Marion County Medical Center

Health Shorts

April 2007

Kidney Stones on Rise–Why?
An increasing number of kidney stones have been diagnosed in recent years, and scientists believe that at least some of this increase may be linked to an increased incidence of diabetes. In a Mayo Clinic study involving 3,561 cases of kidney stones diagnosed between 1980 and 1999, researchers found a significant association between kidney stones and a diagnosis of diabetes. Among subjects with uric acid stones, the prevalence of diabetes was 40 percent.

An earlier study based on data from the Health Professionals Follow-Up Study, the Nurses Health Study and the National Health and Nutrition Survey (NHANES II) found that weight gain and obesity increased the risk of kidney stones. “Larger body size may result in increased urinary excretion of calcium, oxalate, and uric acid, thereby increasing the risk for calcium-containing kidney stones,” wrote the author of the study.

[SOURCE: John C. Lieske, et al, American Journal of Kidney Diseases, 2006;48:897-904; Eric N. Taylor, et al, JAMA, January 26, 2005]

What You Drink Does Matter
To prevent kidney stones, doctors recommend increasing urine volume by drinking plenty of fluids–two to three liters a day.
Water is always a good choice; it’s plentiful, inexpensive and zero calories per serving. Studies show that individuals who drink coffee and beer have a decreased risk of kidney stones. One study found that orange juice was better than other citrus juices such as lemonade in raising levels of citrate in the urine and reducing the formation of stones.

[SOURCE: Vadim A. Finkelstein and David S. Goldfard, “Strategies for Preventing Calcium Oxalate Stones,” Canadian Medical Association Journal, May 9, 2006; Sherri Damlo, “Orange Juice Helps Prevent the Formation of Kidney Stones, American Family Physician, December 15, 2006 from Journal of the American Society of Nephrologists, October 26, 2006]

Kidney Stone Prevention: Normal
Calcium, Less Protein and Sodium
High concentration of calcium in the urine is a risk factor for calcium oxalate kidney stones, but scientists now believe that eating too little calcium-rich foods is not a solution since this may lead to increased absorption of oxalate. A randomized, controlled study found that a diet with a normal amount of calcium combined with reduced protein and sodium was more effective than a low-calcium diet in preventing the recurrence of stones.

[SOURCE: Yadav Rajiv and Kumar Rajeev, “Dietary Modifications for Preventing Recurrent Kidney Stones,” Indian Journal of Urology, October-December, 2006]

Fewer Stones for the Lower Classes
Kidney stones tend to occur more frequently in affluent, industrially developed countries, and some experts attribute the increased incidence of kidney stones over the past several decades to rising affluence. Persons with a large intake of meat and animal protein have a higher risk of forming stones than those consuming mostly plant products.

[SOURCE: Aisling E. Courtney and A. Peter Maxwell, “Renal Medicine: Renal Stone Recurrence Can Be Prevented,” The Practitioner, February 23, 2007]

Anti-Seizure Diet Attracts Interest
A low carbohydrate ketogenic diet has been used effectively to reduce recurrent seizures in both children and adults. Originally developed in the early 1920s when good anti-seizure medications were not available, the ketogenic diet is high fat, adequate protein, low carbohydrate, similar to popular weight loss plans such as the Atkins diet.

In a Johns Hopkins study of children who had averaged 410 seizures a month and had not responded well to medication, researchers found that 7 percent of the children were seizure free after 12 months on the ketogenic diet while another 20 percent had a 90 percent decrease in seizures. The diet seems to be effective for most types of seizures but has negative effects on cholesterol and blood lipids.

[SOURCE: John M. Freeman, Eric H. Kossoff and Adam L. Hartman, “The Ketogenic Diet: One Decade Later,” Pediatrics, March, 2007]

Do Prenatal Habits Affect Seizure Risk?
Moderate consumption of coffee and alcohol by the mother during the prenatal period had no effect on a child’s risk for febrile seizures, according to a Danish study published in Pediatrics [November, 2005]. An effect caused by cigarette smoking could not be ruled out.
Previous studies of maternal habits and seizure risk have had conflicting results.

[SOURCE: Mogens Vestergaard, et al, “Prenatal Exposure to Cigarettes, Alcohol, and Coffee and the Risk for Febrile Seizures,” Pediatrics, November, 2005]

Seizures Affect School Performance
Children with new onset seizures and recurrent seizures showed declines in ratings of school performance by their teachers, according to an Indiana University study published in Epilepsy and Behavior [March, 2007]. Children who went 24 months without additional seizures then showed academic improvement while those with recurrent seizures had continuing decline.

