Orthopedic Sports Medicine Help - Forums and Discussions - MedHelp

New forum on Medhelp:
Orthopedic Sports Medicine Help - Forums and Discussions - MedHelp. This forum is being moderated by Michael L. Gross, MD the CEO of Active Orthopedics & Sports Medicine.

Childhood Social Interventions Pay Off in Young Adulthood

Childhood Social Interventions Pay Off in Young Adulthood
The interventions may result in improved mental and sexual health and higher educational levels in later life. (Arch Pediatr Adolesc Med. December 2008;162:1133-1141.)
Medscape Medical News

Ambulatory BP Monitoring Should Be Used in Resistant Hypertension

CME Ambulatory BP Monitoring Should Be Used in Resistant Hypertension
Continuously measuring blood pressure may predict heart disease and related deaths in patients with resistant hypertension, but office blood pressure readings do not appear to predict these risks. (Arch Intern Med. November 24, 2008;168:2340-2346.)
Medscape Medical News

Personal Health Records (PHR)

MedHelp.org has announced its roll out of Personal Health Records.

Have you ever filled out pages and pages of forms at the doctor's office that asked for very specific information regarding dates, diagnoses, medications, dosages and various other questions about your medical history?

MedHelp's Personal Health Records (PHR) product is a free online service that puts you in charge of your health by storing and managing your medical records and health information online in one safe, secure place. You can easily provide your doctors and healthcare providers with accurate, comprehensive information when needed.

In addition to tracking your personal health, the company has rolled out a series of what they call trackers, which enable the user to track personal items such as weight, ovulation, exercise, cholesterol, heart rhythm, pain, sleep, and set personal goals. This feature rich site was founded in 1994 and is one of the oldest and most respected sites on the Net.

Turning your clock back Sunday may help your heart

NEW YORK – Turning your clock back on Sunday may be good for your heart. Swedish researchers looked at 20 years of records and discovered that the number of heart attacks dipped on the Monday after clocks were set back an hour, possibly because people got an extra hour of sleep.

Drug companies: No cold medicines for kids under 4

WASHINGTON - Don't give over-the-counter cold remedies to kids under 4, drug companies said Tuesday. What sniffling little ones need, doctors said, are plenty of fluids and lots of tender, loving care.

"The best thing a parent can do is comfort their children," said Dr. Laura Herrera, a Baltimore family practitioner and mother of two. "Keeping them as comfortable as possible is certainly better than giving cough and cold medicines."

Full text of article here

Obesity may diminish a man's fertility

NEW YORK (Reuters Health) - Being obese may dim a man's chances of becoming a father, even if he is otherwise healthy, a new study suggests.

Other news:

• Online-mediated syphilis testing shows promise
• Sleep Apnea May Cause Erectile Dysfunction
• Alert Issued on Use of Blood Thinners

Heart Disease Question?

Medhelp's Heart Disease forum now celebrates its 10th anniversary. Started in 1998, this forum gives patients access to doctors from the Cleveland Clinic, which has been consistantly rated the number 1 heart center in the U.S.

On a related heart subject, questions regarding Heart Rhythm can be posted into a separate message board. Questions in this forum are answered by Dr. Michael J. McWilliams, of the Wilmington Health Associates.

FTC warns consumers about bogus cancer cures

WASHINGTON (AP) - The Federal Trade Commission charged five companies with making false and misleading claims for cancer cures and said Thursday that it has reached settlements with six others. "As long as products have been sold there has been somebody out there selling snake oil to consumers," said Lydia Parnes, director of the FTC's bureau of consumer protection.

She said the agency, along with the Food and Drug Administration and Canadian authorities, is launching a consumer education campaign warning about bogus claims for cures."There is no credible scientific evidence that any of the products marketed by these companies can prevent, cure, or treat cancer of any kind," said Parnes.The products the companies marketed include essiac teas and other herbal mixtures, laetrile, black salve — a corrosive ointment — and mushroom extracts.

