Aug
01
2004

Electronic Nose Smells Sickness

By | Health, Lung Disease, Prevention

Sniffing out disease has become a reality with a new device called Cyranose 320.
This electronic “nose” is able to recognize bacteria by sampling a patient’s breath.
The device has been tested and found to be quite accurate, as it was able to successfully diagnose 92 % of pneumonia cases in 25 patients.

This hand-held little invention costs about $8,000, and has been fitted by researchers at the University of Pennsylvania with a smart chip, which is capable of learning chemical “smellprints” of different bacteria. A further study showed that the Cyranose was also able to diagnose sinusitis- the most common respiratory complaint in US outpatient clinics.
This electronic nose will show its value for early detection of pneumonia in the intensive care unit, where patients on ventilators can be safely and quickly tested. About 25 % of these patients on the average develop pneumonia, and the lead researcher of the first study, Dr. William Hanson III, emphasizes that early recognition of pneumonia and avoiding wrong diagnoses is crucial for the swift treatment of pneumonia, which can be life saving.

Electronic Nose Smells Sickness

Electronic Nose Smells Sickness

Reference: National Review of Medicine (Canada), June 30, 2004, page 5

Last edited December 8, 2012

Jun
01
2004

Green Tea Knocks Out Leukemia Cells

By | Cancer, Prevention

Cancer is less common in eastern Asia, where green tea is the most common beverage.
In April 2004 a study was published in the journal “Blood”, which shows that green tea has killing powers in the unpredictable and slow form of B cell leukemia. A component in green tea called epigallocatechin (EGCG) disturbs the chemical information flow in leukemia cells in lab cultures.

It means that the communication between the cells is disturbed, and cancer cells cannot multiply.

Dr. Neil Kay of the Mayo Clinic in Rochester, Minn. is confident that the compound EGCG will be of benefit especially in the treatment of early-stage patients.
In the meantime, a flavorful soothing cup of green tea has its benefits.

More info on leukemia: http://nethealthbook.com/cancer-overview/leukemia/

Based on National Review of Medicine (Canada), April 30,2004

Green Tea Knocks Out Leukemia Cells

Green Tea Knocks Out Leukemia Cells

Last edited October 26, 2014

Apr
01
2004

Acupuncture For Headaches Found Effective

By | Pain, Prevention

For many years it was merely a clinical impression that some headache sufferers were helped by acupuncture. Over the years many attempted to show that acupuncture works for headaches, but the studies were done with too few patients to reach statistically meaningful results.

In a recent English study that was published by Andrew J Vickers et al. in the British Medical Journal on March 27, 2004 patients were randomly assigned to a conventional headache treatment protocol or to treatment with acupuncture. 401 patients were enrolled in this randomized study and the patients came from general practitioners in Wales and England. The patients all had similarly severe headaches or chronic headaches and had mainly migraines, but also tension type headaches. Several universities took part in the design of the study to ensure that the Cochrane criteria of evidence based medicine were adhered to. Headaches were measured according to a score that consisted of detailed standardized questionaires. Treatment with acupuncture consisted of 12 treatments over 3 months. The control headache group was treated with the usual care.

The headache sufferers were assessed at the 12 month point. There were significant differences in favor of the acupuncture treated patients. The acupuncture group had on average 22 fewer days of headaches per year than the control group. This resulted in 15% less medication use, 25% fewer doctor visits and 15% fewer sick days.

Acupuncture For Headaches Found Effective

Acupuncture For Headaches Found Effective

Acupuncture treated headache sufferers felt physically more active, they had more energy and they felt a positive change in their health.

More information about causes of headaches: http://nethealthbook.com/neurology-neurological-disease/common-causes-headaches/

British Medical Journal: BMJ 2004;328:744 (27 March).

Last edited October 26, 2014

Mar
01
2004

Ankle Blood Pressure Reveals Diabetic Problems

By | Diabetes, Heart Disease, High Blood Pressure, Prevention, Stroke

One of the complications of diabetes is that ity leads to clogged arteries from peripheral artery disease and this can lead to heart attacks, strokes and circulation problems in the legs.

