August 17, 2000 Research Update

Approach to Upper Respiratory Tract Infection Care for This Century

This is an interesting article delving into why antibiotics are still used for URT infections despite the evidence suggesting that there are no benefits. Pay careful attention to the line where the author suggests that many doctors continue to prescribe antibiotics for a condition they know it will not benefit because it won't harm. The author (and myself included) suggest that the use is harmful. The Family Physician's Reasonable Approach to Upper Respiratory Tract Infection Care for This Century http://archfami.ama-assn.org/issues/v9n7/full/fed0001.html

Effectiveness of an Intervention Program in the Prevention of Asthma

This is one of those rare articles in the mainstream medical journals that makes some very rational suggestions for preventing the onset of asthma in infants. Now, add to their recommendations the avoidance of common allergens such as milk and corn and the addition of probiotics to keep the immune system in balance, and I think the results of this study would be even more positive. A Randomized Controlled Study on the Effectiveness of a Multifaceted Intervention Program in the Primary Prevention of Asthm http://archpedi.ama-assn.org/issues/v154n7/abs/poa90318.html

Vit E May Reduce Cardiovascular Disease in Type 2 Diabetics

I stongly recommend 800 IU of vitamin E daily to all my patients. This is such a simple and safe addition, and yet the benefit list of vitamin E keeps getting longer and longer.

Circulation 2000:102:191-196 Supplemental alpha-tocopherol (AT) given to type 2 diabetic patients decreases monocyte activity and soluble cell adhesion molecules, thereby possibly reducing the risk of macrovascular disease in this group, according to researchers from the University of Texas Southwestern Medical Center at Dallas. "There are two main findings," Dr. Jialal told Reuters Health. One, he said, is that this study is the first demonstration that there is increased inflammation in diabetes, whether patients have heart disease or not. "This was manifested by the monocyte plaque formation and the production of more superoxide, more cytokines and messenger molecules which bound to the endothelium," he explained. "The second important finding, which is totally novel," Dr. Jialal said, "is that when we gave the subjects vitamin E there was a substantial reduction in the monocyte function. Obviously we showed an antioxidant effect, as we have shown in other studies, but in addition, we showed that vitamin E, in high doses, is an anti-inflammatory agent."

Higher Estrogen Linked to Decreased Homocysteine

This may be one of the routes by which estrogen is known to lower risk of heart disease. Of course, supplementing with folic acid, Vit B12 and B6 will also lower levels of homocysteine WITHOUT increasing your risk of breast and endometrial cancer.

Am J Epidemiol 2000;152:140-148 Data from the Third National Health and nutrition Examination Survey (NHANES III) indicate that estrogen status is inversely related to total homocysteine concentration, a risk factor for vascular occlusion. "Perhaps supplementation with estrogen would be beneficial to women by lowering their homocysteine concentration and thereby lowering their risk of heart attack and stroke," Dr. Morris said. But, she cautioned, "this was a descriptive study, so one cannot draw clinical conclusions about the benefits of estrogen supplementation."

Coffee consumption and the risk of rheumatoid arthritis

This is a small study suggesting that coffee may be a risk factor for development of RA. Considering that coffee has many other effects that are not so friendly to the body, and that green tea has many documented health benefits, switching from coffee consumption to tea can have a large impact on overall health. Ann Rheum Dis -- Abstracts: Heliövaara et al. 59 (8): 631 http://ard.bmjjournals.com/cgi/content/abstract/59/8/631