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What if I were to tell you that there is a life-threatening disease out there that usually has no symptoms and now kills more Americans than HIV — and that most of the people who die from it are middle-aged? Unfortunately, this is all true. Ironically, we’ve all heard of this disease — it’s hepatitis C — but few of us appreciate how dangerous it has become.
To learn why hepatitis C (or “HCV,” with a “V” for virus) is on the rise and why it hits middle-agers the hardest, I called John A. Donovan, MD, a hepatologist and an assistant professor of medicine at the University of Southern California’s Keck School of Medicine in Los Angeles.
A SILENT ATTACK ON YOUR LIVER
HCV is a bloodborne infection that can be transmitted through a needle (like a drug or tattoo needle). from mother to child during birth… through unprotected sex with an infected partner… and you may remember that in a recent Daily Health News story (see the January 2, 2012 issue) I told you that, though it’s not as common, you can even get HCV at a barbershop or a nail salon if the manager doesn’t impose strict hygiene rules and a contaminated instrument nicks your skin.
But why is HCV on the increase? According to Dr. Donovan, the reason is that until 1992, there was no test to detect HCV in the blood, so it was also transmitted in hospitals through blood transfusions and organ transplants. “There has been a delay in the outbreak of the disease because it can take decades for HCV to quietly cause significant liver disease — the first symptom is often a serious health problem like cirrhosis” (when scar tissue replaces normal liver tissue), said Dr. Donovan. Before 1992, the dangers of bloodborne infections weren’t nearly as well-known as they are today — so there weren’t programs in place to warn people about the risks. “In other words,” said Dr. Donovan, “this is a tsunami wave that started decades ago but is now cresting.”
Dr. Donovan said that the HCV upsurge mostly affects baby boomers (as opposed to older people) because in the 1960s, 1970s and 1980s, there was a rise in intravenous (IV) drug use, and during those years, baby boomers were in their teens, 20s and 30s and most likely to participate in risky activities like that. People older than baby boomers who missed the drug culture of those eras might have contracted HCV through a blood transfusion or an organ donation, for example, but since it can take decades for the disease to develop, HCV isn’t affecting as many in that population — probably because they will likely die from something else before HCV manifests itself.
SHOULD YOU BE TESTED?
Testing for HCV is currently recommended by the US Preventive Services Task Force and National Institutes of Health only for people with known past exposures or risks, such as IV drug use and those who got blood transfusions or organ transplants before 1992. But since baby boomers are at higher risk and the disease can progress without symptoms, some doctors, according to Dr. Donovan, are more aggressive and prefer to test everyone born between 1946 and 1964.
If you are too embarrassed to talk to your doctor about some previous risky behavior and ask for an in-office blood test, donate blood. All donated blood is screened for HCV. If screening shows that you have HCV antibodies in your blood, you will be told, and you will need more tests to determine whether your liver function is compromised and how much of the virus is in your blood.
But don’t panic. Only about 20% of people with HCV develop cirrhosis, and only 1% to 5% of that group dies from its consequences (liver cancer or liver failure). Meanwhile, even if your liver is healthy, it’s important to know whether you have HCV because certain habits, such as consuming alcohol, can accelerate its progression. So the earlier you know, the earlier you can start protecting yourself with lifestyle changes.
Source:
John A. Donovan, MD, assistant professor of clinical medicine, department of medicine, Keck School of Medicine, University of Southern California, Los Angeles.
Tags: Baby Boomers, Blood Transfusions, Bloodborne Infections, Cirrhosis, Hcv, Hepatitis C, Hepatologist, Hygiene Rules, John A Donovan, Keck School Of Medicine, Liver Disease, Liver Tissue, Middle Agers, Organ Transplants, Scar Tissue, School Of Medicine, Serious Health, Tsunami Wave, University Of Southern California, Unprotected Sex
Here’s some health news that you can file into the “ugh!” category: There’s yet one more condition that’s trying to get between us and a good night’s sleep — and it’s one that’s nearly impossible to control. The lenses of your eyes are likely to naturally (and gradually) turn an icky yellow color as you age — and now a new Danish study, which was published in the September 1, 2011 issue of Sleep, suggests that the more severe the yellowing of the lens is, the more likely you are to have trouble getting a solid seven to eight hours of ZZZ’s a night.
I called Michael J. Decker, PhD, RN, the Byrdine F. Lewis Chair in Nursing at the School of Nursing at Georgia State University in Atlanta and a spokesperson for the American Academy of Sleep Medicine, to get more insight about what these study findings mean for you and me.
