Posted in Health, news, food

Vietnam Vets May be Unknowingly Battling Deadly Parasites

Image above from Veronidae/Medical News Today

A study finds many Vietnam veterans may have contracted liver flukes decades ago that could now cause pancreatitis, liver disease and/or bile duct cancer.

The Department of Veterans Affairs commissioned a study that looked at bile duct cancer and liver flukes that may have been ingested by veterans while on tour in Southeast Asia during the Vietnam War.

This was in response to a story reported by the Associated Press in which 700 cases,of cholioangiocarcinoma, bile duct cancer, were seen in VA facilities over the last 15 years.

The current small study looked at 50 blood samples, finding 20% of which to be positive for liver flukes.  Most participants were not aware they were infected.  If infection did later lead to cancer, symptoms would come late in the diagnosis.

Tropical medicine specialist, Sung-Tae Hong, from Seoul National University in South Korea, stated he was “surprised” by the results and admits to more research needing to be done.

Cholioangiocarcinoma is still rare, however if Vietnam veterans are at increased risk due to their fish consumption while on duty, they need to be followed closely by their medical provider. Stool tests could be done to look for parasite eggs, and blood tests may look for antibodies fighting the infection.

What is a liver fluke?

Liver flukes are parasites that infect the liver and bile duct.  There are multiple species.  The disease Fasciola hepatica and Fasciola gigantica cause is called fascioliasis. Symptoms may range from none to severe liver disease.  But the liver flukes associated with bile duct cancer include Opisthorchis viverriniO. felineus, and Clonorchis sinensis.  According to the US Department of Veterans Affairs:

 The irritation and scarring caused by liver fluke infection can lead to bile duct cancer.

Two parasites are commonly involved. One is Opisthorchis verrini, which is found in Southeast Asian countries, including Thailand, Lao People’s Democratic Republic, Vietnam, and Cambodia. The other is Clonorchis sinensis, which is common in rural areas of Korea and China.

Eating raw or undercooked fish infected with these parasites introduces the pathogen into the GI system where it can hide out in the liver and bile ducts for decades.

In 2007, Sripa et al discussed how close to 600 million people were at risk of being infected with liver flukes.

In 2011, Lim et al wrote, “More than 35 million people worldwide are infected. The exceptionally high incidence of cholangiocarcinoma in Thailand and Korea is attributed to the high prevalence of liver fluke infection in these areas.”

How does one get contract liver flukes?

In addition to ingesting undercooked contaminated fish, liver flukes can infect multiple mammals, such that eating infected cattle or sheep liver (if undercooked) could transmit the parasite.  Ingesting vegetables washed with contaminated water could introduce the fluke into a person as well.

Medical News Today recommends boiling all untreated water and to avoid water from a stream near where cattle and sheep live.

What are the symptoms of infection with liver flukes?

Although some people with liver flukes may exhibit no symptoms at all, some may incur:

  • Fatigue
  • Abdominal Pain
  • Fever
  • Nausea
  • Vomiting
  • Diarrhea
  • Jaundice – yellowing of the skin and whites of eyes
  • Itchy skin
  • Weight loss

What is the prognosis of cholangiocarcinoma (bile duct cancer)?

According to cancer.net, the 5 year survival, meaning living 5 years past diagnosis, is 30%, assuming the cancer stays locally.  If the cancer spreads to regional lymph nodes prognosis  for 5 year survival drops to 24%. Distant spread of the cancer reduces the 5 year survival rate to 2%.

gallbladder image.jpg

What is the treatment for liver flukes?

Antiparasite medications, such as triclabendazole, have proven effective against Fasciola. Praziquantel has been effective in fighting Opisthorchis infections.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

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Posted in Entertainment, Health, news

David Cassidy dies, age 67.

“Partridge Family” and 70’s teen heart-throb, David Cassidy, has passed away from liver and kidney failure.

Jo-Ann Geffen, president and CEO of JAG Entertainment, said in the following statement, “David died surrounded by those he loved, with joy in his heart and free from the pain that had gripped him for so long. Thank you for the abundance and support you have shown him these many years”.

