ASHLEY MALTZ, MD
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Repost: Because it's SO important!

12/26/2010

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This lengthy report sheds some light on the impact of various potentially cancer-causing environmental toxins. It includes hormone-disrupting perfumes, home cleaners, etc., and really puts our consumer-driven beauty and cleaning markets into perspective.

 From NY Times reviewer, Nicholas D. Kristof: 
'The President’s Cancer Panel is the Mount Everest of the medical mainstream, so it is astonishing to learn that it is poised to join ranks with the organic food movement and declare: chemicals threaten our bodies.'

Check it out asap!

http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf
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New guidelines for preventing strokes

12/21/2010

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The American Heart Association/American Stroke Association (AHA/ASA) has released new guidelines for the primary prevention of stroke, both ischemic (caused by lack of blood flow to an area of the brain) and hemorrhagic (strokes that bleed into the brain).In 1999, AHA set a goal for 2010 of decreasing mortality from heart disease and stroke by 25%, Dr. Goldstein told Medscape Medical News. That goal was achieved early, in 2008, probably due to better prevention strategies, he said.

Of more than 790,000 strokes that occur each year, 75% of those are first events, "so prevention is particularly important." Because risk factors for both ischemic and hemorrhagic strokes largely overlap, he said, "in this guideline we address primary prevention of stroke, not just ischemic stroke, so that's one significant change."The new guideline, affirmed as an "educational tool for neurologists" by the American Academy of Neurology, was published online December 2 and will appear in the December issue of Stroke.


The document is extremely thorough and long, with 68 pages and almost 800 references, so here are a few highlights. I particularly like the Lifestyle Factors paragraph per Medscape:

• Lifestyle Factors:The writing committee evaluated the gamut of new and emerging risk factors, modifiable and nonmodifiable. What remains first among strategies for primary stroke prevention is modification of lifestyle factors, including physical activity, not smoking, moderate alcohol consumption, maintaining a normal body weight, and eating a low-fat diet high in fruits and vegetables, Dr. Goldstein emphasized.

"Those types of lifestyles are associated with about an 80% — that's 8-zero percent — lower risk of a first stroke, and that's true for both men and women," he said. "There's virtually nothing that we can do with medicine or interventions of any kind that's going to have that kind of impact, so that I think is of paramount importance."

• Secondhand Smoke: Cigarette smoking is an established risk factor for stroke, but the new recommendations suggest that avoiding environmental tobacco smoke is also a "reasonable" strategy, he noted.

"We don't know that limiting that exposure decreases the risk because that data just isn't available," he said. "It seems to be true for coronary heart disease and communities that institute clean indoor air acts, for example, the rate of hospital admission for acute [myocardial infarction] drops precipitously in the year after those measures are taken. We believe the same should be true for stroke, although again we don't have that data yet."

• ED Screening: Visits to the emergency department (ED) may be a valuable opportunity to screen for and treat stroke risk factors, including smoking cessation strategies, cholesterol and blood pressure monitoring, or atrial fibrillation screening and treatment implementation, the new guidelines note.

"As we know, a fairly high proportion of Americans don't have healthcare insurance, and they don't seek regular preventive care," Dr. Goldstein said. "They get their healthcare usually because of an acute illness of some kind by going to the emergency department.

"Even though emergency departments are currently overwhelmed with patients receiving their primary care there for these types of illnesses, it's also an opportunity to identify risk factors and potentially have patients referred for appropriate prevention," he said.

Although ED-based smoking cessation programs and interventions, atrial fibrillation identification, and evaluation for anticoagulation are recommended, and ED population screening for hypertension and drug abuse is considered "reasonable," the document adds that the effectiveness of screening, brief intervention, and referral for treatment of diabetes and lifestyle risk factors in the ED setting is "not established."

Taken from http://www.medscape.org/viewarticle/733726?src=cmemp (you may need a subscription to view the article, not sure).
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For those trying to get off of antidepressants, here's more proof that self-awareness/meditation improves your well-being

12/13/2010

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From MedPage Daily, "For patients who achieve an unstable remission after depression -- one dotted with depressive symptoms -- mindfulness-based cognitive therapy may prevent relapse just as well as maintenance antidepressant therapy, researchers say.

