See the pages above for major topics.
Reviews on Minor topics are below:
Degenerative Disc Disease: See Herniated Discs above.
Dermatology: Fluorouracil Best for Most Actinic Keratosis; Aldara Very Expensive: Cryosurgery with liquid nitrogen is the most common technique used to destroy actinic keratosis; other mechanical methods include excision, electrodesiccation and curettage, chemical peels, and laser resurfacing. When lesions are too numerous, topical fluorouracil ($51) is applied once or twice daily for 2-6 weeks. Fluorouracil is effective in more than 90% of patients and treats subclinical AKs, but it can cause temporary erythema, blisters and ulceration. Diclofenac gel (Solaraze; $105) is relatively well tolerated but only modestly effective. Topical aminolevulinic acid ($108) plus blue light ($?) is more effective but less well tolerated. Medical Letter 2002; 44:57. Imiquimod cream 5% ( Aldara; $515) is an immune modifier also approved for treatment of genital and perianal warts. Medical Letter 1997; 39:118. It also be approved soon for treatment of basal cell carcinoma. It produces apoptosis in malignant, but not normal, human keratinocytes. M Schön et al, J Natl Cancer Inst 2003; 95:1138. While it causes fewer side-effects than fluorouracil, it is to be used weekly for 16 weeks. In 2 vehicle-controlled studies, a total of 724 patients with superficial basal cell carcinoma were treated with imiquimod 5 or 7 times a week for 6 weeks. At 12 weeks post-treatment, clinical and histological clearing occurred in 75% of patients treated 5 times a week, and 73% of those treated 7 times a week, compared to 2% with the vehicle alone. J Geisse et al, J Am Acad Dermatol 2004; 50:722.
Diarrhea: Also see Irritable Bowel Syndrome, Crohn's Disease, and Ulcerative Colitis which include several other causes.
Diarrhea: Probiotics Help Pouchitis: A University of Bologna study of people with frequent bowel movements, gas, and discomfort found those given probiotics including lactobacillus did much better although relapsed after the probiotic (yogurt) was stopped. Gastroenterol 2000;119:305-9.
Diarrhea: Traveler’s Diarrhea Helped by Probiotics: 47% decrease. Am J Gastroent 2000;95(1Suppl):S2-4. For more articles, see Yogurt.
Diarrhea: Lactobacillus Milk Helps Antibiotic Diarrhea in Kids: 86 children ages 1-12 were given amoxicillin for acute infections. Forty-four of these children took 80 ml of fermented milk (similar to yogurt), once a day, in the morning, while 42 were given a placebo milk. At 10-day follow up, diarrhea was present in 15% of the placebo group, compared with none of the probiotic group (p < 0.01). The study was presented at the 33rd Argentine Congress of Pediatrics. Reuters, 10/13/03. Many similar studies.
Darhe: Wood Creosote as Good as Loperamide (Lomotil): Osaka, Japan. Clin Ther. 2004 Oct;26(10):1644-51. Ed: Loperamide is inexpensive and available over the counter. Wood creosote looks like an effective alternative.
Diarrhea: Irritable Bowel Syndrome Treatment: Symptoms of IBS are chronic recurrent abdominal discomfort with diarrhea, constipation, or both. Usual treatments are loperamide (e.g. Imodium), antispasmodics like hyoscyamine, psyllium and antidepressants. A relatively new medication, alosetron (Lotronex), a selective serotonin-3 receptor antagonist, is somewhat helpful though can cause severe constipation and the $131/mo. cost makes it a dubious treatment. See IBS.
Chamomile-Pectin Preparation Helped Childhood Diarrhea: In a 3-day DB PC multicenter study of 79 children (6 months to 5.5 years of age) with acute, non-complicated diarrhea, a preparation containing apple pectin and chamomile extract (Diarrhoesan) or placebo (n = 40) ended the diarrhea more frequently (33/39) than placebo (23/40)(p < 0.05) . Pectin/chamomile reduced the duration of diarrhea significantly (p < 0.05) by at least 5.2 h. The parents expressed their contentment more frequently (82%) with pectin/chamomile than with placebo (60%, not significant). Double-blind comparison of an apple pectin-chamomile extract preparation with placebo in children with diarrhea. de la Motte S, et al. Harrison Clinical Research, Munchen. Arzneimittelforschung. 1997 Nov;47(11):1247-9.
