Monthly Archives: January 2015

Obesity And The Brain

obese-depression

Researchers recently announced a finding that obesity in early or mid life may be linked to a risk of dementia in old age. In particular, people who are obese in their 30s now have triple the chance of being among the 115 million people public health experts estimate will be living with dementia by the year 2050. The obesity-dementia connection is not itself new, but it was not previously recognized that the age at which someone is obese makes a difference in the effect obesity has on dementia risk.

Obesity is associated with a number of other health problems as well, It is linked with high blood pressure, cardiovascular disease, and insulin resistance. Insulin resistance, as the name suggests, is a deficiency in the body’s ability to properly use insulin to normalize levels of sugar in the bloodstream, can cause type 2 diabetes. Obesity is also a factor for other illnesses, such as scleroderma and poly-cystic ovarian syndrome. In addition, obese people are more prone to infertility, and pregnancy complications. Several cancers are also more common in obese people.

That’s why obesity prevention is so important. One of the best ways to do this is to eat healthy, but this is easier said than done. Experts suggest that people can maintain a better diet by paying attention, such as by keeping food diary and becoming aware of "e;eating triggers"e; that leas them to turn to food for reasons other than to alleviate hunger. Another thing that helps is to make healthy food, particularly healthy snacks, available—fruits and vegetables instead of cookies and chips. Exercise is another good way to lose weight, but it is important for people to start slow, both to avoid injury and to avoid getting discouraged and quitting.

One of the best ways to lose weight is to find a group. Mutually accountability can really help people stick to a diet and exercise plan. However, this comes with a caveat: studies have found the group is at its most cohesive early on in the program. This isn’t necessarily due to jealousy as people progress at different rates; even when everyone in the group is making reasonably steady progress, as the goal is in sight and confidence builds, group members simply feel the need for support less. This doesn’t necessarily lead to acrimony, but it does sap interest.

Precision Medicine Initiative

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The Information Age is bringing a number of benefits to humanity that were undreamt of, even unimaginable in decades past. One of thee advances ins "e;precision medicine,"e; which means taking into account each individual patient’s medical and personal history, lifestyle, even genetic heritage to find the treatment that will work best for his or her specific situation. To do this requires gathering and cross-referencing data about each patient, as well as research to determine the myriad ways all these factors interact and intersect.

Precision medicine is in some ways a return to medicine’s roots. Medieval medical practice consisted of analyzing not just the patient’s symptoms, but the whole person, including habits and living environment. Although with the rise of industrialization, modern science, and the professional approach, this was derided as superstitious and inefficient, it turns out the problem was merely poor tools and lack of accurate information. The nostrums of old didn’t really work, but the principle was more or less sound—looking at individual factors is actually more efficient than a one-size-fits-all treatment approach that is only truly effective for a subset of the population.

That’s why in the 2015 State of the Union Address, President Barack Obama announced government support for research into this new approach, saying:

I want the country that eliminated polio and mapped the human genome to lead a new era of medicine—one that delivers the right treatment at the right time. In some patients with cystic fibrosis, this approach has reversed a disease once thought unstoppable. Tonight, I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes—and to give all of us access to the personalized information we need to keep ourselves and our families healthier.

In the future, precision medicine could mean stem cell treatments from a patient’s own cells, used to build replacement organs that won’t be rejected. It may mean drugs that don’t merely fight illness but harness the body’s own defenses, thereby reducing side effects. In the speech, Obama alluded to a cystic fibrosis treatment developed by a company in Boston. The researchers worked out a way to create drugs specific to particular genetic mutations of those that cause the disease, rather than the scattershot approach that would otherwise be needed. This means better and more effective treatment, and a similar approach is being investigated for other conditions

Saving Sight

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Eyesight fades a little bit with age. It’s a natural process, one that is an ordinary result of the eye getting older. What is not normal is gradually losing the ability to see things in the center of the visual field, having difficulty adapting to low light levels, not being able to read normally because the words are blurred, or having difficulty making out enough detail on other people’s faces to recognize them.

That is a condition called age-related macular degeneration the most common cause of blindness in developed nations. Macular degeneration runs in families and is more common among smokers and obese people. A healthy diet is recommended to avoid the condition, and studies suggest cholesterol-fighting drugs can help prevent the condition or stop its progress.

Although it’s called age-related macular degeneration and most commonly affects people over age 65, researchers have recently found that the processes within the eye that lead to the condition begin earlier, with some patients starting to show symptoms in their 40s in eye exams. Regular eye exams are an important part of fighting the condition—the degeneration can be slowed or stopped, but lost eyesight cannot be restored. The symptoms of the disease are not always noticeable early on, but there are some signs an eye doctor would be able to spot.

