Medical Articles by Dr. Ray

Dec

2006

Cinnamon And Multivitamins May Boost Fertility

By Ray Schilling | Health, Nutrition, obstetrics, Vitamins and supplements, Women’s Diseases

Prenatal vitamin supplements are the norm, as folic acid has been known to play a role in the prevention of neural tube defect. Generally they are taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard School of Public Health in Boston pointed out, that multivitamin supplementation has its place earlier than just after the pregnancy test has become positive. In one of the largest studies involving 18,000 married pre-menopausal women, regular use of multivitamin supplements were associated with a decrease of infertility. The key is in the regular use. Women who took two multivitamin tablets per week had similar infertility rates as women who did not take supplements at all. Those who took 6 or more multivitamins had a 40% lower risk of anovultation, a condition where no eggs are released by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront in reproductive medicine. One condition known as polycystic ovary syndrome (PCOS) is often a reason for infertility. It is one of the red flags that point to the condition of insulin resistance, and it manifests itself in menstrual irregularity and higher levels of androgens, often showing as increased facial hair. As the metabolism is headed for trouble, diabetes, high blood pressure, high cholesterol and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot study to see if insulin sensitivity in women with PCOS could be improved. Cinnamon, a well-known spice, has been known to have a favorable effect on the insulin response of the body. Researchers found that eight weeks of treatment with cinnamon extract significantly decreased fasting glucose and insulin resistance in women with polycystic ovary syndrome.

Cinnamon And Multivitamins May Boost Fertility

Dr. Jeff Wang who conducted the study reported that no side effects or adverse reactions were reported throughout the study period. If large-scale prospective studies confirm these findings, then recommending cinnamon as a dietary factor may be a simple, inexpensive lifestyle change that can be easily followed. Reducing insulin resistance is a key to improve the overall health status in patients with PCOS, and it ties in with reproductive health benefits as well.

More information about infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: The Medical Post, November 14, 2006, page 32

Last edited November 2, 2014

Dec

2006

Asthma Medication May Not Be Enough

By Ray Schilling | Allergies, Asthma, Prevention

Doctors at an asthma clinic in New York were puzzled as to why their patients were not getting better even after continued medical care. Even though the patients were compliant with their medications, they needed oral steroids and presented with more severe asthma attacks at the emergency department. Looking into the living conditions of the patient group that continued having problems provided some insight: they lived in housing units that were dilapidated. In a program in which St. Luke’s-Roosevelt Hospital and other clinics participated, with the help of legal services of an attorney law firm the hospital was getting help for patients, who lived in substandard housing. When a patient lived in a building with dust, mold, roaches or rodents, any amount of treatment for asthma was almost futile. Even though there were letters and phone calls from social workers to landlords, unacceptable conditions in these housing units were not corrected. One letter from the New York Legal Assistance Group finally did the job. In plain English the notice to the negligent landlord said: Clean the place up or see me in court.

Dr. Luis Chug at St. Luke followed up on the patients one year later. Patients who needed 18 courses of oral steroids could reduce the treatment to just 2 the year after the cleanup. Patients who had made 14 trips to the emergency department because of asthma attacks the year before made only 2 after the conditions were corrected. The overall asthma of the patients also improved. Ten patients were afraid to go to a lawyer to seek help. A year later their living conditions predictably had remained the same. Their asthma had not improved either. The legal action was cost effective, reported Dr. Chug. Each emergency visit cost the hospital about $470 in services, and each course of prednisone cost about $345. The patients do not pay legal fees. Instead the service is funded by grants from participating hospitals. The study shows very clearly how practical public health measures can be used to correct health problems. The legal processes available in New York City are not unique in North America, as many local and regional governments have statutes requiring proper building maintenance.

Substandard housing bad for asthma

The results are also relevant to asthma patients who are not struggling with substandard housing. Patients with asthma simply cannot get better, when they live among irritants and allergy causing substances. Dust, cigarette smoke, perfumes, home fragrances, vapors from household cleansers, animal dander from house pets or feathers from a seemingly cozy down comforter can be the culprits for patients with asthma that does not improve despite treatment.

