Medical Articles by Dr. Ray

Jul

2004

Insomnia Sufferers Will Get Help

By Ray Schilling | Health, Men's Health, Women’s Diseases

People with chronic insomnia not only have difficulties to get a good rest at night. If they reach for the currently available sleeping medications, their days start with a drug-induced mild “hangover”: they feel drowsy for a few hours, and once they discontinue the medication, withdrawal can be a problem.

A new medication by the name of indiplon to treat chronic insomnia will be a safer, more effective form of medicine for patients with sleep disorders, reports Dr. James Walsh (PhD). He is an executive director and senior scientist at St. Luke’s Hospital and the Unity Sleep Medicine Center in St. Louis. Dr. Walsh reports that the new medication has a very short half-life, meaning, that it is out of the body, by the time the patient wakes up in the morning. A 35-day trial showed that it is not only safe and effective, but also suitable to treat patients who have trouble falling asleep and those who have trouble sleeping through the night.
More studies are needed, before the medication will be available in the U.S. (conditional approved in 2007 in the US, see link above) and in Canada. Here is a more extensive review regarding this complex new sleeping pill.

Reference: The Medical Post, May 25, 2004, pg. 16

Insomnia Sufferers Will Get Help

Comment on Nov. 5, 2012: It appears that there are problems with long-term safety studies that were never completed. I would suggest to stick to over-the-counter melatonine proparations in the 1 mg to 3 mg range. Melatonine is safe as it is a body hormone. Prescription hypnotics (as sleeping pills are called) are problematic as they do not fit into the body chemistry receptor-wise. No problems there with melatonine.

Last edited December 8, 2012

Jul

2004

Flu Shots For Young Children And Pregnant Moms

By Ray Schilling | Asthma, Diabetes, Infectious Disease, Lung Disease

It may be summer, but next winter will be there and along with it the threat of flus.
Flu shots are offered in fall, and especially people with health problems (like asthma or diabetes, just to name a few) and seniors have been the primary target groups for public vaccination programs. U.S. health authorities now have also added young children under 2 to the program.

This step has been taken, as babies and young children are at a substantially increased risk for influenza-related hospitalizations.
The U.S. Centers for Disease Control has just release a new recommendation, that all women who are pregnant during the influenza season should get flu shots. Pregnant women who contract influenza frequently have an increased rate of complications, including pneumonia, tachycardia (rapid heart beat), and contractions.
Even though most pregnant women are young and healthy, their hospital admission rate during the flu season is similar to what you see in the elderly.
Statistics show that generally only 12% of women with uncomplicated pregnancies get vaccinated. With the threat of a severe strain of influenza A, which showed its aggressive and widespread activity last winter, it can be expected that there will be an increased demand for flu shots this year.

Flu Shots For Young Children And Pregnant Moms

References: The Medical Post, May 18, 2004, pg. 8 and 9

Last edited December 8, 2012

Jun

2004

Eczema – More Than Skin Deep

By Ray Schilling | Asthma, Skin Disorders

Dermatologists have seen more than a threefold increase of eczema in the last thirty years. The condition is common especially in childhood. Skin irritants can play a role. Dr. Harvey Lui, Professor for Dermatology at the University of British Columbia in Vancouver, Canada, also observed, that eczema is much more common in the Asian population. Patients who came from the warmer climate of Southeast Asia and are exposed to a harsher, colder climate will get into trouble more easily, as dryness of the skin will aggravate the skin condition.

Dr. Lui also stresses, that patient education about sensible skin care is of great importance. Fighting fire with fire – like taking a hot shower to combat itchy and dry skin- will make things worse in the long run. Inflamed skin needs to be kept cool. Dr. Lui also stresses that skin has to be kept from drying out. These simple measures for which no prescription is needed are often neglected.

In severe cases the traditional steroid cream has been replaced by preparations, which have an effect on the immune response. Dr. Lui explains that eczema is partially an exaggerated response of the immune system to whatever is noxious or irritating in the environment. The medication tacrolimus (Prograf) is a naturally derived compound that makes the immune cells (T-cells) less active, as they are responsible for the overactive response. It is called an “immunomodulator”.

Eczema – More Than Skin Deep

Due to this knowledge more treatment options are available than in the past. Atopic eczema is very often combined with asthma and allergies and tends to run in families. As the immune system gets strengthened during childhood, eczema tends to be worse in the young person, and time can be the greatest ally in the healing process.

