Health Newsletter:March 2003
Related Links:From WebHealth
Contents |
Garlic Effective Against Head Lice
The Jan. 21, 2003 edition of the Medical Post published an article about some Argentine research involving the active ingredient of garlic, allicin.
Dr. Juan Barboza and his collegues from the University of Cuyo in Mendoza started their research first with plant lice, as they had been approached by farmers to help them find a natural way to fight lice infestation of their crop .
Of the various chemical compounds in garlic it was the allicin compounds that were most effective in asphyxiating common pests, particularly plant lice. Subsequently they were experimenting with head lice formulations. Shortly after there was a severe outbreak of headlice infestation at the day care center of the university. This was an opportunity for the researchers to test the efficiency of the new formulation of a mixture of allicin with a mint-scented cream. With only one application of this formulation there was a 96% reduction of the number of head lice within only 1 week!
Here is a link to other useful hints about head lice.
Hyperthermic Chemotherapy For Colon Cancer
When colon cancer comes back (Duke stage D cancer) there often are seedlings of cancer cells in the peritoneal cavity, which in the past made surgery impossible. However, at Montreal's Maisonneuve-Rosemont Hospital the surgical oncologist, Dr. Pierre Dubé, is using a brand new technique that allows to do surgery even in these difficult cases. It has been known for some time that cancer cells are heat sensitive.
At the time of the surgery all of the visible cancer is removed, like with ovarian cancer, using a cytoreductive surgery approach. At the end all invisible cancer cells are treated with a combination chemotherapy fluid that is introduced into the abdominal cavity and that is heated in a controlled manner. Heat probes measure the temperature and make sure the fluid is heated to 44°C (111°F). Other experiments have shown that at this temperature chemotherapeutic agents enter into the cancer cells faster, as they had been rendered more fragile by the heat. The end result is an increase in survival by 2 to 2 1/2 years. This is a breakthrough because in the past conventional combination chemotherapy for this group of advanced colorectal cancer patients achieved a remission (meaning "response rate") of 0%. Now with this new technique there is a remission rate of 30% to 50%. Hyperthermic chemotherapy for colon cancer was pioneered at the Gustave Roussy Institute in Paris where Dr.Dubé was introduced to this technique. This was reported in the Jan. 14, 2003 edition of The Medical Post (page 7). According to Dr.Dubé about 10% of all colorectal cancer patients will need this type of surgical approach and about up to 25% of patients who develop cancer spread into the abdominal cavity (peritoneal carcinomatosis) would be potential candidates for this treatment modality.
Comments
Recently there has been a paper intitled "Factors predicting survival after intraperitoneal hyperthermic chemotherapy with mitomycin C after cytoreductive surgery for patients with peritoneal carcinomatosis" by P.Shen et al. (Arch Surg - 01-JAN-2003; 138(1): 26-33). 109 patients with carcinomatosis of the abdominal cavity with different cancers were treated with cytoreductive surgery and hyperthermic chemotherapeutic solutions. With this procedure, after complete removal of gross cancerous disease, the 3-year survival rate achieved 68% versus 21% of those where gross cancer removal was not entirely possible.
Testosterone For Male Menopause (Andropause)
At a recent continuing education meeting at the University of Calgary in Alberta/Canada, which was reported in the Jan. 14, 2003 edition of the Medical Post, Dr. Norman Wong (professor of medicine, biochemistry and molecular biology) reviewed the symptoms, investigations and treatment modalities available for men who experience andropause (the male equivalent of menopause). They are as follows (my summary in table form).
| Androgen symptoms (male menopause) | |
| Symptoms: | Comments: |
| loss of sex drive (libido) | testosterone, which is the male hormone produced by the testicles, is needed for a normal sex drive |
| erectile dysfunction (impotence) | inability to have sustained erections |
| loss of male characteristics | loss
of male type hair distribution, deep voice, muscle mass etc. |
| fatigue and depression | brain hormones dysbalanced from low testosterone levels |
| decrease in muscle mass, increase in fat mass | lack
of testosterone responsible for muscle loss and change in bone metabolism |
| oligospermia or azoospermia | too little sperm count or no sperm present |
Here is a link to the ADAM questionnaire regarding andropause by Dr. Morley, a geriatrician at the St. Louis Unversity in Missouri. If you answer "yes" to question #1 and #7 (sexual dysfunction or lack of sex drive) or if you answer "yes" to any three of the other total of 10 questions, you should see your physician and ask for a testosterone blood test.
What should you know about testosterone blood tests? What counts is the free testosterone or bioavailable testosterone. Dr. Ronald Swerdloff, professor of internal medicine and endocrinology at the UCLA School of Medicine in Torrance, California, stated at this conference that testosterone production decreases with aging, but is actually also one of the causes of aging. Testosterone levels decrease 1% to 2% every year from the age of 30 onwards. However, the sex hormone binding protein (SHBP) can buffer these changes for a certain period of time, if the SHBP is binding less testosterone thus keeping the free or biologically available testosterone relatively stable for a number of decades or years. Often, however, the andropausal men who need testosterone replacement have high SHBP levels. Nobody knows why some men have problems earlier than others. So, if the free testosterone serum level is low (and the LH and FSH hormones are low or normal) this means that this man likely should have testosterone replacement therapy, if there are also clinical signs and symptoms of hormone deficiency.
