Sunday, June 29, 2008

ROTTEN EGG GAS, H2S, MAY SAVE YOUR LIFE

ROTTEN EGG GAS MAY SAVE YOUR LIFE


H2S, hydrogen sulfide, known as rotten egg gas, smells bad, is flammable and can be deadly.  It is found on farms and sewage treatment plants.  Science now feels it may be helpful to injured people and save lives.

Injecting low doses of the gas into healthy people caused no dangerous side effect.  The hydrogen sulfide starves the cells by blocking an enzyme that affects blood flow and hormonal secretion.

It is hoped to curb heart attack damage and side effects of painkillers.  Soon it may be used as a treatment for restricted blood flow to liver and lung injuries.

Can the gas help people survive better after severe injures or traumas as strokes?   The gas also has dangers.  Breathe  3 50 ppm and die in 30 minutes, 1000 ppm and it will kill you instantly.

The human body makes this potentially lethal molecule at much lower concentrations.  A few living microbes actually rely on sulfur not oxygen to get energy from metabolism.

Twenty years ago, the molecule was found to be present in high concentrations in brain samples of humans. It acts as a neuromodulator helping neural circuits.  It opens membrane channels letting potassium leave the cells.   Smooth muscle cells are also relaxed in the wall of blood vessels.

  Cultured neurons are shielded from oxidative damage as in strokes.  It stimulates cells to raise their levels of glutathione, a natural antioxidant.  It seems to limit the damage of a heart attack by protecting the mitochondria that generates cell energy.

 

Another gas being in use for a long time is nitric oxide.  It has similar actions.  It relaxes blood vessels, stops inflammation and stimulates the hypothalamus to release hormones, and transmits signals between brain neurons.

 

The gas seems to protect the gut also by shielding intestinal linings.  This may be of use to stop gastrointestinal bleeding and ulcers cause by anti-inflammatory non-steroids as aspirin and Motrin. 

 

The gas is a master metabolic regulator by turning down metabolism and oxygen demands.  Animals can survive with 2/3 of it blood loss.

 

Rather than resuscitate patients, it may be better to put the patient in a near death state by falling into an altered state of consciousness, and yet have the patient be able to move and respond to pain.

 

A Company, Ikaria is now testing injectable hydrogen sulfide in humans.   Sulfide releasing pills are being tested with a projection to be brought to market by the end of 2009. 

 

There is noting rotten about the medical promises of hydrogen sulfide.

                                                      Source: science, 5.30.08

 

Visit us @ www.drneedles for more medical information.  And of course, your comments are always deeply appreciated.

CANCER OF THE CORONARIES: ARTERIAL PLAQUES

CANCER OF THE CORONARIES: ARTERIAL PLAQUES

Medicine seems to be practiced in the way the health system rewards it.

A recent article in the NY Times showed how a cardiologist can double his income from 200K to 400K by doing heart imaging, called CT angiograms.

If you are covered by Medicare and visit an aggressive cardiologist for a check up but have no symptoms of any heart problems, he might suggest you get a CT angiogram to see if you have any plaques.  Of course, everyone of Medicare age will. 

 

This test gives you  more radiation than 1000 conventional chest X-rays and have other risks. (See our related blog CT scan radiation, 6.15.08 .) 

Since you have plaques you now are told a nuclear stress test will you how much blood is flowing through your coronaries.  You then are told that you require a couple of stents, costing  you 14K,  to prevent an impending heart attack.  If not that, at least you should get another $1500 CT scan next year.  Don’t worry; Medicare will pay for it out of its $800 billion dollar annual budget.

The facts are that the CTangiograms fails to tell you which plaques are stable and which are likely to rupture.  Clinical trials show also that stents are of no benefit to patients who have no symptoms or chest pain.  They do relieve chest pain but do not prolong your life.  No chest pain, no need for a CT angiogram, says Dr. Redberg, Univ. California cardiologist.

Most asymptomatic patients who visit a conservative cardiologist who does not own a one million dollar CT scan, will place you on a diet, exercise program, cholesterol lowering drug and other drugs.

