Nitroglycerin demystified

For over a century no one really know how or why nitroglycerin worked for patients experiencing angina attacks (pain associated with reduced blood flow to the heart). Now they've identified an enzyme that breaks it down (working in a compartment inside each cell) and releases a nitric-oxide related molecule--which helps relax blood vessels. Duke University researchers discovered that the enzyme (mALDH) works only in the mitochondria (that word really brings back school biology lessons)--the "powerhouse" of the cells--to help the process of manufacturing actual nitric oxide.

The research suggests that current ways of using nitroglycerin are not the most beneficial--and may even be harmful to some heart patients. The upshot is that scientists will now be able to better figure out how to use it more effectively.

Good news for the driving horde of baby boomers thundering up on their potential-heart-problem years.

Tidbits of nitric oxide note

Dark chocolate (who picked the substance to test for this experiment?) increases the elasticity of your small veins and arteries--which could help keep your blood pressure in line and reduce your risk of cardiovascular disease, says this Reuters report from the American Journal of Hypertension.

What's that got to do with nitric oxide (NO--one of my favorite topics)? Apparently the abundance of flavonoids (recently getting more recognition as a valuable nutrient), among other things, helps that miraculous NO be more readily available for the body to use in all its many applications.

Speaking of flavonoids, I used to get depressed because I ADORE crisply cooked fresh green beans and I couldn't figure out whether they were good for you because everywhere I read, it said they contained nary a vitamin worth discussing. Now I've discovered they're full of flavonoids--thank God, now I can eat 'em and feel virtuous about my health at the same time.

And oh, listen to this: "Researchers found the active ingredient in Viagra, also known as sildenafil, helped children with pulmonary arterial hypertension (PAH) walk farther and breathe easier when taken over the course of a year." PAH is usually fatal within a year of diagnosis--a worthy disease to look at alternative treatments for. Current approach includes administering inhaled NO (iNO) to relax lung tissue. Sildenafil works kind of like flavonoids--one effect is to increase the availability of NO. Here's a good, easy-to-read discussion about flavonoids and other nutrients that do good things for us but don't trigger deficiency symptoms because they're not know to be essential.

New uses for otolaryngology's new scanning technique

Okay, it caught my eye because it used rabbits as the test subjects (I have a pet bunny named Angelina). But it's a very exciting new technology that can apparently read and measure injuries or problems that are behind other tissues--as opposed to just seeing detecting masses like x-rays or MRI does.

Optical coherence tomography (OCT) was originally created for eye doctors--a "new, noninvasive, noncontact, transpupillary imaging technology" that uses a backscattered light technique (kind of like ultrasound) to let doctors differentiate and measure retinal thickness, according to the New York Eye and Ear Infirmary website. Applications for otolaryngolosits include earlier detection and possibly improved treatments for a whole host of eye problems and diseases, including diabetic retinopathy.

But the rabbit test, reported in the Otolaryngology, a journal on head and neck surgery, shows that OCT can also be used to tell the difference between scar tissue and swelling--which can occur during intubation for surgery. So this technique has promise for many other applications.

Positive emotions: powerful medicine

Most scientists have undoubtedly been aware of the connection between positive emotions and good health. Now a business has built solid research to prove that thinking positive thoughts has an IMMEDIATE and powerfully positive effect on infinitely readable signs like heart rate, heart rhythm, blood pressure, and so on.

I just put up a post about this on my business site--why business? Because productivity depends on people having good health and a smooth heart rate is a sign that a person is thinking clearly. Big companies are investing in putting this stuff to work with their executives.

You can buy their sensor apparatus here. It'll be nice when we can all have one at our desks.

Biotech/biomed officially hits the big-time

Stem cells are revolutionizing medicine. No question--the things they can do are getting closer and closer to what we, with our limited understanding of how the universe really works, have always called miracles. Now, even Business Week is trumpeting the ascendancy of bioscience--the article even has a cool interactive heart graphic!

If we are to believe how simple it can be, you'd think that by 2010 (a mere 5 years away), a medical specialist called, say, a "stem cell expert" will know how to extract them and how to inject them, and s/he will be an expert at healing all kinds of body parts. Of course,we still have to find all the places to use them to heal the various diseases, but that seems like less a puzzle than the way we've had to approach it in the past.

The speed at which discoveries are being made makes many things incomprehensible to most of us--but recovering more easily, enduring less pain, getting healed naturally--those things we can "get." Drugs that don't destroy more than they fix are becoming the norm. Technology will play new roles--as it allows ever smaller and less intrusive mechanisms, it can be used more and more to help, for example, movement disorders. Computers will help with brain problems, etc., etc.

What a time to be alive.