More information about:

1. asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. mold allergies: https://www.askdrray.com/mold-allergies-often-overlooked/

Reference: The Medical Post, November 14, 2006, page 23 and 25

Last edited November 2, 2014

Nov

2006

Eat Your Salad Greens, But No Spinach

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

Spinach has traditionally been regarded as a healthy, green leafy vegetable and a valuable source of vitamins and minerals, in particular iron. The tedious chore of cleaning the tender greens and removing soil and sand traces has been taken care of by packinghouses. As a result, the consumer could purchase ready to eat spinach in plastic bags. These greens were a welcome ingredient for spinach salads or other dishes.
Lately all spinach has been recalled from the world’s largest producer of organic produce. Natural Selection Food has recalled a total of 34 brands that were distributed nationwide, and some of which were available also in Canada. Consumers are still being warned not to eat fresh spinach from the U.S., even though there have been no reported cases of ill effects or diseases in Canada itself. Problems have surfaced in September in form of food borne illness in the U.S. The culprit seems to be contamination with E. coli 0157:H7. Food borne illness can be serious. So far there have been 109 cases of illness in the U.S. and possibly two deaths. The worst affected area so far is Wisconsin, where 29 illnesses were reported and one person died of the disease.
As a result of this alert, salad mixes that contained a variety of greens including spinach leaves have also been pulled from the shelf. It should be mentioned that washing the spinach leaves does not make it safe to consume, as the E.coli bacteria stick to the leaves.
While it seems good-bye to spinach leaves for now, it remains important to eat your greens. Researchers at University of California in Los Angeles and colleagues at Louisiana State University analyzed the salad consumption based on the intake of salad, raw vegetables and salad dressing on 9,406 women and 8,282 men. The researchers also found from their studies that daily consumption of salad and raw vegetables is not the norm in any population group and even less prevalent among African Americans.

Eat Your Salad Greens, But No Spinach

There were data from lab tests on serum nutrient levels, and it showed that consumption of salads was positively associated with above-median serum micronutrient levels of folic acid, vitamin C and E, lycopene, and alpha carotene and beta carotene. All of these nutrients are important for healthy daily functioning. They are weapons that help fight infection, heart disease and cancers. The consumption of salad and raw vegetables remains the most effective strategy for increasing the intake of important nutrients.

Reference: The Medical Post, October 3, 2006, page 21

Here is a follow-up on this story: Apparently the outbreak was caused by a wild boar and by a nearby cattle field: http://www.foodsafetynews.com/2009/09/meaningful-outbreak-7-dole-spinach-e-coli-outbreak/#.VFaWXPTF-88

More information about food safety: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/food-safety/

Last edited November 2, 2014

Nov

2006

Body Can Fight Weight Loss

By Ray Schilling | Nutrition, Obesity, Weight loss

Embarking on a weight loss program needs long-term commitment and persistence. Many dieters have experienced the yo-yo effect of good initial results in losing weight, after which the weight loss stopped, and gradually the weight was gained back. Often dieters blame themselves for their lack of success or are criticized for a lack of self-control.
The “plateau effect” has been discussed and documented before, and now an Australian study has found that “it is not just you”. After initial success and weight loss the human body is designed to strongly resist attempts to lose weight. Dr. Neil King from Queensland University of Technology does research on appetite regulation and energy balance. He conducted studies on groups of people who were overweight and obese people. He found that weight loss from exercise and calorie restriction stops at a certain point, and this plateau remains firmly in place for a prolonged time, despite continuing dieting and exercise.

In the first study 30 obese men and women from Britain took part in a 12-week, laboratory based exercise program in which they exercised five times a week. The second study observed the weight loss in 200 Australian men who were enrolled in a commercial weight loss program, which involved both an exercise program and dietary advice. Although both groups followed different plans, their weight loss still plateaued. The first group averaged a loss of 3 kg during the first 8 weeks, and weight loss in the next 4 weeks was markedly reduced (0.7 kg). The second group had a variable pattern of weight loss, but it, too, showed a plateau.

Body Can Fight Weight Loss

Researchers believe that the human body is designed to cope with famine. As a result there is a built-in mechanism responsible for weight loss resistance. It may be a source of frustration to people on a weight loss program in a society where there are no food shortages, but it is meant to be a lifesaver in times when there was a shortage of food.
For the person who wants to lose weight it involves taking a closer look at the caloric output. Longer exercise times, higher intensity or cross training can combat the plateau effect, but patience is also needed along with the determination to carry on with the program.

More information about weight loss: http://nethealthbook.com/health-nutrition-and-fitness/weight-loss-and-diet/

Reference: The Medical Post, October 10, 2006, page 19

Last edited November 1, 2014

Nov

2006

Diverticulitis Associated With Obesity

By Ray Schilling | Gastrointestinal Disease, Nutrition, Obesity

Medical textbooks used to describe acute diverticulitis as a disease that was mostly seen in adults over 50 years of age. Researchers at the University of Maryland Medical Center have assessed the medical records of 104 patients ages 22 to 88 years with the condition of diverticulitis diagnosed between 1999 and 2003. 56 patients (54%) were age 50 or younger, and the remaining 48 (46%) were over 50. The researchers found that a significantly higher proportion of patients (88 %) with abdominal obesity were present in the younger age group with diverticulitis.
Acute diverticulitis is a condition characterized by the chronic inflammation of sacs in the intestinal tract. The condition causes constipation and severe abdominal pain. It is usually related to a low fiber diet containing refined carbohydrates or processed foods.
Dr. Barry who was leading the study observed that the younger the patients with diverticulitis are, the more obese they are likely to be.

