Dollars and sense of Alzheimer’s

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

As people age, they begin to worry about developing dementia and its most common cause, Alzheimer’s. Alzheimer’s is a neurodegenerative disease that can affect your cognitive abilities, the ability to function in daily life and orientation. If that’s not devastating enough, those with Alzheimer’s only live four years to eight years on average after diagnosis.

In America, Alzheimer’s is the sixth leading cause of death. Today 5.1 million of those 65 or older are living with this disease, a number that is only expected to grow as the population ages — by 2050 it is projected to affect 13.5 million of those 65 or older. The few drugs readily available only moderate the symptoms, as there is no way to cure, slow or prevent Alzheimer’s. Continue reading

Kitchen cures for what ails you

Dr. Victor Sierpina

Dr. Victor Sierpina

I invite you to share your story about some remedies your mother may have taken from the kitchen to soothe your miseries as a child. Many of these were stout, traditional applications surviving from the pre-scientific era. Their evidence was their effectiveness, economy and safety. Often given out of hope, history, and even the hysteria of not knowing what else to do, home remedies are truly the first line of primary care.

Think back to your childhood: a skinned knee, an insect bite, a cold sore, a cough, sore throat, toothache, fever. Likely there was a home cure for all of these.

I grew up in a family that today would be considered the working poor. My dad was an auto and heavy equipment mechanic working on commission. My mom was a stay-at-home ‘50s housewife. I never remember going to the emergency room as a child, nor did my three siblings though we had vaguely heard of Blue Cross/Blue Shield. It helped, I guess, when three of us had our tonsillectomies the same day.

When we got sick, I remember going to the doctor but only sometimes. This was usually for shots. Ouch! I also remember many more times when kitchen cures were applied and seemed to do the trick. I guess they had to since we couldn’t afford a doctor visit for every minor complaint. Continue reading

Gesundheit, again

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Have you ever noticed that many times sneezes come in threes? Repeated sneezes may be your body’s efforts to get rid of irritants in the nose when the initial sneeze is not strong enough to do so.

Sneezing has different meanings in cultures around the world. The Athenian General Xenophon gave an encouraging speech to his army that went on for an hour until a soldier sneezed. Taken as a favorable sign from the gods, the army proceeded to attack the Persians, but was ultimately defeated and the general killed. One of the Pagan beliefs is that sneezing opened one’s body to Satan or evil spirits, which is how the common response “Bless You” arose. In fact, Pope Gregory VII made the short prayer “May God Bless You” a required response to a sneeze as protection from the Black Plague. As you can see, the sneeze has often been misinterpreted in history. Continue reading

Move On

Dr. Victor Sierpina

Dr. Victor Sierpina

A recent ode to the benefits of tennis by a 74-year-old writer caught my eye. Citing various classical authors, philosophers, and the gradual improvement of his game since his 20s, the author championed the power of vigorous sport on his writing and his mind. Riffing off a Robert Frost poem that ended “Here are your waters and your watering place. Drink and be whole again beyond confusion,” the author concluded: “The tennis court is my watering place where I drink and am whole again beyond confusion — at least for a couple of hours.”

As an aging tennis player myself, I found his essay in The Wall Street Journal’s opinion page uplifting as he described “tennis as a refuge from the racket of everyday life.” We all need some kind of healthy activity and discipline to allow us to shut down the grinding gears of our minds for brief periods and refresh it with the drink of stillness and the water of life.

The Physical Activity Council recently reported 28 percent of Americans over 6 get no physical activity meaning they are totally sedentary in the past year. This report is also included a sharp increase in inactivity for those over 65. These are unhealthy trends. Continue reading

A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading

Smoking combined with your DNA increase lung cancer risk

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Smoking isn’t the only thing that raises your risk of lung cancer. As it turns out, your DNA can have that effect too.

A scientific study scanned the genomes, the entire genetic code, of 11,000 people of European descent in an effort to identify if there was any correlation between gene sequences and a common form of lung cancer, non-small cell carcinoma. They discovered that variants of certain genes increase a person’s susceptibility to developing lung cancer, especially in smokers.

One of the three gene variants they identified, named BRCA2, can double a smoker’s chance for developing lung cancer. BRCA2 is a tumor suppressor gene. It encodes a protein involved in the repair of damaged DNA, which is critical to ensure the stability of cell’s genetic material. When cellular DNA is damaged, there are several ways for the body to detect and repair that damage. If the damage to DNA cannot be repaired, then the cell is programmed to die by a process called apoptosis in order to prevent the damage being passed on to its daughter cells. Continue reading

Taking a much closer look at metastasis

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

One of the things that make cancer cells so deadly is metastasis, their ability to dislodge from their original location and migrate to other tissues. Most people who die of cancer are victims of this process. Even if a tumor is removed surgically, doctors can’t be certain that some of the tumor cells haven’t already metastasized, hence the need for treatments such as chemotherapy to target those cells. Unsurprisingly, metastasis is a subject of intense research and luckily scientists now have a new tool to help them understand how tumor cells move.

