about:

1. Chronic obstructive pulmonary disease: http://nethealthbook.com/lung-disease/chronic-obstructive-pulmonary-disease-copd/

2. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/

3. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

References: The Indian data based on www.nejm.org (February 13, 2008); the Italian study was published in Circulation 2008 (Feb. 11)

Last edited November 3, 2014

Mar

2008

U.S. Dietary Guidelines May Have Contributed To Obesity

By Ray Schilling | Nutrition, Obesity

Dr. Paul Marantz of the Albert Einstein College of Medicine, New York has taken a closer look at the current obesity epidemic. He and his coauthors are observing that Americans have listened to the recommendations to reduce their fat intake. This recommendation which first made its appearance in 1980 pointed out the risk of a high fat diet and its connection to cardiovascular disease. Even though there is enough evidence that a modification of fat intake could reduce cholesterol, the government guidelines against fat have not managed to improve cardiovascular disease outcome. The authors of the publication noted that Americans have slightly reduced their fat intake, but their carbohydrate and total calorie intake have actually increased. The consequence is logical: higher calorie intake is contributing to the rise in obesity and the increase in adult onset diabetes. Dr. Marantz drew on records from the Centers for Disease Control and Prevention to arrive at these results. From 1971 to 2001 fat intake has decreased by 9% in women and 5% in men, but carbohydrate intake went up by 6% in women and 7% in men. Total daily caloric intake went up by 335 calories in women and by 168 calories in men. Both genders showed an increase in obesity. While 55% of men and 41% of women were overweight or obese in 1971, by 2001 the rate had risen to 70% in men and 62% in women. The reasons for this are very likely due to many factors. Aggressive marketing of low-fat foods may have given the public the impression, that these foods can be consumed without consequences.

U.S. Dietary Guidelines May Have Contributed To Obesity

Obesity on the rise since the 1970’s

Another reason likely is that fat in the diet can induce satiety and stop us from eating excess calories. It has not helped to label fat in the diet as an enemy instead of pointing out that small amounts of heart healthy fats in the daily diet are an important part of our nutritional team players and allies in the quest to good health. Key to successful dieting is to consume a low fat diet, rich in unrefined, low glycemic carbohedrates. Caloric intake has to be restricted for successful weight loss.

More information about:

Refined carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

Metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: American Journal of Preventative Medicine, Feb. 8, 2008

Last edited November 3, 2014

Sep

2007

MS Vaccine Breakthrough

By Ray Schilling | Multiple sclerosis, Prevention

One of the great hopes associated with genetic research is the goal to combat disease. With the human genome project completed it is now possible to look at new therapies. The work remains large and seems to be overwhelming, but a new vaccine for MS represents a major triumph. MS has been an illness that has devastated individuals and their families. It also has vexed and frustrated researchers and health professionals. Immunomodulating therapy with interferon has been able to make a difference in the quality of life for many patients, but so far it has been a seemingly impossible dream to find a vaccine that is safe and effective.

Montreal research, which has been published in August, confirms that the vaccine works by reducing the numbers of the immune system cells attacking the nerve fiber sheath. MS belongs to the groups of autoimmune diseases, meaning that cells of the own immune system turn against other body cells and destroy them. The challenge has been to stop these cells. So far immunomodulators have been looked at as an answer to this problem. This breakthrough represents a first in the history of medicine where a DNA vaccine will be used in the treatment of an autoimmune disease, which is MS.

MS Vaccine Breakthrough

Other autoimmune diseases are lupus or rheumatoid arthritis. No vaccine is available for these diseases, but the first DNA vaccine represents hope for many, that more therapies will become available.

As this review shows, the DNA vaccine experiment against MS failed, because in clinical trials it did not stop MS lesions from growing: http://multiple-sclerosis-research.blogspot.com/2012/01/research-myelin-dna-vaccination-and.html

More information about MS: http://nethealthbook.com/neurology-neurological-disease/multiple-sclerosis/

Reference: National Review of Medicine, August 30, 2007, page 10

Last edited November 3, 2014

Sep

2007

Weight Loss Surgery Reduces Mortality

By Ray Schilling | Diabetes, Heart Disease, Nutrition, Obesity

Excessive bodyweight contributes to a host of illnesses. Diets and lifestyle changes, physical activity and exercise programs can contribute to successful weight loss, but for a group of patients morbid obesity remains a significant problem. Weight loss surgery, also known as bariatric surgery has been on the increase.

Opinions about the usefulness of bariatric surgery have been divided. Often it was seen as a heroic effort with lots of risks and questionable benefits. In some procedures patients did not show significant weight loss, and there were some doubts whether the risk of surgery was worth taking.

Dr. Lars Sjoestroem of Gothenburg University has a detailed study on 4,047 Swedish patients with obesity, of which 2,010 underwent bariatric surgery, while 2,037 received non-surgical treatment. The two groups were compared for overall mortality after 11 years. The non-surgical control group lost little or no weight. The bariatric surgery patients did better. The most successful group was the one which received gastric bypass surgery with a weight loss of 25%. Vertical-based gastroplasty patients lost 16% of their weight, and those who underwent gastric banding lost 14% of their weight over 10 years.

