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Treatments for Excessive Sweating of Underarms, Feet or Hands

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A sweaty handshake can be an uncomfortable situation for many, particularly in business settings. Called focal hyperhidrosis, the condition is characterized by excessive sweating of the palms, underarms and the soles of the feet. Focal hyperhidrosis usually starts by the end of the teenage years, and is often hereditary.

Treatment options for focal hyperhidrosis include:

  • Non-prescription antipirspirants: Includes products such as Certain Dri, Secret Clinical Strength, Degree Clinical Protection and 5 Day. These products often work well to inhibit mild to moderate sweating.
  • Prescription antipirspirants: These containing aluminum chloride (Drysol, Xerac) and may be more effective than non-prescription antipirspirants.
  • Lontophoresis: This treatment can be done at home and involves placing hands or feet in a pan of water while a battery-powered device delivers a low-voltage current through the water. Treatments last 15 to 30 minutes and are typically done daily for a couple of weeks and then less frequently for maintenance. Iontophoresis is believed to temporarily block the sweat glands, but results may not be any better than using an antiperspirant.
  • Oral medications: Drugs in the anticholinergic class can help. This approach isn’t used often because of side effects that include dry eyes and mouth and difficulty urinating. Anti-anxiety medications may be helpful if stress-induced anxiety contributes to excessive sweating.
  • Botulinum (Botox) injections: Injections of Botox into the palms, soles or underarms can block the nerves that trigger sweat glands. This approach is effective for even severe hyperhidrosis, but the injections are painful. The effect from the Botox wears off after four to 12 months, and the treatment needs to be repeated.
  • Surgery: Two surgical approaches are options when other treatments haven’t worked. They entail surgically removing sweat glands from the underarms or severing the nerve in the chest that carries messages to the sweat glands. Surgery is seldom used because it is a major procedure. If needed, it’s effective.

As with any health concerns, it is essential to consult your healthcare provider before following any course of action.

Are Optimists Healthier than Pessimists?

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According to a series of studies, optimists enjoy better health than pessimists. The May issue of Harvard Men’s Health Watch explores possible reasons for this connection.

Many studies have reported that optimism influences health. Among the findings:

  • Optimistic coronary bypass patients were only half as likely as pessimists to require re-hospitalization.
  • Highly pessimistic men were three times more likely to develop hypertension.
  • People with positive emotions had lower blood pressures.
  • In one study, the most pessimistic men were more than twice as likely to develop heart disease compared with the most optimistic.

These results argue persuasively that optimism is good for health. But people who are healthy are likely to have a brighter outlook than people who are ill, so perhaps optimism is actually the result of good health instead of the other way around.

To counter this argument, scientists have adjusted their analyses to account for pre-existing medical conditions. The studies that made these adjustments found that existing illnesses did not tarnish the benefits of optimism.

One explanation is behavioral. It is possible that optimists enjoy better health and longer lives because they lead healthier lifestyles, build stronger social support networks, and get better medical care. In addition, optimism itself may have biological benefits, such as lower levels of stress hormones and less inflammation.

Finally, heredity may explain some of the link. It is possible that genes predispose some people to optimism, and that the same genes affect health and longevity.

Source: Harvard Health Publications

Exercise Habits Strongly Influenced by Neighborhood

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The quality of a neighborhood can encourage—or discourage—people to stay physically active and exercise regularly, says a Chicago study led by Christopher Browning, associate professor of sociology at Ohio State University. Such factors as levels of poverty, lower education, and more families headed up by women can actively discourage exercise habits. The study found that individual income was less important in determining exercise levels as the type of neighborhood involved.

"We can’t encourage people to exercise more without looking at the neighborhood environment in which they live," said says Christopher Browning, co-author of the study and associate professor of sociology at Ohio State University.. "Some people may have the personal resources and desire to exercise, but don’t live in a neighborhood in which they feel comfortable to go outside for activities."

The study found that neighborhood context was more important for women than for men in determining how much they exercised. Additional factors brought out by the study were that levels of trust among neighbors, perceived violence in the community, and beliefs that neighbors help each other, all contributed to how much people exercised in a specific community.

Ming Wen, assistant professor of sociology at the University of Utah, and Kathleen Cagney, associate professor of health studies at the University of Chicago, collaborated with Browning on the study, the results of which appeared in a recent issue of Urban Studies.

