Category Archives: Reviews

C. diff Bacteria: What Is Clostridioides difficile

“C. diff is a severe, difficult-to-treat infection,” says family medicine specialist Daniel Allan, MD.
Studies show that you’re seven to 10 times more likely to get C. diff while you’re taking antibiotics or right after.”

Cleveland Clinic – Clostridioides difficile (C. diff) is a type of harmful bacteria that causes inflammation in your large intestine (also known as pseudomembranous colitis). The main symptom of a C. diff infection is frequent, watery and sometimes bloody diarrhea. If diarrhea persists, it can lead to:

  • Dehydration.
  • Weight loss.
  • Sepsis.
  • Death.

C. diff is common in the environment. Some people even carry C. diff in their gut but don’t have any signs of illness. Most of the time, the “good” bacteria in your gut prevent a C. diff infection. But certain antibiotics can wipe out your gut bacteria. If you encounter C. diff while taking antibiotics, the bacteria can flourish and grow and make you sick.

“Think about your colon as a plush green lawn. The thick grass crowds out the weeds,” illustrates Dr. Allan. “But if your yard is mostly dirt, all kinds of weeds will grow. Antibiotics reduce the rich collection of bacteria in your gut (the thick grass). This gives C. diff (the weeds) an opportunity to take hold.”

C. diff is most dangerous for people age 65 or older or with a weakened immune system. People who are healthy can also develop life-threatening complications if they don’t receive prompt care.

Hearing Aids: Over-The-Counter vs Prescription

Hearing aids are not one-size-fits all. “While OTC devices may help many people with mild or moderate hearing loss, they might not be appropriate for all types of hearing loss,” says Dr. Naples.

Harvard Health Publishing – A change in FDA regulations has cleared the way for over-the-counter (OTC) hearing aids. What does this mean for you if you’re among the approximately 48 million Americans with some degree of hearing loss? We asked Dr. James Naples, assistant professor of otolaryngology/head and neck surgery at Harvard-affiliated Beth Israel Deaconess Medical Center, to help explain potential pros and cons.

The basics: Hearing aids versus amplification products

There are various types of hearing aids that largely work in the same way. Whether the style is behind the ear or in the ear canal, they amplify sounds to make them louder. They also help filter out certain types of noise. “All hearing aids use a combination of signal processing and directional microphones to filter out some unwanted noise and to improve our ability to hear sounds,” says Dr. Naples.

Don’t confuse prescription or OTC hearing aids with personal sound amplification products (PSAPs) sold at most drug stores. Such products merely amplify nearby sounds. They’re not tailored to an individual’s hearing loss, and aren’t regulated by the FDA or intended to treat hearing loss.

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COMMENTARY:

Humans and their mammalian cousins have lost the ability to regenerate the hair cells in the inner ear. In preindustrial society(how could they know?) people apparently didn’t lose hearing as they aged. However, in the Industrial Age, the prevalence of noise has been increasing along with our power consumption,  and loss of hearing consequently occurs along with Aging.

High frequency loss is the most prominent, and this leads to inability to hear consonants, and have more difficulty with the voices of children and women which tend to be of a higher frequency. The ability of young people to hear high frequencies better than older people has led to various ringtones and songs favoring high frequencies, which the children can hear and older people cannot.

There are a number of things that can add to this hearing loss, such as chronic exposure to loud sounds (such as rock concerts), exposure to drugs that damage hearing, such as certain antibiotics and even aspirin. Otosclerosis and repeated middle ear infections can also accentuate the problem by interfering with sound conduction.

Ringing in the ears, tinnitus, is also associated with accelerated hearing loss.

I have had tinnitus for a long time, and at the age of 90, I have definite hearing loss. Even a couple of decades ago my high frequency loss was quite demonstrable by audiogram. I am resisting the temptation to get it corrected, since the louder sounds from the device would probably gradually reduce my baseline hearing ability. Also  I am now forced to pay strict attention when listening to people. This may slow down the tendency of older people to have a greater difficulty in “decoding” the  spoken word, due to decreased brain processing.