Gastric bypass surgery

At follow up the overall mortality was significantly decreased in the group that underwent surgery. Death risk from disease which is associated with obesity, such as coronary artery disease was significantly decreased by 56%. The risk of death from diabetes was decreased by 92% and the risk of death from cancer also showed a reduction of 60%.

US data show similar results of a decrease in long-term mortality in obese patients who underwent bariatric surgery and lost weight.

More information on weight loss: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/weight-loss/

Reference: August 23, 2007 issue of The New England Journal of Medicine.

Last edited November 3, 2014

Sep

2007

Ginseng Lowers Risk For Common Cold

By Ray Schilling | Infectious Disease, Lung Disease, Nutrition, Prevention, Vitamins and supplements

In Chinese medicine the ginseng plant has been widely used. Its history in North America seems to be shorter at first glance, as it received more attention only, as Chinese medicine and acupuncture have become popular over the last decades. The Asian variety of ginseng known under its botanical name as Panax ginseng is only one of the species. There is however a variety which is native to the eastern part of the North American continent with the botanical name Panax quinquefolius. The first people using it were various Native American groups. They found it useful for childbirth and fertility. It was also used to help those with shortness of breath.

Ginseng root was considered the more valuable part of the plant, and new research has found that root extracts of the North American ginseng have an influence on the immune system. The substance enhances the production of interleukin and interferon-gamma. The immunomodulary effects which can help in the prevention of respiratory disease have also been studied in clinical trials involving older adults.

It turned out that the likelihood of developing acute respiratory illness was significantly lower in the group that was treated with a standardized formulation of 200 mg ginseng extract twice a day than in a group that did receive placebo or no treatment. It was also observed that the number of patient who had common colds was reduced in those who received ginseng. The absolute risk reduction of recurring common colds was 12.8 % and the total number of days with cold symptoms was 34.5% lower in the treatment group.

Ginseng Lowers Risk For Common Cold

Long term studies are still outstanding, but based on the interim findings ginseng extract taken in the winter month can be beneficial especially in the older population as a weapon against respiratory illness.

More information on:

1. Preventing the flu: https://www.askdrray.com/fighting-back-against-the-flu/

2. General info on ginseng: https://www.askdrray.com/studies-show-ginseng-works/

Reference: J. Altern. Complement. Med. 2006;12:153-7.

Last edited November 3, 2014

Sep

2007

Emotional Distress Impairs Cognitive Function

By Ray Schilling | Heart Disease, Mental Health, Prevention, Stress management

Stress has been linked to numerous medical conditions, such as heart disease, stomach problems and muscle spasm. Stress also has been quoted as a silent killer.

Research in the field of Alzheimer’s has shown that negative emotions and chronic distress are associated with increased vulnerability to this disease.

Study author Dr. Robert Wilson of the Rush’s Alzheimer’s disease Center in Chicago has found that people most prone to psychological distress were 40% more likely to develop mild cognitive impairment (MCI) than the group that is least distress prone.

Dr. Wilson stated that these individuals would not necessarily see a psychiatrist to help them deal with their negative emotions. It becomes clear, however, that persistent negative emotional states truly impact the physical well being, and also the cognitive status. For this reason more medical attention should be given to an older patient with emotional problems and even mild depression.

Emotional Distress Impairs Cognitive Function

It can become a treatment challenge, if there are personality traits or deeply entrenched behavior patterns that may not respond well to treatment. By understanding the biological link between chronic distress and loss of cognitive function in old age, early intervention can be a way to delay symptoms or to prevent disease onset.

More information on Alzheimer’s: http://nethealthbook.com/neurology-neurological-disease/alzheimers-dementia-and-delirium/

Reference: The Medical Post, August 7, 2007, page 53

Last edited November 3, 2014

Sep

2007

Gene Identification Helps To Screen for Diabetes Risk Of Juvenile Diabetes (type 1 diabetes)

By Ray Schilling | Diabetes, Hormones, Prevention

Gene therapy is the new buzzword in a hope for cure of disease, and genetic tests also assist in predicting the risk for disease.

These predictions are reaffirmed by research that comes from McGill University in Montreal under Dr. Constantin Polychronakos, a professor of pediatrics and human genetics. A new DNA chip has been used for testing the genetic makeup that produces diabetes type 1 (also called Juvenile Diabetes). So far the analysis has confirmed four previously identified genetic locations that contribute to the development of diabetes 1, and the test identified a new location occupied by the gene.

With the research team working on the discovery of all the remaining genes, they are confident to develop a test which will predict the risk of developing diabetes. According to Dr. Polychronakos the findings will influence future treatment options. The most promising treatment for those already diagnosed with diabetes1 are stem cell regenerative treatments, such as islet transplantation, since the Langerhans islets are responsible for the production of insulin in the pancreas.

