Archive for April, 2009

Interesting facts from medical literature

Beginning today, I will occasionally share with you some interesting facts from articles I have read during my review of current medical literature.

Did you know:

  • Skin cancer on the head or neck is more deadly than on other parts of the body.
  • 30 minutes of aerobic exercise five days a week can reduce blood pressure between 5 and 8 points
  • Extensive use of flip-flop shoes can cause pain in the heel, ankle, lower leg and toes.
  • Pessimistic heart patients are almost twice as likely to die within six to 10 years as heart patients with an optimistic outlook.
  • Trans fats, found in many processed foods, not only increase the risk of heart disease but also increase the risk of breast cancer.
  • If you think you’re having a heart attack, call 9-1-1, then chew and swallow one 325 mg. aspirin
  • Exercising in water burns more calories than doing the same exercise on land.
  • People, who engage in vigorous cardiovascular activities regardless of their size, are healthier and live longer than their sedentary counterparts.
  • Fish oil may help to ease depression.
  • To halt a lower leg calf cramp, flex your foot by pointing it up toward your shin. You can grab and pull the toes and ball of your foot to help flex it.
  • Sixteen percent of people between the ages of 20 to 69 suffer significant hearing loss.
  • Memory loss is linked to low levels of “good” (HDL) cholesterol
  • The spread of flu is linked to airline travel. The fewer people who travel by airline over the Thanksgiving holiday, in particular, the slower the flu moves across the country.
  • Vitamin C may fight wrinkles.
  • Excessive drinking of alcohol leads to increased risk of pre-diabetes.
  • Eating or drinking food high in cocoa improves blood flow to the brain and may help prevent stroke and dementia.
  • People with type 2 adult onset diabetes are two to four times more likely to develop heart disease, mostly because of increasing cholesterol and blood pressure.
  • Those who receive the pneumococcal pneumonia vaccine may be at a lesser risk of heart attacks.
  • Adult muscle mass decreases by 1 percent a year after the age of 30.
  • Drinking up to three cups a day of black or green tea reduced stroke risk by 21 percent.
  • Symptoms of depression can be improved by eating less processed sugary foods and increasing foods such as grains and vegetables.
  • For acute low back pain, a day or two of bed rest may be helpful. For more rapid healing, it is best to get out of bed and move around as soon as possible.
  • Newer cooking recipes have larger portion sizes. Stay conscious of portion size when eating.
  • Drowsy driving is linked to 100,000 motor vehicle accidents causing 1,000 deaths and 40,000 injuries.
  • Accidents with dogs and cats cause 80,000 emergency room visits annually for their owners in the United States.

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Autism is a developmental problem that appears early in childhood. It affects a child’s social interaction, language and behavior. This makes it difficult for an autistic child to communicate and interact with others.

Up to 6 out of 1,000 children in the U.S. are diagnosed with autism, and the numbers seem to be rising. This fact could be because of an actual increase in the incidence of autism, or perhaps it’s just a reflection of better detection and reporting of the condition.

Diagnosis is difficult. Although the signs of autism may show up by 18 months of age, the diagnosis may not be reached until the age of 2 or 3. Early diagnosis is associated with a better chance of improvement.

Common symptoms of autism:

  • Social skills: A child may not respond to his or her name, has poor eye contact, appears not to hear you and retreats into his or her own world.
  • Language: Starts talking later than other children, no eye contact when speaking, can’t start a conversation or keep one going, and loses the previously learned ability to say words or phrases.
  • Behavior: Performs repetitive movements, develops strict routines and rituals, moves constantly, and is disturbed by the slightest change of routine.

There are many possible causes of autism, including:

  • Genetics: Some genes are inherited, and some can change after birth.
  • Environmental factors: Environmental pollutants and viral infections may play a role in triggering autism.
  • Other causes: Problems during labor and delivery during birth and possible effects of the immune system may cause autism.

When it comes to immunizations, this is the greatest controversy concerning autism and a major reason why parents choose not to have their children routinely immunized. After much extensive study, to date, no link has been found between immunizations and autism.