With the passage of a new law permitting people to access hearing aids without a prescription, the price of hearing aids is bound to go down, another reason for waiting.

If you are considering getting a hearing aid, an audiologist would prepare one that is tuned to your specific hearing loss.

The best is none too good.

—Dr. C.

Aging: ‘Healthy Longevity’ Journal – November 2022

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Inside the November 2022 Issue:

Research & review on #Alzheimers, global burden of benign prostatic hyperplasia, #WHO def of vitality capacity, IPD meta on social connection & #cognition, #oralhealth for older people & more.


Hope on the horizon for Alzheimer’s disease treatment?

Social connectedness and cognitive decline

Time to take oral health seriously

Heart Disease: The Best Ways To Lower High LDL Cholesterol Levels

November 1, 2022

What is a healthy target for LDL cholesterol?

Target LDL depends on many factors, including your age, family history, and personal history of cardiovascular disease. For people at intermediate risk, LDL should be lowered by 30% to 50%. For those who have already had a heart attack, target LDL is no more than 70 mg/dl (note: automatic download).

Which non-statin therapies are recommended first?

Five non-statin therapies described in this post aim to help people achieve target LDL goals while minimizing side effects. They may be combined with a statin or given instead of statins.

Each helps lower LDL cholesterol when diet and statins are not sufficient, such as when there is a family history of high cholesterol (familial hypercholesterolemia). But so far, only two options are proven to reduce cardiovascular risk — the risk for heart attack, stroke, heart failure, and other issues affecting the heart and blood vessels.

Ezetimibe (Zetia)

What it does: Lowers LDL and cardiovascular risk by reducing cholesterol absorption.

How it’s given: A daily pill

Relatively inexpensive and often given with statins.

PCSK9 inhibitors, alirocumab (Praluent) and evolocumab (Repatha)

What it does: A protein called PCSK9 controls the number of LDL receptors on cells. These medicines are monoclonal antibodies against PCSK9 that increase LDL receptors on the liver, helping to clear circulating LDL from the bloodstream.

How it’s given: A shot every two to four weeks

Highly effective for lowering LDL, but expensive and may not be covered by insurance.

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The Respiratory Syncytial Virus (RSV) Surge In 2022

Physicians are reporting high numbers of respiratory illnesses like RSV and the flu earlier than the typical winter peak. WSJ’s Brianna Abbott explains what the early surge means for the coming winter months.

Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It’s so common that most children have been infected with the virus by age 2. Respiratory syncytial (sin-SISH-ul) virus can also infect adults.

In adults and older, healthy children, RSV symptoms are mild and typically mimic the common cold. Self-care measures are usually all that’s needed to relieve any discomfort.

RSV can cause severe infection in some people, including babies 12 months and younger (infants), especially premature infants, older adults, people with heart and lung disease, or anyone with a weak immune system (immunocompromised).

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Reports: Tufts Health & Nutrition, November 2022

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Inside the Tufts Health & Nutrition Letter – November 2022:

  • Give Thanks for Good Health
  • Newsbites: Vitamin D; red meat and CVD risk; psyllium and constipation
  • Grain Products: Don’t be Fooled by Healthy-Sounding Labels!
  • Special Report: Top 3 Reasons to Avoid “Top Foods” Lists
  • Diet and Hemorrhoids
  • Featured Recipe: Fresh Cranberry Orange Relish
  • Ask Tufts Experts: Processed foods; calcium intake

New Diabetes Technology: Abbott’s Freestyle Libre 3 Glucose Monitor Review

Abbott Laboratories newest continuous glucose monitor is now available at participating retail pharmacies and through durable medical equipment suppliers. The Freestyle Libre 3 was approved by the FDA in June and is a step up from previous Abbott systems.

Abbott Laboratories and Dexcom are the leaders in the CGM market, which hit $5.1 billion in revenue in 2021 and is expected to reach $13.2 billion by 2028, according to Vantage Market Research. Abbott’s CGM systems, called FreeStyle Libre, generated $3.7 billion in revenue last year, with 4 million users globally.

CNBC’s Erin Black, a type 1 diabetic, tested out the Libre 3 for over a month. Here is her review.