Tag Archives: Medicine

Dr. C’s Journal: Flat Feet And Overpronation

Flat feet will exempt you from the draft, but that is where are their benefit stops. This condition can be inherited, but the arch can also fail to develop during puberty.

The entire bottom of the foot will contact the ground when walking if you have flat feet.

Overpronation happens when the way you walk causes the arches of the feet to flatten even more, putting a strain on the muscles, tendons, and ligaments that support your arches. Overweight and running a lot on hard surfaces accentuates this problem, and pain in the ligaments in the arch of the foot is the result.

Overpronation may be indicated by excessive wear on the inside of the heels and soles of your shoes, and can cause all kinds of problems such as Achilles tendinitis, iliotibial band syndrome, plantar fasciitis, shin splints, and even knee, hip, or back pain. these things may  develop in compensation to overpronation while walking.

As an older person, I have pretty much given up tennis and running, and walk rapidly for long (for me) distances in order to get sufficient exercise. Without noticeably increasing my walking, I have recently developed tenderness in the arch of my left foot that made walking painful. Curling my toes, and walking on the outside of my feet seemed to alleviate the pain. This is an exercise that I remember from my childhood, and may have been shown me because of my moderately flat feet.

Swimming for Exercise, and decreasing the amount of walking seems to have corrected the condition at least temporarily, but I have also ordered some orthotic inserts for my shoes as an arch support, in case I need them going forward. I have been told that if this is insufficient I can go to a specialty store and order some special shoes that might help. I have not mentioned painkillers such as NSAIDs, because I try to avoid them

Please check with the accompanying references for more information about flat feet and over pronation.

—Dr. C.

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Dr. C’s Journal: Plantar Fasciitis And Foot Pain

Our feet are subjected to such abuse that it is amazing we don’t have more problems with them. But problems there are, and I have been having some. I will be exploring the different types and causes of foot pain  beginning with this article on plantar fasciitis.

The plantar fascia is a triangular web of connective tissue on the bottom of the foot that begins at the heel and fans out to attach to the toes. With repeated stress, it can become torn or inflamed and caused pain.

The pain of plantar fasciitis is usually centered around the heel, on the bottom of the foot. It is often absent first thing in the morning, produces a stabbing pain on first walking, and goes away with activity; you can “walk it off”. Plantar fasciitis is usually slow to heal and may take several months

The doctor will usually make the diagnosis by your story(history), and the localization of the pain. X-rays, CT scans, and MRIs or necessary only if there’s a suspicion of a stress fracture.

Conservative treatment focuses upon stretching exercises and orthotics, but there are various types of injections, shockwave therapies, ultrasonic tissue repairs, and surgeries that some people need.

A particularly interesting treatment cited was the injection of platelet rich plasma from your own blood to promote healing. I recently read that this technique, in addition to a collagen scaffold  is currently used to treat rupture of the anterior cruciate ligament of the knee.

Of course, prevention is the ideal. Maintaining a healthy weight is important. Supportive shoes, with thick soles and good arch support will help. stretching exercises are also helpful as a preventative.

Please check with the Mayo Clinic article for more information.

—Dr. C.

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Colorectal Cancer: ‘Miss Rate’ Lowered 50% Using AI

“Colorectal cancer is almost entirely preventable with proper screening,” says senior author Michael B. Wallace, M.D., division chair of Gastroenterology and Hepatology at Sheikh Shakhbout Medical City in Abu Dhabi, United Arab Emirates, and the Fred C. Andersen Professor at Mayo Clinic in Jacksonville, Florida. “The substantial decrease in miss rate using AI reassures health care providers on the decreased risk of perceptual errors.”

The most relevant cause of post-colonoscopy colorectal cancer (CRC) is the miss rate of colorectal neoplasia — the rate at which neoplastic lesions are not detected in a screening or surveillance colonoscopy. Some studies suggest that 52% to 57% of post-colonoscopy CRC cases are due to missed lesions at patients’ colonoscopies. It’s estimated that 25% of neoplastic lesions are missed following screening colonoscopy.

