Tall Women (Over 5'1") Have Higher Risk of Cancer!

Female models may be tall and beautiful, but they are also at markedly increased risk of developing cancer. The New York Times reported on a fascinating research article regarding height of a women and risk of cancer.

Specifically, for every four-inch increase in height over 5 feet 1 inch, the risk that a woman would develop cancer increased by about 16 percent, especially for:

• Colon Cancer (RR per 10 cm increase in height 1.25, 95% CI 1.19—1.30)
• Rectal Cancer (1.14, 1.07—1.22)
• Malignant Melanoma (1.32, 1.24—1.40)
• Breast Cancer (1.17, 1.15—1.19)
• Endometrial Cancer (1.19, 1.13—1.24)
• Ovarian Cancer (1.17, 1.11—1.23)
• Kidney Cancer (1.29, 1.19—1.41)
• Brain/Spine Cancer (1.20, 1.12—1.29)
• Non-Hodgkin's Lymphoma (1.21, 1.14—1.29)
• Leukaemia (1.26, 1.15—1.38)

It is hypothesized that the levels of growth hormone responsible for human height might also be involved in cancer development or because taller people are at greater risk for mutations simply because their bodies are comprised of more cells.

The increased cancer risk was found to be also true across Asia, Europe, Australia, and North America populations.

Perhaps now there's a reason why the average female is 5 feet, 3.8 inches tall! It's a balance between social preferences for being tall versus negative biological consequences for being tall.

The good news here (if there's any) is that head and neck cancer does not increase with height.

Read the NYT article here.

Read the research abstract here.

Reference:
Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk. The Lancet Oncology, Volume 12, Issue 8, Pages 785 - 794, August 2011 doi:10.1016/S1470-2045(11)70154-1

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Dr. Chevalier Jackson, Laryngologist Extraordinaire

On Jan 10, 2011, the New York Times published an article on Dr. Chevalier Jackson, a pioneer in the field of laryngology, who is perhaps best known for his extensive collection of foreign bodies he removed from patients, young and old, with little or no anesthesia. His genius is documented in a new biography called "Swallow" by Mary Cappello.

Among other achievements by Dr. Jackson was passage of the Federal Caustic Poison Act of 1927, esophageal dilatation in kids, and treatment of many poor children without pay.

Perhaps the one thing Dr. Jackson was mistaken on was the discouragement of high tracheostomies or cricothyrodotomies back in 1921.

Of note, Dr. Jackson's foreign body collection (2000+ items) is now owned by the Mütter Museum of the College of Physicians of Philadelphia... a fantastic museum I may add.

Read the NYT article here.

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Pacemaker To Cure Obstructive Sleep Apnea (OSA)?

The Huffington Post on Dec 27, 2010 published a story about a potential new treatment whose goal is  obstructive sleep apnea cure (OSA) cure using a pacemaker made by Inspire Medical... for the tongue. The New York Times also published a similar story more recently about the same device on 1/8/2014.

The device works by stimulating the nerve going to the tongue (hypoglossal nerve) to contract with every breath a person takes while sleeping.

Why would this help? In some patients with severe obstructive sleep apnea, the tongue falls backward against the throat's back wall (tongue prolapse) causing airway obstruction. By stimulating the tongue's nerve, the tongue is stimulated to move forward when a patient takes a breath preventing obstruction.

Of course, this treatment works ONLY if the obstruction is due to tongue prolapse.

There are other treatments that also accomplish the same thing including:

• Base of tongue coblation/reduction
• Geniohyoid advancement
• Repose procedure
• Oral appliance

At least in our office, we only offer the base of tongue reduction to address tongue prolapse that may lead to obstructive sleep apnea.

This pacemaker for the tongue is currently experimental and not available for the general public yet.

Sources:
Sleep Apnea: Experiments Test If Implant Can Block Sleep Problem. Huffington Post 12/27/10

For Sleep Apnea Patients, a Possible Alternative to Masks. NYT 1/8/14

Reference:
Upper-Airway Stimulation for Obstructive Sleep Apnea. New England Journal of Medicine. January 9, 2014DOI: 10.1056/NEJMoa1308659

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Laying on Right Side Worsens Acid Reflux!

Well that's according to a recent New York Times article on October 25, 2010.

