The holiday season is upon us.  That, of course, means fun, stress and lots of opportunities to sample the illnesses of your friends and family.  Although getting a little sick periodically is good for you, take it easy so that you don't partake overmuch in the microbial feast.

I want to thank you all for helping me learn better how to take care of you.  The reason it is called medical "practice" of course, is that we doctors always have room for improvement.  The main reason I have learned so much along that line is because all of you teach me in one way or another.  I have had some great teachers over the years.

Best, Michael Carlston, M.D.
www.carlstonmd.com

For over 2 decades hopeful patients have been bringing in information about an incredible variety of eye drops to treat cataracts, asking for my opinion.  Unfortunately, my reasoned response always had to be pessimistic. None of the products had any evidence that they worked; for many there was no reason why they should work and my clinical experience did not give any reason for optimism.  All I could do was my part to encourage prevention by eating green leafy vegetables and taking the right supplements, while avoiding damage from the sun and from foods like fats, especially fried meats.  That was fine for those who had not already developed cataracts, but less useful for those who had.

I am delighted to say that this situation seems to have changed.  Although the evidence is not absolutely definitive, I am impressed by a series of studies showing that eye drops containing N-acetylcarnosine can reverse cataracts and improve vision.  Over a 6 month period more than 40% of the eyes tested improved significantly (ranging widely from 7 -100%) in visual acuity and in glare sensitivity (27 - 100%).  The improvement lasted over the 24 month study period and there is evidence that many patients continued to improve with longer treatment.

Autistic disorders are becoming more and more common.  At the same time we don't know why. Most theories to date have not held up to careful scrutiny.  One clue to solving this mystery may have been uncovered by a relatively small US study.  Investigators learned that many autistic children experienced a pronounced phase of brain growth.  Although these children had smaller than average head sizes in early infancy, by 2 to 3 years of age their heads were larger than average.

This information can be helpful in at least 2 ways.  First, this discovery might lead to discovery of the causes of that rapid growth (infection or compensatory response or toxin exposure or?).  We usually cannot diagnose autism until the child gets old enough for our neuropsychiatric assessment tools.  This physical change is detectible at a much younger age and easy to measure.  Of course, rapid brain growth alone does not mean the child is autistic.  When we see this growth pattern, we will now watch these children more carefully.  Early recognition will enable us to try to help sooner and that is always a good idea.

The point of doing careful clinical research is to identify useful health practices and clarify how and when to use them.  This is always very difficult to do because it is so difficult to design good clinical research.  There is more and more research that tarnishes hundreds of years of good Echinacea experience.

The alternative medicine office of the National Institutes of Health (NCCAM) funded a study (JAMA. 2003; 290:2824-2830) by the University of Washington and John Bastyr Naturopathic College, testing Echinacea in a pediatric population for treatment of upper respiratory infections (URI).  They used a standardized extract obtained from the above ground parts of Echinacea purpurea.  The dose they used was in the low average range.

Investigators found that this extract in this dosage did not reduce the duration of URI measurably.  They did find a significant protective effect of Echinacea.  Children in the Echinacea group had a reduced risk of developing subsequent URI.  They also found that a few patients seemed to develop a rash as a result of Echinacea treatment.

Among the weaknesses of the study were the part of the plant used, the species of Echinacea used and questions about dosage.

One study does not cancel hundreds of years of clinical experience, but this study does suggest that the best use for this species of Echinacea may be preventively, rather than as a treatment for URI.