You don’t have to dig very deep to find evidence of the existence of these fad cures.  A bit of searching on the internet reveals magic cures for diabetes that can see you stop taking insulin in as little as three weeks, diet and exercise programs that can cure cancer.  Meditations that can replace medicine, and more, even including psychological and behavioral “cures” for autism.

 

Even brilliant people can fall victim to these kinds of scams.  Steve Jobs might still be with us today if he’d opted for a surgery that could well have saved his life, rather than relying on a regimen of diet and exercise to “cure” him.

 

These are all tragic, of course, and all preventable, but perhaps the most tragic of all revolves around fad “cures” for autism.  As if the parents of children did not have enough on their plates, then to be hit with a barrage of hucksters attempting to sell “quick cures” for a condition that has none – it’s enough to make even the hardiest, most well-adjusted of parents break.

 

Almost all of these so-called “cures” have been debunked by science, but they persist.  They linger.  The question is – why?

 

 

At the end of the day, it comes down to hope.

When faced with a disease or condition for which medical science can offer no cure, often, these patients, or the friends and family of the afflicted patient will reach for any hope available.  Even a false one, in the vain belief that if they try enough of these fad cures, one of them will provide the answer that medical science cannot.  One of them will prove to be the magic bullet that makes them or their loved one better.

 

This blinding, overpowering need for hope of some kind is almost impossible to counter via evidence-based means.  In fact, often, what you find is that the more evidence you provide to the patient or his family regarding the ineffectiveness of these treatments, the more tightly they cling to them, and the more fervently they go off in search of yet other, increasingly exotic types of “treatment.”

 

At the root of the need for hope is belief and belief cannot be challenged by, or countered with scientific fact.  There exists a certain subset of patients for whom the need for the belief in a miracle cure is so strong and so pervasive that there’s simply no way to counter it.  If medical science cannot offer this group a cure, then they will reach for anything that promises to, however unlikely.

 

Of course, this ultimately leads to more disappointment and heartbreak when none of the miracle cures turn out to be miracles at all, but unfortunately, in these instances, there is little that the medical community can do.  We cannot force our patients to abandon all hope, and until and unless we can provide them some, there will always be a subset of the population that will gravitate to any form of treatment that promises a cure.

 

This does not mean that we should not continue our efforts at debunking fad cures at every opportunity.  It merely underscores the difficulties associated with stamping them out for good.

It’s basic statistics.  Vaccinations save lives.  The earlier the vaccinations are performed, the more lives they save.  This point was underscored brilliantly by magicians Penn and Teller.  They’re crude and they’re crass, but there’s never been a clearer or more concise explanation for how and why vaccinations are so successful when it comes to the prevention of disease.

 

In any case, a recent study has unearthed an alarming trend.  Increasingly, parents are pressuring their children’s doctors to delay childhood vaccinations, or even forego them entirely, and an increasing percentage of doctors are complying with the wishes of the parents.

 

According to the CDC, there are a total of fourteen vaccinations that children should receive before the age of six, and outlines a generalized plan for when these vaccinations should occur along this frame of time.  Staggeringly, the study finds that fully 93% of doctors have received requests from parents to alter the vaccination schedule for their child.

 

The study was conducted by contacting a total of 534 family doctors and pediatricians to ask a series of questions.  Of the doctors contacted, 66% responded to the inquiry, and of those, 93% answered in the affirmative when asked if they had received requests from parents to alter childhood vaccination schedules.

 

Nearly 82% of survey respondents said they believed that by agreeing to the parental request, it would help foster trust between the doctor and the parents of the patients.  80% of survey respondents indicated that they believed the parents would simply pull their children from the doctor’s care and find a new clinic if their request was not honored.

 

The study found that a clear majority of doctors used a variety of tactics to attempt to change the minds of the parents, and proceed with the vaccinations as scheduled, but most also reported that these were largely ineffective.

 

This, of course, is problematic.  Not only does it put the children at greater risk, but it also puts other groups, such as the elderly and infirm, at heightened risk.  Because of this, the study urges that the medical community adopt a strong policy of evidence-based interventions to help counter this trend.

 

If parents begin to receive evidence-based information as early as the first stages of pregnancy, the researchers believe that we can halt, and then slowly reverse the current trend.  Unfortunately, vaccinations in general, and childhood vaccinations have moved at least partially away from being strictly a matter of science, and into the political arena.  Unfortunately, as we have seen in numerous instances, politics and science rarely mix well, and once an issue becomes a political hot potato, it becomes increasingly difficult to have a rational, fact-based discussion about it.