The 67-year-old had been awaiting a transplant when he fell into multi organ failure a few days prior.

Earlier this year, Cassidy had fallen off the stage during a performance in California and revealed to People Magazine he was suffering dementia.

He had multiple drunk driving offenses and in 2015 was charged with a hit-and-run while intoxicated.  In the latter case, he was given two years probation and his licence was suspended until 2021.

Cassidy has been very open about his battle with drug and alcohol addiction, both of which have been linked to liver and kidney failure as well as early dementia.

David Cassidy rose to fame playing Keith Partridge in the hit 70’s show, The Partridge Family.  He became a teen sensation overnight and pop idol with songs such as “I Think I Love You.”

partridge-family-promojpg.jpg

What causes multiple organ failure?

Multiple organ failure, or multi-organ failure, or Multiple Organ Dysfunction Syndrome (MODS), can be caused by a variety of factors.  Sepsis, or blood infection, is the most common cause.  Yet trauma, inflammation, or lack of blood flow to the organs can cause them to fail as well.

Mortality rate ranges anywhere from 30-100%.

SIRS (Systemic Inflammatory Response Syndrome), without a definitive cause, can cause hypoperfusion and hypotension causing lack of blood flow to the organs inducing failure.

So infection, ischemia (lack of blood flow), inflammation can all trigger an organ or multiple organs to malfunction.

To treat MODS, critical care needs to be instituted immediately to maintain blood flow and oxygen to the organs while the cause is being determined.  If the liver and kidneys cannot recover, organ transplant may be considered.

This is a developing story.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, food

The Holidays and the In-laws: Your Step by Step Guide

 

Thanksgiving is here!! Good food, no school, no work, and most of all….. family!!

For many this is one of the best holidays ever!!

For some…..the most dreaded all year.

This is your very rare and valuable time off, and you have to spend all of it with people who don’t like you and you’re not particularly fond of. Four days of staying with family, (especially if they don’t let you stay a hotel and insist you stay with them), can be more than many can bear.

So here are some steps you can take to make the holidays easier.

1. Huddle up

huddle

Usually your spouse wants to avoid controversy just as much as you do.  Before the encounter, huddle up and create a strategy for:

a.  How to deal with insults

b.  How to take a break – take the car to go grab some last-minute Thanksgiving necessities

c.  Where you get to sit at the table

d.  Potential arguments regarding the children and their upbringing

2.  Try to get a hotel room

hotel

This gives you the much-needed reprieve at the end of the day.  However, if the family insists you stay with them and 4 nights at Hotel Hell are just too much to bear, plan a “sneak away” for an evening with your wife and tell the Grandparents they will host the kid’s slumber party.  Remember to thank them for the huge favor they are doing allowing you and the wife a much needed night away “from the kids” …wink…wink…..

3.  Football

prescott

Thank Heavens the Cowboys are playing this Thanksgiving.  Usually there is someone else in the family just as sane as you are when it comes to football, so you can immediately partner with him to get the television on and the game playing.  Although this may only give you a 15 minute “out” of the family festivities, its 15 minutes of pure euphoria.

4.  Remember you have sciatica

sciatica

The most difficult part of Thanksgiving/Christmas is sitting at a table for hours and usually trapped, physically, because the chairs are pushed together so tight that you can’t push out the chair. If you ever, ever, ever had an issue with your back, knee, leg, muscle, or even pinky toe, use this as an excuse to heave the table forward so you can get up and stretch your legs.  Slowly limp over to the living room where hopefully you left the football game on……

5.  Get called to work

work

No in-law can or wants to take on your boss.  So during the 7 day stent, politely excuse yourself if you need to go onto a computer, make a phone call, or drive 60 miles away for “work”.  Make sure your spouse is on board with this one……

6.  Have “diarrhea”

toilet

You get to leave the room and no one wants to be near you.  You just gained escaping 3-5 times/hour since you need to “run” to the bathroom.

