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Thursday, August 18, 2011




Physical Activity and Cognitive Health
In the office I am often asked by patients--"Could I be getting Alzheimer's Dementia?"  "Is there anything I can do to prevent it? I have written a previous article in this series about the difference between mild, normal cognitive impairment and Alzheimer's. Here let's address the question of what, if anything, can you do to prevent Alzheimer's, if you're worried about. Fortunately there's been some good news recently.

     "Recent epidemiologic, cohort, and clinical-trail data support a role for physical activity in maintaining cognitive health. To assess the effect of physical activity on cognition in the setting of cerebrovascular disease, researchers conducted a retrospective subgroup analysis of more than 2800 female health professionals over the age of 65 with at least 3 vascular risk factors (e.g., diabetes mellitus, hypertension, hyperlipidemia, body-mass index > 30, family history of premature myocardial infarction). Participants reported mean one-year physical activity levels a mean of 3.5 years before an initial global cognitive evaluation. The cognitive evaluation was conducted via telephone; 81% of the respondents completed at least 3 assessments at 2-year intervals....Women in the two highest quintiles of physical activity level--equivalent to brisk walking > 30 minutes daily--had significantly slower rates of cognitive decline than those in the lowest quintile. When the data were compared to an analysis of age-associated cognitive decline, participants in the 2 highest quintiles of physical activity were cognitively 5 to 7 years 'younger' than those in the lowest quintile.  A secondary analysis specific to walking showed a possible threshold effect, with at least 30 minutes of brisk daily walking required for significant cognitive benefit.
 [Arch Intern Med 2011; 171:1251; abstracted in J Watch Specialties Neurology Aug 2, 2011]

COMMENT: Remember the old healthy lifestyle program--the Formula for Health. It works for everything, at every age. Try it! Each of the 5 steps is directly good for preserving mental function and health. There's nothing better.

Friday, August 5, 2011

A New Treatment for Burns (submitted by a patient)



     Burns come in 3 basic varieties: 1st degree, 2nd degree, and 3rd degree.
     Fortunately the first degree burn is most common. It occurs when we touch something very hot, feel a stinging, and pull away quickly. We are left with a tender red mild swelling of the skin. This is a first degree burn. This is also the most common burn you get from sunburn.
     Treatment: First aid for minor (1st degree) burns consists of removing the source of the heat, immersing the burn in ice water, or  covering with a thick ointment (I used to use "Ammertan," a tannic acid product, in childhood). These will provide some immediate relief. But the tenderness will persist. First line of therapy for the pain is ibuprofen--a good anti-inflammatory agent. If this is not enough, then call your doctor for some vicodin or codeine.
     Stage 2 differs from State 1 because the heat penetrates a little deeper in the skin and causes the characteristic blister, which usually rupture, and then leads to loss of skin. So either blistering or skin peeling, means that you have at least a Stage 2 burn. The treatment principles are the same, but with an added step. You have to manage the blisters. Neither Stage 1 or Stage 2 burns lead to scarring, which is the good news. They should both heal completely.
     If the blisters are already ruptured, then you want to cover them with a topical antibiotic (Neosporin, Bacitracin, Silvadene, etc.; whatever you have) and pad them with a bulky (several layers of gauze pads which are then held to the burn site by several wraps of cloth around the affected part). If the blisters are still in tact, then, usually with the consultation with a physician, you have to make a decision whether to go ahead an lance them (in order to avoid them breaking at some time and in some place that might be very dirty). The biggest problem from the blisters is that the fluid in them is a great media for bacterial growth, and so, if not managed carefully, can lead to secondary bacterial infection in the wood. My rule of thumb is that, if a blister is on an area of the body likely to get bumped in ordinary daily activities, it should be lanced and dressed carefully.
      A third degree burn is the worst. This is what they call a "full thickness" burn. The heat from the burn has penetrated below the level of the skin and has started to cause major adverse effects of muscles and ligaments. These burns usually lead to scarring. These burns are best taken care of by a special burn unit in order to avoid late contracture of a joint due to severe scarring. Sometimes later skin grafting is required to removing the scarring and try to give a more normal appearance.

     The key to the care of all burn wounds is:
1. immediate attention. Let someone who knows about burns check it. 

2. Clean it right away. 

3. Take an anti-inflammatory right away. 

4. Bandage it with bulky dressings to provide comfort and protection.

5. Have it checked by some one 3 days after injury to be sure that healing is taking place appropriately.

6. At all times be on the look out for infection (a late, after the first 48 hours, increase in pain, redness, swelling, tenderness, and fluid drainage.). These will all need an antibiotic.

7. Make sure you tetanus immunization is up to date.

And now for another tip on burns, submitted by Ralph Wittick:



Healing Miracle for burns:





This message in its entirety is circulated Courtesy of Ralph Wittick