PROSTATE CANCER BLOOD TESTING WITH PSA This test is now more accurate by watching the "PSA Mobility" over any 12 months and age-adjusting the value. If the PSA rises over 0.25 in any one year between the ages of 40 and 59, or over 0.5 between the age of 60 to 69, or over 0.75 in men older than 69, there should be a strong suspicion that a prostate cancer has developed. Of course the PSA should never take the place of a yearly rectal exam of the prostate. MEDICAL INSURANCE INFO: This website that improves consumer education about health insurance: http://www.insureuonline.org/ MEDICAL INFORMATION: I am very impressed with a new website for all sorts of medical information. Click on to Medlineplus.gov and begin your search of hundreds of medical topics. I also like MayoClinic.com CURING HEART DISEASE: The ASTEROID study showed that coronary artery disease can be reversed by getting your LDL "bad" cholesterol level to 61. In fact, the older the patient, the better it worked. The study was done using Crestor. The arteries were evaluated using intravascular echo (IVUS). Cholesterol plaque volume decreased by 9 percent. Sixty-four percent of the patients treated experienced the benefit. SILENT HEART ATTACKS: More than one-half of all heart attacks in women and about one-third of all heart attacks in men go clinically unrecognized according to the Rotterdam study. POMEGRANATES Lots of people are drinking pomegranate juice such as POM Wonderful hoping to stave off heart disease, cancer, aging, etc. Pomegranate juice contains lots of antioxidants...more than red wine, green tea, blueberries, or cranberries. Some evidence suggests that 2-8 ounces/day of pomegranate juice might improve atherosclerosis or ischemic heart disease. But don't recommend it for these conditions...at least not until more research supports it. There's also some concern about potential drug interactions. Pomegranate juice can inhibit 3A4 and 2D6 enzymes. Therefore, it MIGHT increase levels of some macrolides, benzodiazepines, calcium channel blockers, protease inhibitors, statins, beta-blockers, etc. So far these interactions are just theoretical. But until more is known, consider advising patients on these drugs not to consume large quantities of pomegranate juice. CAN THESE NEW VIDEO GAMES HELP PREVENT ALZHIEMER'S. Mr Snowden, who wrote "Aging with Grace" and a Russian brain reseacher named Goldberg who wrote "The Wisdom Paradox" would think so. Look for the game "Mindfit" and also the following games will help kids and adults alike: Brain Age: measures how old your brain is while Big Brain Academy measures its weight. Midway's Hot Brain for PSP, on the other hand, takes your brain's temperature, depending on how well you perform. Its minigames ask players to solve math problems, memorize audio sequences and unravel yarn to see which strand connects to a ball on the other end of the screen. It lacks the DS brain games' sweet touch screen controls, but we're more than willing to enjoy its mental gymnastics. Brain Age 2: sequel features a new set of training exercises designed to whip those brains into shape. Activities in the game include listening comprehension, word scrambles and Roshambo (aka Rock, Paper, Scissors), played by speaking your choice into the DS microphone. In addition, up to eight players can compete on a single cartridge to see who has the youngest brain. Re-Mission: a PC shooter with flashy graphics and a powerful message. Gamers fly through a cancer-infested body, blasting infected cells and managing side effects from treatment. Like the Math Blaster franchise, it translates a confusing subject into an easily digestible format. It's also a pretty sweet video game, full of useful information, attractive graphics and lots of action. Tetria DS: Nintendo's superb version of Alexy Pajitnov's classic puzzler doesn't include math problems and other brain twisting challenges, but we're convinced that frantic block dropping allows us to solve real world problems, such as successfully packing our cars, suitcases and maneuvering furniture. The New York Times Crosswords: Gamers tired of crinkling newspapers should check out Majesco's DS game, The New York Times Crosswords, which includes 1,000 puzzles ripped from the famous paper. With stylus in hand, players answer all sorts of questions by writing their answers on the system's touch screen. It sounds easy until the game throws insanely difficult questions at the player. One puzzle may take weeks to finish, providing people can stay away from the Hint button. Sim City DS: Solving arithmetic and identifying colors is one thing. Building a city using theories found in MIT brainiac Jeff Forrester's 'Urban Dynamics' book takes some major brainpower. SimCity DS challenges gamers to construct a metropolis and and take on the role of town mayor to keep things in order by monitoring crime, putting out fires (by blowing into the DS microphone) and warding off big monsters and alien attacks. Math Blaster: takes addition, subtraction, multiplication and division and blends it with a cool action adventure game. By solving math problems, players successfully blast aliens and complete other challenges. Over the course of its 20-year history, the PC series won numerous awards and evolved from simple 2-D graphics to detailed 3-D polygons. Kids who hate math (and adults who can't balance their checkbooks) are encouraged to play. Big Brain Academy 1 and 2: On June 11, Nintendo invites Wii owners to enroll in Big Brain Academy. The sequel to the popular DS hit uses all sorts of minigames such as identifying 3-D objects in 2-D, counting animals and other neat exercises to sharpen the brain. In addition, two players can compete in versus mode or work co-operatively to solve puzzles. Folic acid may prevent gum disease (J Am Geriatr Soc 2007;55:108-113). Take 800ug per day or eat more lentil,raw spinach, black beans, asparagus. Always take B12 1000ug a day if you take folic acid. Be aware however that 1000 ugs of folic acid per day has just been associated with 3 times the risk of prostate cancer
Epocrates.com Drug Lookup: Click on Epocrates.com above this paragraph and enter the name of the drug