Dyspepsia: See Peptic Ulcer Disease.
EB Virus: Infectious Mono Strongly Linked to Intercourse: 63% new Edinburgh college students without intercourse EBV positive vs. 82% with intercourse. Two thirds of infectious mono cases, but only a tenth of asymptomatic primary EBV infections, were statistically attributable to sexual intercourse. EBV Sexual history and Epstein-Barr virus infection. Crawford DH, Swerdlow AJ, Higgins C, McAulay K, Harrison N, Williams H, Britton K, Macsween KF. J Infect Dis 2002 Sep 15;186(6):731-6
EB Virus in England: The serological profile of EBV was consistent with an endemic infection with peaks in transmission in those less than 5 years old and in young adults. An age adjusted analysis found a significant association between EBV and HSV-1 seropositivity that is most likely explained by similarities in their mode of transmission. The very low seroprevalence of HSV-2 in this sample J Med Virol 2002 Aug;67(4):522-7
Earache: Hold Antibiotics: Netherlands, doctors prefer a method known as "watchful waiting" in children over 2. Only if the infection does not clear up in one or two days do they administer an antibiotic. The rate of resistance to antibiotics in the Netherlands is about 1 percent. In the United States, it is about 25 percent. NYT 9/17/00
Eczema: Lack LL-37 Peptides in Skin: Research by Gallo has found that people with atopic dermatitis are prone to recurring skin infections because they fail to produce germ-killing peptides known as beta-defensins and cathelicidins. These include "antimicrobial cathelicidin peptide," or LL-37. These peptides kill many common viruses, fungi, and bacteria. LL-37 kills vaccinia virus from smallpox shots and prevents the virus from spreading around the body. In the U.S., 3% adults and 17% of children suffer from atopic dermatitis, a chronic, hereditary disease which is marked by red, itchy, swollen skin, and often accompanied by asthma and allergies. 2/3/04
Eczema: Chamomile Cream Said to Help Eczema: In a 2-week, "partial" DB PC study by the manufacturer, Kamillosan(R) cream (chamomile extract ws tested for eczema on a half-side comparison vs. 0.5% hydrocortisone cream and vs. the vehicle cream as placebo. Kamillosan(R) cream showed a mild superiority towards 0.5% hydrocortisone and a marginal difference as compared to placebo. Proof of efficacy of Kamillosan(R) cream in atopic eczema. Patzelt-Wenczler R, et al. Frankfurt am Main, Germany. . Eur J Med Res. 2000 Apr 19;5(4):171-5
Education: Homework Lowest, Grades Highest in Modern American High Schools: Higher Education Research Institute at the University of California, Los Angeles in 1987 started annual study of college freshman asking about high school study habits. Results of a 2002 survey found the lowest percentage ever (33%) reporting doing 6 or more hours of homework per week in senior year of high school. However, the highest percentage ever reported having an "A" average (over 45%). Beer drinking in past 12 months did fall to its lowest levels (46% vs. 74% in 1982) and 36% reported not attending a single party during a typical week. Keeping abreast of political affairs in 2002 was 33%. The all-time low in political interest, 28%, was recorded in 2000 and the all-time high, 60%, in 1966. Study conducted with the American Council on Education, was based on responses from 282,549 students at 437 public and private colleges and universities to a written survey. A total of 1.2 million students are currently enrolled in four-year schools. AP 1/27/03
Egg Donation: Profiles: 5 of 30 women willing to be donors had histories of major depressive disorder, bulimia nervosa, dysthymic disorder, or alcohol abuse. MMPI suggested they were trying to portray selves too favorably (K above T of 65). MCMI suggested the same. Histrionic and narcissistic tended to be elevated. Gary Bruss, Penn hosp, 800 Spruce St. APA 5/99