[SOURCE: Angela M. McNelis, et al, “Academic Performance in Children with New-Onset Seizures and Asthma: A Prospective Study,” Epilepsy and Behavior, March, 2007]

COPD Is Growing Threat to Women
As recently as 1959, chronic obstructive pulmonary disease (COPD) was primarily a male malady, killing five times as many men as women. For the past four years, female deaths from COPD have slightly outnumbered male deaths.
The change is usually attributed to increased smoking rates for women compared to those for men. A female smoker has a risk of dying from COPD 13 times that of a woman who has never smoked.

[SOURCE: Antonello Punturieri, et al, “The Changing Face of COPD,” American Family Physician, February 1, 2007; American Lung Association, “Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet, August, 2006]

COPD Suffering Comparable
To That of Lung Cancer
Persons in the advanced stages of chronic obstructive pulmonary disease (COPD) have symptoms at least as disabling as those of patients with lung cancer. These include breathlessness, fatigue, sleep problems, anxiety and depression.
According to one study, COPD patients had more frequent breathlessness than lung cancer patients both in the final year and the final week of life. About 90 percent of COPD patients developed depression or anxiety compared to 52 percent of those with advanced lung cancer.

[SOURCE: Donna M. Goodridge, “COPD as a Life-Limiting Illness: Implications for Advanced Practice Nurses,” Topics in Advanced Practice Nursing eJournal, January 29, 2007]

Lung Inflammation, More Wrinkles
Smokers often develop premature facial wrinkles. More importantly, they have an elevated risk of chronic obstructive pulmonary disease (COPD). And the two may be related.

In one study, dermatologists used photos of current and former smokers to select subjects with “profound wrinkling over most of the face.” Of the 25 most wrinkled subjects, 21 had COPD. Researchers noted that the wrinkles were associated with heavier smoking and “strongly predictive” of airflow obstruction and emphysema.

[SOURCE: B. Patel, Thorax, “Online first edition, June 14, 2006; Miranda Hitti, “Wrinkles Predict Smokers’ Emphysema,” WebMD Medical News, June 13, 2006]

Heart Attack, COPD=Double Trouble
A heart attack is life threatening. In a person who also has chronic obstructive pulmonary disease, it is doubly dangerous.
A study published in the American Journal of Cardiology [March, 2007] found that heart attack patients with COPD were twice as likely to die as those without COPD. According to the researchers, patients with COPD were less likely to be treated with angioplasty, beta blockers or cardiac rehabilitation.

[SOURCE: John A. Spertus, American Journal of Cardiology, March, 2007; “MI Mortality Higher in COPD Patients,’ Reuters Health Information]

Dealing with Motion Sickness
Motion sickness in a car, plane or boat is caused by incongruence in perception of movement. The balance mechanisms of the inner ear and the joints and muscles of the body sense movement while the eyes do not.
The solution is to try to bring these perceptions back into agreement. When riding in a boat, look for the horizon when you start to feel seasick; in a car, sit in the front seat and focus on distant scenery. Don’t try to read while riding in a car; in a train choose a seat facing forward.

[SOURCE: Randy Swartz and Paxton Longwell, “Treatment of Vertigo,” American Family Physician, March 15, 2005]

Are You Dizzy? Or Lightheaded?
If you go to a doctor with complaints of being dizzy, you will probably be asked to describe the nature of your dizziness. Do you feel lightheaded? Or is the world spinning around you?
Lightheadedness is a sign that the brain is not getting enough blood–usually because of a sudden but temporary drop in blood pressure or because you’re dehydrated. Many older persons feel dizzy when they rise suddenly from the bed or chair, and the solution is to pause a few seconds before starting to walk. Then drink a full glass of water. If the dizziness is due to a more serious problem such as a heart attack or stroke, you’ll probably have other symptoms such as chest pain, a racing heart or loss of speech or vision.

The feeling that the world is whirling is known as vertigo. The most common cause is benign positional vertigo, caused by shifts in calcium deposits in the inner ear canals and easily corrected through head rotation maneuvers in the doctor’s office. Other causes include labyrinthitis, which may follow a cold or the flu, and Meniere’s disease. Meniere’s disease involves a buildup of fluid in the labyrinth of the inner ear, causing a combination of fullness in the ear, roaring or ringing, fluctuating hearing loss and vertigo.

[SOURCE: Ronald H. Labuguen, “Initial Evaluation of Vertigo,” American Family Physician, January 15, 2006; MedlinePlus Medical Encyclopedia, May 16, 2006]

Health Shorts

April 2007

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