The study examined levels of exercise among 8,782 residents of 373 neighborhoods in Chicago, and combined statistics from three data sources from the 1990s: the Metropolitan Chicago Information Center Metro Survey, the 1990 U.S. Census, and the Project on Human Development in Chicago Neighborhoods Survey. Social and economic factors, and the level of poverty were found to be the most important factors affecting levels of physical activity, although neighborhood characteristics were judged to be more important in determining a person’s exercise level than income.

"The result is surprising enough that it needs to be confirmed by other studies," said Browning. "But if the finding is substantiated, it would show just how important neighborhoods are, and would have important implications for any new initiatives aimed at enhancing health and well-being." Women’s exercise habits were affected more by the neighborhood than men, which could also explain why African-American women have much higher obesity rates than other groups, said Browning.

Contrary to other research, this study found that once neighborhood factors were taken into account, African Americans in general exercised as much as white residents did. Browning said this finding suggests African Americans will exercise more if they live in neighborhoods where they feel comfortable doing so.

Source: Ohio State University

Epileptic Seizures May Lead to Reduced Medication Entry to the Brain, Say Researchers

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Researchers have found that one of the body’s own neurotransmitters released during epileptic seizures, glutamate, could lead to reduced medication entry into the brain. This may explain why approximately 30% of patients with epilepsy do not respond to anti-epileptic medications.

The study was conducted by researchers at the National Institute of Environmental Health Sciences (NIEHS) using a rodent model of epilepsy.

"Our work identifies the mechanism by which seizures increase production of a drug transport protein in the blood brain barrier, known as P-glycoprotein, and suggests new therapeutic targets that could reduce resistance," said David Miller, Ph.D., a principal investigator in the NIEHS Laboratory of Pharmacology and co-author on the paper.

The blood-brain barrier (BBB), which resides in brain capillaries, is a limiting factor in treatment of many central nervous system disorders. It is altered in epilepsy so that it no longer permits free passage of administered antiepileptic drugs into the brain. Miller explained that P-glycoprotein forms a functional barrier in the BBB that protects the brain by limiting access of foreign chemicals.

"The problem is that the protein does not distinguish well between neurotoxicants and therapeutic drugs, so it can often be an obstacle to the treatment of a number of diseases, including brain cancer," Miller said. Increased levels of P-glycoprotein in the BBB has been suggested as one probable cause of drug resistance in epilepsy.

Using isolated brain capillaries from mice and rats and an animal model of epilepsy, the researchers found that glutamate, a neurotransmitter released when neurons fire during seizures, turns on a signaling pathway that activates cyclooxygenase-2 (COX-2), causing increased synthesis of P-glycoprotein in these experiments. Increased transporter expression was abolished in COX-2 knockout mice or by COX-2 inhibitors. It has yet to be shown in animals or patients that targeting COX-2 will reduce seizure frequency or increase the effectiveness of anti-epileptic drugs.

"These findings provide insight into one mechanism that underlies drug resistance in epilepsy and possibly other central nervous system disorders," said Bjoern Bauer, Ph.D., lead author on the publication. "Targeting blood-brain barrier signals that increase P-glycoprotein expression rather than the transporter itself suggests a promising way to improve the effectiveness of drugs that are used to treat epilepsy, though more research is needed before new therapies can be developed."

The study appears in the May, 2008 issue of Molecular Pharmacology.

Research Shows Promise for Cystic Fibrosis and HIV Therapies

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Innovative therapies against cystic fibrosis have shown promise for increasing the effectiveness of antibiotics in the treatment of chronic and acute bacterial respiratory infections in cystic fibrosis patients, and may also provide a model for potential HIV therapies in the future.

A number of compounds that block a key protein (exoenzymeS or ExoS) have been identified by Professor Igor Stagljar of the University of Toronto, with one—exosin—inhibiting infections in mammalian cells.

Past studies have shown it is possible to prevent or delay the onset of certain chronic or deadly infections in cystic fibrosis patients with early antibiotic treatment. But the current availability of antibiotics against Pseudomonas aeruginosa, a pathogen that can cause urinary tract infections, respiratory system infections, dermatitis, soft tissue infections, bacteremia, bone and joint infections, gastrointestinal infections and a variety of systemic infections, is limited and the pathogen shows signs of drug resistance.

In an article published in the journal PLoS Genetics, a team of investigators identified several drugs that block a Pseudomonas aeruginosa toxin called ExoS.

"These studies created a road map to the rational design of more potent, highly selective inhibitors against other similar toxins using a totally novel yeast-based approach," says lead author Stagljar. "This innovative approach is an important advance, not only for the value it may have in cystic fibrosis treatment, but also because this technique could be used to design novel therapies for any bacterial pathogen as well as the HIV virus."

