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********** Health Newsletter ***********
May 29, 2005
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Keeping mosquitoes at bay
2. Spinal fusion not more effective for low back pain
3. Reader submitted Q&A - Hysterectomy for prolapse
4. Hair dyes not associated with cancer
5. Health tip to share - Dried apricots for constipation
6. Humor is healthy
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1. Keeping mosquitoes at bay
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Mosquito and tick-borne illnesses will flair up
again as summer approaches. Recently, the Center
for Disease Control (CDC) said that insect
repellents containing the chemical picaridin (oil
of lemon eucalyptus) offer comparable protection
from mosquitoes as do DEET containing products
when used in similar concentrations. Also
picaridin containing sprays do not have the same
intensive odor that DEET products do. Some people
are very sensitive to DEET odor. On the other hand
DEET may be more effective in preventing deer
ticks from sensing a human meal. Picaridin is
currently being tested for its effectiveness
against deer ticks.
Oil of lemon eucalyptus is a natural ingredient
that offers long acting repellent attributes. Some
of the shorter acting natural repellents
containing plant-based oils such as oil of
geranium, cedar, lemon grass, soy or citronella
may offer limited protection also. As with any
chemical to be applied to the skin, some common
sense tips for safety are appropriate. The experts
at MayoClinic.com offer the following suggestions
for safe insect repellent use:
Do not use products containing oil of lemon
eucalyptus for kids younger than age 3
Do not use insect repellent of any type before age
2 months
For newborns, cover the stroller or playpen with
mosquito netting
Choose the right concentration - A lighter
repellent for the playground or a walk through the
neighborhood; a stronger concentration out in the
woods or a swampy area.
Be cautious with combination products, such as
those containing both sunscreen and insect
repellent; it is better to use those products
separately
Don't use repellents under clothing or over cuts,
scrapes or sunburned skin. Avoid the eyes and
mouth.
Don't let kids apply their own repellent. They are
likely to go overboard with the amount used
Wash off repellent when it's no longer needed
If your skin breaks out from the repellent, wash
the chemical off immediately with mild soap and
water
If you do get an insect or mosquito bite, scrape
off the stinger with the edge of a credit card or
knife. Apply 0.5% or 1% percent hydrocortisone
cream, calamine lotion or a baking soda paste to
the bite or sting several times a day until your
itching symptoms subside.
Keeping mosquitoes at bay
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Spinal fusion not more effective for low back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Chronic low back pain is a common medical problem.
It is usually treated non surgically with
exercises, physical therapy and non steroidal pain
medications. Occasionally when these conservative
measures do not result in significant pain
reduction, spinal fusion surgery to immobilize
several spinal vertebrae against any movement is
performed. The premise is that the low back pain
is produced from movement of the vertebrae against
the disks and bony surfaces of the spinal disk
joints and if the vertebrae are splinted against
movement, pain will be reduced.
It used to be that not many spinal fusions were
performed but because of a recent increase in
these surgeries, a study was launched in the UK at
15 secondary care orthopedic and rehabilitation
centers. This study compared over 300 participants
with low back pain who were refractory to
conservative measures. Half of the group underwent
lumbar spine fusion and half underwent an
intensive rehabilitation program based on
principles of cognitive behavior therapy. The
investigators followed the patients for two years
and measured their ability to walk and their
disability in performing daily tasks.
Both groups, the spinal fusion group and the
physical rehabilitation group, had reduced
disability at the end of the two years. They also
had the same ability to walk. The authors
concluded that there was very little difference
between the two groups. In other words the surgery
group really did not do very much better than the
non surgery group. Therefore the risk and
additional cost of surgery needs to be considered.
"No clear evidence emerged that primary spinal
fusion surgery was any more beneficial than
intensive rehabilitation."
Spinal fusion not more effective for low back pain
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Hysterectomy for prolapse
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have become very confused and frustrated after
reading ALL of the material and talking to various
MD's on hysterectomies. You would have to be a
rocket scientist to figure out the best
appropriate option.
I am 73, healthy, never been in the hospital
except for three childbirths. I have a stage 4
uterine prolapse (outside) with no symptoms except
for a 'dragging' feeling. I guess I should have
something done. Gynecologist warned I could get
renal failure with no symptoms if left untreated.
At first, a colpolesis(sp?) was suggested. I said
no. Then, I have heard that abdominal surgery is
better than vaginal - more permanent and usually
ends up being a better job, etc. Still, it's
riskier. I exercise a lot so my concern is that
if I have the vaginal type, I will be restricted.
Any comments, advice???" - Mary
The reason you are having difficulty determining a
surgical option for treating total uterine
prolapse is because there are many different
trade-offs and success rates with the different
procedures that doctors use.
A colpocleisis is performed vaginally and the
uterus is not removed. It is pushed back up into
the vagina and the vaginal wall is sewn together
along the length of the vagina. The vagina being
sewn together holds the uterus back so it does not
keep falling out of the vagina. This procedure is
about 85% successful in the long run. The main
disadvantage is that a woman can no longer have
vaginal intercourse. Also if you are very active,
you still have the weight of the uterus bearing
down on the vaginal closure and may have a higher
surgical failure rate.
Abdominal procedures usually remove the cervix and
uterus and then the vagina is suspended to
ligaments that attach firmly to the pelvic bone.
Removing the uterus seems result in less doctor's
visits in the long run although it does not have
to be performed at the time of an abdominal
suspension procedure. An abdominal hysterectomy
with suspension is usually quite successful in the
range of 85-90%. It is just as safe if not safer
than a vaginal surgical procedure but the main
disadvantage is that it takes about 4 weeks longer
to recover from an abdominal incision than from a
vaginal procedure.
