May
25
2013

What We Can Do About Superbugs

Introduction

This article is about what we can do about superbugs. Several decades ago nobody talked about superbugs. Then came stories of “flesh-eating disease” or necrotizing fasciitis. Since 2001 it became obvious that these cases have become more common. Methicillin-resistant Staphylococcus aureus (MRSA) was often the underlying cause.

Antibiotics for weight gain in cattle

Government bodies accuse physicians of overprescribing unnecessary antibiotics for viral colds and flus. All physicians had to attend educational programs as part of the continuing education programs to use antibiotics only sparingly.  But the frequency of these serious infections often requiring amputations and mutilating surgeries continued to escalate. Research into the phenomenon of increasing superbugs took place already in the 1970’s. In 1977 the FDA came to the conclusion that antibiotics were used widely in the US by the agroindustry for weight gain in livestock (pigs, cattle, chicken, turkeys). Although masked as protecting animals from infections, the real motivation of the farmer was to increase profits. The FDA recommendation in 1977 to change the practice of feeding livestock antibiotics did nothing to change that.

Farmers continued to use the old antibiotic feeding practice

After a court review in 2012 a New York court ordered the FDA to do something about the same problem. The answer was a lame recommendation of a voluntary program to downsize the use of antibiotics in livestock, requiring a vet and a prescription for antibiotics. The problem with this is that farms had no mandatory checks of livestock by trained inspectors. The ruling about antibiotic reduction contained no penalties for farmers who continued the old antibiotic feeding practice. Fast-forward to an American citizen who visited India recently as told in this story.

Superbugs are all over the world

It is clear that superbugs are all over the world. It is also clear from this article (and other literature I have reviewed) that 80% of today’s antibiotics are fed to livestock, not to treat infections, but because of their effect on weight gain in livestock and the associated larger profits. The result is that we are looking at farming practices that produce deadly superbugs. Next we are reading headlines about a recall of meat meat and meat products.

Here is an interesting list from the Environmental Working Group, which shows what percentage of meats in your neighborhood grocery store is contaminated, and these are the numbers for superbug contaminations: The worst is ground turkey with 81%, pork chops with 69%, ground beef with 55% and chicken breasts, wings or thighs with 39%.

What We Can Do About Superbugs

What We Can Do About Superbugs

Wash meat thoroughly

This shows how important it is to wash meat thoroughly and to cook it long enough to kill the superbugs. It is also extremely important to frequently wash your hands when you prepare meat. This avoids  colonizing your skin surface with superbugs. The first step is for a person to have skin surface flora with superbugs. The second step is to get a small abrasion or a skin sore where a superbug can enter. The final step is that this bug multiplies under the surface of the skin and starts a serious infection. If the immune system is not in top shape to eradicate these bugs right away, the next step may be flesh-eating disease or toxic shock syndrome.

Solutions to stay on top of Superbugs

In northern Saskatchewan, one the provinces of Canada, an 8 year community based study was done to see whether it would be possible to reduce community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) by a combination of hand washing and education regarding appropriate antibiotic use. Using this program it was shown that in the time period of 2006 to 2008 the infection rates went down from 242.8 to 129.3 infections/10,000 population, which is almost half of the infection rate from before.

Hospital associated methicillin-resistant Staphylococcus aureus

What can physicians and nurses do about hospital-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) and other superbugs in the hospital? In a hospital it is extremely important that HA-MRSA free patients do not get exposure to this superbug . Their immune system is already weak from the underlying disease. This is how they got into the hospital. At Stanford University a robot was developed that emits pulsating ultra violet light to kill any leftover superbug after the initial cleanup with scrubbing using bleach and germicidal solutions. Support staff treat the isolation rooms with the double treatment and robots disinfect the operating rooms overnight. So far tests have shown a complete eradication of the superbugs with these methods.

Breaking the chain of infection

Since about 2005 the major food production animals have been shown to be colonized with superbugs (MRSA) as this publication shows.

With 80% of the world’s production of antibiotics still going into the agroindustry for weight gaining purposes, it is high time that international “laws with teeth” apply. The WHO needs to get action in this and the public needs to put pressure on politicians to achieve this. Medical history has shown that infectious epidemics can be cured by breaking the chain of infection. In the example regarding superbugs the story of interrupting the chain of infection is exactly the same here: As shown in this study from Stanford University MRSA bugs are not contained in organic foods. So, by attempting to eat 100% organic, which can be challenging at times, you can intercept the infectious cycle involving MRSA and other Superbugs.

