Dr. Bray Links

Sunday, December 31, 2017

Activist Erica Garner, 27, dies after heart attack - CNN

Erica Garner, 27, an activist for social justice and the eldest daughter of the man who died from a police choke hold in New York in 2014 -- died on Saturday morning days after suffering a heart attack, her mother Esaw Snipes said.

http://www.cnn.com/2017/12/30/us/erica-garner-eric-death/index.html

Thursday, December 28, 2017

Vitamin C may offers life-saving treatment for sepsis

"There are many facets to sepsis, but the one we have focused on for the past 10 years is the plugging of capillaries," says Dr. Tyml. Plugged capillaries prevent oxygenation and the supply of life-supporting materials to your organ tissue and stop the removal of metabolic waste product. Plugged capillaries are seen in organs of septic patients. These organs may eventually fail, leading to multiple organ failure and death. Dr. Tyml's lab was the first to discover this plugging by using intravital microscopy, a technique Dr. Tyml pioneered in Canada.

According to Dr. Tyml's most recent publication, oxidative stress and the activated blood clotting pathway are the major factors responsible for the capillary plugging in sepsis. Through his research, Dr. Tyml has discovered that a single bolus of vitamin C injected early at the time of induction of sepsis, prevents capillary plugging. He has also found that a delayed bolus injection of vitamin C can reverse plugging by restoring blood flow in previously plugged capillaries.

"Our research in mice with sepsis has found that early as well as delayed injections of vitamin C improves chance of survival significantly," explains Dr. Tyml. "Furthermore, the beneficial effect of a single bolus injection of vitamin C is long lasting and prevents capillary plugging for up to 24 hours post-injection."


https://www.sciencedaily.com/releases/2010/11/101117184457.htm

Experts Warn of Severe Influenza, Low Vaccine Efficacy



And if that were not sufficiently unwelcome news, the authors further note that preliminary data put the H3N2 vaccine efficacy at about 10%. This is the same vaccine currently being used in the United States.

One factor in this dismal efficacy is thought to be a mismatch between strain-specific vaccines recommended by the WHO and the circulating influenza strains. However, "[e]ven in years when influenza vaccines are well matched to circulating viruses, estimates of vaccine effectiveness range from 40 to 60%, which is lower than that for most licensed non-influenza vaccines," Dr Paules and colleagues write.

A second factor for low efficacy is that most influenza-vaccine viruses are propagated in eggs, and the vaccine virus changes during egg-based production in ways that facilitate replication in eggs but reduce vaccine effectiveness against circulating virus.

A key change appears to be a mutation in the hemagglutinin (HA) protein that mediates receptor binding by neutralizing antibodies, according to a recent study from researchers at the Perelman School of Medicine, University of Pennsylvania, Philadelphia.  The researchers identified an HA glucosylation site that was lost during egg adaptation but remained in circulating influenza A (H3N2) strains.

https://www.medscape.com/viewarticle/889563

Type 3c Diabetes Misdiagnosed; Patients at Risk of Complications

Patients with a form of diabetes due to pancreatic dysfunction are commonly misdiagnosed as having type 2 diabetes, resulting in poor glycemic control and suboptimal care, the first large-scale analysis of this underrecognized form of the disease indicates.

Diabetes of the exocrine pancreas, also known as type 3c diabetes, arises when pancreatic inflammation, neoplasia, or resection results in beta-cell dysfunction, affecting the production of insulin.

As it occurs in individuals of a similar age group, type 3c diabetes may be misdiagnosed as type 2 diabetes. Those with type 3c diabetes require insulin therapy more urgently than those with type 2, so the consequence of this misdiagnosis are delays in delivering appropriate treatment, which can lead to nerve, eye, and kidney damage, say the authors of the new study, led by Dr Chris Woodmansey of the University of Surrey, Guildford, United Kingdom, and colleagues, which was published online in Diabetes Care on October 23.

https://www.medscape.com/viewarticle/887842

Low-Normal Thyroid Implicated in Unexplained Infertility

A slightly underactive thyroid gland, the low end of normal, may help to explain some infertility of unknown cause, according to findings of a cross-sectional study published online in the Journal of Clinical Endocrinology & Metabolism.

Specifically, nearly twice as many women with unexplained infertility (26.9%) had a thyroid-stimulating hormone (TSH) level greater than 2.5 mIU/L compared with control patients with normal fertility (13.5%) (P < .05), and on average, those with unexplained infertility showed higher than normal levels of TSH, which is usually elevated in women with underactive thyroid glands.

The study was led by Tahereh Orouji Jokar, MD, from Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts.

Importantly, write the authors, "All of the subjects in this study had TSH levels within the normal, pre-pregnancy reference range, suggesting that even mild variations of thyroid dysfunction within the normal range may be an important factor in fertility in women who have no known cause for their infertility."

https://www.medscape.com/viewarticle/890635

Dietary Supplement With Ketones May Mitigate Migraine Attacks

VANCOUVER, Canada — Preliminary evidence indicates that a daily dietary supplement providing ketones can reduce the frequency of migraine headaches with no adverse effects.

Increasing evidence suggests an energy deficit disorder exists in migraine, the researchers note. By supplying ketones as an alternative fuel to glucose, several deleterious components of the deficit may be avoided.

During a poster session here at the 18th Congress of the International Headache Society (IHC) 2017, doctoral candidate Elena Gross, MSc, University of Basel Children's Hospital, Switzerland, told attendees that although a strict ketogenic diet is known to be beneficial in migraine, it is very difficult to follow long term.

"So the idea was what if a lot of the benefits you get from a ketogenic diet are actually due to the presence of ketone bodies vs the absence of glucose?" she asked. "This is where ketogenic substances came in, and we played around with this quite a lot." She said the predominant ketone body (KB) in a physiologic, endogenous state of nutritional ketosis is β-hydroxybutyrate (bHB).

She therefore designed a drink containing calcium and sodium salts of bHB to raise KB levels in the blood. On a typical Western diet, KB blood levels are 0.2 mmol/L or less. Nutritional ketosis can see levels of 0.5 mmol/L to 8 mmol/L, which is below the level of greater than 15 mmol/L at which ketoacidosis occurs.

To assess pharmacokinetics, 4 women and 1 man with migraine (age range, 25 to 61 years; 6 to 24 migraine days/month) received 10 g of the bHB salts twice a day by mouth in a liquid formulation for 4 weeks.

From a mean baseline of 0.162 mmol/L at time 0, blood levels of bHB peaked 1 hour after ingestion at 0.62 mmol/L, with a concomitant drop of 1 mmol/L (18 mg/dL) of blood glucose.

Participants consumed a mixed breakfast 1 hour after ingesting the bHB preparation but before the blood draw at 1 hour. Blood levels of bHB returned approximately to baseline at 3 hours. After 3 weeks of daily intake, the bHB blood levels nearly halved from 0.62 mmol/L to 0.33 mmol/L at 1 hour after ingestion.

https://www.medscape.com/viewarticle/886000?src=dpcs

Not Milk!

If cow's milk is natural for humans, why does the dairy industry feel the need to spend hundreds of millions a year to advertise it? If milk provided the calcium and strong bones that Big Dairy advocates, then why then does America — where the industry produces the most milk — have more people with osteoporosis than those in developing nations? A Harvard study was published suggesting a partial notion for the long-standing enigma that hip fracture rates are highest in populations with the greatest milk consumption. The more milk a person drinks, the higher risk a person has on getting hip fractures. Big Dairy has tried to convince the world for several years that milk is good — and sadly they have succeeded. The interest of the dairy industry is to make money off cows, which is why they market milk heavily in the lens of nutrition despite it being based on false claims.

Today, many people believe they should drink two to three glasses of milk a day because of all the erroneous slogans such as "milk does a body good" and "milk will make you grow." Studies have shown no correlation between milk strengthening bones, boosting growth or even being a sufficient supply of calcium. In fact, research has shown adverse effect of milk on individuals. Milk is the main dietary source of D-galactose which most of us cannot even process. To tell the truth, "about 75 percent of the world's populations, including 25 percent of those in the U.S., lose their lactase enzymes after weaning" according to The Physicians Committee. It is not a coincidence that majority of the world is lactose intolerant.

https://thetacomaledger.com/2017/11/28/opinion-got-not-milk/

Tuesday, December 26, 2017

CDPH Issues Guidelines on How to Reduce Exposure to Radio Frequency Energy from Cell Phones

SACRAMENTO – As smartphone use continues to increase in the U.S., especially among children, the California Department of Public Health (CDPH) today issued guidance for individuals and families who want to decrease their exposure to the radio frequency energy emitted from cell phones. Although the scientific community has not reached a consensus on the risks of cell phone use, research suggests long-term, high use may impact human health.

https://www.cdph.ca.gov/Programs/OPA/Pages/NR17-086.aspx

Canola oil worsens memory loss and causes weight gain | Daily Mail Online

Canola oil has been heavily marketed as a healthy choice because it is low in saturated fat.

But a new study suggests the trendy kitchen staple could worsen memory loss and learning ability in Alzheimer's patients.

