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May 20, 2003 Research Update |
James Bogash, D.C. Mesa, AZ
info@lifecarechiro.com
www.lifecarechiro.com
Dietary (n-3)/(n-6) Fatty Acid Ratio: Possible Relationship to Premenopausal Breast Cancer Risk
Many researchers believe that the healthiest ratio of omega-3 to omega-6 fatty acids is one to one, one to two (twice as many omega-6) at the most. Traditional standard American diet (read: SAD) is closer to 1 to 20 (twenty times omega-6) which leads to a pro-inflammatory profile of cytokines. This will lead to increased inflammation, and since inflammation has been tied to just about every chronic disease known to man, the results of this study are not a surprise. nutrition.org -- Abstracts: Goodstine et al. 133 (5): 1409
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Dietary fibre and colorectal adenoma
Research came out a little over a year ago that stated that fiber did not protect against colon cancer. These findings were pretty well publized in local news. Unfortunately, the study did not take into account the difference between soluble and insoluble fiber and the interaction between soluble fiber and probiotics. Health intestinal flora digests the soluble fiber to produce short chain fatty acids such as butyrate which are the preferred fuel source for cells of the colon. While this study still does not differentiate these other factors, it is nice to see a protective association. Strangely, this finding got no press at all that I heard. The Journal : Current Issue
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Return of Haemophilus influenzae type b infections
It still amazes me how blindly the vast majority hop in line for vaccinations regardless or type or need. Everyone assumes that vaccinations are completely safe, and, furthermore, fully effective. Here the author suggests that the use of HIB vaccines may be setting the stage for more severe and frequent outbreaks in the future. The Journal : Current Issue
Efficacy of intra-articular sodium hyaluronate in knee osteoarthritis
I still believe that this type of therapy and also future advances in cartilage transplants do hold strong hopes for the future of many advanced cases of OA. Patients in my office who have had the procedure done have had mixed results. I do think that advances in the makeup of the injection will lead to better results in the future. Hyaluronic acid the water-holding component of cartilage that keeps it springy and resilant. SpringerLink: Clinical Rheumatology - Abstract Volume 22 Issue 2 (2003) pp 112-117
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SpringerLink: Clinical Rheumatology - Abstract Volume 22 Issue 2 (2003) pp 118-122
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Semiquinone radical intermediate in catecholic estrogen-mediated cytotoxicity and mutagenesis: Chemoprevention strategies with antioxidants
Had to leave the long title for effect... I know this goes into some heavy biochemistry, but the take home message is this... A woman (and a man to a lessor degree) are at risk from the breakdown of her of estrogens. These are not benign compounds that do only good things. Their breakdown, if unfavorable, can strongly increase risk of DNA damage and several types of cancer. This article shows that this risk can be lowered with antioxidants and diets high in fruits and veggies. Cruciferous veggies, additionally, will favorably effect the breakdown of estrogens so that protecting against DNA damage is not even an issue. PNAS -- Abstracts: Samuni et al. 100 (9): 5390
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Impaired Nighttime Sleep in Healthy Old vs Young Adults Associated w/ Elevated IL-6 and Cortisol Levels
Wow!! The implications of this study are quite exciting. Basically, a marker of inflammation (interleukin-6) and cortisol levels (the body's stress hormone) are associated with poor sleep quality and duration. This article does not differentiate whether the lack of sleep causes elevated values (which we already know that lack of sleep is a stress to the body and produces stress hormones), or whether the elevated levels interfere with sleep. Knowing the human body, it's probably both. An important clinical note here--this article would strongly work against the common usage of valium derivatives to help patients sleep. Based on this article, any patient with problems sleeping needs to be fully evaluated for cortisol levels (best done with saliva) and markers of inflammation and treated appropriately. JCEM -- Abstracts: Vgontzas et al. 88 (5): 2087
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Valproic acid, valproate and divalproex in maintenance treatment of bipolar disorder
This is a review done by the Cochrane Collaboration, a group I would NOT want to argue with about their conclusions. Basically, the new "major psychoactive drug of the week" has very little evidence behind its increasing use. But hey, just because it is not as effective and costs multiples more with much more severe side effects (you know...weight gain, death from liver failure...) does not mean we shouldn't use it... Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder (Cochrane Review)
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Food hypersensitivity: association with atopic diseases
I still feel that food allergy is a very commonly overlooked contribution to chronic diseases. Here we see further report for this contribution with dairy being second on the list (kiwi #1). One thing I find interesting is that milk allergy was almost twice as common as peanut, and yet peanut allergy is always getting lots of press and warnings are seen on all types of labels. Although there is the danger of anaphylactic shock from peanuts, the chronic contribution of dairy allergy to disease is still a foreign concept to most clinicians.
