Newsletter – 06/09/18 – We Don’t Need No Stinkin’ Tonsils

To My Patients and Friends,

Here’s the latest medical news summary… enjoy!

What are tonsils good for, anyway?

People who have their tonsils or adenoids removed before age 9 years are at higher risk for respiratory, infectious, and allergic diseases up to the age of 30, according to a study just published in the JAMA Otolaryngology–Head & Neck Surgery.  Tonsils and/or adenoid removal is often recommended to treat recurrent tonsil or middle ear infections, or to help reduce snoring and sleep apnea.  However, as components of our immune system, tonsils and adenoids play important roles in fighting infections.  As it turns out (not surprisingly), removing these may predispose patients to infections and allergy problems.  So before scheduling your child for that tonsillectomy or adenoidectomy, be sure to discuss treatment alternatives that may obviate the need for surgery.

Work stress and life expectancy

A large European study recently published in The Lancet Diabetes and Endocrinology revealed that having a stressful job was linked with higher mortality risk in men (but not women) with cardiometabolic diseases such as atherosclerosis, history of stroke or diabetes.  The gender difference may reflect the fact that atherosclerosis (hardening of the arteries) is more common in working-age men than in women of the same age.  Although this may not be a new concept to many, this study suggests that it’s not just conjecture, and that it might be particularly wise for those with certain health conditions to mitigate job-related stress in order to stay healthy.  To find balance and take time for yourself in this busy, stressful world is easier said than done, I realize… but this latest information is nonetheless worth taking to heart (pardon the pun).

More on colon cancer screening

On the heels of a new recommendation from the American Cancer Society that colon cancer screening for average risk patients should start at age 45 (previously, the recommendation was to begin at age 50), we are now beginning to understand why the rate of colon cancer– the third-leading cause of cancer death in men and women in the U.S.– may be rising in younger people.  In a previous newsletter, I reviewed some lifestyle factors which could be contributing to this trend.  A recent analysis by researchers from the University of Texas has revealed that (1) male gender, (2) being overweight or obese, and (3) chronic kidney disease are independent risk factors for the development of precancerous colon polyps (adenomas).  According to the researchers, this new information raises the possibility that patients with combinations of these characteristics may benefit from earlier colon cancer screening.  If you fall into these categories, consider starting the colon cancer screening process prior to age 45, especially if you have a family history of colon cancer or polyps.

Unintended consequences

A study recently published in The British Medical Journal raises the possibility that certain medications may contribute to the risk of developing dementia.  This study focused on medications with “anticholinergic” effects. These are drugs that block a particular chemical pathway (either by design or as a side-effect) which impacts activity in the digestive and urinary tracts, lungs, and elsewhere. This pathway also affects cognitive function.  Many medications have at least some anticholinergic effects, and about half of older adults in the U.S. take at least one of these medications. Specifically, anticholinergics used for treatment of depression (e.g. amitriptyline), urinary incontinence (e.g. oxybutynin) and Parkinson’s disease (e.g. procyclidine) were associated with a 30% increased risk of developing dementia.  This is yet one more reason to review your medication list with your physician or regular basis.

That’s it for now.  Be well and enjoy the weekend!