Medical commentaries on controversial medical subjects by Dr. Carl Sarnacki M.D., a physician since 1958,retired from active practice in 2013. Webmaster www.drneedles.com since 1994.
Friday, May 30, 2008
SOURCES OF LEAD POISONING
Lead poisoning can result in permanent neurological damage resulting in learning and behavioral problems. This was highlighted recently by articles showing children in poor areas had high levels of lead and this resulted in criminal behaviour. The sad thing it is preventable. Lead poisoning today is not just limited to poor areas with lead in wall paint.
There are numerous source of lead: in our soil, air, drinking water, and homes. There is over 3 million tons of lead in 60 million American homes. It is found on watercoolers at school, windowsills, in the dirt in yards, seals of fine wine, lead crystal glasses, dishes, coffee mugs, crayons, on toys, and even in calcium supplements.
Homes built before 1976 contain some lead in their tap water because of solid lead pipes or lead soldered copper pipes.
Children absorb 50% while parents only 10%. Children pick up lead dust from floors, pets, and toys and then suck their thumbs. The lead compound on paints taste sweet. Lead is stored in baby's teeth and their kneecaps. Lead finds to the red blood cell like iron and is stored like calcium in the teeth. When there is a deficiency of protein, phosphorus, iron, or calcium, more lead is absorbed.
Hobbies like soldering and melting lead is a great source of lead poisoning. Burning colored newsprint or wood coated with lead paint, results in a release of lead into the air. Lead gasoline, phased out in 1976, was also a great source. Storage, preparation and serving of foods are another source. Juices from containers that come from lead soldered cans can leak the acids into the juice and be absorbed.
Pigmented designs on pottery dishes and mugs are glazed with lead to make them washable. The glaze contains deadly cadmium. This lead can be absorbed when hot food is served on them. Leaking is increased by acidic food as coffee, pop, fruit juices, or alcohol, combined with the decorative glaze and lead pigment.
In 1990, 90 % of all canned food was packaged in lead soldered cans (98%lead and 2% tin; lead is 10% the cost of tin.). Note that soldered seams are raised and lumpy with gray metal while welded seams are soft, smooth and flat.
Wine formerly had corks sealed with hot wax and lead foil wrapped around it. The lead went into the wine. Place the wine in fine crystal and you also have immediate absorption of lead also from the crystal directly into the wine.
Calcium pills are made from bone meal and oyster shells (sources of lead). Best to choose calcium carbonate or antacids for your source of calcium. Brass bowls contain 3% lead. Pewter is made from tin and lead. Silver plates contain often an alloy of lead. Newspapers with colored print contain lead. (So don't wrap your fish in the comics.) Water coolers had lead lined storage tanks until 1988. Sandblasting of old bridges releases a large amount of lead.
Pregnant moms absorb more lead than non-pregnant woman. The average lead levels were 17 micrograms per cc in 1976 and today are 4 micrograms. In 1965 the levels were 60 and dropped down in 1985 to 30 and by 1990 to 10 micrograms.
We still must look out for the dangers of lead poisoning. It is entirely preventable and treatable.
source; www.americanacupuncture.com
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Thursday, May 29, 2008
BICARBONATE TO DETECT EARLY CANCERS
BICARBONATE USED TO DETECT EARLY CANCERS
Researchers in Cambridge England found by tagging sodium bicarbonate and injecting it into the body, one could detect early cancers using MRIs. The bicarbonate affects the acid and alkalinc balances in the body.
All cancers are more acidic than surrounding tissues. Cancer cells turn the bicarbonate to CO2 All cancers have a lower pH than its normal surrounding areas. The more acidic the tumor, the more bicarbonate is converted to CO2. The MRI can track the change in the chemical and thus locate very early cancers.
WHAT IS THE MEANING OF ALL THIS?
It is important to find new ways to detect cancers early and to see if the drugs are working.
Using this technique, one could find out if cancer treatments are effective in early stages . Currently we have no way to measure the pH differences in the patient.
This could be a highly sensitive early warning system for cancer. This technique may be a useful tool in finding early cancers and may save many lives.
SOURCE: Dr, Brindle, Cambridge Cancer Research Institute UK 5.28.08
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Wednesday, May 28, 2008
FERTILIZATION IN VITRO
FERTILIZATION IN VITRO
Genetic screening before IVF significantly reduced the rate of pregnancies in women between 35-41 years of age.