Diverticulitis Associated With Obesity

Also, he found the younger they are when they get the disease, the more likely they will get recurrent attacks, and he sees the most important point in diverticulitis prevention is a change to healthy eating habits without over-processed food from fast food outlets.

More information about diverticulitis: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/diverticulitis/

Reference: The Medical Post, October 10, 2006, page 1 and 60

Last edited November 1, 2014

Nov

2006

Houseplants Responsible For Allergic Reactions

By Ray Schilling | Allergies, Asthma

Generally house dust and dust mites, pet dander, feathers, moulds and ragweed are meantioned, when it comes to the topic of allergies. Nuts and peanuts have also been associated with violent allergic reactions.
With skin prick tests (SPT) the allergists can very clearly determine what substances the allergy sufferer is sensitive to.

A small study, which appeared in the September edition of Allergy has shown that allergic rhinitis in a patient, can have its origin in exposure to houseplants. Allergic rhinitis with a runny nose and sneezing is often neglected, as-opposed to asthma or an urticarial rash. It is perceived as more of a nuisance than a threat. Allergic rhinitis sufferers were subjected to SPT’s along with a healthy control group. 78 % of allergic rhinitis patient had a positive STP to at least one plant, while none of the control group developed significant reactions to any of the tested plants.

Houseplants Responsible For Allergic Reactions

The plants that produced the most frequent sensitization were Ficus benjamina, yucca, ivy and palm tree.

More information about:

1. asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. stuffy nose: http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/nose-problems/stuffy-nose/

Reference: The Medical Post, October 10, 2006, page 2

Last edited November 1, 2014

Nov

2006

Think Feet With Diabetes

By Ray Schilling | Diabetes, Prevention, Skin Disorders

This article is about “think feet with diabetes”. About 2 million Canadians are currently living with diabetes. It can be a “silent” disease, as patients may have few symptoms. Once diagnosed with diabetes it is of great importance to be vigilant of lifestyle and nutrition to keep the condition under control. A common problem for about 15% of diabetics is the development of a diabetic foot ulcer. Of those afflicted 14-24% will require an amputation of a lower extremity as a result. In addition to this the mortality rate of patients with below knee amputation due to the complications of a diabetic foot ulcer is 19-55% after three years.
Even though these statistics sound ominous, patients can do a lot in the way of prevention. According to the Canadian Diabetes Association guidelines, a diabetic patient should have a foot exam performed at least annually. Diabetic peripheral neuropathy is the leading cause of diabetic foot ulcers. The physician can examine the feet for loss of sensation. He will check for foot calluses and will debride those, which are pre-ulcer state. The physician also checks for poor circulation in the foot at that time.
If there is no loss of protective sensation, an annual exam will suffice, but if there is loss of sensation, several exams per year may be needed. A vascular surgeon may have to assess the patient to see if the foot circulation is sufficient. Infection is a warning sign and has to be treated promptly. Finally, any source of pressure to the foot needs to be removed or offloaded.
A proactive approach to keep the feet healthy starts at home.

Think Feet With Diabetes

The following points are important especially to the patient with diabetes:
-Inspect your feet on a daily basis. Check for sores, blisters or cracks that don’t heal.
-Check your footwear. If there is debris (sand, pebbles) remove promptly.
-Wash your feet daily with warm, not hot water and dry them well, especially between your toes.
-Trim your toenails. If you have difficulties doing that, seek out the help of a podiatrist. Also don’t use the homemade approach cutting corns and calluses.
-Keep the circulation to your feet going: put up your feet when you sit. Wiggle your toes, move your ankles, don’t cross your legs for long stretches of time.
-Shop for suitable footwear! Ask the sales clerk to measure both of your feet in order to determine the proper size. Shop in the afternoon, as your feet can swell during the day.
-Don’t break in a tight fitting new shoe! This may injure your feet. A new shoe should be comfortable right away.
-Don’t delay looking after problems. If a cut, sore, bruise or blister does not start to heal after a day, see a physician.

Reference: Parkhurst Exchange, October 2006 Edition, page 26

Last edited November 1, 2014

Oct

2006

Antiviral Drugs Not For Flu Prevention

By Ray Schilling | Infectious Disease, Lung Disease, Prevention

With the arrival of the fall and winter season concerns about viral illnesses crop up. The most common ailment is the flu, which occurs seasonally. Prevention measures come in the forefront, and over-the-counter remedies and herbal supplements make their appearance.
Yet at this point the most effective measures remain very basic: good hygiene, hand washing, non-exposure to people who have the flu and non-sharing of personal items that could carry the virus. Flu shots for flu prevention remain the single most effective way to prevent widespread epidemics.
Antiviral agents zanamivir (also known as Relenza) and oseltamivir (Tamiflu) have come under discussion. They have been very effective in the treatment of influenza symptoms. It is not too late to treat with oseltamivir after the patient has been infected with the flu, as the drug prevents lower respiratory tract complications. For the symptomatic relief of influenza 75 mg per day were 61% effective, and 150 mg were 73% effective. Using the drugs strictly as a prophylaxis proved to be a fallacy. Results showed that neither zanamivir nor oseltamivir prevented influenza-like illnesses.

