Archive for December, 2010

PROTEIN FOR PEOPLE WITH DIABETES

The third major constituent of food, besides carbohydrate and fat, is protein. In addition to supplying kilojoules, protein also provides the building blocks for growth and repair of muscles, bones and connective tissue.
Although protein is essential for life, most westerners eat too much of it. The meat and potatoes approach to food may have been needed in earlier days, but our modern lifestyle does not require such an emphasis on meat.
Indeed, as a person with diabetes, your intake of protein may be critical to your risks for development of complications affecting kidney function. Research has shown that the higher the amount of protein in the diet of a person with poorly controlled diabetes, the more likely the kidneys are to suffer increased damage over the years.
If you have been diagnosed as also having kidney function problems in addition to your diabetes, you may be advised to greatly reduce the amount of protein you eat. Even if you don’t have kidney problems, it’s important that you routinely be tested to find out if your kidneys are spilling protein – an early warning sign of kidney function problems. Another recommended test is a creatine clearance assay to determine how well your kidneys are functioning.
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PROTEIN FOR PEOPLE WITH DIABETES The third major constituent of food, besides carbohydrate and fat, is protein. In addition to supplying kilojoules, protein also provides the building blocks for growth and repair of muscles, bones and connective tissue.Although protein is essential for life, most westerners eat too much of it. The meat and potatoes approach to food may have been needed in earlier days, but our modern lifestyle does not require such an emphasis on meat.Indeed, as a person with diabetes, your intake of protein may be critical to your risks for development of complications affecting kidney function. Research has shown that the higher the amount of protein in the diet of a person with poorly controlled diabetes, the more likely the kidneys are to suffer increased damage over the years.If you have been diagnosed as also having kidney function problems in addition to your diabetes, you may be advised to greatly reduce the amount of protein you eat. Even if you don’t have kidney problems, it’s important that you routinely be tested to find out if your kidneys are spilling protein – an early warning sign of kidney function problems. Another recommended test is a creatine clearance assay to determine how well your kidneys are functioning.*16/210/5*

HEART SURGERY: WHEN IT IS REALLY NECESSARY

The problem of unnecessary surgery has been the subject of study for nearly a decade by the Rand Corporation, a policy research center in Santa Monica, California. In the early 1980s, Rand researchers checked the records of patients in one western state who’d had coronary bypass surgery. They found that, of 386 coronary surgeries performed there, 14 percent were unnecessary.
Given estimated average costs of 20,000 dollars per heart-related operation, it seems safe to project that Americans paid 1 billion dollars in taxes and insurance premiums just to cover those costs.
In the early 1990s, however, the Rand Corporation studied bypass surgery in New York State. The scene appears to have changed dramatically: It was found that among 1,500 operations, only 2.4 percent were unneeded. And, reports the New York State Department of Health Cardiac Survey, the death rate also dropped on the operating table- from 3.53 percent in 1990 to 2.51 percent in 1992.
The indications are that doctors keep acquiring skills and that the newer drugs and technology are gaining in their power to heal without injury. Some states keep track of cardiac surgeries. Through New York State Health Department data, in fact, you can discover a heart surgeon’s batting average-how many surgeries he or she performed and their outcomes.
At Columbia-Presbyterian Medical Center physicians have opened a new Heart Failure Center. Here, the doctors turn first to drugs to heal damaged hearts and reduce the battered heart’s workload. Dr. Milton Packer, the center’s chief, says that this approach has:
• taken 40 percent of heart failure patients off the transplant waiting list,
• improved the conditions of 70 percent of people with heart failure, and
• cut the mortality rate by 25 percent.
“Drugs are not as exciting as transplants or mechanical hearts,” Dr. Packer says, “but we have got to give drugs a chance to work.”
A growing number of patients seem to be opting for the drug-treatment-first approach.
One of them is Howard Mills, 48, a British citizen living in Redondo Beach, California. In November 1992, a viral infection had attacked his heart muscle, leaving it weak and flabby. Mr. Mills opted for medication over surgery. He became a patient at the UCLA Cardiomyopathy Center.
“I was taking a lot of different drugs,” says Mr. Mills, recalling the start of his treatment. “I could barely walk. But my heart and body came back. Now I can walk 4 miles an hour, I can swim, and I can ride a bike. I’m glad I escaped the transplant.”
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HEART SURGERY: WHEN IT IS REALLY NECESSARYThe problem of unnecessary surgery has been the subject of study for nearly a decade by the Rand Corporation, a policy research center in Santa Monica, California. In the early 1980s, Rand researchers checked the records of patients in one western state who’d had coronary bypass surgery. They found that, of 386 coronary surgeries performed there, 14 percent were unnecessary.Given estimated average costs of 20,000 dollars per heart-related operation, it seems safe to project that Americans paid 1 billion dollars in taxes and insurance premiums just to cover those costs.In the early 1990s, however, the Rand Corporation studied bypass surgery in New York State. The scene appears to have changed dramatically: It was found that among 1,500 operations, only 2.4 percent were unneeded. And, reports the New York State Department of Health Cardiac Survey, the death rate also dropped on the operating table- from 3.53 percent in 1990 to 2.51 percent in 1992.The indications are that doctors keep acquiring skills and that the newer drugs and technology are gaining in their power to heal without injury. Some states keep track of cardiac surgeries. Through New York State Health Department data, in fact, you can discover a heart surgeon’s batting average-how many surgeries he or she performed and their outcomes.At Columbia-Presbyterian Medical Center physicians have opened a new Heart Failure Center. Here, the doctors turn first to drugs to heal damaged hearts and reduce the battered heart’s workload. Dr. Milton Packer, the center’s chief, says that this approach has:• taken 40 percent of heart failure patients off the transplant waiting list,• improved the conditions of 70 percent of people with heart failure, and• cut the mortality rate by 25 percent.”Drugs are not as exciting as transplants or mechanical hearts,” Dr. Packer says, “but we have got to give drugs a chance to work.”A growing number of patients seem to be opting for the drug-treatment-first approach.One of them is Howard Mills, 48, a British citizen living in Redondo Beach, California. In November 1992, a viral infection had attacked his heart muscle, leaving it weak and flabby. Mr. Mills opted for medication over surgery. He became a patient at the UCLA Cardiomyopathy Center.”I was taking a lot of different drugs,” says Mr. Mills, recalling the start of his treatment. “I could barely walk. But my heart and body came back. Now I can walk 4 miles an hour, I can swim, and I can ride a bike. I’m glad I escaped the transplant.”*14/266/5*

CANCER: THE CAUSES OF MALIGNANT MELANOMA

Determining the cause of malignant melanoma is one of the most pressing problems in cancer research today. The rapid rise of this potentially lethal cancer threatens a new epidemic. This could even be comparable to the epidemic of lung cancer which has been a feature of the twentieth century. Our understanding of the links between smoking and lung cancer is having an impact on the current trends in lung cancer and may as we have seen, gradually be bringing this epidemic under control. It is very important that we should learn from this experience and build some such understanding into our thinking about future risks like cutaneous malignant melanoma.
We know a great deal about the causes of malignant melanoma. The most important of these is ultraviolet light in sunshine. This interacts particularly dangerously with certain kinds of skin: the risk of malignant melanoma is highest in persons with a large number of moles, poor tanning ability, a tendency to develop severe sunburn, fair or red hair, blue or green eyes and pale skin. A family history of melanoma seems to be an additional risk factor.
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