Now that CT scans are in the marketplace, there is no way to get evidence of its value.  The lack of evidence that CT scans have any benefit, has not stopped Medicare from paying for it.  Once the FDA approves a device, Medicare rarely demands evidence that helps the patient. 

It surely benefits the aggressive cardiologist by providing an additional source of income.

Visit us at www.drneedles.com for more medical information.  And of course, your comments are always appreciated.

Monday, June 23, 2008

ARE OFF LABEL DRUG PRESCRIPTIONS SAFE?

WHO REGULATES. OFF LABEL DRUG USE?

If you are given a drug for a problem you have and it is listed as a drug for other illnesses and not your problem, it is called off label use.

Off label uses for drugs are not supported by good evidence. They account for 21 percent of all prescriptions written. Most of them werre for anticonvulsant and antibiotic use. 73% percent of them showed to have no scientific support. Atypical antipsychotic and antidepressants are used frequently without much evidence of success. Is off label use good for patients?

Since doctors are a free to prescribe drugs for any illnesses, this provides important advantages. A doctor can be different and innovative especially when routine treatments do not work. Patients are provided early access to drugs that might be valuable. It also allows doctors to apply new ideas on emerging evidence, and may the only treatment possible for unusual conditions.

But there are also negative consequences to off label drug use. Newer drugs used for off label illnesses certainly increase health costs. It also downgrades patient’s expectations of safety and effectiveness of the drug. Drug companies do not need to meet rigorous standards, and can seek secondary indications for illnesses that have had no clinical trials

CONFLICT IN USING OFF LABEL DRUGS

Insurance is paying for products that are not proven. Doctors want the freedom to try drugs on patients that were not made for their illness. It is hard enough to stay on top of rapidly evolving evidence. Big Pharma can also increase their profits by enlarging uses for their drugs.

We the public want safe and proven drugs that are also affordable. Yet we also want the newest therapies as long as supporting evidence is disclosed. The FDA does not want to strengthen its role in protecting the consumer. Despite the faith doctors and we place on the FDA.

WHAT COULD THE FDA DO?

Changes and labeling drug with black box warnings would be helpful. This would alert doctors that caution is required. Specific restrictions placed on drug usage would also help. Drug company’s marketing practices must be scrutinized.

Current FDA policy

The FDA is using a 1997 modernization act even though these regulations expired in 2006. The act prohibits promotion of products for unapproved uses. The FDA has drafted guidelines about the drug representatives passing out journal articles to doctors. These guidelines emphasize that the FDA action is not binding and suggests the FDA attitude is permissive toward off label drug usage.

The FDA no longer limits promotion of off label drugs that are being evaluated by the FDA. Big Pharma doesn't need to give the FDA and any advance review of the journal articles they distribute.

The drug companies use the ambiguity where FDA policy is not defined as a green light you use off label marketing. They use continuing education programs to promote off label use.

They encourage journal articles that promote off label usage and call it physician education. These articles and trials are drug industry sponsored and placebo controlled instead of comparing the drug with other approved therapies. Questions of off label prescribing often come from litigation rather than from FDA scrutiny.

Drug companies, by saying it is an infringement of commercial free speech, have challenged marketing drugs with restrictions. The FDA concedes the responsibility to the drug companies to regulate their own off label marketing. The FDA feels its limited resources could be best served by confronting other challenges.

What might the FDA do?

They could synchronize key evidence of these drugs use this and report on it. They could restrict marketing efforts that don’t have strong support. They could use active drugs has come persons with often label useless.

They could require also label uses to be presented at the same time the drug approval review of the FDA is presented. They could systematically collect data on drugs after marketing to check the harms and benefits of the use drug uses

The public is always pushing for improvement on drug evaluation after they come to market. Uncertainty about safety of drugs is only recognized after widespread use of these drugs tales of to help the patients.

Perhaps, with increased funding by Congress recently the FDA will step up to the plate and protect us the patients.

source NEJM 4.03.08

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Your comments always appreciated!

