This is a blog about the truth in health and healthcare. I use traditional manipulation, myofacial release, nutrition, deep dry needling and other modalities to provide wellness to my patients. I discusses information and dis-information to keep my patients knowledgeable in healthcare. Not all medical wisdom is correct, not all "quackery" is wrong.
Sunday, December 30, 2007
Tips for Relieving Dry Eyes Naturally
Dry eyes, often referred to as Dry Eye Syndrome, is the most frequent patient complaint to eye doctors. About 33 million Americans in all groups experience varying degrees of dry eye syndromes. Like most eye conditions,
Dry Eye Syndrome is often related to health conditions in the rest of the body. It is commonly associated with dryness of other mucous membranes, interior body surfaces such as joints and brittle nails. It can also be a sign of digestive imbalances or of more serious systemic autoimmune diseases, such as rheumatoid arthritis, Sjogrens syndrome or lupus erthematosus.
Here are some specific recommendations:
Make sure to eat lots of green leafy vegetables.
Avoid sugar and/or artificial sweeteners:
Consumption of more than 11 teaspoons of sugar a day has been linked to dry eye syndrome (a single can of soda contains approximately 9 teaspoons of sugar. Sugar is hidden throughout processed and refined foods including cereals, ketchup, and salad dressings.
Avoid the toxic fats in commercial red meat, dairy products, fried foods and hydrogenated oils (such as margarine and shortening). These fats interfere with the proper metabolism of essential fatty acids in the body and are indirect causes of dry eye syndrome.
Eat organic or free range whenever possible.
Avoid coffee and smoking.
Avoid hydrogenated and trans fatty acid containing foods (i.e.: margarine, most chips ... read labels).
Drink 8-10 glasses of water a day.
Avoid any foods you may be allergic to.
Try cutting out categories of foods for a week at a time, and see how you feel, or visit an allergist for testing. Typical allergenic foods include nightshades (eggplant, peppers, tomatoes, white potatoes and cucumbers), milk, wheat, and corn (or products with corn in it).
Supplement your diet with a good vitamin that has omega 3 fatty acids in it.
Other Recommendations
Use a humidifier at home and/or at work to keep the air from drying out in the winter.
Remember to blink, especially while working at the computer.
Check your medications for any side effects that may cause dry eyes.
Gently massage upper and lower lids, a couple of times a day to stimulate the tear glands.
Nutritional Recommendations
Supplementing with specific nutrients can help with the tear production including omega-3 fatty acids (such as from flax seed and fish oils), specific omega-6 fatty acids (such as those from Black Current Seed and Borage oils), vitamins A, C, D, E, B6, magnesium.
Other nutrients such as tumeric and lactoferrin may be helpful as well. There are formulas available on the market that contain these nutrients.
Natural eye drops without preservatives can be extremely helpful as well.
Monday, December 24, 2007
Tea 'healthier' drink than water
The researchers recommend people consume three to four cups a day
Drinking three or more cups of tea a day is as good for you as drinking plenty of water and may even have extra health benefits, say researchers. The work in the European Journal of Clinical Nutrition dispels the common belief that tea dehydrates.
Tea not only rehydrates as well as water does, but it can also protect against heart disease and some cancers, UK nutritionists found.
Experts believe flavonoids are the key ingredient in tea that promote health.
These polyphenol antioxidants are found in many foods and plants, including tea leaves, and have been shown to help prevent cell damage.
Public health nutritionist Dr Carrie Ruxton, and colleagues at Kings College London, looked at published studies on the health effects of tea consumption.
They found clear evidence that drinking three to four cups of tea a day can cut the chances of having a heart attack.
Some studies suggested tea consumption protected against cancer, although this effect was less clear-cut.
Other health benefits seen included protection against tooth plaque and potentially tooth decay, plus bone strengthening.
Dr Ruxton said: "Drinking tea is actually better for you than drinking water. Water is essentially replacing fluid. Tea replaces fluids and contains antioxidants so it's got two things going for it."
Rehydrating
She said it was an urban myth that tea is dehydrating.
"Studies on caffeine have found very high doses dehydrate and everyone assumes that caffeine-containing beverages dehydrate. But even if you had a really, really strong cup of tea or coffee, which is quite hard to make, you would still have a net gain of fluid.
"Also, a cup of tea contains fluoride, which is good for the teeth," she added.
There was no evidence that tea consumption was harmful to health. However, research suggests that tea can impair the body's ability to absorb iron from food, meaning people at risk of anaemia should avoid drinking tea around mealtimes.