HOW YOUR EYES AFFECT YOUR SLEEP
The researchers asked 970 Copenhagen residents, men and women ages 30 to 60, “Do you often suffer from insomnia?” and if they had purchased prescription sleep medication in the last year. If the answer was “yes” to one or both questions, the participant was put into the “sleep disturbance” category. About 24% of participants were in this category. Those who answered “no” to both questions were the control group. Then each participant underwent a noninvasive eye examination called lens autofluorometry, which measured how yellow their eye lens was.
From past studies, the researchers already knew that eye lenses tend to become yellow as people age — it’s actually a type of cataract — and they also knew that sleep disturbances are more common among the elderly, so their goal was to see if there was a link between the two. In comparing the results of the eye exams with the incidence of sleep problems, researchers found that the more severe the yellowing of the eye lens, the higher the risk for sleep disturbances.
Dr. Decker explained that the yellowing of the eye lens prevents blue light — a type of light that we absorb from short wavelength rays — from entering the eye. That can be problematic, because blue light can alter your circadian rhythms by influencing the release of melatonin, a hormone that tells your body when it’s time to be sleepy. In other words, the more yellow your eye lens becomes, the less blue light your eye absorbs, which changes the patterns of melatonin released in your brain — and therefore, the less restful sleep you’re likely to get. It turns out that what happens in broad daylight every day may have a profound effect on what happens in your pitch-black bedroom every night.
EYEING A SOLUTION
More than eight out of 10 cases of sleep disorders go undiagnosed, Dr. Decker observed, and that is quite troubling when you consider that not sleeping well can seriously impair quality of life and undermine health. So if you suffer from insomnia for more than 30 days, it’s important to see a sleep specialist who can get to the bottom of your problem — and help you find a solution.
If you’re suffering from insomnia, you may also want to schedule an appointment with an ophthalmologist — especially if you are having classic cataract symptoms, such as decreased night vision, glare and halos, decreased vision in very bright light or an inability to see 20/20 with a new pair of glasses. A cataract is not easily detected with the naked eye, because the lens yellowing occurs behind the iris — it usually is discovered only when an ophthalmologist uses a microscope. To find out more about how a yellowing lens might be treated, I called Brett Levinson, MD, an ophthalmologist in Baltimore and clinical instructor of ophthalmology at University of Maryland School of Medicine.
If a cataract is serious enough, it can be removed with surgery. During cataract surgery, your natural lens is replaced with an artificial lens that can transmit the full color spectrum. Of course, since this research on cataracts and sleep disturbances is new, there isn’t much proof — at least not yet — that removing a cataract will make sleep problems go away, so an ophthalmologist isn’t likely to remove yours (nor will Medicare pay for the surgery) unless it’s also impairing your vision.
In terms of fending off (or slowing down) this yellowing of the lens, doctors don’t know of much you can do just yet. But it helps to quit smoking (or don’t start), and make sure you eat a healthy diet and exercise regularly to help prevent diseases like diabetes and heart disease, because those diseases can make lens yellowing more rapid and severe. And, can you simply supplement melatonin to overcome what’s lost by a yellow lens? That is a question still to be studied, but worth asking your doctor.
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Source(s):
Michael J. Decker, PhD, RN, RRT, D.ABSM, Byrdine F. Lewis Chair in Nursing, associate professor, nursing, neuroscience, respiratory therapy, Byrdine F. Lewis School of Nursing & Health Professions, Georgia State University, Atlanta. Dr. Decker is a spokesperson for the American Academy of Sleep Medicine.
Brett Levinson, MD, ophthalmologist, Select Eye Care, Baltimore, clinical instructor in ophthalmology, University of Maryland School of Medicine, Baltimore.
Tags: American Academy Of Sleep Medicine, Cataract, Control Group, Copenhagen Residents, Danish Study, Eight Hours, Eye Examination, Eye Exams, Eye Lens, Eye Lenses, Georgia State University, Insomnia, Phd Rn, Sleep Disturbance, Sleep Disturbances, Sleep Problems, Sleepless Nights, Study Findings, Women Ages, Zzz
If recent research continues along its promising path, stem cells from women’s uteruses might turn out to be the “mother” of all treatments for type 1 diabetes — eliminating the need for patients (men as well as women) to inject themselves with insulin!
A group of scientists from Yale University School of Medicine in New Haven, Connecticut, has converted endometrial stem cells harvested from the base of adult female uteruses into cells that produce insulin. It’s possible that this will turn out to be a major breakthrough for the roughly three million Americans who have type 1 diabetes (meaning that their bodies don’t produce insulin). I contacted Hugh S. Taylor, MD, lead researcher of the study (published in the August 30, 2011 issue of Molecular Therapy) and a professor of obstetrics, gynecology and reproductive sciences at Yale to learn more about this intriguing new application for stem cells.
