Colorectal Cancer

August 5, 2017

The National Cancer Institute reports that over 136,000 people were diagnosed with Colorectal Cancer, and over 50,000 people died from this condition in the US last year, making it the second leading cause of death from cancer in the country. Some racial groups–minorities in particular—seem to suffer from this condition more than others, according to Dr. Jonca Bull, director of the Office of Minority Health for the FDA. The minority population (American Indians, African Americans, Hispanics, and Alaska Natives) is hit hard primarily because of limited access to medical treatment and screening. The biggest remedy for treating this condition is to attack it head on by doing early detection so the patient can be referred and treated, which will decrease the number of deaths occurring from this condition.

The Signs of Colorectal Cancer

The development of polys or other precancerous growths in the rectum (or colon) can turn into colorectal cancer. However, there may not be any outward symptoms if you have precancerous growths. Screening will help your doctor see what’s going on, so the growths or questionable can be removed if needed.

Your Risk for Colorectal Cancer increases if you:

  • Smoke
  • Have diabetes
  • Have a history of ulcerative colitis, Crohn’s disease or inflammatory bowel disease
  • Have a family history of colorectal cancer
  • Have certain genetic syndromes (such as FAP or Lynch)
  • Have a personal history of colon polyps or colorectal cancer

You should see your doctor also if you have any of these Symptoms, even though they do not necessarily indicate colorectal cancer:

  • Frequent bloating, fullness, cramps or gas pains
  • Unexpected Weight loss
  • A change in bowel habits (such as constipation, diarrhea and the sensation that the bowel does not empty completely)
  • Bright or dark blood in stool
  • Stools narrower than usual
  • Vomiting
  • Feeling very tired

The Benefits of Screening

Thanks to screening, surgery and medication, a lot of people with colorectal cancer are seeing a longer lifespan. Companion diagnostics are being conducted to determine if some people are less receptive to some medications than others due to genetic mutations.

There are also clinical trials available for those wishing to participate in research to discover new approaches to treating the condition. If you are considering a clinical trial, make sure you talk this over with your family and your health care provider.

How can I reduce my risk?

Your race, ethnicity, age, medical history, and other factors may increase your risk for colorectal cancer. Here are some ways to reduce the risk:

  • Don’t smoke and avoid second-hand smoke
  • Exercise often and vigorously
  • Eat healthy (adopt a diet high in fruits and vegetables but low in processed and red meats)
  • Drink alcohol in moderation
  • Maintain a healthy weight

If you wake up feeling irritable and like you haven’t had enough rest, and if your spouse complains about your snoring, you may have Obstructive Sleep Apnea (OSA).

OSA is a sleep disorder affecting over 12 million Americans, and it can affect your entire body and mental state if it goes untreated. Untreated OSA causes heart attacks, strokes, high blood pressure, car accidents, depression and work-related accidents.

The FDA (Food and Drug Administration) makes sure that the products used to treat OSA are effective. One of the most common devices used to treat OSA is the Continuous Positive Airway Pressure machine (CPAP), and there is also a new product called the Inspire Upper Airway Stimulation (UAS) System.

What is Sleep Apnea?

Apnea is the Greek word meaning “without breath.”  A person with sleep apnea experiences episodes where breathing is interrupted several times while asleep. The interruptions can last from a few seconds to a few minutes and can happen up to 100 times per hour. (It’s normal to have this happen less than five times per hour.). Sometimes when the breathing resumes, there’s a choking sound or loud snort.

The most common type of sleep apnea is obstructive sleep apnea, and it occurs because of a blockage of the airway (for instance, when the soft tissue in the back of the throat collapses). Central sleep apnea is a less common form of sleep apnea that occurs when the part of the brain that controls breathing doesn’t properly send signals to your breathing muscles.

Dr. Eric Mann, deputy director of the Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices for the FDA, states that most people don’t know they have sleep apnea because it takes place while they are asleep. The frequent interruptions in breathing that cause you to wake up keep you feeling tired and irritable the next day.