Staglar’s next step is to test the action of their inhibitors in an animal model of cystic fibrosis, which if successful may provide a way for the treatment ofthis debilitating disease.
In the next phase of their research, Stagljar and his colleagues plan to test the action of their inhibitors in an animal model of cystic fibrosis. If successful, the therapeutics may provide an avenue for the treatment of this debilitating disease.

Source: University of Toronto

Appendix Removed Via the Mouth in First of its Kind Surgery in US

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Surgeons have performed one of the first removals of an appendix via the mouth in the United States. The surgery was part of a clinical trial designed to test techniques for minimally invasive surgery.

The surgery was performed on Jeff Scholz, a 42-year old California resident, at US San Diego Medical Center by Santiago Horgan, M.D., professor and director of UC San Diego’s Center for the Future of Surgery, and Talamini, president elect of the Society of American Gastrointestinal and Endoscopic Surgeons. UC San Diego Medical Center is first U.S.-based hospital to perform this procedure. India is the only other country to report such an operation.

"Only one small incision to insert a small camera in the belly button was required to complete the surgery versus three incisions required for a laparoscopic procedure," said Horgan. "The patient was discharged 20 hours after surgery and is now reporting minimal pain which is a goal for all of our patients."

"I had to have my appendix removed and the opportunity to participate in something so innovative sounded enticing. A day after surgery, I have little pain, a ‘2’ on a scale of 1 to 10," said Scholz, a resident of La Jolla. "My father had the conventional appendix removal. I didn’t want the standard issue scar on the abdomen."

The procedure, called Natural Orifice Translumenal Endoscopic Surgery (NOTES), involves passing surgical instruments, and a tiny camera, through a natural orifice, such as the mouth, to the desired organ. By avoiding major incisions through the abdomen, patients may experience a quicker recovery with less pain while reducing the risk of post operative hernias.

Horgan and Talamini used FDA-cleared EndoSurgical Operating System (EOS) developed by USGI Medical, Inc. to perform the procedure. EOS was passed through the patient’s mouth and into the stomach where a small incision was made in the stomach wall to pass the instrument through to the appendix for removal.

In addition to Horgan and Talamini, the surgical team included: John Cullen, M.D., Garth Jacobsen, M.D., Karl Limmer, M.D., John McCarren, M.D., Bryan Sandler, M.D.and Thomas Savides, M.D.

Source: University of California, San Diego Health Sciences

Insulin Research May Lead to Longer, Healthier Life

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Insulin can affect aging and lifespan, a previously unknown outcome which could provide a means of gene manipulation capable of lengthening lives and making people healthier.

In a recent paper, researchers from the Joslin Diabetes Center note that Insulin inhibits a master gene regulator protein called SKN-1, whose activity increases lifespan. SKN-1 also controls what is called the Phase 2 detoxification pathway, a network of genes that defends cells and tissue against oxidative stress—damage caused by elevated levels of free radicals (byproducts of metabolism)—and various environmental toxins. This new research result was validated in experiments on the digestive system of C.elegans, a microscopic worm often used as a model organism.

"We’ve found something new that insulin does and it has to be considered when we think about how insulin is affecting our cells and bodies," said Dr. T. Keith Blackwell, senior investigator at Joslin and author of the paper. "This has implications for basic biology since under some circumstances insulin may reduce defense against the damaging effects of oxidative stress more than we realize."

Enhancing the activity of SKN-1 may lead to increased resistance to chronic diseases and influence longevity, said Dr. Keith, and the work could be important as it relates to diabetes and the many problems associated with the disease, particularly vascular and renal complications.

"The major implication is that we have found something new that affects lifespan and aging, and an important new effect that insulin and/or a related hormone called insulin-like growth factor-1 may have in some tissues," said Blackwell. "The implications go far beyond diabetes."

A gene regulator protein called FOXO is important in diabetes metabolism, tumor suppression and stem cell maintenance, a fact known since the 1990’s. FOXO controls a number of genes involved in stress resistance, and studies in C.elegans demonstrated that diminished insulin signaling increased activity of a FOXO protein called DAF-16, leading to greater stress resistance and longer life.

The Joselin research adds to knowledge about insulin and its effects on gene pathways, while putting SKN-1 next to FOXO as a second master gene regulator that is inhibited by insulin signaling. According to the paper, insulin’s effect on SKN-1 occurs independently of its effect on DAF-16.

The paper was published in the March 21, 2008 issue of Cell.