7.  Inform the family you feel a cold coming on

cold

Don’t jinx yourself but this gets you out of hugs, and sloppy lipstick kisses…..

 

 

Ok this gives you a well-coordinated exit plan but what happens if they are on to you?  How do you deal with the remaining, 3 days, 23 hours and 45 minutes?

1.  Don’t take it personally

When the insults and digs come, don’t feel like these personal attacks need to stick.  You have enough people in your life telling you your shortcomings.  The in-laws are either being redundant or telling you something that doesn’t hold true.

2.  You’re not alone

Millions of adults are in the exact same position as you at the same moment in time.  You’re not alone.  Just sneak a peek on facebook and you’ll scroll through hundreds of “Ugh!!!!”s………..

3.  Make a game of it

Bet your wife or coworker that you will get the most insults over the holiday than they will and write down or note every time it happens. The more it occurs, you win.  Compare notes or use it as a “get out jail free card” with your spouse.

4.  Have a happy place

Negotiate with your spouse prior to the holiday a “free day” or “free weekend” that you will earn upon completion of a 7 day holiday with the in-laws.  Plan and fantasize about this reward throughout your tour of duty to make the path easier

5.  Bring the pets

cat-1

Since you are usually outnumbered during these family events, why not have non humans come to your aid.  Dogs need to be walked, cats need to be chased, so this gives you an out and gives you a much-needed buddy during the hard times.

 

Look, it’s not easy, but remember why you’re there.  For YOUR family.  Your spouse and kids need to spend the holidays with you so grin and bear it.  And remember you may be luckier than the average guy.  He could be spending the WHOLE WEEK!  Ahhh, you DO have something to be thankful for.  Happy Thanksgiving!!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

 

Posted in Health, news, sex

Sex Improves with Vasectomy

WARNING:  Graphic medical image and content below

 

A study finds men who have had a vasectomy report stronger erections, more frequent orgasms and increased sex drive.

Reported by Askmen.com and Daily Mail, researchers from Frankfurt University studied 294 couples and found men who had undergone a vasectomy reported having a 12.4% increase in sex frequency.

Researchers believe that the stress of getting one’s partner pregnant is a dampening factor in erections, orgasms and frequency, hence those with a vasectomy could be more free.

Condom use has also been known to interfere with orgasms and erections.

Female satisfaction was noted not to be hindered by vasectomy as well.

So does the anxiety of getting one pregnant supersede the anxiety of getting a vasectomy?  Probably not.

According to WebMD, 500,000 vasectomies are performed each year, accounting for 9% of sexually active men in the US. So its not as popular a procedure as one would think.

A vasectomy is an outpatient procedure in which the medical provider cuts and seals the vas deferens, or tube transmitting sperm from the testicles.  The semen then is devoid of sperm and renders the man infertile.

vasectomy

The procedure takes about 15-30 minutes and most men can return to work within a few days.

The no scapel technique requires a tiny opening to draw out the vas deferens in order for the physician to cut and tie off and usually no sutures/stitches are required.

vasectomy image

At the 3 month mark, or 20 ejaculates, most semen will be free of sperm, but testing will be done until infertility is confirmed.

20 of every 10,000 couples may still become pregnant but vasectomies are overall found to be 99% effective.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Entertainment, Health, news

David Cassidy is in Multi-Organ Failure

“Partridge Family” and 70’s teen heart-throb, David Cassidy, has been admitted to a Florida hospital in multi-organ failure.

The 67-year-old is reportedly in an induced coma and is awaiting a transplant.  Multiple reports have suggested he’s waiting for a kidney and some state a liver transplant.

david-cassidy-partridge-family

Earlier this year, Cassidy had fallen off the stage during a performance in California and revealed to People Magazine he was suffering dementia.

He had multiple drunk driving offenses and in 2015 was charged with a hit-and-run while intoxicated.  In the latter case, he was given two years probation and his licence was suspended until 2021.

Cassidy has been very open about his battle with drug and alcohol addiction, both of which have been linked with liver and kidney failure.  Its been unclear what treatment the actor has had after his arrests and probation.