Attempt to eat mostly organic foods

You do not get exposed to the meat from food production animals treated with antibiotics for growth purposes. In the meantime, you are protecting yourself by keeping fit, taking vitamins and supplements all with the hope that the immune system stays strong from this. By eating organic meats and meat products you also keep your body free of toxins that would weaken your immune system and set you up for getting autoimmune diseases down the road.

The end result is that people who follow this example avoid colonization from exposure to superbug-infected meat products.  At the same time this prevents exposure to other toxins that a manufacturer of organic food can not use. Here is a story of a company that produces meat products without antibiotics (organic meats).

Conclusion

You can interrupt the infectious cycle of superbugs by eating organic foods. Make sure your immune system is strong by exercising, supplementing with vitamins and minerals. Wash your hands with soap and clean water, particularly after handling meat or meat products. Do not take antibiotics for a long time unless there is a specific reason of  bacterial infection that requires it. Do not consume meats from animals that were fed antibiotics. Read food labels!

References

1. Stick to organically grown meats:  http://www.helpguide.org/life/organic_foods_pesticides_gmo.htm

2. Super bugs in hospitals:  http://patients.about.com/od/atthehospital/a/hais.htm

3. Useful 2008 article : hand washing, reducing antibiotic use in humans and in animal feed are the solution to combat superbugs. http://evolution.berkeley.edu/evolibrary/news/080401_mrsa

Last edited May 25, 2013

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Mar
10
2013

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

Introduction

March is colorectal cancer awareness month, so let’s discuss prevention. Only 40 years ago cancer of the cervix was one of the major killers for women, but with the introduction of the Pap test this has all changed.  For those women who get that screening done, there is no need for fear. The mortality rate from cervical cancer since the 1970’s has steadily decreased as shown in this link.

As far as cancer of the prostate is concerned, a lot of progress with regard to early detection has been made due to the introduction of the PSA blood test, which is used as a method of screening. As a result men are diagnosed earlier with prostate cancer resulting in more cures as the cancer found is at an earlier stage. Here is a link depicting the effect of the PSA test on mortality rates from prostate cancer in time.

March is colorectal cancer awareness month, so let’s discuss prevention

March is colorectal cancer awareness month as this article explains. The key is early detection and treatment as with any type of cancer. Specifically, with rectal and colon cancer there are mostly no symptoms, as blood in stool or any other symptoms occur only late into the disease. What we do know, however, is that there is a long latent phase where precancerous mucous membrane changes lead to polyps and these will degenerate in time into cancer of the colon or rectum.

Not everyone has the same risk of developing colon cancer or rectal cancer.  There are people with a higher rate of colorectal cancer, as they carry a susceptibility gene in their families. A healthy lifestyle can also reduce the risk of colorectal cancer.

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

Polyps are the precancerous precursors for colorectal cancer

It is now widely accepted that polyps are the precancerous precursors for colorectal cancer and colonoscopies done on everybody starting at age 50 (those with family risk factors much earlier) have already been shown to have decreased the frequency of the disease as the data from the CDC show. The problem is that the survival curves for colorectal cancer have only a swallow incline. A steeper decline would mean better survival of colorectal cancer patients. In the case of the mortality rates of cervical cancer and prostate cancer the slope showed a more rapid decline translating int much better survival rates.

Not enough colonoscopies are done

The incidence of colon cancer should have gone down to almost the zero point. All that has been achieved so far is a reduction of a portion of cases (those who went for colonoscopies early enough before it turned into colon cancer); this is by far not an elimination of colorectal cancer. The reason for this is the fact that in many cases people have colonoscopies too late when the polyp has already turned cancerous, or invasive colon or rectal cancer is already present at the time of the first colonoscopy.

Designating March as colorectal awareness month makes a lot of sense to me

I happen to come from a family where my mother died in 1980 from colon cancer at the age of 59. Because of this my doctor told me that I have a risk of about 3-fold higher than the population at large to also develop colon cancer. I have had colonoscopies since the age of 40 every 3 years. Ironically a few days ago right during the colorectal awareness month, I was getting my 9th colonoscopy. On three occasions polyps were removed, which tells me that the cancer-screening program works!

Why screen for colon cancer in regular intervals?

So why is it important to screen in regular intervals? One reason is that we are now exposed to more toxic chemicals in our environment and food than 100 years ago. So all cancers, but especially colorectal cancer rates have increased. We know the pathophysiology, which is the science that studies how an illness develops. We know that it takes several years between the occurrence of the first precancerous cells that form in the lining of the gut (called “mucosa”) and the formation of polyps. It takes another few years before polyps turn cancerous. This means that there is enough of a time interval to do screening. If we are not aware of this and ignore it (as unfortunately many people do), the process will run down the conveyor belt on an automatic program, which ends up in end stage colorectal cancer. The stages of colon cancer are depicted in this link.

