March 2018 - The Good Doctor Is In

Mar122018 by DocNo Comments

Trulicity | Expensive Diabetes Treatment

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Trulicity represents an expensive add-on treatment to assist in controlling type 2 diabetes. Only one shot of Trulicity every 7 days is standard in addition to routine diabetes therapy. The cost for one month of Trulicity for a cash paying patient averages about $800. A battle is brewing between Trulicity and a closely related competitor - Victoza. Both activate the GLP-1 receptor which leads to greater insulin release and decrease in a hormone, glucagon, that counteracts the action of insulin. In the process emptying of the stomach is slowed which results in reduced appetite and then the possibility of weight loss. Side effects tend to be mild but relatively common. Among the most frequent are nausea in up to 20%, vomiting in 10%, diarrhea in 10% and abdominal pain in…

Mar122018 by DocNo Comments

SeroVital | A Growth Hormone Booster?

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The question is whether SeroVital really boost growth hormone and if so does it matter? Containing a smaller amount of amino acids than in a bite of steak, chicken or salmon, this supposed human growth hormone booster makes preposterous appearing claims based on extraordinarily shaky evidence. While using such enticing catch-phrases as anti-aging, breakthrough and fountain of youth, the packaging promotes SeroVital to increase lean muscle mass, reduce wrinkles and more. A $100 investment buys one month of product but at best the “increase” in growth hormone raises it only into the low normal range. Ingredients include small amounts of lysine, arginine and several other trace compounds in amounts dwarfed by those in the American diet. While marketing hype suggests special benefits for these supplements, it seems difficult to…

Mar122018 by DocNo Comments

Oxycodone Dangerous Narcotics

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[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Oxycodone and its extended release version Oxycontin belong to the narcotic family of opioids. Closely related compounds include codeine and hydrocodone. Extreme care must be exercised in prescribing oxycodone in combination with muscle relaxants, sleeping pills, anxiety medications and other pain relievers. Surprisingly even the antibiotics erythromycin and clarithromycin or the stomach acid reducer Tagamet generically available as cimetidine may increase the risk of unexpected overdose and death from respiratory arrest. Adding oxycodone/oxycontin to illicit street foretells disaster. Oxycodone was originally synthesized in 1916 in Germany. An interesting historical note, Adolf Hitler was apparently addicted to it among other substances by his personal physician. Most prescriptions for these drugs fail to meet current guidelines for correct use. Treatment for low back pain,…

Mar112018 by DocNo Comments

Cialis | Expensive Erectile Dysfunction Treatment

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Erectile Dysfunction or simply ED at least temporarily affects more than 40% of men beyond age 40. The popular family of inhibitors of an enzyme known as PDE5 include Cialis, Viagra and Levitra. All of these drugs work basically in a similar manner. Selection of which to choose relate more to personal preference and cost than other factors. These drugs require sexual stimulation and release of nitric oxide from the tissues in order to function. Cialis neither functions as an aphrodisiac nor as a treatment for premature ejaculation.. The typical dose of Cialis is 10 mg no more frequently than daily. Results appear within 30-45 minutes when combined with sexual stimulation. Due to its slow metabolism, a considerable amount remains in the tissues for more than 17 hours. Lasting longer…

Mar102018 by DocNo Comments

Diabetes – Is Not Necessarily Permanent

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DIABETES – IS NOT NECESSARILY PERMANENT The likelihood of becoming diabetic increases in parallel with our ever expanding waistlines. Once diagnosed with Type 2 Diabetes or simply diabetes, the condition almost always persists forever. Currently the remission rate averages less than 0.2% basically signifying a lifetime of misdirected attention to diet along with a steadily growing number of oral medicines followed by various injections and typically culminating with insulin treatment after about ten years. BACKGROUND Until relatively recently, the incidence of diabetes hovered at very low levels where it still remains but only in underdeveloped nations. Along with changing dietary habits coupled with a decrease in physical activity, the prevalence of diabetes soared to well in excess of 1 in 11 adults. A recent phenomenon couples the burgeoning waistlines of…

