Friday, August 22, 2014

High Dose Flu Shots Available for 65+

Our high dose flu shots have arrived. This vaccine is for patients over the age of 65, and research has shown it to be more effective in that population than the standard flu shot. 

Please ask us at your office visit if you would like to receive this vaccine. 

Our regular flu vaccines should arrive around September 10th. We will be starting our walk-in flu clinics around September 15th. Stay healthy everyone!

Live Long and Prosper Newsletter August 2014

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP. 

Nutrition
1.   Is there a reverse J-shaped association between 25-hydroxyvitamin D and all-cause mortality? Results from the U.S. nationally representative NHANES.
   what is the optimal level of vitamin D in your blood? It turns out that people with a vitamin D level of about 81 live the longest. Mortality rate increases as your vitamin D level gets above 100 or less than 40. About 85% of people with body mass index over 30 have a low vitamin D level (less than 30). Does taking vitamin D supplements make you live longer? Not as clear.
October 2, 2013

2.   Obesity and early mortality in the United States.
   "CONCLUSIONS: For healthy nonsmokers young- and middle-aged adults who constitute about one-third of American adults, being obese is likely to hasten mortality by 9.44 years"
October 2, 2013

3.   Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?
   People who have diabetes have a 62% higher mortality rate. If you are getting diabetes, it is best to aggressively change your lifestyle and not get it. "Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk"
October 18, 2013



Exercise
1.   Association between various sedentary behaviours and all-cause, cardiovascular disease and cancer mortality: the Multiethnic Cohort Study.
   Sitting at work for more than 10 hours per day had a harmful effect on women, increasing their mortality rate by 19% relative to those who sat less than 5 hours. Sitting watching over 5 hours per day of TV was associated with 19% higher rate of cardiac death in men and 32% higher in women, relative to abstainers.
September 27, 2013

2.   Examining the Behavioral Processes through which Lifestyle Interventions Promote Weight Loss: Results from the PREMIER Trial.
   Not many things reliably help people lose weight. This study (like many others) found that adherence to a weight loss program and self-monitoring of weight both make a big difference. If you want to lose weight, probably best to eagerly participate in a program, and weigh yourself every day.
October 15, 2013

3.   Association of walking speed in late midlife with mortality: results from the Whitehall II cohort study.
   Researchers have been studying how walking speed is a measure of longevity, among people above say 50. This study confirmed this (89% higher mortality for those in the slower 1/3 of people).
October 18, 2013

Lifestyle
1.   The metabolic syndrome.
   Many people have not heard of "The Metabolic Syndrome". It has been all the rage in recent years in primary care. It goes by a number of different names: insulin resistance, glucose intolerance, pre-diabetes. It is thought to be both a risk factor for heart disease and a warning sign that you are about to get diabetes. How can you tell if you have it? Supposedly you have it if you have 3 or more of the following: * waist circumference greater than 40 inches in men or 35 in women, * serum triglycerides > 150, * HDL ("good") cholesterol l< 40 in men or < 50 in women, * blood pressure > 130/85, * fasting blood sugar > 100
August 25, 2013

2.   Better Diet Quality and Decreased Mortality Among Myocardial Infarction Survivors.
   After having a heart attack, those who ate a Mediterranean-style diet lived a little longer.
September 5, 2013

3.   The contribution of diet and lifestyle to socioeconomic inequalities in cardiovascular morbidity and mortality.
   It has long been known that people of more privileged socioeconomic background live longer on average. For example, the more years of school you have had and the more stable your employment, the longer you live. This study investigated why. They found that most (70%) of the benefit of education on preventing heart disease is because people with more education tend to have better diets and exercise habits. So education causes better eating and exercise which causes less heart disease which causes less death. That's most of the story anyway.
September 5, 2013

Prevention
1.   The “New Deadly Quartet” for Cardiovascular Disease in the 21st Century: Obesity, Metabolic Syndrome, Inflammation and Climate Change: How Does Statin Therapy Fit into this Equation?
   The authors cite evidence that particulates in the atmosphere are driving a significant amount of cardiovascular disease.
December 16, 2013

