Fastrack Archives April 2013
Monday April 1, 2013
How to Manage Cartilage Tears and Osteoarthitis of the Knee
A study of 351 patients over age 45 with knee pain, cartilage tear, and knee osteoarthritis were treated with arthroscopy or physical therapy and evaluated after 6 and 12 months. One third of the physical therapy group elected for arthroscopic surgery but the remainder of the group did as well at 12 months as those getting arthroscopy.
In osteoarthritis there is degeneration of cartilage and eventually what remains is bone on bone. In advanced osteoarthritis these patients are not nearly as good candidates for arthroscopy as are those people with cartilage tears and minimal osteoarthritis.
In general, people in these categories can benefit from integrative strategies that involve chiropractic, acupuncture, bodywork, physical therapy, platelet rich plasma injections, cortisone injections, arthroscopy, total knee replacement, DMSO, NSAIDs, and infrared light therapy. Dr. Len and Nurse Vicki review these options.
Tuesday April 2, 2013
Dangerous Viral Gene Found in Most GMO Crops
The European Food Safety Authority (EFSA) belatedly discovered that of the 86 GMO foods developed, 54 contain a virus called Gene 6 that has not been cleared for safety! Gene 6 may also disturb the normal health of crops, including their natural pest resistance as well as human health.
GMO crops should be banned and recalled. In the US we don't even require GMO crops be labelled; 62 other countries do require labelling! Shockingly, Prop 37 in California, which required labelling of GMO foods, failed! This should remind us of how callous Big Agra is in the US. It is all about return on investment! They convinced us that we don't need to know what is put in our food!!
Recently President Obama signed into sequestration legislation of H. R. 933 a section that bars federal courts from being able to halt the sale of GMO crops regardless of what health issues may arise because of them! What is legislation like this doing in a sequestration bill? This section of the bill is being called the "Monsanto Protection Act."
Wednesday April 3, 2013
Neurologists Caution Against ADHD Drugs
The American Academy of Neurology published an article in the March 2013 issue of Neurology a statement advising against the use of neuroenhancing drugs to boost academic achievement is school tests in normal kids. They say the drugs have not been adequately studied in normal kids; it makes you wonder if these drugs are a good idea for kids with these conditions either.
ADD and ADHD are vastly overdiagnosed in our children. All too often children are hyperactive, impulsive, and difficult to teach for reasons other than these diagnoses. Our kids are at the mercy of an epidemic of dysfunctional role models that far too often lead to disordered behavior.
The clinical diagnosis should be guided by adequate observation and testing before using drugs that can be dangerous, especially in the long term. Symptoms characteristic of these syndromes include dyslexia, dyspraxia, night blindness, dry skin, and concentrated urine. They often have abnormal essential fatty acid metabolism defects that can easily and affordably be done. In borderline cases, both fMRIs and spect scans can be very helpful.
Thursday April 4, 2013
Biennial Mammograms are Sufficient to Screen for Breast Cancer
According to researchers at the University of California Medical Center, and published in the March issue of Internal Medicine, screening for breast cancer every two years is preferrable to yearly screens when doing mammograms. This was based on a study of 900,000 women. It appears that this applies to women from the age of 50-94. Mammograms picked up the same number and size of tumors whether done annually or biennially and whether or not women had dense breasts or were on hormone replacement therapy! However, for women under the age of 40 this was not true.
The problem is that mammograms are far from an ideal test because they cause some cancers because they deliver significan radiation and because they result in far too many false positive tests that end in retesting, increasing morbidity, and increasing costs. Fifty percent of women screened annually with mammograms will have at least one recall over a ten year period.
Friday April 5, 2013
Making Conscious Choices
John Renesch is a self taught social entrepreneur who has published 14 books and hundreds of articles on organizational and social transformation. He is actively engaged in teaching social transformation and in this video focuses on how making conscious choices can influence positive change on our cultural values and operations.
