Archive for July, 2013

Dubai On Dieting-Gold For Gut Loss

July 30, 2013

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There are so many fad diets on the market but this idea is certainly unique and one of a kind.
Dubai’s government will pay residents in gold for losing those extra pounds as part of a government campaign to fight growing obesity in the Gulf Arab emirate.

For every kilogram dropped by Aug. 16, contestants who register from Friday can walk away with a gram of gold, currently worth about $42 US.

Health officials in Dubai, the commercial hub of the United Arab Emirates, and in neighboring Gulf nations are spending millions to control obesity among their citizens.

Bottom Line: There’s a law of thermodynamics that you have to consume less or burn more calories by exercise to lose weight. There really is no other way to lose those extra pounds. Maybe adding a little gold to equation might just be the magic elixir to inspire the overweight citizens of the UAE to take off a few kilos.

http://www.cbc.ca/news/health/story/2013/07/19/dubai-weight-loss-gold.html

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Testosterone Deficiency-Treatment Puts a Tiger in Your Tank

July 23, 2013

As men age, the testosterone, the male hormone produced in the testicles, decreases just as a woman’s estrogen levels decrease at the time of menopause. Low testosterone can dramatically affect a man’s sex drive and sexual performance. Also low testosterone can reduce your ability to have satisfying sex. Lack of sex drive and erectile dysfunction are sexual problems that can result from low testosterone. If low testosterone is the cause, effective treatment is available.

Researchers haven’t unraveled the mystery of just how testosterone increases libido. It’s normal for a man’s sex drive to slowly decline from its peak in his teens and 20s, but libido varies widely between men. Also, sex drive changes within each man over time and is affected by stress, sleep, and opportunities for sex. For these reasons, defining what’s a “normal” sex drive is next to impossible. Usually, the man himself identifies a lack of sex drive as a problem. Other times, his partner may complain and send the man scurrying to his doctor for help or the partner may not consider the low sex drive to be an issue and they live happily ever after without an abundance of sexual intimacy.

In a large study of men in Massachusetts, about 11% overall said they had a lack of sex drive. The researchers then tested all the men’s testosterone levels. About 28% of men with low testosterone had low libido. These men were relatively young, with an average age of 47; older men might have worse sexual symptoms.

Low testosterone is only one of the causes of low libido. Stress, sleep deprivation, depression, and chronic medical illnesses can also sap a man’s sex drive.

Surprisingly, low testosterone by itself rarely causes erectile dysfunction, or ED. Low testosterone alone — with no other health problems — accounts for a small minority of men with erectile dysfunction.

Erection problems or ED are usually caused by atherosclerosis — hardening of the arteries. If damaged, the tiny blood vessels supplying the penis can no longer dilate to bring in the strong flow needed for a firm erection. Diabetes, high blood pressure, and high cholesterol are the three main causes of atherosclerosis and erectile dysfunction.
At the same time, low testosterone is a frequent accomplice to atherosclerosis in creating erectile dysfunction. About one in three men mentioning ED to their doctor have low testosterone. Experts believe that in men with other factors causing erectile dysfunction, low testosterone can strongly contribute, making a difficult situation even worse.

Strengthening the connection, low testosterone is linked in some way with many of the conditions that lead to erectile dysfunction:
• Metabolic syndrome
• Obesity
• Endothelial dysfunction
• Diabetes

Although low testosterone isn’t known to cause them, the associations between other medical conditions and low testosterone can be significant.
Testosterone therapy improves sex drive and satisfaction with sex in many men. Treatment consists of injections of testosterone every 1-2 weeks, daily application of a testosterone gel, or the insertion of a testosterone pellet beneath the skin and then repeating the insertion every 4-6 months.

Most men with decreased testosterone levels can be helped. A simple blood test makes the diagnosis and treatment usually restores a man’s sex drive, energy level, and sexual performance.