Dr Ruxton's team found average tea consumption was just under three cups per day.
She said the increasing popularity of soft drinks meant many people were not drinking as much tea as before.
"Tea drinking is most common in older people, the 40 plus age range. In older people, tea sometimes made up about 70% of fluid intake so it is a really important contributor," she said.
Claire Williamson of the British Nutrition Foundation said: "Studies in the laboratory have shown potential health benefits.
"The evidence in humans is not as strong and more studies need to be done. But there are definite potential health benefits from the polyphenols in terms of reducing the risk of diseases such as heart disease and cancers.
"In terms of fluid intake, we recommend 1.5-2 litres per day and that can include tea. Tea is not dehydrating. It is a healthy drink."
The Tea Council provided funding for the work. Dr Ruxton stressed that the work was independent.
Thursday, December 20, 2007
Haemophilus Vaccines Recalled
Merck is recalling over a million doses of its Haemophilus influenzae Type B vaccine because of improper sterilization during manufacturing, according to the New York Times.
CDC and FDA officials said there was no public health threat, although the recall may lead to a shortage of the vaccine this year.
The recall affects Pedvaxhib and the combination Haemophilus/hepatitis B vaccine Comvax that were distributed as early as April 2007. Merck says that physicians should not administer vaccines from the recalled lots. Patients who have already received the recalled vaccines should finish their series with an Hib conjugate-containing vaccine not part of this recall. Revaccination is not necessary, Merck says, because the vaccine's efficacy was not affected.
If something is improperly sterilized, then how can it be deemed as safe? If my acupuncture needles were not properly sterilized would I be so bold to proclaim that there is no public health threat? How much iatrogenesis is necessary to be deemed a "public health threat"?
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Haemophilus Vaccines Recall
Thursday, December 13, 2007
Caesarean births 'may harm lung growth'
Labour may help mature the lungs
Babies born by elective Caesarean section are much more likely to develop breathing problems, a Danish study examining 34,000 deliveries suggests.
Researchers found they were up to four times more likely to have respiratory problems than those born naturally, or by emergency Caesarean section.
The babies may miss out on hormonal and physiological changes during labour which help mature the lungs, they say.
The University of Aarhus study features in the British Medical Journal.
Major operation
Almost a quarter of UK births are now estimated to be Caesarean sections - far above the 10% to 15% rate recommended by the World Health Organization.
A lot of woman are completely unaware of the fact that a planned Caesarean section can negatively impact on their baby
says Dr Maggie Blott Consultant obstetrician
More than half of these were emergency Caesareans, but despite this experts have been calling for measures to reduce numbers of elective Caesareans, warning it is a major operation.
A recent Oxford University study found that women could be four times more likely to die in childbirth if they opted for a Caesarean instead of natural birth.
The Danish team examined data on over 34,000 deliveries, adjusting to take account of factors such as the mother's age, weight, and whether she smoked or drank alcohol during pregnancy
They found that babies born by elective Caesarean section had an increased risk of general respiratory problems.
The risk was higher the earlier the Caesarean was performed.
A nearly fourfold increased risk was found at 37 weeks gestation, a threefold increase in risk at 38 weeks gestation, and a doubling of risk in infants delivered at 39 weeks gestation.
For example, at 37 weeks, 10% of babies delivered by elective Caesarean section developed respiratory problems, compared with 2.8% of infants delivered naturally or by emergency Caesarean section.
At 38 weeks, the proportion was 5.1% of elective Caesarean babies compared with 1.7% of those born naturally or by emergency Caesarean, and at 39 weeks, 2.1% compared with 1.1%.
The risks of serious respiratory problems showed the same pattern.
The researchers conclude that significantly fewer babies would develop breathing problems if elective Caesareans were put off until 39 weeks gestation.
They said: "It is plausible that hormonal and physiological changes associated with labour are necessary for lung maturation in neonates and that these changes may not occur in infants delivered by elective Caesarean sections."
Lung fluid
Dr Maggie Blott, a consultant obstetrician at King's College Hospital, London, said obstetricians in the UK were advised not to carry out elective Caesareans before 39 weeks.
She said part of the problem might be that doctors had to switch support lines to the baby very quickly during a Caesarean, and it was possible that lung fluid is not drained away as well as it should be.
She said: "Some babies do develop transient breathing problems, they usually recover from them, but occasionally a baby can be very sick indeed.
"A lot of woman are completely unaware of the fact that a planned Caesarean section can negatively impact on their baby.
"Any research which reinforces the fact that Caesareans are not necessarily in the best interests of the baby is welcome."
