Newsletter 07/20/18 – Aspirin, Asthma, Alzheimer’s and ADHD

To my Patients and Friends,

Here are this week’s medical updates… enjoy!

West Nile virus on the move

The Connecticut Department of Health has announced that, so far this season, West Nile virus-positive mosquitoes have been found in Darien, New Canaan, Stamford, Bridgeport, Easton, Stratford and Waterbury.  As this list of locations inevitably grows, it is very important to remember to implement appropriate preventative measures, including the use of effective mosquito repellents, wearing of protective clothing, use of mosquito netting to cover cribs and baby carriers, putting screens on windows, use of air conditioning when available (in order for windows to remain closed), and regular emptying of outdoor items that hold water such as tires, buckets, toys, trash containers, etc.

West Nile virus is spread to people by mosquito bites; it is not generally considered contagious.  Most people who contract West Nile virus exhibit no symptoms.  However, symptoms can vary.  Some people may experience a mild-to-moderate flulike syndrome with fever, headache, stiffness or weakness.  More severe symptoms are rare but may include disorientation, convulsions, vision loss, numbness and paralysis, or even coma.  Although there is no specific treatment for West Nile virus, people with severe illness may require hospitalization in order to receive supportive treatments until the illness resolves.  People at greatest risk for severe illness include those over 60 years of age, and people with certain medical conditions such as diabetes, cancer or kidney disease as well as organ transplant recipients.

Remember: preventing mosquito bites is the most effective way to avoid illness due to West Nile virus.

Healthy diet reduces asthma symptoms

A large study of French adults with asthma that was recently published in the European Respiratory Journal has found that a diet rich in fruits, vegetables and whole grains is associated with reduced asthma symptoms by as much as 30%.  The list grows: the brain, the heart, the liver, the kidneys, our bones and muscles, the immune system, and now the lungs… it appears that there isn’t an organ system that hasn’t been shown in the medical literature to be favorably impacted simply by eating a healthy diet.  As Hippocrates wisely said, “Let food be thy medicine and medicine be thy food.”
An attention-grabbing study on screen time

This topic is familiar to pretty much everyone, so I’ll just dive right in: Nearly 2,600 high school students observed over two years were found to be up to twice as likely to exhibit symptoms meeting criteria for a diagnosis of attention-deficit/hyperactivity disorder (ADHD) when they engaged in various social media activities several times each day over the course of two years, according to a study just published in JAMA.  Great news for the makers of ADHD drugs… but for the rest of us, not so much.

More problems associated with a common class of antibiotic

Several commonly used antibiotics, including ciprofloxacin (brand name: Cipro) and levofloxacin (brand name: Levaquin), fall into a class of known as fluoroquinolones.  Although these medications can be useful for treating a number different kinds of infections, they carry significant risks.  We know from previous studies that fluoroquinolones are associated with an increased risk for problems such as tendon rupture, heart rhythm disturbances, nerve damage and colitis.  Now, a new labeling requirement by the FDA warns about mental health issues and potential low blood sugar related to these medications.

To be clear, all medications have side effects, and under the right circumstances, this class of medication can and should be used.  However, physicians are increasingly cognizant of the importance of choosing an antibiotic specific to the particular bacteria being targeted when possible, as a means of minimizing (a) the risk for adverse effects, and (b) the increasingly concerning evolution of bacterial resistance to broader-spectrum (“stronger”) antibiotics such as the fluoroquinolones.

Deaths from liver cancer on the rise

According to a new report from the CDC, the death rate from liver cancer has increased by 43% since 2000.  Cancer of the liver had been the ninth-leading cause of cancer in 2000 but has become the sixth-leading cause as of 2016.  Experts attribute this increase to the rising obesity epidemic.  When we carry excess fat, much of this tissue builds up around organs including the liver, which can then lead to nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).  The inflammatory changes associated with these phenomena contribute to the increased risk for liver cancer.  Although there are no specific medications to treat these conditions, the best way to manage and reverse them is through weight loss.  In my practice, I frequently encounter patients who exhibit laboratory signs of fatty liver.  Particularly for these patients, I stress the importance of regular exercise and healthy diet comprised primarily of whole-food plant-based meals.

What is the proper aspirin dose?

We know from previous studies that a daily low-dose “baby” aspirin (81 mg) helps to prevent heart attacks, strokes and certain types of cancers, including colon cancer.  However, low-dose aspirin may not provide protection in people weighing 154 pounds or greater, according to a study recently published in The Lancet.  This large analysis of 10 separate trials found no significant effect of low-dose aspirin in heavier patients.  And for heavier patients who smoke or who take enteric-coated aspirin (formulated to protect the stomach lining), lower doses of aspirin may be even less effective.  So for the many of us who weigh 154 pounds or greater, a full dose of 325 mg aspirin tablet should be considered when choosing to take an aspirin tablet daily for disease prevention (after having an informed discussion of the risks and benefits with your physician).

Yoga for Mamma

A new study published in the Journal of Obstetrics and Gynaecology Research suggests that practicing yoga during the third trimester of pregnancy activates the parasympathetic nervous system (which calms the body and modulates functions such as digestion), improves sleep at night, and decreases markers of stress in the bloodstream.  Sleep difficulties are common during pregnancy, so this simple modality may help quite a bit.

And this study related to pregnancy is also interesting

A woman’s pregnancy history may provide clues as to her future risk of developing Alzheimer’s disease, according to this study just published in the journal Neurology.  According to the findings in this study, women with a history of an incomplete pregnancy (due either to miscarriage for termination) are less likely to develop Alzheimer’s disease later in life, whereas for women who gave birth to five or more children, Alzheimer’s risk is increased risk by up to 70%.  Although the mechanism behind this association is not certain, the researchers theorized that hormonal fluctuations related to pregnancy may in some way be contributory.  The physiology surrounding pregnancy is complex, and it will take more research to fully understand why this phenomenon has been noted.

Medication recall

The FDA has announced a recall of certain formulations of valsartan (brand: Diovan), a medication commonly used to treat high blood pressure.  If you happen to be on this medication and have not already heard from your pharmacist or physician, I would encourage you to contact your doctor or pharmacy to determine if the brand you use has been affected by the recall, so that an alternative can be provided.

That’s the news for this week… have a nice weekend.