Health Newsletter:April 2008
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Contents |
[edit] H. Pylori Can Be The Culprit For Indigestion
Indigestion, heart burn, bloating and stomach discomfort are common problems. Often the reason is simple. Too much food and drink at a party, a plateful of deep fried Buffalo wings or a midnight order of double-pepperoni pizza will contribute to stomach upset and a bad night’s sleep. A few over the counter antacids will come to the rescue. If indigestion is a faithful but miserable daily companion, the excuse of “just having a sensitive stomach” becomes a form of denial and a dangerous form of self diagnosis. Something is wrong, and it is time to seek medical attention instead of over the counter meds. The first line of defense will be prescription drugs called "proton pump inhibitors" (PPI). They are designed to eradicate excessive acid production in the stomach. If symptoms are more severe, e.g. weight loss, a gastroscopy will be necessary. Even though the prevalence of a stomach infection with Helicobacter pylori (H.pylori) is declining, about 30% of patients with chronic stomach upsets test positive for an infection with these bacteria. This can cause recurrent stomach pains. In this case it becomes necessary to treat this with a combination of PPI’s and antibiotic medication. Eradication of H.pylori can mean a cure from a stomach ulcer. It also reduces the risk of developing gastric adenocarcinoma, a form of stomach cancer, that could have developed out of an untreated gastric ulcer. Just because a person has heartburn does not mean that the condition is due to gastro-esophageal reflux of stomach acid. If after treatment with a PPI the problems of indigestion, heartburn, bloating or stomach aches reoccur, lab tests can give more information. According to a prospective trial conducted by Dr. Delaney and others the H.pylori serology (a blood test) is unreliable, but other H.pylori tests like urea breath test or stool antigen are reliable tests to establish whether a stomach infection with H.pylori is present or not. If the bacterium is present, its eradication with antibiotic therapy will stop the stomach problems in a high percentage of cases with one treatment protocol. What was surprising was that after one year the treatment result of the treatment group with PPI/antibiotic combination was as successful as the control group that was treated with PPI's alone. It was concluded that in the more severe cases with weight loss, vomiting, or overt bleeding an upper gastrointestinal endoscopy should be performed where a direct H.pylori test from samples is also done. However, in the vast majority of cases with minor symptoms can be treated safely by the general practitioner with PPI's and follow-up examinations in subsequent visits. Treatment failures can then be referred to a gastroenterologist, if necessary.
British Medical Journal 336:623-624 (March 22, 2008)
[edit] Eat Your Veggies To Protect Your Eyes
A study at Brigham and Women’s Hospital in Boston has shown that nutrition impacts eye health. Over a stretch of 10 years Dr. William Christen followed a group of 35,551 health professionals age 45 and older. They provided him with detailed information about their dietary habits and vitamin supplements-they were permitted to take multivitamin but were requested not to take vitamin A, vitamin E or beta-carotene. None of them had cataracts in the beginning of the study, but 2,031 did develop cataracts during the follow up period. Dr. Christen and his team analyzed the data and found that those individuals who were the highest consumers of carotenoids- individuals with an intake of 6,617 mcg of lutein and zeaxanthin- were 18% less likely to develop cataracts than those who consumed only 1,177 mcg per day. Also the group that consumed higher amounts of vitamin E –intakes of about 262.4 mg per day- was 14% less likely to develop cataracts. Lutein is a substance that is found in high concentration in eye tissue. It is readily available in many foods, such as green and yellow vegetables, yellow-fleshed fruit and in egg yolks. New research from the National eye Institute in Baltimore has also confirmed the benefits of carotenoids for healthy eyes. Lutein and zeaxanthinoffer protection against age-related macular degeneration. There is no need to shop for supplements. Just bring on the green vegetables: broccoli, brussels sprouts, kale, collard greens, and spinach. Add some corn, the spice saffron and some eggs, and enjoy the taste and the health benefits.