Vaginal procedures offer a quicker recovery but
about a 10% lower success rate overall. You would
be restricted from impact exercise activity and
lifting over 10 pounds with either a vaginal
procedure or an abdominal procedure for at least 3
months. You should consider, however, permanently
avoiding any physical activity that increases
intraabdominal pressure for extended periods of
time in order to guarantee the highest chance of
success from any prolapse surgery.
Probably more important to the success of the
procedure is the experience of the surgeon
performing it. Most surgeons end up using one
approach for most of their cases even though
technically they can perform either vaginal or
abdominal surgery. They have learned over the
years that in their hands, they can maximize the
success and minimize the complications by becoming
very experienced at one approach over the other.
My suggestion is that you should consider having
the uterus removed since you are very active
physically. As to whether you have the surgery
performed abdominally or vaginally, I would just
find an experienced prolapse surgeon and go with
whatever approach they favor. Personally, I favor
the abdominal approach for someone who is
relatively healthy and active.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Hair dyes not associated with cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From time to time, hair dyes are alleged to cause
cancer in epidemiological studies. While these
claims produce alarming news, they are also
controversial. To try to answer questions as to
whether hair dyes could be carcinogenic,
scientists have reviewed the evidence of past
studies in medical journals. Investigators from
Canada looked at 79 literature studies for the
effect of extensive hair dye use (>200 lifetime
episodes of dye use) and any effect on bladder
cancer, breast cancer, leukemias/lymphomas and
cancers of other sites.
Basically, they "did not find strong evidence of a
marked increase in the risk of cancer among
personal hair dye users. Some aspects related to
hematopoietic cancer (leukemia/lymphomas and other
cancers that have shown evidence of increased risk
in 1 or 2 studies should be investigated further."
2 specific studies needs to be followed up."
Hair dyes not associated with cancer
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5. Health tip to share - Dried apricots for constipation
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"A small bag of dried apricots will cure
constipation - quickly! Very quickly! I purchased
a small bag of dried apricots to alleviate my
sweet tooth. I did not realize the consequences
it would have on my bowels. Needless to say that
unless I ever get constipated, I will not eat
dried apricots again." - Pat
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6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Funeral Procession"
A woman was leaving a convenience store with her
morning coffee when she noticed a most unusual
funeral procession approaching the nearby
cemetery.
A long black hearse was followed by a second long
black hearse about 50 feet behind the first one.
Behind the second hearse was a solitary woman
walking a pit bull on a leash. Behind her, a short
distance back, were about 200 women walking single
file.
The woman was so curious that she respectfully
approached the woman walking the dog and said, "I
am so sorry for your loss, and I know now is a bad
time to disturb you, but I have never seen a
funeral like this. Whose funeral is it?"
"My husband's."
"What happened to him?"
The woman replied, "My dog attacked and killed
him."
She inquired further, "Well, who is in the second
hearse?"
The woman answered, "My mother-in-law. She was
trying to help my husband when the dog turned on
her."
A poignant and thoughtful moment of silence passed
between the two women.
"Can I borrow the dog?"
"Get in line."
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That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
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Back to top
********** Health Newsletter ***********
June 12, 2005
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. To avoid malpractice claims, physicians order excess tests
2. Cancer survival rates - What do they mean?
3. Reader submitted Q&A - Cholesterol levels
4. Low dose aspirin not beneficial for those over 70
5. Health tip to share - Patient assistance programs
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. To avoid malpractice claims, physicians order excess tests
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many physicians practice defensive medicine. They
are afraid to miss a rare or uncommon diagnosis
because they might be sued for malpractice. Of all
medical malpractice suits filed, over 25% allege
failure to diagnose a condition, often a cancer.
The big question is, "how much defensive medicine
is being practiced?" and "how much does it cost or
raise prices." A recent survey was performed and
reported in the Journal of the American Medical
Association (JAMA). Physicians in 6 specialties at
high risk of litigation, emergency medicine,
general surgery, orthopedic surgery, neurosurgery,
obstetrics/gynecology, and radiology were given
questionnaires. The authors looked at the number of
physicians in each specialty who reported changes
in their behavior or scope of practice because of
medical malpractice concerns.
This study was conducted in Pennsylvania and over
800 physicians responded to the survey. Over 90%
of physicians reported practicing defensive
medicine. The results were as follows:
"Assurance behavior such as ordering tests,
performing diagnostic procedures, and referring
patients for consultation, was very common (92%).
Among practitioners of defensive medicine who
detailed their most recent defensive act, 43%
reported using imaging technology in clinically
unnecessary circumstances. Avoidance of procedures
and patients that were perceived to elevate the
probability of litigation was also widespread.
Forty-two percent of respondents reported that
they had taken steps to restrict their practice in
the previous 3 years, including eliminating
procedures prone to complications, such as trauma
surgery, and avoiding patients who had complex
medical problems or were perceived as litigious.
Defensive practice correlated strongly with
respondents' lack of confidence in their liability
insurance and perceived burden of insurance
premiums."
Well what does this mean to you, the medical
consumer? On the one hand, doctors are ordering
you to undergo more tests than they think are
medically necessary just to assure you that there
is not a hidden medical condition or disease. If
you are a nervous person who needs certainty that
you do not have a serious disease, then this
behavior should be reassuring to you. If, however,
the costs of a test and the risks of undergoing a
diagnostic procedure or obtaining a false positive
result concern you, then you may want to pin your
doctor down as to how likely that test is going to
be helpful. Let him or her know that if it is
being ordered just to reassure you and he/she does
not really think the test is that necessary, you
may be willing to wait awhile to see how the
symptoms change before having the study.
Secondly, if the doctor perceives you as litigious
(likely to sue for any undesired outcome), then
you may not get recommended certain procedures
such as surgery that you medically need. Also, if
you are high risk medically, doctors may also
avoid recommending necessary surgery.
To avoid malpractice claims, physicians order excess tests
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Cancer survival rates - What do they mean?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you or a family member or friend are
unfortunate enough to be diagnosed with cancer,
you will hear many terms about your chances of
survival that may be confusing. The most common
expression is cancer survival rate. This basically
tells you the percentage of people with the cancer
that are alive after a certain time.
