Skip to content

Category: Uncategorized

Published on Leave a comment on Perhaps No Treatment Is Best For Tennis Elbow?

Suffering from "tennis elbow" ? A new study suggests that it may be best to just wait for the elbow to heal on its own.

Tennis elbow is the painful condition that develops after "overuse" - it's a repetitive stress injury, which typically occurs in the person's dominant arm. The medical name for tennis elbow is enthesopathy of the extensor carpi radialis brevis (eECRB), or lateral epicondylitis. There are many non-surgical alternatives available, such as ultrasound, laser therapy, botulinum toxin injection, corticosteroid injection, etc., but there has been controversy over what works best in reducing pain and improving grip strength (grip strength is diminished in tennis elbow).

Researchers at Beth Israel Deaconess Medical Center compared 11 non-surgical methods of treating tennis elbow, including a placebo group (which received a "sham treatment", such as a saline injection to mimic a treatment, but really was a no treatment group. They reviewed 36 high quality studies, and found that for persons receiving only a placebo - within four weeks most reported little or no pain, and by 26 weeks 99 percent reported little or no pain. Those who received no treatment (placebo) also had the fewest side-effects (e.g. worsened pain, reduced elbow movement, skin rash, nausea, allergic reaction). The odds of an adverse effect was significantly greater in all treatment groups than in the no treatment (placebo) group.

The researchers did mention that of all the treatments, only laser therapy improved both pain and grip strength more than placebo at one month. Some treatments, such as corticosteroid injections, while relieving pain short-term (in the first month), resulted in more pain at 26 weeks than individuals who received no treatment. The researchers wrote: " At best, all treatments provided only small pain relief while increasing the odds of adverse events." They also said that perhaps some people, such as manual laborers, may benefit by short term pain relief treatments. But long-term - doing nothing is best.

From Science Daily: Tennis elbow treatments provide little to no benefit, study finds        ...continue reading "Perhaps No Treatment Is Best For Tennis Elbow?"

Published on Leave a comment on We Are Eating and Breathing In Tiny Plastic Particles?

Most people have heard about the three huge "garbage patches" in the ocean - where tiny pieces of plastic are floating and unfortunately also being eaten by fish and birds. But the story doesn't end there - we, all humans, are also ingesting tiny pieces of plastic, for example when we breathe and eat food (e.g tiny pieces are now in fish and shellfish, so we're also eating tiny pieces of plastic). How much are we inadvertently ingesting?  What is it doing to us? 

These tiny pieces of plastic less than 5 mm in size are called microplastics. As we know, plastic doesn't break down like food and wood (into compost, soil), but it does break apart into tiny particles (from friction, heat, and light). Right now research suggests that we are exposed to more microplastic particles in indoor air then outdoor air - for example, it's in the dust from breakdown of textiles used in our furniture and synthetic fabrics in the clothing we wear and wash. (Fleece especially sheds a lot into the air when worn and into our water when washed.) There are plastic microparticles in the air, in the wind, in our street dust. Examples of microplastics in outdoor air are from the use of vehicles, such as tire abrasion, construction activities, from artificial turf, and plastic litter. It's in our water - in rivers and lakes (and our drinking water), oceans, and in our soil.

Right now no one knows what the effects of ingesting these plastic microparticles are to humans (as pointed out in a 2017 study of urban dust by  Sharareh Dehghani et al) and whether we get rid of them or whether they persist in the body. Or even how much we're ingesting and breathing in. Another concern is whether there is an effect on developing children. Some research finds that microparticles can persist in the lungs.

The good news is that there are things one can do to lower the microplastic amounts in indoor air. To lower the amount of microplastics: open up your windows to vent the air (outdoor air is less polluted generally than indoor air), vacuum frequently, use a good filter on forced air heating systems and central air conditioning systems. Perhaps use a good air purifier. But also reduce the amount of plastics in your indoor environment by buying fewer items made from plastics (from furniture to ordinary household goods to toys to synthetic clothing, especially fleece). Try to buy "natural" as much as possible - especially natural fibers such as cotton, wool, linen, hemp.

Recently there have been a number of articles written about this issue for the general public. Well worth reading is: C. Joyce's article for NPR: Beer, Drinking Water And Fish: Tiny Plastic Is Everywhere  ...continue reading "We Are Eating and Breathing In Tiny Plastic Particles?"