Invasive colon cancer is deadly

As the table of my chapter on colon cancer staging shows, the invasive end stage colon cancer (stage IV or Duke D) has a 5-year survival rate of only 6%. Even when the cancer is limited to stage II (also called Duke stage B) there would be a 5-year survival of only 80% (see table in link).

What does screening really achieve? On an individual basis the gastroenterologist who does the colonoscopy can screen the whole colon for premalignant polyps and remove them during the procedure. This moves the potential cancer staging backwards to beyond any detectable cancer, as all of the potential early cancer cells would have been inside the polyp (called local “in situ” disease) and were removed by cauterizing the stalk (see above link). There is another potential factor that can help to reduce colorectal cancer incidence: Recently a connection was made between

Helicobacter pylori as a risk factor for colorectal cancer

Helicobacter pylori (H. pylori) infection of the stomach and polyps in the colon as well as colon cancer. In the past several smaller studies failed to show this correlation. It took 156,269 patients in this study to show that there was a correlation. As H. pylori is being tested for and treated more and more, this will also have a positive effect on lowering the frequency of colorectal cancer.

Mass colonoscopy screening

On a population basis with mass colonoscopy screening the incidence of colorectal cancer is reduced. The reduction of colon cancer would be much faster. Eventually it would turn into a disease similar to cancer of the cervix. Here it still matters whether you screen or not, but very few people have to suffer from it. Here is an image from a paper (look for Fig. 2, halfway down the page). It shows that survival benefits (longer lives) are registered only after 10 years or more following colonoscopy.

Colorectal cancer statistics

Every polyp that is removed will add up to the colon and rectum health of the nation at large. This shows statistically, when you sum up all of the colonoscopies done around the country year after year.  We need a nationwide and worldwide awareness that colorectal cancer screening is something worthwhile doing. This cancer is the third most frequent cancer in many parts of the world.

I am grateful that colonoscopy screening works, as I had polyps removed three times over a 29 year span and I did not have to go through all the surgical procedures that my mother had to endure. Had I lived 50 years earlier I may not have lived long enough to tell you how important colonoscopy screening is.

Here are the recommendations

      1. Let us assume there is no risk of colorectal cancer in your family. In this case screen once at the age of 50. This makes sure you are not one of the spontaneous colorectal polyp producers. If OK, screen every 10 years provided the colonoscopy is always negative.
      2. A family history of direct bloodline relative increases the risk for colorectal cancer. Direct bloodline relatives are: mother, father, brother or sister. If one of them had cancer of the colon or rectum, you have a higher cancer risk. In these individuals a gastroenterologist must do colonoscopies every 3 years.
Missed polyps during a colonoscopy
      1. There may be up to 15% of missed polyps during a colonoscopy. But with the next colonoscopy there is a high likelihood that the physician catches the abnormal polyp in time. The pathologist confirms that the subsequent screening caught them before they turn cancerous.
      2. There are special cases, families with genetic syndromes like the familial polyposis of the colon. In these families a gastroenterologist needs to screen children/young adults for polyps when they are still young. This is from the age of 20 to 25 years onwards.

Don’t complain, if you belong to category 1 or 2 as it could be much worse (category 3). Cancer is serious business. Remember, March is colorectal cancer awareness month.

More information about colon cancer.

Jan
14
2013

Treat The Cause, Not The Disease

At an anti-aging conference the topic of one of the talks was: treat the cause, not the disease. Traditionally, in Western medicine the doctor listens to the patient’s complaints, examines the patient, does some tests and then comes up with a diagnosis. Meanwhile a specific treatment regarding this diagnosis is then developed and a cure is expected. When there is no treatment success, it is disappointing or frustrating to both the patient and the physician. With anti-aging medicine a different approach is suggested with the principal “treat the cause, not the disease”. It is noteworthy that with this approach the doctor can incorporate all of the aspects that play a role with regard to the causes.

Dr. Magaziner: “Treat the cause, not the disease”

Dr. Allan Magaziner gave a lecture regarding this topic at the 20th Annual World Congress On Anti-Aging And Regenerative Medicine in Las Vegas (Dec. 12 to 15, 2012). His talk was entitled “Treat the Causes, Not the Disease…With a Patient-Centered, Integrative Approach”. He explained that there are 12 different categories that need to be taken into account when it comes to delineating causes of an illness in a patient, which he called the “diagnostic dozen”.
1.      Is there oxidative stress?
2.      Is there nutrient imbalance?
3.      Is digestive absorption optimal?
4.      Are there food intolerances?
5.      Is there mitochondrial dysfunction?
6.      Are the hormones and neurotransmitters functioning properly?