Both treatments were equivalent and were associated with similar reductions in relapse compared with placebo, Zindel Segal, PhD, of the Center for Addiction and Mental Health in Toronto, and colleagues reported in the
Archives of General Psychiatry.

"For those unwilling or unable to tolerate maintenance antidepressant treatment, mindfulness-based cognitive therapy offers equal protection from relapse," they wrote.

Relapse after recovery from depression is common, and the current therapy to prevent relapse is maintenance antidepressants. Medication adherence, however, tends to be an issue.

Mindfulness-based cognitive therapy may be an alternative, the researchers said. The group-based regimen helps train patients to disengage from depressogenic thinking, and puts an emphasis on daily practice of health-enhancing behaviors such as meditation or yoga.

Yet little data on its efficacy exists. So the researchers conducted a randomized trial of 166 patients ages 18 to 65 at two outpatient clinics in Canada who met criteria for major depressive disorder, and focused on the 84 who achieved remission. These patients were assigned to one of the three groups: antidepressant maintenance therapy, mindfulness-based cognitive therapy, or placebo.

Patients who received cognitive therapy discontinued their antidepressants and attended eight weekly group sessions.

During their acute treatment phase, about half (51%) of patients were classified as unstable remitters, while the rest were stable.

These unstable remitters had higher depression scores, spent more days in the acute treatment phase, and spent more days in remission than those who were stable (P=0.03, P=0.02, and P=0.03, respectively).

Thus there was a significant interaction between quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P=0.03).

"Our findings indicated that the quality of remission achieved during the acute phase interacted with the type of prevention treatment patients received to determine relapse outcomes during the subsequent maintenance phase," the researchers wrote.

So they assessed treatment effects among the unstable group. They found that all of these treated patients -- whether they had mindfulness-based therapy or antidepressant therapy -- had a reduction in relapse risk compared with placebo, which didn't differ significantly between the two groups.

Relapse rates were 27% for antidepressant maintenance therapy, 28% for mindfulness therapy, and 71% for placebo.

Individually, mindfulness therapy was associated with a 74% reduced risk of relapse (95% CI 0.09 to 0.79, P=0.01), and antidepressant therapy was associated with a 76% reduced risk (95% CI 0.07 to 0.89, P=0.03).

"For patients whose acute-phase remission was marked by periodic symptom flurries, discontinuing [antidepressants] and receiving [cognitive therapy], or continuing with [antidepressants] significantly lowered relapse/recurrence risk compared with discontinuation to placebo," they wrote.

They said the results are "in accord with previous reports" that time in remission or the presence of residual symptoms are associated with "poorer acute- and maintenance-phase outcomes" and that reduction of this risk "with targeted treatment is beneficial."

"Surprisingly, for patients whose acute-phase remission was stable, there was no differential effect on survival between the treatments we studied," they added.

The study was limited because its power was lessened when the cohort was divided into stable and unstable remitters, and the authors noted that further study is needed.

Link to the article's abstract - http://archpsyc.ama-assn.org/cgi/content/short/67/12/1256
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Great opportunity for students interested in Environmental Health

12/8/2010

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Internship Opportunity Announcement: Man, I wish I was a college student!

CDC’s National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) is offering a 10-week summer internship program for students majoring in environmental, physical, biological, chemical, and/or social sciences, or related fields. During the course of the internship, students are introduced to environmental health at the federal level through collaborative projects, experiential learning opportunities, individual environmental health presentations, journal clubs, field trips, brown bag lunches, and shadowing and mentoring relationships at CDC/ATSDR. Interns will be based at CDC/ATSDR’s Chamblee Campus. Students are paid $500 a week during the course of the program. Please go to the CDC's website
www.cdc.gov/nceh/cleh for more information and application instructions.