There were 350,000 IVF cycles in 2002, with half of the women over 35 years of age. They tend to have more chromosomal abnormalities in their embryos.
Genetic screening before implantation involves aspirating a single blastomere from each embryo, and identifying the copy numbers of a set of chromosomes. It was to become the standard procedure before IVF.
Indeed, there is a higher implantation rate for transferred embryos, but no increase in the rated of successful pregnancies. Instead, it significantly reduced the live birth rates after IVF.
The pregnancy rate per aspirated follicles is 11.7% in the group having genetic screening before implantation and 14.7% in the control.
The number of chromosome analyzed with FISH leads to transfer labeled embryos normal that are in fact abnormal and anacuploid.
Many human embryos are mosaic so their chromosomal constitution may not represent the entire embryo.
SOURCE: NEJM 7.5.07
MEDICAL COMMENTARY
The primary outcome in fertility studies should be live births since that is the goal of the treatment. Biopsy of a blastomere on day 3 has the potential of an embryo to successfully implant and increases the chance of a live birth by 80%.
These results oppose routinely performing genetic screening before implantation as an aid to IVF.
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WATER PIPES VS CIGARETTE SMOKING
WATER PIPES SMOKING VS. CIGARETTE SMOKING
Recent studies in the Harm Reduction Journal showed the Hookah water pipe smokers have low levels of carinoembryonic antigens, CEA. They imply it might be a solution for heavy cigarette smokers.
Those who smoked the hookah, and no cigarettes, bits, etc. had an equivalent of 60 cigarettes each day. The authors found the overall cancer antigen levels were not different from the levels of non-smokers and moderate smokers. However, the heavy smokers of the pipe had significantly high levels of the cancer antigen.
They claim that low nitrosamine smokeless tobacco could be an alternative for heavy cigarette smokers and suggest even low quality moist snuff called naswar could be helpful.
Source: Harm Reduction Journal 5.24.08
MEDICAL COMMENTARY
Beware of the implication of such research. According to the World Health Organization, the water in the hookah does not filter out all the “ bad stuff”. The user is still exposed to 150% the volume of smoke inhaled from one cigarette.
Tobacco smoke still contains high levels of toxic compounds including carbon monoxide, heavy metals, and yes carcinogens. A significant amount of addictive nicotine is still inhaled. The tobacco is no less toxic and more smoke is inhaled because of the massive volume of smoke inhaled.
Naswar is a snuff from the Middle East that is chewed, nasty, and very addictive also. Your dental bills will also skyrocket.
Switching from one poison to another is not the answer. Stop the nicotine habit. Consider medical acupuncture to quit. For information on quitting with acupuncture, visit www.drneedles.com
Your comments always appreciated.
Sunday, May 18, 2008
JOGGING IN TRAFFIC HAZARDOUS TO YOUR HEALTH
Source: NEJM 9.13.07
Vigorous exercise during exposure to high levels of air pollution in heavy traffic may trigger an acute cardiovascular event. A study of 20 men who had a history of cardiac infarctions exercised in an area with high diesel pollution. They all showed a strong association between air pollution and heart ischemia and infarction.
Exposure suppressed net t-PA release and showed impairment of fibrolytic activity. All the men showed ST segment depression and a great ischemic burden during the diesel exposure.
Mechanism of indirect effects from agents crossing the lung epithelium into the circulation included soluble transient metals. The autonomic balance became disturbed resulting in a higher risk of arrhythmias and disruption of arterial plaques. The pulmonary oxidative stress lead to systemic inflammation causing the altered fibrolytic activity.
Decreased oxygen supply to the heart occurs because of vasoconstriction of the arteries and a transient thrombosis formation. There is also a decreased oxygen carrying capacity causing higher levels of carbon monoxide and increased oxygen demand.
The changes in t-PA release show a predisposition to thrombosis formation when a plaque is disrupted.
Patients with coronary disease, who did not have an infarction with transient exposure to air pollution or have sub clinical disease with perhaps plaques, can have a cardiac event triggered by vigorous exercise.
Exercise in traffic free areas is beneficial, but jogging in heavy traffic may be hazardous to your cardiac health. Perhaps health clubs are the answer.
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INFORMED MEDICAL CONSENT
By law and medical ethics, doctors need informed consent to treat patients. The patient must be competent to make a voluntary choice.
A doctor determines if the patient is competent to make decisions, but the patient’s autonomy must always be respected. If the patient is incompetent, an informed consent is invalid.
