Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Feb

2007

Avoiding Back Pain By Relaxed Sitting

By Ray Schilling | Arthritis, Health, Pain, Prevention

This article is about “avoiding back pain by relaxed sitting”. Notably, parents and educators often reprimand children and students to “sit up straight”. The results however are not that favorable. Truly, a 90 degree angle in this position is causing problems. Specifically, it causes the largest movement of the spinal disc and a lot of strain. To put it another way, conventional wisdom has it that sitting up straight avoids back pain. It must be remembered, this has important implications for a large population group that has work situations with mostly sitting jobs. In addition, consequences of bad posture are also quite visible: lower back pain is the leading cause of disability in the U.S. and Canada and a major cause for missed work days.

Improper posture and back pain are related

Investigators have presented evidence, that a 135 degree body/thigh sitting position, leaning back, is the optimal position to avoid back pain. The author of the study, Dr.W. Bashir from the department of radiology and diagnostic imaging at the University of Alberta Hospital in Edmonton emphasizes, that the angle of posture has been under question for some time, and improper posture and back pain are related.

Positional MRI scans

Positional MRI scans have shed more evidence on the spine. There are special MRI machines that take images when the patient is not in a supine position, but in a position that allows the patient free motion during the test. Spinal angles can be measured and spinal disk movement can be observed in various positions and angles.
The 90 degree angle showed most spinal disk movement, creating stress for the spine. Another unfavorable position is a slouching posture.

Avoiding Back Pain By Relaxed Sitting

Scan results showed a reduction in spinal disk height, signifying more wear and tear of the lumbar spine. Spinal disk movement was least pronounced with the 135 degree angle. This more relaxed position poses less strain on spinal disks and the associated muscles and tendons. Employees sitting comfortably versus sitting up straight can make the job place friendlier to people’s backs.

More about back pain: http://nethealthbook.com/arthritis/lower-back-pain/

Reference: The Medical Post, January 16, 2007, page17

Last edited November 2, 2014

Feb

2007

Lycopene Benefits Backed By Science

By Ray Schilling | Cancer, Diabetes, Health, Heart Disease, Nutrition, Osteoporosis

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms “bioflavonoids” and “antioxidants”. Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.
Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the “bad” cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.

Lycopene Benefits Backed By Science

For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer’s disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe “natural coloring agent” and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

More info about lycopene and prostate cancer: http://nethealthbook.com/news/lycopene-reduces-prostate-cancer-risk/

Reference: The Whitehall-Robins Report, December 2006, Volume 15, No.4

Last edited November 2, 2014

Feb

2007

Mechanical Heart As Transplant Alternative

By Ray Schilling | Heart Disease

The device called HeartMate II (see image) is comparable in size and weight to a D-size battery, and it is the latest development to assist the left side of the heart. Older models were pulsating in nature, whereas the HeartMate II produces a continuous flow of blood. As a result of this, recipients of the device no longer have a discernible pulse, nor can their blood pressures be taken with the cuff around the arm. The leg muscles can naturally produce a surrogate pulse, and in the three years of human testing there have not been any problems related to the lack of pulse. It has been implanted at selected American test sites, and recently a 65 year old male patient has become the first Canadian to be implanted with the device at McGill University Health Center. Dr. Renzo Cecere, the heart surgeon involved, is very enthusiastic with the outcome. The patient made an exemplary recovery and stated that he feels more alive than he has in years, which is impressive, as in the past he could hardly take a step. He suffered of end stage left ventricular failure, and at this point only patients with this condition can enroll in the HeartMate II clinical trials.
Dr.Cecere foresees the device being appropriate for many Canadians. The longevity of the “mechanical heart” (it is good for 10 years) will make it a true alternative to a heart transplant. Some patients cannot receive a transplant because of age or medical conditions. Patients with a history of cancer would be the ones who could not be treated successfully with a heart transplant. The anti-rejection drugs that have to be taken on an ongoing basis produce immunosuppression, and this can revive a cancer in remission.

Mechanical Heart As Transplant Alternative

So far the biggest known risk factors are bleeding, as patients have to take small amounts of blood thinners. Another risk is infection.
At this point the cost for the HeartMate II amounts to about $100, 000, and it does not have the Health Canada approval for general use yet.

More information about congestive heart failure: http://nethealthbook.com/cardiovascular-disease/heart-disease/congestive-heart-failure/

Reference: National Review of Medicine, January 15, 2007, page 36-37

Comment Nov. 15, 2012: The device was approved by the FDA in April of 2008.