What causes multiple organ failure?

Multiple organ failure, or multi-organ failure, or Multiple Organ Dysfunction Syndrome (MODS), can be caused by a variety of factors.  Sepsis, or blood infection, is the most common cause.  Yet trauma, inflammation, or lack of blood flow to the organs can cause them to fail as well.

Mortality rate ranges anywhere from 30-100%.

SIRS (Systemic Inflammatory Response Syndrome), without a definitive cause, can cause hypoperfusion and hypotension causing lack of blood flow to the organs inducing failure.

So infection, ischemia (lack of blood flow), inflammation can all trigger an organ or multiple organs to malfunction.

To treat MODS, critical care needs to be instituted immediately to maintain blood flow and oxygen to the organs while the cause is being determined.  If the liver and kidneys cannot recover, organ transplant may be considered.

This is a developing story.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, Politics

Rev. Jesse Jackson Reveals He is Battling Parkinson’s Disease

Civil right’s activist, Jesse Jackson, revealed Friday that he’s been diagnosed with Parkinson’s disease.

The 76-year-old two-time Democratic presidential candidate stated he and his family noticed changes three years ago and, “after a battery of tests, my physicians identified the issue as Parkinson’s disease, a disease that bested my father.”

His father, Noah L. Robinson, died in 1997 at the age of 88 of a heart attack and complications of Parkinson’s.

What is Parkinson’s Disease?

Parkinson’s disease is the second most common neurodegenerative disorder, next to Alzheimer’s, and the most common movement disorder that affects 1% of the world’s population over 60 years old. In the US, 60,000 new cases are diagnosed each year.  It affects several areas of the brain, primarily the substantia nigra, altering balance and movement by affecting dopamine producing cells.

substantia nigra

Image from the Science of Parkinson’s Disease

It was first described in 1817 by James Parkinson as a “shaking palsy.”

What are the Symptoms of Parkinson’s?

Common symptoms of Parkinson’s include:

  • Stiffness and rigidity
  • Poor balance
  • Tremor at rest, especially a pill-rolling tremor
  • Slow movement
  • Inability to move
  • Shuffling steps, gait

and patients may later develop…

  • Depression
  • Anxiety
  • Memory loss
  • Constipation
  • Decrease ability to smell
  • Difficulty swallowing
  • Erectile dysfunction
  • Pneumonia
  • Fractures from falling
  • Hallucinations
  • Delusions
  • Dementia

Who is at Risk for Parkinson’s?

Most cases are idiopathic, meaning the disease arises with no specific cause.  However some cases are genetic and multiple genes have been identified that are associated with the disease.

The average age of onset is 60, but some cases may occur as “early onset”, before the age of 50, and if before the age of 20, it is known as juvenile-onset Parkinson’s.

Men appear to be more affected than women at twice the rate.

Risk may be enhanced with a history of head trauma.

Exposure to herbicides and pesticides has been linked to an increase risk of Parkinson’s as well.

 

How Quickly do Parkinson’s Symptoms Progress?

Average progression rates can last years to decades, however, earlier onset disease may manifest much quicker.

The stages of Parkinson’s are illustrated below:

What-Are-the-Stages-of-Parkinson_s-Disease

How is Parkinson’s treated?

Although there is no cure for Parkinson’s, symptoms can be treated by a variety of measures.

  • Levadopa – converts to dopamine in the brain, helping replace the deficient hormone.
  • Carbidopa (Sinemet) – if given with levadopa prevents the latter from being broken down before it reaches the brain.
  • Dopamine agonists – mimic dopamine
  • MAO-B inhibitors – helps block the enzyme MAO-B, which breaks down natural dopamine
  • Other medications including COMT inhibitors, amantadine and anticholinergics
  • Medications to treat anxiety and depression
  • Deep brain stimulation – a surgeon implants electrodes into the brain, allowing stimulation of parts that help regulate movement.
  • Stem cell therapy – being investigated as a means to create dopamine-producing cells
  • Physical and occupational therapy

 

Famous People Diagnosed with Parkinson’s

  • Michael J. Fox
  • Janet Reno
  • Robin Williams
  • Muhammad Ali
  • Casey Kasem
  • Johnny Cash
  • Linda Ronstadt
  • Pope John Paul II
  • Peanut’s creator Charles Schulz

It’s been postulated Adolf Hitler suffered from Parkinson’s as well.

