Posted in Health, news

Parkinson Risk Tied to Appendix Removal

Those who have had their appendix removed may be at 3X greater risk of later developing Parkinson’s.

Researchers at Case Western Reserve University and University Hospitals Cleveland Medical Center looked at 62 million health records from 26 institutions throughout the US and found that those who had an appendectomy, surgical removal of the appendix, had a 3-fold risk of developing Parkinson’s later in life.

Internal medicine second year resident and study author, Dr. Mohammed Z. Sheriff, states,

“Recent research into the cause of Parkinson’s has centered around alpha synuclein, a protein found in the gastrointestinal tract early in the onset of Parkinson’s.”
“This is why scientists around the world have been looking into the gastrointestinal tract, including the appendix, for evidence about the development of Parkinson’s.”

Researchers suggest more research to be done, with investigational focus on gut health as it relates to neurological health.

The Appendix: NOT a useless organ

 

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
  • Rev. Jesse Jackson
  • Neil Diamond

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

 

spanish book

Learning Medical Spanish is Easy!!!

 

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

Posted in Health, news

Appendicitis May Be Treated With Antibiotics

For decades, scientists have debated whether surgery was necessary for all appendicitis cases.  Well another study has suggested antibiotics may be a suitable alternative.Finnish researchers found in uncomplicated cases of an inflamed appendix (not ruptured) antibiotics will successfully treat 62% of the time.

Dr. Paulina Salminen and her colleagues looked at 267 patients with appendicitis who were treated with antibiotics and found 167 of them, after 5 years, were still going strong.  100 patients, however, did have their appendixes removed within the follow-up period.

Considering the risks that come with surgery, some patients might prefer to take antibiotics instead.  Moreover, even if surgery may be required down the line, antibiotics may prevent the need for “emergent surgery” allowing at-risk patients who may, for example, have uncontrolled diabetes or blood pressure, have time to stabilize their co-morbid conditions before entering the operating room.

Dr. Salimen states, “It’s a feasible, viable and a safe option.”

CT-Scan-Appendix.jpg

Some patients, or physicians, however, may not be impressed by these numbers as of yet and find surgically removing the appendix a more prudent option if a future surgery appears to be inevitable.

The Appendix: NOT a useless organ

In medical school we learned that nothing in the body is useless.  Well maybe my ovaries have become so, but that will be discussed in my next article on facial hair.

It troubled many of us in the medical profession that an appendage attached to the right sided colon, cecum to be specific, would be useless.   We have to study the appendix profusely in school as an appendicitis attack is not one to be misdiagnosed.  I took out so many appendixes in my training that I could do it blindfolded.  This “vestigial structure” denoting it didn’t have a function, did so as far as I was concerned.  It averaged approximately 10 cm, was about 1 cm in diameter when not swollen and abscessed and was a uniquely hollow tube.

If an organ or body part becomes useless, nature selects it out.  This is why humans don’t have tails. We can pull eachothers hair if we need pull something.  Over 500 animal species have appendixes.  Must be for a darn good reason.

Grammar note.  The plural word for the organ appendix is “appendixes”.  If we were discussing a segment in a book, it would be “appendices”.  

Then in 2007, a team of immunologists from Duke University reported that the appendix has a function:  to produce and harbor healthy bacteria that can help “reboot” the gut when it becomes low in its microbiota.  Makes sense.  But not everyone got the memo and I overheard people in line at Starbucks talk about how the appendix was useless all over again.

In January 2017, scientists at Midwestern University Arizona College of Osteopathic Medicine again confirmed that the dangling worm like tube had a purpose. Not only did they believe the appendix to be a reservoir for good bacteria but also play a role in our immune system with its high level of lymphoid tissue.  Dr. Heather Smith, lead author, stated “In animals that have an appendix, there is a higher concentration of lymphoid tissue in the cecum.”   Moreover she said, “The appendix has a concentration of good gut bacteria that can repopulate the gut.”

The cecum is a pouch like structure that marks the beginning of the large intestine.  It receives the food that was digested in the small intestine and starts its passage through the colon, which will absorb its water content and prepare it to become its dream…..poop.

 

cecum-and-appendix

GRAPHIC FROM HTTPS://WWW.NEWHEALTHADVISOR.COM/PARTS-OF-THE-LARGE-INTESTINE.HTML

We see more and more studies discussing our digestive system’s bacteria and its role in our health.  It would make perfect sense that our colon had a means to repopulate its bacteria inhabitants if stress, antibiotics, or diarrhea washed it away.  As we come to learn that we big organisms rely more and more on microorganisms, we face the fact that the simplest of all creatures deserve credit for our existence.  Its time we appreciate the simplest of organs as well……our friend the appendix.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

The Appendix: NOT a useless organ

In medical school we learned that nothing in the body is useless.  Well maybe my ovaries have become so, but that will be discussed in my next article on facial hair.

It troubled many of us in the medical profession that an appendage attached to the right sided colon, cecum to be specific, would be useless.   We have to study the appendix profusely in school as an appendicitis attack is not one to be misdiagnosed.  I took out so many appendixes in my training that I could do it blindfolded.  This “vestigial structure” denoting it didn’t have a function, did so as far as I was concerned.  It averaged approximately 10 cm, was about 1 cm in diameter when not swollen and abscessed and was a uniquely hollow tube.

If an organ or body part becomes useless, nature selects it out.  This is why humans don’t have tails. We can pull eachothers hair if we need pull something.  Over 500 animal species have appendixes.  Must be for a darn good reason.

Grammar note.  The plural word for the organ appendix is “appendixes”.  If we were discussing a segment in a book, it would be “appendices”.  

Then in 2007, a team of immunologists from Duke University reported that the appendix has a function:  to produce and harbor healthy bacteria that can help “reboot” the gut when it becomes low in its microbiota.  Makes sense.  But not everyone got the memo and I overheard people in line at Starbucks talk about how the appendix was useless all over again.

This month, scientists at Midwestern University Arizona College of Osteopathic Medicine again confirm that the dangling worm like tube had a purpose. Not only did they believe the appendix to be a reservoir for good bacteria but also play a role in our immune system with its high level of lymphoid tissue.  Dr. Heather Smith, lead author, stated “In animals that have an appendix, there is a higher concentration of lymphoid tissue in the cecum.”   Moreover she said, “The appendix has a concentration of good gut bacteria that can repopulate the gut.”

The cecum is a pouch like structure that marks the beginning of the large intestine.  It receives the food that was digested in the small intestine and starts its passage through the colon, which will absorb its water content and prepare it to become its dream…..poop.

cecum-and-appendix

Graphic from https://www.newhealthadvisor.com/Parts-of-the-Large-Intestine.html

We see more and more studies discussing our digestive system’s bacteria and its role in our health.  It would make perfect sense that our colon had a means to repopulate its bacteria inhabitants if stress, antibiotics, or diarrhea washed it away.  As we come to learn that we big organisms rely more and more on microorganisms, we face the fact that the simplest of all creatures deserve credit for our existence.  Its time we appreciate the simplest of organs as well……our friend the appendix.

 

 

                                                                                                         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