Recommendations were recently given to physicians in the December edition of the medical journal Diabetes Care that circulation problems in diabetics need to be monitored more stringently to avoid needless amputations.

Medically these circulation problems that affect mainly lower legs and feet are known as “peripheral vascular disease” (or PVD for short). PVD can be detected by the physician checking for ankle pulses. Another valuable and very simple test is to measure the blood pressure in the arm and at each ankle (using the stethoscope just under the inside (medial) ankle bone. If there is a major discrepancy between the arm and ankle blood pressure or if the ankle pulse is missing, this would be a sign of possible PVD. With a diabetic patient it would still be important to get the hemoglobin A1C under control through exercise, a low glycemic diet and possibly anti-diabetic medication. But the patient likely would have to be referred to a cardiovascular surgeon for further testing in order to find out whether there would be hardening of the arteries with circulation problems in the lower leg, the ankle or foot.

Ankle Blood Pressure Reveals Diabetic Problems

Ankle Blood Pressure Reveals Diabetic Problems

Dr. Peter Sheehan, the director of the Diabetes Foot & Ankle Center at the New York University school of medicine, stated that many patients and doctors overlook how frequent this condition is. About 33% of diabetic patients who are older than 50 years have PVD, but only a fraction know about it until it is too late. Once a patient has PVD in one of the legs there is a 4-fold risk of getting a heart attack or a stroke, because the hardening of the arteries is happening simultaneously in all of the body’s arteries. If the blood pressure is normal at the ankle, Dr. Sheehan recommends to check it again in 5 years.

Who should have the blood pressure check at the ankle? Here is a table that summarizes Dr. Sheehan’s recommendations.

Which diabetic needs the ankle blood pressure check?
High risk group: Remarks or more detail:
Anyone with leg PVD* symptoms legs tired or hurting when walking
Young diabetics
with other risks		 smoking, high blood pressure, high cholesterol, diabetes present for more than 10 years are such risk factors
diabetics 50 years of age and over particularly when the hemoblobin A1C is high and other risk factors are present
*PVD = peripheral vascular disease

Why is it so important to screen for circulation problems in the lower legs? Because this is the area where diabetics tend to get problems that often result in amputations of a foot or lower leg below the knee. With early detection of these problems and intervention by a cardiovascular surgeon often disastrous outcomes can be avoided.

More info is available at:

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

High blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

Last edited October 26, 2014

Mar
01
2004

Less Diabetes With Coffee

By | Diabetes, Nutrition, Prevention

A Dutch Study has shown previously that coffee consumption was reducing the risk for developing diabetes. Now Dr. Salazar-Martinez and co-workers have confirmed this in a study involving even larger numbers of both men and women. This was published in the Annals of Internal Medicine and the research team is from the Harvard School of Public Health, Channing Laboratory, Harvard Medical School, and the Brigham and Women’s Hospital, Boston, Massachusetts. A total of 41,000 men and 84,000 women from the Nurses’ Health Study and the Health Professionals’ Followup Study were followed between 12 and 18 years. 1,333 men and 4,085 women developed diabetes during the time of observation. All of the data was analyzed carefully by controlling for other factors such as obesity, smoking, high blood pressure etc. to be certain that the only difference in the observed groups was the amount of coffee consumed.

According to the authors the gender differences are probably unimportant and may have to do with the different sample sizes. However, as the graph shows clearly, with the consumption of around 4-5 cups of coffee per day there is a significant 30 % drop in risk to develop diabetes.

The Dutch Study showed a 50% drop in risk with 7 cups or more per day and the study here suggests a similar drop with 6 cups or more.

Less Diabetes With Coffee

Less Diabetes With Coffee

Dr. Frank Hu, associate professor of nutrition and epidemiology at Harvard School of Public Health, who co-authored this study stated that physicians should still recommend to patients first to exercise and to loose weight to control diabetes. It would be premature to recommend heavy coffee consumption to patients for diabetes control.

