Tuesday, May 31, 2016
But researchers at Stanford and other places have narrowed down the foods that cause the most trouble in the most people with IBS.
These are called FODMAPS, which is short for Fermentable Oligo-Di-Monosaccharides and Polyols. Whew. If you google FODMAPS you will get many explanations of what foods these are. You will get exhaustive lists...and exhausting lists.
Here is one that is fairly simple: http://www.giassoc.org/docs/Low%20FODMAP%20diet.pdf
Basically, we are talking about compounds found in wheat (not gluten other ones), certain fruits and veggies (including garlic and onions, sad face), and sugar substitutes such as xylitol and others.
Recently, researchers the Michigan Health Systems did a controlled study on FODMAPs. Over six weeks, dietitians monitored 90 IBS sufferers. Half went on low FODMAPs, the other half went on a regimen of smaller meals and no irritants such as caffeine and alcohol.
More than half on the low FODMAPs had a major improvement in abdominal pain. Only 20% pf the controls did. Bloating, diarrhea, and urgency also decreased more markedly in the FODMAPs group.
You need to withdraw all FODMAPs for six weeks, then try to see which ones are your triggers--according to experts. I have had relief from the daily pain by eating no dairy (or taking a lactaid pill if I do eat something with milk solids in it), no coffee, and no diet soda, and trying to eat oat bread not wheat.
The diet says there are some cheeses I could eat--but I don't want the pains to start again. (I still get them occasionally if I am stressed or as in the other day, when I eat something weird like hot pepper Chinese noodles).
Mileage may vary--but checking into this could help you.
Friday, May 27, 2016
Now, according to Linda Begdache, research asst prof at Binghamton University, the "kids" are throwing down Adderall, Ritalin, Concerta, and Vyvanse.
These are what I call "big drugs." Basically, we are talking "speed." Brain stimulants.
These not only help with concentration, but induce pleasurable feelings from surging dopamine. Users feel alert, on top of it, brilliant even.
Seven years ago, Begdache says a student asked her about negative side efx of these drugs.
She found that the users of these drugs were usually male--and had LOW GPAs.
The ADHD drugs carry a black box warning, meaning the FDA calls attention to serious or life-threatening risks.
But the kids buy them by the pill--they never see the original bottle or the warning. And many physicians prescribe them helterskelter.
The ADHD drugs rewire the brain the same way illicit drugs do. Abuse can result in addiction--the same way.
Brain changes can be permanent. They affect the "reward" centers of the brain, which affects the brain's self-correcting internal balance. This means the brain starts to want more and more.
These drugs can also "prime" the brain for other substances, such as alcohol, coke, or marijuana.
They can also bring about behavioral changes--aggression, mood swings, psychosis, abnormal libido and suicidal urges.
Some of this can also be handed down genetically to the user's offsrping, according to some researchers.
So...why not study as you go along? Be REALLY smart...taking a "big drug" when you don't need to is not smart.
Thursday, May 26, 2016
This is doctoring?
University of Nevada Las Vegas (UNLV) says their school of medicine is adopting a new approach. Instead of spending years memorizing anatomy, they will team up to treat "paper" patients--with symptoms that need unraveling.
For each paper patient, they will identify the condition and the needed treatment. They will determine what they know--and what they need to find out. Where will they get the needed info? In the course of all this, they will be learning anatomy, chemistry, biology.
This is called Problem-Based Learning--PBL.
The founding dean of the UNLV medical school, Barbara Atkinson, MD, first implemented this approach at the Drexel College of Medicine in Pennsylvania in 1990.
This approach also teaches doctors how to collaborate. It provides them lifelong networking friendships.
Faculty members in this system act as guides.They push the students' learning into necessary directions.
This is about thinking strategies--self-direct investigation, working as a team.
Honestly, this sounds pretty good to me. I have only had one doctor in my checkered past with physicians actually look something up and tell me about it. He had been thinking about ME outside the exam room. I was impressed.
He quit practicing, though--and went to teach.