When It Hurts When You Ejaculate-Coming and Going

July 23, 2013

It is not an uncommon complaint for men to have pain at the time of ejaculation. This is almost always a result of inflammation and can be resolved with medication. Pain at the time of ejaculation can be felt in the area between the anus and the scrotum or in the urethra, a tube that runs from the bladder to the end of the penis. The condition can cause discomfort in the testes and certainly interferes with sexual pleasure.

Painful Ejaculation can be caused by an inflammatory condition of the prostate gland which can make the prostate feel sore and irritated, STDs may cause inflammation in the prostate and the urethra and cause pain with ejaculation and pain with urination, obstruction to the ejaculatory ducts that get distended and then cause pain when the seminal vesicles contract at the time of ejaculation, and finally, psychological problems can manifest themselves as painful ejaculation.

To find the cause of painful ejaculation, a semen sample and urine sample taken after ejaculation (post ejaculation urine analysis) is examined. A sample of the urethral lining is taken to see if there is any infection, such as a sexually transmitted infection. A test that looks at the inside of the bladder and urethra (cystoscopy) may also be done, although this is not a usual procedure for diagnosing painful ejaculation. For some men it can be hard to describe the exact location of the pain.

Treatment
If no physical cause is found, some behavioral techniques to relax the muscles in the pelvic area may help some men. When the cause is prostatitis the use of medications such as ‘alpha blockers’, muscle relaxants, analgesics, and some anti-inflammatory drugs may help. Specific antiviral and antibiotic medications can be given if the cause of painful ejaculation is due to an infection such as herpes.
If the cause is psychological, counseling may help deal with any underlying concerns.

Bottom Line: Painful ejaculation is not life-threatening, but may affect sexual pleasure and can cause a man distress, anxiety and lower self esteem. In most instances the cause can be determined and effective treatment is available..

Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man

July 17, 2013

Normal appearing male sperm

Normal appearing male sperm


Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man
A recent article in the Wall Street Journal (Tuesday July 16, 2013) points out that there by a “sperm crisis” because they believe men’s sperm counts have been decreasing for a decade or more.

A 15 year study in France reported that the sperm concentration of men decreased by nearly one-third between 1989 and 2005. In the U.S., some historical data suggest a decrease in sperm count among American men, but no published recent data exist.
Suspected causes include exposure to pesticides, endocrine-disrupting chemicals like Bisphenol A and lifestyle habits like sitting for too long contribute to the proposed sperm crisis. Also, I reported how men who use lap top computers on top of their genitals for long periods of time, increase the heat to the testicles and the cells that are responsible for sperm production.

In general, men produce upward of 60 million sperm per milliliter of semen. As long as the count is roughly greater than 40 million per ml, men are considered fertile and have the same chance of getting their partners pregnant as someone who produces a higher count. But below that threshold and particularly under about 20 million per ml, their ability to conceive decreases.

Accumulating evidence suggests that early life influences make a difference. Some researchers say that there is a vulnerable period, perhaps between eight and 14 weeks of gestation, in which influences are irreversible. One of the most robust links with decreased sperm count is maternal smoking during pregnancy.

The male’s own current marijuana use was also linked to lower sperm count.

In additional to maternal smoking, there are environmental and lifestyle factors that can affect sperm count which include: shampoos containing phthalates found in plastic bottles, sedentary jobs especially for over hours at a time, hot water such as frequent hot baths which increase scrotal temperature, fatty food appear to contribute to a low count but this impact is potentially reversible.

Bottom Line: By adopting a healthy, balanced diet and lifestyle in pregnancy, you can give your developing baby the very best start in life which will minimize the risk of future decreases in sperm counts.

Dripping and Depends-Loss of Urine After Prostate Gland Surgery

July 12, 2013

You Don't Have to Depend On Depends!

You Don’t Have to Depend On Depends!


Prostate cancer is the second most common malignancy in men. Many men will choose to have surgery on their prostate gland and have the entire gland removed if the disease is confined to the prostate gland. Unfortunately, the sphincter, or muscle that controls urination, is often injured at the time of surgery or is included in the surgical specimen. As a result men will have problems with urination after the surgery.