In the hospital, a patient may make an impaired decision especially in neurological and infectious diseases. A study of over 300 inpatients showed 48% were incompetent to consent to medical treatment and ½ had mild to moderate dementia. Every patient may have some limitations in capacity with old age, little education, language problems, and cognitive impairment.
Currently unstructured judgments by doctors are standard. Yet their assessments greatly vary.
Legal standards for decision making for informed consent require:
1.Ability to communicate a choice
2. Understand the relevant information
3. Understand the medical consequences of a situation
4. Ability to reason about treatment choices.
How can a doctor protect you from the consequences of a bad choice and still respect you autonomy? Most people are capable of making their own decisions and very few are really incompetent.
As doctors see the seriousness of the consequences of the patient’s decision, they rate many patients incompetent. Older patients may not hear or see well and are on hospital medications that may make their mental comprehension temporarily fuzzy.
In an assessment one must be sure that:
1. The patient was given relevant information to make an informed decision about their treatment
2. Disclose the true nature of the patient’s condition and offer available alternative treatments
3. Be given the option of no treatment at all
If one is impaired, one should identify the source of the impairment and try to remedy the cause. Perhaps fever, dehydration, sedation, or lack of oxygen can make the patient temporarily impaired. Fear, anxiety, and lack of education can also interfere with making a competent judgment.
When an advanced directive is absent, and there is no immediate urgency, a family member must be contacted. Today there are no clear standards and guidelines to assess a patient’s capacity to consent to treatment. This is what makes lawyers happy and leads to increased confusion. Don’t let your rights be violated.
What do you think? Your comments always appreciated.
Source: NEJM 11.01.07
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Thursday, May 1, 2008
VITAMIN D AND SUNSHINE NEEDED FOR EVERYONE
Source: NEJM 7.19.2007
Our great grandparents had rickets. Once we fortified our food with vitamin D we thought we had the problem solved. Hah! Vitamin D deficiency is still very common in kids and also adults. A deficiency in pregnancy results in growth retardation, skeletal deformities, and hip fractures in old age.Deficiency also causes bone weakening, bone pain, muscle weakness and increases the risk of fractures.
Most cell in the body have vitamin. D receptor that can convert circulating vitamin D to 1.25di OH vitamin D. This vitamin plays a role in many chronic illnesses including cancers, autoimmune disease, infections, and heart disease.
HOW DO WE GET VITAMIN D
Sunlight, diet, and supplements are sources for vitamin D. Sunlight coverts cholesterol to vitamin D. Fortified foods offer a minimum amount of vitamin D. Ironically, Europeans do not fortify their foods. Oily fish are a great source of vitamin. D. Vitamin supplements are another source with vitamin D2 and D3 available. Two kinds of vitamin D. Vitamin D2 is made from yeast and Vitamin D3 is made from lanolin.
The liver to 25 OH vitamin D then metabolizes the vitamin D that is made. This is then destroyed by the kidney. Calcium and phosphorus are absorbed better with high levels of vitamin. D. In fact, only 10% of the calcium ingested is absorbed if there is a deficiency of vitamin D. A level of 150mg indicates too much, this is very rare.
INCIDENCE
Over one billion people are deficient. 40-100% of all Europeans are deficient. as are 50% of women with osteoporosis taking who are taking osteoporosis medication. Fifty percent of Hispanics and blacks are also deficient as are one third of healthy college students. People close to the equator who soak a lot of sunlight have great levels of vitamin D.
Ironically, in the Middle East, people hide and shield themselves from the sun, and as a result have low vitamin D levels. At risk are even pregnant women who take their vitamins, eat fish, and drink milk. Seventy five percent of these pregnant woman and 89% of their offspring are deficient in vitamin D.
93% of patients admitted to an emergency department with muscle aches and bone pain have a vitamin D deficiency. They often are diagnosed with fibromyalgia, chronic fatigue syndrome and depression.
One third of women between 60-70 have osteoporosis and after 80, 2/3 of them have osteoporosis. Half of women who have osteoporosis will get a fracture in their lifetime.
OTHER ACTIONS OF VITAMIN D
Besides maintaining strong bones, skeletal muscle also requires vitamin D to function. Muscle weakness occurs if there is a deficiency. Seniors have decreased muscle strength because of low levels of Vitamin D and consequently have more falls. A dose of 800 IU of vitamin D3 could prevent manyof these problems
Vitamin D decreases cell proliferation in both normal and cancer cells and makes the cells more mature.