While the cause of macular degeneration isn’t entirely clear, research has found that one culprit might be deposits of minerals forming in the eye. The condition has long been understood to involve fat-and-protein deposits in the retina starving the cells of the center of the eye of needed nutrients. The latest study found the source of these deposits. The scientists discovered that calcium phosphate from the bones and teeth act as seeds, places fat and proteins cluster around to form these blockages. Armed with this information, doctors may be able to diagnose the condition before it really gets underway by looking for calcium phosphate in the eyes.

A different study found that an anti-inflammatory drug called sulindac can help protect the eyes from damage. The researchers determined that the drug helps prevent a type of damage to the cells called oxidative stress, which is behind many signs of aging.

What Causes Schizophrenia

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Schizophrenia, which affects an estimated 3 million people in the United States, is possibly the quintessential mental illness. The stereotypes people have of the mentally ill are symptoms of schizophrenia: disorganized speech reflecting disorganized thoughts, delusions of being persecuted or of being the victim of surveillance, and hallucinations, often of voices issuing disturbing commands. People with schizophrenia are typically socially isolated and unkempt, because the nature of the condition makes it difficult to have normal social interactions or maintain usual standards of dress and hygiene. Additionally, schizophrenia often includes difficulties with what is called "social cognition," meaning the ability to understand and follow the norms of society.

Lately, doctors and researchers have come to regard Schizophrenia as not a single condition but a group of related conditions with overlapping symptoms but different causes and etiologies. All forms generally begin to appear in late adolescence or early adulthood, starting with emotional flatness and social withdrawal. Genetics and environment both are factors in the development of schizophrenia. The roots of the condition appear to lie in the neurotransmitters dopamine and glutamate, along with other chemicals in the brain. Schizophrenic people have different brain structures from people without schizophrenia, but it is not known if the difference is causes schizophrenia or if the disease, along with whatever causes it, itself changes the structure of the brain.

Scientists have revised the estimates of the genetic effect on schizophrenia significantly downward in recent years. One study found that only in 15 percent of genetically identical twins did either both or neither twin exhibit signs of schizophrenia. At any rate, the effect is no more than a greater likelihood of developing the condition. Some people who are genetically prone to the condition seem, for various reasons, to be able to defeat that tendency. High intelligence, which is also the result of a combination of genes and environment, is correlated with a reduced schizophrenia risk; the line between madness and genius may not be as thin and easily crossed as is commonly claimed. It is suggested that environmental factors, such as trauma, that tend to lower intelligence also tend to promote schizophrenia.

Arthritis Relief

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Osteoarthritis is a condition of aging. As a person gets older, the cartilage that protects the joints and helps them move better wears away, leading to pain. Although some wear on the cartilage happens with everybody, arthritis is not simply an inevitable feature of aging. It can be controlled, and even prevented. Repetitive motion without a break wears down the cartilage, and finding a way to avoid that can stave off arthritis. Resting the joints provides some benefit, and lessens wear and tear. On the other hand, exercise can help keep the joints flexible and increase bone strength. Exercise can also help keep weigh under control, which means less strain on the joints, less deterioration of cartilage, and less pain.

One particularly helpful kind of exercise is running. Running wouldn’t seem like an activity that would be beneficial, or even possible, for someone with osteoarthritis, but recent research suggests that going for a run on a regular basis helps prevent damage to the cartilage in the knees. In the past, studies done on professional runners found an increased incidence of arthritis, but people who are involved in less intense forms are less prone to developing the condition. Running helps lower BMI, putting less strain on the knees, as well as building tolerance for movement.

No one has yet found a cure for arthritis, or a way to reverse the damage. A different kind of joint has been suggested as a treatment, but research has found no evidence that medical marijuana is an effective remedy. Medical treatment generally involves drugs to reduce inflammation, along with pain medication. Physical and occupational therapy are used in addition to or instead of medication to manage or relieve pain or to increase range of motion. Braces and orthopedics can help take pressure off affected joints so that the worn-away cartilage isn’t stressed.

Anti-inflammatory drugs called COX-2 inhibitors are commonly prescribed for arthritis, but have been shown to increase the risk of stroke. Another common treatment, acetaminophen, was found in studies to be useless for arthritis pain. However, research has found that high zinc levels contribute to the destruction of cartilage that is behind arthritis, and reducing zinc could help save joints.

Cervical Cancer And HPV

New findings show that one dose of the HPV vaccine may do the trick.