Wednesday, May 25, 2016
|Fun--but can be dangerous.|
What isn't fenced are the little inflatable kiddie pools. As my father used to say, you can drown in a cup of water. You can also drown in a mop bucket of water. And a toddler can easily dart out of the house and head for the kiddie pool before you know it.
More than 10% of child drownings occur in plastic wading pools or above-ground pools, according to Nina Shapiro, MD, professor of head and neck surgery and director of pediatric otolaryngology at UCLA.
More than half the drownings occur when this child is unsupervised or there is a lapse in supervision. The parent dozes off inside, goes in to answer the phone, or is just chatting with a friend.
The idea is to create layers of caution:
--Watch children vigilantly. They are fast--all it takes is a second for them to make a wrong move.
--Have a phone by the pool in case you need to call 911.
--Install a gate at least four feet tall around large pools--make sure it's latched.
--Drain little pools when not in use.
--Remove toys when the kids are not in the water..familiar objects can lure the little ones.
--Remember, life preservers are a safety device, not a toy. Wearing one might not be a bad idea for bold toddlers.
If something happens, you will bear the pain the rest of your life. High stakes.
Tuesday, May 24, 2016
As thousands of Boomers a day retire and face mobility and health challenges, the United States will be facing a huge wave of issues.
This is truly bipartisan--despite the squabbling endemic to DC and especially to the campaign. Everyone knows or is related to someone older who will be facing decisions and problems.
The task force spearheading this year-long study consisted of Henry Cisneros, former Dem HUD secy, Allyson Y. Schwartz, former Dem House member, Mel Martinez, former Rep HUD secy and Senator, and Vin Weber, for Rep member of the House. Two Dems, two Reps.
On the premise that many older people prefer not to leave their homes, and also on the assumption, that it's a good thing to keep people as healthy as possible--on a plateau--in their homes, the task force looked at several areas:
--Relationship not only of one's health to what is needed in the home, but also the connection between what the home is like and health itself. In other words, an older person may need one-story, or grab bars, but the familiarity and comfort of home can also affect health conditions.
--The need for more affordable rentals for older people, not just "poor" people but also middle class (40% of Americans have $25,000 or less in the bank), who need to leave the home for a smaller rental. We need 6 million more affordable rentals in this country. Federal regulations add 25% to the cost of a new home--we need to cut or eliminate many of those. Also--tax incentives can encourage the private sector to build more suitable units and houses.
--Housing can, with planning and forethought, be suitable for a lifespan. You don't need to put in grab bars, but make the walls strong enough to take them when the time comes to install them. There are many other examples.
--Only 3.8% of all housing--now--is suitable for people with limited mobility. Communities also lack transportation (many older people can no longer drive).
--Falls increase health care costs by $34 billion a year. We need to retrofit premises or help people relocate to prevent falls--which would also cut the increase in Medicare.
--And more clinical services need to be brought into the home--rather than making frail older people with no transportation get out to doctors.
These are just a few things the group looked at. The report is due out May 23rd.
I attended this seminar--on the web. This was good because I am limited in my mobility and have no transportation.
Monday, May 23, 2016
The team, led by Univ of Michigan researchers, analzyed data from 1.6 million hospital stays for four operations: gallbladder removal, colon surgery, hernia repairs, and appendectomy.
In this sample:
--The risk of dying within 30 days of the operation were the same in small town hospitals and larger hospitals
--The risk of a complication (heart attack, pneumonia or kidney damage) was lower at critical access hospitals in rural areas
--Patients who had surgery at those hospitals cost Medicare an average of $1,400 less
--The patients in these small town areas were healthier going to surgery, which suggests surgeons may send sicker patients to larger hospitals
--But even after correcting for difference in pre-op health, outcomes were equal to or better than in larger hospitals
--Fewer than 5% of those in small town hospitals got transferred to larger hospitals--this was 25% for non-surgical patients
--Patients in critical care hospitals were less likely to need a skilled nursing facility after leaving the hospital
Hundreds of critical access hospitals are in danger of closing. Medicare pays them slightly more to keep them open and available to people in rural areas.