It may also increase the build-up of plaques in the brain, a hallmark of the degenerative disease.

And despite its seemingly wholesome profile, researchers discovered it caused weight gain.

The findings suggest for the first time that long-term consumption of canola oil is not beneficial to brain health.

http://www.dailymail.co.uk/health/article-5155567/Canola-oil-worsens-memory-loss-causes-weight-gain.html

Sunday, December 24, 2017

Merry Christmas!

Merry Christmas!
Craciun Fericit!
Καλά Χριστούγεννα!
¡Feliz Navidad!
Joyeux Noël!
Счастливого Рождества!
عيد ميلاد سعيد!



Fending off toxic mold syndrome | Fox News

Preventing mold in your home is a good way to fend off serious health problems. According to the Environmental Protection Agency, the key to that prevention is controlling moisture. Where you find mold, there is a water problem——and you'll need to address both to put an end to the issue.

Let's look at a few tips by the EPA for avoiding mold:

    Check problem areas repeatedly to ensure that mold has not resurfaced.
    Address water leaks/moisture problems immediately.
    Clean and repair roof gutters on a regular basis.
    Keep indoor humidity below 50 percent.
    Vent heat-producing appliances to the outdoors (stoves, dryers, kerosene heaters).
    Run your air conditioner or use a de-humidifier to keep humidity low.
    Insulate water pipes.
    Run exhausts during showering, cooking, handwashing dishes, or using the dishwasher. You can also open a window to air out the area.

Mold can have a big effect on your health, causing annoying respiratory symptoms or possibly contributing to other serious diseases. You should know that not all mold will cause problems and reactions to it may vary from person to person.

http://www.foxnews.com/health/2017/12/05/fending-off-toxic-mold-syndrome.html

US life expectancy decreases for second straight year as overdose deaths soar | Fox News

The life expectancy in the U.S. dropped for the second straight year in 2016 as deaths from drug overdoses rose a staggering 21 percent.

The government figures released Thursday put drug deaths at 63,600, up from about 52,000 in 2015. For the first time, the powerful painkiller fentanyl and its close opioid cousins played a bigger role in the deaths than any other legal or illegal drug, surpassing prescription pain pills and heroin.

http://www.foxnews.com/health/2017/12/21/us-life-expectancy-decreases-for-second-straight-year-as-overdose-deaths-soar.html

Area's first IV lounge set to boost tired patrons

The different drips offered by the lounge promise customers energy boosts, faster muscle repair, fat loss, stress relief, along with increased hydration and other specialized customer needs, owner Nichole Pogue said.

"It sounds kind of weird saying like 'Let me just go get an IV in me and get some fluids,'" Pogue said. "But studies show 75 percent of Americans are chronically dehydrated and dehydration affects everything."

Pogue said the lounge, which will be outfitted with recliners and a large television, will have a relaxing and inviting spa-type atmosphere — not a typical doctor's office setting.

http://www.gainesville.com/news/20171218/areas-first-iv-lounge-set-to-boost-tired-patrons

Friday, December 22, 2017

Is a Low-FODMAP Diet Best for Digestive Disorders? - Kresser Institute

Digestive disorders are complex, multifactorial conditions. However, I've seen many patients achieve complete resolution with the proper diet, lifestyle, and supplemental support. Here's a quick summary of my recommendations:

    Start patients with a 30-day Paleo reset. Many patients have digestive disorders that resolve simply from removing inflammatory foods from their diet.
    Try a low-FODMAP diet for 30 days. This can provide significant symptom relief and may reduce proliferation of bacteria in the small intestine.
    After 30 to 60 days, reintroduce FODMAPs by category. Staying on a low-FODMAP diet long term can negatively impact beneficial microbes that rely on fermentable carbohydrates.
    Test and treat SIBO. Most patients find that their symptoms are only managed by a low-FODMAP diet; they do not disappear completely. Addressing SIBO using antimicrobials should improve FODMAP intolerance over time in those with digestive abnormalities. Be sure that the patient is not on a low-FODMAP diet during SIBO treatment though!

https://kresserinstitute.com/low-fodmap-diet-best-digestive-disorders/

Saturday, December 16, 2017

Contemporary Hormonal Contraception and the Risk of Breast Cancer — NEJM

Risk estimates associated with current or recent use of various oral combination (estrogen–progestin) contraceptives varied between 1.0 and 1.6. Women who currently or recently used the progestin-only intrauterine system also had a higher risk of breast cancer than women who had never used hormonal contraceptives (relative risk, 1.21; 95% CI, 1.11 to 1.33). The overall absolute increase in breast cancers diagnosed among current and recent users of any hormonal contraceptive was 13 (95% CI, 10 to 16) per 100,000 person-years, or approximately 1 extra breast cancer for every 7690 women using hormonal contraception for 1 year.

http://www.nejm.org/doi/full/10.1056/NEJMoa1700732

These five tests better predict heart disease risk -- ScienceDaily

The five tests, and the information they provide:

    A 12-lead EKG provides information about hypertrophy, or thickening of the heart muscle.
    A coronary calcium scan, a low-radiation imaging test, identifies calcified plaque buildup in the arteries of the heart.
    A blood test for C-reactive protein indicates inflammation.
    A blood test for the hormone NT-proBNP indicates stress on the heart.
    A blood test for high-sensitivity troponin T indicates damage to heart muscle. Troponin testing is regularly used by hospitals to diagnose heart attacks, but high-sensitivity troponin fine-tunes that measure, pointing to small amounts of damage that can be detected in individuals without any symptoms or warning signs.

https://www.sciencedaily.com/releases/2017/03/170331120358.htm

Experts Caution on CANTOS and Canakinumab's Future | Medpage Today

There were no significant differences in all cause or cardiovascular mortality, though the direction of the numbers favored canakinumab. However, canakinumab was associated with a significantly higher rate of fatal infection compared to placebo: 0.18 in the placebo group and 0.31, 0.28, and 0.34 in the 50, 150, and 300 mg canakinumab groups, respectively, all per 100 person-years. On the positive side, cancer mortality was lower in the canakinumab groups (see below for more on this).

"CANTOS has helped move the inflammatory hypothesis of coronary artery disease forward scientifically," wrote Bob Harrington (Stanford University), in an accompanying editorial in NEJM. "However, the modest absolute clinical benefit of canakinumab cannot justify its routine use in patients with previous myocardial infarction until we understand more about the efficacy and safety trade-offs and unless a price restructuring and formal cost-effectiveness evaluation supports it."

https://www.medpagetoday.com/cardiology/cardiobrief/67534

Analysis of Fusobacterium persistence and antibiotic response in colorectal cancer | Science

The bacterial species Fusobacterium nucleatum is associated with a subset of human colorectal cancers, but its role in tumorigenesis is unclear. Studying patient samples, Bullman et al. found that F. nucleatum and certain co-occurring bacteria were present not only in primary tumors but also in distant metastases. Preliminary evidence suggests that the bacterium is localized primarily within the metastatic cancer cells rather than in the stroma. Antibiotic treatment of mice carrying xenografts of F. nucleatum–positive human colorectal cancer slowed tumor growth, consistent with a causal role for the bacterium in tumor genesis. 

http://science.sciencemag.org/content/358/6369/1443

Little Blue Pill Goes Generic Today, and Pfizer Joins In

Pfizer Inc will bring its own generic version of its erectile dysfunction (ED) drug Viagra (sildenafil citrate) to the United States market today, seeking to preserve some sales as generic competition starts up for one of the world's most famous drugs. Teva Pharmaceutical Industries Ltd is launching its rival generic version today.

Viagra technically does not lose patent protection until 2020, but Pfizer reached a settlement with Teva in December 2013 allowing the company to launch its generic version on today's date.

New York–based Pfizer will start selling what's known as an "authorized generic," manufactured by its subsidiary Greenstone LLC, priced at $30 to $35 per pill, a company spokesman told Medscape Medical News. That's roughly half or less of the $65-a-pill cost for Viagra seen on pharmacy websites. Pfizer noted that it's difficult to determine how much of this discount will reach consumers because of markups and variations in pharmacy pricing. Israel-based Teva declined to comment to Medscape Medical News on its plans for pricing its version of generic Viagra.

https://www.medscape.com/viewarticle/889846

Hormonal Contraceptives and the Lesser-Known Link With Suicide Risk

Hormonal contraceptives are used successfully by millions of women to prevent pregnancy and treat menstrual-related conditions and acne. For a small group, however, contraception is linked with adverse mood effects, including depression. A recent study[1] took this a step further to focus on the risk for suicide.

Almost half a million Danish women were followed prospectively from age 15, before they began using birth control. In women ages 15-33, hormonal contraceptives were associated with an increased risk for first suicide attempt. The risk peaked after 2 months of contraceptive use and decreased after 1 year.

Adolescent women had the highest relative risks. And use of the patch, vaginal ring, and progestin-only products had a higher risk than oral combined products.

https://www.medscape.com/viewarticle/889885

Huntington’s breakthrough may stop disease - BBC News

The defect that causes the neurodegenerative disease Huntington's has been corrected in patients for the first time, the BBC has learned.