Five year survival rates are typically calculated
from medical statistics so that if a doctor says
the 5 year survival rate of Stage 1 breast cancer
(less than 2 centimeters in size and no lymph node
spread) is 98%, this means only 2 people out of a
one hundred will have died from the cancer in 5
years. It does not necessarily mean that the other
98 are totally cured of cancer. For example the 7
year survival rate for Stage 1 breast cancer is
about 92%. In other words, 6 more people of the
original 100 are likely to die between years 5 and
7 from the cancer. This brings up a second term
you need to know - disease free survival rate.
Disease free survival rate refers to patients who
are very likely, but not definitely "cured" of
their disease. At least they have no evidence of
the cancer at the time period being measured.
These rates depend very much on whether the
specific cancer is a rapid grower or a slow
grower. If it is a rapid grower like a ovarian
cancer in which most people who are not
successfully treated die within 2-3 years, then a
statistic such as the 5 year disease- free
survival will reflect almost entirely those who
have been completely cured. If the cancer is a
slower growing tumor, such as prostate cancer in
men or carcinoid cancer of the bowel in men or
women, then the 5 year disease-free survival will
still include many people who have microscopic
disease but undetectable by current methods.
Finally, there is a term called progression-free
survival rate. This is the number of people who
still have cancer, but the cancer is not growing
much. This may be due to the cancer being slow
growing or the treatment being "fairly effective"
but not necessarily curative. The progression free
survival rate includes people who may have had
some success with treatment, but their cancer
hasn't disappeared completely.
While many people lump all cancers together as bad
to have, and they are, doctors make vast
differentiation among cancers according to the
survival rates, cure rates and progression-free
rates. You should make all the effort you can to
understand about the survival rate of whatever
cancer is affecting you or your friends or family.
Cancer survival rates - What do they mean?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Cholesterol levels
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Question submitted: I am a 53 yr obese woman
diagnosed 2 years ago with Type 2 diabetes. With
Avandia, my glucose is doing fine. But this year
my cholesterol numbers are elevated. total
cholesterol 235, HDL 40 and LDL 164. How do you
feel about statin drugs? I would like to bring
down my numbers without taking them, can you
outline what I need to do? The lady at the health
foods store sold me some Soy Protein Granules that
I've begun sprinkling on my oatmeal in the
morning, she said it's helped a lot of people. Do
you agree with that or Chinese red yeast?"
Chinese red yeast rice (Monascus purpureus) has
the same rare complication that statins have, that
of muscle destruction (rhabdomyolysis). It is
quite uncommon but may happen with the same low
frequency as with statins. For that reason, I do
not think red yeast rice has any advantage as a
natural substitute for statins.
Oatmeal with soy protein is a good dietary
treatment for elevated cholesterol but its
effectiveness is in the range of less than 5%. I
would continue it but not totally count on it to
do the job.
In women, a good HDL level above 35 mg/dl (or 45
mg/dl if you have a family history of heart
disease), is more significant to predict a lower
chance of heart disease than is a high total
cholesterol level or a high LDL (bad cholesterol)
level. Since you did not indicate that you
currently have a heart problem, I would guess that
the diabetes you have is going to contribute much
more to any future heart disease in you than will
the elevated total cholesterol level. Therefore
the major recommendation to you would be to remove
all stops to lose at least 15% of your body
weight.
Weight loss is the only factor that someone with
diabetes can control in order to totally cure
themselves of this condition. While adult onset
diabetes does not go away 100% of the time when
you lose significant weight, it does go away often
enough that you need to strongly focus on weight
loss as the single thing you can do to improve
your health. Weight loss will also lower your
cholesterol levels. In simple terms cutting
portions down, cutting out calories is much better
than adding any cholesterol reducing food
supplements, even oatmeal. I wish I had a secret
to share with you on how to lose weight but I do
not. Weight watchers has one of the best programs
that doctors recommend but if you choose to do it
yourself, remember that changing your eating
habits permanently has to be part of the program.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Low dose aspirin not beneficial for those over 70
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Low dose aspirin (a baby aspirin, 80 mg a day) has
been advocated by many physicians and health
publications as a possible preventative against
heart attacks. Aspirin functions as a weak
anticoagulant (blood thinner) so any blood
clotting from atherosclerotic plaques in blood
vessels that produces a myocardial infarction (MI)
or a thrombotic stroke may be lessened by daily
aspirin. The only problem is that blood thinning
of any kind can also cause bleeding in the stomach
or bowels or bleeding in the small blood vessels
in the brain (hemorrhagic stroke).
Recently, investigators in Australia modeled the
benefits versus the risks of low dose aspirin
therapy. They used high quality articles in the
medical literature to make estimates f MI
reductions and bleeding complications under
different circumstances and at different ages.
They found that in men and women over the age of
70 who did NOT have diagnosed cardiovascular
disease, the benefits were almost evenly matched
by the complications. For example in a theoretical
10,000 women, low dose aspirin may have prevented
321 ischemic heart attacks and 35 ischemic
strokes, but it caused 572 major gastrointestinal
bleeds and 54 hemorrhagic strokes.
The authors did not feel that the benefits
outweighted the risks of low dose aspirin therapy
in people over 70 years old. I agree with them.
Low dose aspirin not beneficial for those over 70
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Patient assistance programs
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For people living on a reduced income, e.g., less
than $19,000 per year if single or less than
$30,000 a year for a family, there are programs to
help with the expense of medicines. Many
pharmaceutical companies have programs to help
with medications but you have to apply and
qualify. Until now there has not been a single
source to go to in order to find out what
medications might be available. One group
www.freemedsandsolutions.com has compiled such
lists and will help people to apply to programs
for reduced cost or free medications. There is,
however, a $10 charge for the application fee and
help in applying.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Great Truths About Life That Little Children Have
Learned"
1. No matter how hard you try, you can't baptize
cats.