Endometritis: STDs and Barrier Contraception May Increase: Women with a lower genital tract infection and endometritis were older and reported a history of more sexually transmitted diseases (70.0% vs. 56.7%), abdominal pain (82.2% vs. 60.0%), and use of barrier methods of contraception (28.9% vs. 8.6%) than women with a lower genital tract infection alone. The regression model found that women with a lower genital tract infection and endometritis were 7.1 times more likely to report abdominal pain and 4.6 times more likely to use barrier methods of contraception than women with a lower genital tract infection alone. Factors predicting upper genital tract inflammation among women with lower genital tract infection. Nelson DB, Ness RB, Peipert JF, Soper DE, Amortegui AJ, Gluck J, Wiesenfeld H, Rice PA. University of Pittsburgh. J Womens Health. 1998 Oct;7(8):1033-40
Epilepsy: Ketogenic Diet Very Effective: high-fat/low-carbohydrate diet to treat severe drug-resistant epilepsy: Between three and six years after stopping the diet, one quarter of 150 treated children were free from seizures and more than half showed a 50 per cent reduction in seizure frequency. While 70 per cent of children with epilepsy respond to medication, these drug-resistant children had shown no improvement after trying at least two different anti-seizure drugs. "Almost none of the new medications give you 50 per cent seizure control, and less than 10 per cent of these children would have been expected to ever achieve any seizure control," says researcher John Freeman at Johns Hopkins Medical. Of the 150 children in the trial, 83 remained on the diet for at least one year. Freeman recommends a two-year treatment period. But there is no indication yet of what the optimum length of the diet should be. For the approximately 50 per cent of children in the study who did respond to the treatment, the effects usually began within one to three months. Although Freeman's team focused on children, there are indications from other smaller studies that adult epileptics could also benefit. Ketogenic Diet: 90% of calories from fat. Popular treatment in 1920s and 30s. 10 studies in meta-analysis, all uncontrolled. 16% became seizure free, 32% >90% reduction, 56% >50%. Lefevre, Pediatrics 00;105:e46
Evolution: Clothing, Loss of Fur: Alan R. Rogers of the University of Utah figured out that the ancestral human population had acquired black skin, as a protection against the sun, at least 1.2 million years ago, and therefore that it must have shed its fur some time before this date. Clothing came long after we were naked. Dr. Mark Stoneking of the Institute for Evolutionary Anthropology in Leipzig managed to address this question by calculating when the human body louse (which lives only in clothing, not hair) evolved from the human head louse. That proud event in human history dates to between 72,000 and 42,000 years ago. NYT 8/25/03
Fungal Skin Infections: See Tinea.
Genital Cutting: 94% of Egyptian Women Cut. Lancet 1/11/97 p. 130. This appears to be a very unhealthy custom encouraged by the adult women on girls going through puberty in the cultures in which it is popular. Most or all of these cultures are Muslim, but it has nothing to do with the Muslim religion and is not practiced in all Muslim countries. It is primarily popular in Africa.
Glaucoma: Citicoline Said to Help Glaucoma and Amblopia in DBs: A Polish DB study is reported, but the abstract gives no details other than that citicoline helped. Pharmacodynamics of citicoline relevant to the treatment of glaucoma. Grieb P, Rejdak R. J Neurosci Res. 2002 Jan 15;67(2):143-8; An Italy study of 50 amblyopia patients treated with an open design and 10 with a DB design reports that citicoline helped over a 6 month period of time. Graefes Arch Clin Exp Ophthalmol. 1995 May;233(5):307
Gonorrhea: Current Recommendation IM Ceftriaxone (Rocephin): Because of increasing drug resistance to floroquinolones ciprofloxacin and levofloxacin which attack bacteria DNA, the new 2007 recommendation is to use second-generation cephalosporins such as IM ceftriaxone, which attack the bacteria cell wall. 250-500 mg IM cures gonorrhea and chancroid. This costs as little as $6 wholesale.