An experimental drug, injected into spinal fluid, safely lowered levels of toxic proteins in the brain.

The research team, at University College London, say there is now hope the deadly disease can be stopped.

Experts say it could be the biggest breakthrough in neurodegenerative diseases for 50 years.

Huntington's is one of the most devastating diseases. 

http://www.bbc.com/news/health-42308341

Huntington’s breakthrough may stop disease - BBC News

Haemophilia A trial results 'mind-blowing' - BBC News

British doctors say they have achieved "mind-blowing" results in an attempt to rid people of haemophilia A.

Patients are born with a genetic defect that means they do not produce a protein needed to stop bleeding.

Thirteen patients given the gene therapy at Barts Health NHS Trust are now off treatment with 11 producing near-normal levels of the protein. 

http://www.bbc.com/news/health-42337396

Friday, December 15, 2017

California Officials Release Guidelines To Avoid Cellphone Radiation

The research suggests cellphones could increase our risk for brain cancer and tumors, low sperm count, headaches, as well as impaired memory, hearing, and sleep.

Dr. Joel Moskowitz at UC Berkeley said, "Currently we're not doing a good job in regulating radiation from these devices. In fact, we're doing an abysmal job."

http://sanfrancisco.cbslocal.com/2017/12/14/california-cellphone-radiation-guidelines/

Wednesday, December 13, 2017

The Caregiver Crisis: Rising Demand, Short Supply Puts Elderly at Risk

    The median cost for a one-bedroom apartment in a senior assisted living community is $43,539. It ranges from roughly $30,000 (Missouri) to $80,000 (District of Columbia), according to Consumer Reports.

    The average cost of a private room in a full-service nursing home is over $87, 000 per year.

    At the other end of the age curve, childrens' daycare costs an average of about $20,000. In the last 25 years, childcare costs have doubled.

https://holisticprimarycare.net/topics/topics-h-n/healthy-aging/1919-the-caregiver-crisis-rising-demand-short-supply-puts-elderly-at-risk.html

Monday, December 4, 2017

Pediatric non alcoholic fatty liver disease

Recently, interesting dietary supplements such as probiotics and long-chain omega-3 polyunsaturated fatty acids have been adopted in adults with NAFLD [91, 92]. Interestingly, these dietary supplements, although considered pharmacological interventions, are often based on natural compounds present in specific foods (yogurt, fish oil, etc.). Among the pathogenetic factors leading to NAFLD, the persistent crosstalk among the gut, the immune system, and the liver, plays a pivotal role [93]. In fact, it is now accepted that specific nutrients increase the intestinal permeability to bacterial endotoxins, activating an immune-mediated inflammatory response of liver resident cells, leading to a profibrogenic phenotype [94]. One recent study on animal models [95], has demonstrated a pivotal role of restoring gut microflora in protecting the liver from fat and preventing cardiovascular disease.

https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-13-40

Friday, December 1, 2017

Taking Care of the Physician - NYTimes.com

"It has been shown in some studies that if the physician is exercising, if the physician is taking care of themself, eating well, sleeping better, they have patients who have better clinical outcomes," said Dr. Hilary McClafferty

https://mobile.nytimes.com/2017/11/13/well/family/taking-care-of-the-physician.html

Thursday, November 30, 2017

Benzodiazepines Tied to a 41% Increased Mortality Risk in AD

Patients with Alzheimer's disease (AD) who use benzodiazepines and related drugs (BZRDs) have a 41% higher risk for death than patients who do not use these drugs, new research shows.

Mortality rates in patients with AD who use BZDRs was 13.4 per 100 person-years, vs 8.5 per 100 person-years in nonusers during the 6-month study period (adjusted hazard ratio [HR], 1.4). The association was significant from initiation of use.

"I was surprised by how big the increased risk was," lead author Laura K. Saarelainen, a PhD candidate at the Kuopio Research Center for Geriatric Care, University of Eastern Finland, told Medscape Medical News.

"We would like clinicians to know that these drugs have major adverse events from the very beginning of use," she added.

The study was published online November 15 in the International Journal of Geriatric Psychiatry.

https://www.medscape.com/viewarticle/889244

Tuesday, November 28, 2017

WellCare Ex-Exec Sentenced in $35M Florida Medicaid Fraud

Bereday was general counsel at WellCare's Medicaid HMOs StayWell and Healthease in 2006. According to a plea agreement, Bereday admitted that he and four other executives submitted inflated expenditures in the company's annual reports to the Florida Medicaid Program that reduced the HMOs' payback obligations for behavioral healthcare services.  

http://www.healthleadersmedia.com/leadership/wellcare-ex-exec-sentenced-35m-medicaid-fraud?nopaging=1

Medicare Pay-for-Performance Didn't Deliver

Medicare's Value-Based Payment Modifier program inadvertently shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations, according to a study this week in Annals of Internal Medicine.

In addition, components from that failed pay-for-performance prototype that do not account for patient demographics remain its successor program, and could scuttle its chances for success, researchers said.

"As long as these programs do not account adequately for patient differences, which is very difficult to do, they will further deprive practices serving low-income populations of important resources," said Eric Roberts, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health and lead author of the study.

The research suggests that the Value Modifier may have hit a trifecta of failure. It did not reduce the cost of care, nor improve the quality of the care, nor improve the health of the patients. In fact, it may have made things worse.  


http://www.healthleadersmedia.com/quality/medicare-pay-performance-didnt-deliver?nopaging=1

CDC urges consumers who drank raw milk product to seek treatment | Fox News

As a result, the CDC warned that anyone who has consumed the company's raw milk product may have been infected with Brucella abortus RB51, a rare germ that requires antibiotics.

The bacteria is used to vaccinate young female cattle against B. abortus, but can cause fever, muscle pain, lasting fatigue, joint pain, and swelling of the testicles in humans, according to Live Science. If left untreated it could lead to arthritis, heart problems, enlargement of the liver or spleen, meningitis or miscarriage.


http://www.foxnews.com/health/2017/11/28/cdc-urges-consumers-who-drank-raw-milk-product-to-seek-treatment.html

Monday, November 27, 2017

Flavocoxid for OA Tied to Life-Threatening Health Problems

The US Food and Drug Administration (FDA) is investigating serious adverse events involving flavocoxid (Limbrel, Primus Pharmaceuticals), a prescription product in capsule form that is marketed as a medical food for the management of metabolic processes associated with osteoarthritis.

"While a range of adverse events have been reported, two serious and potentially life-threatening medical conditions are among them: drug-induced liver injury and hypersensitivity pneumonitis," the FDA said in a safety communication November 21.

The FDA said it has received 194 reports of adverse event involving flavocoxid. In 30 of those cases, there was sufficient information to determine that flavocoxid was likely associated with these adverse events, the FDA said.

Flavocoxid is available in capsule form in two doses: 250 mg and 500 mg. The labeling states that the products contain two types of flavonoids: baicalin (from Scutellaria baicalensis) and catechin (from Acacia catechu). The products also contain zinc. The product labels say flavocoxid is intended for the managaement of the metabolic processes associated with osteoarthritis.

https://www.medscape.com/viewarticle/889188

Saturday, November 25, 2017

Urinary Excretion of the Herbicide Glyphosate in Older Adults, 1993-2016 | Toxicology | JAMA

The herbicide Roundup is sprayed onto genetically modified crops and applied as a desiccant to most small non–genetically modified grains. Use of this herbicide has increased since 1994 when genetically modified crops were introduced in the United States. Glyphosate, the primary ingredient in the herbicide, is found in these crops at harvest.1 Environmental exposure through dietary intake of these crops has potential adverse health effects and can be assessed by measuring urinary excretion.2- 4 We measured excretion levels of glyphosate and its metabolite aminomethylphosphonic acid (AMPA) in participants from the Rancho Bernardo Study (RBS) of Healthy Aging.


https://jamanetwork.com/journals/jama/article-abstract/2658306

VA study shows parasite from Vietnam may be killing vets | Fox News

Liver flukes, parasites that infect a human when raw or undercooked fish is eaten, are being investigated as the cause of a rare bile duct cancer among veterans who served in the Vietnam War. It could take years for symptoms to show up, but when they do, the host is left with tremendous pain and given just a few months to live.

The Department of Veterans Affairs this spring commissioned a small pilot study to look into the link between liver flukes and the cancer. More than 20 percent of the 50 blood samples submitted to the study came back positive or bordering positive for liver fluke antibodies, said Sung-Tae Hong, the tropical medicine specialist who carried out the tests at Seoul National University in South Korea.

http://www.foxnews.com/health/2017/11/22/va-study-shows-parasite-from-vietnam-may-be-killing-vets.html

Why Is This Bacterium Hiding in Human Tumors? - NYTimes.com


A mysterious bacterium found in up to half of all colon tumors also travels with the cancer as it spreads, researchers reported on Thursday.