 

This does not bode well for the ability of the medical community to craft a meaningful policy that will help reverse the trend.  Unfortunately, a necessary first step must be doing de-politicize the issue before such action could be undertaken.  That seems unlikely in our immediate future, which has the sad consequence of putting an increasing number of vulnerable patients at risk.

A new study reported in the American Journal of Hypertension reveals and reconfirms something that we’ve known all along.  There’s a strong link between BMI and blood pressure problems in patients.

 

This particular study focused on teens, measuring BMI across a broad spectrum of teens, collecting blood pressure information, and performing a detailed statistical analysis.  The results, while totally unsurprising, underscore an important and growing point.

 

Given the growing number of obese teens in the United States, we’re headed for a calamitous increase in blood pressure problems in future years.  The study, which tracked a population from 1998 to 2011, found that the trend and the link grew stronger over time.  That is to say, as each test subject got older, the blood pressure problems associated with an above-normal BMI tended to worsen over time.

 

There was one surprise in the data, however.  The linkage between BMI and blood pressure was significantly stronger in females than in males.

 

One of the doctors responsible for the study offered it as clear evidence that we need to be spending more time, money, and paying more attention to the growing problem of childhood obesity in the United States, or face a serious health care crisis down the road.

 

The study is, however, not without its detractors.  A study conducted by the University of Pennsylvania demonstrated that BMI is sometimes both misleading and inaccurate in terms of measuring body fat in patients.

That is a fair criticism, but it picks at the edges of the central point.  The linkage between obesity and high blood pressure is both well-known and well understood.  Even if BMI is, or can sometimes be a relatively poor indicator of total body fat, we authoritatively know that obesity often leads directly to high blood pressure and a variety of cardiovascular and related health issues.

 

We also know that childhood obesity in America is a large, and growing problem.  When the two are put together, we see the scope and scale of the future problem in clear, well-defined terms.

 

At this point, we have a window – an opportunity to take steps to reverse the trend.  If we can begin bringing the incidents of childhood obesity down in this country now, then in years to come, we will have saved ourselves from an enormously expensive health care crisis that could be devastating in terms of the number of lives lost.  Far cheaper and more cost effective to deal with it now, than to put it off until later.  The real question is, do we have the will and wherewithal do take the steps necessary to address it now, while the problem is still relatively small and we have the ability to mitigate the long term damages?

 

The answer to that question is uncertain, but at present, the data is trending in the wrong direction.  Health care professionals certainly have a powerful role to play, but ultimately, it comes down to better education for the parents of these teens, and the fostering and maintenance of better dietary habits across the board.

Acetaminophen is the most popular, most widely-used painkiller in the world, when looking at both over the counter and prescription forms.  It is used so commonly and so often that some people don’t even give it a second thought.  When pain arises, take acetaminophen.

 
Unfortunately, there’s a newly released study, recently published in the Annals of Rheumatic Diseases that suggests we’ve been understating the risks associated with the analgesic.

 

The reality is that we do not truly know how acetaminophen actually reduces pain in the body.  Studies suggest that this is accomplished when the drug blocks the production of prostaglandin, but the question is by no means settled.

 

Even more disturbing, a recent study published in Medical News Today found that at least in terms of managing acute lower back pain, acetaminophen was no more effective than a placebo.  On top of that, the drug’s ability to manage osteoarthritis has also been recently called into question, leading researchers to point out that there’s actually no recent data available on the risks of acetaminophen at standard doses.

 

The researchers poured over the 8 studies that were available, and found a disturbing trend.  Despite the fact, and accounting for biases they found in those 8 studies, the trend was clear.  Four of the studies pointed to a heightened risk of adverse cardiovascular events.  Four more reported a tendency toward adverse renal events, and one reported a tendency toward adverse gastrointestinal events.

 

Implications of the Study

Clearly, given the available data, the first conclusion reached is that additional, more up to date, and less biased study is needed.  Having said that, and accounting for the biases in each of the studies, the conclusions are difficult to ignore.  In eight studies, nine different potentially life-threatening side effects were identified.

 

Granted, the chances of any of these actually occurring are quite small, yes.  However, having said that, it seems clear that given these risks, we’ve almost certainly gotten into the dangerous habit of prescribing or taking this medication over the counter without fully accounting for all of the risks.  Given how common acetaminophen use is, the risks don’t have to be high for there to be potentially devastating consequences.

 

This also hints at another important point, not explicitly covered in the research, but made obvious by it.  Acetaminophen is taken both over the counter and by prescription.  Accurate patient information is of paramount importance, especially in this area, because when considering dosages, it’s important to understand if or whether the patient is taking the drug at home in over the counter strength.