While there are new technologies that are fairly easy to use to treat type 1 diabetes (like insulin pens and pumps), people who don’t naturally produce insulin still have to spend lots of time monitoring their blood sugar and need several injections of varying amounts a day.
But even with these advances, insulin injection remains inexact and inefficient, said Dr. Taylor. “Glucose levels change so rapidly that no amount of monitoring allows diabetics to inject insulin at the precise times they need it,” he explained.
ABOUT THE RESEARCH
Dr. Taylor and his fellow researchers extracted the uterine stem cells from adult women and treated them with special nutrients and growth factors (indolactam and exendin) that earlier studies had shown would transform the cells into insulin producers. These new-and-improved cells were then injected into eight mice with type 1 diabetes, while six other mice with type 1 diabetes were injected with placebo cells.
After five weeks, none of the mice that got the new insulin-producing cells developed diabetic problems — their blood sugar didn’t rise any higher, and they started producing insulin. In contrast, blood sugar levels in all of the mice who received placebo cells continued to rise (above 220 mg/dL) and they also began to develop some of the common complications of diabetes that are so destructive, specifically cataracts and fatigue. While the mice with the insulin-producing cells were still considered diabetic, they were clearly in far better shape than their placebo-treated counterparts, and Dr. Taylor told me that he believes that injecting more such insulin-producing cells into them might even lower their blood sugar and make their diabetes actually go away.
COMING SOON TO A DOCTOR NEAR YOU?
Dr. Taylor seems quite optimistic that human beings will react well to this new therapy, too. He believes that we could see treatments based on this technique within three to four years but noted that this depends, of course, on the outcome of research that is currently underway. Thus far, no dangerous or harmful side effects have been identified. Though it is possible that people will need repeat stem cell injections (perhaps every few months or every few years), the stem cells are inexpensive to produce and the injections can be given directly into the skin in a process so simple that it can be done in a doctor’s office. This is a promising development to be watched.
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Source(s):
Hugh S. Taylor, MD, chief of reproductive endocrinology and infertility, director, Yale Center for Reproductive Biology and professor of obstetrics, gynecology and reproductive sciences at the Yale University School of Medicine, New Haven, Connecticut.
Tags: Adult Women, Diabetes Insulin, Dr Taylor, Exendin, Fellow Researchers, Glucose Levels, Growth Factors, health, Insulin Injection, Insulin Pens, New Haven Connecticut, Obstetrics Gynecology, Precise Times, Promising Path, Reproductive Sciences, Stem Cells, Taylor Md, Type 1 Diabetes, Uteruses, Yale University School, Yale University School Of Medicine
Spring is around the corner, and the last thing I want to be thinking about is fruit salad dosed with pesticides or a lovely cut of meat on the grill, generously marinated in bug spray. Why, then, is my mind traveling so firmly in this direction? It’s almost 40 years after DDT was banned, and you would think that we’d now feel safe and comfortable in knowing that we are exposed to fewer toxic pesticides. Instead there’s evidence that we’re exposed to more.
About 70,000 different chemicals are used in the US today, making the chemical companies healthy even if we’re not. Although many of these chemicals are known carcinogens, there isn’t a lot of scientific research that has successfully proved a causal link to cancer — since, in addition to being expensive, this would take decades to prove… and, of course, no one will get rich from the results. Now new research is emerging that links pesticides to other known health problems, so I thought it was important to take a look at what we know — and what we don’t know — about the dangers of the pesticides used in growing the foods we eat.
So Many Chemicals
Fruits and vegetables receive the highest dosage of pesticides, so they’re more likely to be contaminated than other foods. For instance, conventional, non-organic growers can choose from as many as 62 different types of pesticide products to treat a crop of peaches (and each crop is typically treated with many different types)… 52 for blueberries… 42 for apples. And you may not realize that pesticides also have been found in meat and chicken, especially in the thighs.
I spoke to David Pimentel, PhD, a professor in the department of entomology, systematics and ecology at Cornell University about this trend. “About 70% of the foods that consumers buy have detectable levels of pesticide residues,” Dr. Pimentel told me.
Who Is Most at Risk?
Regarding the connection between cancer and pesticides, it is safe to say there’s good reason to worry about one. Noting that more research is needed on this important topic, Dr. Pimentel said. “There is no question that pesticides can cause cancer — the question is, how many people do they affect?” He noted that people with a genetic risk for cancer are quite likely the most vulnerable.
