Patient Balance Problems

Millions of people may suffer from inner-ear disorders that affect their balance but not be aware that they have a problem, a new study has found.Writing in The Archives of Internal Medicine, researchers noted the connection between balance problems and falls, especially among the elderly. The findings of the study, they said, suggest that doctors should make balance tests a routine part of checkups. This is especially true in nursing and assisted-living homes, they said.

“The big deal here really is falls,” the lead author, Dr. Yuri Agrawal of Johns Hopkins, said in an e-mail message, adding that a serious fall can be the beginning of the end for an older patient.The researchers drew on data from a federal study in which more than 5,000 people age 40 and over were surveyed about their history of falls and balance problems. They were then given examinations to determine how well they could maintain their balance in a variety of situations, including with their eyes closed.

More than a third of the subjects, the researchers found, had the balance disorder known as vestibular dysfunction — a figure that would translate to 69 million Americans.They also found that 32 percent of the volunteers who did not report problems with dizziness showed evidence of balance problems. Though they did not experience symptoms, they were still at higher risk for falls, the study said.
For doctors, Dr. Agrawal said, detecting balance problems in a patient is not very complicated. And treatment is available, including exercises that help people compensate for inner-ear problems that lead to poor balance.The cost of the treatment, they said, would most likely be less than medical costs associated with falls.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

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Banned Herbal Ingredient Linked to Urinary Tract Cancer

Natural does not equal safe, and any herb strong enough to have a potential benefit is strong enough to have potential to cause harm."
Exposure to aristolochic acid, found in some Chinese herbal products such as Mu Tong and Fangchi, significantly increased the risk for urinary tract cancer, according to a retrospective study.Researchers in Taiwan found prescription of more than 60 grams of Mu Tong and consumption of more than 150 mg aristolochic acid were independently associated with an increased risk for urinary tract cancer.

• Mu Tong, 61 to 100 g: OR 1.6, 95% CI 1.3 to 2.1
• Mu Tong, >200 g: OR 2.1, 95% CI 1.3 to 3.4
• Aristolochic acid, 151 to 250 mg: OR 1.4, 95% CI 1.1 to 1.8
• Aristolochic acid, >500 mg: OR 2.0, 95% CI 1.4 to 2.9

Used in Chinese herbal preparations taken for weight loss or urinary tract infections, aristolochic acid has been banned in several countries, including in Taiwan and in the U.S.The latest study found a linear, dose-dependent relationship between the amount of aristolochic acid consumed and an increased risk for urinary tract cancer (P<0.001). This was independent of arsenic exposure through drinking water, which has also been associated with bladder and urinary tract cancers.Among the more than 4,000 patients analyzed, 57% had bladder cancer and 43% had upper urinary tract cancer.
The International Agency for Research on Cancer has classified herbal remedies containing high concentrations of aristolochic acid as carcinogenic. Traces of aristolochic acid may still be found in adulterated remedies currently on the market.
Wang, et al "Population-based case-control study of chinese herbal products containing aristolochic acid and urinary tract cancer risk" J Nat Can Inst 2009; DOI:10.1093/jnci/djp467.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

About 2 million older adults undergo abdominal surgeries in the U.S. every year, a number that's expected to grow as the proportion of older adults increases rapidly: by 2020, one in six adults is expected to be older than 65, and 15% will be over 85.
The patient records came from the Comprehensive Hospital Abstract Reporting System, a state-wide database that contains information on the age, sex, zip code, and billed charges of patients, as well as the codes for their diagnosis and procedures.
The study focused on complications that occurred within 90 days of discharge and deaths within 90 days of hospital admission.

After adjusting for various factors, including hospital volume and patient characteristics, the study found that the odds of early death after abdominal surgery increased considerably for each five-year increase in age beyond 65. These associations held for patients with cancer and other diagnoses, and for both elective and nonelective procedures (P<0.001).

The likelihood of complications increased as patients aged beyond 65 years, with the researchers finding the following associations between age and complication frequency (trend test, P<0.001):

• 65 to 69 years, 14.6%
• 70 to 74 years, 16.1%
• 75 to 79 years, 18.8%
• 80 to 84 years, 19.9%
• 85 to 89 years, 22.6%
• 90 and older, 22.7%

Similarly, older patients were at higher risk of mortality. Death rates by age group were (trend test, P<0.001):

• 65 to 69 years, 2.5%
• 70 to 74 years, 3.8%
• 75 to 79 years, 6.0%
• 80 to 84 years, 8.1%
• 85 to 89 years, 12.6%
• 90 and older, 16.7%

Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Arch Surg 2009; 144: 1108-14.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

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For more health info and links visit the author's web site www.hookman.com

Certain dietary supplements Selenium and Omega-3s may reduce colorectal cancer risk

Certain dietary supplements appear to affect the development of colorectal cancer or its recurrence," according to two new studies presented during a medical conference. In one, "researchers from the US National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount."

