August 2014 - Allergy Doctor Dallas

Diabetes High Among Latinos, but No Single ‘Hispanic’ Profile

Posted on August 27, 2014April 10, 2024 by Dr. Barbara Baxter

An ongoing federally funded study of the health of Hispanics in the United States is yielding nuanced and complex data, with one clear finding: There is no single “Hispanic” profile.

diabetes

The prevalence of the metabolic syndrome overall among the Hispanic groups is 35%, compared with 22.5% in the US population as a whole. And the prevalence of diabetes is 16.9% among Hispanics, compared with 11.3% for all US adults. But this prevalence varies, from just 10.2% among those of South American origin to 18.3% for those with Mexican backgrounds.

And curiously, while Mexicans have the highest rates of diabetes among the Hispanic groups, they join South Americans at the bottom of the list for hypertension (around 20% for both), while those of Caribbean origin (Puerto Rico, Dominican Republic) have the highest hypertension rates (around 30% for both).

The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is the largest study of Hispanic health in the United States and began in 2006. There are 16,415 participants aged 18 to 74 at 4 field centers (San Diego; Chicago; Miami; and Bronx, New York), and the trial has now been funded through 2019. Most (79%) were born outside the United States/Puerto Rico.

Mexicans/Mexican-Americans are the largest group, 39%, followed by 17% who self-identified as Puerto Rican, 14% Cuban, 11% Central American, 9% Dominican, 7% South American, and 3% from more than 1 country.

Why Do US Hispanics Live Longer?
Despite lower socioeconomic status and higher rates of cardiovascular risk factors, Hispanics actually live longer than do non-Hispanic whites or African Americans. In 2011, life expectancy for Hispanics overall was 81.4 years, compared with 78.7 years for the US population as a whole. Hispanic women have the highest life expectancy, 83.7 years, according to data from the Centers for Disease Control and Prevention

Dr. Avilés-Santa said the data so far indicate that doctors need to watch out for a high burden of risk factors and for diabetes at a young age among different Latino groups.
They also need to be on the lookout for hypercholesterolemia and for cardiac structural abnormalities prior to a clinical diagnosis of diabetes. Other important findings include the fact that many older Hispanic people have unrecognized diabetes, and there are issues around sleep-disordered breathing and unrecognized dyspnea and pulmonary disease.

COURTESY: MEDSCAPE – For the latest medical news, clinical trial coverage, drug updates, journal articles, CME activities & more!

Chronic Migraine Responds to OnabotulinumtoxinA

Posted on August 25, 2014April 10, 2024 by Dr. Barbara Baxter

OnabotulinumtoxinA (Botox, Allergan Inc) continues to relieve migraine headache when given over the long term, according to a retrospective analysis of patients with chronic migraine treated for 9 treatment cycles, 12 weeks apart.

botox to treat migraines

“Doctors can now tell their patients that Botox is a safe and effective treatment for chronic migraine, with data now reported over 9 treatment cycles, almost double the duration of the previous data set from earlier studies,” Andrew Blumenfeld, MD, from the Headache Center of Southern California, Encinitas, California, told Medscape Medical News.

Gluten May Cause Depression in Subjects with Non-Coeliac Gluten Sensitivity

Posted on August 18, 2014April 10, 2024 by Dr. Barbara Baxter

Gluten, the major protein of wheat, has been established as the causative agent in the development of coeliac disease, characterised by small intestinal injury and immunological activation.

Gluten

Gluten has also been implicated as a causal factor in the development of chronic functional gastrointestinal symptoms similar to those classified as irritable bowel syndrome (IBS). In fact, non-coeliac gluten sensitivity (NCGS) has been proposed as a defined entity in which IBS-like symptoms markedly improve on a gluten-free diet (GFD), but coeliac disease has been excluded.

Aim – To investigate the notion that a major effect of gluten in those with NCGS is on mental state and not necessarily on gastrointestinal symptoms.

Methods – Twenty-two subjects (24–62 years, five male) with irritable bowel syndrome who had coeliac disease excluded but were symptomatically controlled on a GFD, undertook a double-blind cross-over study. Participants randomly received one of three dietary challenges for 3 days, followed by a minimum 3-day washout before crossing over to the next diet. Challenge gluten-free food was supplemented with gluten (16 g/day), whey (16 g/day) or not supplemented (placebo). End-points included mental state as assessed by the Spielberger State Trait Personality Inventory (STPI), cortisol secretion and gastrointestinal symptoms.

Results – Gluten ingestion was associated with higher overall STPI state depression scores compared to placebo [M = 2.03, 95% CI (0.55–3.51), P = 0.010] but not whey [M = 1.48, 95% CI (−0.14 to 3.10), P = 0.07]. No differences were found for other STPI state indices or for any STPI trait measures. No difference in cortisol secretion was identified between challenges. Gastrointestinal symptoms were induced similarly across all dietary challenges.

Conclusions – Short-term exposure to gluten specifically induced current feelings of depression with no effect on other indices or on emotional disposition. Gluten-specific induction of gastrointestinal symptoms was not identified. Such findings might explain why patients with non-coeliac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms.

COURTESY: MEDSCAPE, The latest medical news, clinical trial coverage, drug updates, journal articles, CME activities & more!

Read the entire article at: http://www.medscape.com/viewarticle/824492

Testosterone Doesn’t Up Myocardial Infarction (MI) or Stroke

Posted on August 13, 2014April 10, 2024 by Dr. Barbara Baxter

Contrary to commonly accepted hypotheses, a new retrospective study of data from 40 specialized clinics around the United States has found that testosterone therapy in men is not associated with an increased risk of myocardial infarction (MI) or stroke and may even be cardioprotective.