Published on Leave a comment on Eye Problems Can Develop After LASIK Surgery

LASIK is an incredibly popular eye surgery to correct vision problems such as nearsightedness and farsightedness. But it turns out that LASIK surgery has more short and long-term complications than we realize. Studies show that the persistant "minor problems" (depends on who you ask if they're minor) are more frequent than we realize - up to 55% report symptoms such as dry eyes or visual distortions. But the really serious ones, such as corneal ectasia, and which occur rarely (less than 1%), typically occur a year or two after the LASIK surgery. And unfortunately ectasia can result in total loss of vision.

Sooo... Buyer beware. And before you consider LASIK surgery, please go to the site LASIK Complications to see exactly what can happen in a worse case scenario, read the following NY Times article in full, and this Washington Post article from 2016. This way if you do decide to do the voluntary procedure, at least you will be fully informed. Excerpts from an article by Roni Caryn Rabin in the  NY Times:

Lasik’s Risks Are Coming Into Sharper Focus

Ever since he had Lasik surgery two years ago, Geobanni Ramirez sees everything in triplicate. The surgery he hoped would improve his vision left the 33-year-old graphic artist struggling with extreme light sensitivity, double vision and visual distortions that create halos around bright objects and turn headlights into blinding starbursts. His eyes are so dry and sore that he puts drops in every half-hour; sometimes they burn “like when you’re chopping onions.” His night vision is so poor that going out after dark is treacherous.

But Mr. Ramirez says that as far as his surgeon is concerned, he is a success story. “My vision is considered 20/20, because I see the A’s, B’s and C’s all the way down the chart,” said Mr. Ramirez. “But I see three A’s, three B’s, three C’s.” None of the surgeons he consulted ever warned him he could sustain permanent damage following Lasik, he added.  ...continue reading "Eye Problems Can Develop After LASIK Surgery"

Published on Leave a comment on Is Melanoma Overdiagnosed?

Is melanoma overdiagnosed? I recently wrote about an article on cancer screening where melanoma was discussed as a cancer that was "overdiagnosed". And now an article, with supporting research, from Health News Review  (an excellent site that does "critical thinking about health care") about the issue of overdiagnosis of melanoma during skin screening tests. What? This is definitely news to many.

The following article was written because of a new skin cancer screening test developed using artificial intelligence (AI) that could distinguish between melanomas and benign moles. It turns out that a lot of people have concerns over melanoma being overdiagnosed (and therefore overtreated), including the U.S. Preventive Services Task Force.

But how do we know melanoma is being overdiagnosed? Because even though more and more melanomas are being found (through screening tests) and treated, the death rate from melanoma has stayed the same over the past 40 years (see the graph below).  Just note that what is described here are moles diagnosed as melanoma during screening tests, meaning that small moles just sitting there on the body are examined. It is not talking about moles that are changing in some worrisome way - those should absolutely be checked out. Excerpts from Kevin Lomangino's post at  Health News Review:

Yes, melanoma can be overdiagnosed, but news stories like these don’t discuss it

Many stories, like this U.S. News & World Report piece, suggested that AI “may serve physicians involved in skin cancer screening as an aid in their decision whether to biopsy a lesion or not.” But none of the stories I looked at paused to ask, Is finding more melanoma definitely a good thing?  ...continue reading "Is Melanoma Overdiagnosed?"

Published on Leave a comment on Is A New Organic Label Needed For Farmers Following Traditional Organic Practices?

Something a little different today. For years I've posted studies showing that eating organic foods lowers pesticide levels in the body quickly, eating organic foods is the only way to avoid the presence of the controversial pesticide glyphosate (Roundup) in food, the nutritional profile (especially fatty acids) of meat and milk from grass-fed, pasture raised animals is different and healthier than conventionally raised animals (and even organic animals not raised on pasture), and on and on. In other words, eating organic foods has health benefits. All good.

But meanwhile, the National Organic Program and National Organic Standards Board (which controls the national organic foods certification program) is being influenced by big agriculture lobbying - to the dismay of real organic farmers. Yes - real organic farmers, who farm the way we expect our organic meat and crops to be raised. You know - cows grazing outside, chickens pecking away for insects outside, crops being raised in real soil (and not hydroponics). But ... Big Agriculture with the mega-farms and lots of chemicals, and animals confined by the thousands indoors, have decided they want a piece of the organic action, and have now influenced the National Organic Program and National Organic Standards Board with the result of weakening of organic standards. But there are other problems too with the organic program as it currently exists.