Monday April 8, 2013
Optimal Nutrition in Preparation for Surgery
An article published in the journal, Surgery, in March of 2013 showed that what you eat before surgery may affect your recovery. They demonstrated that in mice consuming a high fat diet that there was more inflammation in the body. These authors also pointed out that when fat tissue is traumatized at surgery that there is a flaring of inflammation both locally and systemically. Surgeons generally cut and damage fatty tissues freely in order to visualize their surgical fields, especially because fat does not bleed much. Surgeons should avoid traumatizing adipose tissues during surgery.
Fat tissue is far more than storage of energy for the body. It stores a number of hormones such as leptin and adiponectin, secretes inflammatory chemicals including TNF-alpha and IL-6, and has an influence on immunity, reproduction, glucose metabolism, tumor development, protein metabolism, and much more!
A healthy pre-operative diet should include healthy fats such as essential fatty acids, juicing, probiotics, and a balanced diet of organically grown foods grown in rich soils.
Monday April 22, 2013
Is Salt Good or Bad?
It is difficult to determine from the medical literature whether salt is good for you or bad because it is conflicting. A recent study claimed that there are 2.3 million deaths from heart attacks, strokes, and other heart related illnesses worldwide caused by taking in too much salt.
On the flip side there are many articles showing that salt is good for us and that it has a minor effect on blood pressure and that heart attacks and strokes either are not affected by salt intake or that the risk is actually lower as shown by the Cochrane Collaboration study. Another study published in the American Journal of Medicine in 2006 reported over 14 years on 78 million people that the more salt taken in the diet, the lower the risk of heart attack deaths!
At the same time, none of these studies differentiates between table salt, which is 97% sodium chloride, and sea salt or Himalayan salt. There is a difference in these products. Himalayan salt has only 85% sodium chloride but the other 15% has 84 different minerals that could be important trace minerals for the human body.
Another article published in the American Journal of Hypertension in 2012 reported that there's little evidence that cutting back on salt decreases the risk for heart attack, stroke, or death in people with either normal or high blood pressure.
Now, keep in mind that we're all different and for some people salt in any form is dangerous. For example when we have edema caused by congestive heart failure or advanced liver or kidney disease, salt could be lethal.
Different people have different salt needs, so consult your physician before consuming high levels of salt!
Tuesday April 23, 2013
Surgical Menopause May Prime the Brain for Stroke and Alzheimer's Disease
Women who abruptly and prematurely suffer from estrogen deficiency caused by surgical menopause have a two fold increase in cognitive decline and dementia. This conclusion comes from research published in the March issue of the journal, Brain that was done on rats with surgical menopause, of which some were given no estrogen replacement, some late estrogen replacement, and some with immediate estrogen replacement. Only those with full estrogen replacement did not suffer from dementia.
Researchers also reported that estrogen reduced the risk for heart attack and stroke. This sounds contradictory to the Women's Health Initiative Study that showed replacing hormones with HRT increased the risk for heart attack, stroke, and many other disorders.
We must remember that HRT is NOT estrogen and progesterone replacement...it is replacement with horse estrogens and a progesterone-like drug manufactured by the pharmaceutical companies so they could patent it and convince MDs to prescribe it to their patients. Ahhh, business as usual!
Wednesday April 24, 2013
Too Many Seniors are on Risky Drugs
According to a study from Brown University that was published in the April issue of the Journal of General Internal Medicine, 21% of seniors received a potentially harmful drug for which there was a safer alternative in 2009. This was based on data from more than 6 million Medicare patients. If one in five seniors are on a dangerous drug, and the average senior takes 6 prescription drugs, that there's only one risky drug for each 30 prescriptions. This seems like a gross underestimation of what these authors are calling "risky." Can you imagine the risks of patients in either hospitals or convalescent hospitals who are often on more than 20 drugs!
One of the conclusions of these researchers is that patients should look into the safety of their medications. Hello! How about MDs and pharmacists taking on this responsibility!
