Monthly Archives: October 2012

Save Your Brain

People often think that as you grow older, you start to lose your marbles, but this doesn’t have to be the case. Dementia is typically a disease of aging, but it is a preventable one, and it as known risk factors. These risk factors include high blood pressure and cholesterol, diabetes or prediabetic conditions such as metabolic syndrome, and smoking. Quitting smoking or reducing the other risk factors, if you have them, will help you keep your faculties, and there are several lifestyle behaviors you can do as well.

If you keep your mind active, it may help you keep your mind going. If you have a hobby, keep it up. Take classes—you’re never too old to learn a foreign language or a musical instrument, and both of these can help keep you sharp. Participate in internet discussions. maintain an active social life. Crossword puzzles and Sudoku may also have a positive effect. Even social networks such as Facebook can give your brain a boost.

Keeping your body active can also help keeping your mind going. A study, published in April, suggested that strength and resistance training can help slow or prevent cognitive decline. Regular exercise can also help fight high blood pressure, and it reduces metabolic syndrome and the associated obesity, both predictors of cognitive decline. You can even combine exercise with social activity by taking a yoga or tai chi class.

Another way to reduce your dementia risk is by lowering your levels of an amino acid called homocysteine. Folic acid and vitamins B6 and B12 can help lower homocysteine levels. Research suggests that these vitamins can slow the progression of dementia-related conditions.

Improving your heart health will also make you less susceptible to neural degeneration. High blood pressure and high cholesterol—anything that puts you at high risk for stroke—also heightens your risk of dementia. The plaques that high cholesterol causes to form the arteries in heart disease patients are very similar to those that form on brain tissue in cases of cognitive decline, so it stands to reason that preventing one will prevent the other.

Halloween Safety

Trick or treating tomorrow night—if you can—is meant to be fun for kids, but it can be scary for parents. But you can get peace of mind by following some simple safety precautions:

  • Kids should go trick or treating in groups
  • Costume accessories, such as swords or staffs, should be soft and flexible, and shouldn’t be so big or bulky as to be unwieldy. Remember that unwieldy to a kid may be rather smaller than to an adult.
  • Be sure your kid is in a costume that doesn’t restrict his or her range of movement or peripheral vision too much—or, ideally, at all.
  • If you’re in an area affected by the hurricane, be aware of debris and other storm damage.
  • Trick-or-treaters should carry flashlights when going out in poorly-lit residential areas.
  • Costumes should have reflective tape. Dark shirts and cloaks my be important to the overall look, but they can make the wearer hard for motorists to see.
  • Children should stay on the sidewalk, if there is one, except when crossing streets. Younger kids especially should not cross the street without holding someone’s hand.
  • Safety rules still apply on Halloween. Kids should remember not to go into strangers’ houses or cars without a trusted adult with them.
  • Costumes should be made of flame-retardant material.
  • Don’t let little kids carve pumpkins or light candles.
  • Set a Halloween curfew, and stick to it.
  • Check treats for choking hazards, and only let kids eat factory-wrapped treats or homemade goodies from people you know and trust. If you didn’t go with your kid, and he or she doesn’t know who gave them a homemade treat, don’t let them have it.

By taking these tips into account, you and your kids can all have a safe, fun, and happy Halloween.

Stress-Related Illness

Millions of Americans struggle with an often painful condition that can strike in times of stress or cold weather. Psoriasis is an autoimmune condition that entails an overgrowth of skin cells. Flare-ups can also be triggered by infections, sunburn, or smoking cigarettes. Psoriasis is the most common autoimmune disease.

A psoriasis flare-up typically appears as red scales on the skin, or dried and cracked skin. Psoriasis is usually found on the elbows and knees, but it can be anywhere. Itchy, scaly, pink skin can be a sign of the condition. Psoriasis can even appear on the scalp, where it can cause severe dandruff. Other symptoms include joint pain and yellowish fingernails. As with most autoimmune diseases, psoriasis has no cure, but it can be treated with anti-inflammatory drugs, and topical creams can alleviate the symptoms. Although psoriasis is generally not debilitating, it can have some serious complications and is linked to more serious diseases.