More points to consider

7.      Is the patient under excessive stress?
8.      Are there specific electromagnetic field disturbances in the body and would biofeedback be helpful?
9.      Is the body’s toxic burden so high that it requires detoxification treatment?
10.    Has there been environmental exposure to heavy metals?
11.    Are genetic factors making the patient more vulnerable to disease?
12.    Is the immune system weakened and are there signs of inflammation or chronic infection?

Treat The Cause, Not The Disease

Treat The Cause, Not The Disease 

BPA from plastic bottles can cause cancer

A point often overlooked is that life in the 21st century has become more complex. That is to say, we are exposed to various degrees of pollution, such as lead and mercury, but also to BPA from plastic bottles. 93% of Americans, Dr. Magaziner said show measurable levels of BPA in urine. Surprisingly, research showed that many years of exposure to BPA causes breast cancer in women and prostate cancer in men!
Specifically, Dr. Magaziner gave an example of a 3-year-old boy with autism with a full discussion of all the diagnostic factors. Notably, conventional medicine treats autism by giving the children special educational programs and speech therapy on the one hand. On the other hand, the physician refers the patient to a physiotherapist to treat their gait problems. That is to say, typically an autistic child does not respond to this approach.

Autistic children often have heavy metal toxicity

In this case, when Dr. Magaziner saw this autistic child, he ordered blood tests that showed heavy metal toxicity. In particular, he ordered several chelation treatments to remove the heavy meals. The child had a leaky gut syndrome, had chronic yeast infection and a gut dysbiosis. It is important to realize that the doctor addressed all of these problems separately. Surprisingly, within a few weeks there was improvement of the child’s condition. First, his balance problems disappeared. Secondly, in addition, there was improvement of his attention span, concentration and memory. Thirdly, the child also started taking an interest in what was happening around him.

A girl with Crohn’s disease

Dr. Magaziner discussed another case, namely a 13-year-old girl that presented with Crohn’s disease. The girl had blood in her stools and had terrible bowel cramps. Conventional medicine including steroid therapy had failed to show improvements. Going through the diagnostic dozen revealed several important positive findings that were unknown before. As a result, attention to these factors led to a complete cure. Important findings in this girl were food sensitivities that could be pinpointed with a battery of blood tests involving IG-G, IG-A and IG-E antibodies to various food groups.

ONDAMED and Lyme disease

The physician used ONDAMED, an electro-diagnostic tool to normalize abnormal electromagnetic fields in the gastrointestinal region.
Perhaps the most impressive case was a patient with Lyme disease. Traditional medicine has very little to offer to such a patient and often the patient will go on to develop a fibromyalgia like arthritic condition leading to chronic disability. The patient responded to a combination treatment consisting of such various things as Curcumin, vitamin D3, cinnamon, CoQ10, D-Ribose, L-Carnitine, magnesium and zinc to help various enzymatic reactions regarding the anti-inflammatory effect. In addition, the patient received  intravenous vitamin C to strengthen the Detox system. All of this helped to detoxify the patient and support the adrenal gland function.

Additional cases of Lyme disease

In addition, Dr. Magaziner gave 10 treatments of ONDAMED involving various frequency settings to assist the body in its recovery. The patient had a complete recovery from severe Lyme disease!
Dr. Magaziner was also one of the speakers in a company sponsored evening about the use of ONDAMED in the treatment of Lyme disease. He presented a total of 7 cases of Lyme disease where ONDAMED was successful in treating this difficult to cure condition! The common denominator in these cases was that various low-grade infections lingered on and other environmental factors weakened the immune system further. ONDAMED helped to strengthen the immune system together with detoxification treatments.

“Treat the cause, not the disease” is true even when multiple causes are present

There is nothing magic about the new approach of treating patients.  Proactive medicine treats the cause of the patient’s illness while conventional medicine focuses on symptomatic treatment of a disease. Often there are several causes that can hide behind a diagnosis and exist parallel in a patient. With treatment of all these causes the patient recovers and regains full health.