ARTHRITIS OF THE HIP

OSTEOARTHRITIS OF THE HIP

The leading cause of disability in the elderly and most common joint disorder is osteoarthritis of the hip. Over two hundred thousand total hip replacements are done each year.  Five percent of everyone over 65 has osteoarthritis of the hip.

 Osteoarthritis begins with articular cartilage degenerating followed by growth at the joint margins and inflammation of the joint synovial fluid.

The examination shows increased pain in the hip when the hip is rotated and the knee is extended straight. Groin pain and tenderness occur in both hips 20 % of the time.  

An x-ray while standing will confirm the diagnosis.  There will be some loss in the joint space.  An MRI will show the same changes and is usually not necessary.

Treatment is to preserve hip function and relieve pain. Exercise doesn’t help much but water exercise shows improvement in 70 percent of the patients.

Acupuncture in a randomized controlled study resulted in significant pain reduction and 40 percent improvement of quality of life scores after three months of treatment. The benefit remained after another three months of follow up. 

Other treatments include acetaminophen and NSDAIDS to relieve pain and help hip function. It seems glucosamine chondroitin and injections of hyaluronic acid are little or no value.

The ultimate answer is total hip surgery with one year therapy after surgery.   I find putting a heel lift in the shoe on the affected side improves sense of balance and takes some weight off the arthritic hip.

Prevention of this problem includes: avoiding marathon running, prolonged standing, and avoiding lifting and moving of heavy objects. All of these can hasten andincrease risks, and aggravate the disease.

 The ultimate solution is don't grow old!

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Your comments are always appreciated.

Sunday, June 15, 2008

THE COSTLY HEALTH CARE MONSTER

THE HEALTH CARE MONSTER MUST BE CONTAINED

Health care now costs 5% of every dollar and will be 20% by 2050.  Why should there be such a jump in the costs of health care?

To control some of the costs we must evaluate how effective are our medical treatments, which one works best for which patient, and does the cost warrant the use of these expensive therapies.

The treatment choices now depend on the doctor’s judgment and the medical evidence.  Only ½ of the medical care is based on supportive evidence.

 

Providers like hospitals, encourage more expensive treatments even without proof of their effectiveness.  Doctors work on fee for service and do these procedures as long as their payment is greater than their costs.  You see today every doctor offering botox, laser vein surgery, eyelid surgery for droopy eyes, and the list goes on and on.  The patient goes along since his insurance pays for most of the treatment and there is no financial incentive for the patient to question the costs.

Private insurance companies don’t know what treatments are effective and necessary and Medicare can’t tell which services should be covered and for what number of dollars.

Keeping pace with new treatments and procedures is difficult.  One has to change the incentives.  If insurance payments do not cover less cost effective procedures and the patients had to pay a part of additional costs for more expensive treatments, the incentives would change.  Incentives to provide additional services must be in place. 

Yet higher deductibles put more burden on people with major health problems. High costs may limit the use of those needing the services.   Is it fair to have more incentives to provide for too little care?

The answer I guess is to target which patients would benefit the most.  This of course eliminates the elderly as myself.

What do you think

Visit us @www.drneedles.com for more health information.

Your comments are always appreciated.

CAT SCAN RADIATION

HOW MANY CAT SCANS ARE TOO MUCH?

 

In 1980 there were 3 million CT scans. Last year there were 62 million and 14 million of these were done on children.  The scans give more radiation than conventional X-rays and this increased exposure will injure many people in the future.

The scans give a 3D view of organs in the body.  Organ CT scans require over 50 times the x-ray dose as an abdominal CT scan.

 

The ionizing radiation affects the bonding energy of electrons orbiting around atoms and molecules.  They knock some electrons out of their orbit and thus create hydroxyl radicals as the x-rays hit water molecules.   The hydroxyl radicals break DNA strands and ionize the DNA.

 

Most of the damage is repaired within the cell, BUT the DNA double strand breaks are not repaired and cause mutations and chromosomal translocations, and gene fusion.

All of the above LEAD TO CANCER FORMATION.

It has been proven epidemiologically that 3 scans result in an increased risk of cancer.  It will take several years to estimate the exact cancer risk from these exposures.  Children especially are more radiation sensitive  and have many more years of life to get the cancers.

