Marion County Medical Center

Health Shorts

November 2005

2nd Hand Smoke, 1st Hand Hazard
The smoke that harms you need not be your own. A unique study recently confirmed the hazards that accompany second hand smoke.
Helena, Montana in 2002 passed an ordinance outlawing smoking in all public places–a ban that was repealed six months later.

During that six-month smoke-free period, there were only 24 hospital admissions for myocardial infarction (heart attack) compared to an average of 40 admissions for the same six-month period in the other years from 1998 through 2003.

According to the American Heart Association, second hand smoke causes an estimated 35,000 to 65,000 heart-related deaths each year.

[SOURCE: Suzanne Hughes and Laura L. Hayman, “The 40-Year Public Health Battle against Cigarette Smoking: Are We Winning?” Journal of Cardiovascular Nursing, March-April, 2005]

Victory Recorded in War on Blindness
Despite continuing population growth, the incidence of blindness decreased worldwide, from about 45 million in 2000 to 38 million today, according to the World Health Organization (WHO). This was the first recorded decrease in the number of blind people and may be attributed in part to strategies developed by WHO’s Vision 2020: The Right To Sight campaign. With a strong focus on cataracts, the program involves training local medical staff and the purchase of the equipment needed for cataract surgery.

Cataracts are the most common reversible cause of vision loss or impairment worldwide. When access to cataract surgery is available, good functional vision can be restored in 90 to 95 percent of cases.

[SOURCE: “Number of Blind People Drops: WHO,” Australian Associated Press, October 13, 2005]

New Lens Implant May Eliminate Need
For Glasses after Cataract Surgery
A new intraocular lens now being tested may eliminate the need for a person to wear eyeglasses or contacts following cataract surgery. The lens is designed to maintain distance vision while improving near vision.
I
n a study involving 118 patients in France, Germany, Italy and the United Kingdom, 74 percent did not need glasses six months after the foldable lens was implanted.

[SOURCE: Jane Salodof MacNeil, “Lens Implants May Improve Post-Cataract Surgery Focus,” Family Practice News, July 1, 2005]

Cataract Surgery Is Cost Effective
Cataract surgery is expensive, but the cost of not treating severe vision impairment due to cataracts–in terms of reduced productivity and need for care–is much greater.

Especially in less developed countries, cataract surgery is considered one of the most cost-effective health measures. Yet in Africa, only 200 per million people get cataract surgery every year compared to 5,000 per million people in the United States.

[SOURCE: Penny A. Asbell, et al, “Age-Related Cataract (Seminar),” The Lancet, February 12, 2005]

Blacks More Vulnerable to Cataracts
African Americans are twice as likely as whites to develop cataracts, according to the nine-year population-based Barbados Eye Studies. Blacks were three times more likely to develop cortical cataracts, and the authors attributed this increased risk in part to the higher prevalence of diabetes, high blood pressure and abdominal obesity in this population.

African Americans were advised to make lifestyle changes to control these conditions and to get regular eye examinations to identify cataracts early.

[SOURCE: Leonid Skorin, Jr. “Cataracts: The Case for Earlier Surgery,” Consultant, August, 2004; “Blacks Have Higher Incidence of Cataract,” Review of Optometry, April 15, 2004]

Treat Mild Hypothyroidism?
Chronically low levels of the thyroid hormones T3 and T4 must be treated because the deficit can lead to serious health problems such as hypertension, high cholesterol and heart failure. When hypothyroidism is mild (with high levels of TSH but normal levels of T3 and T4), doctors don’t always agree about the need for treatment.

Supporting those who favor watchful waiting for mild hypothyroidism, the Leiden 85-Plus study found the lowest mortality rate among
those with elevated TSH, indicating mild hypothyroidism. The highest mortality was among those with low blood levels of TSH, indicating mildly overactive thyroid.

[SOURCE: Louis Kuritzky, “Thyroid Status, Disability and Cognitive Function, and Survival in Old Age,” Clinical Cardiology Alert, February, 2005]

Thyroid Not Key to Weight Gain, Loss
Although the thyroid gland regulates the body’s metabolism, its role in weight gain and loss is not as great as commonly believed. An underactive thyroid often results in a mild to moderate weight gain–5 to 20 pounds–but rarely obesity. If prescribed at the right dose, thyroid medication is unlikely to lead to sudden weight loss, although patients are likely to find it easier to lose weight than before their hypothyroidism was diagnosed.