There are three types of urinary incontinence may develop after prostate cancer treatment. These are stress incontinence, overflow incontinence, and urge incontinence.

If you have stress incontinence, you leak small amounts of urine when you cough, sneeze, exercise or put pressure on your bladder. Kegel exercises may help strengthen the muscles in your pelvic floor. This allows you to delay urinating until you reach a toilet.
You may have thought that Kegel exercises were something only women do. In fact, the muscles that are strengthened with Kegel exercises are the same in both sexes. (For more information on Kegel exercises, please refer to my website, http://www.neilbaum.com)

Urge incontinence occurs when your bladder suddenly contracts and expels urine. You get an urge to urinate even though you know you emptied your bladder not long before. You urinate, and then get the urge again a half-hour later. Urge incontinence often comes in waves. It may not bother you all morning, for example, but it becomes insistent mid-afternoon. In the course of a few hours you may feel the urge four or five times.

Bladder retraining helps by increasing the amount of urine your bladder can hold. In this technique you suppress your urge and gradually prolong the time between trips to the toilet. This really works, but now and then there’s a crisis. You’ve ignored the urge, and ignored it again, and suddenly you’re pretty sure you aren’t going to hold it and need to dash to the bathroom. The trick is to know when your bladder is at its limit and go to the bathroom just before you have to make that mad dash.

Prescription medications, particularly oxybutynin (Ditropan), tolterodine (Detrol) and some antidepressants, can be effective. The antidepressants aren’t treating depression: They calm the sensations that come from your bladder.

Overflow incontinence results when your bladder cannot empty completely. As a result, urine dribbles out. Alpha blocker drugs help to more fully empty the bladder.

Even if your incontinence can’t be cured, it can be managed. Absorbent underwear and highly absorbent disposable pads can be worn with everyday clothing. A condom-like device can be fitted over your penis and connected to a drainage bag. There is also a rubber clamp that can be used to compress the urethra or the tube that transports urine from the bladder through the penis to the outside of the body. Also there is a ring that can be applied to the penis that will gently compress the urethra and prevent urine loss.

Bottom Line: Fortunately, most men who have prostate gland surgery will be able to control their urination. The few who have problems with urination can be helped with exercises, medications, devices, and only rarely will need additional surgery to correct the problem.

Something Fishy About Fish Oil and Prostate Cancer

July 11, 2013

The fish oil supplements that millions of American men take each day to cut their risk of heart disease might have a dark side, at least according to a study released today that is sure to generate controversy.

The new study, published today in the Journal of the National Cancer Institute, suggests that men who have higher levels of omega-3 fatty acids in their system face a 43 percent increased risk of developing prostate cancer and a 71 percent increased risk of the high-grade form of the disease.
To determine this, the researchers relied on data from a past study that examined the blood concentrations of omega-3 polyunsaturated fatty acids in 834 men with prostate cancer and 1,393 men without prostate cancer. When they did this, these researchers found an association between high omega-3 levels and the occurrence of prostate cancer.

Whether the increased level of omega-3 in the men with prostate cancer was from supplements or from oily fish in their diet was unclear. The findings suggest that men should be wary of getting too much of the nutrient.
Men should probably moderate their intake of fatty fish and they should avoid fish oil supplements at this time, especially considering that when men are taking fish oil supplementation they are taking [higher doses than they need.

If you want omega 3′s, get them from food. The more we look at supplements, the more untoward consequences we find.”

Bottom Line:
So where does this leave men who, based on this study, are worried that they will have to choose between a healthy heart and a healthy prostate?
The first thing that these men should do is speak to their doctors prior to making any changes to their diets and discontinuing current supplementation. In particular, men with active heart conditions or elevated cholesterol levels should approach their cardiologists and discuss the risk versus the benefits of consuming fatty fish and fish oil supplementation.

OAB – WHEN YOU REALLY GOTTA GO!

July 10, 2013

OAB (over-active bladder) is found in both men and women and is associated with the symptoms of urgency, frequency, nocturia and urge incontinence.