Risk factors include:

  • Child’s sex: Autism is three or four times more common in boys than girls.
  • Family history: Families with one autistic child run a higher risk for having a second child with the disorder.
  • Paternal age: The older the father, the greater chance of having an autistic child.

Treatment of autism may include:

  • Behavior and communication therapy.
  • Educational therapy.
  • Drug therapy (to help symptoms only).
  • Creative therapy such as music and art.

There are also several ways to cope with autism:

  • Find a team of professionals who you can trust.
  • Learn as much as you can about the disorder.
  • Seek out other families with autistic children.

We, as a community, need to be understanding and supportive of families with autistic children. Working with a child who requires extra attention can be exhausting for families. Autistic children can also bring talents beyond expectation.

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When receiving a new prescription medication from your doctor, I recommend the following steps:

  • Inform your physician of any allergies you may have.
  • Bring a list of all the medications you already take, or bring the actual medications in their original containers.
  • Make sure your doctor is aware of any other medical condition for which another practitioner may be treating you.
  • Ask about the benefits and risks of the new medication.
  • Notify your doctor if you have difficulty swallowing pills or liquid medication and also if you prefer to take the lowest number of doses possible.

After agreeing on the new medication, make sure you have the following information from either the doctor or the pharmacist. (A pharmacist always gives a computerized handout with most of the important information about the drug.)

  • The name of the medication.
  • When, how much and how long to take the medication.
  • What it’s supposed to do.
  • What are the possible side effects.
  • What food, drinks or activities might affect the medication.
  • How the medication should be stored.

Discard any medication that has:

  • Expired.
  • Been discontinued by your doctor.
  • No label on the container.
  • Changed color or smell or seems different from how you remember it.

Since September 2008, it has officially been illegal to discard medicines and sharps (needles, etc.) by flushing them down the toilet or throwing them into the trash.

Most local pharmacies will accept unwanted medications and sharps. Sharps should be transported in an approved safe container that can be inexpensively obtained from any participating pharmacy.

Medications that should be safely discarded include prescription drugs, over-the-counter medications, pet medicines, vitamins, medicated creams and ointments and liquid medication in containers.

Contact your local pharmacy to ensure that they accept your throw-away drugs and sharps. For more information on this topic:               831-454-2160        or http://www.sharpmedsolutions.org.

Editor’s note: This is the third and last in a series of columns about prescription medication.

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Many people take more than one medication, see more than one doctor or have more than one health problem — that makes it essential that you and your doctor are aware of all the medications you take and understand any possible drug interactions that may occur.

When seeing your doctor, bring all your medications or a list of medications you take.

It is very important to read the information given by the pharmacist when picking up your medication. This information can describe possible drug interactions, which can have several harmful consequences.

  • Drug and drug interactions: when two or more drugs interact with each other, such as a sleeping pill (a sedative) taken with an allergy medication (an antihistamine).
  • Drug and food/beverage interactions: food can interfere with drug absorption.
  • Drug and condition interactions: taking the decongestant Sudafed when one has high blood pressure can significantly raise blood pressure.
  • Drug and over-the-counter-medication interactions: taking an antacid can block other medication from being absorbed in the stomach.

One common drug-drug interaction is taking an antibiotic and the effect it has on birth control pills. Medical literature says that antibiotics pose a very small risk of a woman getting pregnant, though they can make birth control more ineffective. A woman being advised of this small risk may decide to temporarily use a back-up birth control method.

Some medications are altered by what you eat and when you eat it. Food may delay or decrease the absorption of a drug, causing it to be less effective. Most medications work best on an empty stomach, which means taking it either one hour before eating or two hours after eating. On the other hand, some drugs work better when taken with food just after a meal. Your medication label will tell you how to take it. If there is no mention of taking it with or with out food, then it can be taken either way.

Patients often ask if alcohol can be consumed while taking medication. The general rule of thumb is that medication and alcohol taken close together may change the potency of a drug. The most serious reaction is the combination of alcohol and narcotic pain medications, sleeping pills or sedatives. Many accidental or suicidal deaths we hear about in the media are the result of these drugs being combined with alcohol.