 

Careful patient questioning on that point can go quite far, but here, technology may soon be able to help us.  Already, there are a number of wearable devices that are enabling medical professionals to carefully monitor a staggering array of patient health factors.  It is absolutely within the realm of possibility for the technology we have today to also monitor the over the counter drugs that a patient may be taking, and use the information to better mitigate risks when prescribing.

Coffee drinkers rejoice!  A new, recently published study has found evidence that consuming three to five cups of coffee per day may help reduce the risk of clogged arteries and heart attacks.  The study, published in Heart, collected data from more than twenty-five thousand people, measuring the amount of calcium in their coronary arteries to get a sense for its association with the daily consumption of coffee.

 

This study isn’t the only one to potentially bring good news to the nation’s legions of coffee drinkers.  In a collection of other studies published in Medical News Today, we find evidence of a number of other possible benefits to moderate coffee consumption, ranging from reduced risks to endometrial cancer, melanoma skin cancer and multiple sclerosis.  Still other studies point to moderate coffee consumption as reducing the risk of heart disease and type 2 diabetes.

 

Not So Fast

Even though these are all positives, there’s a flip-side to the proverbial coin.  There are other studies that have shown that the same moderate levels of coffee consumption can lead to increased cholesterol concentrations, a higher risk of coronary heart disease, and hypertension.

 

Even if the results of these recent studies are somewhat controversial, the basic science behind them is sound.  Calcium levels are a good measure, because when calcium builds up in the arteries, it can harden (calcify), clogging and narrowing the arteries.  This leads patients to be more susceptible to blood clots, which can in turn, lead to stroke or heart attack.

 

To arrive at their conclusions, the researchers broke down their participants into several categories, based on the amount of coffee consumed daily, ranging from none, to less than a cup per day, one to three cups per day, three to five cups, and five or more cups.

What they found was that there was a U-shaped association between coffee consumption and calcium buildup, ranging from 0.77 for the group that consumed less than one cup, to 0.66 for the one to three group, 0.59 for the three to five group, and 0.81 for those who drank more than five cups of coffee per day.

 

The study’s proponent’s claim that this adds to the growing body of evidence that coffee consumption could be inversely associated with cardiovascular disease, though they were quick to point out that additional study is needed in order to confirm their findings.

 

The other major caveat to the study is this.  All of the participants were South Korean.  This by itself does not invalidate the study or its findings, or course, but it is an important factor to point out, because this:

A. This population group is fairly homogenous in its makeup,

B. They’ve got a variety of cultural and lifestyle differences that don’t exist in other parts of the world that may or may not have impacted the study.

 

The only way to be sure is to conduct similar studies with a broader population spectrum and see if the findings hold.

 

In any case, it’s a fascinating study with some interesting and compelling results.

Increasingly, we’re seeing instances where technology is moving into the medical treatment space in new and innovative ways.  There are now a whole host of apps that make it possible for health care providers to collaborate on treatment plans for their patients and share data in ways that simply wasn’t possible just a few short years ago.  The rise of wearable’s and other smart technology gives us an increasing amount of real-time data on our patients that can shade and color our treatment plans for them, and even enable us to detect small problems before they grow into large, unmanageable ones.  So far though, at least until now, there have been few practical applications for virtual reality as a treatment option.

 
The elderly are not, as a group, famous for their willingness to embrace new technology, but in this particular case, the fit is much more natural than you might first think.  The reality is that upwards of a quarter of all people, age sixty-five and over, experience some degree of anxiety.  The reasons for this are manifold, sometimes relating to a general feel of unease about retirement or impending retirement, feelings of decreased social worth, and/or a realization and fear of their declining mental and physical state.  Any one of these would be sufficient to engender feelings of anxiety, and in the case of the elderly, we often find several of these at once.  It’s no great surprise then that such a significant portion of the elderly population is at risk of experiencing it.

 

One of the typical ways of treating anxiety disorders is via cognitive behavioral therapy, which prompts patients to confront their fears by exposing them to mental situations, objects, or images that trigger their fears.  This process continues until their negative reaction to the fear trigger decreases.  Often, this kind of therapy requires patients to physically travel to the locations that are the centers of their fear.

 

The problem, however, is that older patients experience a decreased ability to visualize.  Their abstraction skills weaken and diminish.  Combine this with a gradually decreasing mobility, and it makes treating anxiety disorders among seniors somewhat more challenging.

