Medical Articles by Dr. Ray

Aug

2007

Nicotine Addiction Found More Often in Impulsive Behavior

By Ray Schilling | Heart Disease, Lung Disease, Mental Health, Prevention, Substance abuse

Why do major depression and nicotine addiction often occur together in middle aged people? This is what Dr. Qiang John Fu, assistant professor of community health in biostatistics at Saint Louis University School of Public Health, asked himself and he conducted a study involving 3,360 pairs of middle-aged, predominantly Caucasian twins to find out. Twin studies are a powerful tool to sort out environmental factors from genetic factors. In this particular study the twins had served in the Vietnam war and 45% were fraternal, the rest were identical twins. With identical twins 100% of the genes are identical while the fraternal twins share about half of the genes.

The researchers found that a group of twins who were addicted to nicotine also had a behavioral disorder, called conduct disorder. This can be well defined with psychological tests and is characterized by behaviors such a stealing, fighting, vandalizing, running away from home and drug addiction (including addiction to nicotine). They were also the ones who were much more vulnerable to develop major depression. As published in the June issue of Twin Research and Human Genetics Dr. Fu, MD, PhD, the lead researcher explained that he found a set of genes that are responsible for the development of major depression and for addiction to nicotine.

Nicotine Addiction Found More Often in Impulsive Behavior

Major depression and nicotine addiction are linked through a gene

These individuals attempt to self-treat depression with cigarette smoking. Linked with this can also be the conduct disorder mentioned above. These findings may lead to newer approaches in terms of treatment.

Reference: June issue 2007 of Twin Research and Human Genetics

Last edited December 5, 2012

Aug

2007

New Cure For Drug Resistant Bacteria At The Horizon

By Ray Schilling | Health, Infectious Disease

Drug resistant bacteria (like MRSA, methicillin resistant Staphylococcus aureus) have developed in many hospitals and have caused more than 2 million infections in the US alone of which 90,000 people died. Yet so far research regarding this problem has been very slow and unsuccessful. In Canada there was an outbreak of E.coli, which left 14 people severely ill and simultaneously there was a similar outbreak in the US leaving three people dead.

Dr. Redinbo, PhD in biochemistry and biophysics, from the University of North Carolinaat Chapel Hill made an astounding discovery in his lab. He tested some of the older medications used for osteoporosis treatment, the biphosphonates clodronate and etidronate, to see whether they would have an effect on stopping the multiplication of these harmful bacteria. Dr. Redinbo’s work was published in the July 13 edition of the Proceedings of the National Academy of Sciences. Dr. Redinbo’s team found that an enzyme, called relaxase, is at the center of the development of antibiotic resistance. When resistance develops, there is a genetic transformation that takes place, like a mini Darwinian selection process where the most resistant bacteria survive and multiply. The resistant bacteria mate with each other and with bacteria that are not yet resistant. This process involves the relaxase enzyme system, some DNA stranding and a strand exchange. In this way new resistant bacteria are formed. Experiments under the supervision of Dr. Redinbo found that this process can be stopped by the phosphate-rich compound, biphosphonates (clodronate and etidronate). Other chemicals were found to not be as effective.

New Cure For Drug Resistant Bacteria At The Horizon

The relaxase system is found in a number of problem bacterial strains, Staphylococcus strains, drug resistant Acinetobacter strains and others. Unfortunately the biphosphonates have some side-effects like stomach soreness and birth defects. The researcher said that he hopes that these drugs and perhaps others with less side-effect will offer new treatments for antibiotic resistant bacteria.

Reference: July 13, 2007 edition of the Proceedings of the National Academy of Sciences

Last edited December 5, 2012

Jul

2007

Estrogen In Early Menopause Saves Lives

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, Heart Disease, Hormones, Obesity, Stroke

Introduction

In the June 21, 2007 issue of the New England Journal of Medicine a randomized study of 8.7 year duration the question was examined whether postmenopausal women following hysterectomy would have a higher risk with estrogen replacement therapy than controls who did not take estrogen therapy. The lead author was Dr. JoAnn E. Manson of Harvard Medical School and the method chosen to examine the heart disease risk was a CT of the heart to measure calcium in plaque of coronary arteries.