I do not advise consuming alcohol while taking medication, but I realize that it is a fact of life. If drinking is done in moderation, then it is best that the consumption of alcoholic beverages and the taking of medications be separated by at least two hours.

Regardless, it is important to stress that when taking prescription medication, carefully read the instruction sheet given by the pharmacist as well as the label on the container. This will help to ensure safe and effective use of your medication.

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Before you leave the pharmacy with your prescription medication, take a close look at the label on each container. Make sure it has the following:

  • Your name as well as the prescribing doctor’s name.
  • The name and phone number of the pharmacy.
  • The date it was prescribed.
  • The name and the amount of the medication.
  • Simple understandable directions.
  • The expiration date.
  • The number of refills, if any.

When you arrive home with your medication, be sure to keep it in its original container to prevent future confusion. An exception to this rule would be to put the medication in a weekly pill container, which is the best method for taking medication on schedule. These containers can be purchased at your local pharmacy.

You may dispose of the cotton plug often found in the medication’s container. Always keep containers tightly closed. When bringing a new medication into your home, take time to throw out any medication that has expired or has been discontinued by your physician. (Proper disposal will be covered later.)

Take time to read the drug information given to you by the pharmacist. This is usually a fairly detailed computer printout of things you need to know before taking your first dose. Reading this information will help you understand how often and when to take the medication, what side effects may occur, whether to take the drug on a full or empty stomach, and whether it needs to be refrigerated.

It’s probably safe to say that most people who have prescription medication are not aware of proper storage techniques. Heat and humidity are the greatest factors in the deterioration of stored medications, especially tablets and capsules. The medicine cabinet in the bathroom is actually the worst place to store medication because of the high heat and humidity. A cool, dark, and dry location such as a top dresser drawer or a high shelf in a closet is preferred.

Keeping them out of the reach of children is of utmost importance. Of equal importance is to keep controlled drugs, especially narcotics, in a locked and secure location. Do not store medication in the glove box of your car, as the intense summer heat will cause rapid deterioration.

What actually happens to medication beyond its expiration date? In almost all cases, the drug loses its potency but does not become dangerous or toxic. One notable exception to this rule is common aspirin, which breaks down to form acetic acid (vinegar) and salicylic acid, which are stomach irritants.

Regardless of the expiration date, if at any time you open a medication container and it either looks or smells different from how you remember it, either dispose of it properly or have your pharmacist check it for you.

Editor’s note: This is the first of a three-part series on managing medication. Future columns in this series will cover drug interaction with other drugs and alcohol, tips on traveling with your medication and proper disposal of unused drugs.

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Acute cystitis is the medical term for a bladder infection, most often caused by a bacterial infection. This is the most common cause of what is generally known as a urinary tract infection.

It affects up to 10 million Americans a year, mostly women. About 40 percent of women at some time during their life will have a bladder infection, and many will have multiple episodes.

Risk factors include:

  • Being a woman: This is the most common risk factor, because the female urethra (the tube that connects the bladder to the outside of the body) is very short, allowing germs an easier entrance to the bladder.
  • Sexual activity.
  • Use of a diaphragm.
  • Personal hygiene.

Symptoms include:

  • A burning sensation when urinating.
  • Frequent urination, often of small amounts.
  • A very strong urge to urinate.
  • Blood in the urine, (scary but not necessarily serious.)
  • Urine that has a strong odor or is cloudy.

If you experience any of the above symptoms, regardless of your gender, see your doctor, who will most likely examine you as well as your urine. If you do have an infection, your doctor will prescribe an appropriate antibiotic.

If deemed necessary, a sample of your urine may be sent to a laboratory, where it will be further tested to identify the type of germ to determine which antibiotics would work best.

The most common bacteria identified is E. coli, which is commonly found in the human intestine. There are at least a half-dozen antibiotics that are commonly prescribed for this.

Fortunately, in most cases of acute cystitis only three days of treatment are necessary. You may also be prescribed a medication called phenazopyridine, which quickly improves the symptoms of a bladder infection. This is helpful for the discomfort before the antibiotic “kicks in.”