Antiviral Drugs Not For Flu Prevention

Even though both antiviral agents are not 100 % effective, they still can be useful in the setting of a flu pandemic. They are also of help in population groups with chronic health problems or immunocompromised persons to whom any viral infection can be serious.

More info about the flu: http://nethealthbook.com/infectious-disease/respiratory-infections/flu/

Reference: The Medical Post, September 1, 2006, page 61

Last edited November 1, 2014

Oct

2006

Kidney Transplant Tourists At Risk

By Ray Schilling | kidney disease

Long waitlists for a kidney transplant have caused some people in need of the procedure to venture overseas. Many kidney recipients are reluctant to share information about the source of human organs transplanted overseas, but this is just one problem. Once the patient returns home, proper follow-up care is often hindered by the fact that there is a lack of communication between the foreign transplant team and the physician in North America.
There may be a sheet of paper stating that the kidney transplant went well. Often important information about what medications were given at the time of transplant is missing, and there is little or no information about the donor.
A Canadian study found that 33% of the patients who went abroad came back without medical documentation. The other 67% had often incomplete records. A study that was presented at the World Transplant Congress in Boston showed, that one third of the patients required immediate hospitalization upon their return, primarily for sepsis. More worrisome is the fact that many of the patients had poor long-term outcomes due to sepsis, systemic fungal infections and compromised grafts. All of them had received their kidneys from non-biological or emotionally related donors. Dr. R. Prasad of the University of Toronto examined the three-year graft survival at the Toronto center. Where patients received the kidney from a relative, the results were best, as the graft survival was 98% over 3 years.

Dialysis Patient Awaiting Kidney Transplant

Patients you received a kidney from an emotionally related donor had an 86% success. In the patient group who went abroad and underwent non-biological or emotionally related kidney transplantation the 3- year graft survival
dropped to 62%.
Reference: The Medical Post, September 1, 2006, page 19

Last edited December 5, 2012

Oct

2006

Good Nutrition Is Gender Specific

By Ray Schilling | Cancer, Health, Heart Disease, Nutrition, Prevention, Stroke

It is well known that various health concerns are related to the gender of a person, but there are findings that suggest that even nutrition has to be tailored to the needs of males or females.
Calcium is known to be beneficial to bone health, and while high calcium diet may protect a woman from osteoporosis, it does not have the same evidence for men. As a matter of fact, high calcium intake in males may increase their risk of prostate cancer. For the male it means that calcium should be used in moderation and vitamin D intake could help to offset some risks.
Fat choices, mostly sources of monounsaturated fats in the form of olive oil are important for both, men and women, and for both the omega-3 fatty acids that are found in fish are excellent. Men, especially those with a risk of prostate cancer, should be cautious about loading up on flaxseed and canola oil. Alpha-linolenic acid in these two oils may be a problem for the prostate.
Iron is also emphasized in healthy nutrition, but men need less than women. In the presence of an abnormal gene, excessive iron can accumulate to harmful deposits in various organs.
Social habits, for example the drinking of alcohol seem to have more grave implication to women than to men. The glass of wine that may help reduce the risk of heart attacks and certain strokes may seem harmless enough, and average men don’t seem to develop health problems, as long as the alcohol intake is low. Larger amounts will increase the risk of many ills for males and females alike, but even low doses of alcohol may increase a woman’s risk of breast cancer.
“Super Foods” have made headlines, and all of them are known because of their high content in antioxidants. A recent study from the University of Oslo, Norway, under Dr. Bente Halverson examined, which of them are ranking highest. At the top are, in the order of strength: blackberries, grape juice from Concord grapes, artichoke hearts, walnuts and strawberries. The researchers came up with a list of high oxidant foods on the basis of typical serving sizes.

Everybody needs to find healthy food

These are the winners among the super foods and spices: blackberries, walnuts, strawberries, artichokes, cranberries, brewed coffee, raspberries, pecans, blueberries, ground cloves, grape juice and unsweetened baking chocolate. Males as well as females of all age groups will benefit from those.
Dr H. Simon, associate professor of medicine at Harvard Medical School points out that there are fundamental facts in nutrition that apply to everyone. But there is also a fine print, which varies according to gender, age and medical conditions.

More information about nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Reference: The Medical Post, September 19, 2006, page 25

Last edited November 1, 2014

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