North Shore LIJ

February 27, 2013

Was Lady Gaga Born This Way?

Andrew Goodwillie, MD

Lady Gaga’s hip injury has caused the pop star to cancel the rest of her Born This Way Ball Tour, rendering her starstruck fans speechless. It appears Lady Gaga has struggled with the the labrum of her right hip for “months” and she cites “strenuous repetitive movements” as the likely cause of the injury, according to CNN. Ultimately, the singer will undergo surgery to repair the torn tissue in her hip and take some time to recover.

The labrum is a stabilizing structure in the hip that also provides flexibility and motion. An injury to the labrum can cause vague symptoms of groin pain or intermittent mechanical symptoms like catching or clicking, which make diagnosis particularly tough. If the initial treatment of rest, anti-inflammatory medicine and physical therapy do not help, a corticosteroid injection to the hip can be both diagnostic and therapeutic. If an injection fails to provide relief, recent advancements in the understanding of the injury process allow successful repair or removal torn tissue with arthroscopic surgery.

Labral tears can also be associated with such chronic conditions as degenerative arthritis, femoral-acetabular impingement and hip dysplasia. In fact, researchers suggest that up to 90 percent of patients with symptomatic hip dysplasia may have associated labral damage. So it’s possible that Lady Gaga was just born this way.

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February 25, 2013

Surgical Delivery of Clot-Busting Drug Shows Promise

David Langer, MD

 

 

Stroke patients who had surgery to deliver the clot-busting drug tPA directly into the brain experienced better and quicker recovery than those who received standard treatment, according to researchers at the Johns Hopkins School of Medicine.

There are two types of stroke: hemorrhagic and ischemic. Though their symptoms appear similar, they are very different health emergencies that require different treatment.

• Ischemic stroke happens when an artery in the brain is blocked. This causes brain tissue to die in the area served by the blocked vessel. Doctors can unblock the vessel with clot-busting drugs and mechanical devices.
• Hemorrhagic stroke occurs when a weakened blood vessel ruptures and bleeds into the brain. While it is less common than ischemic stroke, it remains a major public health problem.

 

Doctors haven’t used clot-busting drugs to treat hemorrhagic stroke because they believed it could cause more bleeding. The only options were to monitor the patient or to remove the clot and alleviate intracranial pressure via cranial surgery, which could add risk.

 

However, Johns Hopkins researchers reported that tPA improved hemorrhagic stoke outcomes in a multicentered study of 96 patients. It appears that tPA not only didn’t cause more bleeding, but also dissolved the clots medically--without surgical removal. The results showed improved early and long-term recovery.

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February 22, 2013

Supplements for Heart Health

Robert Graham, MD

While there’s no substitute for consistent, healthy habits, your physician may suggest a nutritional supplement to enhance your heart-healthy lifestyle.

• Soluble fiber: Psyllium (seed grain) is available as a laxative and fiber supplement. Oats and barley contain beta glucan, another soluble fiber that lowers LDL cholesterol.
• Red yeast rice (RYR) extract: A product of yeast (Monascus purpureus) grown on rice, RYR contains monacolins, which are similar in chemical structure to drugs lovastatin and mevinolin and inhibit cholesterol production. Several studies suggest that RYR may lead to a moderate reduction in LDL cholesterol. Side effects are rare, but information on long-term safety is limited so proceed with caution.
• Fish oil: Studies on Omega-3 fats in cold-water fish have been positive for reducing triglycerides. Omega-3 fats also have other potential cardiovascular benefits.
• CoQ10:  CoQ10 has antioxidant and anti-inflammatory effects on blood vessel function. CoQ10 studies show benefits for patients after bypass surgery and heart failure.

A cautionary note for anyone with heart disease, high blood pressure or high cholesterol: The FDA does not regulate dietary supplements or their ingredients as strictly as it does conventional food or medicine, so it’s crucial to discuss them with a doctor before you start taking them to ensure proper monitoring of their effects.

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February 14, 2013

How to Reduce Cholesterol with 3 Healthy Foods

Robert Graham, MD

A heart-healthy diet contains plenty of vegetables, fruit and whole grains. While no single nutrient prevents heart disease, some foods lower cholesterol naturally with soluble fiber, which prevents binds cholesterol in the digestive tract and helps block it from entering circulation, or with polyunsaturated fats, which lower LDL (bad) cholesterol levels.

Here are three foods that are easy to find, easy to make, easy on the wallet—and good for you, too:

• Oats. A bowl of oatmeal or a cold oat-based cereal offers 1 to 2 grams of soluble fiber. Add a banana or blueberries for another half-gram.
• Beans. Beans like lentils, garbanzos, black-eyed peas, navy beans and kidney beans are rich in soluble fiber and take longer to digest, so you’ll feel full longer.
• Nuts. Eating tree nuts (like almonds, walnuts and pistachios) is good for the heart, according to several studies. Just a handful (2 ounces) of nuts a day can lower LDL. Peanuts, which come from a different food group (legumes), offer similar benefits.

What are your favorite heart-healthy dishes? Share them in the comments section.

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February 07, 2013

Heart Disease Prevention: A Gift to Yourself

Suzanne Steinbaum, DO

Heart health can be easier to achieve than you might think. It is not about grueling workouts and living on bland food, but lifestyle choices that help you feel alive and vital and make your heart sing.

It’s empowering to know that 80 to 90 percent of heart disease is preventable. Here’s how to stay healthy with some good-for-you habits.

Choose exercise you enjoy and that fits into your life. For instance, if you are not a morning person and don’t enjoy exercising alone, scheduling a 5 a.m. jog isn’t realistic, but an exercise class with friends could be the ticket. It doesn’t matter what exercise you do, it just matters that you do something.

You don’t have to go on a “diet.” Instead, make heart-healthy foods part of your lifestyle. Be aware of your decisions on what to eat, and know that taking care of your heart with healthy food is not a punishment, but a gift to your overall wellbeing. I assure you, no one ever had a heart attack from not eating the last donut in the box.

Listen to what your heart is trying to tell you. As women, we tend to feel our emotions in our hearts, so pay attention to how you are feeling and know that it matters. Full Post - to Detail View