Last edited November 2, 2014

Feb

2007

Nutritional Research Possibly Biased

By Ray Schilling | Nutrition

Influential articles about nutritional research are widely publicized. What is not so well known to consumers is the fact that a number of the research is funded by industry, which introduces test bias into the results, which can have far reaching implications. These results influence dietary recommendations, the department of public health, or regulations by the Food and Drug administration. The articles are widely publicized and also influence consumers’ choices.
Dr. Daniel Ludwig, author and director of the Optimal Weight For Life program at the Children’s’ Hospital in Boston, which is a Harvard medical institution, looked at 206 interventional and observational studies as well as scientific reviews. All of them were related to milk, soft drinks and juices. All the material was published between 1999 and 2003. The category was chosen, because these drinks are widely consumed by children and adolescents. There has been a considerable amount of controversy about the health risks and health benefit of these drinks. The soft drink industry is large and highly profitable, and the authors concluded that in this environment scientific bias could likely occur.
Of the 206 studies only 111 submitted the source of financial sponsorship. One third of them had mixed sponsorships, half of them were not sponsored by the industry and one in five was industry sponsored. Results showed, that industry sponsored research was 4 to 8 times more likely to be in favor of the companies’ products than those where the studies had independent financial funding.

Nutritional Research Possibly Biased

During the study period the researchers who declared the source of funding or a conflict of interest rose from 50 to 80 %.
Dr. Ludwig and his team suggested that there is the potential to public health harm, unless there is increased government funding available for nutritional research through a peer review process such as that at the National Institute of Health.

More information about sugar substitutes: https://www.askdrray.com/yes-there-are-healthy-sugar-substitutes/

Reference: BMJ 2007; 334:62, 13 January

Last edited November 2, 2014

Jan

2007

Ballroom Dancing Improves Heart Health

By Ray Schilling | Fitness, Health, Heart Disease, Prevention

It has been pointed out that there is not such a notion “It’s too late now to think of an exercise program”.
Researchers led by Dr. Romualdo Belardinelli, director of cardiac rehabilitation from the Lancisi heart Institute in Ancona, Italy took a close look at 110 patients with stable chronic heart failure. The average age of the patients was 59 years and 89 of them were men. The group was assigned different physical activities. Forty-four patients used an exercise bike or exercise treadmill three times a week for 8 weeks. Forty- four other patients chose to participate in 21-minutes of ballroom dancing consisting of waltzes (alternating slow and fast) three times per week. A third group of 22 patients had no exercise. Heart rates during exercise training and dancing were similar at 110 respectively 113 beats per minute. Cardiopulmonary fitness improved at a similar rate in both groups. Oxygen consumption increased by 16 % in the exercise group and by 18% in the dance group. In other words, exercise fitness had significantly improved in these two groups.

Quality of life as measured by the Minnesota Living With Heart Failure Questionnaire improved significantly more in the ballroom dance group, particularly in the emotional domain.

Ballroom Dancing Improves Heart Health

The findings are not just of significance to patients with heart failure. It is the observation that ballroom dancing seems to be a more effective way to get people into an exercise program who otherwise would not be interested in this. For some people it is simply more enjoyable to dance and enjoy social interaction as an additional benefit than running on a treadmill.

More information is available about:

1. Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Health for adults: http://nethealthbook.com/health-adults/

3. Health for seniors: http://nethealthbook.com/health-seniors/

Reference: The Medical Post Dec. 19, 2006, page 17

Last edited November 2, 2014

Jan

2007

Acetaminophen Overdosing Hazards

By Ray Schilling | Arthritis, Infectious Disease, Pain, Prevention

The FDA has expressed some concerns about the self-medicating with acetaminophen as this can led to an acetaminophen overdose. The over-the-counter medication is commonly used and especially in the winter season many sufferers of colds or influenzas will keep it handy. It is readily available, not only in pharmacies but also in supermarkets under the generic name or under brand names such as the commonly used Tylenol. It exists in dosages for adults and there are pediatric preparations like Children’s Tylenol. Acetaminophen is also a common ingredient in cold remedies. Every vial displays a clear warning that the content is enough to cause serious harm. Dosage instructions are also clearly spelled out.
More than 200 million people take Tylenol each year and 400 people die of liver failure every year, as they have accidentally taken too much.
Dr. Charles Cain from the New York Presbyterian Hospital has cautioned that overdoses can happen relatively easy. A patient is not to exceed 4 grams of acetaminophen per day. If the pain reliever is taken every 4 hours instead of the recommended interval of 6 hours, such as 2 extra-strength Tylenol at 500 mg each and some cold medication is added to that, patients may easily reach 4-6 grams of acetaminophen per day. If this practice continues for a few days, it can lead to liver damage, because the liver cannot keep up with the elimination of the drug. Other substances metabolized by the liver such as alcohol can become a serious hazard, if they are combined with acetaminophen. The effects of alcohol slow down the elimination of Tylenol by the liver.

Acetaminophen Overdosing Hazards

It is for this reason that it is important to observe closely how much of the medication is taken in total: if a patient is already taking Tylenol for headaches, more acetaminophen (Tylenol) in the form of an over-the-counter cold medication should not be added as would be reached.
These medications have to be used with an eye to overall daily use and the amount used over a period of time. Used with care acetaminophen remains very safe.

Reference: December 20, 2006 online issue of Time

Last edited December 5, 2012

Jan

2007

Prevent Type 2 Diabetes With Diet And Moderate Exercise

By Ray Schilling | Diabetes, Hormones, Nutrition, Prevention

The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are overweight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.