Whether the bacterium, called Fusobacterium nucleatum, actually plays a role in causing or spurring the growth of cancer is not known. But the new study, published in the journal Science, also shows that an antibiotic that squelches this organism slows the growth of cancer cells in mice.

Scientists are increasingly suspicious that there may be a link: another type of bacteria has been discovered in pancreatic cancer cells. In both types of cancer, most tumors host bacteria; however, only a small proportion of the cells in any single tumor are infected.

"The whole idea of bacteria in tumors is fascinating and unexpected," said Dr. Bert Vogelstein, a colon cancer researcher at Johns Hopkins.

https://mobile.nytimes.com/2017/11/23/health/bacteria-colon-cancer.html

Coronary Calcium Helps Stratify 10-Year Cardiac Risk in Diabetes

Coronary artery calcium (CAC) scores may be better at predicting the risk of a cardiovascular disease (CVD) event in patients with type 2 diabetes than traditional scores such as Framingham, even in those who've had diabetes for 10 years, researchers report[1].

This conclusion is based on a new analysis of participants in the Multi-Ethnic Study of Atherosclerosis (MESA) published online in JAMA Cardiology by Dr Shaista Malik (University of California, Irvine) and colleagues.

https://www.medscape.com/viewarticle/889148

Tuesday, November 21, 2017

The Death of Expertise

The Internet has provided people with an unprecedented abundance of information, but all too often it gives them the illusion of knowledge, encouraging them to believe they know as much as experts. They hear what they want to hear, and live in a bubble community of people with similar beliefs.

https://sciencebasedmedicine.org/the-death-of-expertise/

Thursday, November 16, 2017

Amish Mutation Protects Against Diabetes and May Extend Life - NYTimes.com

Amish people living in a rural part of Indiana have a rare genetic mutation that protects them from Type 2 diabetes and appears to significantly extend their life spans, according to a new study.

The findings, published on Wednesday in the journal Science Advances, shed light on the processes underlying cellular aging and could lead to new therapies for chronic diseases, some experts say. The researchers are planning at least one follow-up trial that will recreate the effects of the mutation so they can study its impact on obese people with insulin resistance, a precursor to diabetes.

The mutation described in the new paper affects a mysterious protein called plasminogen activator inhibitor-1, or PAI-1, that is known primarily for its role in promoting blood clotting. The mutation was first identified in 1991 in a secluded Amish farming community in Berne, Ind. An estimated 5 percent of the community carries the mutation, which causes them to produce unusually low levels of PAI-1.

Scientists have long suspected that PAI-1 has other functions outside of clotting that relate to aging. Dr. Douglas Vaughan, a cardiologist at Northwestern medical school, noticed, for example, that mice that had been genetically engineered to produce high levels of the protein age fairly quickly, going bald and dying of heart attacks at young ages. People who have higher levels of the protein in their bloodstreams also tend to have higher rates of diabetes and other metabolic problems and to die earlier of cardiovascular disease.

https://mobile.nytimes.com/2017/11/15/well/live/amish-mutation-protects-against-diabetes-and-may-extend-life.html

Monday, November 13, 2017

Mortality Lower When Inpatients See Their Own PCP in Hospital

A primary care physician (PCP)'s prior knowledge of a patient has a significant effect on outcomes when that patient is hospitalized, data from a new study suggest.

In a retrospective analysis of more than 560,000 Medicare patients, hospital care by a PCP who had previously seen the individual as an outpatient was associated with a greater chance of being discharged home and a lower 30-day mortality compared with care delivered by a hospitalist or other generalist who had never met the patient before, Jennifer P. Stevens, MD, MS, and colleagues report today in JAMA Internal Medicine.

These findings may be especially important for patients with multiple illnesses and those who require a complex level of care, Seth Landefeld, MD, coauthor of an accompanying editorial, said in an interview with the journal.

https://www.medscape.com/viewarticle/888520

Saturday, November 11, 2017

Mitochondrial Networks Explain Why Caloric Restriction Extends Worms’ Lives | The Scientist Magazine(R)

 "Low-energy conditions such as dietary restriction and intermittent fasting have previously been shown to promote healthy aging," lead author Heather Weir, who conducted the research while at Harvard T. H. Chan School of Public Health and is now a research associate at Astex Pharmaceuticals, tells the Harvard Gazette. "Understanding why this is the case is a crucial step toward being able to harness the benefits therapeutically."

Mitochondria exist in networks that alternate between "fused" and "fragmented" states, which affect how the organelles process energy. This dynamic fission and fusion of mitochondria has been linked to aging, and the new study provides two key players—AMPK and peroxisomes—in orchestrating those fluctuating connections and their effect on organismal health and senescence. 

"Although previous work has shown how intermittent fasting can slow aging, we are only beginning to understand the underlying biology," senior author William Mair, associate professor of genetics and complex diseases at Harvard Chan School, tells the Harvard Gazette. "Our work shows how crucial the plasticity of mitochondria networks is for the benefits of fasting. If we lock mitochondria in one state, we completely block the effects of fasting or dietary restriction on longevity."

http://mobile.the-scientist.com/article/50886/mitochondrial-networks-explain-why-caloric-restriction-extends-worms-lives

Friday, November 10, 2017

New Study Shows Antioxidant-Rich Foods Diminish Diabetes Risk

Consuming a diet rich in antioxidant foods may help decrease the risk of type 2 diabetes, according to a new study published November 9 in Diabetologia.

The trial is the first prospective investigation into the link between total antioxidant consumption and risk of type 2 diabetes, say the researchers.

"This work complements our current knowledge of the effect of isolated foods and nutrients and provides a more comprehensive view of the relationship between food and type 2 diabetes," senior author Guy Fagherazzi, PhD, of the University Paris-Sud, Villejuif Cedex, France, said in a press release.

Prior research has suggested that oxidative stress may contribute to the development of type 2 diabetes. While some studies have found that the antioxidant vitamin E may help decrease the risk of type 2 diabetes, others have not confirmed this effect for the antioxidants vitamin C, flavonoids, and lycopene.

https://www.medscape.com/viewarticle/888350

Wednesday, November 8, 2017

Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy — NEJM

Evidence-based medicine is valuable to the extent that the evidence base is complete and unbiased. Selective publication of clinical trials — and the outcomes within those trials — can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.

http://www.nejm.org/doi/full/10.1056/NEJMsa065779

How Has the Physician-Patient Relationship Changed?

We know from [our experiences from] the early 1970s to now that talking about your dissatisfaction by itself doesn't lead to meaningful change. We need physicians and providers, people who work in the practice, as well as patients, to be willing to make change at a grassroots level. We need to stop looking for a silver bullet from either the government or health insurers to fix healthcare. We need to take that burden on ourselves.

If people say, "I will shift to doctors who spend time with me; I will shift my health insurance to places that treat me like a person and not like a number," then we will see a shift. The thing that is helping people is that more of the healthcare dollar—how much we pay for healthcare—is being shifted to people, and so they can vote with their dollars.

https://www.medscape.com/viewarticle/887853

Tuesday, October 31, 2017

What to Do When Patients Don't Heed Your Advice

The overwhelming majority of my patients act with good sense. Nevertheless, the confusion of preexisting patient conclusions and the use of self-validating search engine searches as a substitute for either research or offered wisdom and experience are seemingly on the rise. It is human nature to seek confirmation bias. However, we've been a nation that has sought education and knowledge, and celebrated wisdom. Increasingly, I've seen the consequences of a societal derision of the educated as being uncool and of the wise as unworthy of notice.


https://www.medscape.com/viewarticle/881711_2

Pesticide Residues in Food May Impair Female Fertility

Women undergoing infertility treatment who consumed more high-pesticide residue foods had a lower likelihood of clinical pregnancy and live birth compared with their peers, a new prospective epidemiological study showed.

Compared with women in the lowest quartile of high-pesticide residue fruits and vegetable intake (<1.0 servings/day), women in the highest quartile (≥2.3 servings/day) had an 18% lower probability of achieving a clinical pregnancy (95% confidence interval [CI], 5% - 30%) and a 26% lower probability of having a live birth (95% CI, 13% - 37%).

Moreover, substituting just one serving/day of low-pesticide residue produce for one serving/day of high-pesticide residue produce was associated with 79% higher odds of clinical pregnancy (95% CI, 11% -188%) and 88% higher odds of live birth (95% CI, 16% - 205%).

"These data suggest that dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences," write Yu-Han Chiu, MD, ScD, from the Department of Nutrition and the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston, Massachusetts, and colleagues.

https://www.medscape.com/viewarticle/887794

Acupuncture for Chronic Pain: Unprecedented Advances

The last two decades have seen "unprecedented advances" in the use of acupuncture to treat pain conditions, with a "rapid rise" in the number and quality of related published studies, according to a physician who is an experienced acupuncture practitioner.

"Right now, we have a pretty solid foundation for the efficacy of acupuncture" for headache, osteoarthritis (OA), and musculoskeletal conditions, said Farshad M. Ahadian, MD, clinical professor of anesthesiology, University of California, San Diego.

"I think it's fair to say that acupuncture is here to stay. It's going to be a permanent addition to our tool box."