Too many CT scans are performed; often for questionable reasons, as headaches, seizures and trauma.  Many of them are ordered to protect the doctor from unnecessary legal exposure.  This defensive medicine is multiplied as a patient is sent from one doctor to another and each orders the same scan because of poor communication.

Over one third of these scans could be replaced with alternative tests as ultrasounds or MRIs. 

If you really need a CT scan medically, the risk is small compared to the information received.  Yet over 29 million adults and 1 million kids are each year irradiated unnecessarily.  Are you one of them?

                                    Source: NEJM 11.29.2007

Visit us @ www.drneedles.com for more information.  Your comments are always appreciated.

INTENSIVE CARE MANAGEMENT

CARE FOR THE CRITICALLY ILL

Today, every hospital has an intensive care unit.  Large hospital has up to 60 beds in their ICU.  Every year 20% of our hospitalized patients travel through the ICU.  Twenty percent of dying people that arrive at the hospital die in an ICU.

There is very little information about the therapies used in ICUs and no one monitors if they are working.  Big Pharma can’t have clinical trials of new drugs because they can’t get consent from the patients.  These services have high costs and provide good revenue for the hospitals.

No one evaluates the high costs of delivering diagnostic workups, sedatives, antibiotics, nutrition, IV solutions, and electrolyte support.

Every patient that gets out of an ICU has some morbidity.  Survivors get mental disorders affecting the quality of their lives.  Those with chronic illnesses get acute illnesses that aggravate their stabilized chronic illness.

Every ICU can’t provide the same high capabilities and certainly can’t monitor their result.  Perhaps they prefer their patient care not to be monitored

What do you think?

Visit us @ www.drneedles.com for more medical information.

 

 

GOD, WHERE ARE YOU HIDING?

WHERE IS MY PERSONAL GOD HIDING?

With MRIs and Pet scans we can find discrete areas of brain activity when we are active mentally, watching movies using drugs, or listening on our cell phones.


Frances Collins, in his recent book, argues for the existence of a personal God.  Some parts in the brain need God.  We have an innate sense of right and wrong.  God implanted moral law into our brains.  We are programmed to use good behavior since it leads to the preservation of the species.

                           Source:  The Language of God, 2007

 

David Linden, in his recent book, says evolution accounts for the development of religion, love, dreams, and memory.  The primitive emotion laden limbic structures in the hypothalamus and brain stem link the rational cortex with the primitive emotional brain stem.  Frequently a breakdown in emotional control is labeled a design of a God.

                                    Source: The Accidental Mind, 2007

 

Michael Timble, an expert on epilepsy says in his recent book, great religious leaders had partial seizures during their conversions.  St. Paul was blind for 3 days and fell frequently into eclectic visionary states.  Mormon founder Smith had lapses of consciousness and speech arrests and saw heaven and angels.

                                    Source: The Soul and the Brain, 2007

 

 

Drugs certainly can change our mental states.  LSD, Mescaline, and psychedelic drugs can block serotonin receptors in the raphe nuclei of the brain.  The non-dominant emotional right side of the brain has sites for religious states, poetry and music. 

 

Researcher Sandi, in a recent NEJM article,  mapped sites involved in language that included parental, temporal and frontal regions.  The analytical left-brain has been found to control great achievements in science and the arts.

                                    Source NEJM 1.3.2008

Going to a house of worship might stimulate many of these sites and free God to work in us.

What do you think?  Is there a God in your future? 

Visit us @ www.drneedles for more medical information.Your comments are always appreciated.

 

 

 

 

 

 

 

Friday, June 13, 2008

DR NEEDLES'S JUNE MINIBLOGS

DR NEEDLE’S MINIBLOGS FOR JUNE 2008

To stimulate your mind I would like you to consider these miniblogs for June 20008.

 

HEARTBURN MEDICINE AND HIP FRACTURES

 Patients using Nexium, Aciphexs or Prilosec long term had 40% more fractures.  There is reduced acid in the stomach and hence less calcium is absorbed and more bone loss occurs.

