Health Newsletter:January 2008
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Contents |
[edit] Stop Smoking With Hypnosis
A New Year usually brings New Year’s resolutions. January’ “Cold Turkey Day” also motivates a lot of people to take a step to better health by giving up smoking. Quitting “cold turkey” is an excellent decision, but it presents a big challenge to persons, even if they are motivated to quit. Like with any large project it is important to plan a successful approach.. Quitting remains a personal decision and commitment, but it does not have to be a lonely journey. Support is of great importance, whereas sabotaging family members or sneering peers can be undermining. For some persons quitting in a buddy system can be helpful. It is also important to be able to cope with withdrawal symptoms and cravings, and to remain smoke-free on the long run. What works? Dr. Faysal Hasan of the North Shore Medical Center in Salem, Mass. And colleagues studied groups of patients who used different approaches to kick the habit. There were four different methods of treatment: hypnotherapy treatment, hypnotherapy combined with nicotine replacement therapy (NRT), NRT alone or going “cold turkey”, meaning stop smoking abruptly. One quarter of the patients who went cold turkey remained smoke free six month after discharge from the treatment program, while only 15.778 % of those who received NRT alone remained to be non-smokers. Hypnotherapy patients had the most impressive result: half of the patients in the hypnotherapy treatment group and those who received hypnotherapy and NRT stuck to being smoke-free. It was important that patients choose their own treatment, and the other just as important key to success is motivation. Dr. Hasan pointed out that there are more data out on the success of hypnotherapy in smoking cessation. Success rates are ranging from 15% to 80%. How important motivation is comes out in a study that was presented by nurse-practitioner Virginia Reichert, who works at the Center For Tobacco Control at North Shore-Long Island Jewish Health System in Great Neck, N.J. At 30 days 58% of the 2,052 smokers involved in a comprehensive 6 week smoking cessation program had successfully quit. She pointed out that the motivation varies according to age groups: the younger population is more concerned about cost, oral health and odors. The older smokers showed more concern about major threats to their health. For this reason it is important in a stop smoking program to zero in on the individual and focus on the items that are important. There is the misperception that “if a patient really wanted to quit, then he or she would”. Reichert points out that smoking is an addiction and it needs to be treated as such. For successful smoking cessation every support has to be given to the patient to stay on the bandwagon and every help is needed to support the will of the patient.
The Medical Post, December 4, 2007, page 17
[edit] Vaccine For Blood Pressure Control
Early trials of a new blood pressure vaccine found it to be safe and effective and it may be an alternative to daily medications. Recently the results of a phase II study were presented by Dr. Juerg Nussberger of the University Hospital of the Canton of Vaud in Switzerland. The study further evaluated the safety and tolerability of the new vaccine, which currently goes under the name CYT006-AngQb. The vaccine is a protein derived from a bacteriophage and it directly targets the substance which is responsible for the constriction of blood vessels and hypertension. This molecule is known as angiotensin II. The vaccine works by creating an antibody response within the patients to attack this molecule directly. Despite the large range of blood pressure medications there are some aspects that remain difficult. One is compliance. Patients may forget their medication, which will trigger a surge of higher blood pressure. The other aspect is a surge of high blood pressure in the early morning, a condition that makes steady blood pressure control very challenging. As a result, Dr. Nussbaum stated, good blood pressure control is only achieved in a maximum of 25% of patients, and there is a need for alternative therapy. The study involved 72 patients with mild to moderate hypertension. The group was split into patients on placebo, on a low dose of 100 mcg of the vaccine and a group with a higher dose of 300 mcg. Patients on the 300 mcg regimen had a significant reduction in blood pressure, and the researchers also noted that the effects were quite pronounced between 5 a.m. and 8 a.m., when blood pressure values tend to spike and blood pressure control is a problem. There were reductions of 25 mm Hg systolic and 13 mm Hg diastolic at 8a.m. as compared to the placebo group. As the treatment is safe and well tolerated by patients future studies can go ahead to check the dose response of the vaccine and come up with an injection schedule.
