***Right-to-left shunt and migraine: the strength of the relationship***
This one has been a hot topic with the cardiologists lately. A whole new set of patients to perform procedures on. However, I do not feel that we have all the questions answered yet. Here is the scenario...it was found that a large number of patients in whom the opening between the right and left ventricles in the heart had never closed (in the fetus, the lungs aren't used so the blood bypasses the lungs via this hole) had migraine headaches. In some cases, these headaches resolved when the hole was surgically closed. So here's some additional thoughts/concerns. We have seen studies linking oxidative stress during pregnancy to increased congenital heart defects. We know a large chunk of the cause of migraine is oxidative stress mediated. Is the oxidative stress causing the migraines merely a continuation of the oxidative stress induced by poor nutrition during pregnancy? Or is the effect more current, and blood missing the lungs makes it up to the brain poorly oxygenated and leads to oxidative stress causing migraines? Could antioxidants fix the problem instead of surgery? Still quite a few questions to be answered...
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***The postdrome of the acute migraine attack***
Given that the topic of seizures is near and dear to me, this one caught my eye. It is well known that after a seizure (the post ictal period) these same symptoms described in this study are seen. And we know that the post ictal period after a seizure is caused by massive levels of oxidative damage. So, this furthers the idea of an oxidative stress model of migraines.
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***Seizure-induced changes in mitochondrial redox status***
And, just in case you thought I was making up that post ictal oxidative stress crap..
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***Nutritional Assessment and Counseling for Prevention and Treatment of Cardiovascular Disease***
This is a pretty strong article pushing for the increased dietary interventions needed to be done by PCPs. A very simple, easy to understand review. Now if only PCPs would actually read it...
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***The Availability and Cost of Healthier Food Alternatives***
This is an interesting study to identify the difference in cost between a healthier shopping trip and the "standard American diet" shopping trip. While the health trip was more expensive by $18 per week (really not that bad...), they did not take into account the proliferation of healthier food markets like Trader Joes', Sunflower, Henry's and Sprouts which have healtier food items at even more comparible costs to the larger, chain supermarkets.
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***Seasonality of birth in Epilepsy: A Southern Hemisphere study***
Would anyone like to place a bet that vitamin D exposure during the 3rd trimester is the reason people born during the spring and fall have lower rates of epilepsy? Talk about far reaching effects in time. And consider this in light of the fear we have induced for sunlight exposure. So, if the mechanisms between migraine and seizure are similiar, would the same increase in migraine sufferers be found in those born in the winter and summer?
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***Dose-response relation between sulfonylurea drugs and mortality in type 2 diabetes mellitus***
Ok. Let me get this straight. One of the drugs that used to be a mainstay for diabetic treamtent, the sulfonylureas (such as glucotrol) actually more than doubled the risk of dying? That sounds much safer than lifestyle changes. Can't quite figure out why this class is still on the market. It's also well known to ultimately destroy the beta cells of the pancreas (the cells that produce insulin), pretty much ensuring that patients on this drug would ultimately be on insulin.
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***Safety of St. John's Wort extract compared to synthetic antidepressants***
Funny, when research suggested that St John's Wort interfered with cardiac medication, it was all over the news (incidently, EVERY antidepressant interferes with cardiac medication!!). As hard as I tried, I couldn't find this one on any of the news broadcasts. I hate to think in consipracies, but sometimes it's just darn hard not to be cynical.
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***Temporal Trends in the Utilization of Diagnostic Testing and Treatments for Cardiovascular Disease in the United States, 1993-2001***
Talk about a clinician's dream. Increased procedures that they can get paid for, but these procedures do not change the need for the really high dollar procedures done later. So, despite all the new interventional cardiac procedures, we are not seeing much of a change in cardiovascular disease rates, nor a decrease in open heart surgeries. Who needs prevention with all this money?
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***Effect of Intensive Versus Standard Lipid-Lowering Treatment With Atorvastatin on the Progression of Calcified Coronary Atherosclerosis Over 12 Months***
And, while you're undergoing one of those new, expensive procedures, you can ask your doctor to up your level of statin drugs. In won't slow the progression of coronary artery calcification at the higher level, but at least the drug companies will make some more money. I ask again..who needs prevention? level, but at least the drug companies will make some more money. I ask again..who needs prevention?
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Dr. James Bogash, D.C.
1830 S. Alma School Rd, Bldg 7, Ste 135, Mesa, AZ 85210
(Alma School Road, just south of the Superstition Freeway/Highway 60)
Chiropractic Health Care for Chandler, Mesa and Tempe Arizona
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