Monthly Archives: March 2014

Poison Prevention

Nearly half of calls to Poison Control—1-800-222-1222 in the United States—involve young children. These calls add up to a hundred children in emergency rooms for poisoning every day. Here are some ways to keep your children safe:

  • Be on the alert for products that can be toxic—not only cleaning supplies, but make-up, art supplies, and other items. Don’t assume things are safe.
  • Make sure all medications are in their original, well-labeled containers.
  • Read labels carefully when giving medicine to children and turn the lights on.
  • Read the label and measure the dosage out every time. Don’t rely on memory or habit.
  • Don’t call medicine "candy." You needn’t be grim about it, but don’t treat your children’s medicine as fun or as an indulgence.
  • Get all medications in bottles with child-resistant packaging and replace the cap tightly when you’ve measured out a dose.
  • Do not have medications out on a table or counter. Measure out the dosage and take the medicine all at once.
  • Put medicines and toxic household products such as cleaners away as soon as you have finished with them.
  • Keep medications where children cannot get to them, ideally, locked away, out of sight, or both.
  • Keep medicine separate from other items, especially anything your child will legitimately need or is likely to (and is allowed to) get and use without supervision.
  • Keep toxic household products and medication away from food items.
  • Dispose of unused or unneeded medicine immediately.

If you fear or have reason to suspect your child has been poisoned, call the doctor or Poison Control immediately. Do not induce vomiting, but be prepared to take the child to get medical attention.

About Anorexia

Anorexia is an eating disorder, but experts say it’s not really about food. Although the condition manifests as severe food restriction, in which patients adopt regimented, ritualized, and woefully inadequate diets, fundamentally anorexia is about control, it’s about body image, and in many cases it’s about difficulty managing the transition of adolescence. Teenage girls are particularly vulnerable to poor self-image and impossible or contradictory societal expectations. Accordingly, anorexia is the third most common illness among teenagers, and as many as 90 percent of anorexic people are female, many of whom started as teens.

Unfortunately, a near total lack of food can have devastating long-term or even permanent effects. Malnourishment, such as from a persistent eating disorder, does damage to the brain, heart, kidneys, and other organs, and this damage is irreversible even if the person is able to acquire normal eating habits. Anorexia can also result in death by starvation- in fact, it is one of the leading causes of death due to mental health issues. Other effects include bone loss, electrolyte problems, heart failure, and anemia.

Treatment for anorexia, as with many primarily mental illnesses, is often a long-term process. An anorexic person sees herself or himself as overweight when this isn’t the case, and an important goal of treatment is to replace this distorted self-image with a more accurate one. Recent studies suggest that the hormone oxytocin can help with this. It’s also important to make sure the return to a healthy weight is done right, without shocking or overwhelming a body grown accustomed to starvation.

Because anorexia so often starts during the teen years, parents are in a particularly good position to watch out for warning signs and to seek help. A difficulty of watching for anorexia is that people will actively try to hide the signs. Eating small portions or refusing food is possibly hardest to hide if the family eats together. Extreme weight loss that isn’t worrying or that the child tries to hide is something else to watch for. If you do suspect your child has anorexia, don’t be accusatory or confrontational, and don’t pursue it immediately if they deny anything is wrong. You should use "I-statements," describing your observation and concerns without discussing your child’s mental state. One factor underlying anorexia is a fear of getting fat, so you may need to reassure them on that ore without reinforcing the fear.