Mervi Jokinen, of the Royal College of Midwives, said Caesarean section rates were too high in the UK.
She said it was a major operation, which had health implications for the mother, as well as the baby.
"The decision to opt for a Caesarean section should not be taken lightly and should be based on good medical grounds," she said.
Tuesday, December 11, 2007
A New Way to Control Weight?
Scientists Say Just Standing Up May Be as Important as Exercise
By LEE DYE, ABC News
Scientists have found intriguing evidence that one major reason so many people are overweight these days may be as close as the seat of their pants. Literally. According to the researchers, most of us sit too much.
In most cases, exercise alone, according to a team of scientists at the University of Missouri, isn't enough to take off those added pounds. The problem, they say, is that all the stuff we've heard the last few years about weight control left one key factor out of the equation. When we sit, the researchers found, the enzymes that are responsible for burning fat just shut down.
This goes way beyond the common sense assumption that people who sit too much are less active and thus less able to keep their weight under control. It turns out that sitting for hours at a time, as so many of us do in these days of ubiquitous computers and electronic games and 24-hour television, attacks the body in ways that have not been well understood.
The Need to Putter
"It was hard to believe at first," said Marc Hamilton, associate professor of biomedical sciences at the University of Missouri-Columbia and leader of the research team. He said the team didn't expect to find a strong signal when they began researching what happens to fat when we remain seated. But the effect, both in laboratory animals and humans, turned out to be huge.
The solution, Hamilton said, is to stand up and "putter."
The research was published this month in the peer-reviewed journal Diabetes, and it will be presented by Hamilton's post-doctoral researcher, Theodore Zderic, at the upcoming Second International Congress on Physical Activity and Public Health in Amsterdam.
Hamilton is not suggesting that anyone quit exercising. But he says his work shows that exercise alone won't get the job done. We have to pay more attention to what's happening when we aren't in the gym, because the body's ability to dispose of fat virtually shuts down, he says, at least if we're sitting down.
Hamilton recruited a few laboratory rats and pigs, as well as about a dozen human volunteers, including himself, to learn more about the physiological effect of sitting. The lab animals laid the foundation for the research in two different experiments. The animals were injected with a small amount of fat that contained a radioactive tracer so the researchers could determine what happened to the fat.
"What's the fate of that fat?" Hamilton asked during a telephone interview. "Is it burned up by the muscle?"
The radioactive tracer revealed that when the animals were sitting down, the fat did not remain in the blood vessels that pass through the muscles, where it could be burned. Instead, it was captured by the adipose tissue, a type of connective tissue where globules of fat are stored. That tissue is found around organs such as the kidneys, so it's not really where you want to see the fat end up.
The researchers also took a close look at a fat-splitting enzyme, called lipase, that is critical to the body's ability to break down fat.
After the animals remained seated for several hours, "the enzyme was suppressed down to 10 percent of normal," Hamilton said. "It's just virtually shut off."
The results from the animal studies were very convincing, he said, and human experiments were just as compelling. The researchers injected a small needle into the muscles of the human volunteers and extracted a small sample for biopsy. Once again, the enzyme was suppressed while the humans remained seated. That resulted in retention of fat, and it also resulted in lower HDL, the "good cholesterol," and an overall reduction in the metabolic rate.
You Need to Move Those Legs
The implications, Hamilton said, are clear. While much thought has been given to the good effects of regular exercise, scientists have not paid enough attention to what happens during the rest of the time when we may be fairly active but are probably sitting too much. That could help explain the rising tide of obesity, because people tend to sit more these days than they did a half century ago. Not to mention eating too much and getting precious little exercise.
Some might argue that playing video games, or even working at the computer, involves movement of the upper body, especially the hands and arms, so that's not really inactive. But Hamilton counters that arms don't weigh very much, and the big muscles in the human body which are so critical to burning fat are located in our legs and back.
"When we think about the postural muscles that are mostly in the legs and back, these are big, powerful muscles," he said. "We're talking probably 20 pounds of muscle in each leg. That's a lot of muscle that can be engaged in routine activities," including burning fat. But they can't do that without the enzyme that is suppressed while seated.
Much is still not known, including such fundamental issues as how long the effect lasts from getting up and moving around for a while, but Hamilton expects the answers to come fairly soon.
"There is going to be a flood of research on this in the next couple of years, and not just by us," he said. "This has raised the attention of a lot of great scientists around the world who have begun doing their own studies."
In the meantime, he suggests, we do the obvious. Take the time to get up and "putter" for a while. If his research turns out to be on the mark, it could save your life.