Dr Ahadian presented the data here at the Academy of Integrative Pain Management (AIPM) 28th Annual Meeting.

https://www.medscape.com/viewarticle/887754

Maternal Use of Acetaminophen Linked to ADHD in Kids

A pregnant woman's use of acetaminophen may be associated with an increase in her child's risk for attention-deficit/hyperactivity disorder (ADHD), the authors of a large, prospective study report.

"[L]ong-term acetaminophen use during pregnancy is related to more than a twofold increase in risk for offspring ADHD," after adjusting for genetic risk factors, indications for the mother's acetaminophen use, use of the drug before pregnancy, and other potential confounders, lead author Eivind Ystrom, PhD, and colleagues write in an article published online today and in the November issue of Pediatrics.

https://www.medscape.com/viewarticle/887773

Thursday, October 12, 2017

$200 Million Gift Could Transform This School's Medical Training

When Susan and Henry Samueli gave $200 million to UC Irvine's College of Health Sciences in late September, they set the stage for a first-of-its-kind educational institution: The Susan and Henry Samueli College of Health Sciences will be the first university-based health sciences enterprise to incorporate integrative health teaching, patient care and research across its schools and programs, according to a university press release.

"Integrative health redefines the relationship between the practitioner and patient by focusing on the whole person and the whole community," the release noted.

"It is informed by scientific evidence and makes use of all appropriate preventatives, therapeutic and lifestyle approaches, and health care professionals and disciplines to promote optimal health and wellness."

https://www.massagemag.com/irvine-integrative-health-program-86917/

Tuesday, October 10, 2017

Quercetin alleviates generalized hyperalgesia in mice with induced adenomyosis

The results demonstrated that treatment with quercetin improved the generalized hyperalgesia by extending the hotplate response latency, reduced myometrial infiltration and decreased the expression levels Trpv‑1, p‑p38 and p‑ERK in dorsal root ganglion neurons. The results indicated that quercetin decreases the incidence of hyperalgesia in mice with tamoxifen‑induced adenomyosis, and the potential mechanism is through reduced central sensitization, which may be a promising treatment for adenomyosis.

https://www.ncbi.nlm.nih.gov/m/pubmed/28849202/?i=3&from=Tamoxifen%20endometrial

Monday, October 9, 2017

Prescribing Pitfalls in Heart Failure With Comorbidities



Interest in the popular supplement coenzyme-Q10 (CoQ10) in heart failure stems in part from its biochemical role in mitochondria, antioxidant effects, and cell-membrane integrity, plus the observation that its levels are reduced in HF patients[4], Chow said.

Clinical trials of CoQ10 in heart failure include a 1993 study with 641 patients in NYHA class 3–4 on medical therapy that was standard for the time[5]. The supplement was associated with significantly reduced risk of HF hospitalization (P<0.001).

Much more recently, the Q-SYMBIO trial randomized 420 patients with NYHA class 3–4 heart failure to receive the supplement or placebo for 2 years on top of standard care, which included ACE inhibitors in 90% and beta-blockers in 72%[6].

Risk of the primary end point (worsening HF, CV death, implantation of a mechanical assist device, or urgent heart transplantation) declined by about half on the supplement (HR 0.50, 95% CI 0.32–0.80; P=0.003). The mortality risk alone went down 42%.

http://www.medscape.com/viewarticle/886762

Woman loses sight in one eye after marathon session playing Honour of Kings on her mobile phone

A doctor was quoted as saying that retinal artery occlusion was a condition associated with elderly people and rarely seen in the young, adding that the woman's blindness was most likely caused by severe eye strain.

http://m.scmp.com/news/china/society/article/2114214/chinese-woman-loses-sight-one-eye-after-marathon-session-playing

Saturday, October 7, 2017

Association Reported Between Fluoride and Reduced IQ

A mother's exposure to fluoride during pregnancy could lower the intelligence of her children, researchers say.

Following a group of Mexican children from the time of their mother's pregnancy to early adolescence, an international team of researchers found an association between high fluoride levels in the mothers' urine and reduced scores on the children's cognitive tests.

http://www.medscape.com/viewarticle/886379

Thursday, October 5, 2017

PPIs Not Superior to Dietary Intervention for Reflux

A primarily plant-based, Mediterranean-style diet with alkaline water showed significantly greater improvement for laryngopharyngeal reflux (LPR) symptoms than treatment with proton-pump inhibitors (PPIs), according to a retrospective study published September 7 in JAMA Otolaryngology–Head & Neck Surgery. 

"This study indicates that, by supplementing with alkaline water and a Mediterranean-style diet, effective control of symptoms as defined by the RSI [Reflux Symptom Index] may be obtained without PPI use," write Craig H. Zalvan, MD, from New York Medical College in Valhalla, and colleagues. "Other benefits of this diet-based approach include decreased risk for and improved control of cardiovascular disease, diabetes, stroke, and cancer, and avoiding the risks of drug interaction or complication."

The researchers retrospectively analyzed the medical records of two cohorts from different timeframes who received different treatments for LPR. One cohort of 85 patients, from 2010 to 2012 with a median age of 60 years, took esomeprazole twice daily or dexlansoprazole daily. They also followed standard reflux dietary precautions, including avoiding coffee; tea; chocolate; soda; alcohol; and greasy, fried, fatty, and spicy foods.

The other cohort, 99 patients from 2013 to 2015 with a median age of 57 years, received alkaline water and a 90% plant-based Mediterranean-style diet in addition to standard reflux precautions. (The water had a pH above 8.0.) Patients with potentially confounding comorbidities, such as a cough, a history of neuropathic pain, or dysphonia, were excluded.

The researchers compared the change in RSI scores between the two groups after 6 weeks of treatment. Among those taking PPIs, 54.1% of the patients had at least a 6-point reduction in their RSI, the minimum improvement deemed clinically meaningful. The average reduction in RSI across the group was 27.2%.

Meanwhile, 62.6% of those receiving the alkaline water and diet had a meaningful improvement in their RSI (difference between the groups, 8.05; 95% confidence interval [CI], –5.74 to 22.76). This group had a 39.8% average reduction in RSI (difference between groups, 12.1; 95% CI, 1.53 - 22.68).

http://www.medscape.com/viewarticle/885356

Wednesday, October 4, 2017

Las Vegas shooter Stephen Paddock was taking psychiatric medications that increase killing behavior by 45%

Records from the Nevada Prescription Monitoring Program obtained Tuesday show Paddock was prescribed 50 10-milligram diazepam tablets by Henderson physician Dr. Steven Winkler on June 21.
A 45% increase in "killing" behavior

Diazepam is a known to promote violent behavior and psychotic episodes. Via the Las Vegas Review-Journal:

"If somebody has an underlying aggression problem and you sedate them with that drug, they can become aggressive," said Dr. Mel Pohl, chief medical officer of the Las Vegas Recovery Center. "It can disinhibit an underlying emotional state. … It is much like what happens when you give alcohol to some people … they become aggressive instead of going to sleep."

Pohl, who spoke to the Review-Journal from the Netherlands, said the effects of the drug also can be magnified by alcohol.

A 2015 study published in World Psychiatry of 960 Finnish adults and teens convicted of homicide showed that their odds of killing were 45 percent higher during time periods when they were on benzodiazepines.

https://www.naturalnews.com/2017-10-04-breaking-las-vegas-shooter-stephen-paddock-was-taking-psychiatric-medications-that-increase-killing-behavior-by-45.html

Monday, October 2, 2017

Arthritis pill: Daily intake halts disabling bone loss and damage

"This drug heralds a new dawn in the treatment of this disease as it is the first evidence we have of a drug which can have a significant benefit on the structure of the bone."

Professor Conaghan, previously chairman of the National Institute for Health and Care Excellence group on the management of osteoarthritis, added: "We now need larger studies to replicate these findings, the results of which we hope will open up a new class of drug."

The treatment, known as M1V-711, is based on a molecule involved in the turnover of bone and cartilage in the joints. It works by interfering with the process that leads to joint breakdown.

It was tested against patients given a placebo and after six months those receiving the treatment showed a 65 per cent reduction in bone loss.

Those on the dummy pills showed slight increases in bone loss. The drug, which was shown to have relatively few side effects, also halted cartilage loss, with those on low doses experiencing a 70 per cent reduction in cartilage thickness and those on higher doses showing a slight increase in cartilage thickness. 

http://www.express.co.uk/life-style/health/860834/Arthritis-pill-disabling-bone-loss-and-damage-osteoarthritis-new-treatment

Tuesday, September 26, 2017

Coffee sold in California could carry cancer warning labels | Fox News

A nonprofit group wants coffee manufacturers, distributors and retailers to post ominous warnings about a cancer-causing chemical stewing in every brew and has been presenting evidence in a Los Angeles courtroom to make its case.

The long-running lawsuit that resumed Monday claims Starbucks and about 90 other companies, including grocery stores and retail shops, failed to follow a state law requiring warning signs about hazardous chemicals found everywhere from household products to workplaces to the environment.