Who’s using the ER

While the health care industry is always changing, there's one place where people in need of treatment will always go: the emergency room. The Centers for Disease Control and Prevention conducted an ER use survey for adults aged 18 to 64 from January through June 2011.1 Their results indicated just how important emergency rooms are to patient well-being:

  • 66 percent of ER patients were there for a serious health concern
  • 79.7 percent of those surveyed visited an ER due to lack of medical coverage
  • 54.5 percent of the patients believed only a hospital could offer them treatment
  • 48 percent surveyed came to the ER because their doctor's office was closed

Emergency room patients
So, who is it that's coming into the ER? Dr. Leana Wen, an emergency physician at George Washington University, explained in Slate Magazine that there tend to be 10 types of patients who seek medical attention in an ER.2

  • Some patients will come in apologizing for "bothering" the staff, but it's important that clinicians take their symptoms and conditions seriously.
  • On the other hand, there are those who demand immediate attention, even though their injury may not be an emergency and there are others who require more attentive care.
  • A number of people who visit the ER aren't making their first trip there – rather they are repeat customers who often suffer from chronic conditions.
  • Someone who has not received satisfactory diagnosis from his or her general doctor may seek the advice of an emergency room professional as a second opinion.
  • While some people consider themselves "totally healthy," that's not always the case. Patients who come into the ER and don't divulge their full medical history can put their health in danger.
  • With the Internet, hypochondriacs have a wealth of information at their fingertips. Unfortunately, this may mean unnecessary trips to the ER due to self-diagnosis.
  • There are also patients who are convinced that something is wrong with them, which may cause them to think they are experiencing more symptoms than they actually are.
  • Regardless of what they are there for, some individuals just want to talk. While it's important for staff to get all of the necessary information, there are other patients who are in need of their care.
  • When someone who is ill comes to the ER, he or she may become overwhelmed with the situation on top of their condition. That's why it's best to bring a friend or family member along.
  • Unfortunately, there are some people who are looking to get a quick fix of narcotics, and they think that the perfect place to do so is an emergency room.

With all of these personalities and needs in one place, there's no doubt that an ER can be a crazy place to work, let alone come for treatment. On top of all that, things get even more hectic when a trauma is thrown into the picture. These are just some of the reasons it may be best to talk to your clinician first, especially if you are a senior.

Where should the elderly go?
More than likely, you are going to have to wait awhile before being treated in the ER. Many seniors are on multiple medications, which can weigh heavily on the proper course of treatment they require. However, these records can easily get miscommunicated or forgotten in an ER. According the The New York Times, it's likely that the number of patients going to the ER for care is going to significantly increase as the baby boomer generation continues living longer.3 So, if it's not an emergency, it may be best to wait until the morning to take a trip to your primary physician.

Medex Supply provides medical professionals and individuals with a wide range of medical supplies.

1 Centers for Disease Control and Prevention, "Emergency room use among adults aged 18-64: Early release of estimates from the National Health Interview Survey, January-June 2011" May 2012
2 Slate, "The 10 types of ER patients" March 18, 2014
3 The New York Times, "Emergency rooms are no place for the elderly" March 13, 2014

Addressing Colon Cancer

The most common cancer in the United States is colon cancer, which strikes over 130,000 Americans every year; it’s also the second most often fatal form, with more than one in three patients dying of the disease within five years, 1,000 each week. Fortunately, colon cancer is also one of the easiest forms to diagnose, and as with most forms of cancer, the earlier colon cancer is detected, the more easily it can be treated. The best way to look for colon cancer is with a procedure called a colonoscopy, in which doctors use a camera to look directly at the colon and see if there are polyps or other indicators. If polyps are small enough, they can be removed during the colonoscopy. Screening is recommended every ten years starting at age 50, with earlier and more frequent screenings urged for people with Lynch syndrome or other risk factors.

Though colonoscopy is the most accurate and thorough form of screening, it is a medical procedure that requires the time and expense of any other doctor visit, as well as complicated prep beforehand and recovery time afterward. Other screening procedures include blood testing and looking for certain signs in stool samples. These samples are less accurate, but can now be collected using home test kits and sent to a laboratory or analysis to provide preliminary testing. People with a positive result on the home test can then get a colonoscopy to confirm it.

There are many reasons polyps might form. Recent research has shown a connection with the intestinal microflora found in the gut. These microflora are bacteria that ordinarily aid in digestion and supplement the immune system. However, these bacteria can also cause inflammation in people who are susceptible, which in turn triggers the development of polyps in the colon and other parts of the digestive tract that can turn into tumors.

