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Looks like summer, or at least spring,
is finally here. We all survived another winter on our beloved rock.
A few of our colleagues’ thoughts for
this month:
Dr. Nigel Duguid,
respirologist, St. John’s
When asthma is refractory to the usual
treatments, consider whether Gastroesophageal Reflux Disease (GERD)
is at play. It can give asthma symptoms and make asthma less
responsive to treatment.
Dr. James Liao,
cardiologist, Boston
There is a significantly lower
incidence of stroke in patients taking statins. This is thought
provoking since cholesterol is known not to be a risk factor for
stroke. The mechanism is not clear, but perhaps it is an
inflammatory process.
Dr. Gary Costain,
endocrinologist, Saint John
Only 20 per cent of the benefit from
bisphosphonates comes from the increase in bone mineral density (BMD)
and it is important not to be misled by non-improvement in BMD after
appropriate bisphosphonate use. Quality of bone is also improved and
we have no way of measuring this. Remember, there can be as high as
six per cent error in BMD measurement. If there is no change or a
decline in BMD, always check to see that the medication is being
taken and that there is adequate calcium and vitamin D intake.
More on vitamin D: It has been found to
have significant effects on muscle as well as bone. Vitamin D
deficiency is the most common vitamin deficiency in the western
world and can cause fatigue. Now we know why prescribing a
multivitamin for otherwise unexplained fatigue sometimes helps!
Also, giving vitamin D to nursing home residents has been shown to
decrease the number of falls.
So, the warm weather is finally here —
warmer at least! Remember to take time to refresh and soak up a
little natural Vitamin D — good for body and soul. Enjoy our
beautiful province and have a happy and safe summer.
Dr. Susan King is a family physician at
the Newfoundland Drive Medical Clinic in St. John’s. Tips and hints
may be emailed to nexus@nlma.nf.ca
or faxed to 709-726-7525.
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