Regulation of bladder storage and voiding involves both sympathetic and parasympathetic control.

Bladder voiding is primarily regulated by the parasympathetic nervous system via the neurotransmitter acetylcholine. Muscarinic receptors (M1-M3-M5) are mediated by acetylcholine in controlling the contraction of the bladder muscle and relaxation of the internal sphincter to facilitate voiding. M2 and M3 are predominate muscarinic receptors found in the bladder. The anti-muscarinic (Ditropan, Ditropan XL, Vesicare, Sanctura, Gelnique, Toviaz and Enablex) all work by blocking the receptor, leading to a reduction in bladder contractions. Because they block the acetylcholine receptor systemically, they can be associated with constipation and dry mouth.

Bladder storage is primarily regulated by the sympathetic nervous system via the neurotransmitter norepinephrine. Norepinephrine released from the sympathetic nerve activates the adrenergic receptors causing the bladder to relax and close the external sphincter. There are three types of beta adrenergic receptors expressed in the bladder. The beta-3 AR makes up 97% of bladder receptors and is predominately responsible for the detrusor muscle relaxation. The drug Myrbetriq has recently been released and is a Beta 3 adrenergic receptor agonist which leads to increased relaxation of the bladder. In contrast to the anti-muscarinics which cause constipation and dry mouth, this is much less common with Myrbetriq which has a small incidence of an increase in blood pressure. Monitoring the patient’s blood pressure is important in patients with a history of hypertension.

A Phase 3 trial in over 400 men and women complaining of OAB symptoms was recently conducted with 3 arms, Tolterodine ER (Detrol LA) Myrbetriq and placebo arm. The incidence of dry mouth was 5 times higher in the Detrol arm than in the Myrbetriq group (10% vs 2%).

It should be noted in all of the clinical trials with both Myrbetriq and the anti-muscarinics, the increase in urinary voided volume was typically in the range of only 1 or 2 ounces. Both approaches do result in a significant decrease in the incidence of urge incontinence.

A few key points that we have found important in treating OAB patients includes:
1. The treating doctor can use a combination of an anti-muscarinic and Myrbetriq to decrease symptoms of OAB especially in patients with severe symptoms that do not respond to either agent alone.
2. In contrast to prior thinking, there is a very small incidence of urinary retention with the use of either anti-muscarinics or Beta-3 agonists. However, caution should be used in men who really don’t have OAB but have impending urinary retention where they have large residual urine volumes as treatment with anticholinergics or a beta-3 agonist can only exacerbate the situation. Since most primary care physicians don’t have access to a bladder scan, but the PCP can use the tried and true old-fashioned way of simple percussion of the lower abdomen to determine if there is, indeed, significant residual urine.
3. The use of anti-muscarinics in patients with closed angle glaucoma is a contraindication. In patients with a history of glaucoma, we typically give the patients a prescription for their OAB suggest that the patient check with their ophthalmologist prior to initiating treatment.
4. There are a number of tips and coping suggestions in patients with over-active bladder that include: Timed voiding, reduction in caffeine and alcohol, reduction in fluids prior to bedtime and Kegel exercises when patients have strong urges to void. All of these suggestions can help. I provide the patient with a handout on coping suggestions which I have found effective. In fact, numerous studies have shown that behavior modification is as effective as medical therapy.
5. For patients who are unresponsive, an intake and output diary can be of help in determining how big a factor fluid intake can be, as well as, monitoring actual response to treatment.
6. It also is important to realize that many patients complain primarily of nocturia. Nocturia can be a result of numerous urologic as well as non-urologic conditions including CHF, venous insufficiency, and increased fluid intake at night. This is certainly a case where a voiding diary also can be of benefit. For patients whose primary complaint is nocturia, DDAVP .1 to .2 mg. can be used but it is important to monitor the serum sodium for hyponatremia.
7. For patients refractory to either combination or individual drug therapy, there are additional alternatives:
a. Percutaneous posterior tibial nerve stimulation involves a small acupuncture sized needle being placed in the ankle and a minimally perceived current transmitted up to the spinal lumbosacral nerve center where one can “reprogram” the bladder. This is indicated for patients unresponsive to oral medication.
b. For patients with refractory OAB symptoms, Interstim therapy can be utilized. Interstim involves an initial percutaneous trial followed by implanting leads from the spinal cord to the nerves supplying the bladder along with a programmed stimulator, which markedly suppresses and reduces urinary symptoms.