Many Gulf War Veterans’ Health Problems Traceable to Toxic Chemicals

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The high incidence of illness in Persian Gulf War veterans can be traced to their exposure to toxic chemicals such as nerve agents and pesticides, say researchers at the University of California, San Diego School of Medicine.

Symptoms reported by deployed personnel include fatigue, muscle pain, memory problems, trouble sleeping, rash and breathing problems. These personnel had a higher rate of chronic, multi-symptom health problems than non-deployed personnel, or those deployed elsewhere.

"This evidence suggests that exposure to this certain class of chemical may be linked to elevated risk of health problems," said Beatrice Golomb, M.D., Ph.D., associate professor of medicine at the UC San Diego School of Medicine.

"Health issues among Gulf War veterans have been a concern for nearly two decades. Now, enough studies have been conducted, and results shared, to be able to say with considerable confidence that there is a link between chemical exposure and chronic, multi-symptom health problems," said Golomb. "Furthermore, the same chemicals affecting Gulf War veterans may be involved in similar cases of unexplained, multi-symptom health problems in the general population."

Chemicals known as acetylcholinesterase inhibitors (AChEis) and organophosphates (OP), nerve gas chemicals, sarin and pesticides were included in the study, together with carbamate pyridostigmine bromide (PB) pills originally given to service members to protect against potential nerve-agent exposure. (Note: As a result of an earlier RAND corporation report by Golomb outlining the risks of using such pills, military policy has been changed.)

The study linked exposure to each of these chemicals with the chronic, multi-symptom health problems in 25 to 33 percent of returning Gulf War veterans.
"There is evidence that genetics have something to do with how a body handles exposure to these chemicals," said Golomb. "Some people are genetically less able to withstand these toxins and evidence shows that these individuals have higher chance of suffering the effects of exposure."

Specifically, illness is linked to lower activity of enzymes that detoxify AChEis, due to genetic variants The enzymes known to be involved are paraoxonase (PON) for OPs, including sarin, and butyrylcholinesterase (BChE) for PB.

Source: Proceedings of the National Academy of Sciences (PNAS), March 18, 2008, vol. 105, no. 11, pp. 4295-4300

Ayuverdic Natural Medicine Balances Health And Life

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Comprising yoga, massage, meditation and much more, Ayuverdic medicine is among the world’s oldest, and reputedly balances life and health. It originated in India more than 5,000 years ago, and is still practiced there alongside Western medicine.

Ayuverdic medicine is based on the belief that balance in life starts at birth, where a person’s innate qualities help to frame the person’s physical and mental patterns, to create the state known as praktiki. A person’s present state is known as vikruti, which is praktiki incorporating everything affecting one’s life—work, diet, hobbies and friends, for example. The closer one is to praktiki the better. Discord in life, or divergence from self, leads to dosha imbalance. Dosha refers to energy patterns.

To identify diseases, practitioners of ayurvedic medicine must evaluate what dosha is the greatest influence in the patient and seek to understand if there’s discourse between the innate and current self. Individuals can apply ayurvedic medicine to everyday situations, too. For example, dry skin may require more than lotion. One may need to look at emotions and consider how to heal emotional dryness.

An overview of ayuverdic medicine is published in the March, 2008 issue of Mayo Clinic Health Letter.

Is the Information We Have About Pharmaceutical Drugs Really Reliable?

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A report in the current issue of the British Medical Journal questions the reliability of what we know about the latest drugs, such as antidepressants or statins.

The Food and Drug Administration Amendments Act (FDAAA) of 2007 stipulated that the results of clinical trials conducted for a new drug are published in a public database, say journalists Jeanne Lenzer and Shannon Brownlee. Despite this Act, lack of access to reliable data remains an ongoing problem. Not all trials have to be registered, while trade secrecy laws protect other products from providing access to full data.

Data can be demanded under the Freedom of Information Act, but trade secrecy laws allow information about a drug that is not approved for a new indication to be withheld, even though the drug is already being marketed for other indications. The stated purpose of these trade secrets is to prevent a company being placed at a "competitive disadvantage" to other companies.

For example, in 2001 Valdecoxib, a COX 2 inhibitor failed to obtain FDA approval as a treatment for acute pain. Some of the trial information was removed from the FDA website, with the public and medical researchers unaware of possible side effects—a situation that should be remedied at once, say the authors.

One possible solution would be to make the FDA database available to researchers, a move resisted by the FDA which claims that putting all its data online would be too burdensome. But doing this future Freedom of Information requests would be reduced, say the critics. Failing to make trial participant data available to the public has to be accomplished, if the public interest is to be served, say the authors.

Source: British Medical Journal, Volume 336, pp 532-534