One researcher remarked that these hospitals are doing what they are supposed to. They are performing common operations in appropriately selected patients who are OK to get their care nearby.
Where we go from here could affect you.
Friday, May 20, 2016
Not all have photophobia, of course--the inability to endure light during the headache. But about 80% of migraine suffers do react to light.
This is usually not as disabling as the headache pain itself, but can cause sufferers to isolate in dark rooms for relief--and of course, away from work.
Now, researchers at Beth Israel Deaconess Medical Center published a study in BRAIN that finds that exposing migraine patients to a narrow band of green light can reduce the photophobia and even lessen the severity of the headache pain.
The research started because blind migraineurs were found to react badly to blue light. This led to testing colors of light on patients who could see.
When exposed to light of say an office, 80% of those tested reported intensification of the headache with all colors--except for green. Green light even reduced the severity by 20%.
They also tested why this was so and found that neurons in the thalamus were less responsive to green and most responsive to blue.
So now what? Bulbs that emit narrow band green light at low intensity are prohibitively expensive. And special sunglasses to admit only this kind of light are also spendy because they are based on light microscopy.
Work remains to be done.
Thursday, May 19, 2016
|Major--but could be your best bet.|
Many people opt for the less invasive surgery--done with small incisions. This is a difficult procedure, but more surgeons have learned it and it's gaining in popularity.
However, it is best for treating hip impingement, labral tears and loose cartilage within the hip--and in younger patients to keep them from getting arthritis in the joint later.
But, increasingly, older patients opt for the arthroscopy--and want it to treat arthritis or inflammation of the hip.
Researchers at the Hospital for Special Surgery in Manhattan identified 7,351 patients in Cali and Florida databases who had arthrscopic and were followed up at two yrs.
They divided them into younger than 40, 40-49, 50-59, and 60-69. They also knew which ones had a diagnosis of hip arthritis and which ones were obese.
--Only 3% of those under 40 had to have a hip replacement done in the two-year period following their arthroscopy.
--35% of patients 60-69 had to. Obesity was also a risk factor for a second surgery, as was having arthritis already in the joint.
Arthroscopy is a good procedure in the right patient, a researcher said. It's a major advance in treating certain hip conditions, but not hip arthritis.
So--discuss with your physician?
Wednesday, May 18, 2016
They published these findings in Frontiers in Neuroscience.
Such neurogenerative diseases--which include Parkinson's and Huntington's--are rising dramatically as populations skew older and we live longer.
Previously, researchers have focused on gooey protein deposits in the brain called amyloid plaques. But why do they form? Or are they even the cause, that has been questioned, too.
Putting together several lines of research, they think the immune cells may malfunction and kill brain cells.
What could cause this malfunction? Genetic mutations, infection, toxins, or physical injury could all be culprits.
Think of this from the inflammation standpoint could lead to new drugs.
Well, stay on it!
Tuesday, May 17, 2016
But the growth of the gluten-free food industry is growing way faster. It's up 136% since 2013.
The J of Pediatrics had a recent commentary on some misconceptions about gluten.
First, little is known about why individuals adopt a gluten-free lifestyle. A 2015 study of 1,500 Americans asked why why they chose gluten-free and "no reason" was the most common box checked.
Yet, some parents sometimes place children on a gluten-free regimen, believing that it offers some protection against celiac disease. Not true. Testing for CD should come first if a parent is concerned with a child's digestive issues.
Another misconception is that this is a healthy lifestyle with no negatives. If you don't have CD, though, there are no proven health benefits--and it could increase intake of fat and calories. Or contribute to nutritional deficiencies.
Gluten is not toxic--that is another misconception.
Gluten-free is also not necessary for close relatives of individuals with CD. Or is it desirable for infants at risk of developing CD.
There is no scientific evidence that gluten-free is of benefit for kids with no CD diagnosis. It could pose more risk than benefit.
Sooo...got all that?
Personally I think this gluten-free thing became a trendy way to tell people why you weren't eating bread or the dreaded carbs...It actually had little to do with gluten itself. Then it led to this "wheat belly" trend and we were off!
