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.

Dec
11
2012

What a Wonderful World

Recently I traveled from Palm Springs to the Caribbean and back and I had to think: what a wonderful world! There were connecting flights and there was waiting at various airports. I had lots of time to watch people and to observe what was happening around me.  Louis Armstrong’s song (1967) “What a Wonderful World“ came to mind. I thought that this would be a fitting title for this Blog. Earlier we had come from Canada escaping the winter. The deep blue sky of Southern California and the sight of palm trees (instead of pine trees) is something that makes our hearts beat faster.

The desert is a special place

The desert is a special place. We had friends join us for a week and we had visited Joshua Tree Park with the grotesque looking rock formations. During the flight it was interesting to see the landscape, as we crossed the desert areas of Arizona and New Mexico, seeing what difference people make when large areas are irrigated and the desert transforms into lush, green areas. It is also very visible, where the desert has taken back the land that no longer is irrigated.

Travel to Dallas Fort Worth and Miami

We came to Dallas Fort Worth and the sky was clear. We traveled on to Miami and the sky was showing signs of pollution, although it was a sunny day. After our take-off from Miami we saw the ocean. I have flown over that region many times before, but this time I detected oil slicks on the surface of the ocean of the Gulf of Mexico, leftovers from previous oil spills. So, the Armstrong song of a “wonderful world” came back to me in a different context. I looked at the landscape and what industries can do to it. Erroneously we had just seen several BP commercials while waiting for our plane at the airport where BP was congratulating itself for the role it plays in cleaning up the environment having spent several billion dollars. But there are still oil slicks…

What a Wonderful World

What a Wonderful World

Watching people on the plane

I looked at the people around me in the plane. More than 35% of them were obese; many of their faces looked sagging and prematurely aged, particularly in women. Males, even middle aged ones looked like they were pregnant (abdominal fat) and often their hair was receding, thinning on top and quite a few were bald. All of the texts I had read about anti-aging medicine came back to me. Too bad that people were eating the wrong foods and obviously did nothing to counter their built-in aging clock from depleting hormones as we age.

Menu of the airline

I looked at the menu of the airline. I won’t mention the name of the airline, but I can assure you that 10 different airlines would have almost the same menus. There would only have been one chicken salad that I could have eaten. In the past I tried to order this and I was told that due to popular demand this item was sold out. Instead they wanted to offer me potato chips, cheese and crackers. My wife and I had anticipated this scenario and we had bought a chicken salad and water before we boarded the plane. We also had packed healthy organic energy bars and a trail mix consisting of nuts and raisins to use as snacks during the trip.

Cutting out starchy foods, eating fresh vegetables and lean meat instead

While travelling we stuck to the same principal of cutting out starches, bread, rice, pasta and only eating fresh vegetables, salads and lean meat (chicken, grass fed beef, ribs, lean pork and veal), which we always do since the fall of 2001.  We also avoid all alcoholic beverages and sugar containing sodas. When we returned to Southern California we were delighted to see that our body compositions when measured with the body composition scales were identical to what they were before the trip.

I think we can all contribute to this wonderful world, if we participate in whatever we can do such as these steps.

End wars

End wars because on the long-term they do not lead anywhere to solve conflicts (in my lifetime I am thinking about the Vietnam war, long-winded Ireland crisis, the Korean war and the German reunification at the end of the Cold War). Right now there is the Middle East conflict, which screams for a peaceful solution. As we are conscious about the devastation that is caused by wars, we have to start with ourselves. We have to resolve our own conflicts that may be present in our own lives. Tolerance, acceptance and forgiveness are the tools.

Address pollution 

Pollution needs to be addressed by the US and all of the world’s countries (including Canada where I live most of the time). This means that anti-pollution devices need to be installed in industrial plants and chimneys. Recycling needs to be done on a larger scale. China and India and other emerging market countries need to be taught how these new anti-pollution measures work. This is an ongoing project, but we need more co-operations between government, industry and countries all around the globe. Also we have to start with our own behavior: we can become more aware of reusing and recycling instead of creating more waste in our landfills.

Become better caretakers of our bodies

What can we do to make us part of this wonderful world? We need to become better caretakers of our bodies. Instead of looking at quantity we must look at quality in choosing  natural food wherever possible. Growing up in Germany after the Second World War in the 1960’s and early 1970’s made me witness that high consumption of fat, sugar and starchy foods (potatoes, pasta and bread) caused people to age prematurely and get heart attacks, strokes, high blood pressure, arthritis, obesity, diabetes and cancer. At that time the “Wirtschaftswunder” (translated into English it means “economic miracle”) had propelled Germany into a nation of  high consumers. During the war they had been poor and often went hungry, they were slim and heart attacks were at an all-time low.