Polyp removal is a relatively minor surgical procedure, but for more advanced or invasive cancers, more intrusive surgery may be needed, such as removal of sections of the colon or bowel. Researchers are looking into simpler treatments to fight colon cancer. Prevention is an important aspect of this, addressing controllable risk factors such as obesity and smoking. In addition, grape seed extract has been shown to help enhance the effectiveness of chemotherapy, meaning more colon cancers may be treatable without major surgery.

Your genes could reduce your risk for heart disease

Currently, there are a number of risk factors that health care professionals have related to one's chances of suffering heart disease. While some of these can be controlled, not all can. According to the Mayo Clinic, common issues that may put you at risk of a cardiovascular episode include:

  • smoking
  • poor diet
  • lack of exercise
  • poor hygienic practices
  • high levels of stress1

Some of these triggers can lead to other health concerns that may increase your risk of heart disease, such as:

  • high blood pressure or cholesterol
  • obesity
  • diabetes

Additionally, there are risk factors that we have no control over, including:

  • family history and genes
  • gender
  • age

Recent research from the University of Michigan and the Norwegian University of Science and Technology has found a specific gene that may worsens one's risk for heart disease.2

New findings
Authors published their findings in Nature Genetics after conducting 80,137 genotyped coding variants in 5,643 Norwegian participants. The collected data indicated that individuals displaying the presence of the gene TM6SF2 were healthier overall, and they were less likely to suffer from a heart attack. This is due to the gene's ability to keep cholesterol levels lower in addition to other blood lipids.

"While genetic studies that focused on common variations may explain as much as 30 percent of the genetic component of lipid disorders, we still don't know where the rest of the genetic risk comes from," Dr. Cristen Willer, senior author of the research and an assistant professor at the U-M Medical School, told Genetic Engineering & Biotechnology News. "This approach of focusing on protein-changing variation may help us zero in on new genes faster."3

This means that medical researchers will be able to learn more about cardiovascular disease and other health issues as they uncover additional information about this and other genes. As a result, other risk factors for heart attack may be uncovered, leading to a greater chance for prevention.

If you suffer from diabetes or another condition that increases your risk for heart disease, talk to your clinician about what you can do to improve your health. Diabetic supplies, blood pressure equipment and other medical supplies can all be purchased online from Medex Supply.

1 Mayo Clinic, "Heart disease: risk factors" January 16, 2013
2 Nature Genetics, "Systematic evaluation of coding variation identifies a candidate causal variant in TM6SF2 influencing total cholesterol and myocardial infarction risk" March 16, 2014
3 Genetic Engineering & Biotechnology News, "Novel technique discovers new gene linked to heart attack risk" March 17, 2014

Hearing Loss And Your Brain

Most people, as they age, gradually lose their hearing. There are a number of reasons for this. the muscles gradually become stiffer all over, including in the ears. This usually erodes hearing near the top of the pitch range. Additionally, most people are exposed to loud noises—music, trains, highway traffic, even conversation—which can gradually diminish hearing; over the decades, it adds up. While total deafness isn’t common, older people do tend to hear less well than younger people do. In many cases, there is a genetic component to hearing loss as well. Some illnesses (including some that can be prevented by vaccination), medications, or chemical exposure can also cause deafness or diminished hearing ability.

Interestingly, not all noise damages hearing the same way. Research now shows that the time of day at which noise exposure occurs has a bearing on how it affects the ability to hear. It turns out that noise exposure at night results in a greater degree of permanent hearing loss than exposure during the day. Damage to hearing sustained during daytime heals more thoroughly than at night.

A surprising danger of hearing loss is that as a person’s hearing starts to g, their brain becomes smaller. Some brain shrinkage is a normal part of aging, though the effect is not always significant. However, a recent study found that for people with impaired hearing—particularly if left untreated—this loss of brain volume is accelerated. Some of this shrinkage is in the auditory processing regions of the brain. According to MRI scans, however, some of the accelerated shrinkage takes place in the parts of the brain where memory and cognition are located, which makes it a dementia danger.