At the center of the dispute is acrylamide, a carcinogen found in cooked foods such as French fries that is also a natural byproduct of the coffee roasting process. The coffee industry has acknowledged the presence of the chemical but asserts it is at harmless levels and is outweighed by benefits from drinking coffee.

http://www.foxnews.com/health/2017/09/26/coffee-sold-in-california-could-carry-cancer-warning-labels.html

Saturday, September 23, 2017

Garlic and Heart Disease

RESULTS: Garlic supplementation reduced blood pressure by 7-16 mm Hg (systolic) and 5-9 mm Hg (diastolic) (4 meta-analyses and 2 original studies). It reduced total cholesterol by 7.4-29.8 mg/dL (8 meta-analyses). The most consistent benefits were shown in studies that used aged garlic extract (AGE). A few small studies that used AGE also showed favorable effects on CAC, CRP, and PWV. Although garlic is generally safe, rare adverse reactions have been documented with limited causality established.

CONCLUSION: We conclude that garlic supplementation has the potential for cardiovascular protection based on risk factor reduction (hypertension and total cholesterol) and surrogate markers (CRP, PWV, and CAC) of atherosclerosis. Larger studies are warranted to evaluate these effects further.

https://www.ncbi.nlm.nih.gov/pubmed/?term=Garlic+crp

Dietary Guidelines for Breast Cancer Patients: A Critical Review

Current dietary guidelines for breast cancer patients (BCPs) fail to address adequate dietary intakes of macro- and micronutrients that may improve patients' nutritional status. This review includes information from the PubMed and Biomed Central databases over the last 15 y concerning dietary guidelines for BCPs and the potential impact of a personalized, nutrient-specific diet on patients' nutritional status during and after antineoplastic treatment. Results indicated that BCPs should receive a nutritional assessment immediately after diagnosis. In addition, they should be encouraged to pursue and maintain a healthy body weight [body mass index (BMI; in kg/m2) 20-24.9], preserving their lean mass and avoiding an increase in fat mass. Therefore, after nutritional status diagnosis, a conservative energy restriction of 500-1000 kcal/d could be considered in the dietary intervention when appropriate. Based on the reviewed information, we propose a personalized nutrition intervention for BCPs during and after antineoplastic treatment. Specifications in the nutritional therapy should be based on the patients' nutritional status, dietary habits, schedule, activities, and cultural preferences. BCPs' daily energy intake should be distributed as follows: <30% fat/d (mainly monounsaturated and polyunsaturated fatty acids), ∼55% carbohydrates (primarily whole foods such as oats, brown rice, and fruits), and 1.2-1.5 g protein ⋅ kg-1 ⋅ d-1 to avoid sarcopenic obesity. Findings suggest that 5-9 servings/d of fruits (∼150 g/serving) and vegetables (∼75 g/serving) should be encouraged. Garlic and cruciferous vegetables must also be part of the nutrition therapy. Adequate dietary intakes of food-based macro- and micronutrients rich in β-carotene and vitamins A, E, and C can both prevent deterioration in BCPs' nutritional status and improve their overall health and prognosis.

https://www.ncbi.nlm.nih.gov/pubmed/28710147

Sulforaphane and neuroinflammmation

Autism spectrum disorder (ASD), characterized by both impaired communication and social interaction, and by stereotypic behavior, affects about 1 in 68, predominantly males. The medico-economic burdens of ASD are enormous, and no recognized treatment targets the core features of ASD. In a placebo-controlled, double-blind, randomized trial, young men (aged 13-27) with moderate to severe ASD received the phytochemical sulforaphane (n = 29)--derived from broccoli sprout extracts--or indistinguishable placebo (n = 15). The effects on behavior of daily oral doses of sulforaphane (50-150 µmol) for 18 wk, followed by 4 wk without treatment, were quantified by three widely accepted behavioral measures completed by parents/caregivers and physicians: the Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Clinical Global Impression Improvement Scale (CGI-I). Initial scores for ABC and SRS were closely matched for participants assigned to placebo and sulforaphane. After 18 wk, participants receiving placebo experienced minimal change (<3.3%), whereas those receiving sulforaphane showed substantial declines (improvement of behavior): 34% for ABC (P < 0.001, comparing treatments) and 17% for SRS scores (P = 0.017). On CGI-I, a significantly greater number of participants receiving sulforaphane had improvement in social interaction, abnormal behavior, and verbal communication (P = 0.015-0.007). Upon discontinuation of sulforaphane, total scores on all scales rose toward pretreatment levels. Dietary sulforaphane, of recognized low toxicity, was selected for its capacity to reverse abnormalities that have been associated with ASD, including oxidative stress and lower antioxidant capacity, depressed glutathione synthesis, reduced mitochondrial function and oxidative phosphorylation, increased lipid peroxidation, and neuroinflammmation.


https://www.ncbi.nlm.nih.gov/pubmed/25313065

Thursday, September 21, 2017

The neurological significance of abnormal natural killer cell activity in chronic toxigenic mold exposures. - PubMed - NCBI

Toxigenic mold activities produce metabolites that are either broad-spectrum antibiotics or mycotoxins that are cytotoxic. Indoor environmental exposure to these toxigenic molds leads to adverse health conditions with the main outcome measure of frequent neuroimmunologic and behavioral consequences. One of the immune system disorders found in patients presenting with toxigenic mold exposure is an abnormal natural killer cell activity. This paper presents an overview of the neurological significance of abnormal natural killer cell (NKC) activity in chronic toxigenic mold exposure. A comprehensive review of the literature was carried out to evaluate and assess the conditions under which the immune system could be dysfunctionally interfered with leading to abnormal NKC activity and the involvement of mycotoxins in these processes. The functions, mechanism, the factors that influence NKC activities, and the roles of mycotoxins in NKCs were cited wherever necessary. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40 degrees C (104 degrees F), cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures. Although sleep is commonly considered a restorative process that is important for the proper functioning of the immune system, it could be disturbed by mycotoxins. Most likely, mycotoxins exert some rigorous effects on the circadian rhythmic processes resulting in sleep deprivation to which an acute and transient increase in NKC activity is observed. Depression, psychological stress, tissue injuries, malignancies, carcinogenesis, chronic fatigue syndrome, and experimental allergic encephalomyelitis could be induced at very low physiological concentrations by mycotoxin-induced NKC activity. 

https://www.ncbi.nlm.nih.gov/pubmed/14625399

Clinical Diagnosis of the Dampness and Mold Hypersensitivity Syndrome: Review of the Literature and Suggested Diagnostic Criteria. - PubMed - NCBI

A great variety of non-specific symptoms may occur in patients living or working in moisture-damaged buildings. In the beginning, these symptoms are usually reversible, mild, and present irritation of mucosa and increased morbidity due to respiratory tract infections and asthma-like symptoms. Later, the disease may become chronic and a patient is referred to a doctor where the assessment of dampness and mold hypersensitivity syndrome (DMHS) often presents diagnostic challenges. Currently, unanimously accepted laboratory tests are not yet available. Therefore, the diagnosis of DMHS is clinical and is based on the patient's history and careful examination. In this publication, I reviewed contemporary knowledge on clinical presentations, laboratory methods, and clinical assessment of DMHS. From the literature, I have not found any proposed diagnostic clinical criteria. Therefore, I propose five clinical criteria to diagnose DMHS: (1) the history of mold exposure in water-damaged buildings, (2) increased morbidity to due infections, (3) sick building syndrome, (4) multiple chemical sensitivity, and (5) enhanced scent sensitivity. If all the five criteria are met, the patient has a very probable DMHS. To resolve the current problems in assigning correct DMHS diagnosis, we also need novel assays to estimate potential risks of developing DMHS.

https://www.ncbi.nlm.nih.gov/pubmed/28848553

Non-Thyroidal Illness Syndrome in Patients Exposed to Indoor Air Dampness Microbiota Treated Successfully with Triiodothyronine. - PubMed - NCBI

Long-term exposure to dampness microbiota induces multi-organ morbidity. One of the symptoms related to this disorder is non-thyroidal illness syndrome (NTIS). A retrospective study was carried out in nine patients with a history of mold exposure, experiencing chronic fatigue, cognitive disorder, and different kinds of hypothyroid symptoms despite provision of levothyroxine (3,5,3',5'-tetraiodothyronine, LT4) monotherapy. Exposure to volatile organic compounds present in water-damaged buildings including metabolic products of toxigenic fungi and mold-derived inflammatory agents can lead to a deficiency or imbalance of many hormones, such as active T3 hormone. Since the 1970s, the synthetic prohormone, levothyroxine (LT4), has been the most commonly prescribed thyroid hormone in replacement monotherapy. It has been presumed that the peripheral conversion of T4 (3,5,3',5'-tetraiodothyronine) into T3 (3,5,3'-triiodothyronine) is sufficient to satisfy the overall tissue requirements. However, evidence is presented that this not the case for all patients, especially those exposed to indoor air molds. This retrospective study describes the successful treatment of nine patients in whom NTIS was treated with T3-based thyroid hormone. The treatment was based on careful interview, clinical monitoring, and laboratory analysis of serum free T3 (FT3), reverse T3 (rT3) and thyroid-stimulating hormone, free T4, cortisol, and dehydroepiandrosterone (DHEA) values. The ratio of FT3/rT3 was calculated. In addition, some patients received adrenal support with hydrocortisone and DHEA. All patients received nutritional supplementation and dietary instructions. During the therapy, all nine patients reported improvements in all of the symptom groups. Those who had residual symptoms during T3-based therapy remained exposed to indoor air molds in their work places. Four patients were unable to work and had been on disability leave for a long time during LT4 monotherapy. However, during the T3-based and supportive therapy, all patients returned to work in so-called "healthy" buildings. The importance of avoiding mycotoxin exposure via the diet is underlined as DIO2 genetic polymorphism and dysfunction of DIO2 play an important role in the development of symptoms that can be treated successfully with T3 therapy.


https://www.ncbi.nlm.nih.gov/pubmed/28824644

New Rules Required to Curb Childhood Obesity

 Three inexpensive programs have proven to be the most cost-effective ways to reduce childhood obesity rates, results from the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) show.