Diabetes risk decreases with coffee consumption (%reduction)
 Less Diabetes With Coffee1

This beneficial effect was also observed to a lesser extent with decaffeinated coffee, but not with tea. According to Dr. Hu caffeine, chlorogenic acid and magnesium likely play a role in the protective effect with regard to diabetes prevention. Further studies will be done to see whether diabetes patients who drink coffee have a better outcome when they develop a heart attack.

Reference: Ann Intern Med – 6-JAN-2004; 140(1): 1-8

Last edited December 8, 2012

Mar
01
2004

Inflammatory Marker Linked To Blindness

By | Diabetes, Eye Diseases, Heart Disease, Prevention, Stroke

This outline is about “inflammatory marker linked to blindness”. Up to now age-related blindness or “age-related macular degeneration” (AMD) as it is medically called, has been a mystery. Notably, the retina is the light-sensitive area of the eye similar to the film in a camera. Specifically, the “macula” is that part of the retina that has the highest visual acuity. It is important to realize that several studies have been conducted lately regarding age-related blindness. Most compelling evidence sheds more light on this important health hazard of old age. One day these studies might even lead to a cure or powerful preventative measures to avoid AMD from ever developing.

Macular degeneration related to C-reactive protein

Particularly, one such study is the one by Dr. Johanna M. Seddon and co-workers published in the Feb. 11, 2004 issue of the Journal of the American Medical Association. Almost 1000 patients with various degrees of age-related degrees of blindness from the Age-Related Eye Disease Study (AREDS) were classified by the degree of their macular degeneration. As an illustration, I have produced the bar graphs below based on these studies.

Details of AMD in relation to CRP

For one thing, the researchers defined four groups, namely those with no AMD who served as controls. The second group were those with mild AMD, the third group those with moderate AMD. And the fourth group were those with severe AMD who were legally blind. Specifically, they suspected that an inflammatory marker in the blood stream of these patients, called C-reactive protein (CRP), might be present in the more severe cases of blindness when compared to the control group who did not have any inflammatory changes in the macula. Indeed, the bar graphs below show exactly what the test results indicated. Another key point, they also found that smokers (blue bars) tended to have slightly worse blood tests in terms of CRP (more inflammatory substances circulating in the system) within the same severity category of the age-related eye changes.

CRP (mg/L) Levels in Various Degrees of Severity of Age-related Macular Degeneration (AMD)

Inflammatory Marker Linked To Blindness

Inflammatory Marker Linked To Blindness

Risk of AMD depends on value of CRP

The investigators studied the risk for the highest percentile of the CRP tests within various subgroups of AMD. They found several differences as shown in the next table. First there was a low probability to develop AMD in a person with a normal looking macula. The investigators took this risk as the 1.0 point for comparison. In contrast a person with a normal looking macula who smokes has a 1.5-fold risk of developing AMD later. Patients with a moderate degree of AMD have about a 2-fold risk of getting a severe degree of AMD. This is true for smokers and non-smokers. Once the inflammatory cycle has started, the process of causing a moderate degree of AMD is so strong. This means that the effect of smoking will not add that much in comparison.

This is the first study of this kind that established that CRP is useful as a screening for the risk to develop AMD. Physicians already use CRP  as a test for monitoring progress in rheumatoid arthritis or to monitor for the risk of developing a heart attack or stroke.

AMD risk studied by another research group

Another study by Dr. Johanna M. Seddon and co-workers was published recently in the Archives of Ophthalmology. 261 people aged 60 years and older with established AMD were followed for 4.6 years and checked for deterioration. 101 patients had deterioration of their AMD.

