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

Jan

2003

Readers’ Digest… Poisons Used For Healing

By Ray Schilling | Cancer, Cosmetic surgery, Women’s Diseases

This article covers Reader’s Digest…poisons used for healing. For instance physicians recently used arsenic trioxide in a trial with leukemia patients. Researchers achieved a remission of leukemia in 70% of cases. Arsenic normally is a powerful poison. But at the right dilution this healing effect in leukemia has less toxic side-effects than chemotherapy.

Dr. J. Michael McIntosh, a psychiatrist at the University of Utah, is researching the poisonous effect of a marine snail that attaches to and kills fish with a toxin. This poison is a powerful painkiller. It is several hundred times stronger than morphine, but is useful as it does not have any effect on the strength or functioning of muscles. This substance in the right diluted dose may one day be useful for the treatment of chronic pain syndromes.

The bacterium Clostridium botulinum produced a powerful toxin, which causes botulism. Neurologists and plastic surgeons are using this poison in a diluted form as “Botox” to inject into wrinkles of skin to make your face look younger. It is also used for chronic spastic muscle conditions like cerebral palsy or tardive dyskinesia.

February Readers’ Digest Edition… Poisons Used For Healing

Jan

2003

Framingham Study…Obesity And Smoking Lead To Loss Of Life

By Ray Schilling | Diabetes, Fitness, Health, Heart Disease, Nutrition, Prevention, Stroke, Weight loss

The Netherlands Epidemiology and Demography Compression of Morbidity Research Group has published an important medical research paper in the Jan. 7, 2003 edition of the Annals of Internal Medicine (Ann Intern Med 2003;138:24-32).

The lead researcher, Dr. Anna Peeters, explained that the group has revisited the Framingham Heart Study 40 years later and analyzed survival statistics of the group of men and women who enrolled in this longterm study between 1948 and 1951. The population at the beginning of the study was aged between 30 and 49. The snap shot, after 40 years had elapsed, is the subject of this analysis. In order to make it easier to understand, I have tabulated the data as seen below.

This study shows that life style choices do matter: being overweight shortens your life by 3 years on average, being obese shortens it by 6 to 7 years.

Add the risk of smoking, and you end up shortening your life by 7 years in the case of being overweight (4 years more than without smoking) or more than 13 years, if you are obese.

Framingham Study…Obesity And Smoking Lead To Loss Of Life

This study was based on 3,457 participants who 40 years ago had a life expectancy of 85 years, if they were in the normal weight category and did not smoke.

The death rates were much higher than the researchers expected. The researchers from the Erasmus Medical Center in Rotterdam stated as a conclusion: ” just think about two things: Don’t get fat and don’t smoke”.

Years of life lost 40 years after Framingham Heart Study Was Started:
Non-smokers:			Smokers:
	Male	Female		Male	Female
overweight *:	3.1	3.3	overweight*:	6.7	7.2
obese** :	5.8	7.1	obese ** :	13.7	13.3
* overweight:BMI = 25 to 29.9			** obese:BMI = 30 and higher

Here are some links to my Internet based Healthbook regarding risks for heart attacks and strokes:

Heart disease: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Strokes: http://www.nethealthbook.com/articles/cardiovasculardisease_strokeandcerebralaneurysm.php

Two things will lead to a normal weight (as you likely have heard before):

Proper nutrition…

http://www.nethealthbook.com/articles/nutrition.php

…and proper exercise (fitness):

http://www.nethealthbook.com/articles/fitness.php

Last edited December 10, 2012

Jan

2003

Deliveries Of Male Infants Mean More Complications

By Ray Schilling | obstetrics, Prevention

A recent article in the British Journal of Medicine on Jan. 18, 2003 (BMJ 2003;326:137) is about a retrospective risk analysis of two groups of full-term delivered newborns that were delivered at a Dublin (Ireland) University Hospital. The delivery records of 4070 male and 4005 female newborns between 1997 and 2000 were analyzed. Dr. Maeve A. Eogan said that the team noted significantly more Cesarean section rates due to more frequent fetal distress in males. There were more forceps deliveries with males and drugs to induce labor had to be used more often in males as well.