As can be seen from this link to menopause in women, the pituitary hormones LH and FSH, which are also known as gonadotropins, should be high to indicate that the feedback mechanism between the estrogen (or in the male the testosterone) no longer suppresses the production of these gondotropins. The fact that this mechanism is lost in most older men shows that the hormone deficiency is likely much more profound than a simple deficiency, it may actually be indicative of the aging process of the hormone glands themsevles. The good news though is that with a simple testosterone patch this can be fixed. Your doctor can discuss this further with you.
Other possibilities are injections every 3 to 4 weeks with a Depot-testosterone hormone preparation or tablets. However, with the tablets the problem is that this will get metabolized in the liver and higher amounts of hormone are required to overcome the liver barrier. Liver cancer has been reported in a small percentage of men taking tablets for a long period of time (I do not like testosterone tablets for this reason). Prostate cancer is the other worry and regular PSA tests and prostate exams should be done by your doctor. As no controlled trials have been done yet regarding the safety of longterm testosterone replacement in andropausal men, Dr. Swerdloff recommended to replace only in the lower dose range to the point where the free testosterone serum values are just barely normalized and the clinical signs and symptoms disappear. Overtreatment should be avoided.
The New Hot Asthma Treatment: Bronchial Thermoplasty
There is a new concept in the treatment of asthma, a mechanical solution rather than the familiar pharmacological solution. As is outlined in the lung disease chapter of WebHealth, the treatment of asthma is usually a combination of inhaled and oral medications that have as a target the smooth muscular envelope of the bronchial tubes, which is depicted in this link. In addition to the spasm of the bronchial tubes some anti-inflammatory steroid inhalers are also needed to control the swelling of the lining of the bronchial tubes, which can obstruct the air flow from inside.
Dr. John Miller has done research with the Alair catheter systemat Broncus Technologies Inc. in Mountain View, CA (San Francisco Bay Area). Dr. Miller helped to develop this bronchoscopic instrument with a concealed expandible wire basket that can be heated. In co-operation with Dr. Gerard Cox from the Respiratory Division of McMaster University in Hamilton/Ontario/Canada they tested this procedure on a small group of 14 mild to moderately severe asthma patients. The procedure consisted of a 30 minute bronchoscopy during which several heat cuts were made through the muscle layer of the bronchial tubes using this instrument (the heat used is only as hot as a cup of coffee). The smooth muscle layer of the bronchial tubes remains relaxed after this. A total of four such treatments were given, 3 weeks apart. The result was surprising in that the breathing performance doubled, which would have been considered to be a good drug effect, if this result had been achieved with the help of medication. However, this effect is permanent and medication can still be used on top of this, if necessary.
The researchers will now start a larger multinational trial including a total of 110 moderate to severe asthma patients from Canada, England and Scotland, Germany and Denmark. Results of this study are expected to be published in 2004. (Based on The Medical Post, Feb.11, 2003, page 37).
A Prospective Feasibility Study of Bronchial Thermoplasty in the Human Airway
Do Diet Drinks Make You More Hungry?
There were some articles recently that stated that diet drinks would make you hungry. However, they lacked proper controls. For this reason the gastroenterologist, Dr. Khursheed Jeejeebhoy, from the University of Toronto/Ontario designed a well controlled 10 week trial where several parameters were measured while patients were either snacking on diet drinks or on sugar containing soft drinks on top of their regular food intake, which was also closely monitored. The only requirement in the beginning of the study was that the subjects had to be overweight (body mass index of 27 to 28). Participants of the study were then divided randomly into subjects drinking soft drinks with either sugar or sugar substitutes. The drinks were blindly given, but meticulous records were kept of what was consumed. In addition the subjects were allowed to eat as many snacks as they liked with either sugar in it or sugar substitutes. Here is a tabular summary of the findings:
| Artificial sweeteners and weight loss (10-week study) | ||
| Findings: | Comments: | |
| additional Calories from drinks per day: | AS:250 Cal. | SG:870 Cal. |
| total caloric intake over the 10 weeks: | AS:decreasing steadily | SG:increasing steadily |
| appetite sensation: | AS:no appetite complaints | SG:sugar stimulated appetite |
| weight gain or loss: | AS:significant weight loss | SG:significant weight gain |
| activity level (exercise) | no change in either groups (AS or SG) | |
| blood pressure | AS:no change | SG:sugar increased blood pressure significantly |
Explanation: AS=Artificial sweetener group SG=Sugar group
The surprising findings were that the sugar group had an increased appetite and wanted to eat more and more. Sugar also raised the blood pressure significantly.
The result was a significant weight gain of the sugar group (SG) during the 10 weeks of the trial while the other group (AS) had lost a significant amount of weight without any hunger pangs. The researchers also measured body fat versus muscle mass and found that the sugar group (SG) had gained fat mass without changing the muscle mass. On the other hand the artificial sweetener group (AS) had lost only fat mass, not muscle mass.
Dr. Jeejeebhoy concluded according to the article in The Medical Post (Jan.14, 2003 edition, page 27) that sugar in snacks and drinks should be kept to a minimum to prevent obesity from developing or getting worse. Patients with high blood pressure should avoid sugar as much as possible and stick to a low glycemic-index diet. Drinks should be diet drinks or fluids without sugar content. Do diet drinks make you more hungry? The answer is: "NO!"
