Medical Articles by Dr. Ray

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

Apr

2007

Nitroglycerin Patch Helps Premature Babies

By Ray Schilling | obstetrics, Women’s Diseases

Nitroglycerine has been a tried and tested drug for patients who suffer from angina, but the chemical has other benefits: the drug can retard labor and delivery, if a woman is having premature labor. This result comes from research at Queen’s University Perinatal Research Unit at Kingston General Hospital, Canada. Other tocolytics, which is the term for labor delaying drugs, are also on the market showing comparable results, but the nitro patch had an advantage, as it significantly reduced morbidity during the neonatal period.

The researchers worked with 158 women who went into premature labor between 24 and 32 weeks of pregnancy. In a randomized trial they either received a transdermal patch of nitroglycerine or placebo. If contractions continued an hour after the patch was put on the skin, another one was added. The following day treatment was repeated. Delivery was delayed 10 days for all, and a very significant 23 days for those in labor before 28 weeks. Any prolongation of pregnancy closer to a term delivery is helpful, but the greatest significance applies to those, where labor starts before 28 weeks. This is the group of babies that are most at risk, says lead author Dr. Graeme Smith of Kingston General.

There may be two reasons for the overall benefits of nitroglycerin treatment. On the one hand nitroglycerine protects pregnancy in the most vulnerable group, where the mothers enter labor before 28 weeks. The other aspect may be that the nitro patch may be having effects beyond the labor-delaying properties such as better blood flow in the placenta, as there is enough of the medication that reaches the placenta.

Nitroglycerin Patch Helps Premature Babies

Dr. Smith reports that at this point there is no “gold standard” tocolytic in Canada. Tocolytics have shown little improvement and frequent side effects. Compared to other tocolytic medications the main side effect of the nitro patch has been a mild headache. In most cases it was not necessary to remove the patch. It is estimated that nitroglycerin is now used in about a third of Canadian centers.

Reference: National Review Of Medicine, February 28, 2007, page 5

Last edited December 5, 2012

Apr

2007

Red Meat Linked To Heart Disease In Diabetics

By Ray Schilling | Diabetes, Heart Disease, Nutrition

Red meat is one of the sources of protein, but doctors from the Harvard School of Public Health reporting in the January edition of Diabetes Care, that a type 2 diabetes diet should be lean in red meat.

Type 2 diabetics are at risk for subsequent coronary heart disease (CHD), and intake of iron rich food was significantly associated with a greater risk of fatal CHD. The results come from a prospective study of 6,161 women from the Nurses’ Health Study. All of these patients reported a diagnosis of adult onset diabetes, and they were followed between 1980 through 2000, which amounts to an impressive 54,455 person-years follow-up. Attention was paid to the food questionnaires, which were monitored for the consumption of iron and red meat such as beef, pork or lamb as a main dish, also for the use of beef in roast beef sandwiches and mixed dishes, hamburger, hot dog, processed meat and bacon. Note was also taken of other nutrients such as seafood and poultry.
Women with diabetes who ate the most iron in the form of heme found in red meats had a 50% increased risk of total coronary heart disease as compared to those with the lowest intake. The risk ratio with women was more obvious in post menopause when compared with pre menopause.

Red Meat Linked To Heart Disease In Diabetics

While lean beef may be a good protein food to the average population, type 2 diabetics might choose to cut back on red meat and processed red meat sources and replace it with a heart-friendlier choice. Fresh seafood, rich in omega -3 fatty acids, would rank high on the list of a healthy eating plan.

Reference: The Medical Post, February 20, 2007, page21

Last edited December 5, 2012

Mar

2007

Dental Signs Indicators for Celiac Disease

By Ray Schilling | Allergies, Dentistry, Gastrointestinal Disease

Celiac disease is a condition, where a person is unable to tolerate wheat products. In other words they have a wheat allergy. It is not enough to avoid the standard foods like bread and other bakery goods that contain wheat. Wheat makes its appearance in many foods and also in taste enhancers like monosodium glutamate. Alone for this reason it is important for a person with celiac disease to carefully read labels in order to avoid foods that contain gluten, which is the offending substance. Often celiac disease goes undetected for many years, but there are early signs that can help to take action sooner rather than later.

Dr.T.Malahias, D.D.S., a dentist from Groton, Conn presented his findings at a recent international symposium for celiac disease. He pointed out that there are signs that are visible in the dental enamel, which will already be present in childhood, once the permanent teeth appear at about age 6. The bilateral symmetrical markings are defects in the tooth enamel. they can be brownish, yellow or white and are most commonly seen on the central incisors. They give the tooth a mottled, non-shiny appearance. Patients with this appearance may also have problems with the delayed eruption of the permanent teeth. These markings are permanent, and even after following a gluten-free diet they will stay, as the development of the enamel started already in the third or fourth month of life. While there may be other reasons for this abnormality, celiac disease should be considered in the context of the patient’s history.

Dental Signs Indicators for Celiac Disease

Dental enamel defects may be the only signs of celiac disease

The results are quite significant in pediatric groups: in patients less than 12 years of age who had celiac disease the rate of enamel defects ran at 90% as compared to 44% of the others without celiac disease. People who have recurrent unexplained aphthous ulcers should take notice too. Five percent have been found to have undiagnosed celiac disease as a result of the constant and chronic overstimulation of the immune system by gluten substances. Once celiac patients start with a gluten-free diet, the ulcers will occur less frequently.

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Reference: Based on MD Consult News, January 31, 2007

Last edited November 2, 2014

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