More info on skin rashes: http://nethealthbook.com/dermatology-skin-disease/skin-rash/

Reference: 1. The Medical Post, March 2, 2004 (p.2 and 65) 2. “Guidelines of care for atopic dermatitis”
Hanifin J – J Am Acad Dermatol – 2004 Mar; 50(3), p.391

Last edited Oct. 26, 2014

Jun

2004

New Antibody Treatment For Colon Cancer

By Ray Schilling | Cancer

The drug Cetuximab landed Martha Stewart in the middle of an insider-trading scandal back in December of 2001. Inside information stated that the FDA had turned down the application for this drug in December. However, now there is good news for patients.

The FDA has recently approved the drug, also known as Erbitux. The medication offers treatment for patients with metastatic colorectal cancer who are not tolerating chemotherapy with irinotecan. The most innovative feature of Erbitux is the fact, that it is the first-of-its-kind antibody that inhibits a specific protein, which in turn stops cell division of cancer cells. Clinical trials that were done in Europe consisted of testing stage III colorectal cancer patients with irinotecan (chemotherapeutic agent) alone or in combination with Cetuximab (equivalent of Erbitux). The survival advantage was almost 9 months better in the combination group. Cetuximab alone also had a certain effect, but was not as good as the combination therapy. In the next few years more of these new antibody therapies will be tested in clinical trials to check out the safety and the effectiveness in various cancer types.

New Antibody Treatment For Colon Cancer

More info on colon cancer treatment: http://nethealthbook.com/cancer-overview/colon-cancer/colon-cancer-treatment/

Based on a paper by Harris M – Lancet Oncol – 01-MAY-2004; 5(5): 292-302: “Monoclonal antibodies as therapeutic agents for cancer”.

Last edited October 26, 2014

Jun

2004

Cellulite – Quacks And Facts

By Ray Schilling | Health, Skin Disorders

California dermatologist Dr. Mitchell Goldman presented an overview at the American Academy of Dermotology, and stated that there are many types of treatment options available to combat cellulite including creams, massage, diet, and exercise. He cautioned however, that nobody at this time has done a study which evaluates the 20 creams that are currently on the market. It is true that a large variety of ingredients in the creams directly help stimulating the fat metabolism, increasing circulation and lymphatic flow.

He suggests to his patients to try a product for a month, and if there is no improvement, a switch to a different one should be made. The effectiveness of the creams can be enhanced by wearing bioceramic neoprene shorts. They look like normal work-out shorts, and wearing them a couple of hours per day can keep the cellulite from coming back.

Endermology is another treatment which can be useful with cellulite reduction: a mechanical action gently folds and unfolds the affected skin areas under the continous action of rollers. These rollers help improve the microcirculation, stimulate fluid exchange and improve overall cell function.
A variety of scams for treatment lurks on the Internet. Patients seeking treatment should be cautious about the most commonly advertised rip-off treatment called “mesotherapy”.
It involves injecting toxic substances into the body, including carbon dioxide gas. There has never been a scientific study which proves that it works, yet there is a great deal of publicity enticing patients to try it.

Cellulite – Quacks And Facts

It is also important that patients are informed that cellulite is a condition that can be successfully treated, but it cannot be cured. Once you stop using the cream or the controlling treatment, the cellulite will return.

Based on The Medical Post, March 2, 2004, p. 21

Last edited December 8, 2012

Jun

2004

Take A Deep Breath For Insulin

By Ray Schilling | Diabetes

Patients with diabetes sometimes find it difficult to face the daily insulin injections.
Studies by Dr. Robert A. Gerber from Pfizer Global Research and Development in Groton, Mass. are showing that improvements in the lab tests for the diabetes marker hemoglobin A1C were similar for patients who received insulin inhalations to those patients who received the conventional injections.

The ease of use, comfort, as well as the overall satisfaction of inhalation as opposed to injection rated high. Long-term improvement in the control of blood sugar is maintained up to the 1 year follow-up.
In the future the patients may very well have the choice between inhalation and injection of insulin. Even though the 1 year follow-up results are in, longer follow-up studies are needed, before insulin shots become a thing of the past.

More info on diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Based on Diabetes Care 2004; 27:1318-1323

Take A Deep Breath For Insulin

Comment on Nov. 5, 2012: Pfizer marketed the inhalable insulin under the brand name “Exubera”. It was available in the US from Sept. 2006 onward after FDA approval. The inhalable insulin was proven to be as effective as the injectable insulin, but the cost of Exubera was prohibitive and Pfizer had to discontinue the production after October of 2007 as it was unlikely to be cost-effective, just 1 year and 1month after its initial release.