Thursday April 25, 2013
Today's Adults are Less Healthy than Previous Generations
A study in the April 2013 issue of the European Journal of Preventive Cardiology showed that despite greater life expectancy, adults today are less healthy than in previous generations. Scientists analyzed data from 6000 people over 16 years that included body weight, blood pressure, total cholesterol, and HDL cholesterol. THey determined that the prevalence of overweight, obesity, increased with age in all generations, but that the increase was highest in the most recent generation. They calculated that the youngest generation is 15 years older metabolically than previous generations.
This should not be surprising considering the differences in lifestyle that include less natural living, more indoor time, less sun exposure, more toxic exposures, more stress, worse food, and more sedentary behavior.
Friday April 26, 2013
Is Obesity Linked to our Gut Microflora?
A recent Cedar-Sinai study published in the Journal of Clinical Endocrinology and Metabolism in April of 2013 could predict who is obese based on a breath test for hydrogen and methane. The question raised is are there bacteria in the gut that cause obesity by allowing the body to extract calories better. The issue that was not raised is could having these bacteria, in this case M. smithii, be present in obese people because there is something about the environment in the gut that preferentially allows this microbe to overgrow?
Researchers could identify the presence of this microbe because it has the unique ability to create both methane and hydrogen gases, which can be measured using a breath test.
Nonetheless, this is an interesting concept and it will be interesting to see if they can eradicate M. smithii from the GI tract and cause weight loss.
Monday April 29, 2013
Drug Reps Do Not Inform MDs About Dangerous Drug Side Effects
An article published in the April issue of the Journal of General Internal Medicine documented that drug reps fail to inform MDs about dangerous side effects in 59% of cases. Yet these MDs still reported that they we still likely to prescribe these drugs. This is against the law as well as immoral, but there is no resource to monitor what happens in the doctor's office.
Who is teaching MDs about new drugs? Why don't MDs do their own research? Where can they obtain literature that they can trust? These problems explain why MDs know much more about the benefits of drugs than they do about their dangerous side effects. They also explain part of why there are 400,000 deaths from medications every year and millions of hospitalizations.
Tuesday April 30, 2013
Reducing Complications may Cost Hospitals Money
Hospitals have a financial incentive to not reduce complications because they are paid per each treatment and each lab or other test according to an article published in the April issue of the Journal of the American Medical Association. While this may not be what hospitals are overtly thinking, the problem is how motivated are they to reduce complications?
Between 3 and 17% of surgeries have complications and average a profit of about $11,500 per patient. On the average, for privately insured patients hospitals make about $17,000 per surgical patient when there are no complications, but about $56,000 when there are complications. Overall, including Medicare patients, hospitals ended up with about $8,000 per complication.
It is easy to see why hospitals would be "punished" for introducintg quality-improvement programs.
Wednesday May 1, 2013
The Mammography Industry is Clinging to a Failed Test for Women Under Fifty
Let's face it. Mammograms are far from a perfect test, especially in women under the age of 50, and particularly in women with fibrocystic breasts. The United States Preventive Task Force no longer recommends screening women routinely for breast cancer with mammograms. There has been a flood of complaining from the American Cancer Society and the mammography industry that this is a mistake and that many lives are lost from breast cancer as a result.
A new study from Cornell Medical Center claims that of 14,500 screens in women under age 50 uncovered 21 invasive cancers. How many would be benefitted from this discovery is not discussed. Depending on the study, between one in 700 and one in 1800 women are benefitted from mammography in women under the age of 50.
The problem, of course, is how many people are being over-diagnosed and over-treated because of mammograms. This number is huge and must be at least in the range of 30-40% and at a cost of billions of dollars and of considerable morbidity and psychological trauma.
Adding breast thermography would be a major advance in screening women in this age group.
Thursday May 2, 2013
L-carnitine Improves Outcome After a Heart Attack
A study in the April 2013 issue of Mayo Clinic Proceedings documented that the amino acid L-carnitine significantly improves cardiac function after a heart attack. Apparently, l-carnitine is depleted after a heart attack and, if corrected, results in a 27% reduction in all-cause mortalitiy, 65% fewer dangerous ventricular arrhythmias, 40% reduction in the development of angina, and a smaller sized infarct. It probably also reduces the number of re-infarction, and the development of congestive heart failure.
