Sunday, November 23, 2008

To call or not to call

How can you tell the difference between a problem that will go away on its own and one that should be attended to as soon as possible? Here are six symptoms that you should call your doctor about.

1. Persistent Headaches
Everybody gets headaches now and then. If you've had the same pattern of headaches for years, chances are that it's going to continue that way for years more. But if your headaches are so severe that you miss work or social gatherings, or if over-the-counter painkillers don't help, see your doctor. There are new treatments now that work well, even for disabling migraines.

If you have an unfamiliar type of headache that's persisted for three days or longer and is associated with vomiting or visual changes, it could indicate an abnormality in or near the brain, such as a blood clot. If you have an unremitting headache on only one side of your head, near the temple or above the ear, it may be a condition called temporal arteritis. It can be cured it with cortisone or steroids, but, left untreated, it can lead to blindness. The most important thing to remember: Any new or extremely painful headache should prompt you to call your doctor.

2. Chest Pain
Colds and respiratory infections often result in inflammation of the cartilage next to the ribs, which can cause chest pain. Pneumonia or pleurisy, an inflammation of the lining of the lungs, can also lead to chest or rib pain. So if your chest hurts, don't panic, but do look into it.

Chest pain can indicate something as simple as a gas bubble in the stomach, or it could be a heart attack. Sometimes it's hard to distinguish between the two. When a nerve near the heart (called the vagus nerve) becomes irritated because of a heart attack, it can cause stomach symptoms. If the pain goes away with an antacid, it's less likely to be related to the heart. Most times, it's probably not a heart attack, but if dull, pressure-like chest pain comes on for no reason, call an ambulance and get to an emergency room.

Why an ambulance rather than your neighbor? For two reasons: Many ambulances now come equipped with sophisticated monitoring equipment, and emergency personnel are trained to administer necessary medication at a time when every minute counts. A number of doctors also recommend that you take an aspirin to protect your heart from a blood clot while the ambulance is on its way.

3. Abdominal Pain
All of us suffer abdominal pains occasionally, and their causes are many. In fact, there are entire medical textbooks on how to evaluate this particular type of pain. In most cases, it's something that can be easily cured. Abdominal pain that occurs before meals and is relieved by food can indicate an ulcer. Treatment is generally simple, so why suffer? If the pain occurs when you eat, it might mean gastritis (an inflamed stomach), or a problem with the gallbladder or pancreas. The pain related to each of these conditions has somewhat different characteristics, so your doctor will probably ask such questions as where does the pain radiate, what eases it, what makes it feel worse, and whether the pain comes on when you lie down.

More serious causes of abdominal pain can include problems with blood vessels that nourish the intestines or with the aorta (the artery that distributes oxygen-containing blood from the heart to other parts of the body), gallstones, obstruction of the intestine, an infection, or cancer. Whatever the possible cause, have the pain checked out.

4. Bruising and Bleeding
If you bump into something and get a bruise, it generally turns blue-purple over a day or two and then slowly fades to yellow over the course of another four or five days. That's normal and is nothing to be concerned about. In addition, many of us develop mysterious bruises from time to time and don't remember bumping into anything. But if you develop spontaneous recurrent bruises in places that aren't prone to being bumped, it could signify a disorder of blood clotting. It could also be because you're taking medications that predispose you to bruising, such as warfarin, which is a blood thinner, or aspirin.

If you cut yourself or brush your teeth too vigorously, you'll start to bleed. Put an antiseptic on the cut or ease the pressure on your toothbrush and you'll be fine. However, if you notice any rectal bleeding, any vaginal bleeding after menopause, any blood in your urine, or any blood when you vomit or cough, make an appointment with your doctor to find out the cause. It might be a simple problem, or it might possibly be serious.

5. Breathing Problems
If you have a cold, sinus problem, or allergies that cause nasal congestion, you may find it difficult to breathe. A cold will generally clear up on its own in a week, and you'll be back to normal in short order. But if a sinus problem or allergies continue to distress you, call your doctor for an appointment. A simple medication will often do the trick, and you'll be smelling the roses soon.

People who are out of shape certainly find strenuous activity more difficult than those who exercise regularly, so difficulty breathing on exertion can be a sign that it's time to start exercising. But it could also raise a red flag that indicates lung problems, heart problems, asthma, or even anemia. Also, if you become short of breath when you're lying down and have to prop yourself up on two or three pillows to sleep comfortably, it might signal heart failure. Call your doctor.