A study in Taiwan released last month found that people with chronic periodontal disease are more likely to have psoriasis. Both psoriasis and poor gum health have been linked with heart disease, and there was no conclusive evidence that gum disease leads to people who are susceptible to psoriasis developing condition. The study tracked nearly a quarter of a million subjects, and found that the people with gum disease were 54 percent more likely to then be diagnosed with psoriasis.

Psoriasis patients are at elevated risk for diabetes as well. Two separate studies earlier this year found a link between the incidence of psoriasis and that of type 2 diabetes. In both studies, the chronic inflammation associated with psoriasis was found to also lead to a prediabetic condition called metabolic syndrome. The anti-inflammatory medications used to treat psoriasis may lower this risk. The link between psoriasis and diabetes exists even when the patient is not overweight or obese.

Possibly the most worrying illness associated with psoriasis is cancer. Multiple studies have found that psoriasis patients are at heightened risk for lymphoma and—perhaps unsurprisingly—skin cancer. Lymphoma affects the immune system, and the increased immune activity associated with diseases such as psoriasis appears to make it more likely for that particular form of cancer to develop. The ultraviolet light treatments used for psoriasis are assumed to be behind the link with skin cancer.

Within the Walls

Could your walls be making you sick? A recent discovery provides new insight into how mold in homes and offices can harm the people who live and work in them—and while the effects generally respond temporarily to treatment, researchers warn that the only permanent solution is to deal with the mold directly.

“Mold” is actually a blanket term for a variety of organisms that are found in damp walls of buildings and elsewhere. These organisms are a natural part of outdoor environments, growing on dead trees and fallen leaves and other dead organic matter. The spores are usually too small to see, and are often blown in through open doorways and windows, or brought in by air intakes for temperature control system. Spores that some in from the outside are harmless by themselves, generally, but they can attach themselves to damp surfaces, and if those surfaces are not permitted to dry—whether because they’re not exposed to the air, or because they get rained on or spilled on, or for any other reason—the mold will settle in and grow.

One of the most famous type of mold is Aspergillus penicillium. Although the drug derived from A. penicillium changed modern medicine, the mold itself can be highly allergenic. Another allergen is ulocladium, which is found in bathrooms, kitchens, and damp basements. It exacerbates asthma symptoms. The toxic, foul-smelling mold acremonium grows in insulation and on drywall when they get damp. One of the most common molds is Trichoderma longibrachiatum. Buildings with indoor air problems are usually found to have a trichoderma infestation.

Trichoderma mold produces toxins called a trilongins, according to findings in September by a Finnish research team. Trilongins are absorbed by the body and prevent potassium and sodium from reaching the cells. This disrupts the heart, the nerves, and the respiratory system. The symptoms recur unless the mold is completely eradicated from the structure.

Overlooked

Perhaps because it’s significantly less frequent, breast cancer in men is often overlooked. However, breast cancer is as serious in men who have it as in women, and can be just as harmful.

There’s no question that more women then men get breast cancer. Only about one in 1,000 men—compared to one in eight women—get breast cancer, and men account for one percent of breast cancer patients. Men typically have less breast tissue than women, as well as lower amounts of the hormones associated with breast cancer. As with women, mutations in the genes BRCA1 and BRCA2 can leave men particularly prone to developing cancer in breast tissue. In men, the BRCA2 mutation causes the greatest risk.

Some of the risk factors for men are the same as those for women, though others are not:

  • A family history of breast cancer, including in female relatives.
  • Obesity.
  • Enlarged breasts, a condition called gynecomastia
  • Exposure to estrogen.
  • The genetic condition Klinefelter’s syndrome.
  • Testicular injury or disease.
  • Liver disease.
  • Exposure to radiation in the area of the chest.

Breast cancer in men has the same stages as in women. It’s really the same disease; the differences are due entirely to the differences in male versus female breast tissue. However, because breast cancer is so much rarer in men than in women, and because even doctors so seldom think of it at first, it’s not as often caught in the early stages.

Baseball Injuries

As the San Francisco Giants and the Detroit Tigers prepare to face each other in the World Series, starting tonight, we’re taking the opportunity to look at baseball medicine. There are some injuries that are particularly common among baseball players, and some treatments that are particularly frequent within the sport.