Last edited October 26, 2014

Jun

2004

Green Tea Knocks Out Leukemia Cells

By Ray Schilling | Cancer, Prevention

Cancer is less common in eastern Asia, where green tea is the most common beverage.
In April 2004 a study was published in the journal “Blood”, which shows that green tea has killing powers in the unpredictable and slow form of B cell leukemia. A component in green tea called epigallocatechin (EGCG) disturbs the chemical information flow in leukemia cells in lab cultures.

It means that the communication between the cells is disturbed, and cancer cells cannot multiply.

Dr. Neil Kay of the Mayo Clinic in Rochester, Minn. is confident that the compound EGCG will be of benefit especially in the treatment of early-stage patients.
In the meantime, a flavorful soothing cup of green tea has its benefits.

More info on leukemia: http://nethealthbook.com/cancer-overview/leukemia/

Based on National Review of Medicine (Canada), April 30,2004

Green Tea Knocks Out Leukemia Cells

Last edited October 26, 2014

May

2004

Chronic Inflammation Causes Cancer, Heart Attacks And More

By Ray Schilling | Anti-aging medicine, Arthritis, Cancer, Heart Disease, Obesity

When the Time Magazine devotes 7 full pages in the March 22, 2004 issue to the topic of inflammation as the source of most of the diseases of the Western World, you know that something important is happening in medicine. Christine Gorman and Alice Park have summarized some of the groundbreaking research of the past few years in this article. I will report about this article here, but also include direct links regarding some of the relevant research the authors have mentioned including some of the key links regarding the metabolic syndrome, which was not mentioned in the article.

Since the beginning of the obesity wave in North America it has become obvious that a cluster of diseases such as heart attacks, strokes, Alzheimer disease, cancer of the colon, multiple sclerosis, arthritis and others have also become more frequent. Dr. Paul Ridker, a cardiologist at Brigham and Women’s Hospital, was one of the pioneers of investigating inflammation as a possible cause and the common denominator of these diverse illnesses. He noticed that certain patients got heart attacks although their blood LDL cholesterol levels (the “bad” cholesterol) were normal. The theory at that time was that all patients who would develop heart attacks would come from a high-risk group of patients with elevated LDL cholesterol. The problem was that 50% of patients with heart attacks had normal LDL cholesterol levels. Dr. Ridker suspected that the C-reactive protein (CRP), which is found to be elevated in the blood of rheumatoid patients, would be somehow involved in the disease process of hardening of the arteries before a heart attack would occur. CRP is produced by the liver cells and by the lining cells of arteries in response to a general inflammatory reaction in the body. Examples of this would be rheumatoid arthritis patients and patients with autoimmune diseases, where CRP levels can be readily measured with a blood test. Dr. Ridker found that there was a very good correlation between the CRP level and the degree of inflammation as well as the risk for developing heart attacks and strokes. Further investigation by others confirmed that CRP levels were perhaps more important than LDL levels in predicting impending heart attacks. This is so, because CRP is the body’s substance in the blood stream that would be responsible for breaking up LDL containing deposits (plaques) in the walls of the arteries, which leads to heart attacks in the heart and to strokes in the brain.

Chronic Inflammation Causes Cancer, Heart Attacks And More

Other investigators found that CRP was only one link in a complex chain of events that includes inflammatory substances (cytokines) from the fat cells as well as insulin and insulin-like growth factors from the metabolic syndrome. Leptins are also a factor as has been discussed under this link.
Dr. Steve Shoelsen from the Joslin Diabetes Center in Boston has developed a mouse model for the metabolic syndrome. These mice will produce huge amounts of inflammatory substances in their fatty tissue in response to any inflammatory process that is started in them. Anti-inflammatory drugs such as the statins or metformin, it is hoped, will be shown conclusively to dampen the inflammatory process and prevent heart attacks, strokes and diabetes as well as cancer, Alzheimers disease and arthritis. Heart disease has already been shown to be improved by anti-inflammatory drugs. Asthma is an inflammatory disease of the small bronchial tubes, which can be stabilized with the anti-inflammatory drug Avastin.

What can we do as consumers to prevent some of those life-threatening diseases? By reducing our weight through calorie restriction on a low-glycemic diet we can help to reduce the insulin-like hormone substances of the fatty tissue. Regular exercise of at least 30 minutes of a brisk walk daily or the equivalent of other sports activities will half our risk for colon cancer and many other cancers. A diet rich in fruits and vegetables as well as fish and fish oils will reduce the amount of free radicals in our system cutting down on the circulating inflammatory substances. This prolongs life, prevents all of the major diseases of modern civilization and leads to longevity as the study of the Okinawa diet has shown.