Application due date: February 2, 2011. Program dates: June 8-August 12, 2011


Eligibility requirements for CLEH interns:

1. US citizenship or Permanent Resident with a green card,
2. Full time enrollment at a college or university as a rising junior or rising senior by fall 2011
3. Minimum cumulative GPA of 3.0 on a 4.0 scale
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Self-care techniques for colds and flu

12/8/2010

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I realize that we don't all have time to be laying in bed for 3-7 days, but here are some general tips to help nip your cold or flu symptoms in the bud...courtesy of my former chiropractor in Galveston, Dr. Mary Mallott-Brechtel.

1. Rest. Listen to your body. If you feel the need to rest or sleep, do so. Though regular exercise can boost your immune system, during cold or flu it may be wise to lighten or skip you usual workout or exercise program depending on the severity of your condition.

2. Drink plenty of water . Drink one half your body weight in ounces of water every day. For example, a 200-pound man should drink 100 ounces of water daily. When you have a cold or flu, increase that number by 20 percent. You can also drink clear soup broths or diluted vegetable juices.

3. Minimize sugar intake. Sugar, even if derived from natural sources like fruit juice and honey, can impair immune function. Keep sugar to a maximum of 50 grams per day.

4. Suck on zinc tablets or lozenges. Zinc is a nutrient which can help the immune system function. A zinc gluconate lozenge every two waking hours may help eliminate some symptoms and can cut the duration of the cold. Discontinue the zinc after one week if symptoms persist.


5. Maintain a positive attitude. At the most, your cold or flu will last three to seven days, so follow these guidelines and allow your body to fix itself.

I will add the following:
6. Get a flu shot every year, especially if you smoke, have asthma or are diabetic. They are relatively safe (very rare adverse events like fever, Guillann-Barre syndrome, allergic reactions)


7. Exercise regularly when not sick to stimulate immune and nervous system health

8. Consider using a Neti-pot (at your local pharmacy or Whole Foods) to clear the mucous from your sinuses and nasal passages. It's cheap and it's natural. Check out Dr. Weil's instructions on how to use this Ayurvedic contraption - http://www.drweil.com/drw/u/TIP03906/How-Do-You-Use-a-Neti-Pot.html

9. And don't skimp on the sleep! Probably the most important variable in this equation...although it's the one most of us are willing to throw by the wayside...tsk, tsk!

Have a wonderful week and STAY HEALTHY!

Dr. M

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Say NO to "corn sugar" (aka high fructose corn syrup)!

12/6/2010

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"High fructose corn syrup (HFCS) is a cheap sweetener chemically derived from corn. This ingredient of junk food has been in the news lately, in part due to a proposed name change by the Corn Refiners Association - the group wants to rename it "corn sugar." Whatever you call it, HFCS is a marker for low-quality food and has no place in a healthy diet. But unfortunately, it is widely used: HFCS is found as a primary ingredient in soft drinks and often hidden in processed foods including salad dressings and ketchup, jams, jellies, ice cream, bread and crackers. It is one of the biggest sources of calories in the American diet" and plays a major role in disrupting metabolism due to the body's inability to metabolize frusctose well. This in turn, leads to obesity, which as avid readers of my blog know, increases risks for diabetes, cancer and other chronic diseases.

So stay away from HFCS/corn sugar by checking food labels and minimizing your consumption. And don't let the sweet emotional marketing put on by the Corn Refiners steer you wrong. This is a man-made sugar developed for cheap use in foods during the industrial revolution. We, as a society, are no longer in need of high caloric intake that these foods provide (due to mechanization of everything, ie, cars, escalators, elevators, etc). In fact, it's quite the opposite.

Happy Monday!

Source info - www.drweil.com
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    Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.  

    Dr. Maltz's specific interests include helping her patients and populations improve their health through lifestyle interventions including, but not limited to, natural pain relief, nutrition, mind-body techniques and decreasing environmental exposures. She spent the last year of her four-year medical residency participating in health policy, cancer prevention and environmental health rotations and enjoys guiding people through the overwhelming amount of health information available on the web.

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