Sleep Apnea in Men more than Women. Risk factors for Sleep Apnea include:

  • smoking
  • being over age 40,
  • being overweight (The extra fat around the neck can obstruct the airway.)
  • a family history of sleep apnea, and
  • a nasal obstruction caused by allergies, sinus problems or a deviated septum

Some children can have sleep apnea between age 3 to 6 if they have enlarged adenoids and tonsils obstructing the upper airway.

Dr. Mann recommends consulting your health care provider as soon as possible if you suspect you (or your child) have sleep apnea. However, to get a confirmation of such diagnosis, there will have to be a sleep study.

A polysomnogram (PSG) is a sleep study used to determine a diagnosis of sleep apnea. It is often done in a lab or center to monitor eye movement, brain activity, blood pressure and how much air moves in and out the lungs.

Getting Treatment

Sometimes a change in our behavior can improve sleep apnea. For starters, we can try managing our weight and reducing the use of medicines and beverages (like alcohol) that makes us drowsy and also make it harder to breathe.

As stated earlier, the CPAP machine is the most commonly used treatment for OSA because it uses mild air pressure to prevent the airway from being blocked. Some devices only cover your nose and some cover both your mouth and nose.

Pubic crabs are tiny parasitic blood-sucking wingless insects that infest the human genitals, causing itching and red spots.

Pubic crabs affect sexually active adolescents and adults much more commonly than children. Pubic lice cannot survive for very long away from the warmth and humidity of a human body. Experts say that crabs are the most contagious STD (sexually transmitted disease).

Crabs can be treated without needing to go to see a doctor. There are pubic crabs treatment creams, lotions and shampoos available at pharmacies which do not require a doctor’s prescription.

Anybody with an infestation should also make sure that other people who came into close physical contact receive treatment; including all members of the household, not just sexual partners. In the majority of cases, the first pubic crabs treatment will be successful and all the lice will be killed off. However, the nits may still be there, with the risk of hatching. If you re-apply the medication after seven days it makes sure that any hatched lice will be killed off before they are mature enough to reproduce.

Juvenile Arthritis

June 21, 2017

Most people think arthritis only affects older people, but that is far from the truth.

Juvenile Arthritis has become a chronic childhood illness. About 300,000 children in the United States are diagnosed with arthritis. Typical symptoms include inflammation (swelling), joint pain, stiffness and tenderness. Morning time limping is also an early sign of juvenile arthritis.

Rheumatologist and FDA clinical team leader Nikolay Nikolov offers hope for those who have juvenile arthritis. Over the past few years, drug companies have been developing new treatments that can control the disease and its effects, which may reduce the onset of physical disability in later adult years.

The cause of juvenile arthritis is unknown, but what scientists do know is it is an autoimmune disorder in which the immune system attacks its own body tissue.

Juvenile Idiopathic Arthritis (JIA) is the name known for the collective group of conditions classified as juvenile arthritis that start before age 1 and has symptoms lasting for at least 6 weeks.

The wrists, ankles, knees and even smaller joints are impacted by JIA. Polyarticular JIA is the largest JIA subgroup because it impacts several joints. Systemic JIA is another subgroup that impacts the entire body and can cause skin rashes and fever.

Past treatment for juvenile arthritis included NSAIDS (non-steroidal anti-inflammatory drugs) like aspirin and ibuprofen. Corticosteroids and methotrexate are used in more severe cases to suppress immune response to the joints.

FDA-approved biologics (medicines originating from biological sources) are now being used to treat both systemic and polyarticular JIA.

Current JIA Treatments

Because of advanced science, doctors are now able to determine what encourages the occurrence of arthritis. Cytokines (molecules responsible for inflammation control in the body) like interleukins (IL), tumor necrosis factor (TNF) and other natural proteins that facilitate immune responses are the focus of new medicines.

Biologics are administered intravenously or subcutaneously (under the skin) over the course of several years to maintain symptom relief.  Not all biologics work the same on all subgroups of JIA.