HYPERPARATHYROIDISM: In the front of your neck at the low midline area and behind the thyroid gland lie the 4 small parathyroid glands. They produce parathyroid hormone which regulates the level of calcium and phosphorus in your blood and bones. It also helps you absorb calcium from milk products and helps you lose less calcium in the urine. If one of the glands develops a benign nodule, too much parathyroid hormone is secreted. This overactivity is called hyperparathyroidism. Hypercalcemia (too much calcium in the blood) occurs and the following symptoms may occur: fatigue, depression, pains in any part of the body, loss of appetite, nausea, vomiting, constipation, stomach pain and ulcers, kidney stones, thirst, frequency of urination. However, most people have no symptoms. Hyperparathyroidism can also cause osteoporosis and frequent fractures with the loss of calcium from your bones. The nodule is usually tiny and too small to feel but can be located by nuclear scans. Surgery is the treatment of choice but in some cases the calcium levels can just be watched every six months to be sure they don't get too high. THE PSYCHOLOGY OF OBESITY: Overweight people tend to eat mostly after 6:00 PM. This is when their cortisol levels from the adrenal gland tend to be high from a day of stress. The brain knows it can reduce the levels by eating lots of sugars and starches. There is no way to totally control these urges when they get going. There also may be an element of hyperacidity involved from stress or any caffeine at all. An over-the-counter Prilosec an hour before supper and totally avoiding caffeine during the day can help. Think about other ways you might reduce the stress hormone levels after 6:00 PM. Perhaps this might be the time for a daily hot shower, exercise, or reading few pages of a good book before even looking at food. B12 DEFICIENCY: Glucophage (metformin) has now been reported to cause B12 deficiency. Anyone on this drug should take 1000 micrograms of B12 by mouth daily. QUININE: This over-the-counter drug is now off the market in the USA. Some of my patients still have stores of this drug at home. There are many other ways of treating leg cramps at night, so they should throw away this drug. It can cause very low platelet counts in some people. This could cause bleeding--even a hemorrhage in the brain. BLACK COHOSH: Avoid this herbal product. If you get cancer, it can mask where the primary cancer is. The cancer then shows itself only when there are metastases elsewhere in the body. LIPIDS: In 2002, he Expert Group on HDL Cholesterol published a position paper that suggests that raising HDL ("good cholesterol") is just as important as lowering LDL ("bad cholesterol"). Low HDL is often associated with high triglyceride levels and small dense LDL. Small dense LDL means you could have millions more bad cholesterol LDL particles even if your LDL number looks normal. So LDL numbers can be deceptive and falsely reassuring. Exercise, weight loss, Tricor (a prescription fibrate drug) can increase LDL particle size. We can measure LDL particle size or, even better, look directly at your coronary arteries with the EBT or Fast CT scan to see if LDL is getting into the artery wall. PREDIABETES: The epidemic growth of diabetes has prompted the Department of Health and Human Services to recommend screening of all overweight people over 45 for "prediabetes". Also, anyone with obesity, a family history of diabetes, or high triglycerides should be screened no matter what age. Fasting blood sugars, two-hour post glucola blood sugars, and Hgb. A1c levels are used as an indicator of the disorder. Patients with prediabetes need to know that their clock is ticking. If allowed to progress, they could be at risk for blindness, kidney failure, cardiovascular disease, and other complications of diabetes. Diet, exercise, and weight loss are better than any medication in preventing the progression. CHELATION: This expensive alternative medication treatment for cardiovascular disease did not, in this double blind study, extend exercise time to ischemia or increase functional reserve for exercise, nor did it alter subjective measures of quality of life. JAMA 287:481-86 MIGRAINE: Patients with frequent migraine especially with premonitory aura such as visual symptoms show subclinical tiny strokes in the cerebellar areas of the brain. JAMA, Jan. 28, 2004, vol. 291. Because of this study, I am recommending now all patients with frequent migraine take one baby aspirin and four Omega3 fish oil capsules daily if they have no contraindication or allergy to aspirin. HHS ANNOUNCES MEDICARE PRESCRIPTION DRUG DISCOUNT PROGRAM: All Medicare patients, except those that already have Medicaid outpatient drug coverage, will be able to enroll in the Medicare-approved prescription drug discount program in the spring of 2004, with benefits beginning in June. The more significant provision of the law, which creates Medicare drug coverage available to all Medicare patients, will take effect in 2006. The discount cards for this year will save Medicare patients 25 percent. In the spring, join by calling 1-800-MEDICARE or going online at www.medicare.gov HYPERTENSION: Does coffee,tea or cola have an association? Neither caffeinated nor decaffeinated coffee showed a positive association with incident hypertension. The data for caffeinated tea were inconclusive, but a positive trend was shown in the NHS II cohort. "By contrast, there was a highly significant association between cola intake (sugared or low-calorie cola) and incident hypertension that was consistent across the cohorts," the researchers say. Not caffeine, but some other compound in soda drinks? Winkelmayer et al speculate that it is not caffeine but some other compound found in soda-type soft drinks that could be responsible for the increased risk in hypertension. Cola beverages were associated with an increased risk of diabetes in the NHS II cohort in a previous study [2], they note.Such studies have attributed these associations to the glycemic load of corn syrup and the advanced glycation end products of caramel coloring found in soda drinks, they say. While they acknowledge the limitations of their study—including the fact that the diagnosis of hypertension was self-reported—"whether caffeinated soft drinks are causally related to the risk of hypertension and its underlying mechanism will require further study," they conclude. Sources Winkelmayer WC, Stampfer MJ, Willett WC, et al. Habitual caffeine intake and the risk of hypertension in women. JAMA 2005; 294: 2330-2335. Schulze MB, Manson JE, Ludwig DS, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle