Monthly Archives: May 2013

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Common Painkillers Killing More Than Pain

We all take various forms of anti-inflammatory drugs. These common painkillers (also known as NSAIDs) take form in our medicine cabinets as Tylenol, Advil, and other ibuprofen tablets.

Well this new study suggests that taking these medications actually puts us at a greater risk for heart problems. Taking 2,400 miligrams of ibuprofen (or 150 miligrams of diclofenac) daily increased the risk of heart attacks, strokes, and death by about one-third. That’s a lot!

Granted, 2,400 miligrams on ibuprofen is about 240 Tylenol pills, which translates to about 120 servings since most take 2 at a time. No one takes that much in a single day.

But still – 1/3 increase of heart attacks, strokes, and death? That’s scary! NSAIDs are also suspected of causing bleeding ulcers and other gastrointestinal issues.

Colin Baigent, with the University of Oxford, urges physicians to take (family) history of heart problem into account when suggesting medications.

“Because NSAIDs sometimes are a crucial part of one’s quality of life, the more we understand about dosing, duration and risk becomes important so we [can] determine which is the best choice—especially for patients with heart disease or those who are at risk,” says expert Dr. Suzanne Steinbaum with Lenox Hill Hospital.

The analysis was conducted on 353,000 patients. For every 1,000 patients, 3 had avoidable heart attacks (after taking high doses of NSAIDs for the duration of a year). One of those heart attacks would be fatal.

While this research does open up a lot of questions, there is also no cause-and-effect relationship discovered. NSAIDs don’t necessarily CAUSE these problems, but it is surely something to keep an eye on. Further research will include the risk of lower doses, the effect of tolerance on the drugs, and residual effects if treatment was stopped. For more information on the study and NSAIDs, check out KOAA local news article here.

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Can’t Recall? Maybe You’re Not Chunking Properly!

It’s no surprise that as we get older, our memory will not remain as good as it once was. But the question is…why?

Does everyone develop at least a mild case of dementia? Does part of our brain deteriorate? Do we simply not have enough room for any more memories?

Heather Bailey, from Washington University in St. Louis, suggests that there is an atrophy in the medial temporal lobe in the brain. This atrophy leads to the inability to process everyday events.

For example, when you struggle to remember what you had for breakfast yesterday morning, you know it’s different from lunch because you’re able to chunk the events of your day properly. People with this atrophy can’t do that.

This study used older individuals, some with dementia and some without, and had them watch movies of people doing everyday tasks. They had to distinguish these “chunks” by splitting the movie where they saw one task ended and a new part beginning. Later, the individuals were asked to recall the movie.

Using an MRI scan, the researchers found that those with atrophy in the medial temporal lobe did not have strong memories and they couldn’t properly segment the events in the movie. They looked for the comparable size of the medial temporal lobe.

This is a big step for memory research, because now it’s not simply a problem with recollection of events, but how we process/absorb that information as well.

To read more on the research, you can read the full article here.

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A Word from a Nurse

Jamie, a nurse at Compass Imaging in Gulfport, MS (228-314-SCAN) contributed her own article about anemia. You can read what she has to say below:

Anemia means that the body does not have enough healthy red blood cells. It can be divided into two broad categories: 1. iron deficient and 2. hemolytic. Some info on each:

Iron deficiency anemias: This is the more common of the two- what people are generally referring to when they talk about anemia. It’s probably safe to say that many, if not most, women experience some iron deficiency anemia at some time.

Iron is needed to make hemoglobin, the component in red blood cells that carries oxygen. About 2/3 of the body’s iron is found in hemoglobin; the rest is stored in other proteins and enzymes. Main causes of iron deficiency anemia are lack of iron in the diet and an ability of the gastro tract to absorb it. Blood loss may also be a factor.

  1. Diet: dietary iron is either heme (animal products) or non-heme (plant sources). Iron-rich foods include red meat, poultry, fish, organ meats, oatmeal, soybeans, tofu, lentils, spinach and raisins. A diet lacking in iron and/or folic acid can lead to anemia.
  2. Absorption: dairy products block absorption of iron in the gut; vitamin C increases it (so a cheeseburger will yield less iron than a hamburger with a slice of tomato). Low nutrient-density foods (junk food) also block absorption. Your body will attempt to absorb more when stores are low, less when they are adequate or high (high iron is toxic). Another factor that affects absorption is the health of the small intestines. Chronic health conditions such as Crohn’s or celiac disease, or a history of intestinal resection will make it harder for the body to absorb iron.
  3. Blood loss and women at risk: menstrual blood loss depletes iron each month, particularly for women who have heavy periods; pregnancy is a major strain on iron stores because they are needed for the baby and also the added fluid in a pregnant woman’s bloodstream means that whatever iron/hemoglobin she has is diluted. Childbirth and postpartum blood loss are also factors, coming at a time when many women are already iron depleted.
  4. At least three other types of anemia are not exactly iron deficiency related but are similar in effects on the body- aplastic anemia is when the bone marrow stops producing adequate red blood cells, usually due to autoimmune disorders, cancer treatment, cancers, or exposure to toxins; pernicious anemia happens in people who do not absorb enough B12 from their diet, and renal anemia can sometimes happen in people with kidney damage, because the kidneys produce a substance called erythropoiten, which signals the bone marrow to make blood cells.

Hemolytic anemias: Hemolytic means “destruction of blood cells”- hemo coming from the word for blood and lytic, meaning tearing apart. These anemias are fairly rare and are usually hereditary; although, they can be acquired as the result of a mechanic action, blood incompatibility or exposure to transient medical issues.

Hemolytic anemias include:

  1. Hereditary conditions like sickle cell (blood cells are sickle-shaped and don’t travel through the blood stream easily- they are rigid, fragile and sticky which causes them to get easily damaged, clump and clog small vessels, and cause pain), spherocytosis/eliptocytosis/ovalsytosis (these are disorders that cause the blood cells to have abnormal membrane shape and surface area, and so they have similar issues to sickle cell), G6PD, Pyruvate kinase deficiency, and paroxysmal nocturnal hemoglobinuria.
  2. Autoimmune hemolytic conditions happens when the body’s cell attack the immune system for an unknown reason. TTP (thrombotic thrombocytopenia purport) is another condition of unknown cause that results in many small clots in the body as well as hemolysis. There are other conditions or infections that also cause hemolysis and anemia, many of them are transient and once they are treated or resolved, the hemolytic anemia goes away.
  3. Mechanical hemolytic anemia happens when the blood is damaged by the mechanical actions of artificial heart valves or by dialysis.
  4. Blood incompatibility due to poorly matched blood transfusion or Rh disease in newborns.

Q: My patient has anemia. Are labs needed?

A: Probably not. For the iron deficiency anemias and the like, labs are not needed. For hemolytic anemias, please notify nursing- the radiologists may want labs on a patient with a hemolytic anemia depending on what type or the situation. When in doubt about anything having to do with anemia, please just feel free to ask.

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Restless Legs?

The overwhelming urge to move your legs while trying to sleep and relax keeps about 5% of the United States up at night

For years, scientists have thought abnormal levels of dopamine could be the reason behind the movements. Dopamine is a neurotransmitter which communicates with brain cells to produce smooth muscle activity. Drugs that increase dopamine levels have been used to treat these symptoms.

Professor Richard P. Allen at Johns Hopkins University recently found that glutamate, not dopamine, may be at fault. Glutamate is a neurotransmitter in the thalamus associated with arousal.

MRIs of 48 individuals, 28 with restless leg syndrome and 20 without, found that increased glutamate levels are congruent with sleepless nights. Also, glutamate results in hyperarousal (day or night), which may be why individuals suffering with restless leg syndrome may not sleep but also not feel tired during the day.

But, does it matter what the cause is, as long as the dopamine medications are working? Well they do…at first. As the body becomes adapted and doses are increased, the symptoms can actually get worse.

There are medications that can lower glutamate levels, such as anticonvulsive gabapentin enacarbil, but they have not been used to treat restless leg syndrome yet. This research can also help explain other problems associated with insomnia.

To read more on the topic, click here.

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“How Good Cells Go Bad”

Corey Neu at Perdue University recently combined an atomic force microscope and nuclear magnetic resonance system (MRI). Why? The fine detail allows the researchers to understand how individual cells react to different things.

The research began to try to understand what makes a cell metastasize to form a cancerous tumor.

The research focused on how the cells react, both physically and biochemically, to the environment. By focusing on the hydrogen molecules, the researchers collected plenty of data because of its abundance.

This study used an electric current passing through the cell, which exchanged electromagnetic radiation with the protons, and then a metal coil detected the charges. This is called “mechanobiology.”

This is the beginning of great strides in cancer research. If we can understand why cells make this initial change to start the disease, we can probably make changes to stop it.

To read more on the study, click here.