Previous research had shown a good correlation of calcification of coronary arteries with the degree of hardening of coronary arteries as shown in this image.

Various doses of estrogen were used and overall there was a reduction of calcium scores in all of the groups ranging from 22% to 31% when the calcium scores of the estrogen treated patients were compared to the non treated controls. This translated into 36% to 64% less heart attack rates when the treated groups were compared to the controls not treated with estrogen.

Discussion regarding estrogen replacement therapy

The discussion regarding estrogen replacement therapy following menopause is not finished, but women can be reassured that the cardiovascular risk appears to not be as straight forward as research seemed to suggest in the recent past. There likely was a bias in these retrospective studies and the present prospective study is much stronger having been done over 8.7 years following randomization. As this study was done on patients who had previous hysterectomies, there is no concern about uterine cancer. Breast cancer risk was not examined in this study.

Estrogen In Early Menopause Saves Lives

The authors concluded that low dose estrogen replacement with 0.625mg of conjugated estrogen (Premarin) appears to be safe and has the most beneficial effect on coronary artery health when taken between the ages of 50 and 59. However, the authors also cautioned that estrogen would have multiple effects and may have negative effects on the cardiovascular system in some other way.

Reference: N Engl. J Med. 2007;356:2591-2602

Comment

Comment on Nov. 18, 2012: The real problem of this study is that the authors took the wrong “hormone replacement”, namely Premarin, which is a non-bioidentical estrogen concoction from horses, which translates into an ill fitting key. The human body’s estrogen receptors do not fit this “key”. The proper experimental set-up would have been to use bio-identical estrogen hormones, which are usually given as a cream and would be the perfect key for the human estrogen receptors. This would have to be balanced with bio-identical progesterone to achieve a balance the way it is in a younger woman. We know from other studies that this prolongs life by preventing coronary artery disease, prevents Alzheimer’s disease, prevents strokes and does not cause uterine cancer or breast cancer. Women on bio-identical hormone replacement also retain their normal sex drive.

See this chapter on menopause in the Net Health Book.

Jul

2007

Regular Exercise Will Delay Onset Of Alzheimer’s Or Dementia

By Ray Schilling | Alzheimer’s disease, Fitness, Prevention

Alzheimer’s and other types of dementia have become a disease that is dreaded by people approaching middle age. As the population ages it has made its way into the foreground not only for the ageing group but also for younger family members who will face difficult tasks as caregivers to their loved ones.

Research is dealing with a possibility of halting the disease progression, and there are encouraging signs, that more effective treatment will be available, as long as the condition is diagnosed and treated in its early stages.

It is also logical to look at preventative measures. Healthy lifestyle choices have been cited, and a closer look has been taken by Dr. Eric Larson, executive director of the Center for Health Studies of the Group Health Cooperative, Seattle. He reports that it does at this point not seem probable that Alzheimer’s dementia can always be prevented from happening, but the onset can be delayed. Four observational studies have shown with consistency, a 30% to 40% reduction in the incidence of Alzheimer’s when people get regular exercise.

In his own study Dr. Larson looked at 2581 individuals age 65 and over. They were tested for cognitive function and interviewed about their exercise habits every two years. It was found that those who followed an exercise regime 3 or four times per week had a 40 % reduction in the risk of developing dementia compared to those who exercised less than 3 times per week.

Regular Exercise Will Delay Onset Of Alzheimer’s Or Dementia

Exercise could consist of at least 15 minutes of hiking, aerobics, stretching, calisthenics, water aerobics, swimming, or weight training. It was also of interest to note that people with the lowest physical performance benefited most from the exercise. For people in the higher age bracket prevention of dementia (and other ills) does not have to be costly. A good pair of walking or running shoes (used more than 3 times per week) will pay a healthy dividend.