Flu Drugs May Cause Dangerous Behavior
GAITHERSBURG, Md. (Nov. 27) - The safety of influenza drugs is under scrutiny as advisers to the U.S. Food and Drug Administration on Tuesday analyzed abnormal psychiatric behavior seen in some patients, especially children.
Medical experts are reviewing cases of patients taking Roche Holding AG's Tamiflu and GlaxoSmithKline Plc's Relenza experiencing hallucinations, delirium and other abnormal behavior. In the case of Tamiflu, several cases resulted in erratic behavior, including jumping from buildings, resulting in death.
It's the third time health officials are publicly discussing flu drug safety, originally prompted by reports two years ago of a dozen deaths, including suicide, of children in Japan who had been taking Tamiflu.
Japan in March warned against prescribing Tamiflu to those ages 10 to 19 when more than 100 people, mostly young, showed signs of strange behavior after taking the drug. It also broadened its probe to other flu drugs, Relenza and amantadine, after additional reports of abnormal behavior.
FDA staffers are recommending a stronger label warning for Tamiflu to note patient deaths and suggest close monitoring children for behavioral changes. For Relenza, addition of a warning about hallucinations and delirium is recommended.
Although there is still no evidence of a direct link, the contribution of the drugs cannot be ruled out, FDA safety reviewer Dr. Adrienne Rothstein told the panel, which will vote later on Tuesday on whether to beef up labeling warnings.
Known generically as oseltamivir, Tamiflu is a pill, while Relenza, generically known as zanamivir, is inhaled. Makers of both drugs have stood by their safety, citing no direct evidence of cause and effect.
Two earlier FDA panels found no evidence of a direct link between Tamiflu and the deaths, although the FDA did ultimately update Tamiflu's label to add a caution urging close monitoring of patients for abnormal behavior such as delirium or self- injury. Relenza's label has no such warnings.
About 48 million people have taken Tamiflu worldwide, including 21 million children, since approval in 1999, according to Roche. Relenza is much less widely used, by about 4 million people since its launch in 1999.
The Japanese have adopted the drug much more broadly than the United States, with a large majority of the worldwide use of Tamiflu occurring in Japan.
Tamiflu had lackluster sales as a drug to prevent and treat seasonal flu, but got a second life when it was the first drug to show real efficacy in fighting a strain of bird flu that raised fears of a human pandemic. Since then, Tamiflu has been stockpiled by governments preparing for a potential flu pandemic.
The influenza virus is a major cause of death and illness in the United States. Complications from the viral illness kills about 36,000 people a year in the country, a government expert told the panel. Children and seniors are especially at risk.
Four drugs are approved for influenza, but generics amantadine and rimantadine are no longer recommended for use as many strains of the virus are resistant to them.
Monday, December 10, 2007
Thousands of Kids Get Dud Vaccines
By MELANIE S. WELTE,
AP
DES MOINES, Iowa (Dec. 4) - Every year, thousands of American children go through the tearful, teeth-gritting ordeal of getting their vaccinations, only to be forced to do it all over again. The vaccines were duds, ruined by poor refrigeration.
It is more than a source of distress for parent and child. It is a public health threat, because youngsters given understrength vaccines are unprotected against dangerous diseases. And it accounts for a big part of the $20 million in waste incurred by the federal Vaccines for Children program.
"This is a substantial problem that needs to be addressed through prevention, and when problems are discovered, often times through revaccinations," said Dr. Lance Rodewald, director of immunization services at the Centers for Disease Control and Prevention in Atlanta.
By CDC estimates, hundreds of thousands of doses of vaccines against such diseases as flu, diphtheria, tetanus, whooping cough, polio, mumps, measles, chicken pox and the cervical cancer virus are thrown out each year because of poor refrigeration at clinics, hospitals and doctors' offices.
In one recent case in Sioux City, Iowa, more than 1,000 families were notified by letter and telephone that they needed to get their children revaccinated. State officials found that the refrigerator at the clinic that administered the shots repeatedly dropped below freezing over a 17-month period in 2005 and 2006, potentially ruining the vaccines stored there.
"We just didn't notice it," said Dr. Ray Sturdevant, president of the Prairie Pediatrics and Adolescent Clinic.
Poor refrigeration has been blamed for similar problems elsewhere around the country over the past 2 1/2 years:
-- In St. Cloud, Minn., a clinic had to revaccinate 8,600 patients, most of them children.
-- In Lane County, Ore., 500 children and adults had to get another shot.
-- In western Florida, it happened to about 250 kids.
