Vitamin K Deficiency Appears to be a Major Risk Factor for Developing Arthritis

Boston University rheumatologist, Tuhina Neogi, reported at the World Congress on Osteoarthritis in Brussels that people who are deficient in vitamin K has twice the incidence of developing osteoarthritis of the knee. Those who eventually developed arthritis in both knees over a 30 month period were 3 times more likely to be vitamin K deficient. Vitamin K is also a factor in Rheumatoid arthritis and in Osteoporosis. Supplements containing both Vitamin D and Vitamin K are now available, and should be considered for a comprehensive preventive program.

See Family Practice News (click here), November 1, 2010, pp. 36-37.

Merry Christmas!

This will be the last blog posting until after Christmas.

One Cause of the Skyrocketing Costs of Medical Care

An exciting new drug, fondaparinux, significantly reduced the incidence of blood clots released from thrombophlebitis in the legs. The drug is given by self-injection for up to 45 days. The cost of the treatment for one patient is up to $7380. You have to treat 88 patients at a total cost of as much as $650,000 to prevent one clot. And no lives were saved. Because the study was published in the New England Journal of Medicine, the chances are that this drug will be very popular indeed. Dr. Lee Goldman of Columbia University and Dr. Jeffrey Ginsberg of McMaster University wrote a commentary in the same journal calling for cost to be a consideration in the FDA approval of drugs. I couldn’t agree more, but that would require sanity and common sense.

See New England Journal of Medicine (click here). 2010;363:1222-32, 1278-80.

Be Careful About Lasik Surgery

Many are reassured because Lasik surgery has a 95.4% success rate. Patients choose the procedure to eliminate the need for glasses and contacts. But Bert Bieler, MD, of Cherry Hill, N.J. wrote a letter-to-the-editor in American Family Physician pointing out that 14 million such procedures were performed in North America between 1997 and 2009. That means that more than 600,000 patients had an unsuccessful outcome or a “failed” procedure with either complications or worse vision afterwards. Dr. Bieler urged caution, as we should exercise for many surgical procedures, for example bypass surgery, when medicines might do just as well.

See American Family Physician (click here), Nov. 1, 2010, P. 1044.

Rapid Weight Loss is More Effective than Gradual Weight Loss

Contrary to what physicians have been taught for many years, rapid weight loss programs designed to lose up to 4 pounds a week have been shown to be more effective than the usual goal of a pound a week. Rapid weight loss can be achieved with a 500 calorie diet. We have seen good appetite suppression with HCG, although that approach has been criticized by the AMA. HCG is given by the patients themselves by shots, but homeopathics preparations have recently become available. Acupuncture can also help decrease the appetite while on very low calorie diets. Maintenance is still a crucial part of either program.

See Family Practice News (click here), Sept. 1, 2010, p. 42.

Huge Rise in Diabetes Predicted

Insulin-dependent Diabetes is doubling every 20 years because of genetics and people living longer. Non-insulin-dependent diabetes is rising at an even faster pace due to increased American obesity. This will present a major obstacle to primary care physcians, according to a recent conference reported in Family Practice News. Patients with diabetes frequently have multiple complications and require complex treatments to control their glucose, lipids and blood pressure. Special clinics are sometimes needed for difficult cases. We currently do not have the resources to properly treat all the expected new cases of this disease. Once again, we need to turn to healthy lifestyle changes to prevent diabetes, which can be done in a good number of cases.

See Family Practice News (click here), Sept. 1, 2010, P. 14.