Dec
17
2012

From Wheat to Autoimmune Disease and Obesity

Introduction

This is a summary of the lessons from the 2012 Anti-Aging Conference in Las Vegas…from wheat to autoimmune disease and obesity. It is not possible to summarize all the multitude of lectures from a three day conference on one page. However, what was striking was that several topics developed into a common thread. These were the topics of autoimmunity, obesity, diabetes, hormone disbalances and more. Dr. William Davis, the author of the book “Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health” explained how the BASF, a major chemical company from Germany was able to chemically modify the genes of wheat in the 1960’s and 1970’s.

Clearfield wheat has much more gluten

The farmers liked that the new wheat (called Clearfield wheat) grew with stronger roots, shorter final stems and much larger grains so the yield per acre was higher. The developers of this type of wheat patented it under the name of Clearfield wheat. They did not publicize at the time that there was a significant increase of the gliadin content. Clearfield wheat contains much more gliadin in comparison to the old wheat strains people consumed for thousands of years. Gliadin gets rid of the glue like substance between the gut cells. This causes leaky gut syndrome, something that came out in many other lectures throughout the conference. This exposes the immune cells to foreign proteins from the gut.  The immune system in turn hyper react with the production of autoimmune antibodies.

Stages of autoimmune diseases

Dr. Aristo Vojdani explained in his lecture that there are three stages of autoimmune disease. First, there is the silent stage where there are no symptoms, but the immune system is starting to react. Next there is autoimmune reactivity, which is the second stage. The third stage is autoimmune disease where there are signs of loss of body function. Autoimmunity develops in about 1/3 of identical twins in families who are prone to this. When the researchers examined non-identical twins as a control group, only 2% to 5% of twins developed it.

Autoimmune diseases due to genetics and the environment

This tells us that genetics are responsible for only about 1/3 of the cases of autoimmunity. The other 2/3 come from the environment such as genetically modified foods. In addition, fat cells secrete toxic chemicals and inflammatory cytokines.  Dr. Vojdani emphasized that gliadin in our foods has become one of the major factors of driving autoimmune diseases up in the last few decades. The immune cells with the name of T cells determine whether they accept our own cells as “self”.  Alternatively, they consider other cells as “foreign” and attack them. This occurs in autoimmune diseases such as Celiac disease, ulcerative colitis, lupus, rheumatoid arthritis, MS and others.

Las Vegas December 15, 2012v

Las Vegas, December 15, 2012

There are regulatory T cells, which are good. But there are also T cells whose genetic material underwent a change and became Th17 cells. These cells are a kind of “Pac Man” cells that attacks body cells. Altered gut flora (called gut dysbiosis) in connection with a leaky gut syndrome contributes to the formation of these aggressive Th17 cells. It is the combination of gliadin with bowel dysbiosis that drives the development of autoimmune diseases. Behind this is the fact that the gut plays a major role in the normal functioning of the immune system. Normally there is a tight connection between the gut cells that form the lining of the gut so that there is no exposure of immune cells from the blood to the contents of the gut flora.

Antibody titer tests

We are fortunate that researchers have developed antibody titer tests for the major food groups and these can be valuable pointers that can be used as a tool during the first two stages of autoimmunity before autoimmune disease causes permanent damage. Using these tests on large population groups researchers have found that common food allergies develop against wheat, dairy products, soy and eggs (as Dr. Pamela Smith remarked and Dr. Thomas Alexander explained in detail). A few blood drops suffice to determine IGG, IGA and IGE antibodies.  The test includes a whole battery of antibodies against common foods. This helps the physician to monitor the development and treatment of autoimmune diseases.

Obesity wave

Back to the leaky gut and obesity. The obesity wave in North America and the rest of the world started when the newly patented Clearfield wheat was introduced. With the higher gliadin in wheat products the balance in the gut was changed, more gliadin entered the body, it bound to the opiate receptors of the appetite center (although it is structurally differently from opium) and caused a hunger for more of the same product. The excess calories –in this case from wheat products- are stored as fat.

Aromatase in fat cells causes estrogen dominance

Fat cells by themselves have their own hormones and inflammatory substances causing various diseases. Diabetes, high blood pressure, heart disease, strokes and even cancer are among these. Add to this that with obesity the enzyme aromatase from fat cells causes elevated estrogen production. This causes estrogen dominance and results in heart disease and breast cancer in females. In males too much estrogen causes heart disease and prostate cancer.