The Medical Post, March 8, 2008, page 25
[edit] High Blood Pressure Decreases Cognitive Function
It is known that high blood pressure that is left untreated gives rise to a host of health problems, some of which are heart attacks and strokes. It is not surprising to Dr. Jose Luchsinger of Columbia University Medical Center in New York that high blood pressure (hypertension) can be related to all kinds of cognitive impairment, which is connected to vascular damage in the brain. A cohort study which was published in the December issue of Archives of Neurology included 918 subjects age 65 or older with no history of mild cognitive impairment (MCI) or dementia at baseline. All participants underwent neurophysical and medical testing every 1 ½ years for more than 4 ½ years. The majority of the individuals had high blood pressure. During the course of the study 334 of the participants developed MCI. 174 cases had impairment in domains such as language and executive function or visual-spatial elements were impaired. 160 individuals had amnestic MCI (affecting memory), which is thought to have the strongest link to Alzheimer’s disease. The study showed that hypertension played a significant role in the higher risk of developing any form of cognitive impairment. Detection of hypertension and proper treatment will not only protect against strokes, but certainly also extend its benefits to cognitive function.
The Medical Post, February 5, 2008, page 65 and Dec.2007 issue of Archives of Neurology
[edit] New HIFU Treatment For Prostate Cancer
High-intensity focused ultrasound, also known as HIFU is a treatment that prostate cancer patients are seeking out. The treatment technique is minimally invasive, has low risks of impotence and urinary incontinence and can be done on an outpatient basis. It is a two to three hour procedure which can be done with some mild sedation and spinal anaesthesia, and generally men can resume their normal lives immediately after surgery with the knowledge of being cancer-free. Dr.Ian Brown, the medical president of the Niagara HIFU clinic in Niagara Falls, Ontario likens the technique to the effect of a magnifying glass that focuses sunrays on a leaf and burns it. Except there is no sunlight but a pulse of high-energy ultrasonic waves focused onto a specific area of the prostate. Temperatures reach approximately 90 °C (= 194°F), until the cancer cells are dead. The transducer is equipped with ultrasonic imaging, so the treating physician can see the entire prostate gland on a monitor, and as a result surrounding nerve structures that are responsible for erectile function are not damaged. There is some inconvenience for the patient after the surgery. He has to wear a catheter for two to three weeks until he can urinate on his own. Like any prostate cancer treatment HIFU also has potential side effects like retrograde ejaculation or urethral fistula. Reports state that these side effects are minimalized with HIFU, but they are not eliminated. This treatment is not suitable for every patient. Patients with early stage prostate cancers are suitable candidates. HIFU is not available in the USA at present, but has been approved by Health Canada in 2004 based on European data. It is not covered by health insurance, and at $20,000 this new costly option is not affordable for everybody.
National Review of Medicine, March 2008, page 35, 39
[edit] Short Daily Exercise Helps Chronic Pain Patients
Chronic pain can be an affliction that turns normal living and functioning upside down. Quality of life will be negatively affected, and often depression and anxiety are resulting mental problems. Effective pain relief is crucial, but often there are undesirable side effects to pain medication, and the patient will explore other avenues that bring a measure of relief. Amy Burleson, Psy .D. of the Cleveland Clinic’s chronic pain rehabilitation program found that chronic pain patients were physically deconditioned due to chronic pain and a chronic lack of physical activity. Depression and other mood disorder also were very common. A 10 minute exercise program was added to the treatment of a group of 28 patients who suffered of various chronic pains: back pain fibromyalgia, neuropathy and migraines. Patients started a simple routine of walking on a treadmill, starting with a low speed of 1 mile per hour and increasing the speed every few minutes, till they walked at a speed of 3 miles per hour, a speed which was manageable for all patients After 3 weeks patients found that their physical endurance had increased. They also experienced less depression and anxiety. Even more remarkable was the fact that the patients’ pain perception had diminished. Likert scale scores which were used in the assessment of pain perception showed a drop from 7.32 in the beginning of the program to 2.75 at 3 weeks. It is obvious that even mild exercise has benefits for patients with chronic pain: the overall well being receives a noticeable boost through an approach that has no pharmacological impact, no side effects and has no high cost of health care.
Pain Medicine, Volume 9, Issue 1, Page 88-141 (January/February 2008)