Currently, there is no data on the long-term effects of these newer medications on children, but there is a lot of information on how these drugs affect adults with rheumatoid arthritis (RA). One also should be mindful that biologics suppressing the immune system can increase the risk of infections like tuberculosis in children.

All of us have had problems remembering something—like where we last put our car keys or where we last placed our glasses.

These occurrences are normal because the brain is always trying to sort, store, prioritize and retrieve information.  But where do we draw the line between normal memory loss and abnormal memory loss? The following checklist should help you make the distinction:

  • Does the memory loss interrupt your daily lifestyle (doing personal hygiene, balancing a checkbook and driving)?
  • Are there signs of confusion? Serious memory problems cause people to be lost even when they are in places they know. They may also move items to inappropriate locations (like putting deodorant in the refrigerator).
  • What’s being forgotten? The extent of the memory loss is another sign. When people start forgetting entire conversations, there’s a problem. Another sign is forgetting the names of people close, such as family and friends or repeating the same information in the same conversation.
  • How often do memory lapses occur? Forgetting where you parked every now and then is normal, but to forget your parking spot where you always park is abnormal.When you start forgetting regular appointments and events, those are signs your memory problems are disrupting your daily functions.
  • Is the memory loss getting worse? If it seems like the memory lapse episodes are occurring more frequently, then you need to seek medical help to get examined.

What Causes Memory Loss?

Anything that can impact mental functions—thinking, remembering and learning—can affect memory.  Therefore, doctors must employ a variety of strategies to determine what’s happening to cause the memory loss.

Medical history, neurological and physical exams, blood tests and urine tests are all used to help determine the cause. Computerized axial tomography (CAT) scans or magnetic resonance imaging (MRI) are brain imaging tools used to rule out tumors and strokes, which can also affect memory.

All these strategies are used to rule out other more dangerous causes of the memory loss. Some causes of memory loss happen alone or in combination with other causes:

  • Stress, especially the kind related to emotional trauma, can impact the ability to remember. In rare instances, patients can develop psychogenic amnesia, which causes wandering and an inability to remember one’s own identity. However, this condition does leave on its own over time.
  • Excessive use of alcohol creates vitamin B1 (thiamine) deficiency, which can create memory loss. Drug abuse can also impact the chemical makeup of the brain and impact memory.
  • Medications: prescription and OTC over-the-counter) sleeping pills, antihistamines, antidepressants, certain medicines used to treat schizophrenia, some post-surgery pain medications and anti-anxiety medicines can impair memory.
  • A blow to the head can cause temporary memory loss that gets better over time. More severe cases like frequent head blows (from boxing and football, for example) can create progressive and more long-term memory loss with a host of other conditions.
  • Depression, especially in the elderly) can create a decrease in focus and attention that may impact memory.  Anti-depression treatments will change the person’s mood and improve memory.
  • Deficiencies of vitamins B1 and B12 can cause memory loss, but the deficiencies can be remedied with injections or pills.
  • An overactive (or underactive) can interfere with remembering recent events.
  • Poor sleeping habits can have a negative impact on your memory.
  • HIV, tuberculosis, syphilis, herpes, and other infections affecting the lining or substance of the brain can create memory issues.

New Tobacco Rules

May 29, 2017

What does this new rule do?

The new tobacco rule establishes discourse taken over seven years ago concerning the regulation of cigarettes. As of  June 2009, The President and Congress passed the Family Smoking Prevention and Tobacco Control Act to give the FDA power to regulate the making, distribution, and selling of tobacco products (cigarettes, cigarette tobacco, smokeless tobacco ad roll-your-own tobacco).

This rule has several implications now.

This authority also applies to recent tobacco creations like e-cigarettes, ENDS (electronic nicotine delivery systems), cigars (even premium), hookah (also known as waterpipe tobacco), pipe tobacco, nicotine gels and dissolvables.

Health warnings are required on all tobacco-related products, and free samples are prohibited. Also, manufacturers of products that hit the market after February 15, 2007 must make sure their products meet FDA health standards to get FDA approval.

