Multivitamins do not cut cardiovascular events

Posted on December 27, 2012 by drlesliegreenberg

What does this mean? Behavioral interventions such as exercise and medications for cholesterol-lowering therapist CAN lower cardiovascular disease risk. Multivitamins daily did not provide any cardiovascular benefits.
There was a study of nearly 15,000 male physicians and rate of cardiovascular events (heart attack or stroke) who took daily vitamins for 11 years was 11.0/1,000 person-years compared with 10.8 events/1,000 person-years in those taking placebo (fake pills).

The message from this study: Eating healthy foods, exercising regularly, avoiding tobacco products and taking proven medications to decrease cardiovascular events DOES help, multivitamins do not.

Source: JAMA 2012; 308: 1751-60.

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Wanting to avoid holiday weight gain?

Posted on December 12, 2012 by drlesliegreenberg
flickr.com/ photos/ reallyboring/ 2860775800

flickr.com/ photos/ reallyboring/ 2860775800

Follow your bodies “satiety signals”– your body’s ability to gauge that you have eaten an appropriate amount.

1.  Mindless or distracted eating (like standing/talking/AND eating or eating while driving) can make food-intake-memory fuzzy.  This seems to override the effects of the body’s satiety signals.

2.  In a 2006 study, when people ate what was named a “meal” they consumed less at the next meal than when the same amount of food was named a “snack.”

Take home points: Pay attention to your food during mealtime and consider it a “meal”, not a snack.

Enjoy the holidays!

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Circumcision may lower prostate cancer risk

Posted on December 11, 2012 by drlesliegreenberg
flickr.com/ photos/ blmiers2/ 6904758951

flickr.com/ photos/ blmiers2/ 6904758951

Interesting study involving 3,399 men. It was found that men who are circumcised before their first sexual intercourse have significantly lower risk for prostate cancer than do uncircumcised men (or men who are circumcised after their first sexual encounter).

The scientists found a 15% reduction in relative risk. They postulated that infectious or inflammatory pathways may be involved in the changing of the prostate cells to cancer. A 1987 study also linked circumcision to reduced prostate cancer risk.

Hmmmm.

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Breast cancer pill rethought

Posted on December 7, 2012 by drlesliegreenberg
flickr.com/ photos/masterslate/ 3003880273

flickr.com/ photos/masterslate/ 3003880273

Tamoxifen is used in the hopes of stopping a  breast cancer recurrence.  For 15 years the standard has been to take a tamoxifen pill once a day for 5 years.  And then stop.

There is new research that women who take tamoxifen for 10 years may have significantly less chance of breast cancer recurrence.  Read on…

http://www.nytimes.com/2012/12/06/health/extended-use-of-breast-cancer-drug-suggested.html

Hope this helps.

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The race is on!

Posted on December 4, 2012 by drlesliegreenberg
flickr.com/ photos/cups/ 4339100355

flickr.com/ photos/cups/ 4339100355

It’s off with a start!  Quickest start in 10 years!… I wish I were talking about the Kentucky Derby, but I am talking about the flu.  There is still time to get vaccinated.

Who should be vaccinated?  Anyone older than 6 months.  That includes pregnant women, children, asthmatics, those with chronic health conditions, and everyone else!

You CANNOT get the flu from the flu vaccine.  CANNOT.  Avoid a week of muscle aches, inability to get out of bed, high fever and a cough.

See your doctor today for a vaccine.

Posted in General Medicine- Adults, Obstetrics, Pediatrics, Uncategorized, Vaccines, Vaccines, vaccines | Tagged , , , , , , , , , | Comments Off on The race is on!

Carpal tunnel. Who? What? Why?

Posted on December 3, 2012 by drlesliegreenberg

Who?  Anyone can suffer from carpal tunnel syndrome.  It is often associated with repetitive motion at work or play but also frequently occurs in people with diabetes, thyroid disease, or in pregnant patients.

What?  Carpal tunnel syndrome occurs when the median nerve gets squished in the wrist.

Why?  Think about all the structures that need to help our fingers move: arteries, veins, nerves, tendons. It’s amazing there’s enough room for all that–so any swelling within the carpal tunnel tips the scale . . . and the hand has symptoms.