                                                              JAMA 12.27.2007

CORONARY DISEASE AND LDL

Since plaque formation occurs with high LDL levels, it makes sense that reducing the LDL might prevent the disease.

Three large trials were done on people with LDL levels of 192.  When given statins, the LDL levels dropped 25%.  Yet after 5 years it made no difference in rates of coronary disease.  Death rates were lower in those not taking statins , 8.3% compared to 10.3% in those patients taking statins.                                              NEJM 10.11.2007

 

STOPPING ORGAN TRANSPLANT REJECTIONS

Organ transplant patients were given IVS to WEAKEN their immune systems.  Injected bone marrow resulted in a hybrid immune system where both recipient and donor cells were able to live together without rejection.   The benefit was that no lifetime anti rejection drug treatment was necessary.

Side effects were tremors, bloating and excess hair growth.  The body is tricked into accepting a foreign organ as  its own.                                                                                                                     NEJM 1.24.2008

VACCINATION  STATS

2% of Americans over 60 get the shingles vaccine

2% of Americans get the whooping cough vaccine.

10% of women 18-26 get at least one dose of a 3 part cervical cancer          vaccine.

TESTOSTERONE IN PREGNANCY

Prenatal testosterone causes changes in the finger ratio of the ring to the index finger.  It may be a predictor of athletic prowess.  Orchestra musicians have a low ratio, shorter ring fingers.   Longer ring fingers seen in people with more testosterone.   The longer the ring finger, the more chance for osteoarthritis in men and knee osteoarthritis in women.

                                    1999 Manning, Southhampton University

NO SMOKING ZONES

Half of Americans live in a no smoking zone compared to 80% of Canadians.  This leaves only 4% of people protected from the effects of smoking.  One in four adults still smoke.

15 countries have 2/3 of the world’s smokers.  How can we globally implement tobacco controls blocking promotion and sponsorship of tobacco products?  WHO which represents 148 countries is working on this problem.

If we can cut smoking from 25% to 20% of adults we will save 100 million people from dying prematurely.  The political short-term costs are great but the health gains are also huge.

                                                      Lancet July 06,2007

Let me know if these miniblogs are interesting to you.

Your comments are always appreciated

Visit www.drneedles.com for more health information

BETTER HEALTH DOES NOT DEPEND ON BETTER HEALTH CARE

HOW CAN WE IMPROVE HEALTH CARE?

We sure can do better.  We spend more on health care than any other nation and our rankings are poor in every category.  How can this be?

Lets be clear.  Better health does not depend on better health care.  Often when we need the care, it comes too late, the quality is too poor, or we don’t get it at all.  Ignoring the poor Americans insures that our health care cannot improve. 

Among other countries, our life expectancy is 46th from birth.  We are 42nd in infant mortality.  We spend heavily for the National Institute of Health and ignore comparisons among nations.  True we are ethnically heterogeneous unlike countries like Japan and Switzerland who are at the top of the rankings.

Forty percent of our deaths are due to obesity, smoking, and physical inactivity.  We must change the behavior of our citizens.

Environmental factors play a role.  Polluted air and water, dangerous neighborhoods, lack of physical activity outlets, lead paint toxicity all compromise our health.

We spend over 2 trillion dollars annually on health care.  It accounts for 16% of each dollar you take home.  Few countries ever approach even 10%.

Despite everything, our nation has never been healthier.  Much of this is due to stop smoking controls, reduced homicide and car accidents, and fluoridation of our waters, vaccines, and heart drugs.

We have all the tools to control obesity and smoking and must act vigorously.

As a doctor, I feel we must become advocates for population health.  It resonates with our deep professional values and is the reason most of us chose medicine as a profession.

We take a lot of pride in being #1 in wealth, number of Nobel Prizes, and our military strength.  Can we become number one in health?  It’s all up to you!

Visit us @ www.drneedles.com for more health care information.  Your comments are always appreciated.

