Monday, October 31, 2016

For Overheated Viewers of Presidential Race

The bitter U.S. presidential race has led to heated arguments among many Americans. But there are ways to lower the tension and prevent spirited discussions about Donald Trump and Hillary Clinton from getting too hostile, psychologists say.

“De-escalate when arguments get too personal,” said Emanuel Maidenberg, a clinical professor of psychiatry and biobehavioral sciences at the University of California, Los Angeles.

“The purpose of many discussions around politics is to express and exchange points of view – not to win. Be the first to de-escalate,” he said in a university news release.

The American Psychological Association reported last week that more than half of U.S. adults felt very or somewhat stressed by the vitriolic campaigns. Those results stemmed from an August poll – conducted well before disturbing recent reports of hacked Clinton State Department emails and sexual misconduct accusations against Trump.

Even if you fervently support one candidate, it’s important to question others about their views, Maidenberg said.

“It can be difficult to show understanding when you strongly disagree with a friend’s view, especially if it upsets your sense of right and wrong. But asking questions about why they feel that way – rather than attacking – is worth the effort,” Maidenberg said.

You need to remember that political views are only a small part of what makes a person who they are. Also, limit your exposure to political coverage in the media. “There’s a difference between being informed and being overwhelmed,” Maidenberg said.

Also, take time to consider the implications before you share your political views on Facebook or Twitter, he suggested.

Friday, October 28, 2016

Monitoring, Not Treatment, May Be Better for Some Prostate Cancer Patients

More than 90% of men in Sweden who have very low-risk prostate cancer choose close monitoring rather than immediate treatment – and more American men should use that option, researchers say.

In a study of nearly 33,000 Swedish men with very low-risk (stage T1) prostate cancer diagnosed between 2009 and 2014, the number choosing what is called active surveillance increased from 57 to 91%.

“For men who are diagnosed with low-risk prostate cancer, it is important to know that active surveillance is an accepted way to manage the cancer,” said lead researcher Dr. Stacy Loeb. She’s an assistant professor in the departments of urology and population health at NYU Langone’s Perlmutter Cancer Center in New York City.

“There is no rush to get treatment – low-risk prostate cancer can be safely monitored,” she added. “Some men will eventually need treatment, but others will be able to preserve their quality of life for many years.”

In the United States, the majority of men with low-risk prostate cancer get treatment upfront, which can have side effects, such as urinary and erectile problems, Loeb said.

Active surveillance isn’t wait-and-see, she explained. It involves regular blood tests and regular biopsies to gauge the growth of the tumor. When the tumor grows to a point where treatment is needed, then it’s time for curative surgery or radiation.

The report was published online Oct. 20 in the journal JAMA Oncology.

A recent British trail showed that 10 years after diagnosis, the risk of dying from prostate cancer was the same whether men initially had surgery or radiation or opted for monitoring, Loeb added.

Wednesday, October 26, 2016

Wisdom Wednesday: ‘Entitled” People May Be Pursuing an Unhappy Path


“Entitlement is a broad construct, but basically it refers to a desire to get something for nothing,” explained study lead author Joshua Grubbs, assistant professor of psychology at Bowling Green State University in Ohio.

According to Grubbs, entitlement is a personality trait where a person has an exaggerated belief that he or she is vulnerable to disappointment. And when disappointment strikes, it can mean anger, blaming others, social strife, collapsed relationships and depression, Grubbs’ team said.

That’s because entitlement is “really an attitude of ‘deservingness’, without any consideration for earning those things you want,” said Grubbs, who conducted the review while a graduate student in psychology at Case Western Reserve University in Cleveland. “I often describe it as someone saying, ‘I exist, therefore I deserve whatever I want.’”

He said this outlook doesn’t necessarily hinge on wealth. “We observe it across cultures and economic status,” he added. But no matter its source, “entitlement has long been known to be associated with negative emotion and distress,” Grubbs said.

The review of the data uncovered a common three-step pattern of pressures and behavior that often plague entitled individuals.