In Sioux City and other cases, the spoilage resulted from a combination of factors: The refrigerator malfunctioned or was not set or maintained at the proper temperature - a problem that can be caused simply by leaving the door open for a while - and the workers responsible for regularly logging the temperature did not seem to recognize when the readings were off.
"We do everything we can to advise and to make people aware that this is very expensive vaccines they're dealing with and we really want to handle it properly and store it properly to prevent these things from happening - but they do," said Charles Alexander, chief of immunization with the Florida Health Department.
Inadequate refrigeration can cause vaccines to lose their potency, although experts say spoiled childhood vaccines are not dangerous in themselves if given to a youngster.
And there are no known cases of children contracting a disease because they had been given a vaccine rendered ineffective by poor refrigeration. But it could happen, and "that's why we're concerned about it," Rodewald said.
Since 2000 the CDC has pushed state health departments to visit clinics and check their refrigerators. Most states require clinics to use refrigerators with reliable thermometers that can be monitored, and staff members must know what to do when temperatures are above or below the proper range, Rodewald said.
Waste costs the $2 billion-a-year federal Vaccines for Children Program about $20 million a year, and the biggest single problem is improper refrigeration, Rodewald said. Other causes: The vaccines expire or were damaged in shipment.
Rodewald had no breakdown of how much in waste is attributable to poor refrigeration. But he emphasized that the losses amount to an extremely small percentage of the childhood vaccine program.
"The childhood program saves $10 billion each year in direct health care costs by preventing disease among children," he said. "Although preventing vaccine wastage is a priority, the amount wasted should be placed in the context of the overall program economic benefits."
Altogether in 2006, there were 32 instances in Iowa in which vaccines were not refrigerated correctly, said Dr. Patricia Quinlisk, state epidemiologist. Quinlisk would not say how many patients were affected, but estimated $750,000 worth of vaccine in the Vaccine for Children Program was wasted.
"We will get months and months and months of vaccine refrigerator logs where the refrigerator is out of the temperature and nobody has done anything except every day mark down it's out of temperature," she said.
In the Minnesota case, the refrigerator was not kept at the proper temperature and there were gaps in documentation, said Jill Marette of the Minnesota Department of Health.
"It's stressful to vaccinate your children in the first place - just the idea of giving them all those shots. Then you have to think about getting revaccinated," Marette said.
Of greatest concern is the chickenpox vaccine. It must be kept frozen at an average temperature of 5 degrees or lower and should be kept in the dark. Children who receive an ineffective vaccine could easily become infected because the disease is fairly common in the U.S.
Dr. Joseph Bocchini, chairman of the Committee on Infectious Diseases with the American Academy of Pediatrics, said his group and others have issued clear recommendations about storing vaccines, and refrigerators can be equipped with alarms that sound when the temperature goes out of range.
Bed Wetting Drug Kils!
WASHINGTON, Dec 4 (Reuters) - U.S. health officials alerted the public on Tuesday about the deaths of two patients who were treated with a prescription drug to control bed-wetting.
The Food and Drug Administration said it was unclear whether the drug, desmopressin, had contributed to the deaths. But the agency said nasal versions were no longer approved for treating bed-wetting and doctors should consider other options.
Desmopressin is sold under the names DDAVP Nasal Spray, DDAVP Rhinal Tube, DDVP, Minirin and Stimate Nasal Spray. Makers include Sanofi-Aventis
Other forms of the drug "should be used cautiously" in patients at risk of sodium imbalances that can be caused by over-hydration, the FDA said.
The agency reviewed 61 reports of patients treated with desmopressin who developed seizures related to hyponatremia, when sodium is too low. Two of the patients died.
"The direct contribution of desmopressin to the deaths is unclear," the FDA said in a notice posted at www.fda.gov/cder/drug/InfoSheets/HCP/desmopressinHCP.htm. The patients who died were ages 28 and 80, FDA spokeswoman Susan Cruzan said.
Thirty-six seizure reports were associated with intranasal forms of the drug, the FDA said. Those versions should not be used in patients with hyponatremia or a history of the condition, the FDA said.
The agency also said treatment with desmopressin tablets should be stopped during episodes that may trigger extra fluid intake, including fever, recurrent vomiting, diarrhea and vigorous exercise.
Sanofi-Aventis spokeswoman Terri Pedone said the company had removed the bed-wetting use and updated the warnings and other sections in the prescribing instructions for its desmopressin products. (Reporting by Lisa Richwine, editing by Gerald E. McCormick and Braden Reddall)
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