Archive for October, 2010
A case study Restless legs cyndrome. Every night, an indescribable creepy-crawly sensation in Selena legs occurred within minutes of getting under the covers. She had to move her legs constantly. Temporary relief came with massage or by getting out of bed and walking. She had learned years ago that caffeine or late-night exercise would make it bad.
Selena was irritated by her chronic sleep loss and daytime weakness. Selena had shared her irritation with her primary care physician. The diagnosis of restless legs syndrome was confirmed based on her history. Selena’s physician reviewed medical therapy options. While she understood that effective therapy was available, Selena was reluctant to start taking medicine that she would have to take for the rest of her life.
While searching the Internet, Selena found a report describing improvement in restless legs syndrome with the use of leg pumps similar to those used on hospitalized patients to prevent blood clots. After obtaining a prescription from her physician, Selena found a medical supply house that stocked athrombic leg pumps. The pumps dramatically decreased her symptoms, but didn’t appear to be a satisfactory long-term solution.
At the age of 25, Selena decided she’d had enough. She felt that there had to be some form of therapy other than leg pumps or long-term medication. At a friend’s suggestion, she visited a sleep center. Selena’s sleep physician confirmed the diagnosis of restless legs syndrome and reviewed medical treatment options once again. She also suggested obtaining a blood test to check for the possibility of iron deficiency. Her sleep physician discussed how iron deficiency was common particularly in menstruating women but often ignored.
A simple blood test confirmed that Selena had severe iron deficiency, undoubtedly related to her heavy monthly menstrual flow. Looking back, Selena realized that her symptoms of restless legs syndrome began soon after she started getting her period as a young teen. Selena read everything she could find on the subject of iron deficiency. She was surprised to learn that in both men and in women, it can be a sign of chronic blood loss from the intestines and is sometimes related to malignancy. Selena learned that iron is the element that carries oxygen in red blood cells to all cells in the body. She also learned that in addition to restless legs syndrome, iron deficiency can cause severe anemia.
Within weeks of taking a daily iron pill, Selena’s restless legs syndrome resolved completely. She was thrilled that her medical condition could be treated with a natural form of therapy. Her sleep physician asked Selena to have her serum ferret level checked periodically by her primary care physician. This specific test was the best way to assess her iron levels. Selena was told that her primary care physician should aim for a ferret level above 50. Her ferret level at the beginning of therapy was markedly reduced at a level of five. Selena was thrilled with her response to treatment, but wondered why none of her health care providers had ever previously thought to administer a simple blood test.
Scientists found that the diet could reduce cholesterol – a major cause of heart disease – by a third and bring blood pressure down by nearly a tenth, reports express.
But rather than just a narrow range of foods being responsible for boosting health, the study showed that the answer was a widely varied diet that might include oily fish, porridge oats and blueberries.
It has long been known that keeping active and a healthy diet can hold back the onset of a range of diseases like heart problems and cancer.
Previous studies have put this down to eating lots of antioxidant-rich fruits, vegetables and nuts, others to a diet rich in fish containing essential fatty acids, like fresh mackerel, and some to wholegrain cereals.
Nutritionist Angela Dowden said: ‘The key is definitely to introduce these kinds of foods into the diet. It is a very healthy diet and completely proves the point that it is about healthy eating as a whole, not just doing one thing.’
‘It is a lifestyle change instead of tweaks here and there. It could be that it is just one of the foods that is producing these effects but it is much more likely that it is an additive affect of them all contributing,’ she added.
“There are so many varieties of food in all over world. But food which we eat is necessary for long life.”
The UAE Ministry of Health has cancelled the registration and forbidden distribution of the drug Amzylite and all products that carry this component. The decision was made after testing proved that the trading composition of the drug is different from that registered at the ministry which is contrary to the rules of the UAE.
Dr Amin Al Amiri, Executive Director for Medical Practices and Licensing, said the drug was registered at the Ministry of Health in 2006 for a private company. However, the company’s licence was cancelled in 2006 for being inactive for a period of six months.
He said: “We found that the product was promoted with false claims of curing diabetes while it was registered with the Ministry of Health as enzymes to help digestion.
“The promotion was carried out through the internet, which showed a person claiming to be the inventor of the product. Besides, text messages were sent with the false information that the drug is a treatment of diabetes.”
Dr Al Amiri said registration of the drug and any product with the name of Amzylite has been cancelled and these will be withdrawn from the market in the UAE.
He said: “The pharmacies or distributors are obliged to report to the Department of Registration and Drug Control while taking the final decision about how to dispose of and to stop trading or importance any of these products.”