Risk of Developing Age-Related Macular Degeneration (AMD) in Highest CRP Percentile
 Inflammatory Marker Linked To Blindness1

Omega-3 fatty acids protect against AMD

The authors analyzed the patients’ diet habits and found that increased fat intake was a high risk factor for deteriorating AMD. Both vegetable and animal fat had a 2-to 3-fold increased risk for deterioration of the AMD to a more severe stage (legal blindness). Fish, omega-3 fatty acid and nuts had a protective effect, but only when omega-6 fatty acid (linoleic acid) intake was low in the same group. The studies showed that the risk of age-related blindness was reduced by 40% when patients ate nuts at least once per week. The authors concluded that a “fat conscious diet” would be good for “maintaining good eye health” and at the same time be beneficial for prevention of heart attacks and strokes.

The authors will do further studies to investigate potential ways of helping patients with AMD and to understand the mechanisms of the disease process better.

References

1. JAMA 2004;291:704-710  2. Arch Ophthalmol – 01-DEC-2003; 121(12): 1728-37

Feb
01
2004

Kidney Disease, Another Complication Of Metabolic Syndrome

By | Hormones, Nutrition, Obesity, Prevention

The metabolic syndrome is a new disease entity that is known to be associated with obesity. In order to make the diagnosis of metabolic syndrome at least 3 of the 5 components listed in the table under this link (hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol level or LDL cholesterol, high glucose level, abdominal obesity) have to be present.

Dr. Jing Chen and colleagues of Tulane University School of Medicine in New Orleans, La., published an analysis of the Third National Health and Nutrition Examination Survey in the Feb.3, 2004 edition of the Annals of Medicine. Patients with chronic kidney disease were identified in this study where 3, 4 or 5 of the metabolic syndrome criteria were positive. Two criteria for chronic kidney disease were measured:

1. if there was a significant reduction of the filtration capacity of the kidney.

2. if there was critical leakage of blood protein into the urine.

Kidney Disease, Another Complication Of Metabolic Syndrome

Kidney Disease, Another Complication Of Metabolic Syndrome

Depending on how advanced the metabolic syndrome was (all 5 criteria of metabolic syndrome positive versus only 3 or 4) there was a higher or lower risk of developing chronic kidney disease.

I have depicted the results of this study in bar graph form here. It shows clearly that chronic kidney damage occurs in a dose-response curve pattern depending on how severe the degree of the metabolic syndrome is.

Risk of developing kidney disease with various degrees of severity of the metabolic syndrome
 Kidney Disease, Another Complication Of Metabolic Syndrome1

With 5 factors of the metabolic syndrome present the risk to develop reduction in filtration capacity of the kidneys is almost 6-fold. This is 3-fold higher than in a person with a milder degree of metabolic syndrome where only two factors are present. Such a person would only have a 2-fold risk for developing chronic kidney damage (dark blue shaded bars in graph). A dipstick urine test can measure protein in urine, which is an alternative way to measure kidney damage due to the metabolic syndrome. These values followed a very similar dose-response curve (light blue shaded bars in graph). The authors of this study believe that the kidney damage inflicted by the metabolic syndrome is different from that caused by high blood pressure or by diabetes. Future studies will have to establish whether this type of kidney damage can be repaired by treating the metabolic syndrome with a low glycemic, calorie restricted diet coupled with exercise.

Based on an article published in: Ann Intern Med 2004:140:167-174.

Last edited December 8, 2012

Jan
03
2004

Poverty Still A Threat To Mothers’ Lives

By | Health, Prevention, Women’s Diseases

Adrienne Germain from the International Women’s Health Coalition, New York, wrote a review in the Lancet (Lancet 363: 65-66, 2004) about the state of health and mortality of pregnant women (maternal death rate) around the world. 500,000 pregnant girls and women die around the globe every year from conditions that are preventable or treatable. 99% of these live in developing countries. At the same time 3.9 million newborns die every year in their first 4 weeks of life!