Toronto doctor Goodman reported that 83% of the breast cancer patients who had adequate Vitamin D when the cancer was discovered were alive 10 years later, while only 69% of patiients who had deficient levels of Vitamin D on discovery of their breast cancer survived 10 years. This 14% drop in survival is very significant.
Vitamin D increases insulin production and also helps the heart muscle to contract better.
WHERE TO LIVE?
Living at higher latitudes increases the risks of disease by 30-50%. Living in upper United States result in more lymphomas, colon and pancreatic cancers, and prostate cancers. Increase sun exposure and higher vitamin D levels result in a decrease in deadly cancers. Vitamin D prevents blood vessel proliferation and can reduce the ability of cancerous cells to survive.
Type 1 diabetes; multiple sclerosis and Crohn’s disease risks are all decreased by 50% in people living at lower altitudes as Florida.
High blood pressure and heart disease rates decrease in lower latitudes. Even heart disease patients have vitamin D deficiencies. One also sees a reduction in rheumatoid arthritis and osteoarthritis in warmer and sunnier states.
HOW MUCH VITAMIN D IS NEEDED?
Without adequate sun exposure, 800-1000IU of vitamin D3 is needed. D3 is three times more effective than vitamin D2, which is found in your common vitamins. Either take 1000 IU of vitamin D3 or 3000 IU of vitamin D2. In pregnancy 4000 IU of vitamin DE3 is advised. Overdose of vitamin D is very hard. A dose of 10,000 IU of vitamin D3 for 5 straight months caused no problems.
SENSIBLE SUN EXPOSURE
Vitamin D is stored in body fat and is released in the winter when vitamin D3 can’t be produced. Exposure to areas of the arms and legs for 5-20 minutes between 10 am and 3 pm should result in plenty of vitamin D. The skin can make a lot of vitamin D3 even in the aged, thus reducing the risk of fractures.
CONCLUSION
Vitamin D deficiency is very very common. A deficiency predicts bone and muscle weakness, and an increase risk for cancers and other chronic diseases. Taking 1100 IU of vitamin D3 reduced the risk of cancer by 75%. Kids need at least 800 IU.
Enjoy your sun and take supplements of vitamin D3 to maintain a healthy body and strong heart and reduce your cancer risk. Also go south in the winter for a while and don’t put your sun tan lotion on for the first 20 minutes of sun exposure.
Blame it all on Henry Ford and the invention of the car. We haven’t been our sunny selves since.
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FETAL TRANSPLANTS
SOURCES: SCIENCE 4.11.2008 & NATURAL MEDICINE 4.2008
In the 1990s, doctors took dopamine producing neurons from aborted fetuses and injected them into the brains of Parkinsonism patients to replace neurons destroyed by the disease.
Two later trials showed that the surgery had no benefit and even caused involuntary movements in some patients.
Three studies were done recently on 6 brains from patients who had these transplants and found that many transplanted cells identified by their pigmentation and staining for an enzyme found in dopamine production that showed Parkinsonism pathology.
This suggests that the disease can spread from the host brain to much younger neurons with different genetics. The pathogenic mechanism is unknown. Immune reactions to the transplanted fetal cells may be a factor.
Today fetal transplant surgery is rarely done. This puts a question on whether stem cell transplants would work.
Time will tell.
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- SOME BACTERIA NEED ANTIBIOTICS TO LIVE (1)
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- Thanksgiving 2010 Trivia Quiz (1)
- THE BEHAVIOR OF CANCER (2)
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- THE DEMISE OF FATHERHOOD page2 (1)
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- VERY FEW OF US ARE MENTALLY NORMAL (1)
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- WOULD YOU BE A WHISTLE BLOWER FOR THE IRS? (1)
- You Are What You Eat (1)
- YOU CAN'T WIN ALL THE TIME (1)
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- YOU DON'T NEED TO KNOW EVERYTHING (1)
- YOUR HEALTH RECORDS GO NATIONWIDE (1)
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- YOUR BLEEDING CAN BE CAUSED BY YOUR DRUGS1 (1)
- YOUR BODY NEEDS A HEALTHY APPENDIX (1)
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- YOUR FACE TELLS IT ALL (1)
- YOUR GENETIC RIGHT TO PRIVACY (1)
- YOUR HEART IS NOT A CAR ENGINE (1)
- YOUR KID IS FAT (1)
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- YOUR TONGUE TELLS HOW HEALTHY YOU ARE (1)