The Washington Post did a series of articles last year about a huge issue of fraud -  about how so-called organic food from other countries may really not be organic (esp. corn and soybeans), and this mega-influx of fake organic food with lower prices is something real organic farmers in the US can't compete with. Also, how "larger agricultural companies have sought to loosen organic rules in the name of efficiency and affordability". The organic market is a big one, and growing bigger every year (billions of $$). It benefits large corporations and huge mono-crop farms financially to have watered down standards.

Another example: the organic milk that one buys may not really be organic (and the same issue with organic chickens). Organic dairies are supposed to have their dairy cows out grazing in the pasture for a minumum of 120 days per year - it is a requirement. But big dairies that are only organic in name ignore that requirement - such as the huge Aurora Dairy. Yup, they lie. And in September 2017, the USDA (US Department of Agriculture) didn't punish the 15,000 cow Aurora Dairy - instead they "exonerated the enormous Aurora Dairy CAFO (Confinement Animal Feeding Operation) of any wrongdoing at their Colorado “farm.” This dairy operation was described in detail in one Washington Post article, along with compelling test results to prove the cattle weren’t on pasture." So of course now they and other mega-dairies will just ignore the organic regulations, because they can without any penalty.  ...continue reading "Is A New Organic Label Needed For Farmers Following Traditional Organic Practices?"

Published on Leave a comment on Drinking Baking Soda as a Medical Treatment?

A lot of ifs in this study, but... if it holds up, then a really, really cheap medicine. A study by researchers at Augusta University (in Georgia) found that drinking a little baking soda (sodium bicarbonate or NaHCO3 ) with water tells the spleen to go easy on the immune response. In other words, ingesting the baking soda promotes an anti-inflammatory response by the spleen ("activates splenic anti-inflammatory pathways") - which the researchers found in both rats and humans.

The researchers thought this could mean that perhaps some day drinking a little baking soda each day could lower the body's inflammation in kidney disease and autoimmune diseases like rheumatoid arthritis. How much baking soda? The researchers tested 2 g of NaHCO3  (less than 1/2 teaspoon) dissolved in 250 ml of bottled water in a small group of healthy adults. More studies need to be done. From Science Daily:

Drinking baking soda could be an inexpensive, safe way to combat autoimmune disease

A daily dose of baking soda may help reduce the destructive inflammation of autoimmune diseases like rheumatoid arthritis, scientists say. They have some of the first evidence of how the cheap, over-the-counter antacid can encourage our spleen to promote instead an anti-inflammatory environment that could be therapeutic in the face of inflammatory disease, Medical College of Georgia scientists report in the Journal of Immunology.  ...continue reading "Drinking Baking Soda as a Medical Treatment?"

Published on Leave a comment on Personal Care Products and Air Pollution

Researchers measured chemicals in the air in 2 cities (Boulder, CO and Toronto, Canada) and found equally high levels of 2 chemicals in the air during morning commute times - benzene (from vehicle exhaust) and a type of siloxane (from personal care products). What? This study's results make a strong case for reading ingredient lists of personal care products (especially lotions, shampoos, deodorants, antiperspirants) - and avoiding those containing siloxane (which emits volatile organic compounds or VOCs!).

If you consider siloxane and fragrances (which can contain a long, long list of chemicals, including VOCs) as significant sources of air pollution, you might not want to breathe it in or put in on your skin to be absorbed.  Bottom line: Read labels! From Science Daily:

Personal care products contribute to a pollution 'rush hour'

When people are out and about, they leave plumes of chemicals behind them -from both car tailpipes and the products they put on their skin and hair. In fact, emissions of siloxane, a common ingredient in shampoos, lotions, and deodorants, are comparable in magnitude to the emissions of major components of vehicle exhaust, such as benzene, from rush-hour traffic in Boulder, Colorado, according to a new CIRES and NOAA study.  ...continue reading "Personal Care Products and Air Pollution"

Published on Leave a comment on Kitchen Cabinet Sealants Can Be A Source of Indoor Air Pollution

Uh-oh, it looks like some (many?) new or fairly new kitchen cabinets are outgassing several types of PCBs from the wood sealants used on the cabinets. PCBs (polychlorinated biphenyls) were banned in the 1970s due to health risks - for example, they are known carcinogens, and some are neurotoxic (also here).

