Posted by & filed under Cardiovascular.

Aortic stenosis is a narrowing of the aortic valve by calcification, usually occurring in older people or those with congenital defects in aortic valve formation. When the valve gets too narrow, the heart has to pump extra hard to force blood into the aorta and into the rest of the body. Eventually heart failure, chest pain or passing out will occur, ultimately leading to death unless the valve is surgically replaced.

Until now, older people who were too ill to undergo open heart surgery to replace the valve would die. A new procedure has arrived, allowing for valve replacement without opening the chest and putting the patient on a heart-lung machine. A special catheter is threaded up the aorta from entry in the groin artery. An artificial valve at the end of the catheter is placed carefully and exactly within the orifice of the aortic valve, then expanded by inflation of a balloon. The calcified natural valve is pushed against the sides of the aorta, and the new valve is fixed in place, allowing for a larger passage. Read more »

Posted by & filed under General.

DoctorsWhether it is alternative or allopathic (conventional), bad medicine is just bad medicine. We have patients who take no prescription or over-the-counter medication at any time. We see others who are taking 10-12 medications at once, who are interested in getting off as many of them as possible. They know that prescription drugs can be and often are toxic, and they experience those adverse effects. Certainly we deplore situations where patients enter the hospital with chest pain and are discharged with eight new medications, with no detailed advice on beneficial life-style changes, and told not to eat vegetables because they are on Coumadin.

There are times, however, that prescription drugs are useful and even life-saving. There are times when surgery can save a life, as in the evacuation of a subdural hematoma, and times when it is massively destructive, as in prefrontal lobotomy for psychiatric disorders.

I have seen physical therapy employed when the cause of pain was obvious but undiagnosed malignancy, herbs employed for critical aortic stenosis that needed surgery, congestive heart failure treated with acupuncture. The list goes on, and indeed every practitioner in every field of medicine has failed at some point to make the right diagnosis, or has offered the wrong therapy, or failed to offer the right therapy. Conventional practitioners are for the most part untrained in alternative therapies, and often demean them, while alternative practitioners have limited training in conventional diagnosis and treatment. Read more »

Posted by & filed under Cancer, Nutrition.

Vitamin C DripIntravenous vitamin C has a storied past. Not at the time identified as the active therapeutic component, vitamin C in citrus fruits was demonstrated by James Lind in 1747 to prevent scurvy in sailors. Citrus fruit therapy had been inconsistently utilized for 500 years for the same purpose, but was not officially acknowledged and promoted by the British admiralty until 1785, 50 years after Lind’s great experiment. During that interval multitudes of nutritionally deprived seamen suffered and died from a preventable disease Scurvy caused gastrointestinal, skin and mucous membrane bleeding, skin rashes, loss of teeth, fatigue, depression, and poor wound healing. Oranges and limes, high in vitamin C, were the answer.

Linus Pauling, a world famous chemist and beneficiary of two Nobel prizes, began studying vitamin C in 1966, after discussions with Irwin Stone, another researcher. From his work came the recommendation of vitamin C for the common cold, an idea repudiated out of hand by the medical community. He later studied intravenous vitamin C as a treatment for lung cancer, with survival rates months longer than for patients who did not receive vitamin C. Read more »

Posted by & filed under Nutrition.

Coffee

In a very large study involving over 400,000 men and women over 13 years, those who drank more coffee were found to live longer. (NEJM May 17, 2012, pp.1891-1904)

Subjects were aged 50-71 at baseline. Compared with men who drank no coffee, the incidence of death was 6% less in men who drank one cup of coffee daily, 10% less in those who drank 2-3 cups daily, and 12% less in those who drank 4-5 cups daily.

In women, those who drank one cup of coffee daily had a 5% lower risk of death compared with those who drank no coffee. Risk reduction was 13% in women who drank 2-3 cups daily, and 16% in those who drank 4-5 cups daily.

Read more »

Posted by & filed under Cancer.

After years of upset, hormone cancellations and denials, now comes more evidence that estrogen replacement therapy does NOT cause breast cancer. Estrogen may even protect against breast cancer. If you find this surprising, read on.

Published in Lancet Oncology, March 7, 2012, the study was an extended, 12-year follow-up of 7,645 women, half of whom had been treated with estrogen for an average of 6 years, the other half with placebo. All of the women had received hysterectomy. Follow-up continued for 6 years after the termination of therapy.