This drug Uristat can now be purchased over the counter and can be useful for treating your symptoms before you see the doctor. Be aware that it will turn your urine a dark orange color.

Many people believe that drinking cranberry juice will help cure a bladder infection. Cranberry juice does not help treat an active infection. It only helps prevent infections in those who get them frequently. There is a chemical in cranberry juice that prevents bacteria from attaching to the inner wall of the bladder, which will prevent the infection from beginning.

Those who rely on cranberry juice to treat an infection are only delaying proper treatment with an antibiotic. If a bladder infection goes untreated, it could worsen and even spread to the kidneys, causing a more serious kidney infection.

Steps to infection prevention:

  • Drink enough liquids to flush the bacteria out of the bladder. Drink more than you feel you really need to.
  • Avoid a full bladder, and empty the bladder whenever the urge is present.
  • Practice good hygiene. “Wipe from front to back,” and wash the skin around the genital area daily.
  • Change sanitary pads and tampons frequently.
  • Avoid bubble baths, which can irritate the urethra and mimic an infection.

Fortunately, bladder infections are not usually serious if recognized and treated in time.

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Doctors are seeing an increased number of patients with symptoms of respiratory infections such as common colds, bronchitis, sinusitis, ear infections and sore throats. I would like to review some important points regarding these common infections, along with their recommended treatments.

Everyone has, at one time or another, experienced a common cold that carried symptoms such as nasal and sinus congestion, a runny nose, a mild sore throat and cough. This common infection may last from a few days to one to two weeks. It is always caused by a virus — therefore patience, not antibiotics, is the main treatment.

Bronchitis can be thought of as any cough that is not caused by pneumonia or asthma. The main symptom of bronchitis is a cough without a fever. People with bronchitis usually just have a cough and do not feel particularly sick and are able to continue their normal daily activities. One can expect coughing from bronchitis to last from one to three weeks.

Again, this is a viral infection, and antibiotics are not necessary. If a cough lasts more than several weeks or is associated with fever, it would be wise to visit your doctor.

Sinusitis is an infection of the sinuses, which are air-filled pockets around the nose in the skull. This infection is usually preceded by a common cold. It, too, is usually caused by a virus, but after lingering for one to two weeks can turn into a bacterial infection.

One of the key factors in determining the proper treatment for a sinus infection is the duration of the symptoms. If you’ve had a cold for one to two weeks and are experiencing pain or pressure in your sinuses along with yellow or green nasal mucus and perhaps a fever, then antibiotics may be helpful.

A sore throat is often a symptom of a cold, but can sometimes be a bacterial strep throat infection. A good rule of thumb is that if a sore throat is associated with a bad head cold, and especially with a cough, it is usually caused by a virus and needs no prescribed treatment.

If, however, one has a sore throat without cold symptoms or cough but with a fever and a past history of strep infections, then the most likely culprit is the strep germ, which needs to be treated with antibiotics. Strep is much more common in children than in adults. Many people go through life without a single strep infection.

Over-the-counter medications for adults can be helpful in alleviating the miserable symptoms of respiratory infections. The following are the basic ingredients of all the myriad combinations of cold and flu drugs found on pharmacy shelves:

  • Acetaminophen (Tylenol) or ibuprofen (Advil) may be used to reduce fever and to ease aches and pains.
  • Pseudoephridine (Sudafed) is a decongestant to help relieve nasal and ear congestion.
  • Guaifenesin (Robitussin or Mucinex) is an expectorant to help loosen mucus. (Dinking lots of liquids may work just as well.)
  • Dextromethorphan is a cough suppressant, which might help ease a persistent cough.
  • One may purchase a sinus rinsing system called Neil Med, which can be found at all pharmacies. This is a natural treatment using a salt-based solution to flush out the sinuses, helping clear out mucus. I have found this to be one of the very best treatments for bad colds and sinus infections.

See your doctor if you have a fever for more than three or four days, or if your fever is 103 degrees Fahrenheit or higher. Your doctor will determine whether antibiotics are necessary to treat you. At the very least, your doctor may prescribe medication that will help treat your symptoms and make you feel more comfortable.

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