Take a Pill to Butt Out

Studies have shown that only five per cent of smokers who try to quit by going cold turkey are successful.

But there is new hope: Zyban.

Originally marketed as an antidepressant, nicotine-free Zyban is thought to decrease the urge to smoke by targeting the brain's addiction centre.

In clinical trials, 49 per cent of smokers quit within seven weeks, and at one year 23 per cent were still smoke-free, nearly twice as many as with the Habitrol patch. No significant weight gains were reported, and common side-effects such as dry mouth and insomnia were usually temporary.

The drug is not recommended for those who have seizure disorders or have been diagnosed with anorexia or bulimia.

Zyban is prescribed for seven to 12 weeks, costs about $1.60 a day and is covered by some health plans.

Fake and Bake can leave you burned

The evidence is in: tanning sessions may not be a safe alternative to the sun 

By: Lanny Boutin
The Straight Goods - May 2000 

You've seen the ads: "Safe UV-A body tanning, protects the skin from sunburns" with "fewer risks to the skin than outdoor tanning because of the absence of UV-C rays."

Each year, 25 million Americans buy 300 million tanning sessions, making indoor tanning a $4 billion a year business in the US alone. A recent Quebec phone survey found 20 percent of participants had been to a tanning salon in the last five years, 11 percent in the last 12 months.

For twenty dollars, is 200 minutes under a tanning lamp really a safe alternative to the sun? 

They now know the UV-A rays used in most modern tanning lamps also cause skin damage.

Doctors once believed UV-B rays, the most prevalent burning rays in sunlight, and UV-C rays, which don't penetrate our ozone, caused the damage. But they now know that UV-A rays used in most modern tanning lamps also cause skin damage. 

"We know that if you're exposing yourself to ultraviolet radiation you're exposing yourself to a known carcinogen."

So before heading off on your next well-deserved vacation should you stop off at the tanning salon for a base tan first? "No," says The Counsel on Scientific Affairs. They recommend you avoid artificial tanning devices altogether.

But we know millions of people are not listening. So if you do go:

• Ask the staff if they're trained to analyze your skin type.

• Set up realistic tanning schedules.

• Always wear eye protection. UV rays can permanently damage your eyes.

• Have the staff time you in case your timer fails or you fall asleep.

Flossing your way to a healthy heart 

Studies show neglecting your teeth may put your health at risk 

By: Lanny Boutin 
The Straight Goods - May 2000

Let's face it, we judge others by the look of their teeth. People with normal looking front teeth, are perceived to be friendlier, more intelligent, more popular and more refined. But brushing and flossing may also be crucial to your health. By neglecting your teeth, you could also be putting your health at risk. 

"People with gum disease are twice as likely to have a heart attack." - Dr. Jack Caton, President, American Academy of Periodontology

He points to epidemiological research showing a statistically real association between gum disease and heart attracts. While specific studies are needed to prove cause and effect, he argues that "there is a large body of evidence on a mechanism which shows gum diseases can increase artery plaque. We are speculating it's one piece of the puzzle."

Mark Herzberg is also studying the links between gingivitis and heart problems. He teaches preventative science and periodontology at the University of Minnesota. "We are not talking cause and effect, but risk." His research in rabbits found the Streptococcus organism, the bacteria in dental plaque, caused heart ischemia, a condition in which the when the heart muscle is deprived of oxygen.

Like other conditions which suppress the immune system, gum disease can raise your risk of contracting pneumonia, bronchitis or emphysema

Like other conditions which suppress the immune system, gum disease can raise your risk of contracting pneumonia, bronchitis or emphysema. 

Gum disease can also be more prevalent in diabetics, who already have an increased susceptibility to infections. Researchers are now looking into whether gum disease makes it harder for diabetics to control their blood sugar. 

Research found that "poor periodontal health in the mother was a significant risk factor for reduced birth-weight in babies."

Researchers are also looking into the association between gum disease and pre-term or low birth-weight babies. "Short gestation periods and low birth weight are two of the leading causes of infant death in the US," says Dr. Ananda Dasanayake, professor of Dentistry at the University of Alabama at Birmington. She notes there were almost 4 million low birth-weight babies born in the US in 1995. Her research found that "poor periodontal health in the mother was a significant risk factor for reduced birth-weight in babies."

So, what can we do to keep our teeth and gums healthy and lower our risk of health complications?

Regular dental check ups, including an examination for periodontal disease are important, says Caton. "If people would not only brush, but also just pass something, floss or sticks or tooth picks, between their teeth every day it would have such a dramatic effect on reducing the prevalence of gum disease, it would be breathtaking in fact."