More information on prevention of Alzheimer’s and dementia: https://www.askdrray.com/dementia-prevented-with-diet-and-exercise/

Reference regarding the work of Dr. Larson: http://www.news-medical.net/news/2006/05/23/18087.aspx

Last edited December 18, 2014

Jul

2007

Asthma And Bronchitis From Exposure To Chlorinated Water In Infancy

By Ray Schilling | Allergies, Asthma, Lung Disease

Every new parent has the wish to stimulate infants in healthy development. Children’s programs are plentiful, whether they involve gymnastics and dance or toddlers play. It is no surprise that swimming classes are also offered, and parents are not only looking at the water fun but also at water safety. They want the best for their baby and make use of swim groups that are offered for babies and infants.

It turns out that it may be better to hold off on putting baby into swim classes at the public indoor pool. The water is fine, but the chlorination is the problem. It is common to see a irritation of the eyes due to chlorination, but data reported in the June issue of Pediatrics described findings from a group of 341 school children age 10 to 13, 13% of whom had participates in infant swimming programs point to damaging effects on the respiratory organs. Among others the respiratory condition of these children was assessed. The infant swimming group had signs of so-called Clara cell damage and changed permeability of the lining of the lung. The group that had been enrolled in infant swim groups also had significantly elevated odds of having chest tightness, physician-diagnosed asthma and exercise-induced airway constriction. The problems were aggravated even more, if the children were exposed to parental smoking.

Asthma And Bronchitis From Exposure To Chlorinated Water In Infancy

Chlorinated water exposure during childhood leads to asthma later in life

The researchers conclude that infant swim practice in chlorinated indoor swimming pools is associated with airway changes, which along with other factors can predispose children to the development of asthma and recurrent bronchitis. More research is recommended to examine the effects of chlorination products on the infant respiratory tract.

More information on asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

Reference: http://www.ncbi.nlm.nih.gov/pubmed/20075053 : Voisin C, Sardella A, Marcucci F, Bernard A.: ” Infant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy.” Eur Respir J. 2010 Jul;36(1):41-7. Epub 2010 Jan 14.

Last edited November 2, 2014

Jul

2007

Waist line reduction scores in health prevention

By Ray Schilling | Health, Hormones, Men's Health, Nutrition, Obesity, Prevention

To women waist measurement has always been of importance. Increased waist measurement and weight gain go hand in hand, and a poor fitting garment in the waist usually signals to cut out the junk food. In the past century extremely tiny waists became an unhealthy obsession, till common sense got the upper hand.

In the past males seemed to be unperturbed by a large girth and often ridiculed the opposite sex about their preoccupation with their waist lines. With more knowledge about the intricate play of metabolism increased waist circumference is a signal to health problems. It may be that a simple measuring tape can be one of the most helpful tools to predict a group of health problems in males. While type 2 diabetes, hypertension and high cholesterol and triglycerides are the problems that would first come to mind, there are more, namely coronary artery disease, prostate enlargement, a high prostate-specific antigen level, erectile dysfunction and ejaculatory dysfunction. Dr. Steven Kaplan, professor of urology at Cornell University, New York presented a study at the American Urological Association. Men with moderate to severe urinary tract symptoms were divided into groups based on their waist sizes, 30 to 36 inches, 36 to 40 inches and greater than 40 inches.

Waist line reduction scores in health prevention

Results surprised even the researchers. Metabolic disorders like diabetes showed an incidence of 11.25% in the first group, 22.3 % in the next higher group and 37.8% in the group with waistlines over 40 inches. Erectile dysfunction was seen in 34.6%, 49.5% and 78.6 % respectively. The percentiles for hypertension showed 12.6% in the first group, versus 24.7% and 37.8 %. The researchers stressed that male pelvic dysfunction and the derailment of metabolic function, also known as the “metabolic syndrome” are closely linked.

More information about metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Last edited November 2, 2014

Jul

2007

Incense Use Causes Cancer Of The Respiratory System

By Ray Schilling | Allergies, Asthma, Cancer, Lung Disease, Prevention

Incense use has been common in East Asia for a long time, but also in the Western world incense burning is not uncommon. It became very much “in” to burn incense sticks to create a certain “atmosphere” in a room. Incense burning during religious celebrations in some churches is a custom that goes back well over 1000 years. It is easy enough to observe, how a cloud of incense triggers a chorus of coughing and clearing of throats in a church ceremony. It has never been a laughing matter to people who suffer of allergies and asthma, as incense smoke –just like any other smoke- is a source of airway irritation.

