Dr. Bray Links

Thursday, October 18, 2018

Vitamin C cocktail for sepsis: randomized trials to test efficacy - PulmCCM

Since Marik et al announced exceptional survival rates among patients with septic shock given a cocktail of vitamin C, thiamine, and hydrocortisone, physicians taking care of septic patients have expressed both enthusiasm and skepticism about the cocktail's reported lifesaving effects.

Soon, more rigorous testing from randomized, double-blind placebo-controlled trials should provide harder data about the sepsis cocktail's efficacy.

Jonathan Sevransky, MD of Emory University announced plans for a clinical trial enrolling between 500 and 2,000 patients at multiple centers over about 18 months, completing by the end of 2019. Patients with septic shock would get either the cocktail, or placebo. Mortality will be tested, as well as days free of vasopressors or a ventilator. The study will be funded by a private foundation.

Michael Donnino, MD of Harvard's Beth Israel plans to enroll 200 patients at multiple centers, also testing the cocktail vs. placebo in patients with septic shock. Organ failure, mortality, and other outcomes will be compared. Major funding will come from the Open Philanthropy Project. The study should be completed in the autumn of 2019.


https://pulmccm.org/infectious-disease-sepsis-review/vitamin-c-cocktail-for-sepsis-randomized-trials-to-test-efficacy/

Saturday, October 13, 2018

High-Quality Diet Linked to Better Outcomes in Bipolar Disorder

A high-quality diet was one that included an abundance of fruits and vegetables, whereas poorer-quality diets included more saturated fat, refined carbohydrates, and alcohol.

https://www.medscape.com/viewarticle/903342

Sunday, October 7, 2018

FDA Bans Use of 7 Synthetic Food Additives

Ever heard of these food additives? Synthetically-derived benzophenone, ethyl acrylate, methyl eugenol, myrcene, pulegone, or pyridine?

These compounds can help mimic natural flavors and are used to infuse foods with mint, cinnamon and other flavors.

https://www.npr.org/sections/thesalt/2018/10/06/655135633/fda-bans-use-of-7-synthetic-food-additives-after-environmental-groups-sue

Friday, October 5, 2018

Patient Advocacy Groups Take In Millions From Drugmakers. Is There A Payback? | Kaiser Health News

It spotlights donations pharma companies made to patient groups large and small. The recipients include well-known disease groups, like the American Diabetes Association, with revenues of hundreds of millions of dollars; high-profile foundations like Susan G. Komen, a patient group focused on breast cancer; and smaller, lesser-known groups, like the Caring Ambassadors Program, which focuses on lung cancer and hepatitis C.

The data show that 15 patient groups — with annual revenues as large as $3.6 million — relied on the pharmaceutical companies for at least 20 percent of their revenue, and some relied on them for more than half of their revenue. The database explores only a slice of the pharmaceutical industry's giving overall and will be expanded with more companies and groups over time.

https://khn.org/news/patient-advocacy-groups-take-in-millions-from-drugmakers-is-there-a-payback/

US woman develops salmonella in breast implant after trip to Cancun | Fox News

An American woman who traveled to Mexico five months after undergoing breast augmentation surgery had to have one of the implants removed because she developed salmonella in her right breast. The 34-year-old patient, who was not named in the JPRAS Open case report, was otherwise healthy before vacationing in Cancun and is believed to be the first documented case of breast implant infection following a case of traveler's diarrhea. 

https://www.foxnews.com/health/us-woman-develops-salmonella-in-breast-implant-after-trip-to-cancun

Tuesday, October 2, 2018

Is Kombucha Actually Good For You? - Eater

Perhaps the only kombucha study that meets today's scientific standards came out in the September 2000 issue of Nutrition. A team of researchers from the University of Alaska Fairbanks department of psychology gave kombucha to a group of lab mice. Male mice that drank kombucha lived 5 percent longer than males that didn't drink kombucha; for females, kombucha extended life by 2 percent. Kombucha also inhibited weight gain, even though kombucha-drinking mice ate and drank more than those that didn't drink it. The authors speculated that this could be due to the free xanthines — naturally occurring chemical compounds with the same base as caffeine — in the kombucha stimulating the metabolism. The tea leaves are likely the source of the xanthines, as xanthines are found in green, black, and oolong tea. These results were in line with anecdotal health claims, but that's not all the study found. The mice that were treated with kombucha also developed smaller brains and larger livers and spleens, which are all associated with poor health in humans. 