The Cold Truth

Kids get colds - six a year on average. They're contagious the entire cold, but it's not feasible to keep them home with every sniffle. So when should you call the doctor?

"Look at how they're acting. Says Dr. Joan Robinson a specialist in paediatric infectious disease at the University of Alberta's Stollery Children's Health Centre. "If they're irritable, lethargic, not interested in playing, or drinking and don't perk up after a dose of ibuprofen or acetaminophen, they should be seen."

Dr. Robinson also notes.

• Unless the child is under three months, fevers are generally harmless. Fever induced seizures, which are rare, generally happen during the first rise of temperature. 

• Unless the child's out of breath - a possible sign of asthma or pneumonia - a cough must run its course. 

• Coloration changes in nasal discharge, are normal, not necessarily a sign of sinusitis.

• Sore throats also typical disappear without intervention. Strep throat, caused by a bacterium, is not normally accompanied by cold-type symptoms.

Caution the keyword on the virtual couch 

Online psychological services - "psybertherapy" - may have people looking for shrinks in all the wrong places. Ask the right questions before baring your psyche online.

By Lanny Boutin
The Straightgoods - April 2000

Thinking of going online to find a psychotherapist? You might first want to consider some words of caution from Dr. James Ogloff, a professor of psychology and law at Simon Fraser University. "It's a buyer beware world on the Internet. And it's maybe even more important when you're dealing with people's
personal problems." notes Dr. Ogloff, who is also president-elect of the Canadian Psychological Association and chair of its ethics committee. "Our committee's worked on psybertherapy guidelines for two years, but with the speed it's changing, it is hard to even know what we're dealing with."   

Anyone can set up a psybertherapy site - Look at Dr. Laura. She's not a psychologist so no one can regulate her behaviour," says the chair of the Canadian Psychological Association's ethics committee 

Some web-based psybertherapists offer audio-videoconferencing, but most provide contact by e-mail only. Dr. Ogloff's personal opinion is that "e-mail is an inappropriate way to do therapy. It can provide information, or answer direct questions. But it's unsuitable for complex questions, especially when the therapist has not even met the patient." 

The use of e-mail for therapy also raises security questions. Most guidelines recommend encryption technology be used for all correspondence, but as Dr. John Grohol, a clinical psychologist, author and member-at-large of the International Society for Mental Health Online's executive committee, notes, "encryption's difficult to install and register, and for a person who's emotionally distressed, it can be too much hassle." 

E-mail can also be misdirected and without a password system can be read or answered by anyone. None of this is to say that there isn't a place for online
therapy. When conducted by regulated professionals, psybertherapy can be used effectively to supplement face-to-face contact, particularly in situations where distance is a problem. 

"I've been involved in a project to bring psychiatric services to the Prince George, B.C. jail," says Dr. Ogloff. "We have someone make a physical visit, and then once a week talk with inmates through audio-video conferencing. With live voice and video, it's almost like being in the same room." 

"Another example of where this type of therapy fills a need is the north," he adds. "The Yukon has one psychiatrist and, I think, four psychologists, so it's very common for psychologists in Whitehorse to travel by car, once every few weeks to remote communities and the rest of the time talk with patients on the telephone." 

Martha Ainsworth, author of Metanoia.org, a consumer review site for Internet therapy, agrees that "online therapy is not a substitute for tried and true face to face psychotherapy," but an adjunct in cases where its difficult to make the trip to a therapist's office. She also list situations where psybertherapy should not be
used: 
 

•  If you have tough or complex problems to work through. 

•  When you have a serious crisis, or are feeling suicidal. 

•  If you're uncomfortable expressing yourself in writing. 

If these circumstances sound familiar, then psybertherapy is likely not for you. But if you do decide to seek therapy online, be sure to ask the right questions about the therapist's background, credentials, and methods before you lie back on the virtual couch. 

Before you try check out some of the recommendations on these sites: 

Metanoia, The ABC's of Internet Therapy - www.metanoia.org
International Society for Mental Health Online - www.ismho.org
American Counseling Association - www.counseling.org
National Board for Certified Counselors Inc. - www.nbcc.org
Credential Check for Online Therapists - www.mentalhelp.net
Canadian Psychological Association, code of ethics - www.cpa.ca

The things we do for whiter teeth 

By Lanny Boutin
The Straightgoods - March 2000

In the quest for whiter teeth our ancestors used ashes, bleach, even urine. Today dentists use peroxide. 

Peroxide gel is placed into a moulded rubber tray, like a mouth guard and worn over the teeth, a few hours each day for at least seven days. The gel releases oxygen, slowly oxidizing stains, at a cost of three to four hundred dollars per treatment.