But a bit of a cough and airway irritation are the smaller problems that long term incense use has in store. A study involving 61,320 Singapore Chinese showed that long term users had more than twice the relative risk of non-nasopharyngeal cancers of the upper respiratory tract, compared with people who did not use incense. The risk of squamous cell carcinomas of the lung rose 1.7 fold and the risk of squamous cell carcinomas of the entire respiratory tract rose 1.8-fold among long-term incense users, wrote Dr. Fribourg and his colleagues of the University of Minnesota, Minneapolis who conducted the study. The participants in the study were 45 to 75 years old and free of cancer when they enrolled in the study from 1993 to 1998. Living conditions, life style and dietary factors were examined and results were adjusted for a host of factors, such as cigarette smoking, alcohol intake, gender differences, and intake of Chinese preserved food.

Incense Use Causes Cancer Of The Respiratory System

The researchers also noted that incense burning is deeply engrained into the way of daily living in Southeast Asia. About half of the population burns incense at home every day. Incense smoke contains a large amount of particular matter and the burning releases many possible carcinogens including polyaromatic hydrocarbons, carbonyls and benzene.

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

Reference: First published June 21, 2007 and subsequently published in a 2008 journal.

Last edited November 2, 2014

Apr

2007

MRI Scan Finds Hidden Cancer in Opposite Breast

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

Approximately 1000 women from 25 cancer centers throughout the US who were recently diagnosed with breast cancer in one breast were all examined, radio graphed with conventional mammograms. They also received an MRI scan study of the opposite breast to make sure no hidden cancer would be overlooked. To the surprise of the investigators 1 in 10 women were found to have cancer in the opposite breast that would have conventionally passed as “normal”. More than 90% of these women were picked up with an MRI scan of the opposite breast that up to now would not have been part of the routine work-up. Dr. Elias A. Zerhouni from the National Institutes of Health (NIH) said that it would be a great break through to have a new technique of diagnosing these women with early cancer in the opposite breast. By diagnosing this condition early, the cancer treatment can be customized to the exact breast cancer stage improving survival significantly for these women.Dr. Constance Lehman, the principal investigator of this ACRIN Breast MRI Trial who is also professor of radiology as well as the director of breast imaging at the University of Washington and Seattle Cancer Care Alliance, pointed out that unnecessary bilateral mastectomies (= surgical breast removal) can be avoided in the 90% women whose opposite breasts were normal. At the same time the 10% of women who were accurately diagnosed with early breast cancer can be treated early and effectively.

MRI Scan Finds Hidden Cancer in Opposite Breast

This trial has been started in April of 2003 and follow-up examinations were done at 12-18 and 24-30 months. This already shows that the group of 30 patients diagnosed with breast cancer in the opposite breast has a much better survival than patients would have had in the past. However, the final figures will only be available several years into the future.

The cancer specialists in the US have estimated that in 2007 there will be approximately 178,480 women who will be diagnosed with breast cancer and about 40,460 will likely die from the disease.

Reference: The New England Journal of Medicine (NEJM), Vol. 356, No.13, March 29, 2007

Last edited December 5, 2012

Apr

2007

Disc Transplantation New For Herniated Disc

By Ray Schilling | Orthopedics, Pain

Back problems can be a source of chronic pain and it is a significant reason for disability in the general population. Often the patient lives with the problem, and treatment with pain killers or over the counter remedies proves to be useless. Once the symptoms are becoming more severe and there is a feeling of numbness that extends into the leg or foot, even the most stoic back pain sufferer will seek out medical advice. Tests such as a CAT scan or MRI scan will reveal that the reason for the chronic pain is a herniated disk.

The only treatment that could be offered has been a discectomy which is performed by an orthopedic surgeon. So far fusion surgery has been the modality of choice, which has the unfortunate consequence of predisposing patients to degeneration in other levels of the spine as the wear and tear following fusion surgery is higher at the adjacent levels.