Leaky gut syndrome

The story of the A4M conference 2012 in a nutshell: Wheat products with the increased gliadin (gluten) content caused increased leaky gut syndrome in the population since the 1970’s. This is the cause of the wheat addiction, which was further fueled by the obsession of the regulatory bodies to recommend eating according to the food pyramid (a splendid marketing pyramid for wheat consumption, as one of the recommended products are cereals and wheat). With these findings the cause of the obesity wave can be clearly seen. Along with obesity comes the flood of autoimmune diseases, which have developed from the action of the Pac Man type TH17 immune cells that attack various tissues in the body. The common denominator in the body is a low-grade chronic inflammation that Dr. Vojdani explained in more detail. This causes blood vessel diseases culminating in high blood pressure, heart attacks, strokes and cancer.

There were many other lectures that I attended. Some dealt with bio-identical hormone replacement. Others discussed telomere health and the effect of fitness on an ongoing basis to achieve longevity. In almost every lecture various speakers discussed the importance of lifestyle issues. This went through the conference lectures like a red thread. Nutrition is not the only factor in longevity. Exercise on a regular basis has a powerful healing effect. It can be instrumental in preventing about 50% of diseases, especially the main killers like heart attacks, strokes and cancer.

More info

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Dec
01
2008

Treating Gastroesophageal Reflux Helps Asthmatic Kids

Asthma in children can be associated with allergies, but as Dr. Aaron K. Kobernick reported recently, other health conditions can also contribute to childhood asthma. He found that approximately two thirds of children with persistent asthma who had no allergic symptoms had another health condition, namely gastroesophageal reflux disease. The condition of acid reflux aggravates asthma. A prospective study examined children with moderate persistent asthma over a 2 year period. Initially the children underwent spirometry testing to assess their lung function. Another test involved monitoring of the acidity (ph values) in the esophagus of those children. The latter test demonstrated that the majority of the asthmatic kids also had GERD (gastroesophageal reflux disease).

Treating Gastroesophageal Reflux Helps Asthmatic Kids

Acid reflux aggravates asthma

 

 

 

Those children who were free of acid reflux received asthma medication only, but the patients with acid reflux and asthma received medication to treat the reflux.
In some cases surgical intervention was necessary. It became apparent that the children whose reflux was treated either surgically or with medication had an improvement of asthma symptoms of 22 to 25 %, whereas asthma medication alone contributed only to an improvement of 11%. Dr. Kobernick concluded that the large airways can react to the exposure of stomach acid, which results in an aggravation of asthma symptoms. Treating the acid reflux condition will result in less asthma in young patients with GERD.

More information on:

1. Asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. GERD: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/acid-reflux-gerd-esophagitis-barretts-esophagus/

Annual Meeting of the American College of Allergy, Asthma, and Immunology, November 6 – 11, 2008, Seattle, Washington

Last updated Nov. 6, 2014

May
01
2008

Early Use of Immunosuppressive Drugs for Early Crohn’s Patients

So far the strategy of treating patients, who were newly diagnosed with Crohn’s disease, was the use of corticosteroids to control abdominal pain and bloody diarrhea. The conventional mode of treatment consisted of a “step-up” treatment: after corticosteroids the use of immunosuppressants and finally antibody treatment would follow to curb the inflammatory response. International data which were published in the Lancet (February 23 issue) points to a safer and more effective treatment protocol. It consists of a “top-down” approach rather than of the conventional “step-up” approach. Patients receive immunosuppression early in the form of azathioprine and also the antibody infliximab, known as Remicade. Another study examined patients who were on maintenance therapy with adalimumab (Humira). They experienced sustained improvements in the symptoms that are associated with Crohn’s disease. After 4 weeks of induction therapy with the medication patients with mild and severe depression had improved to such an extent that they returned to the normal range. They were also assessed regarding fatigue and after treatment they showed a significant improvement in their daily functioning. The two treatment protocols were compared in a trial involving 129 patients with Crohn’s disease who had no previous treatment. At the end of the trial the researcher found that 65% of the group that had received the “top-down” treatment was symptom free after 26 weeks of treatment. Contrary to this only 36% of the “step-up” patients went into remission during the same time.

Early Use of Immunosuppressive Drugs for Early Crohn's Patient

Crohn’s before and after immunosuppressive drugs

When the patients were examined after 1 year, 62% of the “top-down” group was still symptom free, but only 42% of the “step-up” group had no symptoms. Dr. Brian Feagan of the University of Western Ontario coordinated this trial involving international sites in Belgium, Holland and Germany. He points out that the newly diagnosed Crohn’s disease patient that has the worst prognostic signs will benefit from this form of treatment. The top-down modality also is safer, as it protects the patient from high exposure to steroids. Similar results were demonstrated in patients with rheumatoid arthritis. The results of these trials and Dr. Feagan’s research suggest that the top-down treatment option could also give the best chance to patients with other chronic autoimmune diseases such as ulcerative colitis.