Meanwhile, researchers continue to uncover more ways that absorbing pesticides — by eating, touching or breathing them — is bad for our health… most especially for people who are already somewhat unhealthy due to poor lifestyle or other conditions that depress their immunity. Among the recent findings…
- Parkinson’s disease. It appears that exposure to pesticides may trigger Parkinsons’s disease in genetically predisposed people. In a large 2006 study, researchers at Harvard School of Public Health found that participants exposed to pesticides (specifically, farmers, ranchers, fishermen and people who used pesticides in their homes or gardens) had a 70% higher incidence of Parkinson’s than those who weren’t exposed. The latest research, reported in February 2011 and conducted by the National Institute of Environmental Health Sciences, shows that people exposed in their professions to the pesticides paraquat or rotenone developed Parkinson’s approximately 2.5 times more often than people who were not exposed. Both pesticides cause cellular damage. Paraquat, in particular, is an extremely toxic substance originally developed as an herbicide.
- Dementia. A study that collected data between 1997 and 2003 from French vineyard workers who spent at least two decades applying pesticides to plants or working in buildings where pesticides were housed showed that these workers scored low on a test of memory and recall. Researchers speculate that the changes demonstrated in the mental functioning of these people indicate that they may eventually develop a neurodegenerative disease, such as Alzheimer’s.
- Infertility. In a 2008 review of studies on pesticide exposure, epidemiologists showed a decline in the semen quality and quantity of farm workers, which impaired male fertility by 40%. “Infertility, especially in men, is increasing in proportion to greater exposure to pesticides,” said Dr. Pimentel.
Kids Are Vulnerable
For children, there is bad news and good news. First of all, the problem of pesticide exposure is amplified compared with adults. “Kids are growing,” noted Dr. Pimentel. “In relation to body weight, they eat more than adults.” One study found that the urine of children eating a variety of conventional foods contained markers for organophosphates, a lethal group of pesticides used to disable the nervous system of pests that is, not incidentally, used to make the deadly nerve gas saran. However, the study also found that when the children’s diets were switched to only organic foods, the chemicals disappeared from their bodies within 36 hours.
What To Do
You may take some comfort — briefly — in knowing that, by Dr. Pimentel’s reckoning, newer pesticides are used at 1/1,000 of the amount as had been the case with DDT. But don’t be fooled by this simplistic comparison — ounce for ounce or pound for pound, “These newer materials are far more toxic, not just to pests but also to humans.”
Washing and peeling helps only if a chemical is on the outside of a fruit or vegetable, Dr. Pimentel noted — but the sad fact is that some of these toxins are taken up by the plant as it grows, meaning that the pesticides end up inside the flesh of the produce and therefore cannot be removed even with careful washing and peeling.
Foods least likely to have pesticide residue after washing include onions, avocados, corn, pineapples, mangoes, asparagus, sweet peas, kiwi, cabbage, eggplant, papaya, watermelon, broccoli, tomatoes and sweet potatoes. Some of these foods have thick skins that protect the food, while others face fewer threats from pests and so are sprayed less.
Avoiding the most contaminated types of fruits and vegetables or buying their organic counterparts reduces your pesticide exposure by 80%. The following foods, when grown conventionally, contain the most pesticide residue even after washing and/or peeling: Celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, kale, cherries, potatoes, grapes, carrots.
Bottom line: Choose carefully, buy organic when possible and be sure to wash fruits and vegetables thoroughly to be certain they’ll keep you healthy, not make you sick.
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Source(s):
David Pimentel, PhD, professor, department of entomology, systematics and ecology, Cornell University, Ithaca, New York.
As if it weren’t tough enough to face cancer, many patients who receive chemotherapy experience severe nausea and vomiting afterward, particularly on the first day of a treatment cycle. And even when antivomiting drugs are used, nausea often continues.
Good news from a recent study: For three days before and after their chemotherapy cycles, cancer patients took conventional antivomiting medication plus either a placebo or capsulated ginger root (purified, dried ginger extract). The daily ginger dosage was 0.5 grams (g), 1 g or 1.5 g—equal to about one-quarter teaspoon to three-quarters teaspoon of ground ginger. Results: At all doses, ginger users reported significantly less nausea than placebo users… patients who took 0.5 g or 1 g of ginger had the biggest benefit, experiencing about 40% less nausea on the first day of chemo than placebo users.
Best: If you are scheduled for chemotherapy, ask your doctor about adding ginger supplementation to your treatment regimen before and after chemo to reduce nausea.
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Source: Julie L. Ryan, PhD, MPH, is an assistant professor of dermatology and radiation oncology at the University of Rochester Medical Center in Rochester, New York, and author of a study of 644 cancer patients, most of whom had breast cancer.
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