Nearly every person who develops cervical cancer did so as a result of contracting one of around 15 types of human papillomavirus, or HPV, a sexually transmitted disease. There are actually more than 150 types of HPV, though most of them are not associated with cancer; a substantial portion of sexually active people have one form or another of the infection, but because most strains cause no symptoms, the exact percentage is hard to determine.

Both HPV and cervical cancer in its early stages are generally asymptomatic—the strains of HPV that cause genital warts are different from those that cause cancer. That is why it is important to be screened for HPV for someone who is sexually active regularly. A test called a Pap smear, after a shortening of the name of the doctor who developed it, Georgios Papanikolaou, is used to look for signs of cancer in the cervical canal, the exit and entrance of the uterus.

Cervical cancer strikes more than 10,000 women each year. It is very rare for someone to get it except as a result of HPV infection. While a high partner count makes transmission of the virus more likely, anyone who is sexually active can acquire HPV. Not every HPV infection, even with the high-risk strains, leads to cancer. Things like smoking and smoking, stress, poor overall health, and other sexually transmitted infections such as chlamydia can make it more likely that cancer will develop.

Nonetheless, HPV prevention, quixotic a task as that is, can help reduce the incidence of cervical cancer. Many of the risk factors for HPV appear to be behaviors that are related to having more than one sexual partner—either resulting from decision, facilitating it, or simply the behaviors of someone likely to make it—and it is more likely that their contribution of these factors to getting HPV is mediated by that. Regardless, condom use provides a degree of protection, but it is imperfect because the virus can be transmitted by contact between areas of skin not covered.

The HPV vaccine is becoming more popular. It is available for children and teenagers—since HPV can be transmitted during a person’s first sexual encounter, it is recommended that people be vaccinated before they become sexually active, but the vaccine is effective through age 26 in women and 21 in men. The vaccine provides protection against the three HPV strains that cause more than three quarters of all cervical cancers, and experts say vaccination programs could cut cervical cancer deaths by as much as two-thirds.

Pancreatic Cancer Spreads

pancreatic tumor

Pancreatic cancer is one of several types of cancer that has been linked to the genes primarily associated—and named for—breast cancer. As with breast cancer, however, genetic susceptibility is only a small part of the picture. Because the pancreas is where insulin is produced, pancreatic cancer is associated with diabetes, and diabetic people are more likely to develop cancer, as are people with other diseases of the pancreas. That means obesity and other risk factors for diabetes are also risk factors for pancreatic cancer.

It is also one of the cancers to which smokers are particularly vulnerable, and the vulnerability lasts a long time, taking years or even decades after quitting to return to non-smoker risk levels. Cutting back on red meat is suggested for cutting risk, but the evidence for a connection is unclear.

As with many forms of cancer, pancreatic cancer ordinarily has no obvious symptoms in the early stages. However, pancreatic cancer can lead to the appearance of jaundice. Other symptoms include poor appetite and weight loss, odd stools, or pain in the upper abdomen, though these are not as specific. Moreover, while diabetes is a risk factor for pancreatic cancer, it can also be caused by it. That means the sudden onset of type 2 diabetes can be an indication that pancreatic cancer screening is in order, particularly in patients with no real risk factors for diabetes, those with a family history of pancreatic or breast cancer, or African-American patients.

Even with an early diagnosis, however, pancreatic cancer has a relatively low survival rate, around one in three, largely because it is such an aggressive form off cancer. Recently this month, researchers found that a gene called TRIM29, which is involved in a substantial majority of cases of pancreatic cancer, affects the way tumor cells grow. The pancreatic cancer variant of the gene also alters the structure of the tumor cells in such a way that they have an easier time moving around and spreading through the organs of the body.

Because it is so deadly even in the early stages, prevention is more important that screening for pancreatic cancer. The means quitting smoking, exercise, and a healthy diet that includes fruits and vegetables.

About Myasthenia Gravis

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Poor communication can cause all manner of trouble. That’s true not only between people, but even in a single person’s body. When the parts of the muscles responsible for receiving nerve impulses are mistaken by the immune system for disease and destroyed, the nerves can no longer properly communicate with the muscles, and voluntary muscle movements are affected, resulting in a condition called myasthenia gravis. Myasthenia gravis affects about one in 5,000 people. It can strike anyone at any time, but initial onset is most common people between the ages of 50 and 70 and in in women under 40.

It’s not always clear what causes the immune system to attack the muscles. Myasthenia gravis is one of the few autoimmune diseases that does not appear to have a genetic component, but there is probably an inborn predisposition that, in combination with environmental triggers, leads to the condition. People who take certain medications—some types of antibiotics, beta blockers, quinine, or some others—are more likely to develop the condition. Other risk factors involve the thymus gland, where immune antibodies are produced. Occasionally, myasthenia gravis patients have a non-cancerous tumor in the thymus gland. More often, an enlarged thymus exhibits excess activity, producing the undesired antibodies.