Another effect of hearing loss on the brain involves mood. Hearing loss—though not total deafness—was associated in a study with higher rates of depression. The correlation was stronger in women than in men. Researchers suspect, however, the hearing loss is not a cause of depression; rather, people who live alone, heavy drinkers, and people with a relatively low educational level were more likely both to have depression and to have suffered some hearing loss.

Seafood And Your Kidneys

Hypertension and heart disease can cause damage to the kidneys. So can diabetes, kidney stones, some cancers, prostate enlargement that blocks the urinary tract, and a number of rarer conditions: vesicoureteral reflux, urine backing up into the kidneys; glomerulonephritis, an inflammation of the parts of the kidney used for the organ’s filtering function; and polycystic kidney disease in which cysts develop on the kidneys. Between these conditions, recurrent kidney infection, and plain bad luck, kidney disease affects ten percent of the global population.

Sometimes, the source can e hard to pin down. A chemical called domosic acid, produced in the ocean by algae and frequently found in shellfish, has long been known to be a neurotoxin, damaging the brain, at high doses, but was believed to be safe enough in smaller quantities. Now, however, scientists have found that these much lower amounts are nonetheless high enough to cause toxicity in the kidneys, which, filtering the blood, get the brunt of these amounts.

Unfortunately, left untreated, kidney disease can be fatal, either through the kidney itself failing or when the damage to the kidney and consequent diminished function leads to cardiovascular disease. That is why early detection is so important. The good news is that tests for kidney disease are simple and reliable, even if there are no symptoms. A doctor may test a patient’s blood or urine, looking for telltale signs of damage, or an ultrasound scan is used to detect changes in the size or density of the kidneys that point to health problems. Testing is particularly important not only for early detection, but because the symptoms of kidney disease—persistent itching nausea, vomiting, loss of appetite, and changes in the amount and quality of urine—could be caused by a number of other conditions as well.

Knowing the cause is also important to proper treatment, because treatment often involves addressing the cause of the damage. In addition, dietary changes may be recommended so as to give the kidneys less work to do. Other treatments are directed at the symptoms. In severe cases, when one or both kidneys has failed entirely, a transplant or dialysis with a machine that functions as an artificial kidney may be necessary.

Health Benefits Of Aerobic Exercise

Aerobic exercise is exercise for the heart. These forms of low-intensity, long-duration workout activity involving what are called "slow-twitch" muscle fibers build strength and endurance, rather than speed, focusing on sustained activity rather than short bursts. These exercises have a number of important health benefits. Heart rate increases and blood vessels widen. This not only delivers needed oxygen to the muscles- the source of the term "aerobic"—it helps carry away metabolic and respiratory waste products that build up in muscles, causing stiffness and soreness. Aerobic exercises release the endorphins that are responsible for the "runner’s high" people feel after working out.

These types of exercise help more than just heart and mood. Aerobics is the best for of exercise for weight loss—both getting it off and keeping it off, in conjunction with a proper diet. Doing aerobics can boost the immune system, help lower cholesterol, strengthen the heart, and keep blood pressure under control. That means that people who do aerobics are less prone to obesity, type 2 diabetes and a pre-diabetic condition called metabolic syndrome, heart disease, stroke, hypertension, and even some types of cancer. In addition, people who do aerobics are reported to have longer lifespans, and to be healthier and more active in their later years. At all ages, aerobic exercise builds stamina.

Aerobics can be particularly good exercise for people with certain conditions, including some that at first blush would seem unlikely candidates for benefiting from any sort of workout. Age-related macular degeneration is a condition in which the retina slowly becomes more and more damaged, eventually leading to blindness in people with the condition. It affects at least 2 million Americans over age 50, but experts say that aerobics can help slow this seemingly inexorable march. Aerobic exercise raises levels of a particular protein in the brain that appears to protect retinal cells, preventing people at risk for or in the early stages of macular degeneration from totally losing their sight.