So, what does l-carnitine do? The heart gets the vast majority of its energy from burning fat! L-carnitine transports long chain fatty acids into the energy-producing part of heart cells, the mitochondria, and allows it to metabolize them to produce energy (ATP). It has been shown that in a heart attack, levels of l-carnitine are depleted quite quickly, so it should be replaced.
Friday May 3, 2013
The Importance of the Doctor Patient Relationship
Drs. Welby and Kildare are now a thing of the past for the most part. Today's fragmented health care has lost the personal relationship between doctor and patient and is oriented to saving money and getting people back on their feet and back to work as quickly as possible. The personal relationship where a healer listens and cares has become "unaffordable" and treatments have become standardized and insensitive to each individual's special and unique needs.
The Center for Medicare and Medicaid Innovation is taking another look at bringing back a form of the comprehensive care physician who will take care of both out and inpatients by awarding researchers at the University of Chicago a $6 million grant to measure the cost effectiveness of less fragmented health care.
Real health care addresses the whole person--physically, emotionally, mentallly, and spiritually. There is little attention to holistic medicine today in mainstream medical care.
Monday May 6, 2013
Comparison Shopping by Doctors Saves Hospital Costs
Physicians are primarily concerned with providing the best laboratory tests and patient care possible, and cost is not a huge consideration. A study published in Internal Medicine in April of 2013 showed that if hospitals would post the cost of tests on lab requisitions that MDs would pay more attention to ordering fewer and less expensive tests. In fact, the cost of lab tests decreased by 9% at Johns Hopkins Medical Center when these costs were posted.
As a result MDs have lost control of patient care, which is now too often in the hands of insurance companies and large physician conglomerates.
Tuesday May 7, 2013
The US is Prescription Happy
Four billion prescriptions were filled in the US in the year 2011 and at a cost of $227 billion according to the World Pharmaceutical Market Summary. The top five therapy classes of drugs were statins, antiulcerants, antidepressants, antipsychotics, and antihypertensives. The top five drugs sold were, Lipitor, Plavix, Nexium, Seretide, and Crestor. The top five drug companies were Pfizer, Novartis, AstraZenica, Merck, and GlaxoSmithKline.
It is shocking that all of these drugs are massively overused, often as an off-label application that is not approved by the FDA. We are a massively over-medicated society!
Wednesday May 8, 2013
Stress Increases the Risk for a Heart Attack
A Danish study published in April of 2013 of 11,000 patients without heart disease were followed for 16 years and grouped on the basis of mental vulnerability (tendency for psychosomatic problems or poor interpersonal relationships). They found that the mentally vulnerable had a 36% higher risk for a cardiovascular event.
A second study of 14,000 people over 3 years evaluated the effects of demanding physical labor on cardiovascular risk and found that leisure activity, as expected, was beneficial, but demanding labor increased the risk for heart attacks! For those who did both kinds of exercise, the risk increased 400% compared to those with a sedentary job. Overall, those with a sedentary job had a 20% lower risk of a heart attack! There was a 60% benefit for those people with sedentary jobs who did leisure activity.
In a third article published in April of 2013, researchers found that high levels of cortisol, which reflect stress, measured in hair samples showed a higher risk for type 2 diabetes, heart attacks, stroke, and peripheral artery disease.
So, there's more to exercise than meets the eye and it is important to know more about the effects of exercise and the setting.
Thursday May 9, 2013
Low Dose Naltrexone
Low dose naltrexone (LDN) has been implicated to help with cancer, HIV/AIDS, autoimmune diseases, and much more. Now it has been shown to have a potent antitumor effect on human ovarian cancer in both tissue culture and in animal xenografts. Naltrexone (NTX) is a general oioid receptor antagonist that results in compensatory elevation in endogenous oioids and opioid receptors. It has a powerful inhibition of cell lproliferation. Studies showed that LDN could also increase the effects of chemotherapy for ovarian cancer.