Monday, May 16, 2016
I immediately thought, "Oh, no, here comes that dementia I have been fearing."
But no...researchers at Georgia Tech are making new discoveries about how the brain "leaves things out," even when those objects are plainly in sight.
The frontal cortex is our "thinking cap," they say. For a long time, this part of the brain was thought to not be involved in vision (taking the images transmitted by the retina of the eye and interpreting them).
Actually the thinking cap oversees the whole process.
Vision is not like a camera, they explain. The brain isn't just "seeing," it's constructing the available visual scene and making decisions about it. If the frontal cortex isn't expecting to see something (the orange juice), it blots it out of consciousness.
In other words--believing is part of seeing.
Friday, May 13, 2016
But worldwide, the US Govt has invested $1.4 billion in programs promoting abstinence and marital fidelity.
There is no evidence this has been effective, Stanford researchers say.
The President's Emergency Fund for AIDS Relileft (PEPFAR)) has gradually been reducing its support for such programs. As outlined in the May issue of Health Affairs, PEPFAR thinks other prevention methods are more effective.
The use of funds has a human cost--spend them on one thing, another thing is not supported--things such as condom use, male circumcision and methods to prevent transmission from others to children.
When launched in 2004, PEPFAR had $15 billion in the kitty for programs in 15 countries. A third was to be dedicated to abstinence and fidelity programs.
In 2008, this one-third requirement was eliminated, but funds continued to flow to those programs, though at a lesser rate.
The Stanford researchers hope their findings will emphasize the difficulty of changing sexual behavior--and also highlight the need to measure the impact of programs instead of just throwing money at them.
--Of the 345,000 women studies, they found no difference in number of sexual partners among those living in PEPFAR-influenced countries over those in non-PEPFAR countries.
--They did find a slight delay in first intercourse along more women than men in PEPFAR v non-PEPFAR--but the difference was four months, not statistically meaningful.
It should be noted that abstinence programs did not work in the US either.
When people want to have sex, said one researcher, they don't think about a billboard they saw or what some guy said when he came by the village.
Thursday, May 12, 2016
Now, researchers at the Johns Hopkins Bloomberg School of Public Health suggest that too much folic acid (say four times the ideal blood level at birth) could double the risks of the baby developing an autism disorder.
Very high Vitamin B12 levels carry a similar risk. If both are high, the risk to the baby is 17 times higher than if the levels were normal.
The problem is, the pills contain a hefty dose--but so do fruits and veggies (the folate B Vit) and cereals and breads (B12).
Adequate supplementation does ensure proper neurodevelopment. A deficiency of folic acid is bad for the baby's development and can also lead to autism problems. But too much? Also bad.
Autism is a neurodevelopmental disorder characterized by social impairment, abnormal communication, and repetitive or unusual behavior. One in 68 kids in the US have some level of it--with boys five times more likely than girls to be affected.
The jury is still out on how much is optimal for the woman to take. The researchers said also they did not know why the majority of the women studied had taken multivitamins and only one in 10 had excessive levels.
They might have taken extra pills, gotten too much from fortified foods or even have been genetically wired to absorb greater quantities of folate, or metabolized it slower.
This does raise a flag about the old belief that if one took too many vitamins, they just get flushed from the body as urine. Maybe not, least with folic acid and B12.
Wednesday, May 11, 2016
A small and thus far preliminary study at the Univ of Florida shows that inflammation occurs more quickly, hurts more, and sticks around longer in older adults than younger ones.
For one thing, older adults have a certain amount of chronic inflammation. But the researchers found that when they induced pain in older adults, it increased more than it did in younger adults and peaked later.
Induced pain in older adults--what a fun project.
Also, in older adults, elevated inflammatory responses resulted in pain in the periphery of the body--meaning the tissues and limbs outside the spinal cord and brain.
They had set out to see if getting a lot of painful procedures (as older people tend to have) made them more pain-prone. It's possible, they still think, although this did not show that.