Gene Identification Helps To Screen for Diabetes Risk Of Juvenile Diabetes (type 1 diabetes)

Family tree for inheritance of type 1 diabetes

These therapies will only work if the immune system is also treated, so the patient does not suffer a relapse of the disease. Once all the diabetes genes are identified, there will not only be fast screening but also therapies that can be targeted more effectively.

Reference: The Medical Post, August 7, 2007, page 1 and 60 of the Medical Post

More on genetics and diabertes: http://www.who.int/genomics/about/Diabetis-fin.pdf

Last edited December 5, 2012

Aug

2007

More Fiber in Diet Lowers Diabetes Risk

By Ray Schilling | Diabetes, Health, Nutrition, Vitamins and supplements

Skipping breakfast seems to be nothing unusual for many individuals. Busy lives and hectic schedules contribute to a rush in the early morning. It has been emphasized by several articles, that breakfast is indeed important for a healthy jumpstart of the day. A German study which has been published in the May 14 edition of the Archives of Internal Medicine points out more clearly why breakfast may well be the most important meal of the day.

More than 25,000 adults were enrolled in a study, which found that the intake of fiber can be an effective nutritional tool to reduce the risk of developing type 2 diabetes. The connection between type 2 diabetes and the intake of cereal, fruit, vegetable and associated fiber intake, also the intake of soluble and insoluble fiber and magnesium were closely examined. During the seven year period of follow-up 844 cases of diabetes 2 were identified.

The study found that the consumption of 29 grams per day of soluble fiber was associated with a significantly lower risk of 21% less diabetes. Soluble fiber, including pectin is mostly found in fruit, vegetables and legumes. Roughage alone such as wheat bran, whole grains and brown rice was not associated with a lower diabetes risk.

Once the source of fiber was broken down according to origin (fruit, vegetable or cereal), the study found that the participants who consumed the highest part of cereal fiber had a 28% lower risk of diabetes compared to those who had the lowest amount of cereal fiber intake. High magnesium intake was associated with a 23% lower risk.

More Fiber in Diet Lowers Diabetes Risk

It has to be stressed that not every breakfast cereal qualifies as a source of high cereal fiber. Consumers must become educated and be aware of the fiber content in food servings to ensure that they are getting the necessary amount to reap the benefits.

More information on:

1. fiber in diet (also helps with metabolic syndrome): http://nethealthbook.com/hormones/metabolic-syndrome/

2. diabetes (type 2): http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference: May 14, 2007 Edition of the Archives of Internal Medicine

Last edited November 3, 2014

Aug

2007

Alcohol Can Be Culprit in Irregular Heart Beat

By Ray Schilling | Heart Disease, High Blood Pressure, Prevention, Substance abuse

Dr. Gregory M. Marcus, an electrophysiologist at the University of California, San Francisco gave a presentation at the Annual Meeting of the Heart Rhythm Society about the effect of alcohol on the heart in younger people. This convention took place at the Colorado Convention Center at Denver/Co. where from May 9 to 12, 2007 about 11,000 physicians and scientists gathered to discuss the newest in irregular heartbeats (arrhythmias) and new treatments. Dr. Marcus found that in persons younger than 60 years of age one alcoholic drink per day could lead to atrial fibrillation (=atrial fib) or to atrial flutter. He found in persons older than 60 years he was not able to show a statistically significant risk effect of alcohol, but he pointed out that in this older population there were other risks like older age by itself and hypertension, both of which were independent risk factors for atrial fib/atrial flutter.

This was a case study where 195 consecutive patients with atrial fib/atrial flutter were studied. 2/3 of them were 60 or younger. There were also 185 controls with 75% who had supraventricular arrhythmias and 25% with healthy hearts. There was a linear dose-response curve between number of alcoholic drinks consumed per day and atrial flutter. With atrial fibrillation there was a tendency in this way, but it had not reached quite statistical significance. This study is the first one to show that in the younger age group there is sensitivity, at least in those who came down with atrial fib or atrial flutter, of the conductive nerve fibers in the atrial wall tissue to the effects of alcohol. Alcohol seems to reduce the effective refractory period of atrial tissue. Dr. Marcus called this the arrhythmogenic effect of alcohol.

Alcohol Can Be Culprit in Irregular Heart Beat

One drink a day can cause atrial fibrillation

It is not clear at the present time how to balance the cardioprotective effect of moderate alcohol intake against this newly found arrhythmogenic effect. Also, why would the younger age group be more vulnerable to this effect than the older generation? Is there perhaps a subpopulation of more sensitive patients? These are unanswered questions, but at any rate it is important that those who had atrial fibrillation or atrial flutter refrain from alcohol, as they have shown to be especially sensitive to this arrhythmogenic effect.

More information about irregular heart beats: http://nethealthbook.com/cardiovascular-disease/heart-disease/irregular-heart-beats/

Reference: Dr. Gregory M. Marcus at the Annual Meeting of the Heart Rhythm Society

Last edited November 3, 2014

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