  • There’s a burden of living with the constant threat of failed expectations.
  • Adversity tends to cause them to lean even more heavily on an inherent sense of superiority.
  • These behaviors just perpetuate the cycle of disappointment, unhappiness, frustration and social turmoil.

“Ambition, drive and high standards are not necessarily symptoms of entitlement at all,” he said. “You can want to be successful and have high standards for yourself while still being humble and grateful. Many of the world’s greatest, most-accomplished leaders have been truly humble people.”

Monday, October 24, 2016

Americans Are Changing Their Supplements of Choice

Traditional multivitamins are falling out of favor among Americans, while supplements such as vitamin D, fish oil and probiotics are gaining ground, a new study finds.

Researchers found that between 1999 and 2012, Americans’ overall use of supplements remained stable. Slightly more than half of adults said they took vitamins, minerals or some other type of dietary supplement. What’s changed are the products of choice.

Multivitamins and many individual vitamins and minerals are less popular, as are botanicals such as Echinacea, ginseng and garlic extracts, the investigators found.

On the other hand, more people are using vitamin D, omega-3 fatty acids and probiotics – “good” bacteria said to benefit the digestive system.

“I did expect to see that vitamin D use would go up, and that fish oil would go up,” said lead researcher Elizabeth Kantor, an epidemiologist at Memorial Sloan Kettering Cancer Center in New York City.

That’s because both have been the focus of a lot of research and media attention in recent years, Kantor pointed out.

Some studies, but not all, have suggested fish oil pills can curb the risk of heart attack and other cardiovascular trouble. And studies have hinted that vitamin D could be protective against a range of ills, from cancer to diabetes to multiple sclerosis – though clinical trials testing those ideas have yet to be finished.

The drop in multivitamin use was less expected, Kantor said. But it also makes sense, she added. During the study period, a number of studies questioned the value of multivitamins when it comes to preventing major health conditions.

Americans Are Changing Their Supplements of Choice

Traditional multivitamins are falling out of favor among Americans, while supplements such as vitamin D, fish oil and probiotics are gaining ground, a new study finds.

Researchers found that between 1999 and 2012, Americans’ overall use of supplements remained stable. Slightly more than half of adults said they took vitamins, minerals or some other type of dietary supplement. What’s changed are the products of choice.

Multivitamins and many individual vitamins and minerals are less popular, as are botanicals such as Echinacea, ginseng and garlic extracts, the investigators found.

On the other hand, more people are using vitamin D, omega-3 fatty acids and probiotics – “good” bacteria said to benefit the digestive system.

“I did expect to see that vitamin D use would go up, and that fish oil would go up,” said lead researcher Elizabeth Kantor, an epidemiologist at Memorial Sloan Kettering Cancer Center in New York City.

That’s because both have been the focus of a lot of research and media attention in recent years, Kantor pointed out.

Some studies, but not all, have suggested fish oil pills can curb the risk of heart attack and other cardiovascular trouble. And studies have hinted that vitamin D could be protective against a range of ills, from cancer to diabetes to multiple sclerosis – though clinical trials testing those ideas have yet to be finished.

Friday, October 21, 2016

The ‘Love Hormone’ May Quiet Tinnitus

People suffering from chronic ringing in the ears – called tinnitus – may find some relief by spraying the hormone oxytocin in their nose, a small initial study by Brazilian researchers suggests.

“Oxytocin has actions in the brain and the ear that may help in tinnitus treatment and provide immediate relief,” said lead researcher Dr. Andreia Azevedo. She is with the department of otolaryngology at the Universidale Federal de Sao Paulo. She speculated that it may regulate fluid in the inner ear, and a brain effect that may be related to the production of the neurotransmitter dopamine.

Although oxytocin appeared safe, its long-term effects aren’t known, Azevedo said. “We did not have any side effects, but further larger studies are necessary to establish the role of oxytocin in tinnitus treatment, she added.

As many as one in 10 Americans suffers from tinnitus. The disorder is characterized by hearing sounds when there are none. The sounds can be perceived as ringing, buzzing, crickets or hissing. For those who struggle with it daily, the noise is so bothersome that it interferes with thinking, emotions, hearing, sleep and concentration, according to a previously published study.

