April 7, 2023

This Week

• Autism on the rise in Black children
• Americans with Kidney Disease moved up on the transplant registry
• When pollen allergy season starts
• FDA proposes using salt substitutes in more foods

Top of Mind

The New England Journal of Medicine recently published a new study suggesting patients with localized instances of Prostate Cancer may be able to delay more invasive treatment. Researchers found those that opted for active surveillance had the same survival rates as those who underwent surgery or radiation after fifteen years. Active surveillance does not mean, forget about the tumor and move on. The goal of watchful waiting is to observe the Prostate Cancer until it has metastasized (spread to distant sites) or started to cause symptoms such as pain or blockage of the urinary tract. At that point, patients may choose treatment.

So this sets up choices for survival but what other issues were raised by the study that I would consider. Whole survival rates are the same with these 3 procedures. Radiation, surgery or watchful waiting, but metastasis of the tumor was higher in the active surveillance group. On the other hand surgery and radiation have more side effects.

So my preference was radiation. I weighed, as you should, the impact of quality of life before making a selection. I wanted to reduce the chance of metastasis. In my case, the chances of recurrence was small with this procedure with few side effects. But what we can agree on dying from localized Prostate Cancer is less than 3%. And, you don't have to rush to make a decision what to do after the diagnosis is made.

Stay Healthy,

Dr. Mike

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Among all U.S. 8-year-olds, 1 in 36 had Autism in 2020, the CDC estimated. That’s up from 1 in 44 two years earlier.

But the rate rose faster for children of color than for white kids. The new estimates suggest that about 3% of Black, Hispanic and Asian or Pacific Islander children have an Autism diagnosis, compared with about 2% of white kids, but have less access to services.

In my experience, it’s difficult to know when an infant under my care has Autism before 18 months. I usually suspect it before the parents will consider it. I used to wait until they suggested something was wrong and often it is speech delay. I am a little more proactive now because Autism in Black children is more common and rising. But more importantly the earlier you begin management of the process, the better the outcome for any child with Autism. Some early signs include:

• Poor eye contact
• Impaired social interaction
• Aggressive or unusual behavior

If you see something, say something to your provider.

For many years Black patients were denied access to kidney transplants because one of the major kidney functions was calculated differently. That function, the glomerular filtration rate was often used to determine who got kidney transplant sand who didn’t. More recently, that separate formula should never have been used. The numbers calculated were too high Black Americans who should have gotten kidney transplant did not.

Now the US Organ Procurement and Transplantation Network (OPTN) is to require transplant centers to modify the kidney transplant wait times for Black patients who might have been adversely affected by the race-based approach to the estimation of glomerular filtration rate.

Know your pollen counts is an online service that provides pollen counts, every day, so you know what you’re dealing with day-to-day. Plan to stay indoors when the pollen counts are the highest. Traditionally, the trees in your area will pollinate first and the grass will pollinate subscribe to that.

Tighten up your other allergy problems. Dust in your bedroom and animals should be moved out of your room if you’re allergic. Avoid foods that you know causing problems.

Stock up on your antihistamines drugs, such as cetirizine, loratadine, and fexofenadine. These drugs are often found in order as Zyrtec, Claritin. Allegra. Also, nasal sprays such flonase will help.

I would take my medication daily once the pollen season starts. There will be days, when it rains, that the pollen counts will be lower and you may not have to use your medication. However, it is my experience and most of those days you benefit from taking medication.

If you have sinusitis, as well as allergies during this period, you need to get a drug that also has a decongestant. They can be found without prescription at your local pharmacy counter.

If your allergies significantly alter your quality of life or the activities of your children during allergy season, talk with your doctor or see an allergy specialist.

The U.S. Food and Drug Administration has proposed allowing salt substitutes more as part of efforts to reduce sodium consumption. U.S. Food and Drug Administration will propose an update on more use of salt substitutes. 

In 2021, the FDA set a goal for manufacturers, along with chain restaurants, to reduce the level of salt in food. The agency set voluntary guidelines to reduce salt levels by 12% in packaged foods, the FDA said, citing high salt consumption which studies have linked to heart attack, stroke and high blood pressure. 

According to the American Hearth Association, around 90% of Americans consume more than twice the recommended salt intake each day. 

The FDA gives details describing what it sees as standardized foods, including products like milk — including flavored milks— peanut butter and ketchup. 

According to the Cleveland Clinic, salt substitutes can achieve a salty taste by replacing sodium chloride with potassium in diets. Still, the data also warns that some consumers with underlying conditions could be harmed.

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