Colon X-ray seen as effective at spotting cancer

(AP) ATLANTA - A long-awaited federal study of an X-ray alternative to the dreaded colonoscopy confirms its effectiveness at spotting most cancers, although it was far from perfect.

Other News:

The results of a study suggest that online-mediated syphilis testing is helpful in detecting syphilis in gay men.

Men with sleep apnea may suffer from a treatable form of erectile dysfunction caused by regular deprivation of oxygen experienced during these episodes of obstructed breathing, a new report says... full text

Ask A Pharmacist

MedHelp has announced a new free forum. Questions in the Ask-a-Pharmacist Forum are being answered by pharmacists from the drugstore.com

FDA expands use of cervical cancer vaccine

WASHINGTON - The cervical cancer vaccine Gardasil also works to prevent cancers of the vagina and vulva, federal health officials said Friday, as they approved expanding its use to protect against those diseases as well.

"Condom" ring-tone a hit in India

CHENNAI, India (Reuters Health) - A ring-tone that sings "condom, condom, condom" has attracted over 270,000 downloads since its launch last month and has spread the message of safe sex to many more mobile phone users in India and abroad.

The innovative "Condom a Capella" ring-tone that has the word "condom" sung in many overlapping melodies is the work of an Indian duo, Rupert Fernandes and Vijay Prakash. The website http://www.condomcondom.org, where the ring-tone can be heard, has had over 2 million hits.

Study sees longterm benefit of blood-sugar control

Diabetics who tightly control their blood sugar — even if only for the first decade after they are diagnosed — have lower risks of heart attack, death and other complications 10 or more years later, a large follow-up study has found.

The discovery of this "legacy effect" may put new emphasis on rigorous treatment when people first learn they have Type 2 diabetes, the most common form and the type linked to obesity.

Doctors warn that people should not let their blood sugar spin out of control — that could have serious health consequences.

Reported by AP, full text

New Safety Information - Potential drug risks

The U.S. FDA reports serious safety issues with the following drugs:

Potential Signals of Serious Risks/New Safety Information Identified by the Adverse Event Reporting System (AERS) January - March 2008

Product Name: Active Ingredient (Trade) or Product Class	Potential Signal of Serious Risk/New Safety Information
Arginine Hydrochloride Injection (R-Gene 10)	Pediatric overdose due to labeling / packaging confusion
Desflurane (Suprane)	Cardiac arrest
Duloxetine (Cymbalta)	Urinary retention
Etravirine (Intelence)	Hemarthrosis
Fluorouracil Cream (Carac) and Ketoconazole Cream (Kuric)	Adverse events due to name confusion
Heparin	Anaphylactic-type reactions
Icodextrin (Extraneal)	Hypoglycemia
Insulin U-500 (Humulin R)	Dosing confusion
Ivermectin (Stromectol) and Warfarin	Drug interaction
Lapatinib (Tykerb)	Hepatotoxicity
Lenalidomide (Revlimid)	Stevens Johnson Syndrome
Natalizumab (Tysabri)	Skin melanomas
Nitroglycerin (Nitrostat)	Overdose due to labeling confusion
Octreotide Acetate Depot (Sandostatin LAR)	Ileus
Oxycodone Hydrochloride Controlled-Release (Oxycontin)	Drug misuse, abuse and overdose
Perflutren Lipid Microsphere (Definity)	Cardiopulmonary reactions
Phenytoin Injection (Dilantin)	Purple Glove Syndrome
Quetiapine (Seroquel)	Overdose due to sample pack labeling confusion
Telbivudine (Tyzeka)	Peripheral neuropathy
Tumor Necrosis Factor (TNF) Blockers	Cancers in children and young adults

Exercise trumps obesity gene in study

CHICAGO (Reuters) - Vigorous physical activity can help even people genetically prone to obesity keep the weight off, U.S. researchers said on Monday.  They said a study among a group of Amish people found those who had an obesity-related gene called FTO but were very physically active weighed about the same as others who did not carry the gene
Full Text

Ask the Doctor- Ear, Nose & Throat, Hepatitis C, and Liver Transplant

Mount Sinai Medical Center has teamed with MedHelp.org  in opening up three new (free) ask the doctor forums:

Ear, Nose & Throat
Hepatitis C
Liver Transplant

The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai Hospital is one of the nation’s oldest, largest and most-respected voluntary hospitals. Founded in 1852.