For example, in 1974, Yankees pitcher Tommy John underwent a procedure to repair a ligament in his elbow. Now known as Tommy John surgery, the operation was controversial, with some fans and commentators feeling it gave him an unfair advantage. Though John’s performance did improve, it is generally believed that the apparent improvement was simply John and others getting the surgery returning to their previous levels of ability—the operation didn’t make those pitchers better than they had ever been, only better than in the months or years right before the surgery.

Thirty-six years later, similar controversy attended a procedure performed on pitcher Bartolo Colón. Colón, now with the Oakland A’s, had stopped playing early in the 2009 season due to rotator cuff damage and shoulder pain. In March 2010, he received a stem-cell transplant to repair the damage, with the approval of baseball officials. The procedure seemed to rejuvenate his arm when he returned to the field, playing for the Yankees in 2011.

When players have shoulder injuries, it is important not only to treat the injury but to minimize recovery time. Modern athletes have rigorous training schedules, and often can’t spare the weeks or months it might take to fully recover—the long stretches of enforced idleness mean athletes are comparatively out of shape and need to work to get back into pre-injury condition.

Now some injuries can be treated with a new technique that can cut recovery time in half. With the surgery, tears in the cartilage lining the shoulder joint—a common injury for athletes who make overhand motions—are treated by adjusting the structure of the arm musculature so that the injured area is placed under less strain.

Dealing with Bullying

With the tragic death earlier this month of Amanda Todd, there’s a new focus on the problem of bullying. Research has shown that bullying is not just an emotional strain that can take a toll on victims’ mental health. There is clear evidence that it can be physically harmful as well.

Too often, bullying is seen as an ordinary and inevitable part of childhood. More and more, however, it is being seen as the serious problem that it is. Children who are bullied have been found to have more mental health issues than children who aren’t. Bullied children have higher rates of depression, anxiety, and low self-esteem; they are more likely to think about suicide, and consequently they are more likely to commit suicide. The effects of bullying aren’t limited to childhood, they can in a significant number of cases remain as the child becomes an adult, long after the bullying has stopped.

However, not all the effects are on mental health. There are physical effects too. Kids who are bullied report increased health problems. The stress and sleeplessness that can result from being bullied can themselves cause health problems, such as a compromised immune system, as well as affecting school performance. These kids experience fatigue, pain, and other physical symptoms as a result of bullying.

The role of the adult in stopping bullying is important. “Kids will be kids” is not a sufficient response; adults need to show that bullying behavior is not acceptable and will not be tolerated. Parents and others who may not see the bullying need to learn to recognize its effects: changes in behavior, poor appetite or sleep, and avoiding certain places or activities the child used to enjoy. Tastes do change, but a child who seems to get no joy from anything is almost certainly being targeted in this way. If a child you know is being bullied, one way to help is to counter the messages the bullying sends by working to boot the child’s self-confidence.

Adults can also help by empowering kids. Witnesses and bullied kids can all take steps to reduce bullying in schools. One way is to stop participating. Bullies sometimes have their packs; simply refusing to be part of the pack, taking a stand, can help. On the other hand, kids who are being bullied may find it helps to band together—it improves confidence and presents a less appealing target, as well as the value of knowing you have an ally. Avoiding the bully may not be a good long-term solution, but he or she may at least get distracted. One of the best things a kid can do is tell an adult; be sure your children know you’ll be there for them.

Dealing with Disfluencies

One in twenty children stutters, speaking with noticeable disfluencies that interfere with communication. These disfluencies can take the form of repeating sounds, prolonging sounds, or just unnatural pauses between syllables and words. Often it’s just an ordinary part of learning how to speak, but for roughly one percent of children, stuttering is a lifelong problem.

Although it’s not clear what causes stuttering, there’s some evidence of a genetic cause, and it’s been observed to run in families, with about three in five stutterers having a relative who stutters—the writer and television presenter Dominick Dunne and his brother, the novelist and critic John Gregory Dunne both had trouble with stuttering.

It has been found that the brains of people who stutter process language differently than those of other people. Sometimes people who did not previously exhibit disfluencies start to stutter after a stroke or brain trauma. Most likely, a combination of factors influences stuttering.

