Tuesday, December 22, 2009

Simplified Approach to Measuring Lipids

An article in the American Medical Association journal contends that lipids as a risk factors for vascular problems can be accurately measured in non fasting specimens. In summary, you no longer have to fast for 10-14 hours prior to getting cholesterol testing, which makes the process much easier on the patient. We are incorporating this change in the office, not only for convenience but also because we can get these blood tests much cheaper for the patient if we draw the specimen in the office as opposed to the hospital.

See Nov. 11 issue of JAMA, p. 1993-1998.

Wednesday, December 16, 2009

Serotonin and Sleep

Serotonin was discovered in the 1940’s and is one of the oldest biologically active substances on earth. It has been shown to be active in virtually all behavioral and cognitive actions in the body. A new book reviewed in the American Medical Association Journal reviews serotonin’s role in sleep problems such as sudden infant death, panic disorder, sleep apnea and depression. Adequate sleep is an important requirement for many illnesses, including chronic fatigue. The AMA emphasizes drugs that inhibit the breakdown of serotonin, but nutrients such as 5-HT can increase serotonin more effectively, especially after measuring neurotransmitters in the urine, an excellent approach utilized by Integrative physicians.

See Nov. 11, 2009 issue of JAMA (click here), p. 2036 and the book, Serotonin and Sleep: Molecular, Functional and Clinical Aspects, Edited by J.M. Monti, et. al.

Tuesday, December 8, 2009

Most Melanomas are Discovered Incidentally by the Physician

Dr. Jonathan Cantor in the Archives of Dermatology published a study showed that 56-60% of Malignant Melanomas were discovered by a dermatologist doing a full body exam for another complaint. Currently, the US Preventive Service Task Force states that there is not enough evidence to support full-body examinations as a screening procedure, so most doctors do not do so. If you have multiple moles or if you have had strong sun exposure, even many years ago, it might be prudent to ask your doctor to do a full body exam. If detected early, melanomas are much easier to treat.

See Family Practice News, Sept. 15, 2009, p. 28.

Tuesday, December 1, 2009

Avoid Treating Fever in Patients with Flu Symptoms, Especially in Children

It has been long recognized that fever should not be treated with medications in patients with the flu for two reasons: the fever helps the body kill the virus and there is a higher incidence of the deadly Reyes Syndrome in patients with flu treated with anti-pyretics. The British Medical Journal has speculated that the high incidence of deaths in Mexico might be related to harmful effects of ibuprofen used for fever. Since the Japanese have warned against the use of such drugs, the death rate has decreased. In the horrible flu epidemic of 1918, the US surgeon General and the AMA recommended the first-line use of aspirin and probably increased the death and complication rate. In conclusion, we should avoid aspirin, ibuprofen, Motrin, Alieve, and even Tylenol in cases of the flu. But be sure to keep the levels of vitamin D3 high.

Google Mayer Eisenstein, MD, JD, MPH to get his newsletter.