2.   Recent progress on nutraceutical research in prostate cancer
   Those who drank soymilk daily had 70% lower rate of prostate cancer than abstainers. men with prostate cancer who ate more fruits and veggies reduced their risk of progression by 59% relative to those who are the least. Green tea reduced the rate of widespread prostate cancer. In short, eating a plant-based diet and avoiding the usual suspects (meat, dairy, and eggs) is our best medicine against prostate cancer. Far tastier than PSA tests and digital rectal exams (yuck).
December 27, 2013

Safety
1.   Choice of motorcycle helmet makes a difference: a prospective observational study.
   In emergency room circles, they call them donorcycles, because that's where organ donations come from. For every mile ridden on a motorcycle, the rider has 35 times the risk of dying relative to riding in a car. But if you in that demographic of safety-conscious motorcycle riders, hear this: Riders who wear Full Face Helmets enjoy about 1/5 the risk of having a facial fracture.
September 5, 2013

2.   A prospective study of carpal tunnel syndrome: workplace and individual risk factors.
   Carpal tunnel syndrome (CTS) occurs most commonly with forceful hand exertion. Obesity triples your risk of CTS.
September 11, 2013

3.   Randomised clinical trial: sodium alginate oral suspension is non-inferior to omeprazole in the treatment of patients with non-erosive gastroesophageal disease.
   Sodium alginate oral suspension was as affective as omeprazole (Prilosec), for regular-old espohageal reflux (GERD), without ulcers or other erosions. Omeprazole and other proton-pump inhibitors (PPIs) are know to increase risk of some infections and of bone thinning. 
September 14, 2013

Wednesday, August 13, 2014

Our Phone Restored

The problems with our phone system have been resolved.  It is now operating properly.

Monday, August 11, 2014

Live Long & Prosper Newsletter August 2014

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.

Nutrition
1.   Fruit and vegetable consumption and all-cause mortality: a dose-response analysis.
   Study of Swedes and their fruit & vegetable (FV) intake: There was a dose-response effect, meaning the more FV eaten per day, the lower the death rate (up to a point). "Those who never consumed FV lived 3 y shorter and had a 53% higher mortality rate than did those who consumed 5 servings FV/d".
September 25, 2013

2.   A comparative study of phytochemical composition of genetically and non-genetically modified soybean (Glycine max L.) and evaluation of antitumor activity.
   Consumption of soy products is associated with lower rates of colon cancer, and this study found that non-GMO soybeans had higher concentrations of the putative anticancer compounds that they tested.
September 27, 2013

Exercise
1.   The effect of selected lifestyle factors and diet on mortality of men with documented physical fitness in the city of Łódź
   Some interesting findings in men from Lodz, Poland: "The probability of death was more than fourfold higher in the case of individuals who eat "beef or pork meat", as compared to those who consumed these products rarely or never. On the other hand, the subjects who declared regular consumption of yellow cheese had nearly fourfold lower death probability. Current smoking was found to be a significant negative risk factor while moderate consumption of beer a protective one. The level of physical fitness ... did not significantly influence mortality."
September 22, 2013

2.   Infant Feeding in America: Enough to Break a Mother's Heart?
   Mothers to be, another reason to plan to breastfeed! "A growing body of literature indicates that mothers who prematurely discontinue lactation face increased risk of visceral adiposity, hypertension, hyperlipidemia, diabetes, and subclinical cardiovascular disease, as well as cardiovascular morbidity and mortality. Breastfeeding is not always easy, but neither is dieting, exercise, smoking cessation, or treating hypertension."
October 12, 2013

Lifestyle
1.   Mortality in middle-aged men with obstructive sleep apnea in Finland
   Sleep apnea (OSA) kills. At least it kills middle aged Finnish men. "The overall mortality in the moderate to severe OSA group was 26.4 %, while in the normal group it was 9.7 %". If you are overweight and snore you most likely have sleep apnea, and should get a sleep study.
August 31, 2013

2.   Obesity and Low Back Pain: Is There a Weight of Evidence to Support a Positive Relationship?
   Obesity and back pain are correlated. For each pound you lose, your risk or severity of back pain goes down by 1% (roughly)!
August 31, 2013