Beyond biological causes, there is also a psychological aspect. Stuttering isn’t a mental disorder, but people who grew up in high-pressure family environments often show signs of strain. Stuttering can be one of those signs. In very rare cases, emotional trauma or mental or intellectual problems can manifest themselves as what’s called psychogenic stuttering; however, only a tiny percentage of actual cases of stuttering are psychogenic.

There is currently no cure for stuttering, though when it can be traced to an underlying cause, if the cause is treatable, treating it often also treats the stuttering. In the case of children who stutter, time is usually sufficient to treat it. Anti-stuttering applications are an off-label—unofficial—use of some medications, but most treatment focuses on developing strategies to minimize or disguise the disfluencies.

Addressing Ascites

More and more Americans are being diagnosed with the liver disease cirrhosis. Experts say it’s on track to pass hep‌‌atitis C as the number one reason for liver transplants within the next few years. Often associated with excessive drinking, cirrhosis occurs when liver function is compromised by scar tissue and can be the result of any of a number of factors, including being overweight, even in people who don’t drink.

One effect of cirrhosis is a condition called ascites (uh-SAI-teez). Ascites can be easily ignored in its mildest forms, when it is only detectable with diagnostic imaging procedures such as CT scans; in advanced cases, it can cause discomfort and shortness of breath. People with severe ascites often complain of abdominal distension.

Ascites is the condition that used to be known as “dropsy.” It occurs when fluid collects in the abdomen as a result of what is called portal hypertension, or high blood pressure in the blood vessels leading into and out of the liver. This creates an imbalance in pressure, and fluid rushes into the abdominal cavity to correct this imbalance. Water retention is also a factor, as the kidneys sense low volume and retain sodium and water in response.

Left untreated, ascites can raise a person’s chances of infection. The condition can be treated with diuretics and reduced salt intake, though neither of those is an effective treatment alone. The patient needs to cut his or her salt consumption to less than 2 grams per day, and go on a regimen of water pills to get retained water and salt out of the kidneys. In extreme cases, a sterile needle can be used to quickly remove fluid from the abdomen.

Less directly, ascites generally goes away with treatment of the underlying cause, such as cirrhosis. In cases of complete liver failure, for example, a liver transplant will also clear up the ascites.

Cirrhosis is the most common cause of ascites, but there are a number of other ailments that can lead to the condition. It can result from any form of acute liver failure or liver cancer, or from a condition called Budd-Chiari syndrome in which the veins that blood exiting the liver goes through become blocked. Beyond the liver, heart failure, kidney disease, and pancreatitis can all lead to ascites.

Saving the Brain from Stroke

When a stroke happens, time is of the essence. Brain damage can happen in mere moments. Now Canadian researchers have found a drug that seems to be effective in preventing this damage and protecting brain function. Research into such drugs has been sparse due to pessimism about their efficacy, but this study suggests that such an approach could very well be successful.

When blood vessels in the brain are damaged—broken or blocked—the result is generally a stroke. Blood can’t get to some or all of the brain and brain cells begin to die off. The functions these cells perform, whatever they happen to be, are obviously affected by this; that’s why stroke is the fourth-leading cause of death in the United States and a major cause of disability that isn’t congenital or inborn.

Now a partial solution may soon be at hand.

“Through our lab research and clinical trial, we now have a better method of predicting whether a stroke drug may be effective in humans and we now have the evidence that there is a neuroprotectant that can prevent damage in the brain caused by reduced blood flow,” said Dr. Michael Tymianski, who invented the drug under study, in a statement. “The benefits of this can be explored not only for stroke, but for other conditions such as vascular dementia.”

What that means is that Dr. Tymianski created a medication that protects the brain when it’s not getting proper amounts of bloodflow due to a stroke. Right now it has only been shown to be effective for certain kinds of strokes, but Dr. Tymianski thinks it could work for other kinds as well.

The National Stroke Association’s advice for spotting a stroke is based on the letters in the word “FAST”: face, arms, speech, time. If you think someone is having a stroke, ask them to smile and see if their face droops on one side, ask them to raise both arms and see if one drifts downwards, ask them to repeat a phrase and see if their speech is slurred; if any of these are true, contact emergency medical services immediately and note the time symptoms first appeared. The sooner treatment is begun, the better.