2. When your mom is mad at your dad, don't let her
brush your hair.
3. If your sister hits you, don't hit back. They
always catch the second person.
4. Never ask your 3 year-old brother to hold a
tomato.
5. You can't trust dogs to watch your food.
6. Reading what people write on desks can teach
you a lot.
7. Don't sneeze when someone is cutting your hair.
8. Puppies still have bad breath even after eating
a breath mint.
9. Never hold a vacuum and a cat at the same time.
10. School lunches stick to the wall.
11. You can't hide a piece of broccoli in a glass
of milk.
12. Don't wear polka-dot underwear under white
shorts -no matter how cute the underwear is.
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That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
June 26, 2005
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. How does cancer treatment affect libido?
2. Fish oil supplementation and heart rhythm
3. Reader submitted Q&A - Shellfish allergy
4. PMS and vitamin D, calcium intake
5. Health tip to share - Nausea from chemotherapy
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. How does cancer treatment affect libido?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
It is not uncommon for sexual desire to decrease
or become absent when one is undergoing treatment
for cancer. Sometimes the causes are physical,
sometimes mental and often times both. Losing
interest in sexual intimacy, even just kissing or
cuddling causes strain between partners. It is a
very important time for good communication to
determine just exactly what the problem is.
Of course any cancer treatment affecting the
genital organs such as vulva, cervix, uterine or
ovarian cancer in women or prostate, penile or
testicular cancer in men is going to produce
physical changes that decrease libido. Any
treatment causing menopause in women also may
decrease libido by producing vaginal pain from
dryness. Radiation therapy can produce extreme
fatigue which in turn affects sexual desire.
In addition to physical changes, emotional changes
are also associated with cancer treatment. Some
people may feel guilty that sex caused a cancer or
that having sex may cause a spread of cancer to
your partner. Neither of these are true. Sex does
not cause cancer nor is cancer contagious. Even
the often sexually transmitted human papilloma
virus (HPV) which can play a role in setting the
background for cervical cancer occurence is not a
sole cause of cancer. Most people with HPV
infection never develop any cancer at all.
Depression over the future is a major concern. It
is an emotional component among cancer treatment
and cancer survivor individuals that affects
sexual desire. Heightened self-consciousness about
appearance is another emotion that can interfere
with libido. Loss of your hair from taking
chemotherapy, the loss of a limb, breast, or
testicle, scars from surgery, and ostomies can
make you feel less attractive and concerned that
your partner will not find you attractive either.
Truthfully, most partners are not as concerned
about these changes as you are.
Perhaps the major impact on libido when undergoing
cancer treatment is the stress and anxiety of all
the decisions that need to be made and the stress
of making significant changes to your daily living
activities while taking treatment. Stress
decreases libido even if you are not undergoing
cancer treatment. Stress causes you not to be
relaxed and sexual intimacy requires some degree
of relaxation or a least freedom from worrying
about multiple issues while trying to engage in
intimacy.
Most couples probably have not spent much time
discussing sex before a cancer diagnosis and
adding cancer to the mix makes it all the more
difficult. However, the only real answer to this
problem is communication. You need to talk with
your partner as well as the doctors and nurses on
the health care team. Discussions with other
individuals undergoing cancer treatment can also
be very helpful. You may need to change your
definition of sexual intimacy for a while. Look
for ways of being intimate without having vaginal
intercourse.
How does cancer treatment affect libido?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Fish oil supplementation and heart rhythm
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Fish oils are rich in omega-3 polyunsaturated
fatty acids (PUFAs) and have been thought to play
a role in decreasing heart disease. It is not
certain if the mechanism is by decreasing
cholesterol levels or possibly by having an anti-
arrhythmic effect. The PUFAs are associated with a
decrease in sudden cardiac death so one of the
premises of PUFAs blocking heart arrhythmia was
tested by a group from Oregon. They conducted a
randomized clinical trial of giving fish oil PUFAs
or placebos to patients who already had
arrhythmias. They wanted to see if the fish oils
decreased the episodes of heart arrhythmias that
those patients already experienced.
In the group of patients who had an implantable
cardioverter defibrillator (ICD) and a recent
episode of sustained ventricular tachycardia or
ventricular fibrillation, taking omega-3
polyunsaturated fatty acids resulted in more
episodes of arrhythmias. In other words it may
have caused arrhythmias more than it prevented
them. It seems we have to look for a different
reason as to why fish oil may reduce acute cardiac
events.
Fish oil supplementation and heart rhythm
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Shellfish allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I read an interesting submission regarding
shellfish allergy in possible relation to salt. I
have had anaphylactoid-like reactions from
childhood spaced by years, to stewed jumbo shrimp
(my throat swelled at around 7 yrs), and crab (my
tongue swelled and darkened, a few years later).
Now, I find that salty broth/stew will cause my
throat to swell in the same way as lobster bisque,
crab meat and corn soup, salmon stew, and sometimes
shrimp. While these are all very infrequent
reactions, I am very afraid of ingesting too much
salt. I thought it was the iodine which maybe the
salt had in common with the fish (as such I was
avoiding iodized salt), but I have come to believe
it may in fact be sea salt in particular which is
the problem, since it gives me the same closed
throat reaction as cooked shellfish. Is this
possible, or rare? How do I read more on this?
Also, are raw shellfish or shellfish cooked
plainly possible even more threatening for this
reason! I am 44 y.o. and generally healthy, recent
celiac disease diagnosis, plus separate allergy
diagnosis to eggs, corn, beef, soy, and wheat!" -
A.M.
Food allergies are a complicated business. The
body has several different ways of producing an
immune response. The most dangerous allergies are
mediated by IgE antibodies and are probably what
you describe as your shellfish and fish allergy.