For the new study, the researchers randomly assigned 17 people with tinnitus, average age 63, to puffs of oxytocin or placebo (distilled water) in each nostril.

The study volunteers were asked to assess their symptoms 30 minutes after treatment, and then again, 24 hours later. Azevedo’s team found that patients who received oxytocin reported a significant reduction in tinnitus compared with those who received the placebo.

Wednesday, October 19, 2016

Wisdom Wednesday: Omega 3 Fatty Acids: DHA vs EPA


Chronic inflammation has been identified as a potential link between obesity and cardiovascular diseases. In people who are obese, fat cells release greater amounts of inflammatory and signaling molecules (adipokines) that induce insulin resistance, blood vessel dysfunction, and systemic inflammation, all of which increase the likelihood that an artery may become damaged. Once damaged, the artery will express proteins that attract white blood (immune) cells to the location to help with repair and recovery. These immune cells also begin secreting chemicals (cytokines) that signal more immune cells to come to their location.

Theoretically, the damage should resolve but that doesn’t happen because the chronic inflammation and dyslipidemia associated with obesity continually damages the arteries, never allowing them to fully repair. As the damage accelerates, LDL particles become trapped in the artery wall and become oxidized. Macrophages engulf the LDL particles creating “foam cells” and ultimately accumulate to form plague on the artery wall.

There is a growing body of literature suggesting that the omega-3 fatty acids EPA and DHA have the potential to reduce the inflammatory state associated with obesity. EPA and DHA serve as the precursor molecules from which anti-inflammatory compounds (resolvins, protectins and maresins) are synthesized. A recent meta-analysis of 68 randomized controlled trials showed that EPA and DHA supplementation significantly reduced several inflammatory molecules: tumor necrosis factor alpha, C-reactive protein and interleukin-6.

However, some studies used EPA and DHA in combination while others used only one of the fatty acids in isolation. A new double-blind, randomized placebo-controlled crossover study was recently published to try and differentiate the effects of these fatty acids. Men and women with abdominal obesity and low-grade inflammation consumed 2.7 grams of EPA, 2,7 grams of DHA, or three grams of corn oil for 10 weeks each. Inflammatory molecules, blood lipids, and body composition were assessed before and after each phase.

Compared to corn oil, DHA supplementation affected numerous inflammatory markers and blood lipids, including a significant reduction of CRP, whereas EPA was more limited in its effects.

Monday, October 17, 2016

Could Prescribed NSAID Painkillers Raise Heart Failure Risk?


Use of prescription-strength ibuprofen, naproxen and other commonly used pain relievers may be tied to a higher risk of heart failure, researchers report. These medications known as NSAIDs, may raise a person’s relative risk of heart failure by nearly 20%, according to the analysis of medical records.

The risk increases with the amount of NSAIDs a person is taking, said study author Andrea Arfe, a Ph.D. student at University of Milano-Bicocca, in Italy.

“Our findings – which focused only on prescription NSAIDs – might apply to over-the-counter NSAIDs as well,” Arfe said. “Although over-the-counter NSAIDs are typically used at lower doses and for shorter durations, they are sometimes available at the same doses as prescription NSAIDs and they may be inappropriately overused.

The findings were reported Sept. 28 in the BMJ.

According to the American Academy of Orthopaedic Surgeons (AAOS), NSAIDs decrease inflammation and pain by blocking an enzyme called cyclooxygenase. This enzyme comes in two forms, COX-1 and COX-2. COX-1 protects the stomach lining from digestive acids, while COX-2 is produced by injured or inflamed joints.

Traditional NSAIDs – like aspirin or ibuprofen – block the action of both COX-1 and COX-2, which is why some people suffer from stomach upset after taking them, the AAOS said. Newer NSAIDs like celecoxib (Celebrex) target only COX-2, and are referred to as COX-2 inhibitors.

“These drugs have been around for a long time, and they have important pain relief and anti-inflammatory properties, but they also have cardiovascular side effects,” said Dr. Christopher O’Connor, editor-in-chief of the cardiology journal JACC: Heart Failure. They have been shown to hold onto sodium, and there’s some reduction in kidney function.

Friday, October 14, 2016

U.S. Life Expectancy Lags Behind Other Wealthy Nations

The health of U.S. citizens is specifically challenged by smoking, diabetes, high blood pressure, drug abuse and gun violence, said study co-author Dr. Mohsen Naghavi. He’s a professor with the Institute of Health Metrics and Evaluation at the University of Washington in Seattle.

The United States isn’t meeting the high expectations set by the country’s wealth and the amount it spends on health care, mainly because not all U.S. citizens benefit equally from their nation’s advantages, Naghavi said.

“This comes from inequality in access to health care, along with other social and economic factors,” he said.

Infant mortality in the United States was six deaths out of every 1,000 kids younger than 5, while the average for all high-income nations combined was about five deaths per 1,000.

U.S. men and women also had poorer life expectancy, compared with the rest of the developed world.
These findings are part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2015, a scientific analysis of more than 300 diseases and injuries in 195 countries and territories.

The numbers show that the United States needs to rethink its approach to health care, said Dr. Prabhjot Singh. He is director of Mount Sinai’s Arnhold Institute for Global Health in New York City.

“We are investing in the wrong stuff, and we are paying for it with our lives,” Singh said.
Researchers found that drug abuse and diabetes are causing a disproportionate amount of ill health and early death in the United States, compared with other countries.

Wednesday, October 12, 2016

Wisdom Wednesday: Supplements: Pharmaceutical vs Whole Food


Recently a patient inquired about a supplement that I recommended for her. Is it pharmaceutical or natural? Although the question was valid, I realized immediately that her understanding of the terms was skewed. So let’s clear up some misconceptions.

A supplement that has all natural ingredients can be pharmaceutical quality. In fact, all the herbal supplements I recommend are pharmaceutical quality and all natural. As I have mentioned in numerous blogs, I purchase my herbs from Australia and by law, they are manufactured to pharmaceutical standards.

So what does that really mean? Medi-Herb sources the raw herbs from various growers throughout the world. Pre-shipment samples are tested in the lab for identification, validation (species, plant part), and efficacy (actives, phytochemical profile). Then chromatography is used to separate the phytochemicals in an herbal extract in individual components. High performance thin layer chromatography (HPTLC), ultra-high performance liquid chromatography (UHPLC), and gas chromatography (GC) are all used prior to mass spectrometry (MS). If the sample passes all these quality tests than an order for bulk purchase is placed. Once the bulk shipment arrives, samples are taken and the tests are repeated. When all aspects of quality control of the raw material are confirmed then manufacture begins. If not, the herb is sent back.

After manufacture through proprietary cold percolation, samples are again tested using all the same processes noted above. When all extract meets all criteria, it is bottled for sale. This creates an extract of the full spectrum of compounds of the herb without causing damage or degradation.

The result – an all-natural, pharmaceutical quality herbal extract.

Monday, October 10, 2016

Are There Alternatives to Statins?

Statins are the go-to therapy for lowering “bad” LDL cholesterol, but other treatments also can effectively reduce risk of future heart problems, a new evidence review reports.

These alternative therapies – including a heart-healthy diet, other cholesterol-lowering medications, and even intestinal bypass surgery – seem to confer the same level of heart health protection as statins when cholesterol levels decrease.

Nonstatin therapies reduced the risk of heart problems by 25% for each 1 millimole per liter decrease in LDL cholesterol levels. That’s very similar to the 23% reduction per 1 millimole per liter decrease seen with statins like atorvastatin (Lipitor) and simvastatin (Zocor), the researchers said.

What’s more, the benefits of these therapies stack up if more than one proves effective at lowering a person’s cholesterol levels, said senior researcher Dr. Marc Sabatine, a cardiologist at Brigham and Women’s Hospital in Boston.

“The focus really should be not on a particular drug, but on reducing LDL cholesterol,” Sabatine said. “These data show there are multiple interventions that can do that.”

Statins, which work by reducing the liver’s production of cholesterol, were taken by more than one-quarter of U.S. adults aged 40 and over during 2011-2012, according to a national survey.

