Medical FAQ and Q&A

Medical FAQ and Q&A have moved!

2008-11-03T03:58:00.000-08:00

To better serve a rapidly growing online community, we have moved our Medical FAQ and Q&A to our discussion forums: http://www.medrounds.org/forums/

You may still send in questions via e-mail or post directly in the forum.

What are USANA vitamins and supplements?

2006-11-07T22:43:00.000-08:00

USANA Health Sciences formulates exceptional, science-based nutritional and personal-care products. However, inferior manufacturing can destroy even the greatest product formulations. For this reason, USANA manufactures its own nutritional supplements, and voluntarily meets pharmaceutical Good Manufacturing Practices (GMP). Pharmaceutical GMP standards are far more stringent than the food GMP requirements set by the U.S. government for supplements.

To adhere to the exacting standards of pharmaceutical GMP, and to ensure the quality of every product manufactured, USANA inspects all raw ingredients before they are mixed, tests the product during manufacturing, and performs a final analysis before any product is sent to the customer. USANA's Quality Assurance team keeps track of every detail, from careful testing and evaluation of raw materials, to meticulous product shipping and storage. Visitors to USANA's corporate headquarters can take a self-guided tour to see USANA's manufacturing process firsthand.

Can a damaged optic nerve be repaired?

2006-05-20T15:30:00.000-07:00

One of the readers submitted the following question:

I came across your name while looking for information related to optic nerve repair – I was also trying to locate the email address of Dr. Neil Miller, which I couldn’t find – then I came across your blog, and hence this email. This subject has been of profound personal interest to me – my sister, who is now 46, and lives in India, lost her eye-sight completely in 1991. She had undergone three brain surgeries over a 14 year period – the surgeries were done to remove a persistent brain tumor that occurred in the vicinity of the optic nerve. While the initial surgeries were successful, the final surgery in 1991 left her with complete blindness after the tumor was removed. The tumor has not returned since 1991, and neither has her vision.

I’ve been in the US for the last 14 years, and have been reading articles on this subject - perhaps neurosurgery would advance to the level that could result in a cure for my sister. I’d very much appreciate hearing your views on this. I am happy to bring her to the US for treatment, even if there were a slim chance of success.

Several components of the human visual system must work together for an image to be detected, transmitted, and then processed by the brain. A simple model for the complex visual system can be represented by a video camera, wires, and computer. The eye is similar to a video camera with sensors that detect colors, shapes, and motion. The optic nerve is the wire that connects the eye (i.e. video camera) to the brain (i.e. computer) for processing of visual information. The average human optic nerve is about 1.5-2.0 mm in diameter (less than one tenth of an inch) and contains 1.2 million nerve fibers.

The ganglion cells in the eye give rise to the nerve fiber layer which aggregate and form connections with the brain via the optic nerve. Disruptions along the path of the optic nerve result in visual loss. In the situation of a brain tumor, the tumor can compress the optic nerve and cause visual loss. When there are surgeries around the optic nerve, parts of the optic nerve may be damaged resulting in visual loss. Sometimes, during tumor removal surgery, the entire optic nerve can be cut.

When the entire optic nerve is cut, all 1.2 million nerve fibers within the nerve are also cut. Current research is focused on growth factors that guide the growth of a damaged optic nerve and assist the connection of the nerve with the proper areas in the brain [review article]. The problem is that 1.2 million nerve fibers must be reconnected properly for the visual system to function correctly. At the present time, we do not have the medical technology to repair damaged optic nerves in humans.

Readers may submit questions to: webmaster@medrounds.org

Is there a vaccine for cervical cancer?

2006-05-19T16:23:00.000-07:00

The human papilloma virus is a major cause of cervical cancer in woman. The FDA recommended recently that the agency approve a new vaccine from Merck to fight against the sexually transmitted virus that causes cervical cancer.

The vaccine targets four strains of the human papilloma virus, the most common type of sexually transmitted infection. Two of the strains are responsible for 70 percent of cervical cancer cases. [article]

Is there a pill to help people quit smoking?

2006-05-11T19:08:00.000-07:00

The FDA Approves Pfizer Anti-Smoking Pill

The FDA approves Pfizer's new anti-smoking pill, varenicline. Pfizer plans to market the new medication later this year as Chantix. Varenicline works by cutting the pleasure of smoking and reducing the withdrawal symptoms that lead smokers to light up over and over again.

Several studies conducted in Europe on about 2,000 smokers and presented in November at an
American Heart Association conference showed that a year after initial treatment with varenicline, abstinence rates were 22 percent, versus 16 percent among those given Zyban. Just 8 percent of those given dummy medicines had stopped after a year. [link]

Varenicline binds to the same receptors in the brain that nicotine binds to. Binding to these receptors leads to the release of dopamine in the pleasure centers of the brain. Taking varenicline blocks nicotine from binding and activating the release of dopamine. The most common side effect of Varenicline is nausea.