Unhealthy foods and snacks

After the war they made up for times of deprivation and overindulged:  pretzels, buns, bread, butter, French fries, sweets, cakes, cookies, jams, chocolates, pralines-everything was consumed with gusto!  What happened to Germany in the 1960’s and 1970’s is happening again right now in front of our eyes with the obesity wave in the US, Canada and all the other civilized countries around the world. Food companies have been very successful with their advertising through the media. Already kids get hooked to the wrong foods! Hyperinsulinism will ensure that we get hungry every two or three hours. Refined carbs and extra calories are turned into fatty acids by the liver and stored as fat. It shows that we have to resist the wrong food temptation and cut out all refined carbs.

Healthier alternatives

It is healthier to stick to salads and vegetables like broccoli, cauliflower, asparagus, and spinach and eat a small piece of lean meat with it. Have probiotics as plain yoghurt (0% to 2% fat). If you need a sweetener, use a small amount of Stevia, which is a natural sweetener that leaves your body chemistry untouched. Have some fruit as a dessert like blueberries, cherries or strawberries. Eat an apple, the occasional grape. Drink lots of purified water or mineral water.

Buy organic food

Buy ORGANIC food whenever possible. Farmers treat most of the vegetables and fruit with insecticides, which contain residuals in them. When these are ingested, they act like estrogenic substances causing breast cancer in women and prostate cancer in men. The safest in our society is to stick to organic foods. More expensive, but the best insurance against future disease. Question politicians whenever possible to make yourself heard. You want unadulterated food and water. And as I’m writing about water, have a water filter under the kitchen sink with a carbon filter. In addition, it is good to have reverse osmosis to get rid of chloride or fluoride from the city water. This is what you use to cook your food. You may want to take an iodine tablet once or twice a day to counteract the negative effects of chlorine from having a bath or shower (the skin absorbs chlorine). Why? Because chlorine and fluoride can displace the iodine of the thyroid hormones and make you hypothyroid.

Regular exercise

Exercise every day. Nobody gets fit in their muscles from sitting in front of the TV for hours. You also don’t get fit from spending hours and hours of computer work. If you have to, counterbalance this with an exercise program of 1 hour per day. Walk 30 minutes on a treadmill and do 30 minutes of weights or use specific exercise machines in a gym to strengthen your upper and lower extremity muscles.

Replace missing hormones with bioidentical ones

Did I mention hormones? Yes, I did above when I mentioned depleting hormones as we age. We know for some time that each hormone of the body has its own peak in life and then it declines in production as we age. Or should I rather say, we age when these hormones decline? I like the latter way of wording it, because we can measure hormone levels and when one of the hormones is too low, we can replace it with a bio-identical hormone and the person’s energy comes back and whatever function was missing is restored. This is in essence what anti-aging medicine does. Many conservative physicians and clinics do not like to hear this. Big Pharma does not like to hear this when I am talking about replacing hormones in the body with bio-identical hormones. But the patented cheap copies that are mass manufactured and sold at inflated prices are no fit to the hormone receptors in the body and therefore are dangerous. The artificial drugs cause heart attacks, strokes and cancer as the Women’s Health Initiative has shown in 2002.

What people need to do

What did I think the people I watched on the plane should have done? Their physicians should have tested the hormones of many of them. Many of the overweight or obese patients would likely have had high fasting insulin levels. The extra fat does not just sit there; it is a hormone producing factory for inflammatory compounds and estrogen-like substances. This causes heart attacks and strokes in women. It causes prostate cancer and hair loss in males as well as impotence (“erectile dysfunction”). What I said above would help these people that I met. When you lose fat through changes in the diet and when you start an exercise program, the body mass index slowly comes down as fat melts away. The estrogen production comes down, the inflammatory substances abate. The person feels more energetic and may even think straighter. This is when you realize what a wonderful world it is.

Saliva hormone test

One special test is a saliva hormone test that looks at 5 steroid hormones: DHEA-S (storage form of DHEA), testosterone, estradiol, progesterone and cortisol. Every man and every woman needs a certain balance between these hormones and this test should be done when there is a change in energy or appearance (hair loss) somewhere when we are 35 to 40 years. In women it is important that the progesterone level is 200 times fold higher than the estradiol level (progesterone/estradiol ratio) or she is at risk of developing breast cancer and other cancers (ovary, colon etc.). In a man it is important that his testosterone to estradiol ratio is higher than 20 to 1. This protects him from cancer of the prostate or other cancers.