Based on an article in the Time Magazine, March 22, 2004 edition, page 54 to 60.

Here is a chapter on arteriosclerosis from the Net Health Book, which explains inflammatory changes of the arterial wall:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Last edited October 26, 2014

May

2004

Sugar And Starchy Foods Cause Colorectal Cancer

By Ray Schilling | Cancer, Heart Disease, Nutrition

A study from the Harvard University involving 38,000 women and having been started in 1993 has surprised the researchers. They wanted to find out whether there were certain foods that may cause colon and rectal cancer. So they administered a “food-frequency” questionnaire with 131 questions to women 45 years or older who entered into the study. Such factors as low-dose aspirin, vitamin E and beta-carotene were included in the questionnaire as was the exact food composition for the year prior to enrolment into the study.

A sugar load (glycemic load) was calculated. This way the impact of various sugar and starch containing foods could be assessed and compared among different subgroups regarding the later development of cancer in the colon and rectum.
When Dr. Susan Higginbotham and Dr. Simin Liu analyzed the diets of the 174 patients who did develop cancer (26 rectal cancers, 148 colon cancers) they found that the women with the highest sugar and starch load were 3 times more likely to develop cancer than the controls with a low glycemic load. High glycemic load foods are candy, cakes, cookies; any other refined flour products including white bread, pasta, French fries and baked potatoes. Together with other literature in this field the authors of this study concluded that the high glycemic food load leads to increased insulin levels in the blood as well as insulin-like growth factors. This in turn leads to cell division in normal and cancerous cells including the lining of the colon and rectum. In addition it is known that the C-reactive protein promotes an inflammatory response that will lead to heart attacks and to cancer.

Sugar And Starchy Foods Cause Colorectal Cancer

Dr. Bob Bruce from the University of Toronto has shown in his research on colon cancer that insulin and related factors are important in the promotion of this cancer. He commented regarding the Harvard study reviewed here that more research is required before the exact cause of cancer of the colon and rectum would be understood. This knowledge is required before more effective preventative measures can be found other than a simple reduction of sugar and starch in the foods we eat.

Based on the Feb.4 edition of the Journal of the National Cancer Institute (U.S.) and the National Review of Medicine (Canada) March 15, 2004.

More info about Colorectal cancer can be found through this link.

Last edited October 26, 2014

May

2004

Age-Related Macular Degeneration Can Be Postponed

By Ray Schilling | Anti-aging medicine, Diabetes, Eye Diseases, Heart Disease, Stroke

In a well-controlled study that was published earlier in 2004 Dr. Johanna M. Seddon

has shown that age-related blindness (AMD) is caused from an inflammation in the blood vessels, which is associated with an elevated blood marker, called C-reactive protein (CRP). The authors of this study also showed that the dry form of AMD would tend to deteriorate with age and/or from smoking cigarettes into the more serious wet form, a common cause of blindness.

The inflammatory component of cardiovascular disease is known to be controlled by the use of aspirin (ASA) or the statins, medication that is known to lower the bad LDL cholesterol. It is with this background that the author of the study that I am reviewing here, Dr. Jacque L. Duncan from the University of California at San Francisco, has examined the effects of ASA and of statins on AMD. 326 patients with AMD (204 with dry AMD, 104 with wet AMD from blood vessels forming underneath the retina and 18 with geographic atrophy) were followed between January 1990 and March 2003. Patients were at least 60 years old or older and followed at the San Francisco VA Hospital Eye Clinic.
Dr. Duncan found that patients with blindness due to wet AMD used ASA or statins significantly less than patients with stable AMD. Moreover, he found that patients who had AMD and took statins were 49% less likely to develop wet AMD and if they took ASA the were 37% less likely to develop wet AMD.

Age-Related Macular Degeneration Can Be Postponed

The study also suggests that there is a link between the inflammatory process that leads to heart attacks and strokes on the one hand and the further deterioration to blindness when dry AMD is not treated on the other hand. The notion that inflammation is the missing link in both of these processes is a relatively new finding.

More information about Macular Degeneration here.

Based on article by Dr. Jacque L. Duncan in the American Journal of Ophthalmology 2004;137: 615-624.

Last edited October 26, 2014

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