Gout: Etoricoxib as Good as Indomethacin: In a DB PC study of 194 men treated for 8 days, etoricoxib at a dosage of 120 mg once daily was confirmed to be an effective treatment for acute gout. Etoricoxib was comparable in efficacy to indomethacin at a dosage of 50 mg 3 times daily with fewer side-effects. Univ. North Texas. Efficacy and safety profile of treatment with etoricoxib 120 mg once daily compared with indomethacin 50 mg three times daily in acute gout: A randomized controlled trial. Rubin BR, Burton R, Navarra S, Antigua J, Londono J, Pryhuber KG, Lund M, Chen E, Najarian DK, Petruschke RA, Ozturk ZE, Geba GP. Arthritis Rheum. 2004 Feb;50(2):598-606. Ed: This is another example of the giant rip-off of the American consumer by multinational drug companies. The side-effects of indomethacin are not much different from aspirin or ibuprofen, i.e., relatively mild, especially over 8 days. The cost of etoricoxib will be high, while indomethacin is very inexpensive.
Hair: Melatonin Helped Female Hair Loss: Melatonin has been reported to have a beneficial effect on hair growth in animals. In a DB PC study of 40 women suffering from diffuse alopecia or androgenetic alopecia, a 0.1% melatonin solution daily for 6 months led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo (n=12; P=0.012). For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia (n=28; P=0.046). Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Fischer TW, et al. Friedrich-Schiller-University, Jena, Germany.
Halitosis: Good Bacteria Lacking: People with halitosis lack three strains most common in sweet-smelling mouths and have high levels of sulphurous chemicals. Paster, Forsyth Institute, New Scientist 3/1/03
Halitosis: Wrigley's Big Red Gum Helps: In a University of Illinois, Chicago, College of Dentistry study funded by Wrigley, dental researchers found that gum containing cinnamic aldehyde, a plant essential oil used for flavoring, inhibited the growth of bacteria responsible for cavities, periodontal infections, and bad breath in the 15 volunteers studied while a placebo gum had no effect. Several other plant essential oils do likewise. Microbiological analysis showed that Big Red reduced by more than 50% the concentration of anaerobic bacteria in the saliva. It was particularly effective against anaerobic bacteria residing at the back of the tongue, reducing the population by 43 percent. These bacteria produce volatile sulfur compounds through the putrefaction of proteins and are considered the major contributors to halitosis, or bad breath. Christine Wu, 4/1/04.
Head Trauma: Citicoline Helped Closed Head Injury: A Univ of Texas DB PC 1 month study of 14 patients with mild-moderate closed head injuries reported that citicoline helped reduce post-concussional symptoms, primarily recognition memory. Treatment of postconcussional symptoms with CDP-choline. Levin HS. J Neurol Sci. 1991 Jul;103 Suppl:S39-42;
Head Trauma: Citicoline Helped Severe Head Injury in DB: A French study of 60 patients who were comatose in DB PC design found that citicoline reduced the duration of the coma. A precursor of phospholipids in the treatment of severe traumatic comas. Cohadon F, Richer E, Poletto B. For more, see citicoline.
Hearing: Karaoke Damages Hearing: 100 minutes of karaoke. Results showed that noise levels in the typical karaoke singing environment were higher than 95 decibels. Maximum noise levels frequently exceeded OSHA’s non-permissible level of 115 decibels, roughly equivalent to a pneumatic drill at a distance of one meter. "Further statistical analysis of hearing threshold shift revealed that up to 8dB of significant hearing loss was found at the most important human hearing frequency band, centered at 4000Hz, after about two hours of Karaoke noise exposure, indicating that Karaoke facilities may pose a serious threat to noise-induced hearing loss," warned the report of the study (International Journal of Industrial Ergonomics 2003;31:375-85).