More information about Crohn’s disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/crohns-disease-crohns-disease/

Reference: The Medical Post, March 4, 2008, page 2; April 1, 2008, page 17

Last edited November 3, 2014

Apr
01
2008

H. Pylori Can Be The Culprit For Indigestion

Indigestion, heart burn, bloating and stomach discomfort are common problems. Often the reason is simple. Too much food and drink at a party, a plateful of deep fried Buffalo wings or a midnight order of double-pepperoni pizza will contribute to stomach upset and a bad night’s sleep. A few over the counter antacids will come to the rescue. If indigestion is a faithful but miserable daily companion, the excuse of “just having a sensitive stomach” becomes a form of denial and a dangerous form of self diagnosis. Something is wrong, and it is time to seek medical attention instead of over the counter meds. The first line of defense will be prescription drugs called “proton pump inhibitors” (PPI). They are designed to eradicate excessive acid production in the stomach. If symptoms are more severe, e.g. weight loss, a gastroscopy will be necessary. Even though the prevalence of a stomach infection with Helicobacter pylori (H.pylori) is declining, about 30% of patients with chronic stomach upsets test positive for an infection with these bacteria. This can cause recurrent stomach pains. In this case it becomes necessary to treat this with a combination of PPI’s and antibiotic medication. Eradication of H.pylori can mean a cure from a stomach ulcer. It also reduces the risk of developing gastric adenocarcinoma, a form of stomach cancer that could have developed out of an untreated gastric ulcer. Just because a person has heartburn does not mean that the condition is due to gastro-esophageal reflux of stomach acid. If after treatment with a PPI the problems of indigestion, heartburn, bloating or stomach aches reoccur, lab tests can give more information. According to a prospective trial conducted by Dr. Delaney and others the H.pylori serology (a blood test) is unreliable, but other H.pylori tests like urea breath test or stool antigen are reliable tests to establish whether a stomach infection with H.pylori is present or not.

H. Pylori Can Be The Culprit For Indigestion

H. Pylori Can Be The Culprit For Indigestion

If the bacterium is present, its eradication with antibiotic therapy will stop the stomach problems in a high percentage of cases with one treatment protocol. What was surprising was that after one year the treatment result of the treatment group with PPI/antibiotic combination was as successful as the control group that was treated with PPI’s alone. It was concluded that in the more severe cases with weight loss, vomiting, or overt bleeding an upper gastrointestinal endoscopy should be performed where a direct H.pylori test from samples is also done. However, in the vast majority of cases with minor symptoms can be treated safely by the general practitioner with PPI’s and follow-up examinations in subsequent visits. Treatment failures can then be referred to a gastroenterologist, if necessary.

More information about gastritis and H. pylori: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/gastritis/

Reference: British Medical Journal 336:623-624 (March 22, 2008)

Last edited November 3, 2014

Apr
01
2007

Quick Test Predicts Sepsis

One of the big risks for a patient undergoing abdominal surgery has been the threat of peritonitis, which means infection in the abdominal cavity. Apart from pneumonia, which can be another one of those life threatening diseases, peritonitis remains a severe threat even today, as it is accounting for roughly 60% of mortality in the surgical intensive care units. It is not the peritonitis itself that is the killer but the spread of the infection through the blood stream to vital organs. Once the vitals are affected, infection will lead to a general shutdown: multiple organ failure or septic multi-organ dysfunction syndrome known as MODS, which is what kills the patient.
Our ancestors could not control sepsis. Antibiotics had yet to be discovered. Today the main challenge remains a timely detection of sepsis. Once sepsis has overrun the body, even antibiotic treatment comes too late for the patient.
The best methods that are currently available for the detection of sepsis are CAT scans and fine needle aspiration. Both have their shortfalls: the CAT scan may be unavailable and fine needle aspiration can increase the infection risk. One biomarker, the C reactive protein has only a limited use to predict septic MODS, as C reactive protein levels show a sharp increase in the presence of surgical trauma, regardless whether there is infection or not. German research has tested another potential blood sepsis marker, procalcitonin. Unlike the C reactive protein procalcitonin levels are not affected by surgical trauma, but it shows an increase in the presence of bacterial or fungal infection. There is a rapid automated assay for procalcitonin, the Kryptor PCT essay. It can be completed in 20 minutes, which is important, as time is of essence in emergency situations. Among 82 recruited patients with peritonitis, more than half had infections due to E.coli. Nine had fungal infections. Procalcitonin levels were markedly higher in patients who later went on to suffer MODS. All patients in the study were tested within 96 hours of the onset of symptoms. C reactive protein levels were not useful in terms of a predictive value.