One known factor is the that males have a higher birth weight as well as larger heads compared to their female counterparts. But the investigators are looking for further explanations of why males seem to be more prone to distress during deliveries than females. There may be a genetic component that may also play a role, but more investigations are needed to find out why this would be so. In the meantime doctors have to play it safe and watch both mother and the baby about to be born and make sure that there is a good outcome.

Deliveries Of Male Infants Mean More Complications

This means monitoring the fetal heart rate to check on the baby and monitoring the mother with regard to progress of labor. In case of problems it usually means a Cesarean section or induced labor, both of which are procedures that are associated with potentail complications.

Last edited December 10, 2012

Jan

2003

Vertebroplasty And Kyphoplasty: Are These Procedures Safe?

By Ray Schilling | Arthritis, fractures, Orthopedics

These two orthopedic spinal reconstruction pocedures have become popular in the past few years. “Vertebroplasty” means doing a repair job on a damaged vertebral bone (spinal column bone). Originally this was developed for end stage cancer patients who had a single bone metastasis that led to a collapse of this vertebral bone. The difference in a good outcome of this procedure can mean the difference between being bedridden until death or walking and being active.

In a recent review of THE BACK LETTER (Vol.12, 12, Dec. 2002, Lippincott Williams & Wilkins), which critically reviews the literature regarding back pain and treatments, this procedure, even if successful, has not been researched long enough to be considered “standard therapy”. Many investigators report a success rate of 95% for compression fractures in patients with osteoporosis. But the FDA has warned that the bone cement that it used in this type of spinal surgery has never been properly investigaed for this application in non-cancer patients.

Nevertheless the technique of vertebroplasty has been clinically so impressive that those with severe kyphosis in the spine also wanted surgery. Kyphosis is a roundback in the mid spine area (thoracic spine) that can significantly interfere with normal posture, breathing action and cardiovascular functioning. Kyphoplasty is the procedure of repairing the curvature of the kyphosis, which consists usually of a series of several vertebral bodies with wedge shaped compression fractures in the thoracic spine. Often these patients are older and have osteoporosis.

Vertebroplasty And Kyphoplasty…Are These Procedures Safe…

THE BACK LETTER warns that the verdict on longterm follow-ups is not out. It may take a long time, even 10 to 15 years before this will become available as proper controlled studies have never been done. As the FDA link show, there can be serious life threatening complications from the procedure itself (spinal cord compression, respiratory arrest and death etc.). However, the longterm complications have not been reported properly as there is no longterm trial going on where the investigators would specifically concentrate on finding complications and untoward side-effects.

A well-designed multicenter trial regarding vertebroplasty and kyphoplasty is badly needed to answer these safety questions. Apparently efforts are on their way to attempt to do this.

Here is a link to my nethealthbook.com chapter on osteoporosis:

http://www.nethealthbook.com/articles/rheumatologicaldisease_osteoporosis.php

Last edited December 10, 2012

Jan

2003

The Liverpool Eye Study…How Often The Eye Sight Of Patients With Diabetes Should Be Examined

By Ray Schilling | Diabetes, Eye Diseases

In the January 18, 2003 issue of the Lancet (Lancet 2003; 361:195-200) Dr. Dr. Naveed Younis and his collegues published a study from the Royal Liverpool University Hospital, U.K. where diabetic patients underwent thorough eye examinations in regular intervals for 5 years. The question of this study was whether it mattered at what interval patients would be examined with regard to their eye-sight, so that perhaps blindness could be postponed or avoided through early interventions.

At the baseline of the study a special eye-photography method (three-field mydriatic photography) was used to document the blood vessel changes in the back of the eye. This helps the physician to assess whether or not there is a degree of retinopathy (blood vessel damage from diabetes) of the eyes or not. The investigators defined three groups:

For group one (no eye damage in the beginning of the study) there was a retinopathy rate of 0.3% at the end of the first year. Group two (moderate retinopathy in the beginning) showed a worsening of the retinopathy at the end of the first year of 5% (threatening blindness). Group three (significant retinopathy in the beginning) showed a rate of 15% of worsening retinopathy (threatening blindness) at the end of one year.