The risk of invasive breast cancer was LOWER (0.27% per year) in women taking estrogen than in women taking placebo, meaning no hormone (0.35% per year). In women who did develop breast cancer, those taking estrogen were less likely to die from it (6 deaths, or 0.009% per year) than women who took placebo (16 deaths, or 0.024% per year). Death from any cause was also lower in the hormone-treated group.

Read more »

Posted by & filed under Gastrointestinal.

Heartburn ControlMillions of people suffer every day from the very uncomfortable symptom of heartburn. This is also known as GERD (gastroesophageal reflux disease). Heartburn is a very unpleasant burning sensation located in the anterior chest that radiates from the stomach to the throat.

Sometimes it appears as a sensation of pressure on the chest and can mimic symptoms of a heart attack. It is worse at night when the patient is lying down and it is aggravated by eating spicy food, tomato, chocolate, coffee, citrus fruits and juices. Symptoms improve with the use of antacids.

When untreated, it can progress to esophageal ulcers, strictures, hoarseness and respiratory problems. Dental erosions, laryngitis, nocturnal choking, sinusitis and cancer of the esophagus are additional complications.

An estimated 14-20% of all US adult have some degree of gastroesophageal reflux.

Americans spend in excess of $10 billion dollars a year on acid reducing medications which are considered the first line of therapy for GERD. Despite the use of these medications, the incidence of esophageal cancer has increased significantly in the past 20 years, with an estimated increase of 200-600%

The other problem related to the use of acid reducing medication is that suppression of acid decreases absorption of iron, calcium and vitamins.There is also a moderate increased risk for fractures in menopausal woman on these drugs. Read more »

Posted by & filed under Cancer.

It was found previously that low vitamin D levels increase the risk of developing breast cancer. Recently it has also been found that low vitamin D levels are associated with markers of more aggressive disease and of metastases. (Aggressive Breast Tumors Linked to Vitamin D Deficiency: April 29, 2011, at http://www.urmc.rochester.edu)

Women with vitamin D levels below 32 ng/ml had a higher percentage of hormone negative cancers, known to be more aggressive. They also had a higher Onco Dx score, a genetic test of cancer cells that predicts the likelihood of metastasis.

In other words, higher vitamin D levels not only lessen the chance of getting breast cancer, but will likely also improve survival in those who have breast cancer. Read more »

Posted by & filed under Gastrointestinal.

Gastroesophageal reflux is common. It occurs when stomach acid moves up into the esophagus and causes burning, erosions or ulcerations. If the acid moves higher, it may enter the larynx or even the lungs, causing cough, wheezing or shortness of breath. Many patients with nighttime cough suffer from reflux, and are treated with antacids and proton pump inhibitors.

It now appears people with nocturnal reflux should also be evaluated for sleep apnea. During sleep apnea, tissues in the back of the throat, including the tongue, fall backward and occlude the airway. The body struggles to get enough air, leading to a tightening of abdominal muscles, and forcing the stomach up against the diaphragm. This pushes stomach contents up through the gastroesophageal sphincter (valve) into the esophagus, thus causing reflux.

Treatment for sleep apnea may also eliminate reflux. If you know of someone who is awakened by nighttime coughing, and doesn’t get a good night’s sleep, suggest evaluation for sleep apnea. The diagnosis will be missed unless specifically looked for.

Allan Sosin

Posted by & filed under Muscle/Joint Pain.

Twenty-seven million Americans have degenerative arthritis, called osteoarthritis. The rate of knee replacement surgery has dramatically risen, by a factor of ten in the last thirty years. Over 100,000 knee replacement procedures are performed every year. However, evaluation of knee x-rays has not confirmed an increase in radiologic abnormalities to coincide with the increase in surgical procedures. (Annals of Internal Medicine, Dec 6, 2011, pp. 725-731) Read more »

Posted by & filed under Cardiovascular.

An invasive cardiologist in Maryland recently had his license revoked by the state medical board for 2 years, for implanting unnecessary cardiac stents in his patients. He was the head of cardiology at his hospital. One day he had implanted 30 stents. Review of his cases revealed that he had overestimated the degree of blockage, and between 2007 and 2009 had inserted 585 unnecessary stents, at a cost of $3.8 million paid by Medicare.

Six hundred thousand angioplasties are performed in the US every year. Cardiac stents are of value in patients with new heart attacks, where they may reduce the extent of damage, and in patients with disabling angina, whose chest pain prevents them from performing daily activities or exercising. In patients with stable, non-limiting chest pain, heart catheterizations and stents offer no benefit, either in preventing heart attacks or prolonging life, over optimal medical therapy. Read more »