 

 

FDA AND INTRACARDIAC DEVICES

PROTECTION OF MEDICAL DEVICES BY THE FDA

When a drug or medical device is approved, the FDA makes a judgment call about its safety.  They rely on the manufacturer’s studies after following 500-3000 people over a few months.  This called a small clinical trial.  It is meant to measure the drugs safety and effectiveness in a targets small group of patients.  They do not consider the wide variety of health problems the drug might pose when taken in a wide variety of conditions.

 

Only after a drug has been used for months or years by thousands of patients can true risks show up.  This kind of surveillance is the most important phase of testing.

 Implantable defibrillators  were approved by the FDA in 2004 without any human clinical trials.  The doctors raved about how tiny they were and how easy they could be implanted.

After 3 years on the market, and 279 thousand implants, it became apparent the implants were fracturing.  The company quickly took the devices off the market.

Billions of dollars were at stake as the doctors and patients screamed about the poor performance of these devices.  They wanted regulation to protect the patients from their use.

A lead in the device has to withstand hundreds of millions of heart contractions in a hostile human body.  The device must deliver high voltage energy in a split second’s notice.

But when an intracardiac device, ICD, breaks, it fails to defibrillate and produces unnecessary shocks and death.  When the lead failed, it was not removed from the patient and hence not returned to the manufacturer.  This led to a gross underestimation of the failures of the leads.  There was consequently no data after marketing the device to see if there was a performance problem.

The company sent an application for design changes in May 2007 and got approval from the FDA two months later.  The old defective leads stayed on hospital shelves and continued to be implanted by unknowing surgeons.

Finally, 5 months later, after 5 deaths and 665 fractured leads returned, the company voluntarily recalled its product and asked all unused leads to be returned.

Well, lawsuits were flying immediately, alleging personal injury, negligence in manufacturing and failure to warn the patients about possible defects.  The company continued to sell their inventory of potentially defective devices even after they saw the flaw and corrected the problem.  Two other companies were involved in marketing their potentially defective devices without telling the patients.

The arrhythmia device industry routinely does not disclose risks to the patients.  The FDA allowed a flawed product to be made while the manufacturer was submitting a revised design and waiting for its approval.

Some argue that the patients get a lot of reliable information and there is no need to make the patients anxious.  They might not choose to have the device implanted when given information about its flaws.

Solution:  Tell the patient about the risks and benefits and let them make their own decisions.  This is called informed consent.

The FDA is to protect the public and give them information they need.  Patients do not tolerate unnecessary and preventable risks.  However, when given accurate easily understood information they will make informed decisions

It seems consumer medical protection is lacking.   Protection of the consumer is present for airline travel, cable TV customers, and cell phone users.  Yet when you receive a life sustaining medical device, there is no protection.  There is no consumer representative or patient advocacy group to speak up for the patients. 

Who protects the well being of patients?  Who treats them ethically?  Where is the informed consent and where is the disclosure of safety information? 

The company’s first duty is to protect its shareholders and not the patients who are using their products.  Who is around to protect you the patient?

                                             Source NEJM 3.6.2008

What do you think?

Visit us @ www.drneedles.com for more medical information.

 

 

 

SPOT PARKINSONISM EARLY

VERY EARLY SIGNS OF PARKINSONISM

Most doctors concentrate on the major features of Parkinsonism and miss  the early subtle features of the disease because non specific health questions were not asked. 

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A typical scenario of early signs of Parkinsonism might be the following:

Many of your friends may have a shaky hand, softening in their speech, and some loss of dexterity.  They deny all the problems except the slight tremor.  It seems the hand shakes at rest.  Their facial expression has changed and seems masked.  The voice has become weaker and is softer.  When walking the arm with the tremor fails to swing.

 

When you ask questions you will find that he lost his sense of smell about 6 years ago.  He gets up twice a night to urinate and he has been talking in his sleep for several years.  He may have hit his wife but does not remember it the next day.

He seems to have a change in mood, and is becoming depressed at times.  He becomes anxious at times and has more difficulty concentrating on details at work.

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Sure all the above could be due to other causes e.g. sinusitis, possible prostrate enlargement, stress of the job, restless leg etc.

There is no good way to check preclinical Parkinsonism except with expensive PET scans and SPECT tomography. 