MedHelp, with over 5.5 million monthly users, is the largest online health community site connecting people with shared medical experiences. MedHelp provides its users with access to advice from experts at the top medical institutions such as the Cleveland Clinic, Johns Hopkins, National Jewish Health, Partners Healthcare, and The Mount Sinai Medical Center.

Daily ibuprofen may cause heart risks

Posted by Reuters Health on Thursday, September 4, 2008

WASHINGTON (Reuters) - Ibuprofen may raise the risk of heart attacks and other fatal and serious problems when elderly people take it daily for arthritis, U.S. researchers reported on Wednesday.

They said the popular over-the-counter pain reliever was the only drug in the class that includes aspirin and other analgesics to raise the risk of serious heart disease -- along with the now-withdrawn COX-2 inhibitor Vioxx.

Full text at U.S. govermnent Medline Site...

Fish Oil Supplements Help With Heart Failure

From the Washington Post;

Daily supplements of omega-3 polyunsaturated fatty acids -- the kind found in fish oil -- reduced deaths and hospitalizations of people with heart failure, an Italian study found.

But a cholesterol-lowering statin drug had no beneficial effect in a parallel heart failure trial.

"There is a benefit of omega-3 polyunsaturated fatty acids for heart failure patients."

Full text at: http://www.washingtonpost.com/wp-dyn/content/article/2008/08/31/AR2008083100444.html

CDC: Salmonella Outbreak Over, Source May Never Be Known

The government said Thursday that the salmonella outbreak that sickened at least 1,440 people appears to be over, but its ultimate source may never be known, partly because of shortcomings in the nation's food safety system.

The Centers for Disease Control and Prevention and the Food and Drug Administration said they found strong evidence to implicate jalapeno and serrano peppers, and a farm in Mexico, in the largest outbreak of foodborne illness in a decade. Investigators were unable to clear domestic and imported tomatoes, however, although the evidence against tomatoes is weaker.

The FDA also lifted its warning that consumers avoid eating jalapeno and serrano peppers from Mexico. But officials pointedly said that doesn't guarantee another such outbreak can be prevented.

Tracking Alzheimer's-linked protein in live brains

Scientists for the first time have peered into people's brains to directly measure the ebb and flow of a substance notorious for its role in Alzheimer's disease. The delicate research was performed not with Alzheimer's patients but with people suffering severe brain injuries — because a brain injury increases the risk of developing dementia later in life. 

The goal is to learn why, so that doctors one day might be able to lower that risk.
For the full text of this AP article may be found at:
http://news.yahoo.com/s/ap/20080828/ap_on_he_me/med_injured_brain

Elevated Choleterol 101

The following was posted by Lee Kirksey, M.D. and excerpted from Medhelp where he moderates the Peripheral Arterial Disease (PAD) forum:

What can cause high cholesterol?

Elevated cholesterol levels can be caused by several factors, including heredity, poor diet, obesity, sedentary lifestyle, age, and gender (premenopausal women have lower cholesterol levels than men.) Of these causative factors, only heredity, age and gender cannot be controlled.

"Secondary" elevation of cholesterol

Some people have elevated cholesterol levels as a result of specific medical conditions, including diabetes, hypothyroidism (low thyroid,) obstructive liver disease, chronic renal (kidney) failure, and drugs (anabolic steroids, progesterone drugs, and corticosteroids.) In these patients, treating the underlying disorder often improves cholesterol levels.

Who needs to be treated for elevated cholesterol?

Deciding when to treat can be based on two factors: lipid levels (total cholesterol, LDL, and HDL,) and the presence of additional risk factors, as follows.

