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?-