'prevention' posts

Everyone is talking about their allergies at this time of the year, so I thought it would be a good time to write about seasonal allergies.

Seasonal allergies occur only at certain times of the year and are usually caused by exposure to pollens from plants, trees and grass. They affect a large number of people of all ages and are seen mostly in urban areas. They are uncommon in children less than 2 years of age. Some patients may have similar symptoms year around and this is usually due to exposure to insects (cockroach), dust mites and animal dander (dogs and cats).

Most people do not react on exposure to these substances, but people with allergies hyperreact to these substances when exposed, and they subsequently develop these symptoms.

What are the symptoms of seasonal allergies?
Usual symptoms in children include runny nose, nasal congestion, itching of the eyes, nose and throat and occasionally cough. Sometimes these symptoms may interfere with sleep and thus cause fatigue, fussiness and tiredness during the day....

 (Read part 1 of this ‘Spring Cleanse' series here for more on how many calories you actually need, how to track your intake, and what you need to know about fluids.)

The Cleanse…

There are thousands of books out there, everything from an intensive fasting period to a detailed 21+ day program. Pick one that seems like it would yield the highest degree of success for you, but remember these basic parameters of all detoxes and cleanses:

• Don’t go less than 1200 calories a day. (Doing so stimulates a decrease in your metabolism, which unfortunately won’t immediately correct once the cleanse is completed. )
• Don’t expect more than 2 pounds of weight loss per week. If you see this on the scale, it means you are losing lean muscle mass (not a brilliant idea since this tissue is most metabolically active = your best friend in the battle of the bulge) or you are under-hydrated. The goal is gradual fat loss, hydration maintenance, and preservation of lean muscle mass if you want your results to last.
• Avoid junk (caffeine, alcohol, sodium, artificial sweeteners, refined sugars and refined grains). You want to get the biggest bang for your caloric buck, so opt for whole grains, fruits and vegetables rather than processed food.
• Assess your tendency for withdrawal. This can be from caffeine, alcohol, salt, refined grains/sugars, or simply the habit of heading for frozen yogurt on weekends.

What you should know about….

• Caffeine:

Spring is finally here! Finally, the opportunity to congratulate Seattle for behaving according to season, and enjoy tulips that Dougie in the spring breeze, and the first panic wave reminds you that you’ve got only a few weeks before bikini season (you get the point). Your innocent neurons automatically fire “detox diet’ and “cleanse”. Well, let me warn you that I am not a fan of the “drink maple syrup and eat lemon wedges” diet. Not because nutritionally they are a joke, but if you follow one, you morph into a mix of Tasmanian devil and Garfield, a creature with a short temper, little patience, an appetite with no boundaries, yet profound laziness.

Instead, how about something realistic with sustainable results? Here are tips to clean up your eating behaviors and make sure you are on track to tackle your goals.

Track Your Intake:

Do you know how much calories, fat, sugar, fiber, fluids, etc. you are concerned about, that you are consuming these days? This is where you need to start...

Pertussis (whooping cough) is a potentially devastating bacterial infectious condition involving the human respiratory tract. The disease begins with mild upper respiratory symptoms similar to common cold (catarrhal stage) lasting an average of two weeks which progresses to paroxysms of cough (paroxysmal stage) characterized by inspiratory whoop. Subsequently the symptoms wane gradually over a few weeks (convalescent stage) to potentially months. The incubation period is 7-10 days. Fever is usually absent or minimal.

Whooping cough in infants younger than 6 months of age can be atypical with a short catarrhal stage, gagging, gasping or apnea as prominent early manifestations; absence of whoop; and prolonged convalescence. The disease can be severe in young infants particularly if unimmunized or preterm with case fatality rate of approximately 1%. The duration of classic pertussis is 6 to 10 weeks. Complications among infants can include pneumonia (22%), seizures (2%), encephalopathy (0.5%), and even sudden death. The illness in immunized children and adults can be mild and unrecognized. In adults the disease may only present with prolonged cough. Infected people are most contagious during the catarrhal stage and the first two weeks after cough onset.

Factors affecting the spread of whooping cough include...

We currently have a pertussis (whooping cough) epidemic occurring in Washington State. Infants under 6 months of age are particularly vulnerable but anyone, even if you are fully vaccinated, could potentially contract the disease and spread it.

(Is it really an epidemic? Yes: an epidemic (of a disease) affects many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent.)

Pertussis (whooping cough) is a very contagious disease caused by a type of bacteria called Bordetella pertussis. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States (CDC).

What are the symptoms of whooping cough?

The early signs for pertussis are ...

In 2009, the United States Preventive Services Task Force (USPSTF) created significant controversy and confusion for both providers and patients when they revised their breast screening guidelines. (The USPSTF is promoted as an unbiased group that reviews relevant studies and makes guideline recommendations. Specialists may be asked to review the guidelines but no breast specialists (surgeons or radiologists) were on the actual review panel.)

The guideline development process aims to weigh the potential benefit of services against the potential harm, and make recommendations accordingly. For breast screening, the harms considered were “psychological harms,” imaging tests and biopsies in women who were ultimately found not to have cancer, inconvenience, and the possibility of treating a cancer that might not have been life threatening. Radiation exposure was considered to be a minor concern. Regarding benefits – the only benefit considered was reduction in death rates from breast cancer.

These USPSTF guidelines recommend...

This week a large European consortium updated the data on a huge study on prostate cancer screening. The study included over 160,000 men in eight European countries followed for an average of 11 years. The men were randomly assigned to prostate cancer screening with the PSA blood test or no screening. The primary endpoint of the study was death from prostate cancer. The current report in the New England Journal of Medicine gave an additional two years of follow-up data over the prior reports.

As expected with longer follow-up, the benefits from screening have become more clear. The study now shows a 29% decrease in the number of men dying from prostate cancer in the screened group. This confirms the expected benefit for early detection.

This publication comes at a time of great controversy regarding prostate cancer screening here in the United States...