Desirable lipid levels:
Total cholesterol: Desirable levels are below 200 mg/dL. Total cholesterol is considered "borderline high risk" at levels between 200 and 239, and "high risk" at levels above 240. LDL cholesterol: Optimal LDL levels are less than 100 mg/dL. Near optimal levels are between 100 and 129 mg/dL. Levels between 130 and 159 are considered "borderline high risk;" and levels between 160 and 189 are considered "high-risk;" and levels of 190 and above are considered "very high risk." HDL cholesterol: HDL cholesterol levels below 41 mg/dL are considered too low.

The full text of his journal entry may be found here


(Dr Kirksey is a vascular surgeon at The University of Pennsylvania Healthcare System who specializes in the diagnosis, prevention, medical and surgical treatment of blood vessel disorders of the body.)

Neurology and Neurosurgery related questions

There are several neurology and neuro related forums running on MedHelp. Some are moderated by doctors from large medical institutions such as the Cleveland Clinic and Johns Hopkins, others are patient support forums (a.k.a. Communities).

The doctor moderated Neurology Forum happens to be one of the oldest on the Net- spanning over 10 years. This forum covers issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury, etc.

The newer forums include: Back and Spine Surgery (Paul J. Slosar, MD, President, SpineCare Medical Group of Daly City, CA.). Brain Tumors and Trigeminal Neuralgia (Michael Lim, MD - Johns Hopkins Medicine).

The full list of over 200 forums may be found at http://www.medhelp.org/forums/list

Breast Cancer: weekly taxol vs. tri weekly tch?

Question posted in Breast Cancer Forum:

I'm very concerned over the 2 different paths of treatment proposed to me by 2 different oncologists. Onc #1 proposes a 12 week regimen of taxol administered weekly adding herceptin later then followed by tamoxafin, while onc #2 suggests taxotere, carboplatin, herceptin every 3 weeks for 6 cycles then followed by tamoxafin. Not sure who to go with.
I had an excisional biposy done for a breast tumor that measured 4 x 4 x 1 and during a pet scan a vauge area on my liver approx 2.1 x 1.8 in size which onc #1 believes metastasis has occured and will not order a liver mri while onc #2 wants a liver mri to confirm but believes that metastasis is definitely possible. My tumor is her 2 positive and estrogen sensitive.
Because of my age of 27 they both believe that aggressive treatment is necessary. I just don't want to make a fatal mistake. What are the + / - of either treatment and why are the 2 onc on different pages?

Reply from the Cleveland Clinic:

There is no absolute correct way to approach breast cancer treatment. Certain factors about the tumor may help to direct aspects of therapy, such as whether the tumor is HER2 positive or Estrogen and Progesterone receptor positivity, but these do not dictate the exact treatment regimen. An MRI may or may not clarify the appearance of the liver lesion (it may increase or decrease suspicion) but it will not be absolute. The only way to know for certain is to biopsy and this may or may not be advised depending on your situation. Without evaluation, we cannot determine what regimen we would recommend. If you are not comfortable with either option, consider a third opinion, preferably with an oncologist who specializes in breast cancer. These are often affiliated with large academic medical centers.

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Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Full Text of this article can be found on MedHelp at: weekly taxol vs. tri weekly tch?-

Americans Made Over 1 Billion Hospital and Doctor Visits in 2006

According to the Centers for Disease Control ...
"Americans Made Over 1 Billion Hospital and Doctor Visits in 2006
Patients in the United States made an estimated 1.1 billion visits to physician offices and hospital outpatient and emergency departments in 2006, an average of four visits per person per year, according to new health care statistics released today by the Centers for Disease Control and Prevention.

The data come from various components of CDC’s National Center for Health Statistics National Health Care Survey and are featured in a series of new National Health Statistics Reports. Some of the findings include:

• The number of visits to physician offices and hospital outpatient and emergency departments increased by 26 percent from 1996 to 2006, faster than the growth of the U.S. population, which rose by 11 percent.
• The rise in visits can be linked to both the aging of the population, as older people have higher visit rates than younger people in general.
  
