26 February 2011

Zinc May Stop or Shorten the Common Cold

This is one area that I have to wonder where science has been. I have used zinc lozenges for years, 40 plus, and it has always either shortened or alleviated my cold. The problem with even this, they have not determined the correct dosage or even a dosage range for this to be effective. Therefore, I would have to say these studies are just bad science with little redeeming value. They have again gone for sensationalism and not medical accuracy.

Zinc is an essential nutrient needed by the body, but many people think because it can help the common cold, more is better. Wrong, wrong, and definitely in error. Over dosing is toxic and causes damage to the nervous system. When ever I would get the start of a sore throat or other beginnings of a cold I would start sucking on zinc lozenges of 15 mg. Sometimes, I have no doubt, I took too large a dose in a 24 hour time frame, but I always stopped using them when I knew that the cold was not getting worse.

I know from personal experience that this does what they are claiming, but until they can use good science and determine proper dosages, or dosage ranges or establish the level at which toxic damage occurs, this will continue to be misused, abused, and people will damage their bodies.

Two statements that I found that are good to heed are “experts stress that more research is needed before the most effective kind of zinc can be determined, and they caution that in high doses -- more than 40 milligrams per day -- zinc can cause dizziness, headache, drowsiness, increased sweating, loss of muscle coordination, alcohol intolerance, hallucinations, and anemia.

They also warn against using zinc nasal sprays, which some reports suggest can cause loss of smell, or from using nasal swabs.”

So until research can tell us what is safe, I would strongly urge being cautious when taking zinc lozenges. Don't abuse it.

Read the articles – one in WebMd here, one from sciencedaily here, and another from BBC Health News here.

25 February 2011

Vaccination Checklist for Adults

This article appears to be centered and written for women, but men need to keep their vaccinations up-to-date as well. Even many doctors seem to forget about this and let their patients slide when it come to vaccinations.

I have been fortunate that I have kept mine up-to-date except in one area. The list is not complete, but in any case you should check with your doctor for vaccination information and update your shots. If you are traveling outside the US, you must have a current vaccination certificate for many countries. Check with the State Department for vaccinations required for the countries you plan to visit.

Adult vaccinations you may need.

Tetanus, diphtheria, pertussis (Td/Tdap): a booster is needed every 10 years.
Human papillomavirus (HPV): three-dose series given to females age 11-26
Varicella (chickenpox): two-dose series given to adults with no evidence of immunity to the chickenpox virus.
Zoster (shingles): one-dose vaccine for adults 60 and older.
Measles, mumps, rubella (MMR): one or more doses given to adults with no evidence of immunity.
Influenza (flu): yearly vaccination given to adults 50 and older.
Pneumococcal: given to adults 65 and older. A one-time booster is given five years later.
Hepatitis A: two-dose series given to adults.
Hepatitis B: three-dose series given to adults.
Meningococcal: one or more doses given to adults.
Other vaccinations: Travelers to some parts of the world or people with professions that bring them into contact with animals might need other vaccines.

Please read this article for further information and details. I must emphasize consulting with your doctor for other vaccinations depending on the countries you will be visiting. You can be stopped and not allowed entry if your vaccinations are not up-to-date. In these cases you can be put on a flight back to the US and you will have no recourse.

24 February 2011

Another Reason for Talking to Your Doctor

There is a growing epidemic in this country and it is on two fronts. Many people are not talking to their doctors. And at the same time doctors are not talking to their patients. These are not what I am referring to, but are part of the epidemic.

Medical situations arise every day and people think they can handle them without talking to their doctor. A brief article the other day made a excellent point about the need to talk to your doctor. Some people will disagree with what I am going to say, but they are the ones that will end up in the emergency room and the hospital or even the local mortuary. Yes, it is that serious.

When people come down with the common cold or also develop problems with mucus plugging their nose, they head for the nearest store or pharmacy to get a decongestant. If you are healthy and have no known medical problems, chances are that no damage will be done.

But if you have any of the following health conditions, doing this is not advisable. These health conditions are heart problems or high blood pressure, glaucoma, thyroid problems, diabetes, or prostrate problems. With these conditions, it is wise to consult with your doctor. Most over-the-counter products like decongestants are clearly labeled with a warning for high blood pressure but little else. Some do say they will raise blood glucose levels.

Most people will demand privacy and other grounds for avoiding what I am proposing, but after seeing a friend in the hospital last week for just the above situation, I think for the sake of safety, all over-the-counter drugs that require a warning, should only be available through a pharmacy and be kept behind the counter requiring either a prescription if they have health problems or must be handed out by the pharmacist.

This may be an unnecessary burden on doctors and pharmacists, but in this day with computers, this should be workable. Some patients will go to extreme measures to avoid this happening and shop pharmacies to avoid the need for a prescription. They will do anything to step around the system. The dangers of doing this are there and people still want to ignore them.

This is the reason that I only have two pharmacies and and all my doctors know which ones to deal with. If I am looking for an over-the-counter medicine, I talk with the pharmacist after I have read the label. Often the pharmacist suggests another product that does not have the dangers. Occasionally I am told to not take any and go to the doctor. I respect the pharmacist for this and this is one reason you do not want many pharmacists to deal with.

I find that these relationships work for my better health care and as a result, the doctors are more confident in what I do. Plus the pharmacist is more willing to answer questions and even supplies me with additional information when it is felt that it will be of value.

Read the very brief article here.