 

Virtual reality solves this, and manages to do so with no side effects whatsoever.  The only real hurdle might be in getting the patients to give the new technology a try, but even this has been much easier than anticipated.  When faced with the prospect of either trying new technology as a treatment option, or continuing to deal with their anxieties on a daily basis, the patients in the various tests and trials that have been conducted thus far have overwhelmingly embraced the new approach.

 

Granted, this treatment approach is still in its infancy.  Much more work needs to be done in this area before broad based conclusions can be drawn, but the early results are promising.  By making use of virtual reality to expose the elderly to the source of their fears, we remove the barriers imposed by both their physical limitations where travel is concerned, and their reduced ability to visualize, as the computers do it for them.  A wonderful approach to treatment using the latest in technology.

It is well known that the human skin is the first line of defense in terms of protecting the body from disease.  What is currently unknown, however, is whether or not our immune system influences the shape and composition of microbial communities on our skin.

 

It’s not something that many people put much thought into, but the reality is that our skin plays host to an elaborate and thriving microbial ecosystem.  Some of these millions of organisms are beneficial, and play an active role in helping our bodies remain disease free, while others are clearly pathogenic, and are themselves the cause of some conditions.  Eczema, for example, is a clear case of the latter.

 

The relationship between these microbial colonies and our immune system is a complex one.  It is known definitively, for example, that some pathogenic colonies present on our skin help “train” our immune system to make it more capable of warding off disease.  What is not currently well understood is if that relationship works in both directions.  In other words, does our body’s immune system have any influence over what microbes live on the body and where?  Scientists at the National Human Genome Research Institute have recently begun to explore that very question.  It’s an exciting research project because if evidence is found that our immune system does control, in some fashion, the level of microbial diversity at any given point on the human body, then it could lead to a great leap forward in understanding all manner of immunodeficiency conditions, and open the door to a whole new range of treatment options that had not previously even been considered.

 

The key finding so far in the study has been this:  Patients with some kind of immunodeficiency disorder tend to have a much less robust and diverse microbial ecosystem living on their skin.  Patients who are in good health tend to have a broad and deep level of diversity, with distinct colonies of very different microbes living in different parts of the body, and in different concentrations.  For example, at the back of the knee, there tend to be relatively few types of microbes living on a healthy patient, and those that are present exist in relatively small number.  Contrast that with the back of the earlobe, which tends to play host to a high concentration of different types of microbes that are also found in dense population clusters.  In immunodeficient patients, however, not only are the numbers of different microbes quite similar in both locations, but the populations tending to be much more evenly distributed as well.

 

Is this evidence of the immune system’s inability to properly manage the microbial colonies on the skin?  Some researchers think it might be, although more study is needed to tell for certain.  Researchers from the National Institute of Allergy and Infectious Disease and the National Cancer Institute have joined forces with researchers from the National Human Genome Research Institute in order to continue studying the matter.  The eventual results should be fascinating, when they are published at the conclusion of the study.

There have been a number of interesting approaches to the treatment of Alzheimer’s in recent years.  Everything from drugs that seek to alter brain chemistry to neurofeedback, and everything in between.  Recent studies have strongly indicated though, that testosterone could have positive impacts on patients with Alzheimer’s disease, and it offers tantalizing glimpses into some other potential benefits that the hormone might grant.

 

Testosterone – The Wonder Hormone

Testosterone then has become something of a cure-all and a wonder treatment.  Athletes use it as a performance enhancer.  Among other things, it can elevate mood, and possibly protect against heart attacks.  In addition, of course, its ability to improve the sex lives of men with no, or low testosterone is well understood.  The idea then, that testosterone could also be a treatment for a disease like Alzheimer’s is more than a little exciting.

 

So far, there have been pair of studies that have borne this out.  One from the University of Hong Kong, and another conducted here in the United States, with results published in the Archives of Neurology.  In both cases, it was found that a daily application of testosterone gel to the skin produced a measurable increase in cognitive skills, and decreased symptoms of anxiety and depression, giving those patients treated with testosterone a significantly improved quality of life.

 

There are two things that make this aspect of testosterone treatment so interesting.  First, there are approximately 5.2 million Americans who suffer from the disease.  That’s a big enough number to add some urgency to finding a viable treatment.  Second though, is the way in which testosterone treatments provide the improvement?  They do so by decreasing the production of beta amyloid, and increase its rate of degradation.  By doing so, the body is able to break it down more quickly and get rid of the excess.