The other pill approved for smoking cessation is bupropion (tradename Wellbutrin and Zyban).

Is breast cancer linked to estrogen use?

2006-05-08T20:03:00.000-07:00

A new study of 28,000 women conducted by Harvard researchers demonstrated that unopposed estrogen therapy for 10 years or more was linked to a higher risk of developing breast cancer in postmenopausal women. Estrogen therapy is used to prevent or treat osteoporosis.

According to the study, the multivariate relative risks (RRs) and 95% confidence intervals (CIs) for breast cancer with current use of unopposed estrogen were as follows (P for trend .001):

Less than five years, RR 0.96 (95% CI, 0.75-1.22);
Five to 9.9 years, RR 0.90 (95% CI, 0.73-1.12);
10 to 14.9 years, RR 1.06 (95% CI, 0.87-1.30);
15 to 19.9 years RR 1.18 (95% CI, 0.95-1.48);
20 years or longer RR 1.42 (95% CI, 1.13-1.77).

Based on these results, the risks of developing breast cancer is slightly higher at 10-14.9 years, and higher in women taking estrogen for more than 15 years.

[external link]

Wendy Y. Chen, et al, "Unopposed Estrogen Therapy and the Risk of Invasive Breast Cancer," Archives of Internal Medicine 2006;166:1027-1032.

What are the numbers of bird flu victims to date?

2006-05-08T11:39:00.000-07:00

The World Health Organization (WHO) confirmed on Monday that a 30-year-old Indonesian man from Jakarta has died from bird flu. To date, there has been 25 deaths in Indonesia from the avian influenza H5N1 strain. [link]

Here are some statistics relating to the bird flu:

Since 2003, bird flu outbreaks have been confirmed in more than 48 countries and territories, according to data from the World Organization for Animal Health (OIE).
Since the beginning of January, 2006, more than 30 countries have reported outbreaks, in most cases involving wild birds such as swans.
The virus has killed 115 people since 2003 in nine countries and territories, according to the WHO. Countries with confirmed human cases are: Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam.
In total, the virus is known to have infected 207 people since 2003, according to the WHO.
The avian influenza strain H5N1 virus first infected humans in Hong Kong in 1997, infecting 18 people and killing six of them.

What is naltrexone and can it be used to treat alcoholism?

2006-05-08T07:18:00.000-07:00

Naltrexone (brand names: ReVia, Depade) is a medicine blocking the brain receptors that interact with alcohol and narcotics. When alcohol and narcotics interact with these areas in the brain, people feel pleasure when using these agents. When these receptors in the brain are blocked, people feel less need to drink alcohol and can stop drinking more easily. Unlike disulfiram (brand name: Antabuse), another medicine that is sometimes used to treat alcoholism, naltrexone does not make you feel sick if you drink alcohol while taking it. [link]

Research in the U.K. provides evidence that naltrexone can be used to treat alcoholism. Currently, in the U.K., naltrexone is only licensed to treat drug addiction, which works by reducing the craving and neutralizing the hit. Additional studies on naltrexone and alcoholism bring hope to patients suffering from this addiction. [link]

Is prostate cancer linked to genetics?

2006-05-07T20:15:00.000-07:00

Scientists are closer to identifying the genes linked to prostate cancer in men. Iceland scientists from deCode genetics published in Nature Genetics a common genetic marker that is associated with a 60 percent heightened risk of prostate cancer in men who carry it, and it may help explain why black men are unusually prone to the disease. Among whites, the genetic marker appeared in about 19 percent of patients and 13 percent of the other participants. Among blacks, both numbers were about twice as high. [link]

What is autism? - a disease affecting 1 in 175 school-age children

2006-05-07T09:55:00.000-07:00

According to the Centers for Disease Control and Prevention, "autism spectrum disorders (ASDs) are a group of developmental disabilities that are caused by unusual brain development. People with ASDs tend to have problems with social and communication skills. Many people with ASDs also have unusual ways of learning, paying attention, or reacting to different sensations. ASDs begin during childhood and last throughout a person's life." [link]