Dr. Dike Ruan from the Navy General Hospital in Beijing reports about a new treatment in the form of disc transplantation instead of fusion. Artificial materials have been tested and the results have been very variable. Contrary to organ transplantation it is possible to work with donor material from non-related persons as the inert disk material does not cause transplantation rejection. The herniated disc is removed including the adjacent end plate and a fresh-frozen composite disk with end plate is introduced. Five patients who underwent the procedure had improved neurological status after three months. Also the bony union at the end plate was nearly complete after three months. Long term follow up, which continued for at least five years, continued to show improvement.

Disc Transplantation New For Herniated Disc

Contrary to organ transplants in which anti-rejection drugs have to be used, the disk transplants caused no immunological reaction. Motion and stability remained excellent, and only minor degenerative changes were observed after five years.

With further refinements, such disc transplants will likely become an effective alternative treatment for degenerative disc disease.

More information about disc herniation treatment suggestions: http://nethealthbook.com/arthritis/lower-back-pain/treatment-low-back-pain-2/disc-herniation-treatment-suggestions/
Reference: The Lancet, 2007; 369-993 and p.999

Last edited November 2, 2014

Apr

2007

Quick Test Predicts Sepsis

By Ray Schilling | Gastrointestinal Disease, Infectious Disease

One of the big risks for a patient undergoing abdominal surgery has been the threat of peritonitis, which means infection in the abdominal cavity. Apart from pneumonia, which can be another one of those life threatening diseases, peritonitis remains a severe threat even today, as it is accounting for roughly 60% of mortality in the surgical intensive care units. It is not the peritonitis itself that is the killer but the spread of the infection through the blood stream to vital organs. Once the vitals are affected, infection will lead to a general shutdown: multiple organ failure or septic multi-organ dysfunction syndrome known as MODS, which is what kills the patient.
Our ancestors could not control sepsis. Antibiotics had yet to be discovered. Today the main challenge remains a timely detection of sepsis. Once sepsis has overrun the body, even antibiotic treatment comes too late for the patient.
The best methods that are currently available for the detection of sepsis are CAT scans and fine needle aspiration. Both have their shortfalls: the CAT scan may be unavailable and fine needle aspiration can increase the infection risk. One biomarker, the C reactive protein has only a limited use to predict septic MODS, as C reactive protein levels show a sharp increase in the presence of surgical trauma, regardless whether there is infection or not. German research has tested another potential blood sepsis marker, procalcitonin. Unlike the C reactive protein procalcitonin levels are not affected by surgical trauma, but it shows an increase in the presence of bacterial or fungal infection. There is a rapid automated assay for procalcitonin, the Kryptor PCT essay. It can be completed in 20 minutes, which is important, as time is of essence in emergency situations. Among 82 recruited patients with peritonitis, more than half had infections due to E.coli. Nine had fungal infections. Procalcitonin levels were markedly higher in patients who later went on to suffer MODS. All patients in the study were tested within 96 hours of the onset of symptoms. C reactive protein levels were not useful in terms of a predictive value.

Kryptor PCT measures procalcitonin for quick diagnosis of sepsis

The test is useful for two purposes: it helps with the early detection of a septic condition, so treatment can start early. It also identifies patients who won’t develop septic MODS.The sensitivity and the accuracy of the test does not necessarily make it a true “sepsis marker”. Researchers believe that the degree of systemic procalcitonin reflects a weak immune system. The test picks up those patients who are susceptible to severe infections. As a result timely treatments can be started for them right away.

Reference: National Review Of Medicine, March 15,2007, page 3

Last edited December 5, 2012

Introduction

Discussion regarding estrogen replacement therapy

Comment

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Navigation Menu

Tags

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Tags

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Tags

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Tags

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

askdrray.com Insider

Recent Posts

Tags

A Survivor’s Guide to Successful Aging

Prostate Cancer Unmasked

Healing Gone Wrong – Healing Done Right

Medical Question Answered

Social Media Links

Certificates