The allergic response is usually to a protein in
the shellfish or even to a parasite contaminant;
it is not to iodine. See our article about
shellfish and iodine allergies at:
/ngen22.htm . Most people
are familiar with the immediate-onset food
allergies caused by IgE mediated immune reactions
such as those that children have to milk, nuts,
peanuts, eggs, shellfish etc. These are severe
reactions bringing on severe stomach reactions,
cramping, diarrhea, skin rashes, hives, swelling,
wheezing or even anaphylactic shock. The reactions
usually occur within 2 hours of eating.
The most common food allergies (70-80% of the
population) are what are called delayed-onset food
allergy mediated by IgG antibodies having an onset
from a couple of hours to several days after
consuming allergic foods. Delayed-onset food
allergy/intolerance has been associated with many
medical conditions including: arthritis, asthma,
candidiasis, celiac disease, cardiovascular
complaints, hypertension, epilepsy/seizures,
sinusitis, skin rashes, weight problems, immune
deficiencies, migraines, autism, irritable bowel
syndrome, chronic fatigue, headaches, allergy/hay
fever, stress, hypoglycemia and fibromyalgia. It
sounds as if you have had some testing for IgG
food antibodies and also have some of these
allergies going on. There are also other types of
rarer allergies to food mediated by the IgA
antibody system.
None of these immunoglobulin mediated allergies
apply to salt however. Pure salt can cause
swelling in tissues like the throat but it is not
an allergic response and there are no allergies to
pure salt that I know of. After all the body is
basically made up of a 1% salt solution. It would
be rare to have any sort of reaction to normal
amounts of salt other than mild swelling of the
tissues of the mouth and throat if you ingest a
high salt concentration.
On the other hand, could sea salt be contaminated
with proteins such as the shellfish allergens? I
think that would be possible since much sea salt
is derived from just dried ocean water. It is
conceivable that sea salt has organic proteins
that are essentially contaminants and could
possibly produce an allergic response. If I were
you, I would stick with reputable manufacturer's
commercial iodized salt in very small amounts and
stay away from sea salt since there is no way of
knowing how it has been prepared. I do not know of
any reading sources for you since this had not
been studied very well. With your multiple food
allergies, you will have to stick pretty much to
foods you have prepared yourself or commercial or
restaurant foods that you have found to be non
allergenic and stick with them.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. PMS and vitamin D, calcium intake
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Premenstrual syndrome refers to a complex of
physical and mood symptoms that worsen in the one
to two weeks prior to a woman's menses and
disappear by the end of a full menstrual flow.
These symptoms often include fatigue,
irritability, labile mood, and depression along
with physical symptoms of bloating, breast
tenderness, leg swelling and headache among other
things. There have been a few things shown in good
clinical trials to reduce the severity of PMS
symptoms: nonsteroidal anti-inflammatory drugs
such as naproxen, vitamin B6 at 100 mg a day,
magnesium oxide at 600 mg a day, and calcium at
1000 mg a day.
While medical studies suggest that blood calcium
and vitamin D levels are lower in women who have
premenstrual syndrome (PMS) and that calcium
supplementation may reduce the severity of PMS
symptoms, we do not know whether any of these
supplements can prevent the initial development of
PMS versus just giving some symptom relief once
you have it. To answer this, investigators who
were conducting the Nurses’ Health Study II cohort
looked prospectively at a subset of women aged 27
to 44 years and free from PMS at baseline entry
into the study. There were 1057 women who
developed PMS over 10 years of follow-up and 1968
women reporting no diagnosis of PMS and no or
minimal premenstrual symptoms. The investigators
looked at dietary questionnaires to determine how
much vitamin D and calcium subjects were ingesting
on the average throughout the decade.
In this study, women taking the greatest amount of
vitamin D and calcium in their diet had a risk
ratio of 0.7 compared with women taking in the
lowest amount of vitamin D and calcium. In other
words, more vitamin D and calcium intake resulted
in a 30% reduction of developing PMS symptoms.
A good supplement for PMS prevention would have
vitamin B6-50mg, vitamin D-200 IU, calcium 500 mg,
and magnesium oxide 300 mg and you would need to
take one tablet twice a day. I could not find any
specific supplement that has this formula in it so
you may need make it up with more than one pill.
PMS and vitamin D, calcium intake
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Nausea from chemotherapy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Ginger helps with nausea: I found sucking on
small sections of crystallized ginger, and
drinking ginger tea with honey especially helpful
with nausea related to chemotherapy treatment.
Another drink I found helpful to the stomach when
on chemotherapy was about 1/4 tspn. nutmeg + 2-3
tsp. honey dissolved with 1 tsp. hot water and
mixed with a glass of fresh cold milk. These
remedies are much better for the body than taking
prescription medications, if the natural products
ease the problems." V.W.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Good Advice - Rules for Inner Peace"
I am passing this on because it definitely worked
for me, and we all could use more calm in our
lives. By following the simple advice I heard on a
Dr. Phil show, I have finally found inner peace.
Dr. Phil proclaimed "The way to achieve inner
peace is to finish all the things you've started."
So I looked around my house to see all the things
I started and hadn't finished, and before leaving
the house this morning, I finished off a bottle of
Merlot, a bottle of White Zinfandel, a bottle of
Bailey's, a bottle of Kahlua, a package of Oreos,
the remainder of both Prozac and Valium
prescriptions, the rest of the cheesecake, some
saltines and a box of chocolates. You have no idea
how freaking good I feel.