Mayo Clinic Gastroenterology and Hepatology, in collaboration with colleagues from around the world, found that using artificial intelligence (AI) in colorectal cancer screening produced a 50% reduction in the miss rate for colorectal neoplasia. Results of the study were published in the July 2022 edition of Gastroenterology.

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Dr. C’s Journal: What Are Symptoms Of Gonorrhea?

Gonorrhea been present since the earliest times. The United States has one of the highest incidences, and it was very common in colonial America, where it was called “clap”. Adolescents, with their increased sexual activity, have the highest incidence, and girls are somewhat more likely to have it than boys.

The symptoms have to do with infection and inflammation of the urethra. Burning on urination is almost universal, and purulent discharge and presence of pus in the urine is frequent. The infection is mostly a nuisance, but it can travel up the genito-urinary tract, and into the spermatic ducts in the male or the fallopian tubes in the female, and it is a common cause of sterility and pelvic inflammatory disease, or PID.

With its high frequency in young females, bacterial ointments are routinely applied to the eyes of newborn babies to prevent severe infection and possible blindness.

When I was practicing medicine, the diagnosis was made by culturing for the bacterium neisseria gonorrhea. Now the NAAT, the nucleic acid  amplification test, is the gold standard.

In my practicing  days, penicillin was the magic bullet, but resistance he has developed so that a cephalosporin and azithromycin combination is currently used.

STDs, sexually transmitted diseases, are one of the commonest conditions encountered in student health, according  to a good friend.

Please refer to the attached Mayo Clinic article for more information.

—Dr. C.

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Prevention: Flu Shots Lower Heart Attack Risks

Influenza-related stress on your body can launch a negative chain of events that builds toward a heart attack. This video shares how getting a seasonal flu shot can significantly lower your risk of having a heart attack or cardiac arrest, especially if you’re in a high-risk group.

Chapters: 0:00 Can flu shots lower risk of heart attacks? 0:37 How does the flu shot lower risk of heart attacks? 1:08 Who is most at risk of having a flu related heart attack? 1:30 Why else should you get a flu shot?

Melanoma: Men Have Higher Mortality Rates

Researchers say men are more likely to die from melanoma than women. And by the time a man is 50, the likelihood of developing melanoma increases every year, compared with women.

“The main risk factors for melanoma are sun exposure, amount of sun exposure, high-level sun exposure — meaning sunburns — but also light skin color,” says Aleksandar Sekulic, M.D., a Mayo Clinic dermatologist.

The most common places for melanoma to occur are body parts exposed to the sun, including the face, back, arms and legs. The first signs are often a change to an existing mole or an unusual-looking growth on the skin.

“The big problem with melanoma is not only that it starts in the skin, but that it can spread. And it can be deadly,” says Dr. Sekulic.

Avoid prolonged exposure to the sun, especially in the middle of the day to prevent sunburns. Wear protective gear outside, such as a broad-brimmed hat, tightly woven clothing that covers your arms and legs, and sunglasses to protect your eyes. And use sunscreen generously with a sun protection factor of 30 or higher on exposed areas of skin. Reapply at least every two hours. And if you’re swimming or sweating, use water- and sweat-resistant sunscreen.

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Tendinopathy: Diagnosis, Treatment & Prevention

Tendinopathy is the broad term for any tendon condition that causes pain and swelling. Your tendons are rope-like tissues in your body that attach muscle to bone. When your muscles tighten and relax, your tendons and bones move. One example of a tendon is your Achilles tendon, which attaches your calf muscle to your heel bone and causes ankle movement. If you have pain and/or swelling in that area, you might have Achilles tendinopathy.

The pain from tendinopathy can interfere with your daily life. For example, it can keep you from playing sports and from doing housework. So, if you have pain or swelling, make sure to contact your healthcare provider for help.

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Insulin Resistance: Risk Factors And Treatment

Learning about insulin resistance, or prediabetes, can be intimidating. Eleanna De Filippis, M.D., Ph.D., an endocrinologist at Mayo Clinic, walks you through the facts, the questions, and the answers to help you better understand this condition.