2004 is the 10-year anniversary of the recommendation for reproductive health from the 1994 International Conference on Population and Development (ICPD). The maternal death rate in Europe is about 1 in 4000 pregnancies; in many African countries (sub-Saharan Africa) it is 1 in 16! Despite some progress that has occurred, still 70% of all deaths associated with pregnancy occur in only 13 countries. In another article in the Lancet (Lancet 2004; 363: 23-27) Prof. Wendy Graham and co-workers used a new familial technique to determine whether there is a statistical association between poverty and the maternal death rate. The answer is not only a clear “yes” for the maternal death rate within one country, but there is a clear association between poverty and maternal death rate in countries all around the world!
A high mortality rate in babies and children in addition to the maternal death rate has traditionally been a grave concern in poor countries. Research in development countries has shown that 70% of the poorest 1.3 billion people in the world are women. The study also shows that these mothers have a high mortality rate. Maternal death can occur during pregnancy or birth, and the poorer the population group, the higher the maternal death rates will be. The reasons are varied: for the poorest of the poor, medical treatment is often unaffordable.

Poverty Still A Threat To Mothers' Lives

Poverty Still A Threat To Mothers’ Lives

Also seemingly simple measures such as clean drinking water, toilets and whether floors are present in dwellings do have an impact on health. At the same time the level of education determines whether death rates are higher or lower. These results are not only true for one specific country. Even though most of the alarming numbers come from the African countries such as Burkina Faso, Chad, Ethiopia, Kenya, Mali, and Tanzania, other countries like Indonesia and the Philippines show the same troubling picture.
The main causes of maternal deaths were due to the following conditions: bleeding after delivery, early pregnancy bleeding; infections that would lead to sepsis and death; complications surrounding abortions; blood pressure problems such as eclampsia with seizures and kidney damage; and prolonged labor when the baby’s head is too large. This latter condition requires an Cesarean section on an emergency basis, which is not always readily available in rural areas.

As we know from other studies, even closer to home, poverty and rural isolation remain a risk to health and life.
Adrienne Germain in her editorial review pointed out that some poor countries such as Bangladesh have taken the recommendations for reproductive health from the 1994 ICPD-conference seriously and have instituted a nationally sponsored program.

The result has been that between 1988 and 2002 the percentage of women receiving antenatal care has improved from 26% to 47% while the maternal death rates have declined from 410 to 320 per 100,000 women during and after the pregnancy. Childhood mortality also improved significantly as did the mothers life expectancy (from 58 to 60 years). There are success stories in other countries as well.
What is needed is political will around the globe, co-operation between the appropriate agencies such as the WHO, the UNICEF, the International Women’s Health Coalition, and others. Locally in every country it is vital to have an interdisciplinary co-operation to fight poverty and to provide shelter with a certain minimum living standard.

Link to UNICEF. Link to WHO. Link to International Women’s Health Coalition.

Last edited December 8, 2012

Jan
03
2004

China Blows Alarm Whistle On Smoking

By | Cancer, Health, Heart Disease, Lung Disease, Prevention

The risks of smoking are being addressed in China, where roughly 300 million people or one quarter of the population are puffing away. The number is rising by about 3 million new smokers each year, and according to statistics of the WHO 700,000 die each year from smoking.

In November of 2003 China joined the Framework Convention on Tobacco Control (FCTC), a subsidiary of the World Health Organization. As a member China is now obliged to tighten restrictions on cigarette marketing and consumption.
Due to an economic boom in the country foreign tobacco giants are putting their hope into this rising market, as revenue has decreased elsewhere in the world. So far tobacco taxes, which are collected from the 1.7 trillion cigarettes sold in China amount to 8 billion $US or one tenth of government revenue. In the wake of SARS, however, the realization has come to the forefront, that health care cost have a severe impact on the economy of a country. Despite the seemingly enticing short-term gain from tobacco tax revenue, short cuts in health care can economically damage a country in the long run.

Health officials will have a battle with their counterparts in finance, when it comes to implementing tobacco control. In some areas of the country the sale of tobacco products to children has been banned and an attempt has been made to restrict cigarette commercials.

China Blows Alarm Whistle On Smoking

Quit smoking!