Symptoms

Social skills: People with ASDs might not interact with others the way most people do, or they might not be interested in other people at all. People with ASDs might not make eye contact and might just want to be alone. They might have trouble understanding other people's feelings or talking about their own feelings. Children with ASDs might not like to be held or cuddled, or might cuddle only when they want to. Some people with ASDs might not seem to notice when other people try to talk to them. Others might be very interested in people, but not know how to talk, play, or relate to them.
Speech, language, and communication: About 40% of children with ASDs do not talk at all. Others have echolalia, which is when they repeat back something that was said to them. The repeated words might be said right away or at a later time. For example, if you ask someone with an ASD, "Do you want some juice?" he or she will repeat "Do you want some juice?" instead of answering your question. Or a person might repeat a television ad heard sometime in the past. People with ASDs might not understand gestures such as waving goodbye. They might say "I" when they mean "you", or vice versa. Their voices might sound flat and it might seem like they cannot control how loudly or softly they talk. People with ASDs might stand too close to the people they are talking to, or might stick with one topic of conversation for too long. Some people with ASDs can speak well and know a lot of words, but have a hard time listening to what other people say. They might talk a lot about something they really like, rather than have a back-and-forth conversation with someone.
Repeated behaviors and routines: People with ASDs might repeat actions over and over again. They might want to have routines where things stay the same so they know what to expect. They might have trouble if family routines change. For example, if a child is used to washing his or her face before dressing for bed, he or she might become very upset if asked to change the order and dress first and then wash.

The Centers for Disease Control and Prevention estimates that 1 in 175 school-age children are suffering from some degree of autism. Autism may affect over 300,000 American children. [link]

At the present time, there is no known treatment for autism. However, interventional therapy and social support will assist children develop communication and social skills.

Soda Distributors to End Most School Sales

2006-05-07T07:02:00.000-07:00

A decision by the nation's largest beverage distributors to halt nearly all sales of sodas to public schools last week is a positive step towards improving the health of our children. Under the agreement, the companies also have agreed to sell only water, unsweetened juice and low-fat milks to elementary and middle schools. Diet sodas would be sold only to high schools. [link]

The first step towards becoming healthy is eating healthy. It is extremely difficult to eat healthy, however, when kids are enticed by sweetened snacks, candy, sodas, and deep-fried foods. There is increasing evidence that obesity in childhood is associated with obesity and health problems in adulthood. [article]

What is the average student loan debt for medical school graduates?

2006-05-07T06:20:00.000-07:00

In the U.S. we are facing a crisis in healthcare funding. Medicare is anticipating cutting back on physician reimbursements over the next five years. While doctors are paid less, the average medical student is graduating with increasing student loans. The average medical student owes more than $100,000 in student loans for a public medical school and over $135,000 in student loans for a private medical school.

According to the American Medical Student Association:

"Medical education debt in the United States is staggering. Over 80% of graduates carry educational debt. The median debt burden for indebted graduates of public medical schools now exceeds $100,000, and the median debt for graduates of private schools is $135,000. According to data from the Association of American Medical Colleges, medical education debt is 4.5 times as high in 2003 as it was in 1984, far outpacing the consumer price index. Moreover, 25% of students have debt exceeding $150,000, and some new physicians have debt over $350,000.

Medical educational debt and the current loan-oriented system of financing undergraduate medical education adversely affect the entire American health care system. Our nation is struggling to increase racial diversity in health care and reduce health disparities, and the rising debt burden is canceling out the modest gains we have made. Even though African Americans, Hispanic Americans, and Native Americans make up approximately 25% of the U.S. population, they account for only 11% of medical students. At the same time, more and more of the country's medical students are coming from wealthy families - in 2002 more than 60% of incoming medical students were from families in the top 20% of annual income. " [link]

Future doctors will need expertise in medicine, business, accounting, and debt management in order to be successful and survive.

Is childhood obesity associated with adult obesity later in life?

2006-05-07T05:49:00.000-07:00

Studies by Professor Jane Wardle and her team on nearly 6,000 children in Britain over five years showed that children who are overweight or obese by the age of 11 are likely to be obese into adulthood. Obesity as adults is associated with related health problems, which may include:

Hypertension
Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea and respiratory problems
Some cancers (endometrial, breast, and colon)

According to Professor Jane Wardle, “children who joined the study at age 11 and were already plump did not slim down at all over the five years of follow-up."

“I think society as a whole needs to take childhood obesity much more seriously,” she added.

[link to article]

Wardle J. Understanding the aetiology of childhood obesity: implications for treatment. Proc Nutr Soc. 2005 Feb;64(1):73-9. Review. [link]

What is Fusarium keratitis?

2006-05-06T07:51:00.000-07:00

Fusarium is a fungus that can cause infections of the eye. The fungus can infect the cornea, the clear tissue on the surface of the eye, which may lead to scarring and vision loss. If the scarring is extensive, a cornea transplant may be needed. When detected early, anti-fungal drops are used to treat the infection.

Recently, Bausch & Lomb Inc. halted U.S. sales of its ReNu with MoistureLoc solution on April 10 when the Centers for Disease Control and Prevention revealed it was investigating a link between Fusarium keratitis infections in Americans using the product. So far the CDC had received 191 reports, including 86 confirmed cases. [link to AP]

What is avian Influenza, also known as the Bird Flu?

2006-05-06T07:28:00.000-07:00

This illness is a type of bird flu, called avian influenza A, caused by the influenza virus subtype H5N1, that has caused infections in birds and in humans. There is a low risk of infection in people.