Among 19,968 hypogonadal men who received testosterone therapy during a 5-year period (2009–2014) at Low T Centers nationwide, the risk of MI was 7-fold lower and the risk of stroke 9 times lower than the risks experienced by samples of men from the general population.

These findings are counter to those of 2 widely reported recent studies that have generated enormous controversy and prompted an investigation into testosterone safety by the US Food and Drug Administration and the European Medicines Agency. The US Endocrine Society has also called for randomized controlled trials to investigate testosterone therapy and cardiovascular risk and has advised against giving testosterone therapy to men who have had a recent cardiovascular event.

Why the Differences?
One of the recently quoted studies showing a 36% increased risk for MI among 55,593 men who received a new prescription for testosterone therapy, published in PLoS One earlier this year, was based on a heterogeneous patient population that was seen at different practices with different protocols and that received varying exposures to testosterone for less than 3 months’ duration.
In contrast, the Low T Center population was more a homogeneous group, received regular follow-ups, and had longer exposure to testosterone therapy, he noted.

And in the other oft-cited recent study ― published in JAMA in November 2013, they found a 30% increased risk for death, MI, or ischemic stroke among 1223 older veterans on testosterone therapy who underwent coronary angiography.

Dr. Robert Tan, author of the study, also noted that one-third of the patients in the JAMA study received testosterone patches, whereas 90% of Low T Center patients received testosterone via injection, and fewer than 1% used the patch. Moreover, only 60% of the JAMA study patients had their testosterone levels reassessed, whereas 100% of Low T Center patients receive such reassessments. The study was conducted on patients seeking treatment for low testosterone, which may have biased the results, and a randomized, controlled trial is underway, and eagerly awaited by all.

COURTESY: MEDSCAPE – For the latest medical news, clinical trial coverage, drug updates, journal articles, CME activities & more!

Asthma Allergy and Immunology

Posted on August 12, 2014April 10, 2024 by Dr. Barbara Baxter

Allergy, Asthma and Immunology More than half of United States citizens suffer from at least one allergy, a potentially harmful hyper-sensitivity to a specific substance, whether it is a pollen, food, drugs or material. The immune system controls how the body defends itself, creating reactions that can range from minor to life-threatening. Asthma is an allergic disease involving air restriction, leading to wheezing, coughing and shortness of breath. Allergies affect more than 50 million people in the United States, while about 23 million have been diagnosed by asthma, according to the American Lung Association, Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases. With over 30 years of experience, Dr. Baxter specializing in Asthma Allergy and Immunology has kept her patients’ allergies under control and helped them enjoy a better quality of life. If you are seeking relief from allergy symptoms and want a better quality of life, Dr. Baxter encourages you to meet with her and discuss your case.

Breakfast Like a King: 2 Large Meals Benefit Diabetes

Posted on August 8, 2014April 10, 2024 by Dr. Barbara Baxter

Eating just 2 large meals a day, consisting of breakfast and lunch, could be the best way for people with type 2 diabetes to help control their weight and their blood sugar, new research suggests.

Often it is been recommended that people with type 2 diabetes eat 5 or 6 small meals a day, But in Western societies at least, it turns out that snacks are not usually healthy, they are high in sugar and fat. So a regimen of frequent eating hasn’t resulted in better control.

In the crossover trial, published online May 15 in Diabetologia, when patients were eating a large breakfast and lunch but skipping dinner, they lost more weight on average and had less hepatic fat and lower blood glucose, fasting insulin, and fasting glucagon than those who were consuming 6 smaller meals.

Two Meals per Day Regimen Lowered Glucagon
The research involved 29 men and 25 women who were being treated with oral type 2 diabetes drugs, aged 30 to 70 years, with body mass index (BMI) between 27 and 50 kg/m2 and HbA1c in the range of 6% to 11.8%.

One group of 27 started on the first regimen, six small meals a day for 12 weeks, while the remaining 27 had 2 large meals, breakfast and lunch, each day for 12 weeks. They then switched to the other regimen. The diet in both groups had the same macronutrient and calorie content.

Weight loss was more pronounced in those on the 2-large-meal regimen, who shed 1.4 kg more, on average, than those eating 6 smaller portions. Fasting plasma glucose and C-peptide levels also fell in both groups, but again, these reductions were both more pronounced when just 2 meals a day were being eaten. And fasting plasma glucagon also fell with the regimen of 2 large meals a day, whereas it increased among those consuming 6 small meals each day.

These results suggest that, for type 2 diabetic patients on a calorie-restricted diet, eating larger breakfasts and lunches may be more beneficial than 6 smaller meals during the day, Novel therapeutic strategies should incorporate not only the energy and macronutrient content but also the frequency and timing of food.
Dr Kahleová stressed to Medscape Medical News that perhaps a more practical approach should be to emphasize to type 2 diabetes patients that “3 meals a day is enough; breakfast should be the largest meal of the day, and dinner may be light.”

COURTESY: MEDSCAPE – For the latest medical news, clinical trial coverage, drug updates, journal articles, CME activities & more!

Sinus

Posted on August 7, 2014April 10, 2024 by Dr. Barbara Baxter

Sinusitis is characterized by inflammation and swelling of the sinuses (the air-filled cavities around the nasal passages). Some of the symptoms include:

sinus

Nasal congestion
Thick nasal discharge
Post-nasal drip
Facial pressure or pain (especially behind the eyes)
Difficulty in smelling
Cough
Soar Throat
Headache

If you are experiencing any of these symptoms, you should consult Dr. Baxter to talk about diagnosis and treatment options. #sinus #allergist #asthmatreatment #allergies #dallas

Month: August 2014