Thursday, January 23, 2014

Update on flu, apples, coffee, vitamin D, and polio in India

*Flu – there have been at least 29 deaths from this year’s flu epidemic in the Bay Area, with many more people in intensive care.  It’s not too late to get the flu vaccine, which contains protection against the HINI virus.  Get yourself protected.

*Apples – I previously reported on the benefits of apples in prevention of cardiovascular disease. See my column on 12/23/13.  Researchers at Cornell University have identified compounds in the peel of apples that have anti-cancer effects in the laboratory against liver, breast, and colon cancer cells.  So – buy organic apples whenever possible, and eat the peel!

*Coffee –New positive votes for coffee!   Researchers in Turkey have reported on numerous studies showing that coffee drinking is associated with a lowered risk for metabolic syndrome, as well as a reduced risk for non-alcoholic fatty liver disease.  Metabolic syndrome is a name for a group of risk factors for diabetes, heart disease and stroke.  These factors are: a large waist line (apple shape), an elevated triglyceride level, high blood pressure, low HDL cholesterol (the ‘good’ cholesterol) and a high fasting blood sugar.  Non-alcoholic fatty liver disease affects about 25% of the US population.  It is a buildup of fat in liver cells, not caused by alcohol, that tends to develop in people who are overweight, have diabetes, high cholesterol or high triglycerides.  A previous large study on coffee, run by the National Institutes of Health (400,00 men and women followed for 12 years)  showed that coffee drinking – either caffeinated and decaffeinated – is associated with a lower risk of death from heart disease, stroke, respiratory disease, injuries and accidents, diabetes and infections.  Coffee is also associated with a lower risk of uterine cancer in women, and of basal cell skin cancer.  A recent large Harvard study showed that caffeinated coffee, but not decaf, is associated with a 50% decrease in suicide.  This is huge.
Oh, I almost forgot – researchers at Johns Hopkins have found that caffeine enhances memory.

*Vitamin D – The American Geriatrics Society advises that older people should have a vitamin D intake sufficient to keep their blood level at about 30ng/ml. This level has been associated with a lower risk of falls and fractures.  While the influence of vitamin D on bone density is small, the impact on muscle strength and fall prevention is impressive.  If you, or a relative, are over 65, getting a vitamin D level is important. The test is called 25(OH) D. Supplementation with vitamin D can bring your level up, and the amount of D to take should be discussed with your health care provider.  The Geriatrics Society suggests that doctors prescribe up to 4000 IU daily to achieve good blood levels.  I suggest getting a blood level before taking 4000 IUs daily – start with 1000-2000 IUs and talk to your doctor or NP.  Calcium intake is also important for strong bones: I will write more on this mineral in a forthcoming column. 
*Polio eradication in India!  India, a country of 1.4 billion people, has successfully eradicated polio, with no cases reported for the past 3 years.  India had 150,00 cases in 1985, 6,028 cases in 1991, 741 cases in 2009, and the last  one case – on Jan 13th, 2011.  The country used 2.3 million vaccinators each year; mobile teams immunized children (with oral vaccine – kept cold for potency – no small feat) in homes, in railway stations, inside running trains, at bus stands, marketplaces, and at construction sites. They walked miles to towns not connected to roads. Muslim leaders were identified and went along with the program.  The vaccinators publicized this message  - wherever you stay, wherever you go, protect your child against polio.  This was an astounding public health success, funded by the government of India, the Bill and Melinda Gates Foundation, the U.S. government and many other countries and organizations.   Only 3 countries still have cases of polio – Nigeria, Pakistan and Afghanistan.  In these areas there has been very tragic threatening and killing of vaccination teams.  May the opposition see the light and protect their people against paralysis. 

Sadja Greenwood, MD , MPH  Check out my novel, Changing the Rules, at local bookstores or Amazon.

Monday, January 6, 2014

Access to Abortion is Declining in Many States

In a country so dedicated to individual liberty, it is perplexing that conservatives oppose a most fundamental freedom  - to control one’s own reproduction.  State legislatures have passed increasing numbers of restrictions on abortion in recent years – 70 in 2013. (California is not included, we are one of the most liberal states with regard to abortion laws and access.)  Both sides in the abortion debate are preparing for new political campaigns and court battles this year.

Texas made news in June when State Senator Wendy Davis filibustered for 11 hours against regulations that required doctors performing abortions to have admitting privileges in local hospitals, imposed costly surgery-center standards for clinics, sharply limited medication abortions and adopted a 20 week ban.  Senator Davis was not successful in her attempt to block the new bills, but is planning to run for governor this year, along with another woman State Senator for lieutenant governor.  The primary is in March – stay tuned for that. The restrictions on abortion have left much of Texas without access to family planning and abortion clinics.  A federal judge blocked the rules as medically unnecessary, but the US Court of Appeals reinstated them pending a trial.  Stay tuned – the Appeals Court is about to hear arguments in New Orleans. 

South Dakota has a law mandating a 72-hour waiting period between a first visit for an abortion and the procedure. Weekends and holidays cannot count as part of this wait.  This can only be seen as punitive - some women will be waiting 6 days.
North Dakota has passed a law to criminalize all abortions after a fetal heartbeat is detected, at about 6 weeks. By passing this law, which has been blocked while it is being contested, its supporters hope for a reconsideration of Roe v Wade by the Supreme Court.   North Dakota voters will also vote on a bill granting personhood to fertilized eggs this year.
North Carolina passed anti-abortions restrictions inserted at the last minute into a motorcycle safety law.  It required clinics to meet the same safety standards as ambulatory surgical centers, to have transfer agreements with local hospitals, to have physicians present for medication abortions, and a restriction on abortion coverage in the state healthcare exchange. 
Oklahoma passed a law in 2011 to ban off-label use of abortion-inducing medications – legal challenges and state appeals to defend the law continued into 2013.  Numerous other states –including Texas - are attempting to block medication abortions, which are becoming more popular with women.  The Oklahoma law even blocked doctors from treating tubal pregnancies with medication.  The alternative treatment is surgery.  Tubal pregnancies will never develop but will rupture, causing serious internal bleeding, and are fatal if not treated as a surgical emergency.    
If you support a woman’s right to plan her family, or to plan not to have a family, this is a time to get active.  You can contact Planned Parenthood locally or nationally, and send a contribution or volunteer your time.  The same is true for NARAL (National Abortion and Reproductive Rights Action League).  Both organizations have a long track record on behalf of women, men and couples.  NARAL’s work is political, while Planned Parenthood provides a wide range of reproductive health care as well as education on the issues that might limit it.

Flu Season is here!  The viruses circulating this year include H1N1, which caused a major pandemic in 2009 with thousands of deaths worldwide.  Young and healthy people are not immune.  Who wants fever, coughing, sore throat, weakness, headache, aches and pain in the joints and muscles, pneumonia, ear or sinus infections, and dehydration or hospitalization??  If you have not had the vaccine yet, get it at once!
Sadja Greenwood MD, MPH   Check out past issues on this blog - it is finally indexed.  My novel, Changing the Rules, is in local bookstores and on Amazon.