Bioidentical hormone creams

The physician or a knowledgeable naturopath can prescribe whatever hormones are missing. The health care provider needs to be familiar with the use of bio-identical hormone creams. This program can prevent diseases like osteoporosis, diabetes, cancer and arthritis. It also prevents disabilities.

With this I leave 2012 behind and I am looking forward to a new year (2013). I am looking forward to the time when more people can see Louis Armstrong’s vision of a “What a wonderful world”.

More information on:

1. Pollution: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

2. Obesity: https://www.askdrray.com/stop-obesity/

3. Processed food: https://www.askdrray.com/caution-processed-food-ahead/

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Dec
01
2008

Climb Stairs And Stay Healthy

Everybody knows that walking from the TV to the fridge does not qualify as exercise, and those few steps to the mailbox don’t do the trick either, when it comes to staying fit. But by the same token it is also a fallacy to believe that only the work-out in the gym will reap benefits and improve aerobic capacity. According to Dr. Philippe Meyer and colleagues at Geneva University Hospital in Switzerland, the mundane task of taking the stairs can show statistically significant changes in aerobic capacity, decrease in body weight, decrease in fat mass, waist circumference, decrease in diastolic blood pressure and increase in heart healthy HDL cholesterol. Dr. Meyer asked 77 healthy hospital workers including 20 physicians to exclusively use the stairs at the 12-storey hospital. During this 12 week quest for more fitness promotional signs encouraged stair climbing. All of those 77 participants were a sedentary group of individuals. Nevertheless they had to walk…the cafeteria was on the twelfth floor! At the baseline the participants walked up and down an average of 4.5 storeys per day, and at the end of the twelve weeks they were walking about 20.6 storeys per day.

Climb Stairs and Stay Healthy

Climb stairs and stay healthy

The tangible results showed that aerobic capacity and fat mass remained significantly improved, even though the participants walked less storeys after 12 weeks. It seems that initial change of habits-walking instead of taking the elevator- had made the difference in the transformation from couch potato to more active individual.

Stair climbing is an excellent exercise for healthy individuals in the general population. This high intensity exercise cannot be recommended to heart patients that are not entirely stable or to a patient who has angina. In these cases caution and a supervised exercise program is needed.

More information about fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

The Medical Post, November 18, 2008, page 17

Last updated Nov. 6, 2014

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Nov
01
2008

Low Testosterone And Heart Disease

More men than women seem to be affected by cardiovascular illness, and the reasons have been manifold. At one time work stress was cited for the prevalence of heart disease in men. Other lifestyle factors, lack of exercise, being overweight, poor dietary choices and smoking have been found to play significant roles. The risk for cardiovascular disease increases with age, as does the likelihood for hypertension, elevated cholesterol levels and glucose intolerance.

Some attention has been paid to the fact that hormones can also play a role, and research has now shown that testosterone has some direct cardiovascular effects. Testosterone has been found to dilate blood vessels. The effect can be likened to the calcium channel blocker Nifedipine. It has also been substantiated that males with coronary artery disease and heart failure tend to have low levels of testosterone. If testosterone deficient men receive replacement therapy, vasodilatation (dilation of blood vessels) has been demonstrated in males who have received testosterone replacement for a few months. Male hormone replacement therapy has also been found to relieve the symptoms of angina in patients with heart failure. The question, how testosterone fits into the concept of disease prevention, comes up in this context. Researchers have found enough evidence that a low testosterone blood level has an independent association with accelerated atherosclerosis (hardening of arteries).

Low Testosterone And Heart Disease

Testosterone in men prevents heart disease

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding is the fact that this condition is reversible by replacement of testosterone. Male hormone therapy has received a lot of bad press in the case of overtreatment with androgens to achieve muscle growth in body building. However, in this case there was no testosterone deficiency and athletes and their coaches were using doses that were too high. This type of administration entails grave health risks and has nothing to do with good medicine. In case of hormone deficiency replacement the normal body function of a younger male is restored with bioidentical testosterone, which can be a tool to better health for the aging male. Anti-aging physicians are very familiar with this treatment modality.

More on the heart vessel protecting effect of bio-identical hormones:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Journal of Men’s Health – Volume 5, Issue Suppl (September 2008)

Last updated Nov. 6, 2014

Mar
01
2008

The Culprits For Periodontal Disease

When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years.