• In 2006, seven out of 10 visits had at least one medication provided, prescribed, or continued, for a total of 2.6 billion medications overall. Analgesics (pain relievers) were the most common, accounting for 13.6 percent of all drugs prescribed, and were most often used during primary care and emergency department visits.
• The emergency department served as the route of admission to hospital inpatient services for roughly 50 percent of non-obstetric hospital patients in 2006, up from 36 percent in 1996.
• Patients with Medicaid use the emergency department more frequently than patients with private insurance – 82 per 100 persons for Medicaid vs. 21 per 100 for private insurance.
  Most emergency department visits occurred after business hours (defined as 8 a.m. to 5 p.m. on weekdays), when 63 percent of adults and 73 percent of children younger than age 15 arrived.
• The overall average waiting time to see a physician in the Emergency Department was nearly 56 minutes.
• Over the past 36 years, the percent of hospital inpatients who were 65 years of age and older grew from 20 percent in 1970 to 38 percent in 2006. Over the same time period, the percent of inpatients who were 75 years of age and older grew from 9 percent to over 24 percent.
• The rate of knee replacement for those aged 65 years old and over increased 46 percent between 2000 and 2006, and the rate doubled among those aged 45-64 years during the same time period.
• The rate of coronary atherosclerosis (clogged heart arteries) more than doubled during the 1990s but since 2002 declined for all age groups, particularly for those 65 years and over.
  Between 1996 and 2006, the percentage of visits to hospital outpatient departments made by adults 18 years and over with chronic diabetes increased by 43 percent and visits with chronic high blood pressure increased by 51 percent.

The full text of this article can be found at the CDC website.

New Brain Tumor forum

Med Help has recently launched a new Brain Tumor forum. Questions in the forum are being answered by doctor Michael Lim from John's Hopkins. In researching this, it appears that this is the first brain tumor message board that is being moderated by a doctor and especially compelling is that he is from a renowned medical institution- John's Hopkins.

In reviewing the Brain Tumor forum, the questions and answers appear to range from; what's wrong with me/do I have a brain tumor? to more in depth Q&A from those that have been diagnosed (e.g. Diffusely Infiltrating Low Grade Glioma (grade 2) - astrocytoma)

Such a poorly understood disease- at last some professional support.

New drug for Huntington’s Disease

Federal regulators approved the first treatment for Huntington’s disease in the U.S. Huntington's, is a rare disease that causes uncontrolled movements, deterioration of mental abilities and, ultimately, death. The disease is inherited. The new medication called, Xenazine, is not a cure, and has some potentially serious side effects. The full text of this article may be found on the Newsday website among others.

Topamax poses serious risk of acute narrow angle glaucoma

In a posting on www.medhelp.org Dr. Kutryb (affiliated with the American Academy of Opthamology) discusses the danger of topomax with respect to vision problems. His journal discusses the case of a woman on Topamax for 7 days who seemed to have lost almost all her vision.

He further goes on to state : "So, if you are taking Topamax or getting ready to increase you dose or considering starting it - please, please take my advice and remember that it can cause sudden worsening of your vision, and if an attack of narrow angle glaucoma starts, you can develop severe eye pain, extreme headache, nausea, vomiting and nearly complete loss of vision. Next on my list of least favorite drugs - Flomax - the only drug I know of that actually caused it's own completely new syndrome - the formidable "Floppy Iris Syndrome" nemesis of cataract surgeons everywhere."
Source:
Topamax and Another Acute Glaucoma Attack - Almost. - Michael J Kutryb, MD

How to motivate the unmotivated?

Today's kids are bombarded with tons of distractions. We have perhaps raised a generation of young adults needing instant gratification. One writer laments about her stepson dropping out of college and being non motivated. This issue is discussed in the post How to Motivate the Unmotivated, which is answered by Dr. Jason Greenburg a specialist in anxiety and depression.

Thymus surgery and allergies

Found an interesting post:
Thymus surgery and allergies
Questions in the Asthma and Allergy forum are being answered by doctors from National Jewish Health- at no charge!