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COPD

 Chronic obstructive pulmonary disease (COPD), also known as emphysema, occurs in about 14 percent of US adults aged 40 to 79 and it is the third leading cause of death in the US. Unlike asthma, which is a reversible restriction of airflow, airflow restriction in COPD is not reversible meaning it often does not respond to medications that improve asthma symptoms. In asthma, airflow restriction is due to spasm or narrowing of bronchial tubes. Airflow restriction in COPD is due to destruction of lung tissue, specifically the alveoli, which are the small sacs in the lung where gas exchange occurs....

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Whoa, Whoa, Hold Off On That Advice

I am often asked where I get the ideas for my columns. In most cases my columns are based on research and opinion articles in traditional medical journals. These journals include JAMA (Journal of the American Medical Association), New England Journal of Medicine, Cleveland Clinic Proceedings, etc. After reading an article that might be a basis for a column, I do additional research on the Internet. So each column provides education and information to you, the readers of the columns, and also to me. Unlike the editor of this wonderful paper, I usually skim the other weekly paper published in...

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OA And Joint Pain

Osteoarthritis (OA) is one of the most common causes of chronic pain and reduced activity in middle aged and elderly people. While it is estimated to affect from 20 to 30 million people, up to 85 percent of those 65 and older have x-ray findings consistent with it. Traditionally it has been thought that OA is caused by mechanical wear and tear of the joints however there is mounting evidence that inflammation is a significant factor as well, especially in younger people. There is also a genetic factor, especially among women as it is estimated that about 60 percent of women with OA got it from...

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Ask the DOC

 As you are most likely aware, there is an epidemic of obesity in this country. There are no magic bullets to cure obesity. The two-pronged approach to lessen obesity is based on diet and exercise. Although exercise is probably less effective than diet in reducing weight, most experts agree that adding exercise to a diet program will increase weight loss. Exercise has additional benefits of lowering blood pressure, improving lipid levels, improving insulin sensitivity and lowering blood sugar. Increasing energy expenditure by exercising can mobilize and burn fat, thereby reducing weight. Typically,...

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Narcolepsy

 My last column dealt with sleep apnea, or OSA. Today I would like to discuss a related but very different syndrome – narcolepsy. Narcolepsy is one of the most common causes of chronic sleepiness and affects about one out of every 2,000 people. Despite its frequency the average time from onset of symptoms to diagnosis is five to 15 years, and about half of those affected remain undiagnosed. Some cases of narcolepsy are caused by chemical changes in the brain while many cases have no known cause. Symptoms often begin early in life, usually between 10 and 20 years of age. Narcolepsy causes daytime...

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Don’t Sleep On This – Get Checked

 The prevalence of obstructive sleep apnea, or OSA, in the United States is high, estimated at 2% of women and 4% of men in the middle-aged work force. The incidence of OSA in black people, Asians and older adults is estimated to be even higher. Unfortunately only 10% of people with OSA are diagnosed – a dismal figure considering that OSA is associated with resistant hypertension and a greater risk of stroke, cardiovascular disease and death. In fact OSA is directly linked to hypertension, coronary artery disease, heart failure, cardiac arrhythmias, sudden cardiac death, stroke and diabetes....

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Brain Food

Seafood is usually recommended as part of a well-rounded diet. But seafood, because of decades of river and ocean dumping, may contain elevated levels of mercury. This is especially true for striped bass as they spawn in the upper Hudson River into which factories dumped pollutants for many years. Mercury is well known to be a neurotoxin, in other words it may damage the nervous system, which includes the brain. But seafood is also considered to be helpful in fending off Alzheimer’s dementia. So is it good or bad to consume seafood? A recently published study by Rush University Medical Center...

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The State Of Statins

It has been generally accepted common knowledge that medications like statins (i.e. Lipitor, Crestor) should not be taken with grapefruit juice, the reason being that compounds found in the juice may potentiate, or enhance, the effects and side effects of the drugs. A recently published study by the Wolfson Institute of Preventative Medicine in London casts doubt on that common knowledge. The interaction between medications and grapefruit juice was discovered by accident in 1989 during an experiment designed to examine the effect of ethanol on the action of felodipine, a calcium-channel blocker....

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That Medicine Cabinet

Recently a reader inquired about what the average home medicine closet should contain, how to dispose of old medicines and how to keep meds from kids and teens. The average medicine closet should contain in addition to toiletries and cosmetics a basic first aid kit. Band-Aids of different sizes and types, butterfly dressings, a roll of paper dressing tape, sterile and non-sterile 4×4 gauze pads, an ace bandage or two and an arm sling for starters. You might want to add a thermometer, bottle of 325mg aspirin, alcohol pads, non-sterile gloves, a bottle of alcohol and a bottle of hydrogen...

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