Researchers from the University of Iowa monitored air inside and outside 16 Iowa homes and found 3  types of PCBs (PCB-47, PCB-51, and PCB-68) wafting off the finished kitchen cabinets. They suggest that the PCBs becoming airborne are "unintentional impurities", that is, inadvertent byproducts of polymer sealants (from the common ingredient 2,4-dichlorobenzoyl peroxide) used in modern kitchen cabinetry. They found that unfinished cabinets had no PCB emissions. The concentrations seemed to be dependent on the year the house was built - with higher levels in houses built in the past 5 years (one house had just been completed),  and also in a recently remodeled kitchen (new cabinets!). The cabinets were made by different manufacturers.

So now we have a new source of indoor air pollution to think about. The big questions are: 1) What, if anything, does this mean for human health? 2) How long does this outgassing from sealants go on for? 3) Are there alternative sealers that don't have this problem? By the way, the researchers discuss that household paints emit PCBs (such as PCB 11) as byproducts of paint pigment manufacturing, and yes, they were found both inside and outside houses. We love our plastics, use them in so many products, but there are consequences. From Env. Health News:

Finished kitchen cabinets are emitting toxic PCBs

Researchers tested indoor air at 16 homes and found three types of PCBs are widespread, and finished cabinets are the source of the toxics, according to a study released today. They suspect the PCBs [polychlorinated biphenyls] are byproducts of sealants used on the cabinets. The study, from the University of Iowa, is the first to suggest wood finishing products are a significant source of PCBs to indoor air and finds that, despite federal bans on PCBs, the chemicals are still being released into the environment, including our homes.  ...continue reading "Kitchen Cabinet Sealants Can Be A Source of Indoor Air Pollution"

Published on Leave a comment on Are You Getting Unnecessary Medical Tests?

This post is about an issue that I've covered before - the issue of unnecessary medical tests and care, which has been documented by many, especially Dr. H. Gilbert Welch (here and here). In the past I've focused on research documenting physical and emotional harms resulting from overuse of some medical tests and procedures, especially some types of cancer screening, but today's post is about the financial harms of unnecessary medical tests and procedures.

We're talking about medical tests or services that are overused, perhaps done "routinely" when there are no symptoms or real reasons to do the test. The cost of unnecessary tests and services can be financially devastating to the person receiving the bill(s). But this "waste" has also been estimated  at $765 billion a year by the National Academy of Medicine. This is about a fourth of all the money spent each year on health care! Wow. The following article by Marshall Allen is co-published on both ProPublica and NPR. Excerpts from NPR:

Unnecessary Medical Care: More Common Than You Might Imagine

It's one of the intractable financial boondoggles of the U.S. health care system: Lots and lots of patients get lots and lots of tests and procedures that they don't need. Women still get annual cervical cancer testing even when it's recommended every three to five years for most women. Healthy patients are subjected to slates of unnecessary lab work before elective procedures. Doctors routinely order annual electrocardiograms and other heart tests for people who don't need them.

That all adds up to substantial expense that drives up the cost of care for all of us. Just how much, though, is seldom tallied. So, the Washington Health Alliance, a nonprofit dedicated to making care safer and more affordable, decided to find out. The group scoured the insurance claims from 1.3 million patients in Washington state who received one of 47 tests or services that medical experts have flagged as overused or unnecessary. What the group found should cause both doctors, and their patients, to rethink that next referral. In a single year:

  • More than 600,000 patients underwent a treatment they didn't need, treatments that collectively cost an estimated $282 million.
  • More than a third of the money spent on the 47 tests or services went to unnecessary care.
  • 3 in 4 annual cervical cancer screenings were performed on women who had adequate prior screenings – at a cost of $19 million.
  • About 85 percent of the lab tests to prep healthy patients for low-risk surgery were unnecessary — squandering about $86 million.
  • Needless annual heart tests on low-risk patients consumed $40 million.

Susie Dade, deputy director of the alliance and primary author of the report released Thursday, said almost half the care examined was wasteful. Much of it comprised the sort of low-cost, ubiquitous tests and treatments that don't garner a second look. But "little things add up," she said. "It's easy for a single doctor and patient to say, 'Why not do this test? What difference does it make?'"

