Diseases & Conditions Archive

People doing tai chi look like they're moving in graceful slow motion, but something about those carefully controlled movements — and perhaps the mindset they put people in — seems to have health benefits. Tai chi has been tested in dozens of studies, and the findings suggest that it can help people with conditions ranging from heart failure to osteoporosis to fibromyalgia. Now it seems that Parkinson's disease can be added to that list.

Perhaps the most surprising thing about the Parkinson's study was that it wasn't done sooner. Parkinson's disease, a brain disorder that affects muscle control, causes trembling and stiffness. Balance is adversely affected, so falls are a major problem. Doctors already recommend that Parkinson's patients exercise, although perhaps not as often and as forcefully as they might. This study included 195 people with mild-to-moderate Parkinson's disease (1 to 4 on a scale of 5). They were randomly assigned to twice-weekly sessions of tai chi, strength-building (resistance) exercise, or stretching. After six months, the patients who did tai chi performed better on tests designed to measure balance and the ability to control movement than the patients in the other two groups. The difference was especially pronounced on the movement tests. The patients in the tai chi group also performed better on some secondary tests involving gait and reach and fell less often than those in the stretching group (the difference with strength-building wasn't large enough to reach statistical significance on those measures). The results were reported in the Feb. 9, 2012, issue of The New England Journal of Medicine.

Doing cataract surgery with high-speed lasers may make the operation more precise — but will it be worth the extra cost?

Each of our eyes comes equipped with a lens tucked behind the pupil that focuses light on the retina in the back of the eye. When we're young, those lenses are quite clear. But with age and exposure to light and other harmful factors, they have a tendency to cloud up, as the proteins in the watery mixture inside the lens clump up. Clouding of the lens is called a cataract.

Q. In the past you have discussed blood in the urine. I don't have that problem, but during my annual checkup last week, my doctor found protein in my urine. Is it a serious problem? And what should I do about it?

A. Your kidneys have many functions, ranging from helping to regulate your blood pressure and stimulating the production of red blood cells to converting vitamin D into its active form. But their best-known job is to rid your body of excess fluids and metabolic waste products. To do that, the blood that flows into each kidney passes through about one million tiny vascular filters called glomeruli.

1. Thyroid medicine

People take levothyroxine (Levothroid, Synthroid, other brands), a synthetic version of thyroid hormone, when their thyroid glands don't produce enough of the hormone naturally. Many start taking thyroid medicine when they're relatively young, so by the time they're older, they've been on thyroid medicine for years, if not decades.

With age, the body's need for thyroid hormone decreases. So in many cases, if an older person sticks with the dose she took when she was younger, she may be taking too much thyroid medicine. Yet patients (and their doctors) often like the higher doses, because thyroid medicine helps people keep weight off and may also have an antidepressant effect.

Bedtime is far from relaxing for women with this common condition.

Restless legs syndrome (RLS) is a sensory-motor disorder that causes an irresistible urge to move the legs, often accompanied by an uncomfortable "creepy-crawly" sensation. RLS affects 3% to 5% of adults and is twice as common in women as in men. Symptoms typically flare at night, just as you're settling down in bed, but they may also arise when you're resting in a chair. RLS not only causes discomfort and distress, but can also wreak havoc on sleep, causing daytime sleepiness and mood changes. Fortunately, certain lifestyle strategies can help you manage milder forms of RLS, and several medications can provide relief for more serious symptoms.

I have a Baker's cyst in my right knee. It has been drained twice and recurred. Are there any other treatments for it?

Q. I have been diagnosed with type 2 diabetes and sleep apnea. Is there any connection between the two?

A. There's one sure connection between type 2 diabetes and obstructive sleep apnea: if you're overweight, you have an increased risk of developing both conditions. But it's an unsettled question whether sleep apnea might somehow increase your chances of getting type 2 diabetes.

It once seemed that only people who drank excessively were at risk for fatty liver disease. Not anymore.

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States. Almost unheard of before 1980, NAFLD is now believed to affect as many as 30% of adult Americans and is expected to become the main reason for liver transplant by 2022. NAFLD is not a single disease but rather a spectrum of disorders, all marked by the accumulation of fat inside liver cells. Under the microscope, this fatty buildup looks just like alcohol-induced fatty liver disease, but it occurs in people who consume little or no alcohol (less than two drinks a day for women). The condition usually causes no symptoms and few, if any, complications. However, some people with NAFLD go on to develop irreversible liver damage that can result in liver failure and cirrhosis. Not enough is known yet to predict exactly who will progress to serious liver disease, but certain risk factors have been identified that may help clinicians fine-tune diagnosis and treatment.

About 10 million people in the United States have essential tremor (ET), a movement disorder that causes uncontrollable shaking of the hands and often the head as well, and sometimes a quavering voice. ET is an action tremor, meaning that the shaking is largely absent when you're at rest but increases when you try to use your hands — for example, to pick up a cup or use a fork. (ET is sometimes mistaken for Parkinson's disease, in which it's the other way around: the tremor is noticeable during rest and stops with activity.)

There's no cure for ET, but clinicians have various ways to control the symptoms, including drugs and surgery. The American Academy of Neurology (AAN) has issued updated treatment guidelines, based on a review of 252 studies published since 2005, when the AAN issued its first evidence-based guidelines for the treatment of ET. Results were published in Neurology (Nov. 8, 2011).

Kidney stones have plagued men throughout recorded history; the problem has even been "diagnosed" in Egyptian mummies that date back some 7,000 years. In the modern world, this old problem is more common than ever. In the U.S., the prevalence of kidney stones increased from 3.2% in the mid-'70s to 5.2% in the mid-'90s, and the rates are continuing to rise. At present, kidney stones send almost three million Americans to the doctor each year, including over 500,000 trips to emergency rooms. Between 5% and 10% of all active stone passers may require hospitalization.

It's a big problem caused by tiny deposits that may be less than a tenth of an inch across. It's a painful problem that can have serious complications. But it's a treatable problem and, best of all, a largely preventable one.