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Fast Eaters are More Likely to Gain Weight

Another study has found eating too fast may lead to weight gain and metabolic syndrome.

Researchers from Hiroshima University in Japan found that those who ate their meals quicker were more likely to suffer from metabolic syndrome.

What is metabolic syndrome?

Metabolic syndrome is comprised of a group of risk factors that puts one at risk for heart disease, diabetes and stroke.  Any three of the following classify as one having metabolic syndrome:

  • Large waistline or apple shaped habitus
  • High blood pressure (over 130/80)
  • High fasting blood sugar (over 100)
  • High triglyceride level
  • Low HDL (good cholesterol)

Researchers looked at 1000 people in 2008 who didn’t have metabolic syndrome and rated them as slow eaters, normal eaters and fast eaters. Those who scarfed down their food were more likely to develop metabolic syndrome within 5 years.

Previously I discussed how our eating speed has helped fuel our obesity crisis.

***************************

Fast food has become the staple of many American and European diets and we’ve seen obesity rise.  True more people take public or private transportation to work over walking, and many have given up smoking every time they had a hunger itch, but the most popular reason for our waistline increase is fast food.  But is it the caloric content of the fast food that’s fueling the obesity epidemic, or the speed at which its ingested?

What is Fast Food?

According to the Merriam-Webster dictionary, Fast Food is “food that can be prepared and served quickly”.  A burger, shake and fries is considered fast food but so is a take away salad or sandwich.  It’s implied that fast food is a meal that is not made fresh but made previously and preserved such that it can taste fresh when needed to be served.

How Caloric is Fast Food?

According to CalorieKing, a McDonald’s Big Mac is 540 calories.  A large order of fries is 510 calories.  So a meal over 1000 calories is obviously not the healthiest choice.

But let’s return back to the sandwich alone.  While a Big Mac is 540 calories, CalorieKing finds Chick-Fil-A’s Cobb Salad (without dressing) 500 calories.  Bob Evans Restaurant’s Cobb Salad is 516 calories.

fast food.jpg

Now on the same site a Tuna Salad Sandwich (5 oz) w. mayo, 3 oz Bread is 679calories.

So are we becoming obese eating cobb salads and tuna salad for lunch just as one would eat a Big Mac?  We don’t know since people don’t study cobb and tuna salad eating consumers.  My guess is No.

Are we eating too fast?

Yes, and so fast that I believe it could be messing with our metabolism.

Think back to caveman days.  We had to chew.  And not on a soft sesame seed bun, but chew our meat.  Nuts and vegetables took a chewing as well.  Food was more scarce so it was savored and meals weren’t on the run while on a subway or at a stop light in one’s car.

Previous studies have shown that eating slowly and chewing it multiple times allow the body’s signals to trigger the satiety sensation sooner, hence one would eat less.

So gulping down a burger in 5 bites could be accomplished prior to the brain receiving the signal that it should be satisfied.

Now the metabolism issue.  Fast food could contain sugars, fats and preservatives that alter metabolism.  But eating on the run could cause metabolism issues in and of itself.

When a body senses that the food source is short-lived, unpredictable, and coming at a speed preventing proper absorption of nutrients, it may slow down metabolism to allow the body to make the most of what it has.  Eating a meal slow and methodical may be the most successful way to not only feel full but to eat less and lose weight.

I suggest a study be done looking at two groups of people eating the same food with the same caloric content but differing on the speed at which they eat it.

I suggest to you all to take an extra 15 minutes to complete your meal than what you’re accustomed to and determine if you see results after a few weeks.

Of course avoiding fast food would be the most beneficial for our weight but if you must eat fast food, eat it slowly.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician