Dr. George Lundberg, a pathologist by training and Editor-in-Chief of Medscape General Medicine, presents an intriguing method for treating seborrheic keratosis. He terms the procedure “fingernail surgery”. Dr. Lundberg also provides a helpful hint on how to differentiate seborrheic keratosis from other skin lesions, such as cancer.

Please remember that information from the Internet, including this site, cannot replace the professional opinion of a licensed physician. Consult your medical doctor when you notice a questionable skin lesion, especially if it has irregular borders, non-homogenous appearance, or changed in any way.

Alzheimer disease is a chronic condition that afflicts more than 14% of the geriatric population. It is the most common cause of dementia, characterized by a progressive decline in cognitive function. Although there are pharmaceutical drugs (i.e., donepezil) that attempt to stave this decline, there is yet no cure.

A recent study published in the American Journal of Clinical Nutrition has correlated green tea consumption with a lower prevalence of cognitive impairment. Although previous animal studies have suggested a protective effect of green tea against neurodegenerative diseases, this is the first study that addresses the topic in humans.

Researchers at the Tohoku University School of Medicine (Sendai, Japan) surveyed 1003 geriatric citizens at ages 70 years or older from the Tsurugaya district of Sendai City. The study examined several variables, including the consumption of certain beverages, the health status, and the social habits of the participants. Their cognitive function was assessed using the Mini-Mental Status Examination (MMSE), a tool commonly used by neurologists and geriatricians.

The study found that participants who routinely consumed greater quantities of green tea generally scored higher on the MMSE. Consumption of black or oolong tea, or coffee did not produce similar trends. The researchers also adjusted the data for several possible confounders, such as presence of different diseases, level of physical activity, educational background, dietary habits, and substance use. The results still demonstrated a positive effect of green tea in cognitive function.

Does green tea hold promise for dementia patients? Can it reverse the cognitive decline in Alzheimer disease? What about using it as prophylaxis by healthy individuals? The findings are exciting, but there is yet much research needed to validate and extend the results of the Tsurugaya Project.

• Source
• Kuriyama S, Hozawa A, Ohmori K, Shimazu T, Matsui T, Ebihara S, Awata S, Nagatomi R, Arai H, Tsuji I. Green tea consumption and cognitive function: a cross-sectional study from the Tsurugaya Project. Am J Clin Nutr 2006;83:355-61.

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Melatonin is a hormone produced by the pineal gland and associated with regulation of the sleep cycle. There have consequently been melatonin products, and biosynthetic variants (i.e., ramelteon), marketed as sleep aid products. A popular use for melatonin has been to combat jet lag or for adaptation to different time zones. Two recurring questions I have encountered regarding melatonin are whether it actually works and whether there are any adverse side-effects.

The February 10 issue of the British Medical Journal includes a study by a Canadian group that reviewed the efficacy and safety of melatonin use with secondary sleep disorders and sleep restriction. Secondary sleep disorders are sleep problems with a physiologic cause, such as hyperthyroidism or substance abuse (toxicity). Sleep restriction, on the other hand, results from voluntary sleep disruption. On-call physicians or third-shift police officers are examples of people who endure sleep restriction.

According to the meta-analysis (a review of several research efforts examining the same topic) of 15 separate studies (524 participants), melatonin is not effective for both secondary sleep disorders and sleep restriction. Commonly reported side-effects were drowsiness, headache, nausea, and dizziness. Otherwise, the report does not indicate significant adverse effects of short-term melatonin use (3 months or less).

In another meta-analysis performed by the same group, and published two months earlier in the Journal of General Internal Medicine, there is some evidence of efficacy in delayed sleep phase syndrome (DSPS), a shift in the circadian rhythm that makes it difficult for the person to fall asleep and wake up. Study participants who suffered from this disorder were able to fall asleep around 38.8 minutes earlier with melatonin. The study does not however report significant improvement in sleep onset with melatonin use for other sleep disorders. The findings on safety are similar here as in the BMJ article.

In short, melatonin is not effective for most sleep disorders, but it is safe with short-term use.

• Sources
• Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Baker G, Klassen TP, Vohra S. The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. J Gen Intern Med 2005;20:1151-8.
• Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Vohra S, Klassen TP, Baker G. Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis. BMJ 2006.

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Roche Laboratories has produced an interesting marketing adjunct to its famous Tamiflu^® (oseltamivir) drug: The Tamiflu Desktop Flu Tracker. The software tracks the latest trends of reported influenza cases throughout the United States and generates a geographical representation of disease demographics. The Desktop Flu Tracker also lets you set alerts for flu outbreaks in different neighborhoods. Additional preventative health information is included. Learn the classic symptoms of flu and how it differs from the common cold.

The program currently runs on Windows (98SE and above). It is not available for the MacOS.

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