In one study, researchers from the U.S. National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount.

In the selenium study, 411 people, 25 to 75 years old, who'd had one or more colorectal polyps removed took either a supplement or a placebo. The supplement, described as an antioxidant compound, contained 200 micrograms of selenomethionnine (a combination of selenium and methionnine), 30 milligrams of zinc, 6,000 international units of vitamin A, 180 milligrams of vitamin C and 30 milligrams of vitamin E.

Participants had a colonoscopy one year, three years and five years after starting the regimen.

The researchers estimated that, after 15 years, about 48 percent of those taking the supplement were free of polyps, versus about 30 percent of those not taking the supplement.

Among the white participants, those whose diets were in the highest fourth of omega-3 fatty acid consumption were 39 percent less likely to have colorectal cancer than those in the lowest fourth. However, for reasons the authors said they did not know, no association was noted between omega-3s and a reduction of colorectal cancer risk among black participants. The disease occurs at a higher rate among blacks than whites.
"Our finding clearly supports the evidence from previous experimental and clinical studies showing that long-chain omega-3 fatty acids inhibit tumor growth," said the study's lead author, Sangmi Kim, a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences in Research Triangle Park, N.C.

Kim said the research supports boosting omega-3 intake through diet or perhaps by taking an omega-3 supplement. Omega-3 fatty acids are found in fish, especially oily fish such as salmon, mackerel, herring, anchovies, sardines and tuna. Plant-based sources include flax and flaxseed oil, Brussels sprouts, soybeans and soybean oil, canola oil, spinach, walnuts and kiwi.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

HOW TO LOWER PROSTATE CANCER RISK

Harvard scientists have discovered that "drinking coffee may lower the risk of developing the deadliest form of prostate cancer." In fact, "the five percent of" study participants "who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any."."

A Frontiers in Cancer Prevention Research conference" also touched on the "role that exercise...could play in the fight against prostate cancer. An analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all." As for walking, those who did so "for four or more hours per week" had "overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week."


Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.com

Autism increases in the US

Almost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."

Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.

Among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said. Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls.

From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both).
The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old which is especially important, as early recognition and treatment improves outcomes.

ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3.

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Cluster Headaches

Concerned about recent overdoses of radiation in CT perfusion scans, an FDA official urged imaging practitioners to go "back to basics" when they're performing the scans.
The advice comes after more than 250 patients in two states were exposed to excess radiation during CT perfusion brain scans.

"Until we get through whether we're dealing with errors that people are making (or) whether these are problems with the CT scanners themselves, we're saying go back to basics," said Jeffrey Shuren, MD, acting director of the FDA's Center for Devices and Radiological Health.

Shuren and colleagues released a set of interim recommendations while the agency continues to investigate cases of overexposure reported in California and Alabama.
They include:

• Imaging facilities should review their radiation dosing protocols for all CT perfusion studies to ensure that dosing is correct for each study.

• They should implement quality control procedures to ensure that protocols are followed and correct radiation is used.

• For each patient, technologists should check the CT scanner displays to make sure the radiation to be delivered is appropriate.

• If more than one study is performed during one session, practitioners should adjust the radiation dose so it is appropriate for each study.
The agency also urged imaging facilities to check whether any patients who underwent CT perfusion scans have received excess radiation.

"We're reminding (practitioners) of good practices that they should be employing routinely," said Charles Finder, MD, also of the agency's Center for Devices and Radiological Health.

The issue arose when the FDA was told of more than 200 cases of excess radiation delivered during CT perfusion brain scans at Cedars-Sinai Medical center in Los Angeles. (See CT Safety Warnings Follow Radiation Overdose Accident)
Since then, the agency has received reports of 14 cases at Glendale Adventist Medical Center, also in Los Angeles, as well as an undetermined number of cases at St. Joseph's Medical Center in Burbank, Calif., according to Simon Choi, PhD, also of the Center for Devices and Radiological Health.

Choi said the the agency is investigating reports in Alabama, too, but he did not give numbers or the name of the facility involved.

The agency said scanners made by two manufacturers, GE and Toshiba, are involved in the incidents.
Affected patients had redness of the skin and some hair loss, but potential long-term consequences include an increased risk of cancer and cataracts, Finder said.
The standard radiation dose for a CT perfusion scan is between 0.5 and 1.0 Gray, but it was reported that some patients at Cedars-Sinai got as much as 3.0 or 4.0 Gray.
According to a statement from the hospital, "there was a misunderstanding about an embedded default setting applied by the machine."

The recommendations apply to all CT perfusion imaging, since the methods involved are the same as for brain perfusion scans, the FDA said.

While the agency is probing cases in the two states, Shuren said, "we would not be surprised to find there are similar occurrences in other states."

Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com