Increasing the prescribed dose in an effort to lose weight is unlikely to be effective since it will increase appetite. More importantly, the high dose could cause serious adverse effects, including heart problems and weakened muscles and bones.

[SOURCE: American Thyroid Association, “ATA Hypothyroidism Booklet,” 2003]

Radioactive Fallout Affects Thyroid
Exposure to radioactive fallout, such as through nuclear accidents, is associated with an increased risk of thyroid cancer. About four years after Eastern Europeans were exposed to radioactive fallout following the Chernobyl explosion of 1986, pediatric cases of thyroid cancer began to soar in this region.

A National Cancer Institute study concluded that more than 150 million Americans have been exposed to radioactive fallout great enough to cause an increased risk, most notably through above ground nuclear tests conducted in the 1950s.

[SOURCE: Janet Yagoda, Shagam, “Thyroid Disease: An Overview,” Radiologic Technology, September, 2001]

Potential Causes of Thyroid Problems
David Brownstein, M.D., author of Overcoming Thyroid Disorders [Medical Alternatives Press, 2002] believes that as many as 40 percent of Americans have some level of thyroid dysfunction. Among items he lists as possible causes are beta blockers, birth control pills, estrogen, lithium, chronic illness, infections, advancing age, heavy metal toxicity, vitamin and mineral deficiencies and hormone-disrupting chemicals in commercially packaged foods.

Dr. Brownstein has an alternative medicine point of view, and he advises eating more organic foods to avoid these hormone-disrupting chemicals. Otherwise, his dietary recommendations are mainstream and consistent with overall good health: go easy on refined sugar and trans fatty acids, drink more water, eliminate artificial sweeteners and eat a balanced diet.

[SOURCE: David Goldstein, “The Many Faces of Thyroid Disorders,” Townsend Letter for Doctors and Patients, December, 2002]

Ranks of Uninsured Growing Rapidly
More than 40 million Americans today lack health insurance because they can’t afford it. That compares to 32 million without health insurance in 1995–an increase of 25 percent.

[SOURCE: “Consumer Insight,” McKnight’s Long-Term Care News, September, 2005]

After Dinner Mint: Bad for Heartburn
An after dinner mint is a cultural tradition, and many Americans assume that the purpose is to aid digestion. In fact, while the mint may freshen your breath and leave you with a good taste in your mouth, it is not recommended if you’re prone to heartburn. Both the mint and the chocolate tend to relax the sphincter at the bottom of the esophagus, making it easier for stomach acids to wash up, causing heartburn.

Smoking and high-salt intake have also been linked with an increased risk of heartburn. Regular exercise and a high-fiber diet reduce the risk.

[SOURCE: Richard Honaker, “Peppermint May Freshen Breath But Worsen GERD,” Consultant, July, 2005; Jeff Evans, “Lifestyle Risk Factors for GERD,” Internal Medicine News, December 15, 2004]

Acid Reflux May Trigger Asthma
Gastroesophageal reflux disorder (GERD) and asthma often occur together in both adults and children, and it’s believed that the acid reflux may trigger the asthma. Some asthma medications such as theophylline, oral corticosteroids and nebulized albuterol have been found to cause acid reflux or make it worse.

When GERD is associated with asthma attacks, studies show that therapy with a proton pump inhibitor such as Prilosec or Prevacid improves asthma symptoms and reduces the need for medication. One study found that surgery was even more effective than medication in relieving GERD-related asthma.

[SOURCE: Kate Johnson, “Silent Gastroesophageal Reflux Linked to Asthma,” OB GYN News, May 15, 2005; Subin Jain, “Proton-Pump Inhibitor Therapy of Gastroesophageal Reflux Disease: Does It Treat the Asthma?” Chest, April, 2005]

No H. Pylori-GERD Link found
Most stomach ulcers are caused by helicobacter pylori bacteria and can be treated effectively with antibiotics. Based on early studies, some experts suggested that the presence of helicobacter pylori may decrease the risk of acid reflux. However, a recent study of 1,558 patients successfully treated for helicobacter pylori infection in Bristol, England found that eradication of the bacteria had no significant impact on the prevalence of gastroesophageal reflux or heartburn.

[SOURCE: “Value of Eradicating H. Pylori,” Family Practice News, August 15, 2004]

Health Shorts

November 2005

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