One in the United States, another in Germany reports strong proof that diabetes rates climb with growing air pollution in the form of little airborne particles.
“Although before studies had hinted at this possibility, the data were mostly from small studies or from animals exposed to high levels of particulate matter,” notes Aruni Bhatnagar, a cardiovascular investigator at the University of Louisville in Kentucky who did not take part in either study. He says the new data provide important and more rigorous proof that real-world pollution may be tampering with blood sugar control in a large and growing number of people.
Both new studies focused on little airborne motes spewed primarily by traffic, coal-fired power plants and industrial boilers.
The new findings are particularly disturbing when set against “an exploding pandemic, if you will, of type 2 diabetes, particularly in urbanized areas around the world,” adds cardiologist Sanjay Rajagopalan of the Ohio State University College of Medicine in Columbus, who is also unaffiliated with either new study. “The traditional explanation for this pandemic,” he says, “has been changes in lifestyle — diet and exercise — and increasing obesity.”
Particulate pollution is emerging as another potentially important candidate for causing obesity, he says, owing to its ability to trigger chronic, low-grade inflammation — initially in the lung but also in a host of other tissues, including fat.
Last year, Rajagopalan’s team published data from mice that for the first time demonstrated that fine particulate pollution can conspire with obesity to promote metabolic disease. The researchers exposed animals for half a year to what’s known as PM-2.5, airborne particulate matter 2.5 micrometers in diameter or smaller. All the animals ate a high-fat diet and became obese.
Compared with fat mice breathing clean, filtered air, those that inhaled high but real-world concentrations of PM-2.5 developed chronic inflammation, insulin resistance, a propensity to deposit their fat around the belly and a host of other prediabetic changes. The study’s findings appeared in the Feb. 3 Circulation in 2009.
The next step was to look for signs that PM-2.5 promotes diabetes in people, and the new studies tackle that question, Rajagopalan contends.
For the U.S. study, John Pearson of Children’s Hospital Boston and his coworkers compared Environmental Protection Agency measurements of fine particulates in counties across the nation against county-by-county diabetes prevalence numbers that had been collected by the federal Centers for Disease Control and Prevention.
They found that for every 10 micrograms per cubic meter increase in average PM-2.5, diabetes prevalence climbed — in absolute terms — by about 1.15 percent. (For instance, the incidence in a county whose average particulate concentration was 15 µg/m3 might be 7 percent of all adults, versus 5.85 percent in a county where the average PM-2.5 level was just 5 µg/m3.) The probability that the observed associations are due solely to chance is less than one in 1,000, Pearson’s team reports in the October Diabetes Care.
Even after accounting for a host of known diabetes risk factors including obesity, diet, exercise and a community’s population density, air pollution’s link to the disease held, Pearson says. To further test the link his team reran its analyses, taking out areas of the country with high average pollution readings or eliminating data for ethnic groups known to be at especially high diabetes risk. “And no matter how we analyzed it, the association remained strong,” he says.
In the second study, epidemiologist Wolfgang Rathmann of the German Diabetes Center in Düsseldorf and his colleagues tallied new cases of the metabolic disease between 1990 and 2006 among 1,775 middle-age women. All were taking part in a study probing air pollution’s links to lung disease, inflammation and aging. In all, 187 of the participants developed diabetes.
Because PM-2.5 measurements were unavailable, the researchers used proximity to roads — where vehicles would be a major pollution source — as a proxy for exposure to fine particulates. Women who developed diabetes were more likely to have lived nearest to heavily trafficked roads, Rathmann reports.
Compared to the 25 percent of women living farthest from busy roads, the relative risk of developing diabetes was 15 percent higher for the 25 percent of women living closest to major roadways. The findings appear in the September Environmental Health Perspectives. That diabetes risk associated with PM-2.5 in this study was similar to what Pearson’s group measured in comparing the quarter of counties with the highest PM-2.5 values to the 25 percent of counties with the least fine-particulate pollution — about a 20 percent difference.
“There is a growing body of literature suggesting that people with diabetes may be more susceptible to the harmful effects of air pollution,” notes Gregory Wellenius of Brown University in Providence, R.I. These new studies suggest this hypothesis is worth investigating further, he says. However, the epidemiologist cautions, while such studies are useful in generating hypotheses, they can’t establish causation. He says additional studies with exposure values for individuals will be needed to confirm or refute these apparent links.
The big U.S. analysis is particularly motivating, Bhatnagar says, because it’s the first to show “in such a large and complete study that air pollution is associated with diabetes.” But it does not address a perplexing trend, he notes: From 1994 to 2004, U.S. particulate pollution fell rather, while the prevalence of diabetes increased by between four and six percent.