Quick Test Predicts Sepsis

Kryptor PCT measures procalcitonin for quick diagnosis of sepsis

The test is useful for two purposes: it helps with the early detection of a septic condition, so treatment can start early. It also identifies patients who won’t develop septic MODS.The sensitivity and the accuracy of the test does not necessarily make it a true “sepsis marker”. Researchers believe that the degree of systemic procalcitonin reflects a weak immune system. The test picks up those patients who are susceptible to severe infections. As a result timely treatments can be started for them right away.

Reference: National Review Of Medicine, March 15,2007, page 3

Last edited December 5, 2012

Mar
01
2007

Dental Signs Indicators for Celiac Disease

Celiac disease is a condition, where a person is unable to tolerate wheat products. In other words they have a wheat allergy. It is not enough to avoid the standard foods like bread and other bakery goods that contain wheat. Wheat makes its appearance in many foods and also in taste enhancers like monosodium glutamate. Alone for this reason it is important for a person with celiac disease to carefully read labels in order to avoid foods that contain gluten, which is the offending substance. Often celiac disease goes undetected for many years, but there are early signs that can help to take action sooner rather than later.

Dr.T.Malahias, D.D.S., a dentist from Groton, Conn presented his findings at a recent international symposium for celiac disease. He pointed out that there are signs that are visible in the dental enamel, which will already be present in childhood, once the permanent teeth appear at about age 6. The bilateral symmetrical markings are defects in the tooth enamel. they can be brownish, yellow or white and are most commonly seen on the central incisors. They give the tooth a mottled, non-shiny appearance. Patients with this appearance may also have problems with the delayed eruption of the permanent teeth. These markings are permanent, and even after following a gluten-free diet they will stay, as the development of the enamel started already in the third or fourth month of life. While there may be other reasons for this abnormality, celiac disease should be considered in the context of the patient’s history.

Dental Signs Indicators for Celiac Disease

Dental enamel defects may be the only signs of celiac disease

The results are quite significant in pediatric groups: in patients less than 12 years of age who had celiac disease the rate of enamel defects ran at 90% as compared to 44% of the others without celiac disease. People who have recurrent unexplained aphthous ulcers should take notice too. Five percent have been found to have undiagnosed celiac disease as a result of the constant and chronic overstimulation of the immune system by gluten substances. Once celiac patients start with a gluten-free diet, the ulcers will occur less frequently.

More information on celiac disease: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/celiac-disease/

Reference: Based on MD Consult News, January 31, 2007

Last edited November 2, 2014

Mar
01
2007

Pancreatitis Can Occur With Statin Use

Drug safety is a concern in the administration of prescription medications and non- prescriptions and any new drug that hits the market has undergone a rigorous screening procedure before its release. Side effects still can occur, and all of the possible ones have to be listed. For physicians it always remains a matter of careful judgement, whether the benefits of a prescription outweigh the disadvantages of any side effects. It is also a concern for the patient to be fully informed. Despite all precautions there are still surprises: some drugs have been taken of the shelves, because the side effects showed up after some time and the risk for the patients were too much. There may be the sense of false security about a prescription drug that has been on the market for a long time that all is known about possible side effects, but researchers and physicians remain alert to the fact that there may be adverse drug reactions that have not been observed.Statins, which are used for lowering high cholesterol levels, have been researched in a review of case reports and observational studies led by Dr.Sonal Singh of Wake Forest University in Winston-Salem, N.C. The authors reported in the December issue of Drug Safety that there have been numerous case reports in which statins have been implicated in acute pancreatitis. It appears to be a genuine adverse reaction, but it remains rare. The researchers estimate that there would be one case of acute pancreatitis in 300,000 patients treated with statins for a year.

Pancreatitis Can Occur With Statin Use

Pancreatitis Can Occur With Statin Use

The review suggested that pancreatitis can occur in high and low statin doses, but it is more likely to happen after many months of therapy. Due to the low incidence and mild severity in the majority of cases, statin therapy is still considered safe.
The first line of defense in the treatment of high cholesterol remains a proper diet and an active lifestyle. Statins are needed for patients with familial hypercholesterolemia and those where diet and lifestyle choices have not been successful enough.

More information about:

1. Statins: https://www.askdrray.com/statins-can-hurt-the-consumer/

2. Pancreatitis: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/pancreatitis/acute-pancreatitis/

Reference: The Medical Post, February 2, 2007, page 2

Last edited November 2, 2014