Prevention
1.   Diet and vitamin D as risk factors for lung impairment and COPD.
   Chronic lung disease. Add it to the list of things that seem to be helped by eating a diet rich in plant-based foods like fruits. Also, "Higher intakes of vitamin D have been associated with better lung function and a lower prevalence of COPD".
November 13, 2013

2.   Prevention of Colorectal Cancer: The Future Is Now
   Wow interesting paper. There is more you can do to prevent colon cancer than I knew about. For example aspirin, NSAID drugs, and the diabetic drug metformin significantly reduce your risk of colon cancer, like 30-50%. The evidence is strong that red and processed meats increase your risk. A sedentary lifestyle is a huge risk factor. Get physically active and reduce your colon cancer by as much as 46%. Let's not forget the important role of colon screening. If you were going to pick 1 cancer to screen for, this would be the one. Many people are unaware that in addition to the standard colonoscopy, stool card testing is an alternative approved screening method.
December 9, 2013


Safety
1.   The effectiveness of helmets in bicycle collisions with motor vehicles: a case-control study.
   Cyclists who got in accidents with a car were 74% less likely to have a head injury if they were wearing a bike helmet.
August 29, 2013

2.   Occupational safety and health enforcement tools for preventing occupational diseases and injuries.
   Review of the 23 studies: "Inspections decrease injuries in the long term but not in the short term.... First inspections, follow-up inspections, complaint and accident inspections resulted in higher compliance rates... There is an urgent need for better designed evaluations" Maybe DuPont could publish a study on the effectiveness of its safety culture and its inspections to prevent injury.
September 4, 2013

Device
1.   Note: High frequency vibration rejection using a linear shaft actuator-based image stabilizing device via vestibulo-ocular reflex adaptation control method.
   Say that 3 times fast.
September 8, 2013

Monday, June 23, 2014

Live Long & Prosper Newsletter #5

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP. 

Nutrition
1.   Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis.
   Based on 16 studies, people who eat > 1 egg/day have a 42% greater risk of getting diabetes, relative to those who eat less than 1 egg per week.
August 28, 2013

2.   Effect of the vegetarian diet on non-communicable diseases.
   The science overall is very favorable for vegetarian vs omnivorous diets. E.g. "RRs for all cancers were 0.82 (0.73-0.93) in pescetarian and 0.88 (0.81-0.96) in vegetarians". However "vegetarian diets may lead to an inadequate intake of several important nutrients, particularly Fe, Zn, vitamin B12 and n-3 PUFA, which are associated with some disadvantages and health risks" So perhaps don't be strict and perhaps take a supplementary multivitamin containing just a little zinc, iron, B12 and omega-3s.
August 29, 2013
Exercise
1.   A non-exercise testing method for estimating cardiorespiratory fitness: associations with all-cause and cardiovascular mortality in a pooled analysis of eight population-based cohorts.
   Ho hum another big study shows people who are physically fit live longer.
August 25, 2013

2.   The role of physical activity in cancer prevention, treatment, recovery, and survivorship.
   With all these studies the question is: is this association causal or not? For this review, they found " all-cause mortality in cancer survivors decreases with increasing amounts of exercise". Does the exercise reduce your risk of cancer recurrence? Or are people who are not likely to get cancer recurrence for other reasons, happen to walk more? We don't know but I figure better to put yourself in the lower risk category if you can!
August 29, 2013
Lifestyle
1.   Multicenter, Randomized Controlled Trial of Yoga for Sleep Quality Among Cancer Survivors.
   Cancer survivors have a high incidence of sleep problems. Yoga helps these problems.
August 15, 2013

2.   Smoking status, physical health-related quality of life, and mortality in middle-aged and older women.
   Women who smoke have lower quality of life and higher mortality. The more you smoke, the bigger the effect.
August 15, 2013
Prevention
1.   Mediterranean Diet and Cardiovascular Disease: Historical Perspective and Latest Evidence
   "Contrary to the pharmacological approach of cardiovascular prevention, the adoption of the Mediterranean diet has been associated with a significant reduction in new cancers and overall mortality". If you have high cholesterol, it might be just as important to switch to a Mediterranean-style diet as it is to take medications to lower your cholesterol.
October 8, 2013

