Annapolis Allergy and Health Enhancement Center - Richard Bernstein, MD, PA

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Could Acetaminophen cause Asthma ?

Is Acetaminophen a Culprit in Asthma?

Positive associations exist between acetaminophen use and asthma in children.

 

That was the conclusion of a recent article in Pediatrics. This has been a topic of much debate in the pulmonary literature. Why might this be the case? Acetaminophen depletes gluathione levels which is a key antioxidant. This may predispose to chages in the bronchioles after the infection which make them more sensitive to irritants and allergens causing wheezing. Of course this is only a theory. We suggest you discuss this issue with your physician.

 

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CITATION(S):

McBride JT. The association of acetaminophen and asthma prevalence and severity. Pediatrics 2011 Dec; 128:1181.

Most people overestimate how well controlled their asthma is

We see this over and over in our practice. Now a study confirms this impression particularly in adolescents. 

Keys to good control

1. Identify and address underlying triggers such as allergens, irritants,  reflux of stomach acid and proper use of controller and rescue medications
2. Know what good control is: These include 1. No nocturnal awakenings, 2. Requiring a rescue inhaler less than 2 x per week,  

For more information visit our website and view our slide show on asthma

Working long hours can kill you

Longer Working Hours and Risk for CHD

Risk rose when workdays stretched beyond 10 hours.

In this important study the effect of stress should not be underestimated.  The hazard ratio was similar  from the effect of cigarette smoking.

After adjusting for Framingham risk score, participants with workdays of 10 hours (hazard ratio, 1.45) or ≥11 hours (HR, 1.67) had higher rates of CHD than those with workdays of 7 to 8 hours. The addition of working hours to the Framingham risk score led to a net reclassification of approximately 5% of participants from a lower-risk to a higher-risk group.

Comment: While this study did not determine true cause and effect, the implication is  we should all take heed of our stress levels 




CITATION(S):

Kivimäki M et al. Using additional information on working hours to predict coronary heart disease: A cohort study. Ann Intern Med2011 Apr 5; 154:457. (http://www.annals.org/content/154/7/457.long)

Omega 3 Fatty Acids associated with increased risk for high grade prostate cancer

I have to admit that this was somewhat of a surprise. However not as much as you might think. If you recall previous studies  demonstrated that the 5 foods in the Mediterranean diet associated with longevity were legumes, vegetables, olive oil, nuts in small amounts and red wine in moderation. Fish consumption correlated neither positively or negatively, and red meat (grass fed) had a negative correlation. In addition there have never been any studies linking fish oils to longevity. This again points out the importance  of focusing on your lifestyle including diet not supplements. I'm sure there will be more to come on this topic. Below is the abstract. There have been previous studies demonstrating a decreased risk of some cancers by switching to a Mediterranean diet as well as a decreased risk of overall mortality.





Cancer Risk: Results From the Prostate Cancer Prevention Trial

  1. Theodore M. Brasky*, 
  2. Cathee Till, 
  3. Emily White, 
  4. Marian L. Neuhouser,
  5. Xiaoling Song, 
  6. Phyllis Goodman, 
  7. Ian M. Thompson, 
  8. Irena B. King,
  9. Demetrius Albanes and 
  10. Alan R. Kristal
  1. *↵Correspondence to Dr. Theodore M. Brasky, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-B402, Seattle, WA 98109-1024 (e-mail: tbrasky@fhcrc.org).
  • Received October 12, 2010.
  • Accepted January 19, 2011.

Abstract

Inflammation may be involved in prostate cancer development and progression. This study examined the associations between inflammation-related phospholipid fatty acids and the 7-year-period prevalence of prostate cancer in a nested case-control analysis of participants, aged 55–84 years, in the Prostate Cancer Prevention Trial during 1994–2003. Cases (n = 1,658) were frequency matched to controls (n = 1,803) on age, treatment, and prostate cancer family history. Phospholipid fatty acids were extracted from serum, and concentrations of ω-3, ω-6, and trans-fatty acids (TFAs) were expressed as proportions of the total. Logistic regression models estimated odds ratios and 95% confidence intervals of associations of fatty acids with prostate cancer by grade. No fatty acids were associated with low-grade prostate cancer risk. Docosahexaenoic acid was positively associated with high-grade disease (quartile 4 vs. 1: odds ratio (OR) = 2.50, 95% confidence interval (CI): 1.34, 4.65); TFA 18:1 and TFA 18:2 were linearly and inversely associated with risk of high-grade prostate cancer (quartile 4 vs. 1: TFA 18:1, OR = 0.55, 95% CI: 0.30, 0.98; TFA 18:2, OR = 0.48, 95% CI: 0.27, 0.84). The study findings are contrary to those expected from the pro- and antiinflammatory effects of these fatty acids and suggest a greater complexity of effects of these nutrients with regard to prostate cancer risk.

Key words

Brushing Your teeth twice a day Keeps the cardiologist away

In this interesting study published in the British Medical Journal  patients who self reported poor oral hygiene had a 70% higher risk of having a cardiovascular event then those who reported good oral hygiene. In addition those with good oral hygiene has lower markers of inflammation such as cardiac crp and fibrinogen.

BMJ 2010 May 2010

Coffee consumption associated with decreased risk of stroke

While not a health food it is reassuring to see that that morning cup of coffee may actually  help prevent stroke. This Swedish study had a lot of problems but the bottom line is indulging in that morning cup of coffee should no longer be considered a vice and may actually be beneficial.

Larsson SC et al. Coffee consumption and risk of stroke in women. Stroke 2011 Mar 10; 

Diabetes and Vitamin B12 deficiency

We routinely check vitamin B12 levels in all of our patients with diabetes who take the drug metformin. Metformin can lower vitamin B12 levels. Signs and symptoms of B12 deficiency include anemia, peripheral neuropathy (numbness in the lower extremities), fatigue, anxiety and depressive symptoms. If you take this drug its worth asking your doctor to check a vitamin B12 level with your next blood work.

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