Please pass this on to those you feel are in need
of inner peace!!!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
July 10, 2005
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Circulating male hormone levels and female sexual dysfunction
2. Menstrual cramps in adolescents lessened by B.C. pills
3. Reader submitted Q&A - Pregnancy at age 41
4. Postpartum depression prevention
5. Health tip to share - Tai Chi can prevent falls
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Circulating male hormone levels and female sexual dysfunction
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As you may be aware there have been recent efforts
by pharmaceutical companies to promote low dose
testosterone patches for women who have decreased
sexual libido or arousal levels. The FDA has
delayed the patches because of concern about the
long term effect of testosterone on women,
especially with regard to heart disease. While
there have been studies showing that testosterone
supplements for women may increase sexual desire
and arousal, the basic premise of whether low
blood levels of circulating male hormones in women
causes or is even associated with low arousal and
desire has not been shown in good scientific
studies.
A recent study reported in the Journal of the
American Medical Association (JAMA) looked at over
1000 Australian women. They categorized their
self-reported sexual desire and sexual
satisfaction levels to see if they were more
likely to have low serum androgen blood values
than women without self-reported low sexual desire
and sexual satisfaction. They measured total and
free testosterone, androstenedione, and
dehydroepiandrosterone sulfate (DHEA-S).
As it turns out, there was no correlation of serum
testosterone levels or of androstenedione levels
with degree of sexual arousal and desire. This
refutes the concept that replacement of low levels
of blood testosterone in women with testosterone
patches is curing any deficiency. On the other
hand there was some correlation of low DHEA-S
blood levels and degree of sexual desire and
satisfaction. Perhaps the advocates of DHEA
supplements have a better argument for replacement
than testosterone advocates. The authors did point
out, however, that there were many women with low
DHEA-s levels who had normal levels of sexual
desire and arousal. Who knows?
Circulating male hormone levels and female sexual dysfunction
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Menstrual cramps in adolescents lessened by B.C. pills
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Teenaged girls often suffer from severe menstrual
cramps. These are not always present in the first
1/2 to 1 year after menses starts but when the
ovaries begin to ovulate regularly, cramps often
appear. The medical term for menstrual cramps is
dysmenorrhea. Pressure inside the uterus in
dysmenorrhea has been measured to frequently be
higher than that of a labor contraction. It is no
wonder that the cramps can cause loss of time from
school and other daily activities.
The first line treatment for severe menstrual
cramps is non steroidal anti-inflammatory drugs
(NSAIDS) such as ibuprofen or naproxen. This
applies not only to adolescents but to women of
any age with severe menstrual cramps. The NSAIDs
have to be taken on a regular basis not just when
cramping occurs. They work by blocking the
substances that cause the uterine muscle to
contract. Teens need to be told this in order to
take the NSAIDs before the cramps cause pain
otherwise the lack of quick pain relief will make
them think NSAIDs do not help.
Another treatment that doctors also use for
dysmenorrhea is oral contraceptives. Birth control
pills seem to have a quieting effect on the
uterine muscle as well as decreasing the amount of
tissue that is passed during menses. While oral
contraceptives are thought to be effective, good
studies have been lacking.
In a recent study from New York, investigators
gave low dose oral contraceptives to adolescents
having menstrual cramps and they found a
significant reduction in pain scores as well as a
reduction in pain medicine use.
The pills do not make the cramps go entirely away
but they do seem to reduce the symptoms and pain
medicine use by more than in half.
Menstrual cramps in adolescents lessened by B.C. pills
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Pregnancy at age 41
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I am 41 years old and I am trying to get pregnant
by IUI (intrauterine sperm insemination) or IVF
(in-vitro fertilization). My concern is I have
FSH of 5.8 but my estrogen is high. What does this
mean? Plus my FSH fluctuates. I have never tried
a IUI because my doctor is waiting for my FSH to
be under 9 w/o any drugs and my estrogen to be
under 60? I would like to have a full explanation
of what these exact numbers` mean. If I use drugs
to stimulate my follicles I will be using
Follistim. Additionally, is it true Clomid should
not be used with woman in their 40's, I welcome
your insights and suggestions. I would like to
get pregnant as soon as possible."
If your FSH level is too high and the estrogen
levels are too high you run the risk of ovarian
hyperstimulation syndrome when the doctors give
you medicines (eg., Follistim) to stimulate
ovulation from the ovaries. Ovarian
hyperstimulation syndrome expands the ovaries to
almost bursting point with multiple follicles. In
some cases it can be fatal. That is why the
doctors insist that your baseline hormone levels
before stimulation are low so you are at lower
risk for this serious complication.
Over age 40 it is tough to get pregnant. Some
women do but I assume you have been told the
chances are not good. Infertility experts will try
to stimulate the ovaries to give you the best
chance of getting pregnant but even then the
chances are still low but expensive. From a
literature review, it appears that the costs per
child born greatly increase after the age of 40
for both intrauterine insemination with mild
ovarian stimulation and in vitro fertilization
treatment, while in cases of age 44 and over,
prognosis is flat zero.
Over age 40, the IVF success rate (full term
delivery rate) is about 3.6% in one study. In
another study, using a combined clomiphene
citrate/gonadotrophin protocol for non-assisted
reproductive technology fertility treatment,
pregnancy rates varied significantly with patient
age: 9.3% in women less than 40 years vs. 2.4% in
women greater or equal to 40 years old. You can
use Clomid over age 40 but it is not very
successful.
Intrauterine insemination without ovarian
hyperstimulation for male or cervical factor in
women aged 40 or over results in a cumulative
probability of ongoing pregnancy following 3
cycles of IUI of 28.2% for women under 40 and 0.0%
for the older group over 40.
Overall, the chance of becoming pregnant over age
forty is about 5% or less. I am not sure that it
is any lower than that without any treatment at
all. While you are presumably very desirous to get
pregnant, all the money you spend with ovulation
stimulation and IUI may only increase your chances
from 4% to 5% or so. You will need to decide
yourself if the money is worth it.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Postpartum depression prevention
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As Tom Cruise and Brook Shield use the media to
discuss their thoughts on the management of
postpartum depression, others are looking at what
studies have been done in order to PREVENT
postpartum depression. A recent scientific paper
looked at numerous studies in the medical
literature to see if there were any successful
strategies that could be used to prevent or at
least lessen the likelihood of developing
postpartum depression.