In the late 1980's the manufactures blocked the FDA's attempt to reclassify bleaching from cosmetic to a drug

It's estimated ten to fifteen percent of patients experience some degree of tooth sensitivity and even though researchers have found little evidence of permanent pulp damage, Dr. Rick Easton, a clinical assistant professor of dentistry, at the University of Alberta, notes "the bleaching agent gets into the pulp of the tooth, that's what causes the sensitivity; it's irritating the nerve." 

Dr. Xinyi Yu, Director of Clinical Research for Den-Mat Corporation (makers of Rembrandt tooth whiteners), believes that "some of the tooth's protective protein layer is being removed during bleaching, exposing the interior structure of the tooth to peroxide". 

Peroxide has the potential to irritate soft tissue and increase the release of mercury from amalgam fillings And even though sensitivity typically stops soon after the bleaching is finished, Easton notes, "that even low levels of repeated trauma can cause tooth death". 

A study from the University of North Carolina found "bleaching significantly lowered a tooth's stores of calcium and phosphorus and reduces the thickness of the material around its core". A similar Hungarian study found bleaching "increased the depth of small groves on the teeth".

Researchers also note peroxide has the potential to irritate soft tissue and increase the release of mercury from amalgam fillings.

Once swallowed, it seems to be safe. Our livers make around 7 grams of hydrogen peroxide each day, it's also found in processed foods, coffee and some vegetables. Dr. Dittakavi Sarma, an expert in chemical carcinogens, and professor in the Department of Medicine and Pathobiology, at the University of Toronto notes, "peroxide is a weak cancer promoter".

Perhaps ashes wasn't such a bad idea, after all...   
 

Jury still out on New Flu Pill

What's it worth to shorten the misery? 

By Lanny Boutin
The Strightgoods - February 2000

Drug companies make a bundle this time of year - flu season - with drugs to ease the symptoms. Now they are selling a new drug that purports to shorten the misery. 

Studies show Tamiflu (oseltamivir) manufactured by Hoffmann-La Roche Ltd, reduces the duration of flu symptoms by 1.3 days, the severity of symptoms by 40 percent and secondary complications like bronchitis and sinusitis by 50 percent in otherwise healthy subjects. So is Tamiflu the miracle drug we've been waiting for?

Tamiflu is "the first pill which treats all common strains of influenza by stopping it from replicating," claims Dr. Fred Aoki, Professor of Medicine at the University of Manitoba. 

Yet other physicians are more cautious. "I think you're not alone in wondering about these new agents to treat the flu," says Dr. David Moores, chair of Family Medicine at the University of Alberta. And the College of Family Physicians wants to "let the post-marketing studies reveal the truth about Tamiflu".

As Moores notes the flu is hard to diagnose, but Tamiflu must be started within 2 days. A New Zealand study recommends starting within 36 hours of the first 
symptom.

And, "Unlike the flu shot which prevents 80 to 90 percent of flu in healthy individuals and protects against three separate strains" notes Dr. Marcia Johnson, the Deputy Medical Officer for Capital Health region, Edmonton, "Tamiflu leaves you susceptible to the other two strains".

So should healthy individuals fork out forty-two dollars, for a drug that causes nausea or vomiting in 10 percent of patents, to shorten their symptoms by less than a day and a half?

The manufacture thinks so, and is using scare tactics to convince the public. Their web site, flupill.com, claims to be "a comprehensive resource about one of the world's most deadly and dangerous diseases: the Flu, a disease which kills 6000 to 7000 Canadians in a typical winter."

Scary stuff, for a disease with a morbidity rate of less than .01 percent, and for which Johnson notes, "virtually all deaths are people in the high risk categories".

Symptom: Sore Wrists

If you've been diagnosed with carpal tunnel syndrome (CTS) without the aid of diagnostic tests, you should consider getting reexamined.

Studies show that conditions such as hypothyroidism, diabetes and arthritis can cause numbness and pain in the wrist and hand similar to that caused by CTS. 

One german study found that one third of its 224 CTS patients suffered from conditions that mimic CTS.

"A misdiagnoses of CTS could cause a person to suffer the consequences of a delayed diagnoses" says Dr. Liam Martin, a rheumatologist and associate professor in the facility of medicine at the University of Calgary. "It could also subject you to unnecessary carpal tunnel-release surgery.

To diagnose CTS accurately, Martin recommends a nerve conduction test, which uses electric impulses to test the median nerve as it crosses the wrist. Also, a thyroid-function test and a complete blood count to rule out other diseases.

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