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Latest HERS Report Links HRT to Increased Risk for Urinary Incontinence
I'm starting to think that maybe I'll try this stuff!! Increases risk of heart disease and breast cancer, doesn't improve quality of life, most commonly derived from horse urine and now we find that it increases risk of urinary incontinence!! Who wouldn't want all these "benefits" I'm scratching my head trying to figure out why this stuff is still on the market, and, even more unbelievably is still in demand. I would think market forces would have driven this product into oblivion by now, but not so...
ACOG 51st Annual Clinical Meeting: Abstract 10S. Presented April 29, 2003 Women with a history of cardiovascular disease (CVD) who take estrogen plus progestin may have a significantly higher rate of urinary incontinence than women who don't take the hormones, according to the latest analysis from the Heart and Estrogen/Progestin Replacement Study (HERS) investigators."And the risk increases with length of treatment, so women taking estrogen for five years have a five-fold increase in risk while women taking it for a year double the risk," said Jody Steinauer, MD, a research fellow at the University of California in San Francisco. Dr. Steinauer presented the study results here at the 51st annual meeting of the American College of Obstetricians and Gynecologists. She said that 48% and 54% of the women who took daily estrogen plus progestin developed urge incontinence and stress incontinence, respectively. Only 36% of women taking placebo developed urge incontinence and 38% developed stress incontinence.The study also gauged the risk for increasing severity of incontinence as judged by numbers of episodes of leaking in a week. Here, too, hormone use was associated with a worsening situation; women in the active therapy arm were twice as likely to have an increase in numbers of leaking events compared with women in the placebo arm.The results are based on information collected from 1,208 women who had no symptoms of either stress or urge urinary incontinence at baseline. All of the women in the study had a history of CVD and the average age of the women was 66 years. Women were asked to fill out continence questionnaires at study entry, four months into the study, and again at one year, two years, and four years. The women were randomized in a 1:1 manner to either 0.625 mg of conjugated estrogens plus 2.5 mg of medroxyprogesterone acetate daily or to placebo.Dr. Steinauer said she is not sure why estrogen increases the risk for incontinence but she noted that estrogen does make tissue "more supple and it may be that making it more supple may also make it more relaxed, which decreases bladder control." Or, since the women have CVD, she said "there may be some vascular component in these women that influences the effect of estrogen on incontinence risk." At one time researchers thought that estrogen could "be used to treat incontinence. This is understandable since there is such a wide network of estrogen receptors in the bladder and throughout the urinary tract. But earlier treatment studies reported no advantage," she said. Gerald Joseph, MD, medical director of women's services at St. John's Health System in Springfield, Missouri, told Medscape that he is not surprised by this finding. He noted that many surgeons direct women undergoing pelvic reconstructive surgery to use estrogen to promote healing but he said that he has never seen any clinical evidence of benefit.These latest data should be considered in the context of the entire estrogen picture, Isaac Schiff, MD, chief of Vincent Memorial Hospital, Obstetrics and Gynecology Service, and the Women's Care Division of Massachusetts General Hospital in Boston, told Medscape. "The final sentence has not yet been written." He noted, for example, that there "is some suggestion that estrogen may be useful for treating women with recurrent urinary tract infections." Dr.Schiff, who, like Dr. Joseph, was not a HERS investigator, presented a perspective on the history of hormone replacement therapy for the Irving Cushner Memorial Lecture at the meeting.Dr. Schiff is not alone in his willingness to follow estrogen to the end of the story — Dr. Steinauer takes a similar approach. She told Medscape that despite the study results, she still prescribes estrogen for women who have "debilitating hot flashes. Hands down, estrogen is still the best treatment for those symptoms."