New weight-loss-aid drug looks promising even for youth

I'm writing a piece on diabetes for my client and this item caught my eye--a fairly new drug (brand Name Olistat) has undergone some serious testing with adolescents and come out looking very helpful for overweight adolescents.

Here's what the NIH has to say about it: MedlinePlus Drug Information: Orlistat

The interesting part is that the drug should NOT be used with a meal that's extremely high in fat (more than 30%), so the abusive scenario of a kid taking a drug after stuffing him or herself with triple-decker bacon cheesburgers is unlikely. The physiological repercusionss of such misuse are very unpleasant.

I don't much like the idea of kids using drugs. But diabetes is irreversible--it's a lifelong sentence to having to watch everything you eat like a hawk. That's not easy for anybody to manage, let alone youngsters. If this drug can be used to help kids learn better eating habits--and avoid the endless suffering of having to live with diabetes-- until they're old enough to manage the stress of their lives that's likely part of their problem, I think I'm for it.

Good news--and bad--about a new procedure

It's a small sample group, but Deep Brain Stimulation (DBS) procedures that implant electrodes in the brain seem to be delivering spotty results on promises to help patients who are experiencing increasing loss of control of movement (from conditions such as Parkinson’s disease, Essential Tremor, dystonia, and tremor due to multiple sclerosis).

From the archives of the journal Neurolology comes this report that says about 50% of patients who complained of poor results improved after remedial actions were taken.

It was a small sample group (only 41 patients), but it looks as though the study indicated the people who improved did so because interventions were able to correct issues that developed due to pre-screening, surgical and device, programming and medication errors.

Well, this isn't an official source of medical information, so I feel safe saying it's nice to know that correcting for errors can help such a promising percentage of patients. And of course the hope is that the number of errors needing remediation will get smaller as the practitioners get more practice in.

AMA guidelines for health info on the web--New site for the public

Tried to look at an interesting article about some new oral medications that work pretty well for men who experience erectile dysfunction after having prostate surgery, but the information is listed as restricted--not even an abstract was available without a subscription (all their journal subscriptions hover in the $200-area). Not sure why, so I checked out The American Medical Association's website.

Doctors in general are understandably concerned about people just jumping onto the Internet for medical information. How do they tell what's legitimate? So the AMA has issued some lengthy guidelines. Here's an excerpt:

The Internet has permitted physicians, other health care professionals, patients, and other consumers to quickly access medical information in unprecedented volume. Such access has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment (with sometimes questionable patient understanding and adherence to recommendations) to that of shared decision making between patient and physician. However, several substantial barriers remain before this relationship can be realized. These barriers include equitable access to information, imbalance between patient health literacy and the information provided, extreme variability in the quality of the content, potential for commercial interests to influence content, and uncertain preservation of personal privacy.1-4

Web users have been warned regarding the incomplete, misleading, or inaccurate medical information available on the Web.3 For those seeking easy ways to identify high-quality, reliable information, some Web sites and organizations have provided rating systems to evaluate quality of information on the Internet. However, these systems often do not provide the criteria used to assess quality, nor do they provide the reliability and validity of their measures.2,4,5 Ultimately, assessing the quality of content depends on the same factors that readers of print publications depend on: authorship of the content, attribution to the sources of content, disclosure of funding and competing interests, and timeliness of the information presented.3

And here's the best--they've teamed up with 6 other medical professional associations to start a new site designed specifically to provide the public with health information--it's called Medem and it's a very user-friendly site. You can keep a record of all your medical information (wonder how many privacy-conscious people will do this?), find a doctor, sign up for education programs, use their medical library to look for info by your time of life or for a particular disease or condition, and so on.

So now you can check what you might read somewhere else against an approved authority. It'll be interesting to see how well they cover alternative care options.

Herbal help for migraine sufferers

This has been out a couple of months, but my daughter was just diagnosed with migraine headaches, so it caught my eye. An ancient herb called butterbur has been shown to reduce the occurrence of migraine.It's scientific name is Petasites hybridus root "over 4 months of treatment...migraine attack frequency was reduced by 48% for Petasites extract 75 mg bid."

Apparently the only side effect for some of the subjects was burping--not a bad price to pay for being able to get out a migraine or two each month.

And the best part is, it's a natural remedy. I hope the $10,000 honorarium the scientists received from Weber & Weber GmbH & Co. KG, Biologische Arzneimittel, a German pharmaceutical company, doesn't mean they are going to develop it into a pricey designer drug that we'll have to pay a fortune for--it's a natural substance, for heavens' sake! But maybe they never would have found it if the pharma folks hadn't supported the research. Sigh. It can be hard on a person to see both sides of the story...

Either way, I pray that our researchers will find many more answers like this.

Female orgasm: "What's genetics got to do with it?"