Prevent Type 2 Diabetes With Diet And Moderate Exercise

Diabetics need exercise and a proper diet

It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

More information about:

1. Diabetes type 2: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

2. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Last edited November 2, 2014

Jan

2007

Less Invasive Surgery Through Body Orifices

By Ray Schilling | Gastrointestinal Disease, Men's Health, Orthopedics, Women’s Diseases

Natural orifice transluminal endoscopic surgery (NOTES) has become increasingly popular during the last few years. This is not surprising, as a surgical procedure which does not need an incision is less threatening for the patient. Unsightly skin scars are not a concern and recovery is usually less complicated. Procedures have become more varied. Transvaginal procedures have been performed for a number of years, such as vaginal hysterectomies.
In 2004 Anthony Kalloo, a gastroenterologist from John Hopkins University reported on the feasability and safety of gastrointestinal surgery and research has proceeded at a stunning rate. The idea behind NOTES is to use a body orifice (the oral cavity in the case of gastro-intestinal surgery) as an entry point to the surgical area. An incision into the abdominal wall is avoided.

The concept of minimally invasive surgery is not new, as laparoscopic procedures for gallbladder surgery and hernia repair are currently in use. Joint surgery through arthroscopic surgery is common and surgery to the pineal gland in the brain has been performed by using the nostrils as an entry to the area.

Experience in gastrointestinal surgery through natural orifice transluminal endoscopic surgery at this point is limited. Seven transgastric appendectomies have been performed by the surgeons Dr. N.Reddy and Dr.V.G Rao in Hyderabad, India.

Less Invasive Surgery Through Body Orifices

Removal of gallbladder through colorectal approach

The research group from John Hopkins is aware that this new technique will revolutionize surgeries, but there is the sentiment that things should not be rushed. The procedures need to be thoroughly researched to ensure that they are safe and beneficial to surgical patients. To this effect the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) has been formed in the US, which promotes research and monitors safety of these new approaches of less invasive surgeries.

Reference: MD Consult news, January 3, 2007: “New procedure aims to avoid surgery”

Last edited December 5, 2012

Jan

2007

Nanotechnology For Better Healing

By Ray Schilling | Eye Diseases, Skin Disorders

Nanofibers for the healing of wounds can become a new technique to promote faster healing with less scarring. The application of these tiny fibres that consist of peptides can be manifold. The fibers can self-assemble into a mesh that can help heal areas affected by trauma. A mesh of the fibers applied to a bleeding wound can help the surgeon to stop the bleeding.The fibres can “knit” an injury,but they also can work in repairing areas of trauma in vital organs and restore tissue. Researchers have raised the possibility of application for the central nervous system too. So far the experience has come from animal experiments. Nanotechnology has been applied in animals, where the optic nerve had been severed and with the application of nanofibers the nerve could be “knitted” together and as a result the vision was restored.
The research comes from the Institute of Technology from Cambridge, Massachusetts where Rutledge Ellis-Behnke,PhD reported that healing of the nerve could be observed already within 24 hours. An incidental finding was that bleeding could be stopped when nanofibers were applied.This technique is unlike any other like cauterization. It is fast and as a result blood loss during surgery can be minimized and time needed for surgical procedures can be decreased, which translates into a faster recovery time for the patient.

Nanotechnology For Better Healing

Researchers are optimistic about the potential for clinical use, as the fibers are biodegradable and are excreted through the urine within 3-4 weeks or taken up by the tissue adjacent to the treatment site in the body.

Reference: JAMA. 2007;297:31 (Jan.3, 2007)

Last edited November 2, 2014

Dec

2006

Vaccine Can Protect Against Bird Flu

By Ray Schilling | Infectious Disease, Lung Disease, Prevention

To take the flu shot or not to take it becomes an issue as the northern winter and with it the flu season is approaching.
It has to be stressed that the influenza vaccine not only limits flu epidemics and saves lives. It is the only reliable protection available to protect all age groups. Of course it does not offer protection against the common cold, but it is a preventative weapon against many influenza strains that cause serious illness and death.

Dr. Robert Webster, a virologist and internationally recognized influenza expert recently quoted data from his laboratory at St. Jude’s Children’s Research Hospital in Memphis. He noted that the currently recommended seasonal influenza vaccines contain A/New Caledonia 20/99 that is an H1N1 virus. Its composition is very similar to the bird flu virus H5N1.

In animal experiments this immunization was given, after which the test animals were exposed to the highly lethal Vietnam 1203/04 strain of H5N1. The treated animals had a survival rate of 50%. Controls without the vaccination prior to exposure had a death rate of 100 %. There is indeed a basic cross-protection and people who take the current influenza vaccine 2006/2007 will have this partial protection against the bird flu should it suddenly become an epidemic. The bird flu (H5N1) has not made its appearance in the Americas.

Vaccine Can Protect Against Bird Flu

Dr. Webster pointed out that the greatest concern is its entry through the illegal trade of animals. After drug smuggling, the smuggling of animals is probably the greatest illegal trade in the world and at the same time the most likely way in which the virus could come into the country and spread. The other concern is the entry of the virus through migratory birds.

References: The Medical Post, November 3, 2006, page 19

Last edited December 5, 2012

Improper posture and back pain are related

Positional MRI scans

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