Multiple sclerosis is another chronic condition that can be attenuated by aerobics. Half of all people with multiple sclerosis suffer memory loss. This appears to be a result of cell death in the brain, particularly in a region known as the hippocampus. Aerobic exercise provides a boost to the hippocampus, helping to mitigate this otherwise intractable problem. In a study, patients who had done aerobics had less damage in the hippocampus and showed better memory function after three months.

Treating Down Syndrome

The 21st chromosome is unique in the gene: it’s the only numbered pair that someone can survive having three of rather than the standard two. Three of any of the other chromosomes, aside from the X and Y that are primarily involved in sex characteristics and determination, will prevent the zygote from developing into an embryo and the baby from being born. In cases of trisomy 21, the baby can survive, albeit with Down syndrome, the most common birth defect.

Down syndrome used to be associated with a short lifespan—an average of 25 years for babies born with the condition in 1983—but that has changed. A person with the condition will exhibit stunted growth, profound cognitive deficits, a flat face with a protruding tongue, creased palms, small hands and feet, and often short fingers and poor muscle tone. These children, and later adults, are at heightened risk for hearing impairment, leukemia, and heart problems, and they are more prone to Alzheimer’s disease.

Today, Down syndrome can frequently be detected in utero with prenatal testing. Now a new testing procedure has been developed that is more accurate and better for women. When initial tests find signs of Down syndrome in the fetus, the next step is to confirm it with amniocentesis or a different test called chorionic villus sampling. However, these procedures are physically taxing for the mother-to-be and have a danger of miscarriage, which is why obstetricians try to avoid doing them. The new approach, a simple blood test, has a much lower false positive rate, meaning that it seldom find signs of Down syndrome in a fetus that doesn’t have the condition. That means the riskier procedures can be avoided in more cases.

After the child is born, new treatments may soon be available. Scientists have found a way to silence the extra chromosome in the lab. If this can be done in a living fetus, it would mean that the effects of the extra chromosome would be nullified, so that a child born with the genetic cause of Down syndrome would avoid the condition. Another research team is testing medications that, it is hoped, will enhance the ability of neurons to form connections, thereby facilitating learning and forming memories. This would enable students with Down syndrome to keep pace with their non-Down peers academically and socially.

Brain Training

"Neuroplasticity" refers to the ability of the brain to reshape itself and to adapt to changes. This is, essentially, what learning is, but the term encompasses much more than that. For example, if the brain is damaged, such as by a stroke or head trauma, it has the ability to restructure and redesign itself so that the operational parts are able to partly take over the functioning of the damaged areas. This isn’t always perfect—there’s only so much real estate available, and the remapped parts have to perform their original functions as well—but it does happen, which is why stroke and traumatic brain injury is survivable in the first place.

Several companies sell "brain training" programs that are said to enhance neuroplasticity, but the evidence in favor of this is mixed at best. These programs take the form of games, which challenge and develop pattern recognition, memory, attention span, and other cognitive functions. However, there is little evidence these techniques have a significant effect in people who don’t have some kind of deficit to begin with. In fact, according to a recent study, the games are very effective mostly at improving performance on the games themselves—the more practice someone gets at playing a game, the better they are at that, but not at the tasks on which the game supposedly improves performance.

That’s not to say it’s entirely useless, however. Baseball players who completed a game designed specifically to enhance vision did show improvement in vision, and, correspondingly in playing baseball. At higher levels, baseball players tend to have significantly better levels of visual acuity than most people, since it’s a major component of the game. The trained players did nearly 5 percent better at the plate and scored far more runs than controls.

Training can also be useful for children diagnosed with attention deficit hyperactivity disorder. The usual treatment for ADHD is stimulant medications, but doctors and parents can be reluctant to prescribe such medications long-term. Neurofeedback games—which directly reward focus and concentration—and cognitive training games have even investigated as possible alternatives. A study earlier this year found a slight improvement for students who received cognitive training, and dramatic improvement for those who had gone through the neurofeedback therapy. In these cases, they were able to generalize the cognitive skills, sing them in the classroom and elsewhere as well as in the lab.