The Liverpool Eye Study…How Often The Eye Sight Of Patients With Diabetes Should Be Examined

This shows that not every person with diabetes is equal with respect of having the threat of blindness. The medical investigators found that about 70% of patients fell into the group that did not have serious diabetic retinopathy. However, the other 30% would not do well with simply yearly eye examinations as it is recommended now. Instead the authors of the Liverpool study were able to make practical recommendations as follows:

After a baseline eye examination those who belong into group one would get an eye examination every 3 years. Those with prior moderate retinopathy (group2) on the initial baseline examination would get examinations at yearly intervals (until the degree of retinopathy worsens). Group 3 with significant retinopathy at the beginning would, however, be examined every 4 months (new recommendation) so that blindness hopefully could be avoided or significantly postponed through interventional therapies.

The following link is telling you about hardening of the artieries (arteriosclerosis) and how diabetes accelerates this process:

The following site is about the metabolic effects of diabetes on the body and in particular also about the danger of diabetic retinopathy:

Diabetes: http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited December 10, 2012

Dec

2002

Obesity (Excessive Weight) A Predictor Of High Risk For Stroke

By Ray Schilling | Obesity, Stroke

In the Dec.9th issue of the Archives of Internal Medicine an important follow-up from the US Physicians’ Health Study was published. It examined the effect of obesity on the development of stroke later in life. 21,414 male physicians of the US have been followed now for 12.5 years in this study. At present there were 747 strokes (631 ischemic, 104 hemorrhagic, 12 others).

They found that the rates of strokes were in direct relation to the amount of excessive weight, in other words the higher the weight, the higher the risk to develop a stroke. It did not matter what kind of stroke it was (ischemic stroke or hemorrhagic stroke), a body mass index above 30 was always associated with a 1.9-fold risk to develop a stroke when compared to normal weight controls (body mass index less than 25). This risk of obesity was independent from other risk factors such as diabetes, high cholesterol or high blood pressure. Dr. Kurth from the Brigham and Women’s Hospital, Boston, said that this finding is very significant in view of the fact that many young adults in the US are either overweight or obese and they will be exposed to this risk for a longer period of time inreasing the risk to develop strokes even further. He hopes that physicians will concentrate on treating obesity more aggressively preventing a stroke. In industrial countries strokes are the main cause of disability and are on the third place on the list of causes of death.

Obesity (Excessive Weight) A Predictor Of High Risk For Stroke

(This info based on: Arch Intern Med 2002;162:2557-2562.)

Other information about strokes can be found through this link: http://www.nethealthbook.com/articles/cardiovasculardisease_strokeandcerebralaneurysm.php

Last edited December 10, 2012

Dec

2002

What Goes Around Comes Around With Blood Pressure Medications

By Ray Schilling | Heart Disease, High Blood Pressure, Prevention, Stroke

A large clinical study with 42,418 men and women 55 years and older has been published in the American Medical Association Journal recently(JAMA 2002:288:2981-2997,3039). The thiazide type water pill chlorthalidone(12.5 mg to 25 mg/day) is the clear winner in this trial, called the ALLHAT trial. It stands for “Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial” and is the largest hypertension trial that was ever performed going over a period of 5 years.

In this trial a calcium channel blocker(amlodipine) and an ACE (=angiotensin converting enzyme)inhibitor(lisinopril) were tested as the initial medication and compared to chlorthalidone.There was a 15% higher risk to develop a stroke with lisinopril and a
38% increased risk with amlodipine to develop congestive heart failure when compared to the chlorthalidone group. The interesting conclusion from this study is that the least expensive therapy for high blood pressure turns out to be the safest. Another ineresting finding was that black patients responded much better to water pills than to ACE inhibitors, which had been noted before by other authors. When more than one medication is required to control high blood pressure, the dosage of the second medication can often be kept lower with a combined therapy thus reducing the likelihood of side-effects and complications.

What Goes Around Comes Around With Blood Pressure Medications

Comments: Several decades ago the teaching was that the doctor would start a new high blood pressure patient with a water pill first, and combine this with a second or even third pill of a different medication class, if the water pill would not be effective enough on its own (it was called the “step care therapy”). For decades the side effects of the water pill consisting of low potassium blood levels brought the water pill treatment in disrepute. The original trials,however, were done with chlorthalidone doses of 50 and 100 mg per day, much higher than would now be recommended. It appears that with this study medicine has gone a full circle back to the old stand-by water pill, but at a much safer, lower dosage.