One can suspect the disease with mood changes, bowel and bladder changes, sleep disturbances, impaired cognitive ability, autonomic and motor changes, and loss of the sense of smell.

There may be a mixture of vascular problems, Alzheimer’s, and Parkinsonism. The symptoms of Parkinsonism vary, as the disease is heterogeneous. Treatment of the dopamine deficiency with levodopa results in dramatic improvement. 

Be suspicious and ask your parents questions.  You will be the first to make the presumptive diagnosis of Parkinsonism before your doctor is involved.

Visit us @ www.drneedles.com for more medical information.

 Your comments are always welcomed.

 

  

Thursday, June 12, 2008

CAN YOUR DRUGS CAUSE YOU TO BLEED?

ARE YOUR DRUGS CAUSING YOU TO BLEED?

Bleeding from drugs is not common, but can be fatal.  Simply stopping the drug can prevent it.  What drugs can cause this condition? 

Often you take a drug for a week or longer.  You may get lightheaded, nauseated and then vomit.  A fever is often present before you bleed. Bleeding from the bowel, urine and nose cause heavy bleeding.  Once the drug is topped, the symptoms disappear, usually in 24 hours.

Fifty-eight drugs can cause bleeding and 27 are probable causes of bleeding.  Antibiotics, diuretics, sedatives, anticonvulsants, and ant rheumatic agents lead the list.   Vaccinations can result in severe bleeding several weeks after the vaccination.

To find this list of drugs go to:

www.moon.ouhsc.edu/jgeorge/DITP.html

 

Treatment involves simply in stopping the drug immediately if hemorrhage occurs.  Once one is sensitized, the drug sensitivity lasts forever.  Cortisone and immune globulin are used in severe cases but there is no evidence it helps.

                                                      source NEJM 8.9.07

For more information on drug reactions visit www.drneedles.com

Your comments always appreciated and welcomed.

 

WHAT IS YOUR CORONARY RISK?

WHAT IS YOUR CORONARY RISK?

One out of three of us will die of coronary disease.  Over 15 million Americans have coronary disease, and the rate is rapidly rising.  How can we identify who has it and what causes it.

Sure high cholesterol and diabetes can inflame the coronary arteries.  Plaques can form, rupture, and hemorrage, and a heart attack will occur.  All of this results in atherosclerosis. 

A different apporoach was take by Samani.  He identifies chromosomal loci that are found in coronary disease.  He looks for sites not linked before with coronary disease, looking for unsuspected connections. 

Looking at the genotypes of 5000 people with coronary disease, he looked for an association of single nucleotide polymorphisms called SNP in patients with and without coronary disease.  There are over 3 billion pairs  of these in the human genome.

Four hundred of these pairs were significantly associated with coronary disease, and in particular three seem to contribute to overall coronary disease. The most common was on chromosome 9p211.3. 

The application of genetics to coronary disease seems to be on the cutting edge of intensity in this area.  This is the first unbiased scan of genome and sequence variants studied for this disease.

Looks like the emphasis in on the human genome identification of risks in all of us.  

But what do we do when we find we are at increased risk?

                  source NEJM 8.20.07

Visit us @ www.drneedles.com for more information.  Your comments are always appreciated.

Wednesday, June 11, 2008

FATHER'S DAY GIFT FROM GRANDPA

FATHER’S DAY GIFT FROM GRANDPA

Children have a great relationship with their grandpas.  They can reach grandchildren better than the child/s father. Kids listen to their grandpas and know what we say is important.

 

With the coming of Father’s day, Grandpas give your grandchildren the gift of your wise words on drugs and sex.  Kids know you are cool and relaxed and very smart.  You are not on their firing line every day.  Kids many days hate their parents, but you are revered and never ever hated.  You can ask point blank embarrassing questions about drugs and sex and get away with it.

Grandpa, you are never too nervous to ask:  Who is that chick you are with?  How are you doing in math?  Why are your eyes always so red?  What did the doctor say about your rash?  Are you serious about this new girl?

Your grandkids lie to their parents daily, but they would be too ashamed to try to con you.  Besides, you know how to keep a secret and would never squeal to their parents.  You can talk about the dangers of drugs openly with your grandkid and they know you make sense.