In looking at 15 studies that encompassed almost
770 women, the authors concluded that most
strategies did not really work well to prevent
postpartum depression (PPD). The only ones that
showed a small trend toward significantly
preventing PPD involved health care professionals
who singled out women at high risk and followed
them frequently after delivery. Individual therapy
was better than group therapy and postpartum
therapy alone was better than antepartum plus
postpartum therapy.
The authors concluded that "diverse psychosocial
or psychological interventions do not
significantly reduce the number of women who
develop postnatal depression". The most promising
intervention is to provide intensive, professional
postpartum support.
Postpartum depression prevention
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share - Tai Chi can prevent falls
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In the U.S. it is estimated that 30% of people
over 65 living in the community fall each year and
this rises to up to 50 percent for people in long-
term care facilities, such as residential homes.
One in 10 falls results in a fracture.
Tai Chi is an ancient Chinese martial art form. It
consists of a series of slow, gentle, continuous
movements. In a recent study of Tai Chi in the
elderly (average age 28) the participants
significantly reduced their risks of falling.
Twenty-nine elderly people took part in a 12-week
course three times a week, while 30 others were in
a non-exercise control group. The study found the
physical fitness of the Tai Chi group showed
significant improvement, with stronger knee and
ankle muscles, improved mobility and flexibility
and better balance.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Disaster"
One afternoon a man came home from work to find
total mayhem in his house.
His three children were outside, still in their
pajamas, playing in the mud, with empty food boxes
and wrappers strewn all around the front yard.
The door of his wife's car was open, as was the
front door to the house.
Proceeding into the entry, he found an even bigger
mess.
A lamp had been knocked over, and the throw rug
was wadded against one wall.
In the front room the TV was loudly blaring a
cartoon channel, and the family room was strewn
with toys and various items of clothing.
In the kitchen, dishes filled the sink, breakfast
food was spilled on the counter, dog food was
spilled on the floor, a broken glass lay under the
table, and a small pile of sand was spread by the
back door. He quickly headed up the stairs,
stepping over toys and more piles of clothes,
looking for his wife.
He was worried she may be ill, or that something
serious had happened. He found her lounging in the
bedroom, still curled in the bed in her pajamas,
reading a novel. She looked up at him, smiled, and
asked how his day went. He looked at her
bewildered and asked, "What happened here today?"
She again smiled and answered, "You know everyday
when you come home from work and ask me what in
the world did I do today?"
"Yes," was his incredulous reply.
She answered, "Well, today I didn't do it."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Back to top
********** Health Newsletter ***********
July 24, 2005
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Biweekly from BackupMD on the Net
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. SSRIs effectiveness for depression rx questioned
2. Ovarian Cysts
3. Reader submitted Q&A - Splenda(R)
4. Negative urinalysis may still benefit from treatment
5. Health tip to share - Baking soda to wash with
6. Humor is healthy
The next newsletter will be in two weeks.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. SSRIs effectiveness for depression rx questioned
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Many medical professionals and patients have
accepted that selective serotonin re-uptake
inhibitors (SSRIs) make a difference in treating
the symptoms of depression. Prescriptions for
citalopram (Celexa(R)), fluoxetine (Prozac(R)),
paroxetine (Paxil(R)) and sertraline (Zoloft(R))
have increased tremendously in the last decade.
Unfortunately the data on which recommendations of
SSRI use for mild or moderate depression are based
has come into question.
Investigators in the U.K. point out that even
though SSRIs reduce the symptoms of depression,
they only do so by a minimum amount. Scores on
depression scales were only reduced by less than 2
out of a possible maximum score of 52. Analysis of
multiple studies found that SSRIs were only about
10-17% better than placebos. If you look at the
data and arguments in the below referenced British
Medical Journal, you might conclude that SSRIs do
not make a meaningful difference in mild to
moderate depression symptoms.
While you might think that in severe depression,
SSRIs are more effective, data for that is also
questionable. Any effect the SSRIs may have may be
due to a slight sedative effect they have that can
alter depression rating scores. The authors came
to the following conclusions:
1. Recent meta-analyses show selective serotonin
reuptake inhibitors have no clinically meaningful
advantage over placebo
2. Claims that antidepressants are more effective
in more severe conditions have little evidence to
support them
3. Methodological artifacts may account for the
small degree of superiority shown over placebo
4. Antidepressants have not been convincingly
shown to affect the long term outcome of
depression or suicide rates
5. Given doubt about their benefits and concern
about their risks, current recommendations for
prescribing antidepressants should be reconsidered
If you or someone you know is on an SSRI
medication, you should seriously consider talking
to your doctor as to whether it is really helping
you enough to be worth the expense as well as the
risk of side effects.
SSRIs effectiveness for depression rx questioned
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Ovarian Cysts
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ovarian cysts are sometimes misunderstood by both
patients and doctors alike. In a reproductive age
woman, an egg is formed each month in the first
two weeks of the menstrual cycle. It is surrounded
by a cystic area full of fluid and called a
follicle. Usually a follicle does not get bigger
than 1 inch (2.5 cm). At approximately 2 weeks
after menses and 2 weeks before the next menses,
the egg extrudes from the follicle (ovulation) and
the cystic area heals over to become a corpus
luteum (luteal) cyst. This cyst forms some cells
which secrete estrogen and progesterone. When
pregnancy does not occur, the cyst just dissolves
and goes away.
Both the follicular cyst and the luteal cyst can
sometimes go "haywire" and just continue to grow
and not go away when they should. Eventually they
both go away but sometimes they can swell up,
rupture, bleed or even twist causing moderate pain
before they go away. Most cysts under 3 cm (1.5
inches) will gradually regress on their own and do
not cause any symptoms. Cysts up to 5 cm in size
(2 inches) almost always regress eventually and
most doctors do no recommend intervening with
surgery without giving those cysts 3-4 months to
dissolve themselves.