The work has provided clear evidence that the interventions save more than they cost to implement, said investigator Steven Gortmaker, PhD, from the Harvard T.H. Chan School of Public Health in Boston.

"That's extraordinary," he said here at the American Academy of Pediatrics 2017 National Conference and Exhibition. "These are actual cost-saving interventions."

Dr Gortmaker and his colleagues assessed more than 40 programs on the national agenda by examining evidence reviews from some 130,000 peer-reviewed publications. The team used big data and microsimulation models to project the impact of interventions and their cost-effectiveness over the decade from 2015 to 2025, taking into account trends across states and populations.

The first intervention is the imposition of an excise tax — $0.01 per ounce — on sugar-sweetened beverages. This has been shown to reduce consumption and is inexpensive to implement because tax systems are already in place. Projected savings of about $14 billion come from the slower rise in obesity rates induced by the tax, and do not include the expected $12.5 billion increase in national tax revenue.


http://www.medscape.com/viewarticle/885984

Dietary Supplement With Ketones May Mitigate Migraine Attacks

"We know that ketone bodies are not only metabolized, they're also signaling molecules. First of all, they're a more efficient fuel than glucose. Per molecule, they produce a lot more ATP [adenosine triphosphate] than a molecule of glucose," she said. "They also induce mitochondrial biogenesis, [and] they're very potent reactive oxygen species inhibitors.

Further, they produce less oxidative stress per molecule burned and reduce brain excitability, she added. "They shift the equilibrium between glutamate and GABA [γ-aminobutyric acid] in the direction of GABA, and they also have an influence on glutamate transport itself."

She went on to note that supplying more KBs increases ketone body transporter mechanisms, they are anti-inflammatory, and they reduce blood glucose levels. "So they have a variety of potential migraine-relevant mechanisms in addition to being a more effective fuel" than glucose.

She and her colleagues have started enrolling patients with migraine in a double-blind, randomized, placebo-controlled trial (NCT03132233) to test the bHB supplement in a crossover design over 3 months in a group of 90 participants.

The impetus for this work was the fact that Gross developed migraines in her mid-teens, and she said she wants something that will work for her and for many other patients with migraine. The side effects of currently approved prophylactic drugs are "intolerable for most patients," she said, and avoiding food and lifestyle triggers of migraines severely limits ones activities and life.

http://www.medscape.com/viewarticle/886000

Sunday, September 17, 2017

Nickel allergy: How to avoid exposure and reduce symptoms | American Academy of Dermatology

Avoid foods containing nickel if you are extremely sensitive to nickel. Some foods that contain high amounts of nickel include soy products—such as soybeans, soy sauce, and tofu—licorice, buckwheat, cocoa powder, clams, cashews, and figs.

https://www.aad.org/public/diseases/rashes/nickel-allergy

Frame Materials and Metal Allergies

The most common cause of metal allergies is mercury, and this is followed by metals including nickel, cobalt, tin, palladium and chrome.Conversely, metals such as gold, titanium, silver and iron are less likely to produce allergic reactions since they rarely dissolve upon contact with perspiration or other bodily fluids.

Of the metals most likely to produce allergic reactions, nickel is the one that is most commonly used in spectacle frames. For a long time, nickel has been used in the form of an alloy as a material for spectacle frames and is also used as the base plating material for plating and gold plating, for example. 

Compared with other metals, the properties of nickel make it readily dissolvable, and this means that contact of the body with nickel will result in the metal beginning to dissolve due to the effect of sodium ions in perspiration, causing an allergic reaction.

However, as a recent measure to prevent allergic reactions, the materials used in many products on the market nowadays are nickel-free. In addition, frames with vinyl-covered temples are now available for people with metal allergies.

People who may have metal allergies are recommended to undergo a patch test at a dermatologist. Forearmed with knowledge of which metals are likely to cause an allergic reaction, you will know which metals to avoid when purchasing spectacles.

http://seikoeyewear.com/eye-information/about-frames/materials-metal-allegries

Nickel Allergies on Rise as Devices Meet Skin - NYTimes.com

Nickel, one of the most common allergens in the United States, can be found in things like hand-held devices and jewelry. But unlike Europe, the United States has no restrictions on its widespread use in consumer products. That worries some doctors who say that the growing use of mobile and hand-held devices combined with a lack of regulatory oversight could lead to a spike in allergic reactions.

"I am absolutely concerned about it," said Stephen P. Stone, the director of clinical research in dermatology at the Southern Illinois University School of Medicine and the former president of the American Academy of Dermatology.

The Centers for Disease Control and Prevention estimates that 10 to 20 percent of the population is allergic to nickel. The reactions can be unpleasant, but not fatal. Typically they include blistering, redness and dry skin.



https://mobile.nytimes.com/2014/08/21/technology/personaltech/nickel-allergies-on-rise-as-devices-meet-skin.html?referer=https://duckduckgo.com/

Wednesday, September 13, 2017

Fire Retardants Found in Furniture and Gym Mats Implicated in Infertility

PFRs are commonly added to polyurethane foam, gym mats and baby items such as car seats, ostensibly to reduce the risk of the items catching fire. However, the chemicals do not remain in these items. They spread, contaminating air and dust. They can also migrate through direct contact. One 2015 study13 found nearly every dust sample collected from American homes contained the flame retardants Tris phosphate and triphenyl phosphate (TPHP).

Ninety-one percent of urine samples from the residents also contained metabolites of Tris phosphate, and 83 percent had metabolites of TPHP. Disturbingly, toddlers have been found to have levels of flame retardants that are as much as five times higher than their mother's.14 Needless to say, bioaccumulation can have serious health consequences over the course of a lifetime, and may ultimately affect the reproductive capacity of coming generations.


http://fitness.mercola.com/sites/fitness/archive/2017/09/08/flame-retardants-health-effects.aspx

Tuesday, September 12, 2017

Exposure to Disinfectants Linked to COPD

This was a "well-performed study," said Lidwien Smit, PhD, from the University of Utrecht in the Netherlands. "I just wonder about the pathology, and how it influences the microbiome."

"Disinfectants are meant to kill off bacteria, but if you're exposed to large concentrations, you're also inhaling them, which could affect your airway microbes," she explained.

In fact, disinfectants could play a role in killing off bacterial communities in the airways that are responsible for "immune homeostasis" and keep users healthy, she added.

If that immune balance gets disturbed, it might have an influence on a person's reaction to pathogens or inflammation. "This is all part of the COPD pathology — that could be another interesting hypothesis to study," Dr Smit told Medscape Medical News.

Dr Dumas is clear that this is preliminary observational research and more studies are needed. Determining which agents are most harmful "would help define guidelines to protect workers," she noted.

The current findings do not show that the disinfectants are a direct cause of COPD, but they do draw an association between some disinfectants and development of the disease. "I hope this study will help open the discussion for better guidelines," Dr Dumas said.

http://www.medscape.com/viewarticle/885575

Saturday, September 2, 2017

The Unexpected and Troubling Rise of Candida auris

Hello. I am Dr Tom Chiller, chief of the Mycotic Diseases Branch at the Centers for Disease Control and Prevention (CDC). As part of the CDC Expert Commentary Series on Medscape, I would like to tell you about Candida auris, a novel yeast that is behaving in unexpected and concerning ways, causing severe disease in countries across the globe, including the United States. Today we'll share how you can protect your patients from this potentially deadly infection, the history of this unusual bug, and how the United States is working with global partners to combat its spread.


http://www.medscape.com/viewarticle/884470

Monday, August 28, 2017

Dark Hair Dye and Chemical Relaxers Linked to Breast Cancer



The study of 4,285 African-American and white women was the first to find a significant increase in breast cancer risk among black women who used dark shades of hair dye and white women who used chemical relaxers.

Black women who reported using dark hair dye had a 51 percent increased risk of breast cancer compared to black women who did not, while white women who reported using chemical relaxers had a 74 percent increased risk of breast cancer, the study found.