Please do not hesitate to contact me if I can be of assistance. I can be reached 504-891-8454 or email me at doctor whiz@gmail.com or via my website, http://www.neilbaum.com

Just Say “No”…To Soda Pop! The Pop And Prostate Cancer Connection

July 2, 2013

There’s an obesity epidemic in America and soda pop is one of the fuels of that problem. If you are looking for reason to kick the soda pop habit, you may have just found it. According to a study out in Sweden, men who drink as little as one soda beverage a day have a greater risk of contracting prostate cancer. The increased risk goes up as far as 40%.
The study, carried out by Swedish scientists, tracked the health of more 8,000 men aged 45-73 over a 15 year span. Those men who on average drank just one can of soft drink a day appeared 40 percent more likely to develop aggressive prostate cancer. The researchers stressed that one of the most important factors in risk-association was genetics. However, they noted this research would appear to suggest that dietary factors could play a stronger role than previously thought in terms of men developing prostate cancer.

Prostate cancer is among the most common cancers in men. It is estimated that some 241,740 new cases of prostate cancer will be diagnosed in the US this year, with 28,170 men dying of prostate cancer by the end of 2012. There are of course plenty of other reasons to drop soft drinks from your diet. Previous studies have found that soft drinks–and in particular their high concentrations of sugar–may cause increased heart disease risk, an elevated stroke risk, the potential for long-term liver damage, increased rates of diabetes and more.

Maybe just a glass of water then?

Bottom Line: Want to stay healthy? Drink less soda and a lot more water!
– Read more: http://www.care2.com/causes/yet-another-reason-to-avoid-soda-prostate-cancer.html#ixzz2XiaYVde1
– See more at: http://www.vibe.com/article/put-pop-down-study-links-soda-prostate-cancer-risk#sthash.cczMrxXv.dpuf

Saying Goodbye To Jumping Jack “Hot” Flash

July 2, 2013

Not all women will experience hot flashes, but three out of four will, with one of 10 experiencing them through their seventies. The cause of hot flashes are the dilation of the blood vessels in the face and upper chest result in increased blood flow to these areas. Some women also sweat during hot flashes. For some women, the hot flashes are not very common and are an inconvenience. For other women, they impact the woman’s quality of life and are incapacitating. The time-honored treatment for hot flashes has been estrogen replacement therapy or hormonal therapy. While hot flashes are not dangerous, they cause discomfort, embarrassment and sleep loss. During menopause some women may have more than 10 a day.

Women with uncomfortable hot flashes now have a medication option that doesn’t involve hormones. The U.S. Food and Drug Administration approved the first nonhormonal drug to treat moderate to severe hot flashes and night sweats associated with menopause. The drug, Brisdelle, contains peroxetine, a selective serotonin reuptake inhibitor (SSRI) that is also the active ingredient in the antidepressant Paxil.

Many women are reluctant to treat menopausal symptoms with hormones including estrogen and progesterone, as a 2002 study conducted by the Women’s Health Initiative implied that a combination of hormones, estrogen and progesterone, with increased cancer risk.

Side effects of the drug included headache, fatigue, nausea and vomiting. Brisdelle will be available starting in November.

Bottom Line: Every woman would like to have her hot flashes disappear like magic. Although estrogen replacement therapy has been effective in reducing hot flashes, many women do not want to take hormones. Brisdelle may just be the solution that many women have been waiting for.

Read more: http://www.nydailynews.com/life-style/health/nonhormonal-hot-flash-treatment-approved-fda-article-1.1388094#ixzz2XvmVGY89