 

Beta amyloid is a plaque that, when it is allowed to build up, is the chief agent behind the degradation of brain function.  Supplementing these studies on Alzheimer’s, there have been additional studies where the rate of brain aging has been reduced in lab animals, including a study published in the 2013 Edition of the Neuroscience Journal.  Human trials of such experiments are obviously some years off yet, but again, the early results have been promising.  Testosterone might be able to do more than just improve quality of life for patients with debilitating diseases; it may also one day let us slow down the aging process of the brain itself.  The implications are staggering.  While no one thinks it could one day be possible to reverse the aging process altogether, science is slowly moving us toward being able to slow its onset, potentially indefinitely.  There are few fields of research that are more dynamic or exciting.

 

Clearly more study is needed before firm conclusions are drawn, but the early results have been impressive, and it seems we can add yet another condition to the long list of things that can be treated with testosterone.

A recent study conducted by Professor Ruth Defrin at Tel Aviv’s University’s Department of Physical Therapy, in Israel concluded that pain intensity is increased and our ability to cope with pain is decreased by psychological stress.

 
The study was conducted with 29 male participants who were asked to take part in the Montreal Imaging Stress Task (MIST for short).  If you’ve not heard of it before, MIST is an intriguing construct.  A kind of psychological trick.

 

Participants are asked to answer a number of test questions.  Before they begin, they are told that the average score a participant can expect to receive is 80-90%.  The game, however, is rigged.  No matter what answers the participants choose, they will never achieve a higher score than 45%.  The harder they try, and the more times they re-take the test, the higher their stress levels climb.

 

Both before and after taking the rigged test, participants also participated in a series of exercises designed to test their ability to withstand pain.  In this particular case, the pain stimulus was a gradually increasing heat.

 

The results were surprising.  It turns out that there was a proportional, inverse relationship between the level of perceived stress, and one’s ability to cope with increasing pain levels.  The higher the stress, the lower the pain modulation ability, across the board.

 

The researchers involved in the project had expected that their results would align with earlier sports medicine studies, but this was not the case at all.  In those previous studies, they found that people who played sports and were injured in-game led to a higher level of pain modulation.  That is to say, in a sports setting, injured players seemed to be able to rise above the pain, then most past it.  When they found quite the opposite impact brought on by the inducement of psychological stress, it raised more than a few eyebrows.

It is widely understood that insufficient sleep, or poor quality of sleep can negatively impact a number of the body’s systems.  Sleep apnea, for example, is a fairly common sleep disorder that has been linked to increased risks of heart disease, heart attack, and stroke, and that’s just on the physical side.  Insufficient sleep can also lead to any number of psychological problems, which is one of the reasons that getting a sufficient amount of good quality, uninterrupted sleep each night is one of the foundational aspects of good health overall.  What has only been recently understood is that the condition may also impact the health of the skeletal system.  In fact, a recently concluded study recently identified a link between sleep apnea and osteoporosis.

The Science behind the Claim

A study published in the Journal of Clinical Endocrinology and Metabolism tracked the medical records of a sample size of more than 1400 individuals from 2000 to 2008 that were diagnosed with obstructive sleep apnea.  These records were compared with a like-sized population of individuals that did not have the disorder.  The findings were surprising.  The patients with sleep apnea were found to be nearly three times more likely (2.7 times, to be exact) to be diagnosed with osteoporosis.  In particular, of the population surveyed, women with sleep apnea showed the highest degree of likelihood to also have osteoporosis.

 

It’s an intriguing finding, but it comes with an important caveat.  Correlation does not prove causation.  We know that there’s an association between the two conditions, but we cannot say, at least not on the basis of this study alone, that one necessarily causes the other.

 

Scientists have speculated on ways that sleep apnea could potentially cause osteoporosis, but so far, there is no definitive proof.  The mechanism would work as follows:  During episodes of sleep apnea, the body is periodically and temporarily deprived of oxygen.  Over time, these periodic depravations set up conditions in the body that are favorable to an overall weakening of the bones and an increased risk of osteoporosis.

 

More study is needed to confirm the causal relationship, but what we know so far is that a) there’s definitely a relationship between the two, and b) there are documented medical reasons that would support the theory of a causal relationship.

 

Unfortunately then, it’s too early to say for certain that sleep deprivation can cause osteoporosis in patients, but we do know that certain sleep disorders can weaken and thin the bones of the skeletal system, so it is safe to say that in general, the body’s skeletal system can be negatively impacted by sleep disorders, if those disorders manifest themselves in the form of periodic oxygen deprivation.

 

Based on studies like this, it is easy to envision a future in which an important part of the treatment plan for patients with certain bone and joint degenerative conditions involves strategies for ensuring that they get enough high quality, uninterrupted sleep each night.  Whether that takes the form of using a CPAP machine, or some or other as yet to be developed app to help track quality of sleep is unclear, but the possibilities are exciting.