Thursday, February 24, 2011

Daily Low-dose Aspirin Reduces the Cancer Death Rate 30-40%

Adult low-dose aspirin (81 mg) has been used to reduce the incidence of heart attacks and strokes, but caution has been advised because of an increased risk of bleeding episodes. Dr. Peter Rothwell headed a group in England that found that in those who took aspirin for 5 years or longer, the death rate for the following cancers was reduced substantially: esophagus, pancreas, brain, stomach, colorectal, prostate and lung. The pendulum is swinging back in favor of taking low-dose aspirin, especially if you have a family history of cancer and cardiovascular disease. However, if you bleed easily or have a history of a peptic ulcer, aspirin is not for you.

See Lancet(click here) 2010;376:1741-50.

Thursday, February 17, 2011

Self-Treatment for Cardiac Emergencies

Dr. Sherry Rogers has a great newsletter called Total Wellness. In it she advocates the use of d-Ribose, a simple sugar available at any health foods store. It is used to increase energy, especially in patients with chronic fatigue, fibromyalgia or heart problems. Two scoops or packets also can prevent a threatened heart attack if given immediately. Conventional medicine advocates taking an aspirin at the first signs of a heart attack or stroke to minimize the damage. More effective than aspirin are magnesium and heparin, each of which is given by injection and each is 30-55% effective in preventing heart damage when there is significant chest pain. If you are at risk, talk to your doctor about putting your own emergency kit together. It could save your life.

Tuesday, February 15, 2011

The 12-minute Fitness Revolution
The Progressively Accelerating Cardiopulmonary Exertion (PACE) system was discovered by Dr. Sears. It focuses on maximal fitness, strengthening bone, improving the immune system and preventing heart attacks and strokes with a commitment of 12 minutes a day. You can use any physical activity that makes you breath harder. The basic workout consists of a warm-up for 2 minutes, exercise for 4 minutes, then 3 minutes, then 2, then 1, with a recovery time between. Surely you can find 12 minutes in a busy day to help you live longer and feel better.

Dr. Sears PACE program (click here)

Thursday, February 10, 2011

Comparative-Effectiveness Research and Integrative Medicine

Recent legislation mandates comparative-effectiveness research (CER), which seeks to find which treatments work best in the “real world” of medicine. It recognizes that randomized clinical trials reduce the variables to a minimum and provide conclusions only for the average patient. Individuals and subgroups of patients are often ignored by our dependence on double-blind studies. CER will work through generating questions by “data mining” of large group practices and electronic medical records (EMRs). It is estimated that 50-78% of research conclusions are changed by further research and that at least 48,000 key clinical questions remain to be answered in family practice alone.

Obviously, integrative medicine approaches diagnosis and treatment radically different than conventional medicine. Patients who do not respond to standard treatment often thrive under the guidance of an alternative practitioner. However, integrative patients and practitioners are reluctant to utilize EMRs because of privacy issues. The most important source of new knowledge in medicine awaits discovery in the records of integrative patients. A way must be found to make the knowledge known while unquestionably preserving the privacy of the patients who have benefited.

See Djulbegovic, Mia and Benjamin, Implications of the Principle of Question Propagation for Comparative-Effectiveness and “Data-Mining” Research.
JAMA,(click here) January 19, 2011, P. 298-299.

Tuesday, February 8, 2011

H1N1 Flu Shots Were Poorly Accepted in 2009

According to data from the National Vaccine Advisory Committee at the CDC, only 38% of physicians and other health care workers were vaccinated for H1N1 last year. This is about the same rate as for the general population. Only 25% of adults who were immunecompromised received the vaccine. The biggest reason given was fear of side effects, especially the paralysis called Guillan-Barre syndrome. Of those who did receive the H1N1 vaccine, there was a slight increase in the syndrome, but not to high levels. Another reason given was late delivery of the vaccine to physicians, while pharmacies seemed to get their supply sooner. The pandemic predicted for last year did not materialize, nor has there been one this year. But some people who have contracted the disease have become pretty sick. The H1N1 vaccine is included in the regular flu shot this year. If you choose not to take it, I would suggest a homeopathic as a preventative (e.g. mucococcinium).

Friday, February 4, 2011

New Concepts in Health Care Delivery

The Affordable Care Act recently signed by Obama might significantly change the way medical care is delivered, at least by primary care physicians. Patient-centered medical homes (PCMH) will give qualified primary care doctors the responsibility to coordinate the patient’s care. It emphasizes a team approach and a shift from routine specialty care to family docs and pediatricians. Pilot projects have shown great savings by better preventive care, fewer hospitalizations and less testing. Our practice is in the process of becoming certified as a PCMH. PCMH patients will still have the choice between conventional and alternative medicine. Accountable Care Organizations (ACO) is another approach being encouraged by the government. ACOs pay the same total amount per patient to hospitals, specialists and primary care docs, which is then split among the participants. This smacks of socialized medicine, while pitting hospitals and docs against each other in competition for payment.

ACOs sound like a recipe for disaster. Finally, some groups of docs on their own have set up Direct Primary Care Models, which have some similarities to the PCMH but they eliminate insurance companies as middle men, except for high-deductible catastrophic care. Patients pay a flat fee directly (typically around $100 a month) to get unlimited access to their family doctors. A lot more prevention is done with longer office visits. ER visits and hospitalizations have been reduced significantly with Direct Primary Care. This might be something we could consider for the future.

Tuesday, February 1, 2011

Several Studies Point to the Importance of Sleep in Young People

Family Practice News reported on three studies showing how lack of sleep can adversely affect young people. Recommended levels of sleep is 8-9 hours per night. For each one hour of sleep deprivation, there is a 14% greater incidence of psychological disturbance, including major depression. After a traumatic event
sleep disruption often occurs and is a precursor for post-traumatic stress disorder (PTSD). Overweight children with sleep apnea, whether mild or more severe, had lower grades in school than those who did not. We certainly need to pay more attention to sleep problems for both children and adults.

See Family Practice News (click here), October 1, 2010.