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Celiac disease (CD), also known as gluten-sensitive enteropathy as well as two older and no longer recommended terms,3 nontropical sprue and celiac sprue, is a chronic immune-mediated disorder induced by dietary gluten in genetically susceptible individuals. In CD patients, the ingestion of gluten results in the development of small intestinal mucosal villous atrophy with crypt hyperplasia and mucosal inflammation. Patients may be asymptomatic or may manifest classic malabsorptive symptoms of abdominal pain, bloating, weight loss, diarrhea, and steatorrhea. They also may present along a spectrum with more subtle gastrointestinal and/or extraintestinal symptoms and signs of the disease; virtually every body system can be affected.
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Sjogren's syndrome is an autoimmune condition that leads to chronic inflammation with salivary and lacrimal gland dysfunction. The diagnosis of Sjogren's often is delayed by several years because the initial presenting symptoms can be non-specific. However, some manifestations of Sjogren's may be life threatening, including brain damage and cancer. It is very important for the primary care physician to recognize the early signs and symptoms and to initiate the appropriate workup and treatment in coordination with consulting specialists to prevent further morbidity and mortality.
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Menopausal women anecdotally report that their hot flashes are worse with stress;1 for instance, if a woman has an unpleasant confrontation, she notices that it will trigger a hot flash. Research supports these anecdotal experiences. Lab stressors such as arithmetic tasks can also increase hot flashes. When women are randomized to a lab stressor condition vs a non-stress condition, those in the stress condition have 47-57% more hot flashes.2 Women are not just reporting more hot flashes during periods of stress; objective measurements of hot flashes confirm the increase during stress conditions. Stress appears to lower the threshold for hot flashes to occur.
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Strong evidence supports regular exercise as a lifestyle habit and intervention that lowers risk for a myriad of diseases including coronary heart disease, high blood pressure, type 2 diabetes, obesity, and breast and colon cancers.1 In addition, exercise has gained treatment status for cardiometabolic risk factors, type 2 diabetes, osteopenia and osteoporosis, and rehabilitation for existing cardiac disease.
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Findings from this unique investigation add a new wrinkle to concerns over the increasingly sedentary nature of American society. They also suggest that years could be added to general life expectancy simply by limiting time spent sitting and TV viewing.
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Low serum 25-hydroxyvitamin D correlates with the development of mobility limitations and disability in older people who were otherwise healthy.
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In this case-control study, dietary lignan intake was inversely associated with risk of breast cancer in both premenopausal and postmenopausal women. Also noted were more favorable prognostic characteristics associated with lignan intake, especially in premenopausal women.
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Results from this small open-label trial out of Turkey suggest that vitamins C and E decrease Helicobacter pylori (H. pylori) intensity and possibly local inflammation in patients with H. pylori-positive non-ulcer dyspepsia. The results provide added support to results from an earlier clinical trial by the investigators that found adjunctive use of vitamins C and E improved eradication rates of conventional triple therapy for H. pylori infection.