Here is a useful link (regarding hypertension): http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited December 10, 2012

Dec

2002

Bone Growth Can Be Stimulated Even In Desperate Cases

By Ray Schilling | fractures

In the past bone fractures that did not heal (called “non-union of a fracture” in medical terms) could not be treated other than with an electrical device, called bone stimulator. But now a large international team of 66 researchers from the US and South Africa have published a well controlled randomized study in the American Journal of Bone and Joint Surgery (84:2123-2134;2002). Dr.S.Govender et al. used a newly developed protein substance (rhBMP-2, from the Wyeth Laboratories) to treat 450 comparable open shin bone fractures.

The patients were either treated conventionally or with the additional help of this bone growth substance and data on wound healing, infection rates and delayed unions were collected. At 6 weeks 83% of the experimental group showed complete wound healing of the soft tissue compared to 65% of the control group. There were also significantly lower hardware failures, wound infections and need for postoperative visits by the doctor.

At the 12 month follow-up point there were 44% less non-unions when the two groups were compared with a lot less invasive secondary surgeries being needed.The authors of the two scientific collaborative teams concluded that this new bone producing protein will raise the standard of treating complex fractures that are difficult to heal.

See this news of the FDA approval

Bone Growth Can Be Stimulated Even In Desperate Cases

Last edited October 14, 2014

Dec

2002

Folic Acid In Cereal Reduces Abnormalities Of The Brain and Spine In The Unborn Child

By Ray Schilling | Nutrition, Other neurological conditions, Prevention, Women’s Diseases

In 1998 the Canadian government approved the mandatory addition of folic acid in cereal products as studies in the past had shown that pregnant women did not always take their prenatal folic acid supplements to prevent neural tube defects (abnormalities in brain and spine formation).

A total of 336,963 children of women who were either pregnant before or after the 1998 folic acid fortification program was institued, were screened for open neural tube defects. The result was that prior to the legislation there were 113 cases per 100,000 pregnancies. After 1998 there were only 58 per 100,000 pregnancies found.

Dr. Joel G. Ray from the Sunnybrook and Women’s College Health Sciences Center in Toronto who was the lead researcher stated that a food fortification program with folic acid in addition to the regular prenatal folic acid tablet supplementation is essential. To a large extent this will prevent these devastating congenital malformations that cause disabilities or death.

Folic Acid In Cereal Reduces Abnormalities Of The Brain In The Unborn Child

Based on: Lancet 2002;360:2047-2048.

Comments: It is also important for women to know that folic acid tablets need to be taken already before, around and after conception to be most effective with regard to preventing brain and spinal malformations. The nervous tissue is one of the fastest growing tissues in the first few weeks of pregnancy. Any deficiency of cell differentiation, for which folic acid is an essential ingredient, has devastating longterm consequences for the child.

Last edited December 10, 2012

Dec

2002

Study Shows Echinacea Not Effective For The Common Cold

By Ray Schilling | Infectious Disease, Lung Disease, Prevention

A study shows echinacea not effective for the common cold. 148 college students participated in this experiment at the University of Wisconsin. The researchers wanted to see whether Echinacea was more effective than placebo (“fake pills” with no herb in it). The Annals of Internal Medicine (Ann Intern Med 2002;
137:939-946,1001-1002) published this study recently.

How they did the experiment

The students were given 1 Gram capsules of a mixture of Echinacea herbs that can he bought in health food stores. With the onset of the common cold the students were given 1 capsule 6 times daily for the first day and three times daily from the second to the 10th day. The researchers examined all the students in the placebo group and the Echinacea group for symptoms, duration of the cold and the severity of the cold. The mean duration for both groups was 6 days. None of the criteria in measuring the severity of the cold symptoms were different in both groups. Dr. Barrett, the lead investigator concluded that there was no measurable difference between the two groups, but added that the findings of this trial should not be “the last word” on Echinacea. More studies need to investigate this matter.

Study Shows Echinacea Not Effective For The Common Cold

Conclusion

Here is the problems with the study. The investigators assumed that a placebo pill would not have an effect. However, countless other studies have shown that a placebo often has a 15% to 20% effect. On the other hand it is difficult to have another control for this by not taking any pill. It would be obvious to the subject in the trial that they are the negative control. A negative placebo effect would kick in. So, don’t stop taking Echinacea yet, if you have been taking this normally to treat a common cold. But those of you never took it in the past, you may want to wait first. See what other studies will say in future regarding Echinacea.

Last edited September 16, 2018

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