RedScrubs
The Resource for Medical Professionals

I was speaking with a colleague the other day who was telling me that he was being “re-assigned” because his job was being in-sourced. He went on to explain to me that instead of sending the functions out of the country, it was being done by a company in Iowa.

I started thinking about this for a second; is this the future? Will more administrative functions be sent to other organizations within our country instead of abroad? Will we have fewer employees at our companies and more vendors? When I need a procedure, will the Surgeon live in San Francisco and operate remotely?

I just thought his situation was compelling to mention, for we never know what the future may hold. Speaking of compelling, I had better announce the winner before I get outsourced.

- Dr. Incognito

Recent research has shown that the biological sphere of influence of vitamin D is much broader than originally thought as shown by the massive tissue distribution of the vitamin D receptor or VDR. Researchers have now shown that the prohormone vitamin D is active as a pluripotent hormone in 5 physiological arenas where activity of the VDR has clearly been defined. These physiological areas are the adaptive immune system, the innate immune system, insulin secretion by the pancreatic beta cells, multifactorial heart functioning and blood pressure regulation and brain and fetal development. This expands the role of vitamin D from bone homeostasis into many other physiological areas.

Proton-pump inhibitors (PPIs) such as omeprazole have been used for years to reduce gastric acid reflux. Recent studies have shown, however, that long-term use of proton-inhibitors may increase a patient’s risk for hip fracture.

Hip fracture is the main manifestation of senile osteoporosis, which results from secondary hyperparathyroidism associated with low calcium intake, calcium malabsorption and other factors. The mortality rate during the first year after a hip fracture is 20% and among those who survive this period, 1 in 5 require nursing home care.

I am reflecting on all of the blogs that I have read as of late and feel that the blogging world is changing a bit. When we first started this, there were many Medical Blogs complaining about their dog, job, spouse and car instead of discussing relevant Healthcare issues.

One of the blogs that I remember reading, spoke about how the Blogger stepped on a cat’s tail and he accidentally spilled his coffee. The coffee ruined his pictures and he also had to replace a fried keyboard. While it was entertaining, I did not get anything out of the post that would provide better patient care and/or improve outcomes. I hope that the trend of writing about relevant issues continues.

- Dr. Incognito

When blood sugars run high, a process known as protein glycation occurs where the sugar bonds with proteins to form advanced glycation end products (AGE). These compounds activate the immune system resulting in inflammation and tissue damage that is so much associated with the aging process and the disease of diabetes.

Researchers from the University of Georgia (UGA) found a strong and direct correlation between the phenol content of common herbs and spices and the ability of the AGE compounds to form. Spices such as cinnamon and cloves had high phenol levels. Blueberries were also high on the list. Researchers stated that consuming a variety of spices was probably the best approach to kicking AGE formation since everyone responds differently to phenols (i.e. absorption, response rate, etc).

Because the rate of diabetes is increasing so rapidly, the need for education exceeds the number of health professionals available to provide such education. In response to this need, the University of California, San Francisco (UCSF) has implemented a website that provides curriculum for both Type I and Type II diabetics. This website is similar to the highly successful American Diabetes Association (ADA) accredited teaching program curriculum presented to thousands of patients at UCSF over the past 30 years.

The American Institute for Cancer Research (AICR) is the cancer group that encourages research on the relationship of nutrition, physical activity and weight management as it relates to cancer risk. They interpret scientific literature and report it to the public. AICR has recently published two landmark reports that interpret the scientific literature and is providing a wide range of educational programs to translate the results of the literature to help Americans learn to make dietary changes for lower cancer risk.

Fasting is not a new invention. It is advocated in the Bible. However, recently there has been a resurgence of interest in fasting as a means of increased weight loss and prevention of chronic disease. There has even been some mention that the calorie restriction in alternate day fasting (ADF) prolongs the life span. Since 2007, several studies have emerged.

My cardiac and pulmonary patients often ask me, “How will I know if it’s too hot to exercise outside?”
My answer to someone who is physically compromised in some way is, ”When the sum of the ambient temperature and the relative humidity is greater than 150, it is best to move exercise inside into an air conditioned room or wait until later in the day when those numbers go down.” For example, a noontime temperature of 93 degrees Fahrenheit and relative humidity of 88 percent far exceed this guideline for safe outdoor exercise.
Individuals living with chronic disease, including heart disease, pulmonary disease, diabetes, or cancer, should use extra caution when exercising – especially outdoors. Excess heat and high humidity can tax the heart and lungs and make it difficult for these organs to keep up with the increased demands of exercise. Other outdoor exercise rules also apply: drink more water, wear sunscreen and light, breathable clothing, and modify your routine so that your heart rate remains in your training zone.
If you have a chronic illness, it is best to get your doctor’s clearance before you begin and to consult with an exercise professional to determine safe parameters for your exercise routine, i.e. heart rate, blood pressure, duration, intensity, frequency, and conditions for exercise.