Are surveys the same as science? Well, at least they often form the basis on which research is conducted. Okay. Here's the setup.

A team of investigators in England got 4037 completed answers from 6000 female twins to a confidential questionnaire about how often they achieved orgasm during intercourse and masturbation...including replies from 683 pairs of non-identical twins and 714 pairs of identical twins aged from 19 to 83 (about 3% were lesbian or bisexual).

The conclusion is that 1/3 of women are genetically preprogrammed not to achieve orgasm or to achieve it very rarely--and that this proves it's not a critical evolutionary issue (despite the fact that the contractions of orgasm tend to encourage the upward mobility of sperm and therefore enhance fertility).

As the article says in the opening, great excuse for men who don't care? But it'll be very interesting to see whether actual gene studies confirm these conclusions. And after that, to see what happens when the psychologists have a field day with this. It's bound to be as hotly debated as studies that say things like one race is genetically programmed to be less intelligent than another.

But there's always a danger in scientific research that you find what you're looking for--rather than all of what's there. The "discovery" that there are more kinds of intelligence than just what the typical IQ test measures came as a surprise when it was first introduced--I believe in 1993.

So investigators, beware.

What price: lack of control?

I'm fond of quoting something I heard long ago about the highest rates of suicide being among dentists and secretaries. Checking it out today yields inconclusive results, but the point is, higher risks of suicide seem to occur among people who have little control over a) daily tasks (laborers, the unemployed) and/or b) the outcomes of their work (medical professionals, especially female). A recent British study found that men with 'low-grade jobs,' who had little control over daily tasks, and men in low social positions had faster and less variable heart rates"--which is a strong indicator for heart disease.

So the answer is getting clearer--mental and physical health are strongly related to your sense of control over your life. I love the simple definition my counselor/massage therapist brother David gives for mental health: "The ability to see alternatives."

Fight stroke

From a close friend who suffered a stroke at age 48, this item describing 3 simple questions to ask if you see someone acting strangely and looking distressed:

Sometimes symptoms of a stroke are difficult to identify. But speed is essential as the stroke victim may suffer brain damage if observers fail to recognize what's happening. Now doctors say a bystander can recognize a stroke by asking three simple questions:

1. Ask the individual to SMILE.
2. Ask him or her to RAISE BOTH ARMS.
3. Ask the person to SPEAK A SIMPLE SENTENCE.

If he or she has trouble with any of these tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher.

These 3 questions were reported as useful at an American Stroke Association meeting. As the boomers age, this simple approach could save much misery and quality of life--if not lives themselves. Maybe you can even help someone you love.

Technology in the biomed sphere

Managing IT records for 20% of the hospitals in the US is no small task. One solution to keeping things manageable is to host applications on the web instead of on your own server. A company called ChartOne went through a lot of growing pains doing the switch.

But really, technology doesn't stand still. It moves ahead in fits and starts--there's never a guarantee that the solution you buy today is going to be the best solution next month. Our world today challenges the most basic of human resistances--the desire not to have to change. Here's more in my latest newsletter.

But the biomed folks are more attuned to that kind of challenge than most corporate types. Their whole business is about making discoveries and being open to change.

Survey says: malpractice risk increases unnecessary testing

Too many doctors have to live with too much fear of malpractice persecution. That reality contributes to skyrocketing medical costs. Where can the destructive cycle be broken? Yes, "defensive medicine is more likely to be practiced when doctors perceive they are caught in a malpractice crisis."

I once was astonished to read an article about how a very creative group had come up with an idea for intervening in the terrible recidivism cycle of crime and punishment/imprisonment. I had always wondered, how in the world can we help when so many young people have grown up with crime as their role model? These people had come up with the idea of going into prisons and engaging the prisoners in live theater--in which they could act out their anger, alienation and shame. A healthy way to begin to rid oneself of the negative effects of the sad lack of parental warmth, love and supervision with which they'd grown up.

How can we apply this idea to the spiraling health care cost crisis in the United States? When someone who lived in Singapore for 8 years comes here and says he's had to mortgage his home to pay for the birth of his second child in a U.S. hospital--when all he had to do was write a check for the birth of the first one in Singapore--the crisis takes on very real dimensions.

Where do we start? Money-hungry, misery-chasing attorneys? (Yes, I served on a jury of my peers at a totally frivolous lawsuit some shameless attorneys had foisted on the system by advising their clients to sue for an imaginary breach of service they'd received at the Cleveland Clinic.) Do we ask doctors to expose themselves? Do we ask people to put up with terrible service?

Why don't we have intermediaries who can help people resolve their issues fairly and equitably before they take the drastic step of calling an accident a negligence and dragging everyone down into the mud. 'Cuz lets face it, accidents are always going to happen. Let's all contact our government officials about setting up an ombudsman system.