https://www.eater.com/2018/5/23/17208400/kombucha-health-benefits-studies-history

Kombucha Isn't Making You Any Healthier - Tonic

But if it's a probiotic boost you're seeking, Hallen-Adams recommends yogurt or kefir instead—it boasts more good bugs, has been more solidly linked to health benefits (including a reduced risk of type 2 diabetes, abnormal cholesterol levels, and obesity) and fewer risks. As Murad points out, it delivers other nutrients like protein, calcium, and vitamin D.

Besides, you don't necessarily need to ingest more bacteria, even the beneficial types. "You have good seeds, you just need to take care of them. You don't need to keep planting in poor conditions," Li says. In other words, you're better off nurturing the flora already growing in your gut with high-quality soil and fertilizer, aka a healthy diet full of vegetables, fruits, and bacteria-feeding fiber. "If you really want to grow the garden with rich variety, take good care of it by eating right." 

https://tonic.vice.com/en_us/article/7xx9bz/kombucha-isnt-making-you-any-healthier

Thursday, September 27, 2018

Signs point to growing abuse of gabapentinoids in the U.S. | Internal Medicine News

Three states have now added gabapentin to their list of Schedule V controlled substances: Kentucky in 2017, West Virginia this May, and Tennessee in July.

Ohio, Minnesota, Virginia, and Massachusetts have taken a different tack to controlling dispensing. In those states, all pharmacies, prescribers, and wholesalers must report all dispensing and sales of gabapentin to their prescription monitoring databases.

https://www.mdedge.com/internalmedicinenews/article/175585/addiction-medicine/signs-point-growing-abuse-gabapentinoids-us

Caffeine Linked to Lower Mortality in CKD

A large observational study found a significant inverse relationship between consuming caffeine and all-cause mortality among US patients with chronic kidney disease (CKD). The research was published online September 12 in Nephrology Dialysis Transplantation.

https://www.medscape.com/viewarticle/902567

Friday, September 21, 2018

Physician Foundation 2018

The Physicians Foundation's 2018 survey, now in its sixth edition, reveals some startling findings about the impact of several factors driving physicians to reassess their careers. The survey of nearly 9,000 U.S. physicians across the country examines the impact of poverty on healthcare outcomes, practice patterns, career plans, how physicians are responding to the opioid crisis and perspectives of today's physicians.

https://physiciansfoundation.org/research-insights/the-physicians-foundation-2018-physician-survey/

Wednesday, September 19, 2018

Turmeric behind woman's liver problems? | Fox News

It's known that in about 10 to 15 percent of people with autoimmune hepatitis, the condition is triggered by drugs or supplements, the report said. In these cases, the condition is called drug-induced autoimmune hepatitis. It's unclear how drugs or supplements trigger drug-induced autoimmune hepatitis, but it's thought that in some cases, the breakdown of drugs may lead to the formation of molecules that trigger an immune reaction, according to the NIH .

When the authors of the new report reviewed 35 previous studies of turmeric supplements in people, they found that about 5 percent of participants in those studies experienced liver problems tied to the supplements. It may be that some patients, such as older adults or those who consume alcohol, are more prone to these problems tied to supplements.

Still, the authors said that it's unclear whether turmeric compounds were indeed responsible for the liver problems in the woman's case. A sample of the product was not available to test, but it could be that contaminants in the product, rather than the turmeric itself, triggered the condition, the report said. Or, it may be that the combination of turmeric and other medicines and supplements that the woman was taking led to the condition.

http://www.foxnews.com/health/2018/09/18/turmeric-behind-womans-liver-problems.html

Syphilis cases up 44 percent in California county | Fox News

Health officials are attempting to combat a record number of syphilis cases in San Joaquin County after the area saw a 44 percent increase from 2016 to 2017, making it the second highest in the state.

"We're just trying to inform the public as much as possible that this is a public health concern in the county," Dr. Kismet Baldwin, a health officer with the county's health services, told Fox 40.

