Wednesday, August 31, 2011

Mammograms Shown to be Ineffective in Europe

A study from 6 European countries published in the British Medical Journal indicated that screening mammograms had no effect on mortality from breast cancer. The study compared similar countries that were much more aggressive in performing the screening procedure to those who were not. In all three cases, there was no improvement in outcomes attributable to increased surveillance. Since mammograms carry extra risk from radiation with compression and they detect only cancers that are already present, breast thermograms might be a preferable screening tool. There is no risk from the latter, and they detect the tendency toward cancer before the disease actually develops.

From news release in the Toledo Blade, August 8, 2011.

Thursday, August 25, 2011

U.S. Health Statistics Lag Behind

Life expectancy in the U.S. is 78.1 years, in Switzerland 81.9 years. MRI exams per 1000 people in the U.S. is 91.2, in Canada 31.2. Our coronary bypass rate is 521 per 100,000 people, in Ireland it is 128. Our death rate from heart attacks is 145 per 100,000, in France it is 54. Health expenditures here are 16% of GDP, in France 11% and in Ireland 7.6%. The message is that we could drastically reduce health care spending and greatly improve results by emphasizing prevention and the use of natural healing. A good place to start is with Chelation therapy.

See Brook RH, Facts, Facts, Facts: What is a Physician to do? JAMA, July 27, 2011, 432-433.

Tuesday, August 23, 2011

Americans Give the Health Care System Very Low Grades

Recent surveys by the Commonwealth Fund and the Robert Wood Johnson Foundation suggest a major dissatisfaction with U.S. health care. 2/3 of respondents gave it a barely passing or failing grade overall. 71% said they had trouble getting access to care when needed. Nearly half said their care was poorly coordinated and wasteful. About half also gave hospital care a grade of C, D, or F. Our practice has recently been recognized by the National Center of Quality Assurance as a Physician Practice Connections®--Patient Centered Medical Home™(PPC-PCMH), which directs that the patient’s family doctor coordinates the care and makes it more accessible. Hopefully, this will improve our national health care, make it more affordable and accessible.

See Family Practice News(click here), May 1, 2011, p. 60.

Thursday, August 18, 2011

The Risk of Sudden Death from Taking ADHD Stimulants

The risk is not high but it is does happen. Patients should be questioned for a history of fainting with exercise, known cardiac abnormalities, and a family history of sudden cardiac death at a young age. If there is a yes answer to any of these inquiries or if the physician hears a click or murmur with a stethoscope, an EKG should be obtained and/or the patient referred to a specialist before stimulants like Ritalin are prescribed. It is safer to take natural supplements and look for food allergies to treat ADHD. It is not a standard guideline, but the same questions might be asked during a pre-participation PE for sports, with a similar workup if any of the answers are positive.

See the from the American Academy of Child and Adolescent Psychiatry, Dr. James J McGough of UCLA presenting.

Tuesday, August 16, 2011

Avoid Withdrawal Symptoms from Anti-Depressants

Anti-depressants can be helpful for some people, but others do not get the expected improvement or might get significant side effects. Still others take them for a period of time and just want to get off them. What you do not want to do is stop them suddenly. Dr. Kurt Kroenke of Indiana University warms against the Antidepressant Discontinuation Syndrome, which can make patients miserable and possibly suicidal for several weeks. I prefer to taper such meds over two weeks and replace them with a nutrient program like Empower plus. Another option would be to measure the neurotransmitters and boost up the ones that are low with specific amino acids. If the intention is to switch to another medication, tapering is not usually needed.

See Family Practice News,(click here) May 1, 2011, p. 32.

Thursday, August 11, 2011

Triglycerides Noted as a Significant Risk Factor

The American Heart Association has dramatically reduced the allowable level of triglycerides to 100 mg/dl. Previous limits have been 150-200. The good news is that drug therapy is not recommended unless the level exceeds 500, which is more closely associated with pancreatitis than heart disease. Of note is that the good cholesterol (HDL) is inversely proportional to triglycerides. One can dramatically reduce triglycerides by going on a low carb diet, especially avoiding table sugar and fructose. Then the HDL will usually rise to cardioprotective levels. Weight loss, exercise and fish oils are also helpful.

See American Heart Association, Circulation (click here-subscription needed), 2011.

Tuesday, August 9, 2011

Natural Therapies for Diabetic Nerve Pain

Guidelines for treating diabetic nerve pain were published this spring by two Physical Medicine groups. Unfortunately, the only remedy that had good evidence was pregabalin, which is expensive and has side effects. Many of the existing therapies, such as gabapentin, anti-depressants and narcotics, which are commonly prescribed had only limited evidence for effectiveness. Natural approaches, such as capsaicin, alpha lipoic acid, electrical nerve stimulation, Reiki and cold laser treatments, had mixed results, just like the drugs. The study only looked a pain relief and did not look at side effects and quality of life. The guideline did stress that significant relief might be obtained in specific patients with any of these therapies. I suggest using a combination of natural remedies to attempt to find the best result with the least side effects.

See the April 2011 editions of Muscle and Nerve(click here)