Common symptoms are

  • numbness,
  • tingling or pain in thumb, index or middle fingers,
  • swelling and tightness in the hand,
  • pain that shoots from your hand up through your arm,
  • numbness in the entire hand.

Associated symptoms include

  • difficulty holding (or dropping) objects,
  • numbness that’s worse at night or in the morning,
  • weakness in the hands or arms in the morning,
  • trouble opening a lid on a jar or using a screwdriver.

Treatment depends on the severity and frequency of symptoms.  Early diagnosis is important to successful treatment.  Options may include stretching, wrist braces or splints, physical therapy, anti-inflammatory medicines, strengthening exercises, cortisone injections, or surgery.

… I’m having an Abbott and Costello flashback.  Who is on first? What is on second?  I don’t know is on third?!

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Sleeping too much or too little has risk.

Posted on November 27, 2012 by drlesliegreenberg

flickr.com /photos/mart3ll/ 255289520

Heart health is tied to how much sleep you get.  There is an optimal amount of sleep: 6-8 hours per night.

Those who slept less than 6 hours per night had twice the risk of heart attack or stroke compared to those who slept 6 to 8 hours per night.  Studies have linked insufficient sleep with

  • hyperactivation of the sympathetic nervous system,
  • glucose intolerance,
  • an increase in cortisol,
  • increase in blood pressure,
  • decreased variability in heart rate,
  • disruption of hypothalamic axis, and
  • increase in inflammatory markers.                               Wow!  All bad things!

Those who slept more than 8 hours per night had a twofold increased risk of heart pain (angina) and an increased risk of coronary artery disease (which may lead to heart attack). It is postulated that patients who sleep more than 8 hours per night may do so because of an underlying condition like lung disease, diabetes, or low socioeconomic status which all could contribute to cardiovascular risk.

Hope this helps.

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Reducing waste in healthcare

Posted on November 23, 2012 by drlesliegreenberg

flickr.com/ photos/ nickhumphries/ 2215306696

Choosing wisely?  Choosing Wisely campaign is a coalition of medical societies and physician groups that wants to reduce waste in healthcare.  Here are a few examples of wasteful use of healthcare dollars (because treatment frequency is not justified by the medical literature)

  1. EKGs and exercise stress tests for heart disease
  2. Imaging tests for lower-back pain
  3. CT scans and MRIs for headaches
  4. Bone-density scans (DEXA scans) for low-risk women
  5. Antibiotics for sinusitis

Want to see more?  Visit http://choosingwisely.org/

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70 is the new 100!

Posted on November 19, 2012 by drlesliegreenberg

flickr.com /66109304 @N00/ 486082775/

What?  There are new guidelines on lowering cholesterol.  We have, for years, targeted  LDL (the bad cholesterol) to be under 100 in at-risk patients.  Now, the LDL target number is under 70!

An LDL below 70 mg/dL should be the goal for all patients with coronary artery disease, or those with diabetes plus at least one additional risk factor (smoker, high blood pressure, history of stroke, chronic kidney disease).

Be aware of your risk factors. And, get to goal!

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Falls among the elderly can be decreased.

Posted on November 15, 2012 by drlesliegreenberg

There are many treatments to decrease falls in the elderly that’ve been not helpful.   Home-based and group exercise intervention programs help the most (for elderly living in their own home)!    A second factor to reduce falls is “home safety interventions” when done by occupational therapists.

Treatments which have not been shown to help are

  • walking programs,
  • hormone replacement therapy, and
  • adjustment of medication regimens,
  • cognitive behavioral therapy,
  • vision improvement interventions, and
  • withdrawal of psychotropic drugs,
  • vitamin D supplementation, and
  • nutritional therapy.

The above information was collected by the 2012 Cochrane Database.  These combined studies performed in 21 countries and included 79,193 patients.  Other specifics include the fact that vitamin D supplementation only helped decrease falls they were vitamin D deficient.

The most successful exercise programs included more than one of the following techniques gait training, balance training, functional training, muscle strength/resistance training, tai chi, walking and 3-D training which is constant, repetitive movements through all three special planes.

If you (or a loved one) need help, please get it.

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