The Medical Post, November 27, 2007, page 16
[edit] Bipolar Patients Do Better Without Alcohol
Bipolar disease treatment has made great advances with better therapeutic agents, and as a result many patients with bipolar disorder are able to lead happy and full lives and can be successful socially and at work. As with any disease it is important that the patient is compliant with the treatment, and it is common sense that lifestyle choices play an important role in getting well and - just as importantly- staying well. Dr. Ben Goldstein of the University of Pittsburgh examined the association of alcohol consumption with future symptoms, illness course and health care among non-alcoholic patients with bipolar disorder. The individual participants in the study were ranging in age from 18 to 60 years; they were in full or partial remission and had no history of substance abuse. 63 % were considered minimal drinkers who consumed less than one drink per week, 32% had moderate use and consumed one to six drinks per week. 5% who consumed 7 or more drinks were considered heavy users. Despite the low volumes of alcohol consumption by the majority of participants (95%), alcohol was associated with statistically significant increase of manic symptoms. The moderate users did have the same risk of manic relapse as the group of minimal drinkers. Moderate drinking was a predictor for worse social and family adjustment and the use of health care was also higher than those of the minimal drinkers. The results clearly show that even minimal alcohol intake has the potential to destabilize a bipolar patient with manic, not depressive symptoms. Based on these findings true low risk behavior for any patient with bipolar disorder may be abstinence from alcohol.
The Medical Post, December 4, 2007, page 21
[edit] Sunshine Vitamin D Prevents Disease
The winter season sees brisk sales of cough and cold remedies and vitamin C preparations at the drugstore counter, yet one of the most valuable vitamins is only inching its way into the foreground: vitamin D. In the past vitamin D was known to be necessary for infants to eradicate rickets, but currently vitamin D deficiency and rickets seem to be on the rise again. Dr. Michael Holick from Boston University has observed this alarming trend and recommends that as part of the annual physical examination the vitamin D status of the patient should be checked. Among North American women between 1% and 25% are vitamin D deficient. Dark skinned individuals had alarming rate of deficiency between 29% and 42%. The degree of deficiency varied between the seasons. Dr. Joseph Lane, head of the osteoporosis prevention center at the Weill-Cornell –affiliated Hospital for Special surgery in New York believes that vitamin D deficiency is running as high as 80% in older women worldwide. Vitamin D is known to be important for bone health. Aside from the role of the vitamin in calcium homeostasis vitamin D functions like a hormone and it seems to be a key player in the prevention of colon, breast and prostate cancer. It also plays a role in the prevention of various autoimmune diseases like multiple sclerosis, rheumatoid arthritis, Crohn’s and Alzheimer’s disease. The results of two separate meta analyses that were released in 2006 concluded that taking 2,000 IU of vitamin D and getting 15 minutes of sunshine daily might reduce the risk of colon cancer by as much as two-thirds and half the risk of breast cancer. People at risk of deficiency are those who live in northern latitudes. Dark skinned people are at a higher risk than light skinned individuals. Also at risk are adults over 65 and people who stay mostly indoors or use sunscreen faithfully. It is also of importance to note that obese populations have significantly lower vitamin D levels than non-obese counterparts, as serum 25 dihydroxy Vitamin D is sequestered within the fatty tissue stores and as a result unavailable for systemic use. Certain medications like anticonvulsants, glucocorticoids, rifampin and cholestyramine adversely affect the availability and metabolism of the vitamin. Vitamin D can also be deficient in vegan diets. It is still the most significant source to have exposure to sunlight. Dietary sources of Vitamin D are fatty fish, egg yolk and foods that are fortified like milk and soy beverages. Multivitamins and cod liver oil supplements are also useful. An intake of 1,000 IU of Vitamin D has been recommended by the Harvard School of Public Health, the Canadian Cancer Society and the Osteoporosis Society. Like with any supplementation the consumer should not be misguided into believing that “more is better”. Excessive intake will lead to harm, and adult doses of 100,000 IU can cause toxicity if taken daily over several months.
The Medical Post, December 4, 2007, page 23
[edit] Test Tattooed Patients For Hepatitis C
New York researchers have found that tattoos are strongly associated with hepatitis C (HepC) infection. This does not apply only to individuals with traditional risk factors such as receiving blood transfusions or being an injection drug user. Dr.Edmund Bini, the main investigator in the study who is also director of gastroenterology and hepatology research at New York Medical Center was surprised to find this association of disease and tattoo in a multicenter study involving 2000 patients. It was found that patients who had one or more tattoos were 35.2 % more likely to have HepC infection. The connection between tattoos and hepatitis C has been long suspected, but there has never been a study to substantiate this suspicion until now. Previous studies had included patients with the traditional risks of HepC. The finding is significant enough that Dr. Bini concluded that all patients with tattoos should be tested for hepatitis C. This will assist in early identification and treatment of the disease. The researchers expect to refine the information by assessing the risk of multiple tattoos and also the risk factors of tattoos done in the U.S or overseas.
The Medical Post, November 27, 2007, page 1 and 25