The average age of first time drug users and first sex encounters among teens is about 13.  Fifty percent of teens between the ages of 15 and 19 are already having sex.  Another 25% of those not having sex are having oral sex.  One can’t have one without the other for long.

Illegal drugs are offered to 25% of kids between the ages of 9-12.  The offers come often from a friend and even a family member.  These drugs result in increased violence in communities; drug related crimes, Aids, and homelessness.

You hold a special placed in the hearts and minds of your grandkids.  Share your love and your knowledge with them. Ask them questions and you will get answers that their parents could never get.   Show you have faith in them.  You have the power and influence to keep your grandkids from being teen parents and druggies.

Father‘s day gives you a good chance to connect with your grandkids again.  Don’t waste this opportunity to talk to your grandkids.  You have the power to save them.  Use this power.

                  Sincerely, Dr. Needles

Your comments always appreciated.  Visit us @www.drneedles.com

Monday, June 2, 2008

YOYR EYES TELL IT ALL

YOUR EYES COMMUNICATE WITH THE WORLD

The recent pictures from the Yale researchers are right in line with Chinese readings of the eyes.  The following may help you when you contemplate eye surgery.

THE EYE IS THE CHANNEL OF YOUR HEART

Eyes are the heart channel. Big eyes signify a receptive person who sees a lot and expresses a lot. Narrow eyes are a function of thinking and are seen in mental stress and detailed work with squinting. The left side tells who you are. If the left eye is wider than the right the person is emotional. If the left eye is narrower the person is analytical.

Joy lines under the eye are caused by endorphins released because of humor. Too much excitement is bad for the heart. Painkillers put out the fire channel. Eyes that slant upward are seen in open-minded people. Closed-minded people have eyes that slant downward.

Eyes that are small and triangular are seen in people who are opinionated. If you don't follow their belief, you will be cut off. They surround themselves with people like them.

EYELIDS ARE A SIGN OF DEEP LOVE

The eyebrows are controlled by the liver meridian (wood element). Tweezing the eyebrows or constant anger result in the temples of the eyebrows being irregular, with the right side thinner and the left side thicker. Pain lines are diagonal lines across the outside corners of the eyes. They can be physical or emotional. They are always worse when one tries to hide the pain. The left side is always worse.

When the eyebrows are raised, you appear aloof and it places boundaries on others. When the eyebrow is close to the eye you feel bonding with people and have eye expectations of people (classic coaches eyebrows).

Deep and large eyelids are a sign of loving deeply, responding fully, and good at suffering. Shallow eyelids are seen in people who don't let emotions affect them. When the outside of the eyelid droops, signifies a person overly analytical, picky, self critical, and often having autoimmune disease (allergy, rheumatoid arthritis, viral infections). A straight eyelid is seen in persons who see other's points of view and can pull back from a situation. Rounded eyelids are seen in subjective persons who think how others feel.

EYEBROWS ARE A CHANNEL OF YOUR EMOTIONS

Tweezing the eyebrows or constant anger result in the temples of the eyebrows being irregular, with the right side thinner and the left side thicker. The eyebrows are controlled by the liver meridian (wood element).

The inner edge of the eyebrow is a liver element and the outer edge is controlled by the gall bladder meridian. If eyebrows are back it indicated strength. When they grow together it indicates the person does not follow the rules and wants to cause trouble to get excitement. When the arch is up and down, the person likes to make up his mind fast and then do things quickly.

When the eyebrows go in opposite directions, it signifies the person will say no and change his mind. Eyebrows that are long signifies many friends and the person does ask for help. Short eyebrows signify few friends and rarely asking for help. Abnormalities of the outside of the eyebrow (gall bladder element) signify one must always pay back for any gift received. Tapered eyebrows are seen in artists. Demanding people have long eyebrow hairs.

Two vertical lines between the eyebrows is seen in diffuse anger. When three or more lines are present, anger is managed.

LOOK INTO THE EYES AND YOU WILL READ THAT PERSON'S ENTIRE PERSONALITY.

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