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.


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."


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.


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.


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."


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.


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.


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.


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.


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.


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.


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.


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!


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.


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.


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."


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. 


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.


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.


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. 


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. 


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."


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.


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.


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