2.   The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk.
   "Physical activity may be as or even more important than pharmacotherapy for reducing the risk of mortality in adults with hypertension. However, the risk of mortality remained higher for physically active adults with treated and controlled hypertension than did the risk of mortality for physically active normotensive populations. Prevention of hypertension is therefore imperative for reducing the all-cause risk of premature mortality in adults. " We have been telling patients to think of physical activity as the most important medication you can take. Take it every day.
October 23, 2013
Safety
1.   Light physical activity is a better determinant of lower adiposity during the menopausal transition.
   Starting menopause? Lighter-intensity physical activity was best to prevent fat gain.
August 22, 2013

2.   Diet and food allergy development during infancy: Birth cohort study findings using prospective food diary data.
   More helpful tools for nagging your daughter-in-law: "An infant diet consisting of high levels of fruits, vegetables, and home-prepared foods is associated with less food allergy by the age of 2 years."
August 22, 2013

3.   [Cognitive behavioral therapy for chronic insomnia].
   Have insomnia? Consider seeing a therapist. Cognitive Behavioral Therapy improved insomnia in 80% tested.
August 22, 2013

Tuesday, April 22, 2014

Return Old Prescription Drugs April 26


Have old prescription drugs that expired?  Or ones that you don't take anymore?  Saturday, April 26th is the day to safely discard these medications.  See link for more information and to find a site near you:

Sunday, April 6, 2014

Live Long and Prosper Newsletter #4

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP. 

Nutrition
1.   Relationship of sedentary behavior and physical activity to incident cardiovascular disease: results from the Women's Health Initiative.
   Women who sit over 10 hours per day have 18% higher risk of cardiovascular disease relative to those who sit less than 5 hours.
August 15, 2013

2.   Morbidity prior to a diagnosis of sleep-disordered breathing: a controlled national study.
   Sleep apnea is thought to make us sick in many ways. This study found that people with sleep apnea had more health problems, from head to toe, for 3 years prior to their diagnosis. Is this because undiagnosed sleep apnea was eating away at their health for years before anyone knew? Or whatever causes sleep apnea (especially overweight) is also causing other problems. Unclear from this study.
August 16, 2013


Exercise
1.   Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention.
   If you have coronary artery disease, you should go for cardiac rehabilitation and exercise training program. You will probably live longer.
August 14, 2013

2.   Healthy lifestyle behaviors and decreased risk of mortality in a large prospective study of U.S. women and men.
   Very large 13 years study, following over 2 million person years of Americans' lives. Findings are compelling. Achieving any of these key health goals reduces your mortality significantly. * abdominal leanness (waist under 34 inches in women or 40 inches in men) * nonsmoking * regular exercise (60 minutes vigorous/week or 150 minutes moderate) * Mediterranean diet People who achieved all 4, had a whopping 73% of reduction of their mortality relative to those who achieved none.
August 15, 2013

Lifestyle
1.   Consequences of Nocturia.
   Get up to pee at night? We have a word for you people: nocturic. It is a significant source of sleep problems and other health problems. Frequent nighttime awakenings in general can be a sign of SLEEP APNEA, a common, underdiagnosed problem that very much affects quality and quantity of life.
August 12, 2013

2.   Vegetarian dietary patterns and mortality in adventist health study 2.
   73,000 7th Day Adventists followed for 5 years: Pescatarians had the lowest mortality rate. "The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians"
August 12, 2013

Prevention
1.   Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)
   This big Greek study observed 22,000 people for 11 years and found that a Mediterranean diet (low starch and sugar and meat and dairy, high legumes, vegetables, olive oil, fish) reduced diabetes by a whopping 12%.
October 31, 2013

2.   Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women’s health initiative
   Women who took a multivitamin with mineral for about 7 years experienced a 24% reduction in their risk of death from breast cancer during that period, after controlling for confounding variables. This is the first study I have seen in along while attesting to the merits of multivitamin. Just because a multivitamin reduced deaths from breast cancer in 1 observational study, does not mean it will make you live longer.
October 8, 2013

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