Powerful tobacco lobby groups actively undermine these efforts.
It is encouraging to see at least a beginning of public education about the risks of smoking. However, in a nation where cigarette manufacturing and consumption are the highest worldwide, it will be a long and arduous journey to clear the air to better health.

Based on The Lancet 363, No. 9402 (Jan. 3, 2004)

Last edited December 8, 2012

Jan
01
2004

Flu Season Not Over Yet

By | Health, Infectious Disease, Lung Disease, Prevention

Influenza type A is the cause of many flu epidemics including the one that recently affected the northern hemisphere. It is known to change its surface characteristics from time to time. This has occurred in the southern hemisphere (Australia and New Zealand) during the summer of 2003 and the same new type has caused the recent epidemic in Canada, the US and Europe.

Prior strains of flu viruses in recent years were variants of the Panama strain, that’s why the infection specialists decided in the beginning of 2003 to suggest a Panama strain type vaccine to be used for protection for this flu winter season. However, 70% of the cases tested in Canada by the end of November turned out to be influenza type A/Fujian,full name A/Fujian/411/2002(H3N2), different from type A/Panama, full name A/Panama/2007/99(H3N2), according to Dr. Theresa Tam. She is a specialist in the division of respiratory diseases at the Health Canada Centre for Infectious Disease Prevention and Control. Similar observations regarding a shift from the type a/Panama to the type A/Fujian strain of the flu virus has also been reported in the US and in Europe. It appears that those who have been vaccinated with the type A/Panama vaccine have had partial protection from this new flu as some of the flu virus characterisitics (e.g. the H3N2 determinants) are the same.

Dr. Tam mentioned that the recent deaths in children from the flu in the US, England and Canada would likely be explained by the fact that in the last 3 years there have not been any H3 type flus and the flus that did circulate were relatively mild. This means that children have not developed enough background resistance to fight a flu when it comes. Most adults have background resistance, but older people are loosing some of the resistance due to aging. Dr. Tam explained that not too many children have had the flu vaccination. One would expect that children are most vulnerable for the flu and this explains why these deaths would have occurred.

Flu Season Not Over Yet

Flu Season Not Over Yet

Production of flu vaccines that protect from flus: One of the problems with getting the best match for an upcoming flu season is the lag period between the decision to produce a certain type of flu vaccine and the mass production of the vaccine to serve a world population. This can take 6 to 8 months. A new technique of vaccine production is being investigated, called “reverse genetics”, where the lag period may only be a few weeks.

Dr. Webster, an infectious disease specialist at the St. Jude Children’s Research Hospital in Memphis, has produced a vaccine with this method against an avian flu with the characteristics H5N1(different from the others mentioned above). This is an older flu transmitted by birds that has resurfaced earlier in 2003 again. However, this vaccine that has been produced in cell culture and not in egg cultures, has only been tested in animal models, not in humans yet. Both Dr. Webster and Dr. Tam agree that human trials under FDA guidelines are needed to test these newer vaccines utilizing reverse genetics. Regulatory and patent issues need to be settled for this to happen.

Use of antiviral drugs: Another issue is that type A influenza can be treated with antiviral antibiotics, but every flu season these types of drugs tend to run short. Each country should have a national stockpile of these antiviral drugs (such as Tamiflu) so that enough stock is available in case of a serious epidemic where the vaccine may not fit the flu strain that comes around. This is not happening at the present.

What is needed is that international discussions take place through the Global Health Security Network (right now consisting of the G7 countries and Mexico), Dr.Tam said.

Conclusion: The flu season has started early this season. Many people have died because of a lack of vaccination. Some of those who were vaccinated against the flu may have caught the flu as the fit this year with regard to the vaccine was not the best. However, they likely survived the flu, whereas those who did not have the vaccine were more likely to have experienced the flu more severely and some of these have died. It is not too late to get the flu vaccine before the spring season. Typically there is another peak of the flu between February and April.

Based in part on The Medical Post, Dec.9, 2003 (p.1 and 73).

Last edited December 8, 2012