This act also prohibits the sale of all tobacco-related products to minors (people under age 18) and in vending machines not placed in adult-only locations. A government issued ID must be presented to verify age to purchase tobacco products.

What was the FDA’s point in doing this act?

Because of the detrimental effect of tobacco on public health, the FDA’s role in implementing the Family Smoking Prevention and Tobacco Control Act is to help reduce the risk of tobacco-related diseases and death.

FDA regulation does not equate to endorsing the products as being safe to use. However, it does stop the sale of products like hookah, cigars, and e-cigarettes to people under 18 years of age.  Although there is a significant decrease in traditional cigarette use among youth, there is a marked increase in the use of other tobacco-related products. The FDA and the Centers for Disease Control and Prevention. (CDC) report that over 16 percent of the high school population smokes e-cigarettes (up from 1.5% in 2011), and there is a great increase in the use of hookah.

But aren’t e-cigarettes safer than regular cigarettes?

The FDA realizes that not all tobacco-related products have the same level of potential harm. Therefore, the nature of tobacco regulation will change when the FDA has more information on the extent of harm all new tobacco-related products cause.

The FDA recognizes that some of these new technological tobacco products can be both beneficial and harmful. For example, e-cigarettes can reduce air pollution and encourage people to change from using real cigarettes. However, if products like these promote more youth encouragement to use tobacco and promote more encouragement for people to not stop using tobacco-related products, then their effect is negative on society.

The current goal of the FDA is to persuade manufacturers to consider new products that have a more beneficial impact on society than a negative one. The Family Smoking Prevention and Tobacco Control Act gives the FDA power to research the effect of these products on users and non-users and regulate how these products are marketed.

Think about using an over-the-counter (OTC) antacid product for upset stomach or heartburn that does not contain aspirin.

The U.S. Food and Drug Administration (FDA) says that if you use an aspirin-containing product for acid indigestion, upset stomach, sour stomach or heartburn, you risk the potential for having stomach or intestinal bleeding.

To date, stomach bleed cases are rare but possible. Since 2009, the FDA has warned about the potential for stomach bleeding risk when consuming aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). However, there have been reports of antacid products causing that same effect since the 2009 caution, and some people have had to get a blood transfusion.

Most people don’t consider the potential of stomach products causing more stomach problems because they don’t read the label. Therefore, when considering a product for treating a stomach ailment, always check out the Drug Facts label to see if the product contains aspirin. If it does, you may want to find another product that is friendlier to your stomach.

It’s not that the FDA does not want people to use aspirin at all. The FDA just feels it’s important consumers are educated about the risk antacid products with aspirin can have.

So, when considering which OTC antacid to take for upset stomach, all you have to do is read the Drug Facts label to see if the product has aspirin and has a warning about stomach bleeding. If the medicine contains aspirin, you still have a lot of other options out there that don’t.

Who’s at Higher Risk of Bleeding

The FDA believes antacids with aspirin influence stomach bleed episodes because aspirin acts as a blood thinner. People with risk factors for stomach bleeding are more prone to have a bleeding episode than others when using these products.

People at a higher risk for bleeding when using aspirin-containing aspirin products are people who:

  • Are age 60 or older.
  • Have a history of stomach bleeding or ulcers.
  • Take anticoagulants or blood thinners that reduce the body’s ability to form blood clots.
  • Take steroids to treat inflammation (like prednisone)
  • Take other NSAIDs (like naproxen or ibuprofen).
  • Consume three or more alcoholic drinks daily.

Signs of stomach/intestinal bleeding are abdominal pain, bloody (or black) stools, vomiting blood or feeling faint. If you experience any of these signs, get medical attention as soon as possible.

How to Settle an Upset Stomach

There are alternative treatments for soothing stomach ailments. Look for product labels that say the product is an acid reducer or antacid.

A lot of products on the market for stomach ailments only have antacids like magnesium hydroxide, calcium carbonate or some other antacid. If you suffer from frequent heartburn, you can get acid reducers like H2 blockers (ranitidine, famotidine, cimetidine) or proton pump inhibitors (esomeprazole, omeprazole or lansoprazole).