This normal physiologic process becomes
complicated when a woman has an imaging study such
as an ultrasound or CAT scan for abdominal pain
and a "cystic area" in the ovary is detected. If
it is reported by the radiologist as a cyst, many
patients will assume their pain is coming from the
cyst as opposed to the cyst being just an
incidental finding. I wish the radiology
technicians would not mention any cystic areas to
the patient that are less than 3 cm because if
they do, a patient begins to believe that
something has to "be done" about that ovarian
cyst.
Sometimes other cysts can form in the ovary that
do not come and go with the monthly menstrual
cycle. Endometriotic cysts (endometriomas) and
benign ovarian tumors like cystadenomas or
dermoids can form in the ovary. Endometriosis can
cause pain whereas the other ovarian tumors
generally do not.
When cysts other than endometriomas cause moderate
pain, they usually do so rather acutely such as
when they rupture, bleed or twist. If you get a
sudden onset of lower abdominal pain then you need
to be evaluated for a cyst. Also if you get sudden
onset of pain and nausea and vomiting, that may
represent a twisted cyst.
If you have a ruptured cyst or bleeding into a
cyst (some call it a bruised ovary), the pelvic
pain may take as long a 3-4 months to totally go
away. At other times the pain is incapacitating
enough that emergency surgery has to be performed.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Reader submitted Q&A - Splenda(R)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I recently received an email entitled "Splenda
A Poisonous Clorocarbon"..... I would like your
opinion on this. Do you agree it is lethal? Or do
you recommend it to your patients? I am a 53 yr
old female with Type 2 Diabetes and am also
obese." - DF
I do not consider Splenda(R) lethal or even harmful.
That is the short answer.
Splenda is made from regular sugar (sucrose). In 3
places on the molecule, chlorine (Cl-like the Cl
in NaCl table salt) is substituted for the OH
molecules (like the OH in water-HOH). This makes a
new molecule called sucralose which tastes sweet
like sugar but is not metabolized to calories like
sugar. There have been hundreds of animal studies
indicating that it is very safe and about half a
dozen randomized controlled human studies with no
adverse effects. I am not aware of any adverse
effects of sucralose other than somewhat
unsubstantiated claims on Internet web sites.
All of the artificial sweeteners (acesulfame-K,
aspartame, neotame, saccharin, sucralose) have at
sometime or another been subjected to circulating
rumors that they are toxic or they produce cancer
or some other medical problem. Epidemiological
studies in humans did not find the bladder cancer-
inducing effects of saccharin and cyclamate that
had been reported from animal studies in rats. The
Nutrasweet (aspartame) rumors I occasionally hear
about do not have any substantiated studies
showing adverse affects. Some initial concerns
about Splenda because of animal studies about
brain tumors and a decreased seizure threshold
with epilepsy, have not been observed at all with
humans. Remember even Tylenol is dangerous in
animals.
Still, I have family members who swear up and down
that aspartame causes medical problems even though
I keep showing them that no data exists for such
claims. Therefore I have no reservations about
people consuming Splenda or other artificial
sweeteners. They do reduce your calorie intake and
effect on raising blood sugar compared to the same
food or drink with plain sugar in it. The American
Dietetic Association considers Splenda safe. They
state that "consumers can safely enjoy a range of
nutritive and non nutritive sweeteners when
consumed in a diet that is guided by current
federal nutrition recommendations."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Negative urinalysis may still benefit from treatment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Urinary tract infections are not uncommon,
especially in women. Symptoms include burning on
urination, urinary frequency during the day as
well as having to get up from sleep to void and
lower abdominal midline pain or discomfort. When a
woman goes to the doctor with a suspicion of
having a urinary tract infection, the common
doctor's office laboratory tests are:
1) using a dip strip to check for bacterial
infection chemical problems abnormalities in the
urine such as leukocytes and nitrites
2) performing a microscopic analysis of the urine
looking for red blood cells and white blood cells
3) sending the urine for a bacterial culture
The dip strip is the most commonly used method of
detection because it is the least expensive and
about 85% accurate in picking up an infection. The
question the doctor has to answer is what if the
dip strip is negative but you still have symptoms,
should the doctor still prescribe antibiotics even
if the test is negative?
A recent study in New Zealand looked at women aged
16-50 years presenting with possible urinary tract
symptoms but in whom a dipstick test of midstream
urine was negative for both nitrites and
leukocytes. Half of the women were given
trimethoprim 300 mg daily (a sulfa-based
antibiotic for three days or a placebo. They then
measured how many days it took for the burning
urination to resolve as well as the other
symptoms.
At the end of seven days of treatment, only 10% of
the women taking the antibiotic still had burning
on urination while 40% of the women who had taken
placebo still had burning.
These findings would imply that women should be
treated for any symptoms of urinary tract
infection even if the dip strip is negative.
Remember these findings the next time you have any
urinary symptoms and go to the doctor.
Negative urinalysis may still benefit from treatment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Health tip to share
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"I have found that using baking soda in the shower
is great for washing all the 'stinky parts' of the
body. A hand held shower is probably necessary.
Baking soda gently exfoliates and is gentle enough
for the genital area (all the way) to the more
oily, 'fragrant' areas of the rear." DIY
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
11 People On A Rope"
Eleven people were hanging on a rope under a
helicopter, ten men and one woman. The rope was
not strong enough to carry them all, so they
decided that one has to leave, because otherwise
they are all going to fall.
They were not able to name that person, until the
woman held a very touching speech. She said that
she will voluntarily let go of the rope, because
as a woman she is used to giving up everything for
her husband and kids, or for men in general, and
was used to always making sacrifices with little
in return.
As soon as she finished her speech, all the men
started clapping their hands.......
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time.
Your BACKUPMD on the Net.
Rick
Frederick R. Jelovsek MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