This claim is based on several studies published whereby “the total amount of reflux time was significantly greater” when the subjects laid on their right side after eating a high-fat meal.

This makes sense anatomically. Keep in mind that the stomach is located on the left side and the esophagus (swallowing tube) is located in the middle (comes off the stomach's "right side" so to speak). When you lay down on the right side, gravity is literally "emptying" the stomach into the esophagus located in the middle. Laying on the left side has gravity keeping stomach contents inside the stomach as the middle is now above the stomach.

Of course, the best thing to do is lifestyle changes to minimize reflux including- avoid eating high-fat, spicy, acidic foods as well as not eating/drinking within 3 hours of laying down when the stomach is empty. Keeping the head and chest elevated 30 degrees is also helpful thereby using gravity to help keep things down. Mattress wedges are helpful. Should lifestyle changes not help, there are plenty of medications that can help.

Read the NYT article here.

Read more about reflux here.

References:
Body position affects recumbent postprandial reflux. J Clin Gastroenterol. 1994 Jun;18(4):280-3.

Effect of different recumbent positions on postprandial gastroesophageal reflux in normal subjects. Am J Gastroenterol. 2000 Oct;95(10):2731-6.

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Botox for "Sale" Due to Market Influences of Supply and Demand

The NYT wrote a somewhat humorous article on Oct 7, 2010 regarding botox injections for wrinkles from both a supply (physician) and demand (patient) viewpoint.

In NYC, one can now find neon colored signs advertising botox specials!

Read the NYT article here.

Of note, our clinic performs botox injections not for just cosmetic reasons (wrinkles), but also medical reasons including migraine headaches, TMJ, spasmodic dysphonia, torticollis, etc.

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Sleep Apnea Can Mimic Dementia

NYT published a great article on Oct 6, 2010 regarding how obstructive sleep apnea (OSA) can mimic many of the symptoms of dementia, especially in the elderly.

Symptoms of OSA that can be confused with dementia include trouble concentrating, inattention, difficulty staying focused, constantly dozing off during the day, and other cognitive deficits.

Unfortunately, many elderly patients live alone and nobody is around to see whether there are any sleep issues. Most elderly patients deny any sleeping difficulties and it is not until someone stays with them during the night (like on holidays when family members are around) that a sleep disorder is noticed.

They key thing is to consider OSA in the differential for an elderly patient who may be exhibiting some symptoms of dementia and to realize that one needs to talk to family members whether sleep issues are present.

Read the NYT article here.

Read more about OSA here.

Read a study about the relationship between OSA and dementia here.

Reference:
Cognitive Effects of Treating Obstructive Sleep Apnea in Alzheimer's Disease: A Randomized Controlled Study. Journal of the American Geriatrics Society Volume 56, Issue 11, pages 2076–2081, November 2008

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NYT: Zinc Does NOT Help Fight Off Ear Infections

The New York Times on March 12, 2010 published a story discussing whether zinc can help fight ear infections. The story titled "The Claim: Zinc Can Help Fight Off Ear Infections" states in the end that the mineral zinc does not. A research study on the subject revealed its lack of efficacy.

Read the NYT story here.

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NYT: Kids with Allergies

The New York Times published a story on pediatric allergies on March 5, 2010 titled "A Child’s Allergies Are Serious but Can Be Treated Effectively."

Some treatments mentioned in the article include allergy shots, medications, and avoidance.

Our office is able to provide allergy shots, allergy drops, medications, as well as allergy testing.

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NYT: Blowing the Nose May Actually Make You Sicker???

On February 9, 2009, the New York Times published an interesting story regarding what happens if you blow your nose too hard. The story "The Claim: Never Blow Your Nose When You Have a Cold" reported that nose blowing generated enormous pressure — “equivalent to a person’s diastolic blood pressure reading,” — and propelled mucus into the sinuses every time. It was unclear whether this was harmful, but added that during sickness it could shoot viruses or bacteria into the sinuses, and possibly cause further infection.

The story is based on research done at the University of Virginia and published in the journal of Clinical Infectious Diseases in 2000. Read the research here.

Based on this research, it does seem wise to avoid nose-blowing, but if one must, to use decongestants and blow only one nostril at a time gently. Using saline flushes would be helpful as well.

Read the story here.

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