The Culprits For Periodontal Disease

The Culprits For Periodontal Disease

In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health. This is particularly important as heart disease, which is also an inflammatory condition is closely linked to inflammatory disease of the gums and you likely have heard that heart attacks can be prevented by brushing and flossing teeth.

More information about periodontal disease: http://nethealthbook.com/dentistry/periodontitis/

Reference: Journal of American Medical Association 2008; 299(5): pages 574-575

Last edited November 3, 2014

Jul
01
2007

Waist line reduction scores in health prevention

To women waist measurement has always been of importance. Increased waist measurement and weight gain go hand in hand, and a poor fitting garment in the waist usually signals to cut out the junk food. In the past century extremely tiny waists became an unhealthy obsession, till common sense got the upper hand.

In the past males seemed to be unperturbed by a large girth and often ridiculed the opposite sex about their preoccupation with their waist lines. With more knowledge about the intricate play of metabolism increased waist circumference is a signal to health problems. It may be that a simple measuring tape can be one of the most helpful tools to predict a group of health problems in males. While type 2 diabetes, hypertension and high cholesterol and triglycerides are the problems that would first come to mind, there are more, namely coronary artery disease, prostate enlargement, a high prostate-specific antigen level, erectile dysfunction and ejaculatory dysfunction. Dr. Steven Kaplan, professor of urology at Cornell University, New York presented a study at the American Urological Association. Men with moderate to severe urinary tract symptoms were divided into groups based on their waist sizes, 30 to 36 inches, 36 to 40 inches and greater than 40 inches.

Waist line reduction scores in health prevention

Waist line reduction scores in health prevention

Results surprised even the researchers. Metabolic disorders like diabetes showed an incidence of 11.25% in the first group, 22.3 % in the next higher group and 37.8% in the group with waistlines over 40 inches. Erectile dysfunction was seen in 34.6%, 49.5% and 78.6 % respectively. The percentiles for hypertension showed 12.6% in the first group, versus 24.7% and 37.8 %. The researchers stressed that male pelvic dysfunction and the derailment of metabolic function, also known as the “metabolic syndrome” are closely linked.

More information about metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Last edited November 2, 2014

Jan
01
2007

Less Invasive Surgery Through Body Orifices

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

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Sep
01
2006

Moral Preaching Is Not Enough In AIDS Intervention

At a recent conference of the International AIDS Society in Toronto the full spectrum of the disease was covered: science, community, activism, and people with AIDS.
News Canada data released before the conference suggests that HIV infection remains a serious problem. There were somewhere between 2,300 and 4,500 new cases of HIV in Canada. The numbers are up from the estimated 2,100-4,000 cases that came up in 2002.
There is one statistic that can be a source of hope: the number of deaths from the infection has shown a steep decline in the mid-90’s. This effect is largely due to the discovery and application of three-drug antiretroviral therapy. The widespread use of this therapy has also reduced the viral load, and as a result infectiousness may be reduced.
UBC epidemiologist Dr. Evan Wood sees the encouraging development, but he emphatically spoke of the horrendous effect of AIDS. He stated, ” HIV remains the biggest threat to humanity globally.” He feels that the threat of terrorism pales in comparison to the carnage HIV results in every day. In this light it is short sighted and non-supportive of Canada’s PM, not to appear at this conference, as he had other commitments.
This year also marks the 25th anniversary of AIDS’ discovery, but it is known that the disease was ravaging Africa at least 25 years before it first appeared in the West.
The diagnosis of HIV infection does no longer sound like a death sentence. Things have been improving, but not fast enough, says Dr. Wood. Also one of the speakers, Bill Gates, spoke against naïve insistence on abstinence as a primary weapon in the battle against AIDS.

 

Moral Preaching Is Not Enough In AIDS Intervention

Moral Preaching Is Not Enough In AIDS Intervention

Dr. Wood shared this sentiment. He stated that while the whole idea is well intended, sexuality is part of normal human behavior, and everybody knows that abstinence cannot exist forever.