Hearing: Testing Method: Almost 40% of people over the age of 60 and 90% over the age of 80. Conducting the whispered voice test: 1) The examiner stands arm's length (0.6 m) behind the seated patient and whispers a combination of numbers and letters (for example, 4-K-2) and then asks the patient to repeat, 2)The examiner should quietly exhale before whispering to ensure as quiet a voice as possible, 3) if the patient responds incorrectly, the test is repeated using a different number/letter combination. Passing is if the patient repeats at least three out of a possible six numbers or letters correctly, 4) Each ear is tested individually, starting with the ear with better hearing, and during testing the non-test ear is masked by gently occluding the auditory canal with a finger and rubbing the tragus in a circular motion; The test is 95% sensitivity and 80% specificity, as good as a portable audioscope. Whispered voice test for screening for hearing impairment in adults and children: systematic review Sandi Pirozzo et al. BMJ 2003;327:967 10/25/03
Homeopathy Doesn't Work: Homeopathy is a strange theory from the 1700s that the weaker the solution of an antidote/toxin, the more powerful the effect. "There was weak evidence for a specific effect of homeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homeopathy are placebo effects,” was the conclusion of a study comparing the findings from 110 homeopathy trials and an equal number of conventional medical trials. Medical doctors were urged to tell their patients they were wasting their time taking homeopathic medicines. Matthias Egger et al. Switzerland. University of Berne. Lancet 8/26/05. Ed: The dilutions in homeopathy are so strong that it is unlikely that even one molecule of the original treatment still exists in the bottle. Homeopaths claim that in some way the diluting water is imprinted with the beneficial effect.
Homeopathic Dilution of Podophyllin Fails in Calf Diarrhea: A German study found no benefit in 44 calfs of a 30 dilution preparation with diarrhea of 3.1 days vs. 2.9 days with placebo. Author says it should not be used in view of the importance of animal welfare. Acta Vet Scand. 2003;44(1-2):97-101
Homocysteine: Age, Male, Folate, B-12, B-6, Genes: While cigs, coffee assoc with high homocysteine, this disappeared when corrected for folate in Shang-hai study of 486. Methylenetetrahydrofolate reductase genetic variations also associated with high levels when two abnormal genes. higher age and maleness strongly associated with higher homocysteine. Amer J Clin Nutr 2/01;236
Homosexuals: Homosexuals Die Young: 1996 National Household Survey of Drug Abuse (N = 12,381) and 2000 Kaiser Family Foundation 15-city survey (N = 405) reported that homosexual men and women are seldom aged 50+ yr. and that older homosexuals are more apt to have a homosexual partner. Deaths of 228 homosexuals as recorded in the Washington Blade 1999-2001 were examined. Although more apt to have a partner when older, the median age of death of 88 homosexually partnered men was 45 yr., while for 118 unpartnered homosexual men it was 46 yr. Homosexual partnerships and homosexual longevity: a replication. Cameron P. Psychol Rep 2002 Oct;91(2):671-8
Hot Flashes: See Estrogens and HRT.
Hysterectomy: Leave the Ovaries In: Twenty-five times more women die from heart disease than from ovarian cancer. The prevailing medical wisdom has been to remove the ovaries when the uterus is removed if women are past childbearing age to prevent ovarian cancer. About half of women have their ovaries removed during hysterectomy. However, the ovaries keep making small amounts of estrogen for years after natural menopause. Of more than 600,000 hysterectomies done annually in the U.S., 90% are for benign diseases, such as uterine fibroids or endometriosis. For women at average risk of ovarian cancer, heart disease, osteoporosis, breast cancer and stroke, the probability of survival to age 80 after hysterectomy at ages 50 to 54 ranged from 62% for those who kept their ovaries but didn't take estrogen, to 53% for those who had their ovaries removed but didn't take estrogen. Keeping the ovaries without estrogen therapy reduced the percent of women dying by age 80 of heart disease from 15% to 7%, and those dying of hip fractures from nearly 5% to 3%. These reductions far outweigh the increase in ovarian cancer deaths by age 80. William Parker, et al. Santa Monica-UCLA Medical Center. Obstetrics & Gynecology 8/05.