Video timeline: 0:00 Introduction 0:41 What is insulin resistance? 1:32 Who gets insulin resistance? / Risk factors 2:38 Symptoms of insulin resistance 4:04 How is insulin resistance diagnosed? 4:34 Treatment options 5:21 Coping methods/ What now? 5:41 Ending

COMMENTARY:

The (developed) world just has too much food. Food producers race with each other to make It tastier, to advertise it widely, and make it available on demand. As a consequence of their success, at least 1/2 of the developed world is overweight and has decreased insulin sensitivity, prediabetes or diabetes. This leads to severe health consequences in the form of hypertension, arteriosclerosis, heart disease, brain disease, liver disease, and a variety of back and joint problems.

Mankind did not evolve in an environment of chronic nutritional oversupply, but rather it’s reverse. Mankind did not develop in a sedentary environment, but rather it’s reverse.

Insulin resistance is caused by overfilled energy stores (excess fat), increased inflammation from distended, dying fat cells, excess fatty acids and stresses to some of the important micro structures in our cells, such as mitochondria and endoplasmic reticulum, not to mention metabolic pathways such as the mTOR and Sirtuin systems.

Eating is a pleasure, and turning down food takes self-discipline, which is a pain, and is becoming increasingly unpopular. “Maybe a pill will come along to get rid of fat and prevent its accumulation”. but don’t count on it. The main hope for avoiding the danger of overnutrition is being discriminating about what and how much you eat.

Exercise is inconvenient and uncomfortable, but is the second necessity for a healthy life. Two of its many benefits is to increase adiponectin, which increases burning of the fatty acids which are so toxic to the body, and to increase insulin sensitivity, counteracting type two diabetes.

The third necessity is getting enough sleep.

Replay the old record. Diet, exercise and sleep, sleep  diet and exercise.

Please excuse me, it’s time for my evening exercise.

—Dr. C.

For more reading visit: https://mayocl.in/3waShVV.

Infographic: Diagnosis & Treatment Of Psoriasis

Psoriasis is a skin disease that causes a rash with itchy, scaly patches, most commonly on the knees, elbows, trunk and scalp.

Psoriasis is a common, long-term (chronic) disease with no cure. It can be painful, interfere with sleep and make it hard to concentrate. The condition tends to go through cycles, flaring for a few weeks or months, then subsiding for a while. Common triggers in people with a genetic predisposition to psoriasis include infections, cuts or burns, and certain medications.

Treatments are available to help you manage symptoms. And you can try lifestyle habits and coping strategies to help you live better with psoriasis.

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COMMENTS ON ‘PSORATIC ARTHRITIS’:

My practice was restricted to allergy, but I saw many patients with psoriasis. The red scaly patches made them think they had allergic dermatitis, eczema. Psoriasis on the arm is usually located on the elbow, and atopic dermatitis on the opposite side, in the flexural area. Thick, pitted fingernails are also common in psoriasis. It’s combination with arthritis is worrisome.

Psoriasis will usually develop first, and the psoriatic arthritis will follow years later, but 10% of the time the arthritis Is the first problem. This form of arthritis can be very painful, and cause deformities. It is often worse than rheumatoid arthritis, although does not affect as many joints, and is often asymmetrical. It inflames the area where tendons attach to the bone, which is one of the reasons that it can be more painful than rheumatoid arthritis.

Psoriasis is an autoimmune problem and can involve practically any organ in the body.

It is often associated with metabolic syndrome and diabetes.

Psoriatic arthritis does not have the rheumatoid serum markers that can help diagnose rheumatoid arthritis, and unless psoriasis is also present on the skin, it can be hard to diagnose.

Symptomatic treatment with NSAIDs, physical therapy, phototherapy and topical treatments can be helpful, but very expensive biologics are sometimes needed to help out methotrexate and other first line DMARDs (Disease modifying antirheumatic drugs).

This condition can be  progressive.  If you develop scaly red patches on your skin, be sure to check with the doctor about the possibility of psoriasis.

—Dr. C.