The risk of breast cancer was even higher for white women who regularly dyed their hair dark shades and also used chemical relaxers, and it more than doubled for white dual users compared to white women who used neither dark dye nor chemical straighteners.

The association between relaxers and breast cancer in white women surprised lead author Adana Llanos, an epidemiologist at the Rutgers School of Public Health in Piscataway, New Jersey, although she worried enough about the safety of hair relaxers in African-American women like herself to stop using them years ago.

http://www.medscape.com/viewarticle/882833

Sunday, August 27, 2017

HLA-DQ:gluten tetramer test in blood gives better detection of coeliac patients than biopsy after 14-day gluten challenge

A 14-day gluten challenge was not enough to establish significant mucosal architectural changes in majority of patients with coeliac disease (sensitivity ≈25%–50%). Increase in CD4+ effector-memory gut-homing HLA-DQ:gluten tetramer-binding T cells in blood 6 days after gluten challenge is a more sensitive and less invasive biomarker that should be validated in a larger study.

http://gut.bmj.com/content/early/2017/08/04/gutjnl-2017-314461

HPHPA and Clostridia


The dysbiosis marker 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA), the predominant dihydroxyphenylpropionic acid isomer in urine, is also measured in the Organic Acids Test offered by The Great Plains Laboratory. This marker was proven by Dr. William Shaw to be due to a combination of human metabolism and the metabolism by a group of Clostridia species, including but not limited to C. difficile.

HPHPA has been one of the most useful clinical markers in recent medical history. Treatment with metronidazole, vancomycin, or high doses of probiotics of individuals with high urinary values has led to significant clinical improvements or remissions of psychosis.

The biochemical role of Clostridia in altering brain neurotransmitters is due to the fact that Clostridia metabolites inactivate dopamine beta-hydroxylase, leading to an excess production of brain dopamine and reduced levels of the neurotransmitter norepinephrine. Excess dopamine is associated with abnormal or psychotic behavior. This imbalance can be demonstrated in the Organic Acids Urine Test by observing the ratio of the major dopamine metabolite, homovanillic acid (HVA), to that of the major norepinephrine metabolite, vanillylmandelic acid (VMA) when the Clostridia marker HPHPA is elevated. After treatment with metronidazole or vancomycin, HPHPA values return to normal along with normal ratios of HVA/VMA and normal behavior.

The highest value of HPHPA was measured in the urine of a young woman with first onset of schizophrenia. Treatment of Clostridia bacteria resulted in loss of auditory hallucinations. In autism, children with gastrointestinal Clostridia commonly exhibit aggressive behavior, agitation, obsessive compulsive behavior, and irritability. They may have very foul stools with diarrhea with mucus in the stools although some individuals may be constipated. Stool testing for Clostridia is usually of limited usefulness since most Clostridia species are considered probiotics or beneficial. There are about 100 species of Clostridia that are commonly found in the gastrointestinal tract. Only seven of these species are producers of HPHPA including C. sporogenes, C.botulinum, C. caloritolerans, C. angenoti, C. ghoni, C.bifermentans, C. difficile, and C. sordellii while C. tetani,C. sticklandii, C. lituseburense, C. subterminale, C.putifaciens, C. propionicum, C. malenomenatum, C.limosum, C. lentoputrescens, C. tetanomorphum, C.coclearium, C. histolyticum, C. aminovalericum, and C.sporospheroides do not produce compounds that are converted to HPHPA.

The same article by Dr. Shaw indicates that 3,4-dihydroxyphenylpropionic acid (DHPPA) is a marker for beneficial bacteria in the gastrointestinal tract such as Lactobacilli, Bifidobacteria, and E. coli. The exception is one species of Clostridia orbiscindens that can convert the flavanoids luteolin and eriodictyol, that occur only in a relatively small food group that includes parsley, thyme, celery, and sweet red pepper to 3,4-dihydroxyphenylpropionic acid. The quantity of C. orbiscindens in the gastrointestinal tract is negligible (approximately 0.1% of the total bacteria) compared to the predominant flora of Lactobacilli, Bifidobacteria, and E. coli (7). DHPPA is an antioxidant that lowers cholesterol, reduces proinflammatory cytokines, and protects against pathogenic bacteria. 2,3-Dihydroxyphenypropionic acid, a different isomer has been claimed to be a metabolite of Pseudomonas species but the literature indicates that this compound is formed by the in vitro action of these species on quinoline, a component of coal tar, a substance missing from the diet of virtually all humans. 

http://integrativemedicineformentalhealth.com/articles/shaw_hphpa.html

Saturday, August 26, 2017

More Young People Are Dying of Colon Cancer - NYTimes.com

While rates of cancers tied to human papillomavirus, or HPV, have been rising in recent years, that virus causes cancers mainly of the cervix, back of the throat and anus, and scientists do not believe sexual behaviors or HPV are driving the increase in colon or rectal cancer (anal and rectal cancers are distinct).

Obesity, a diet high in red or processed meats and lack of physical activity are among the factors tied to increased risk, but new research is looking at other possible causes. One recent study found, for example, that prolonged use of antibiotics during adulthood was associated with a greater risk of developing precancerous polyps, possibly because antibiotics can alter the makeup of the gut microbiome.

https://mobile.nytimes.com/2017/08/22/well/live/more-young-people-are-dying-of-colon-cancer.html

Toxic metal hip replacements could cause Alzheimer's | Daily Mail Online

Doctors are being urged to check for signs of dementia or heart disease in hip implant patients.

There are concerns that the metal-on-metal devices are leaching toxic chemicals into the blood which cause serious health complications.

The Medicines and Healthcare products Regulatory Agency announced last month that patients would be called in for x-rays and blood tests to check for adverse reactions.

Now a spokesman for the watchdog said it was also keeping a 'weather eye' on a possible link to heart attacks and dementia.

Dr Neil McGuire, clinical director of medical devices at the MHRA, said he wanted to establish whether cobalt leached from the implants was causing adverse effects.
Patients with the 'metal on metal' hip implants will be advised to have X-rays and undergo blood tests due to fears of their toxicity

http://www.dailymail.co.uk/health/article-4682268/Fresh-warning-toxic-metal-hip-replacements.html

Saturday, August 19, 2017

Why You’re Not Losing Weight On Your Diet | Time.com

Another area that has some scientists excited is the question of how weight gain is linked to chemicals we are exposed to every day--things like the bisphenol A (BPA) found in linings of canned-food containers and cash-register receipts, the flame retardants in sofas and mattresses, the pesticide residues on our food and the phthalates found in plastics and cosmetics. What these chemicals have in common is their ability to mimic human hormones, and some scientists worry they may be wreaking havoc on the delicate endocrine system, driving fat storage.

"The old paradigm was that poor diet and lack of exercise are underpinning obesity, but now we understand that chemical exposures are an important third factor in the origin of the obesity epidemic," says Dr. Leonardo Trasande, an associate professor of pediatrics, environmental medicine and population health at New York University's School of Medicine. "Chemicals can disrupt hormones and metabolism, which can contribute to disease and disability."

Another frontier scientists are exploring is how the microbiome--the trillions of bacteria that live inside and on the surface of the human body--may be influencing how the body metabolizes certain foods. Dr. Eran Elinav and Eran Segal, researchers for the Personalized Nutrition Project at the Weizmann Institute of Science in Israel, believe the variation in diet success may lie in the way people's microbiomes react to different foods.

http://time.com/4793832/the-weight-loss-trap/

Wednesday, August 16, 2017

Japanese fungus spreading in UK hospitals - BBC News

What is Candida auris?

It belongs to a family of fungi or yeasts that live on the skin and inside the human body.

A more common "cousin" in this family is Candida albicans, which causes the yeast infection thrush.

Candida auris was first identified in 2009 in a patient from Japan.

Hospital outbreaks have since been reported in the United States, India, Pakistan, Venezuela, Colombia, Israel, Oman, South Africa and Spain, as well as the UK.


http://www.bbc.com/news/health-40934190

Wednesday, August 9, 2017

Medicare to cover supervised exercise for heart disease

Following a request from cardiologists, the CMS will now offer national Medicare coverage of supervised exercise therapy for treating peripheral artery disease

The agency said in a coverage decision released Thursday that research has shown supervised exercise therapy can help alleviate common symptoms of the cardiovascular disease, including pain and discomfort in a patient's legs.

Peripheral artery disease occurs when plaque buildup narrows the arteries outside the heart. It affects 12% to 20% of Americans age 60 and older, and the incidence of the disease increases considerably with age.

Without exercise, individuals with peripheral artery disease could see their condition worsen to the point they lose functional independence.

"Medicare beneficiaries, a significant portion of which have peripheral artery disease will benefit considerably from participating in supervised exercise therapy sessions," American Heart Association CEO Nancy Brown said in a statement. "Evidence shows this therapy can improve quality of life for patients and enhance clinical outcomes."

Supervised exercise is a non-invasive treatment option, which can alleviate leg pain during exercise and improve a patient's walking distance, according to the American Heart Association.



http://www.modernhealthcare.com/article/20170530/NEWS/170539995