"If you're not treated you move onto the secondary stage and in the secondary stage you could have multiple sores like that but it could be in the mouth."

http://www.foxnews.com/health/2018/09/18/syphilis-cases-up-44-percent-in-california-county.html

Mediterranean Diet Linked to Improved Sleep Quality

Adherence to the Mediterranean diet (MeDi) may improve quality of sleep in older adults, new research suggests.

Investigators analyzed sleep duration and quality, as well as adherence to the MeDi, in more than 1600 adults. Results showed that in individuals aged 65 to 75 years, sleep quality was better for those who adhered to the MeDi than for those who did not, even after adjusting for possible confounding factors, including cognitive status.

https://www.medscape.com/viewarticle/902107

Air pollution affects thyroid development in fetuses, research finds

Soot and dust alters thyroid development in fetuses before they are born in smoggy cities, raising concern about health impacts later in life, new USC research shows.

It means before a doctor cuts the umbilical cord or a parent hugs a baby or a sibling gazes at the newest member of the family, the caress of air pollution already reached the womb's inner sanctum. The timing couldn't be worse, as the researchers found that no matter when they checked, thyroid impacts were evident until the final month of gestation.

https://m.medicalxpress.com/news/2018-09-air-pollution-affects-thyroid-fetuses.html

Tuesday, September 18, 2018

Healthcare Bluebook, your free health care guide to fair pricing for health care services

 Did you know that the cost for a single procedure could vary 400% or more at a different in-network facility just down the street? Or that the higher cost procedure could be performed by a provider with a much lower quality rating? Healthcare Bluebook levels the playing field with reliable cost and quality information that makes shopping for healthcare simple and straightforward. 

https://www.healthcarebluebook.com/
Ultimately, however, Myles envisions a day when consumer skin products are tested for their effects on the microbiome before they end up on store shelves. Topical products like soaps and shampoos, he believes, are among the "biggest offenders" behind the explosion of eczema in industrialized nations since the 1980s. In his recent study, some common preservatives, such as parabens and quaternium 15, inhibited the growth of R mucosa more than S aureus or inhibited healthy strains of R mucosa more than unhealthy ones. These preservatives can be found in skin products like baby shampoo, bubble baths, and even some lotions marketed as treatments for eczema, he said.


What should I do about insomnia?

Friday, September 14, 2018

Nutrition Training for Young Doctors Lacks Bite

The survey of the 133 US medical schools with 4-year MD programs in 2012 showed that medical students received a median of 16 hours of nutritional education that year—roughly the same as in 2000, 2004, and 2008.[1] Meanwhile, the percentage of US medical schools that do not require medical students to receive any instruction about nutrition increased from 5% in 2000 to 10% in 2012. Only around 1 in 4 medical schools have a required nutrition course.

Typically, in the first 2 years of med school, students learn about the molecular structures of vitamins and metabolites, Dr Kohlmeier said. However, teaching students about "the structure of Krebs-cycle metabolites," for example, "doesn't teach them anything about diabetes."

"Fewer than one half of all US medical schools offer any kind of clinical focus on nutrition—no rounds, no clinics—which reflects the reality in a lot of these teaching hospitals," Dr Kohlmeier observed. "Even in those that offer something, the average is in the range of 5 hours at most, which is not enough."

Students are not getting practice in "making patient assessments or understanding which patients are at risk from malnutrition before or after surgery," nor are they learning how to help motivate patients to lose weight.


https://www.medscape.com/viewarticle/886722

Wednesday, September 12, 2018

Healthy Midlife Diet May Preserve Memory, Prevent Mental Illness

A healthy diet, as reflected by AHEI-2010 score, is rich in vegetables, fruits, whole grains, nuts, legumes, omega-3 fats, and polyunsaturated fatty acids, and is light on sugar-sweetened drinks, red and processed meat, trans fat, and sodium-rich products. It is also characterized by low alcohol intake. In the current study, low alcohol intake was a "key component" associated with larger hippocampus volume, the researchers say.

"Our findings lend support for the hypothesis that overall diet may affect brain structures with a specific impact on hippocampus volume," the researchers conclude. "Accounting for the importance of hippocampus with long-term, declarative, episodic memory, as well as for flexible cognition network, our findings reaffirm the need to recognize diet and nutrition as potential determinants of cognition, mental health and social behavior."

https://www.medscape.com/viewarticle/901867