ProPublica has spent the past year examining how the American health care system squanders money, often in ways that are overlooked by providers and patients alike. The waste is widespread – estimated at $765 billion a year by the National Academy of Medicine, about a fourth of all the money spent each year on health care.

Dr. H. Gilbert Welch, a professor at The Dartmouth Institute who writes books about overuse, said the findings come back to "Economics 101." The medical system is still dominated by a payment system that pays providers for doing tests and procedures. "Incentives matter," Welch said. "As long as people are paid more to do more they will tend to do too much."

Published on Leave a comment on Furniture Can Be A Cause of Indoor Air Pollution

I recently read a nice article discussing indoor air pollution, which can be worse than outdoor air, even that of cities. Yes, that's true! In past posts I've discussed problems (and health issues) with air fresheners, fragrances, incense, dryer sheets, scented candles, synthetic rugs, "stain-proofing", and flame retardants in upholstery, but this article is about furniture and how it can emit various chemicals ("outgassing"), especially when new. Think of all the stains, glues, paints, etc. used in making furniture.

The article points out that when buying new furniture, can look to see if it is certified by Greenguard or SCS Global Services as having low or no emissions of  hazardous chemicals. Another thing to do is avoid particle board, engineered wood, or pressed wood (frequently emits formaldehyde, a carcinogen). But in the mean time - it's generally a good idea to frequently get fresh air in your residence by opening windows for a while. Excerpt's from E. Leamy's article in the Washington Post:

Your furnishings could be causing indoor air pollution

We feel safe in our homes, but that can be a false sense of security. The threat I’m talking about is something we can’t see: indoor air pollution. The air in our homes and workplaces can be more polluted than outdoor air in the most industrialized cities, according to the Environmental Protection Agency. The EPA says the problem is compounded by the fact that Americans spend 90 percent of their time indoors. Many different things can cause indoor air pollution, and they have a cumulative effect on our health.

Let’s look at one of those possible sources: our furnishings. Yes, your new carpet or cabinet could be subtly poisoning you with chemicals such as benzene, ethylene glycol or formaldehyde. It’s called “off-gassing.” Four of the top 10 chemicals emitted from furnishings are considered “acute” hazards, or irritants. “Poor indoor air quality can cause or contribute to the development of infections, lung cancer and chronic lung diseases such as asthma,” according to the American Lung Association.

How do researchers know that some furnishings emit harmful gaseous chemicals? Greenguard, a division of UL Environment, has developed a way of testing furniture to find out. In a ­generic-looking office park outside Atlanta, researchers heft furniture into giant, airtight chambers. .... Greenguard developed the testing method so manufacturers who wanted to sell low-emission furniture could prove their products were healthier. UL awards its Greenguard certification to furniture that emits low or no levels of hazardous chemicals. 

Manufacturers don’t have to state what chemicals they use in their furnishings. The EPA singles out engineered wood — otherwise known as particleboard — as being particularly prone to emitting formaldehyde, a probable carcinogen. UL Environment adds that products that are applied wet, such as glues and paints, often off-gas while they are curing. Sometimes a strong industrial odor is a good hint that a piece of furniture is emitting chemicals. If you develop a headache while inside a building where paints, stains or glues are being used, that’s another clue. 

However, it is possible to know whether harmful chemicals are not present, because more and more furnishings are being certified as having low emissions. Here are certifications you can look for and other steps you can take to reduce your exposure to indoor air pollution from your furnishings: 

1. Check certifications. Look for an indoor-air-quality certification, such as the one offered by Greenguard. Another firm that certifies low-emission furniture is SCS Global Services. 2. Air out. .... 3. Paint first. If you’re renovating your house, paint it and air it out before installing carpeting and curtains, because they can absorb chemical fumes from the paint..... 4. Buy used. Off-gassing diminishes over time, so buying older furniture can be better. ....5. Avoid particleboard. This material is also called pressed wood, engineered wood and MDF. The glues used to hold the material together often contain harmful chemicals such as formaldehyde. Alternatively, look for certified particleboard products. 6. Choose unscented. .... 7. Beyond furnishings. Other products frequently used in homes can also off-gas and cause indoor air pollution.