Because myasthenia gravis affects the brain’s ability to send impulses to the muscles, it interferes with voluntary muscle movements, though autonomous activity such as the heart beating remain unaffected. That means difficulty taking a breath or speaking—speech becomes soft or hoarse—trouble chewing or swallowing, facial muscle paralysis, double vision and problems looking people in the eye, and a feeling of having to work harder than usual to move, stand from a chair, or climb up stairs. Another symptoms is a diminished sense of smell, even though this doesn’t involve the muscles.

Fortunately, myasthenia gravis generally is easily treated. When there is a tumor involved, removing the tumor, or even all or part of the gland itself, generally clears up the condition. When there is not, a common approach is to flood the body with the neurotransmitter that relays the signal to the muscles, o compensate for the damage to the receptor sites. As with many autoimmune diseases, drugs that suppress the activity of the immune system alleviate the condition.

Hysterectomy

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A hysterectomy is the surgical removal of the uterus. This can range from a small part of the uterus up through the entire thing, along with the ovaries and fallopian tubes. Perhaps unsurprisingly, this is a major decision and is generally used only wen less-drastic treatments have bee tried without success. A patient who has had a hysterectomy will be unable to bear children and as a result the operation is not generally performed unless that is not an issue. Nonetheless, one in three American women will have ha a hysterectomy by age 60.

The operation can be performed either vaginally or, more commonly, through a small incision in the abdomen similar to that made for a caesarian section. An abdominal hysterectomy is ordinarily performed when the uterus is enlarged or inflamed, or when the entire uterus needs to be removed together with the ovaries and fallopian tubes. The abdominal incision offers better access in these cases. Vaginal hysterectomy is fewer complications and a shorter recovery time, but doesn’t afford surgeons the same opportunity to see the condition of the organs, and can only be used if they know exactly what needs to be done.

There are a number of reasons a hysterectomy might be performed. When cervical, uterine, endometrial, or ovarian cancer is localized, removing the affected organ could be a complete treatment. Heavy menstrual flow, such as that caused by fibroids, can lead to anemia as well as severe pain, and hysterectomy may be performed in such cases as a last resort. It is also used for endometriosis or for uterine prolapse. Sometimes a pregnancy so damages the uterus—typically, a case of the placenta growing in an unusual place—that it needs to be removed.

However, a recent study suggests that too many hysterectomies are being done, and as many a one in five are not necessary at all. According to the researchers, for conditions for which hysterectomy is recommended as a last resort, it was actually the only treatment offered to almost 40 percent of patients. Less than a third of the women whose cases were looked at got medical treatment for their conditions before the operation even though in many cases it would likely have been sufficient.

If It Talks Like A Duck…

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In 17th-century Netherlands, snake-oil sellers were called kwakzalvers. That’s why today we call them "quacks." Regardless of the name, they all do the same thing: sell useless and often harmful medical treatments and health advice to a defenseless public. Some of them may well believe the claims they are making, and sincerely think they’ve hit upon a remedy or a treatment approach that no one else has thought of before but that works. Others simply don’t care whether what they’re hawking does anything or not. Regardless, the results for the patient are the same—no improvement and, often, a delay in seeking or using remedies that might actually improve their health.

That is the most consistent danger of quackery. People will spend time, money, and other resources on treatments that don’t treat anything. Even if these fake treatments are harmless in themselves, the illness isn’t being treated—and may be getting worse—while the patient goes on this wild goose chase. Sometimes, however, the treatment is actively harmful. Colloidal silver turns the skin blue. "Black salve," a concoction sold to skin cancer sufferers, can be incredibly damaging, eating away at the skin it is supposed to heal. Worst of all, some hucksters convince perfectly healthy people that they need a lifestyle change to preserve their health, or suffer an ailment that has no symptoms and may well be unknown to medical science, which they need to pay the quack to cure.

There are some indicators that strongly suggest that a proposed treatment is nonsense. One is universality—a medication that treats a broad range of very different ailments may sound like a wonder drug, but the truth is that isn’t generally how drugs work. A real medication is generally specifically aimed at a particular cause or part of the body. Some quacks offer an alternative hypothesis about disease, medicine, or even anatomy, claiming it is superior to the conventional medical understanding. At the same time, many will use scientific-sounding language and other external trappings of legitimate medicine. Quacks will often claim that the medical establishment is trying to silence them or keep their discoveries secret, including by branding them quacks. The word "toxins" is a key sign, especially when it is not further elaborated upon.