So what is the upshot? More research needed...
I think many older people can attest that pain is a part of aging. I know my friends and I--on lower pain days--email each other saying it doesn't hurt much today...But we always add, "Don't want to jinx myself."
Tuesday, May 10, 2016
The DSM (list of mental disorders) recognizes three types of eating disorder--anorexia nervosa, bulimia nervosa, and binge-eating disorder.
All three are based on fear of losing control over food intake.
Bulimia and binge-eating are characterized by eating too much, and bulimia balances the eating with vomiting or laxative use to prevent weight gain. These two are more common than anorexia.
Now, a fourth disorder has surfaced and been named orthorexia nervosa, though it's not yet in the DSM. This is when a person shows a disproportionate focus on healthy eating and feelings of anxiety and disgust when presented with "unhealthy" foods. This has also been called "food fear" or "fatphobia." Often it is accompanied by "cleanses" and fasts.
How do you know if you are going over into orthorexia?
--Your concerns about food are increasing.
--Food excites fear, anxiety, dread, and guilt.
--You separate foods into "good" and "bad."
If this sounds like you, maybe you should talk to a doctor or nutritionist about a more varied diet and relaxed approach to food--it actually is delicious and enjoyable and not your enemy.
Monday, May 09, 2016
A report in Biological Conservation says vultures are--er, croaking--from toxins in their carrion.
Most vulture species are either declining or about to become extinct.
This poisoning thing, which affects 88% of threatened vulture species, has a ripple effect.
In the mid-90s, India lost more than 95% of its vultures. This was traced to diclofenac an anti-inflammatory drug for cattle that is highly toxic to vultures (my sister took it, too, incidentally).
Vultures tend to feed in big crowds--so one cow would take out a lot of them.
In sub-Saharan Africa, potent new poisons are used to control predators such as lions or jackals. These are so toxic, mammals, insects, birds, everything around a carcass dies.
One elephant carcass killed 600 vultures in 2007.
OK, OK--so what.
In the vultures absence, animals that eat carrion as part but not all of their diet flourish--this includes crows, rats, gulls, and dogs. A lot of vultures can chase dogs off a carcass, but if there are only a few vultures, the dogs move in.
Vultures are also quick to get to the carrion--often before it goes bad. This prevents disease from forming--disease that can affect humans. Also, as happened in India with the dropoff in vultures, dogs can overrun--carrying rabies. Forty-eight thousand people there died of rabies--because of the lack of vultures.
Also affected are societies that put their dead out for vultures to consume. No vultures--you've got a problem.
Yes, we could bring back vultures--as we did California condor (a vulture). But it would cost millions and would take decades.
Better to think about this now while we still have some of these ghastly but useful birds around.
Friday, May 06, 2016
The day is sunny, the field beautiful, but why is she sort of lying there like that?
Christina Olson was a good friend and neighbor of the artist. For most of her life she suffered from a disorder of some sort. Gradually she lost her ability to walk and eventually, to use her hands.
She died at 74 and no one really knew what was wrong with her.
Now, neurologist Marc Patterson at Mayo thinks he knows. He says she probably had an early-onset form of Charcot-Marie-Tooth Disease, a cluster of inherited disorders that affect the peripheral nerves.
He is presenting his findings at a meeting of experts who try to diagnose historical figures, which I find interesting in itself.
Aren't people's various interests fascinating?
Thursday, May 05, 2016
At first, they recommended a drug to regulate the rhythm. I almost died on it--nine months of terrible coughing and one hospitalization. They said we didn't know if you were coming out alive.
Then I went on the old stand-by--warfarin. I had to get blood tests every month. Then I got an intestinal bleed---overnight in the hospital, human plasma to try to reverse the warfarin so they could do a colonoscopy, which was never completed.
They are very adamant about afib patients being on an anticoagulant. I stayed on it. Less than a year later, my eye started to bleed inside. Four operations for detached retina (it was pushed off by clots) later, my right eye is sightless.