More information about AIDS: http://nethealthbook.com/infectious-disease/sexually-transmitted-disease/aids-introduction/

Reference: National Review of Medicine, August 30,2006, page 14

Last edited November 1, 2014

Aug
01
2006

New Aphrodisiac Nasal Spray

Sildenafil and other phosophodiesterase-5 inhibitors(PDE-5 inhibitors) have taken the drug market by storm for erectile dysfunction. Viagra-just to name one of the drug names- has certainly enhanced the treatment possibilities for a male problem that was difficult to treat in the past. The market has had its heyday with splashy TV commercials, creating hype like seldom before. The truth remains, that any drug has also possible side effects that are not mentioned in the upbeat commercials, and patients with preexisting heart disease have experienced heart attacks. The medications for the treatment of erectile dysfunction are not recreational fun, but serious prescription drugs.
In the meantime these drugs are facing competition from a new class of erectile dysfunction drugs, the melanocortin agonists.
They claim to have remarkable properties due to the fact that they will not only help men but also women with a range of sexual disorders, including lack of desire. Contrary to the previous drugs they are not working through the vascular system but through the central nervous system. Through receptors in the brain area called hypothalamus, they stimulate areas of the brain associated with sexual arousal. Preliminary experiments have shown that they are increasing libido, but also help a man to get better erections.
The melanocortin agonist closest to the market is known as bremelanotide. Previously known as PT-141, the nasal spray has been tested in about 300 men up to phase II with promising results. A study on women has been too small in numbers to give detailed results, but significantly more women reported increased libido after bremelanotide treatment as opposed to placebo. The drug’s half-life is only two hours, but women have reported effects lasting 10 to 12 hours. They also reported that the quality of their sexual encounter had improved. The older group (women over 34) responded slightly better than their younger counterparts.

New Aphrodisiac Nasal Spray

New Aphrodisiac Nasal Spray

Bremelanotide still has some way to go till it will be on the market, but it is getting some positive press in magazines as the “first equal-opportunity aphrodisiac”. Palatin Technologies, the manufacturer of the drug is more cautious and does not want bremelanotide to be perceived as a leisure drug, even more so as it has not seen its approval at this point.

National Review Of Medicine, July 30, 2006, page 11

Comment on Nov. 13, 2012: The FDA did not approve this drug due to reports of elevated blood pressure in a minority of test subjects. However, the drug has been synthetized by other pharmaceutical companies around the globe and is actively traded in Argentina, Armenia, Aruba, Australia, Austria, Azerbaijan, the Bahamas, the United Arab Emirates, United Kingdom and Uruguay.

Last edited December 6, 2012

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Jan
01
2006

Plastic Surgery For Men

Makeover TV shows are very common, but it is usually women who are featured in them.
The fact that males are not talking as much about makeovers, Botox, Restylane and face lifts does not mean that cosmetic surgery is a topic only reserved for women. In 2004 1.2 million procedures were performed on men according to statistics from the American Society of Plastic Surgeons. The number of surgical procedures rose by 16% from 2000, and in 2004 there was also a 43% increase in minimally invasive treatments for men.
The reasons for this shift of attention may have several reasons. Men feel that there is more pressure on them to look vibrant, youthful and energetic. There is a lot more exposure of plastic surgery in the news media. Information about cosmetic surgery is also disseminated on the Internet.
An executive who has experience and skills and looks tired and old may be at a disadvantage on the career ladder, observes Dr. Lorne Tarshis, a Toronto plastic surgeon. If drooping eyelids convey the look of defeat and tiredness, it is not likely a reflection of how the patient really feels. As a result, men in this category will often opt for a blepharoplasty. Women are more willing to talk about plastic surgery to their doctor. Men are more reluctant than women to go to the doctor’s office and ask about procedures. They are more likely to get their information on the net and walk into the office of the plastic surgeon with their minds made up. Dr. Arie Benchetrit, a plastic surgeon from Pointe Claire, Quebec finds that men are more pragmatic, whereas women are more open to discuss options. Men are looking for “natural” results, meaning in this case, that they want to look great but they don’t want people to know why they look great. As a result they prefer less dramatic procedures. It does not mean that men are less nervous or anxious about their appearance than women, but mostly they won’t talk about it, because admitting vulnerability in a competitive context goes against male culture.
Plastic Surgery For Men

Before (above) and after (below) blepharoplastyDr. A. Carruthers from Vancouver reports that some patients with facial wasting as a result of HIV benefit from cosmetic fillers like restylane and silicone oil. Some of them were well enough to work. Their condition was stable, they felt fine, but they were sent home and told to go on disability because they looked too sick to be seen in the workplace. “Getting their faces back” had an immense emotional impact on those patients, who no longer felt stigmatized. Dr. Carruthers reported that in the past cosmetic surgery was looked at with skepticism. When Sigmund Freud heard that someone wanted to undergo a cosmetic procedure, he responded by prescribing psychoanalysis. But times have changed. Cosmetic procedures are more about well being, and the word “vain” is a four-letter word.

More on cosmetic surgery: http://nethealthbook.com/dermatology-skin-disease/cosmetic-surgery/

Reference: The Medical Post, December 20, 2005, page 31

Last edited October 30, 2014