Mar62018 by DocNo Comments

Cancer Breakthrough: CAR – T Cell Therapy

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[caption id="attachment_586" align="alignleft" width="150"] Upward and onward with new CAR-T Cell Cancer therapy[/caption] CANCER BREAKTHROUGH: CAR – T CELL THERAPY Cancer ranks as the most feared disease stirring memories of suffering, pain and disability followed by a lengthy downward spiral to death. Traditional approaches include surgery, radiation and chemotherapy. While still evolving into the modern era, these options unfortunately offer limited success. Newer targeted therapies with drugs including Gleevec, Herceptin and Opdivo provide major a advance but still leave considerable room for improvement. Enter the cancer breakthrough CAR-T Cell Therapy capable of directing the body’s immune system at malignant cells previously unable to be destroyed. Considered as “breakthrough therapy” by the Food and Drug Administration, the initial two agents received priority review followed by marketing approval within less than one…

Mar62018 by DocNo Comments

Ringing in the Ear – Tinnitus

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RINGING IN THE EAR – TINNITUS Ringing in the ears will affect everyone. Fortunately for the overwhelming majority of individuals the condition appears fleeting and not sufficiently bothersome to warrant medical attention. However for about 10-20% or more than 50 million Americans the situation causes mild annoyance or distress. In slightly less than 1% of the population tinnitus significantly and negatively impacts on an person’s capacity to enjoy life and for some may be so devastating that it leads to consideration of suicide. Tinnitus refers to noise a person perceives that does not originate from any external source. No one, not even the most highly trained specialist, possesses any tools capable of confirming the very existence of the complaint. Symptoms are described as ringing, buzzing, hissing, roaring, clicking, sizzling or…

Mar52018 by DocNo Comments

High Blood Pressure | Controversy

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HIGH BLOOD PRESSURE | Controversy Caution: the American College of Cardiology and the American Heart Association jointly issued new guidelines on November 13, 2017 for treating high blood pressure that may be hazardous to your health. Startling media coverage of these new guidelines regarding diagnosis and treatment fails to acknowledge the significant disagreement that exists regarding the basic tenets of the condition. Even among the most highly respected professional societies, no uniform definition exists of what precisely constitutes high blood pressure (HBP). Of course in the absence of agreement on a diagnosis, it seems highly disingenuous to recommend lifelong therapy. Everyone agrees that excessive blood pressure wreaks havoc on the vascular system over a period of years to decades. Along with cigarette smoking, obesity and improper diet, HBP ranks among…

Mar52018 by DocNo Comments

Hallucinations and Delusions of Parkinson’s Disease

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HALLUCINATIONS AND DELUSIONS OF PARKINSON’S DISEASE As many as 1 million Americans experience symptoms of Parkinson’s Disease with many ultimately suffering the complications of hallucinations and delusions. Early manifestations of Parkinson's Disease generally include a resting tremor principally affecting the hands and remarkably occurring in the absence of other body activity. This shakiness tends to disappear during body movement. As this progressive disease worsens an overall slowness interferes with walking and leads to characteristic rigidity. Other complicating factors with varying frequency include excessive saliva, drooling, sleep disruption, depression and constipation. Recently advertisements in the guise of public service messages focus attention on the relatively neglected accompaniments of this condition: hallucinations and delusions. These tend to occur relatively late in the disease generally developing many years after the original diagnosis. These…

Mar42018 by DocNo Comments

Dry Eyes and Their Treatment

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DRY EYES AND THEIR TREATMENT Prominently aired commercials serve to increase awareness of the common but frequently overlooked disorder known as Dry Eyes and their treatment. Fortunately even when undiagnosed, this nuisance complaint almost never leads to loss of vision. Also known as Aqueous Tear Deficiency, Xerophthalmia, Keratoconjunctivitis Sicca or merely KCS its main feature involves inadequate tear coverage of the eye’s surface. Tears function to lubricate and nourish the front of the eye, provide oxygen and nutrients, focus light and remove both foreign particles and infectious organisms. Obviously interrupting tear’s normal activities may be met with problems. Symptoms Symptoms of the DES tend to occur with increasing frequency as we age with those over age 40 most at risk. The peak incidence occurs in senior citizens. Overall the prevalence…