At this point, I made the decision to ditch the warfarin---I take a full-strength aspirin and hope for the best. I have looked into the new drugs on TV--but the studies don't show that much of an improvement. They say you don't need the monthly tests, but one of them says it might be a good idea to get them anyway. One TV drug says it has a reversal agent--so I guess the plasma would not be needed.
I am not saying you should drop the warfarin--your cardiologist will freak (I have had eight).
Researchers at the Intermountain Medical Center Institute in Salt Lake City have found that afib patients treated long-term with warfarin had higher rates of dementia.
So that's nice.
Seems the thinner blood from blood thinners can result in bleeds in the brain (or elsewhere).
They enrolled 10,537 patients with no history of dementia. They considered age, hypertension, diabetes, cholesterol, renal failure, smoking, prior heart attack or brain incident, and heart failure.
Seven yrs later, they found all types of dementia increased in the afib group more than the non-afib group.
When warfarin levels were too high or low (they can jump around, thus the monthly tests), dementia rates increased.
Patients under 70 tended to be most susceptible to dementia.
The researchers said it is important to understand anticoagulants are needed, but there are risks we are just beginning to understand. Only those who absolutely need blood thinners should be placed on them long-term. Patients on them should not take aspirin in addition. And patients with erratic warfarin numbers should consider the newer agents.
So...your call. This is powerful stuff. At least know the risks.
Wednesday, May 04, 2016
Whew. Terrible. Isn't being a helpless kid bad enough?
The reason for the increase isn't clear--but increased access to health care and more health literacy may contribute--meaning more
is being diagnosed than before.
The study did not look at causes, though.
The researchers looked at the National Survey for Children's Health for 2003, 2007, 2011, and 2012. The findings are prelimary because they have not been peer-reviewed.
More frequent health care, they speculate, might help poor children.
That's one for The Big Book of Duh, if you ask me.
Tuesday, May 03, 2016
|Watch for gorillas.|
Maybe not, according to a study presented to the British Psychological Society.
Researchers at the University College Cork (and Dublin) say we only have a set amount of attention--and it needs to be on traffic and the road.
This is called the perpetual load theory--once we have put our attention to the maximum load of info, other info is not processed.
They used a full-size driving simulator and tested whether listening to the radio would affect the ability to see or take in other info.
Thirty-six drivers took part. Half were told to listen for when the traffic reporter switched from a male to a female voice (low attention needed). The other half wer asked to listen for updates on a specific road (requiring high attention).
Every so often as they drove, a gorilla or elephant would be at the side of the road.
In the low-attention load group, 71% spotted these. In the high attention group, less than a quarter saw the out-of-place animals.
The high attention group also performed less well in obeying yield signals, recalling what vehicles had passed, and in actual driving--meaning lane position, speed, and reaction time to hazards.
Hmmm...Think that one over. That was the radio--it didn't even count the screaming kid in the back, the yammering spouse, the putting on of makeup and eating of breakfast.
Monday, May 02, 2016
|Tech in protective wear--child not.|
CT stands for computed tomography. To get detailed images of bones, organs, blood vessels, and soft tissues, it uses ionizing radiation.
Use of CT scans is growing worldwide, according to the World Health Organization.
Radiologists and other experts are urging awareness and accountaibility for CT scans on children.
One of the authors of the WHO report, Donald Frush, MS, medical director of the Duke Medical Radiation Center, says this radiation in very high doses can cause hair loss and skin redness.
Children tend to be more susceptible because they are still growing.
According to the WHO report, the average dose of radiation in the US has increased since 1987, due most to medical procedures.
Parents should be afraid to ask questions.
--Why is this test necessary?
--What are our other options, such as ultrasound or MRI (no radiation)?
--How will they adjust the radiation to suit a child?
--Does your facility routinely do this? Is this a priority? Does the staff have proper training to do this?
It's OK to ask, Frush says--in fact, it's a good idea.
Look, I know it's hard when your child or even you are hurt and when you finally see a doctor, that doctor says we need pictures. But radiation can build up. At least ask.
Personally, I have succumbed to many CT scans...Now I will ask.