Friday May 10, 2013
High Blood Sugar, Elastin, Ferroelectricity and Aging
Ferroelectricity is the response of a molecule to switch from a positive to a negative charge and is necessary to maintain the elasticity of elastin, a protein that gives elasticity to tissues such as blood vessels as well as heart and lung tissue. Ferroelasticity of elastin is lost when blood sugar levels rise and this causes it to lose about 50% of its elastic properties that allow blood vessels to transmit a pulse, and heart, lung, and other tissues to stretch.
This concept is a new additional explanation for the development of a process called glycation, which leads to damaging proteins that cause nerves and blood vessels require to work properly. When blood sugar levels rise above 170, an enzyme called aldose reductase becomes active and converts sugar into sorbitol, which is toxic to our tissues and causes many of the complications of poorly controlled diabetes.
Tuesday May 14, 2013
What is the Difference Between Brown and White Fat?
There are many different ways to classify fat: saturated, trans, unsaturated, brown, white, and essential fatty acids. Some are essential for life and some are lethal. Where fat accumulates is also important. If white fat accumulates inside the abdominal cavity it predisposes to the metabolic syndrome and type two diabetes with all of its complications. However, if it accumulates in other places, it actually extends life expectancy!
Brown fat accumulates in the neck in humans. Contrary to white fat which stores fat and makes us overweight, brown fat burns fat when the body is exposed to cold and is associated with a lower body weight. Wouldn't it be wonderful if we could convert white fat to brown fat so we'd tend to burn it and weight less? Maybe not! So far, drugs that do this have been lethal.
I find it very interesting that we're always looking for ways to subvert the way nature operates rather than live a healthy lifestyle. It is also interesting that fat is a highly active tissue metabolically. In general, we have a fat phobia in this country that is off target. Fat is a healthy food and what our body burns for fuel most of the time.
Tuesday May 15, 2013
Naturopathy Reduces Cardiovascular Risk Factors
According to a study published in the Canadian Medical Association Journal in April of 2013, naturopathic care enhanced conventional care from MDs by showing a 17% reduction in prevalence of the metabolic syndrome over a one year period.
Primary healthcare supposedly provides in-depth lifestyle counselling, however, why then does ND care lower the risk for metabolic syndrome in those people getting conventional health care? MDs are simply not trained anywhere near as well as NDs when it comes to lifestyle management that includes diet, exercise, sleep, weight control, use of supplements such as omega 3 fatty acids, coenzyme Q10, l-carnitine, and much more, so we should not expect they will know about lifestyle medicine.
It is time for integrative medicine to be brought into clinical practice...we deserve nothing less!
Thursday May 16, 2013
One Session of the Relaxation Response Alters Gene Expression
According to an article published in the May 2013 issue of PLoS ONE, a single session of the relaxation response produced immediate changes in gene expression of immunity, energy metabolism, and insulin secretion. Investigators from Harvard analyzed the expression of more than 22,000 genes and found that the relaxation response alleviates symptoms of anxiety and improves heart rate, blood pressure, oxygen consumption, and brain activity through genetic changes in DNA.
Various other forms of relaxation, such as meditation, yoga or prayer were not reflected in changes in gene expression.
Friday May 17, 2013
Most Cancers are Preventable Today
An article published in Science Translational Medicine in March of 2012 concluded that 1/3 of all cancers were caused by smoking and another 20% from being overweight or obese. However, diet, exercise, sleep, and exposure to environmental toxins likely account for another 30-40% of all cancers. Genetic factors are not that common. The American Cancer Society promotes finding the cure and avoids promoting prevention. This is not much of a surprise when you consider their conflicted position with the pharmaceutical industry.
There will be about 1.5 million new cancers in 2012 and nearly 600,000 deaths. We need real health care reform that is based on wellness and prevention.