According to the Centers for Disease Control, "Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The “low pathogenic” form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100% often within 48 hours." [link]

During outbreaks of the avian influenza in birds, there is a risk that humans coming in contact with infected birds may become ill. Symptoms of avian influenza in humans range from:

typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches)
eye infections
pneumonia
severe respiratory diseases (such as acute respiratory distress)
other severe and life-threatening complications
the symptoms of avian influenza may depend on which virus caused the infection

Medical researchers and the NIH are currently developing a vaccine for humans. [link to article]

“These findings represent an important step forward in the nation’s efforts to prepare for the possible emergence of a human pandemic of H5N1 avian influenza,” notes NIH Director Elias A. Zerhouni, M.D.

What is LASIK ( laser in situ keratomileusis)

2006-02-01T18:43:00.000-08:00

LASIK is a surgical procedure for refractive errors. It consists of placing a suction device on the eye and using an oscillating blade to cut a circular flap of the cornea. The thickness of this flap depends on the surgeon but can vary from 100 microns to 180 microns (i.e., one to two tenths of a millimeter). The corneal flap is lifted and the Excimer laser is used to treat for the desired refractive error.

Refer to Dr. Hampton Roy's eBook on LASIK and Advanced Surface Ablation.

What is a cataract?

2006-02-01T18:40:00.000-08:00

Cataracts are clouding of the human lens. Cataracts may be associated with age, trauma, infection, inflammation, systemic illnesses, and congenital syndromes. The most common cause of cataracts is age. There are approximately one million cataract surgeries performed yearly in the United States. Contrary to common belief, cataracts cannot be removed by lasers. An ophthalmologist, i.e., eye surgeon, makes small incisions in the eye and uses a special surgical instrument to remove the opacified lens.

To learn more about cataract surgery, please refer to Dr. Oetting's eBook on Cataract Surgery.

What is a temporal artery biopsy?

2006-02-01T11:02:00.000-08:00

A temporal artery biopsy is a surgical procedure to assist in the diagnosis of temporal arteritis, also known as giant cell arteritis. Giant cell arteritis is an inflammatory disease of small to medium arteries and can be vision and life threatening.

Symptoms consist of:

temporal headache
scalp tenderness
loss of vision
double vision
jaw claudication
back and shoulder pain
loss of appetite
loss of weight
loss of energy

Video of a temporal artery biopsy.

What is age-related macular degeneration?

2006-01-31T17:56:00.000-08:00

Macular degeneration is a disease process that affects the eyes. Scarring, swelling, and the growth of abnormal blood vessels in the retina may affect the central vision.

Learn more in Dr. Folk's age-related macular degeneration column.

Index of Medical FAQ

2006-01-31T17:22:00.000-08:00

Topics
Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A Back to top

Alcoholism

What is naltrexone and can it be used to treat alcoholism?

Autism

What is Autism?

B Back to top

Bird Flu

Statistics & Deaths

Breast Cancer

Is breast cancer linked to estrogen use?

C Back to top

Cataracts

What is a cataract?

Cervical Cancer - Is there a vaccine?

Childhood Obesity

Cystinosis - What is cystinosis?

D Back to top

Debt - Medical School

E Back to top

F Back to top

Fuchs' Endothelial Dystrophy - What is Fuchs' Endothelial Dystrophy?

Fusarium keratitis

G Back to top

H Back to top

I Back to top

J Back to top

K Back to top

L Back to top

LASIK

What is LASIK?

M Back to top

Macular Degeneration

What is age-related macular degeneration?

N Back to top

O Back to top

Optic Nerve - Can damaged optic nerves be repaired?

P Back to top

Prostate Cancer

Is prostate cancer linked to genetics?

Q Back to top

R Back to top

S Back to top

Smoking Cessation - Is there a pill?
Sodas in schools

T Back to top

Temporal Artery Biopsy

What is a temporal artery biopsy?

U Back to top

USANA Vitamins and Supplements

V Back to top

W Back to top

X Back to top

Y Back to top

Z Back to top

Introduction

2006-01-31T17:18:00.000-08:00

Medrounds Q&A

We have answered frequently asked questions in medicine. If you have a question, then submit your question to us. These answers are provided for information purposes and do not replace the advice of your licensed physician.

The information contained herein, therefore, should not be used in determining diagnoses or treatments for patients in clinical practice. You should not act or rely on any information contained on this site without first seeking the advice of a physician. Those who follow diagnostic or treatment guidelines found on this website, do so at their own risk and liability. Under no circumstances shall MedRounds Publications, FEP International, the authors, or editors be liable for any damages resulting from use of the books, videos, software, and information found on this website.

Click below for a complete list of the questions in the Medrounds Q and A section. The questions are organized alphabetically based on subject.