6. Sadness
I don't know a single person who hasn't felt blue or sad from time to time. These feelings are a normal component of human emotion and deserve attention and recognition, but not necessarily medical intervention. So if you're blue because a friend moved away or someone close to you is ill, that's unfortunate - but it's not a reason to call your doctor.

If you feel sad or irritable most of the day for at least two weeks, however, and you take less interest in activities that once gave you pleasure, then it's time to seek help. You could be suffering from depression, which is a painful and disabling problem. Other signs of depression include crying spells for no apparent reason, unexplained aches and pains that won't go away, difficulty in making decisions, an inability to concentrate, and a feeling that the future looks grim. Many people believe that persistent feelings of hopelessness are part of aging. That's not true. So by all means talk to your doctor. Fortunately, depression is treatable. Nobody should have to suffer from it, and nobody should have to live with it.

Thursday, November 20, 2008

Sometimes you cure cancer and end up preventing diabetes

Two cancer drugs prevent, reverse type 1 diabetes, study shows
Medicine & Health / Medications
Two common cancer drugs have been shown to both prevent and reverse type 1 diabetes in a mouse model of the disease, according to research conducted at the University of California, San Francisco. The drugs – imatinib (marketed as Gleevec) and sunitinib (marketed as Sutent) – were found to put type 1 diabetes into remission in 80 percent of the test mice and work permanently in 80 percent of those that go into remission.

The findings may offer a new weapon against this autoimmune disease, formerly called juvenile-onset diabetes, for which few drugs have been developed to address the underlying causes, the lead scientists say.

"There are very few drugs to treat type 1 diabetes, especially after disease onset, so this benefit, with a drug already proven to be safe and effective in cancer patients, is very promising," said Jeffrey Bluestone, PhD, director of the Diabetes Center at UCSF and an expert in the study of autoimmunity. "The fact that the treated mice maintained normal blood glucose levels for some time after the drug treatment was stopped suggests that imatinib and sunitinib may be 'reprogramming' their immune systems in a permanent way."

Bluestone is the A.W. and Mary Margaret Clausen Distinguished Professor of the Diabetes Center at UCSF and a senior author on the paper.

Both drugs treat cancer by inhibiting a small subset of the more than 500 tyrosine kinases, which are enzymes that modify cells' signaling proteins through a simple biochemical change. Kinases are ubiquitous agents of cell growth and proliferation, and are also involved in many diseases such as inflammation and cancer. In the immune system, tyrosine kinases are thought to be key to nearly every aspect of immunity, from the signaling that initiates a response by the immune system's T and B cells to later stages of inflammation that can cause tissue damage.

Because type 1 diabetes is caused by an autoimmune response that destroys insulin-secreting cells in the pancreas, the scientists sought to determine if one or more of the tyrosine kinases blocked by the two cancer drugs might also be responsible for the destructive inflammation in the pancreas. If so, the drugs might be promising candidates to treat diabetes.

Fighting aging with no side effects

An Anti-Frailty Pill for Seniors?

University of Virginia Health System Study Shows New Drug
Increases Muscle Mass in Arms and Legs of Older Adults

CHARLOTTESVILLE, VA (November 4, 2008) - Researchers at the University of Virginia Health System report that a daily single oral dose of an investigational drug, MK-677, increased muscle mass in the arms and legs of healthy older adults without serious side effects, suggesting that it may prove safe and effective in reducing age-related frailty.

Published in the November 4, 2008 issue of Annals of Internal Medicine, the study showed that levels of growth hormone (GH) and of insulin-like growth factor I (IGF- I) in seniors who took MK-677 increased to those found in healthy young adults. The drug restored 20 percent of muscle mass loss associated with normal aging.

"Our study opens the door to the possibility of developing treatments that avert the frailty of aging," explains Dr. Michael O. Thorner, a nationally recognized researcher of growth hormone regulation and a professor of internal medicine and neurosurgery at UVA. "The search for anti-frailty medications has become increasingly important because the average American is expected to live into his or her 80s, and most seniors want to stay strong enough to remain independent as they age."

Funded by the National Institutes of Health, the two-year, double-blind, placebo-controlled, modified-crossover study involved 65 men and women ranging in age from 60 to 81.

The study drug, MK-677, mimics the action of ghrelin, a peptide that stimulates the growth hormone secretagogue receptor (GHSR). Drug developers are focusing on GHSR because it plays an important role in the regulation of growth hormone and appetite. They think it may prove to be an excellent treatment target for metabolic disorders such as those related to body weight and body composition.

According to Dr. Thorner, the UVA research was a "proof-of-concept" study that sets the stage for a larger and longer clinical trial to determine whether MK-677 is effective in people who are frail and to assess its long term safety