While most tumors have the ability to metastasize to many different tissues, they prefer to spread to certain ones, like those in the bones, liver and lungs. Cancer begins to spread by invading nearby tissue, then through a process called intravasation, tumor cells enter a blood or lymphatic vessel, allowing them to circulate to other parts of the body. Continue reading

Both sides now

Dr. Victor Sierpina

Dr. Victor Sierpina

Some of you may remember the old ballad by Judy Collins:

“I’ve looked at clouds from both sides now, from win and lose and still somehow, it’s clouds illusions I recall, I really don’t know clouds at all.”

This is a metaphor for life. Clouds often symbolize sadness and depression but can be bright, fluffy, and filled with water and rainbows.

Perhaps you got up one morning recently to look out at a cloudy sky. Gloom, depression, irritation, getting soaked, and your newly washed car getting spotted. Dang. The day is off to a bad start. That is unless you are from California where skies are decidedly not cloudy all day but they haven’t had but a smidgen of rain in nearly four years. North and West Texas are suffering from some of the same. Here on the wet Gulf Coast, we have gotten plenty of good soaking rain this year. Let’s be grateful.

On the other side of clouds is always the possibility for positive or negative imagery.

Try to imagine those clouds as big bellies pregnant with rain and giving birth to spring plants, flowers, and flourishing trees and later raising wonderful summer children of vegetables, fruits, green grass and roses. Continue reading

Cigars are no better than cigarettes

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

A common argument made by those who smoke cigars is that they are safer than cigarettes. However, several studies argue that this is not true.

Cigar smoking has increased dramatically in the U.S. Between 2000 and 2011, small cigar sales rose 65 percent and large cigar sales increased 233 percent. Americans smoked more than 13 million cigars in 2010, twice the number from 2000. About 13.4 million people age 12 or older smoke cigars. A cigar culture has arisen, with cigar bars or clubs, shops with walk-in humidors and magazines for those who consider themselves cigar connoisseurs. Their use among sports figures and celebrities has made it seem fashionable or sophisticated, a symbol of status or success.

The tobacco in cigars is cured and fermented to enhance the flavor, but this process also increases the amounts of harmful ingredients. Cigars come in three basic sizes, but the classic cigars are the large ones that contain more than half an ounce of tobacco, and some contain as much as an entire pack of cigarettes.

Just like cigarettes, cigars contain nicotine and can be very addictive. Most people who smoke cigars do not inhale, and therefore the nicotine is absorbed more slowly. However, cigar smoke dissolves more easily in saliva than cigarette smoke, enhancing the amount of nicotine absorbed. Smokers absorb one to two milligrams of nicotine out of the eight total milligrams in cigarettes. The large cigars contain anywhere from 100 to over 400 milligrams of nicotine, and the amount a person absorbs varies greatly depending on how long the cigar is smoked, how many puffs are taken, and how much smoke is inhaled. Second- and third-hand cigar smoke is dangerous, just like it is with cigarettes.

In one study, scientists measured the levels of two biomarkers for tobacco as well as arsenic and lead in over 25,000 cigar smokers. Cigar smokers had higher levels of these carcinogens than nonsmokers and equal levels to cigarette smokers. Overall, the study found that cigars are not safer than cigarettes. Cigar smokers are less likely to develop lung cancer than cigarette smokers, but they are at higher risks of developing other cancers.

Those who inhale while smoking cigars are more likely to develop laryngeal cancer, lung cancer, bladder cancer, pancreatic cancer and cancers of the tongue, mouth or throat than nonsmokers. Even those who don’t inhale the smoke directly still inhale the secondhand smoke and are at an increased risk of lung cancer. Cigar smokers are four to 10 times more likely to die from cancers of the mouth, larynx and esophagus than nonsmokers.

Cigar smoking also increases the risk of other diseases including emphysema, chronic bronchitis, heart attacks, gum disease and erectile dysfunction. One long-term study determined that cigar or pipe smoking costs people 10 years on average — they spent an extra five years in bad health and died five years earlier.

So before you take up cigars in an attempt to look cool, ask yourself if your image is more important than your health.

Professors Norbert Herzog and David Niesel are biomedical scientists at the University of Texas Medical Branch. Learn more at medicaldiscoverynews.com.

MIND your diet for brain health

Dr. Victor Sierpina

Dr. Victor Sierpina

With increasing frequency, I have the unenviable task of informing a patient or their family members that they have dementia. Often, the patient themselves has not realized that they have problems other than occasional attention lapses, even though family members have observed major behavioral and memory problems.

Perhaps nothing creates so much anxiety among those of us who are growing older than the loss of our higher mental functions. The old term, senility, or even kindly tolerance of eccentric age-related forgetfulness has been overshadowed by the specter of Alzheimer’s disease and other dementias. These are among the leading causes of death in the elderly and contribute to loss of function, dignity as well as adding tremendous stress on families. I understand the challenges of these conditions from professional, personal, and family experiences.

Like most areas of medicine, prevention is the preferred way of approaching chronic problems. A recent study by Dr. Martha Morris of Rush University’s Internal Medicine and Nutrition departments in Chicago and published in the journal, Alzheimer’s and Dementia in March 2015, has garnered national media attention. Entitled “MIND Diet Associated with Reduced Incidence of Alzheimer’s disease,” this is one of the few prospective studies on neuroprotection and dementia prevention. In this study, the MIND diet was the active intervention in more than 900 participants 58 to 98 years old. The researchers followed these subjects for an average of 4.5 years and found that moderate adherence to the MIND diet may decrease Alzheimer’s disease risk. Continue reading