A heart-heathy diet reduces the amount of LDL cholesterol you eat while increasing dietary components like fiber has been shown to help clear cholesterol from the bloodstream.

Zetia (ezetimibe), is a drug that blocks absorption of cholesterol in the digestive tract.

Friday, October 7, 2016

How Older People Can Head Off Dangerous Drug Interactions

Potentially serious drug interactions are a daily threat to older people who take multiple medications and supplements, according to the U.S. Food and Drug Administration.

One drug can affect the effectiveness of other drugs and how your body uses them. For example, your kidney and liver may not work as well, which affects how drugs are broken down and leave your body, the FDA said.

“There is no question that physiology changes as we age. Many chronic medical conditions don’t even appear until our later years,” Dr. Sandra Kweder, an FDA medical officer, said in an agency news release. “It’s not that people are falling to pieces; some changes are just part of the normal aging process.”

The FDA says these safety tips will help prevent harmful drug interactions or side effects:
  • Follow your doctor’s directions
  • Keep a medication list
  • Learn about possible drug interactions and side effects
  • Routinely go over your medication list with your doctor

“As a society, we have become reliant on pharmaceuticals to help us attain a longer and higher-quality life. It’s a wonderful success of Western medicine,” Kweder said. “The goal should be for each of us to access that benefit but respect that medicines are serious business. To get the most out of them, you should take them with great care and according to directions.”

Wednesday, October 5, 2016

Wisdom Wednesday: Five Tips to Protect Yourself from the Seasonal Flu


Experts say an annual flu shot is the best way to avoid the aches, fever, congestion and fatigue that flu brings – and to protect those who are at high risk for flu-related complications.

“Every year, people die from influenza,” said Cindy Weston, an assistant professor of nursing at Texas A&M University. “After sizable outbreaks, people will respond with large amounts of vaccinations, but they should be getting vaccinated every year to protect those most vulnerable, mainly children and the elderly.”

The U.S. Centers for Disease Control and Prevention recommends an annual flu shot for everyone older than 6 months of age. This includes pregnant women.

“The flu strain mutates every year,” she explained. “The flu shot you get this year is different from the one you got last year because it is made specifically for the prominent strains of the virus.”

If vaccination rates are low, a potentially deadly flu outbreak could occur, Weston said. Millions of people get the flu every year, leading to hundreds of thousands of hospitalizations and thousands of deaths, according to the CDC.

“Flu season typically lasts from fall to spring,” Weston said. “The outbreak may peak at various times during those seasons, but people should be vaccinated before they return home for the holidays to prevent an outbreak.”

After you get the shot, it takes two weeks for your body to develop antibodies against the virus, Weston pointed out.

Monday, October 3, 2016

Smart City Planning Can Cut Deadly Diseases, Improve Air Quality

Cities that promote walking, bicycling and public transportation can expect a drop in chronic illnesses such as heart disease and diabetes, a new study suggests.

The findings stem from an international study led by the University of Melbourne in Australia and the University of California, San Diego (UCSD).

The goal: To see how city design – including street layout and access to shopping within walking distance – affects the environment and health in places like Boston; Copenhagen; Delhi, India, London and Sao Paulo, Brazil.

Team members reported their findings Friday during a meeting at the U.N. General Assembly. The findings were also reported in the latest issue of The Lancet.

“With the world’s population estimated to reach 10 billion people by 2050, and three quarters of this population living in cities, city planning must be part of a comprehensive solution to tackling adverse health outcomes,” report co-author Billie Giles-Corti said in a Lancet news release. Giles-Corti is lead investigator at the NHMRC Center for Research Excellence in Healthy Livable Communities at the University of Melbourne.

In the 19th century, she said, city planning helped curb outbreaks of infectious disease through improvement in sanitation, housing and efforts to separate housing and industrial areas.

“Today, there is a real opportunity for city planning to reduce non-communicable diseases and road trauma, and to promote health and well-being more broadly,” Giles-Corti added.

The researchers used computer models to study several factors that could affect a city’s quality of life. Among them: how far people must travel to shop; availability and safety of bike paths; parking costs; and access to public transportation.