23 February 2011

More on Islet Cell Transplantation

More science is being put into islet cell transplantation and effective ways of accomplishing this. This may be an answer for Type 1 diabetes although not the cure yet. Researchers in Italy are relooking at the roll of bone marrow stem cells in diabetic therapy and islet cell regeneration. Canadian researchers are offering improved strategies to optimize pancreatic islet culture in vitro.

Italy's science is still a ways from completion, but may in the future offer some possibilities. They have started a clinical trial aimed at expanding on the idea that bone marrow may hold some possibilities as the ideal micro-environment for islet survival.

Canadian researchers have a need to find a method of ensuring the integrity of islet cells that have been harvested from nonliving donors. This is a successful practice in Canada, but there has been problems with cell integrity. Researchers report that nearly half of the islet mass is lost during donor surgery, preservation, transport, and isolation. This means that patients undergo a second islet infusion.

The researchers are looking for means of improving post-isolation culture for up to two months duration. This requires a better understanding of islet biology. The researchers recommend combining many strategies supporting understanding of the need to maintain islet structural integrity and to provide a viable environment for islet preservation.

Some of these strategies include manipulation of the culture media, surface modified substrates, and the use of various techniques, such as encapsulation, embedding, scaffold and bio-reactor approaches. The survival of islets after isolation remains a significant limiting factor in the field of islet transplantation.

Read the article here. The Italian study is here and the Canadian study is here. These are at present the full text of the studies and you may access the full text in the format you desire from the links.

22 February 2011

New Device Will Assist Blood Pressure Monitoring

This is a device long over due and may indeed be the device of the future that is so desperately needed. In all the times I have had my blood pressure taken, I have seldom had it done correctly. Most of the time before it is supposed to be taken, you are to be at rest for five minutes. Most nurses and others are in a hurry and take it as soon as you are seated.

The only time this would be correct is if they are measuring blood pressure increase and decrease in a stress test or another medical procedure. That is why this device may become so important. Researchers at the University of Leicester and in Singapore have developed a device that measures pressure in the largest artery in the body and it is proving to be more accurate that the arm cuff.

The device works by a sensor in the watch recording the pulse wave of the artery, which is then fed into a computer together with a traditional blood pressure reading from a cuff. Physicians will then be able to read the pressure close to the heart, from the aorta. The researchers rightly believe that unless the measurement is from the aorta, doctors are not getting an appreciation of the risks or benefits of a treatment.

The device is expected to be used in specialist centers soon and then widely within fife years. The issue that has me wondering is when will this device become available for use in the U.S., at what level, and for what type(s) of patients.

The University of Leicester collaborated with the Singapore-based medical device company HealthSTATS International. The study will result in a very significant worldwide impact, empowering doctors and their patients to monitor central aortic systolic pressure, even in their homes. This will allow for changing the course of treatment.

Read the article here.

21 February 2011

ACP Discourages Intensive Insulin Therapy

The American College of Physicians (ACP) may be doing a good thing. The new clinical guideline for glycemic control in hospitalized patients does not want the use of intensive insulin therapy. What they are trying to stop is the errors in insulin dosage which causes many cases of severe hypoglycemia.

The hypoglycemia is because many doctors and most nurses are not familiar with insulin and its proper use. They have fixed and inflexible ideas about proper dosage and often do not check that they are using the correct syringes or even the correct insulin. Most people attending in ICUs do not know how to count carbohydrates, or account for IV solutions, and match insulin requirements. And it seems no amount of training affects their decisions.

I do have to wonder why the guideline is set so high. They recommend a blood glucose level of 7.8 to 11.1 mmol/L. This equates to 140 to 200 mg/dl. I do question why there is nothing mentioned about allowing patients monitoring their own insulin use once they are able to communicate and/or capable of care. Oh, I forgot, this is the ICU and we are not able to make decisions while in this setting and our advocates are to keep their place.

Surprise! The American Diabetes Association and the American Association of Clinical Endocrinologists are not totally in agreement. The ADA spokesperson said that the new guideline is basically consistent with the ADA recommendations. The upper limit is higher that the 180 mg/dl recommended as this is the point at which the kidneys start to spill glucose. Patients could become dehydrated above this level.

The ACP guideline is expected to be for everyone, diabetes specialists, hospitalists, critical care specialists, and primary care providers. The ADA spokesperson also stated that some may still want to use the lower range of the ADA recommendations of 110 to 140 mg/dl.

Several noted that the ACP guideline applies only to patients in the ICU and that they were concerned about what the goals should be for non-ICU patients. Also of concern is developing better systems to prevent hypoglycemia.

Read the article here and an article by the ADA and AACE here.

20 February 2011

Why are Bariatric Docs Disappointed?

Apparently the Bariatric doctors are very upset with the latest FDA action. This is the third drug the FDA has turned down in the last year.

One doctor has taken his displeasure to the extreme. It will be interesting to see if he remains on the FDA committee. He states quite bitterly - "I think it does send a very bad message to the drug companies who invested billions of dollars in the drugs and have tried to follow the rules the FDA laid out, and yet when they show up with the data they're rejected,"

Then he went on to say, "We also think it sends a very bad message to patients as well. It says, 'Don't expect any help from the FDA, and don't expect any new medicines, so you better go see the quacks in your neighborhood, because that's all you're going to get."

I am very happy that I do not know this doctor. His actions just reinforce why we are so distrustful of the FDA. We do need good doctors on the FDA committees and in other positions, but when they are overly vocal, maybe it is time for them to resign.

I am just thankful that the FDA has chosen to ask for more trials and data. This is their duty and too many drugs have been allowed that maybe never should have been allowed to pass.

Read the article here.