The flu is difficult to treat with a frequency device like the FSCAN because any serious flu has multiple faces. I have seen this enough times now that the pattern is clear.

Last week a flu started in our office that has put almost every individual out of work for a least a day. I detected the frequency immediately and warned people to take oscillicosinum, since the initial frequencies in the 360KHZ range were treatable by that homeopathic remedy and most people don’t have a frequency device. The lower frequencies in the 250KHZ range which develop later are not treatable with oscillicosinum which explains why this remedy is most useful at the onset of the disease.

I went home with the virus and infected my wife. The next morning she had intestinal problems. I went home at noon and cured her. I then cleared myself of all viruses every night as soon as I came home to avoid reinfecting her. I still had the problem of sitting in meetings every day with infected people.

An allday meeting last Tuesday demonstrated clearly the clinical pathway of this flu. As soon as I had symptoms (runny nose, chest constriction, or sneezing), I left the meeting, detected the frequency, cleared it from my system and went back into the meeting. By the end of the day, I had this frequency set.

376675

367739

367655

364775

253333

276735

355644

253333

In order to clear all symptoms of this flu, you must treat all of these frequencies. My hypothesis after working with this problem during the past couple of years is that all these frequencies are one disease. The time period is too short for the virus to evolve and I have seen the same frequency pattern months later in people who were not able to eliminate the flu from their system and had a chronic chest problem.

You must be able to detect the exact frequencies to treat effectively. The frequencies above are one example and another flu will have a different frequency set. Just as flu shots are often ineffective because the strain of the virus may vary, unless you get the right frequencies, the FSCAN will be just as ineffective.

To make things more confusing, there are a number of cold viruses running around in the same frequency ranges. They are easy to eliminate in a few minutes with the FSCAN. The flu is not easy to eliminate once it gets a foothold in your physical system so you can distinguish between the cold viruses and a flu.

There are also interesting opportunistic infections that arise. For example, I had a sore throat with this flu for several nights. It took me a while to figure out the sore throat was not the flu virus, but a parasite infection that proliferated due to the assault of the flu on my immune system.

So a bad flu is a tricky disease to eliminate. The good news is that it can be done. The bad news is that it is tricky enough that you may give up and resort to Nyquil!



Finally, I have an F100 device that is very useful for treating multiple frequencies simultaneously. It is fully programmable and can be driven by a computer or a Palm Pilot. I program it as follows:

dwell 20

lable loop

376675 367739 367655 364775 253333 276735 355644 253333

goto loop

Treat until done, i.e. no more symptoms.

We are getting much better data on medication error from multiple studies published recently in leading medical journals. Here, we note that 6.3% of malpractice claims are for adverse drugs events, of which 43% are life threatening or fatal and 73% preventable.

Since there are about an equal number of inpatient and outpatient adverse events noted in malpractice claims, we can infer that the number of deaths due to medication error is at least double that estimated by the two studies noted in the recent Institute of Medicine reports, since those studies reported only inpatient errors.

Analysis of Medication-Related Malpractice Claims: Causes, Preventability, and Costs. Arch Intern Med. 2002;162:2414-2420

Jeffrey M. Rothschild, MD, MPH; Frank A. Federico, RPh; Tejal K. Gandhi, MD, MPH; Rainu Kaushal, MD, MPH; Deborah H. Williams, MHA; David W. Bates, MD, MSc

Background: Adverse drug events (ADEs) may lead to serious injury and may result in malpractice claims. While ADEs resulting in claims are not representative of all ADEs, such data provide a useful resource for studying ADEs. Therefore, we conducted a review of medication-related malpractice claims to study their frequency, nature, and costs and to assess the human factor failures associated with preventable ADEs. We also assessed the potential benefits of proved effective ADE prevention strategies on ADE claims prevention.

Methods: We conducted a retrospective analysis of a New England malpractice insurance company claims records from January 1, 1990, to December 31, 1999. Cases were electronically screened for possible ADEs and followed up by independent review of abstracts by 2 physician reviewers (T.K.G. and R.K.). Additional in-depth claims file reviews identified potential human factor failures associated with ADEs.

Results: Adverse drug events represented 6.3% (129/2040) of claims. Adverse drug events were judged preventable in 73% (n = 94) of the cases and were nearly evenly divided between outpatient and inpatient settings. The most frequently involved medication classes were antibiotics, antidepressants or antipsychotics, cardiovascular drugs, and anticoagulants. Among these ADEs, 46% were life threatening or fatal. System deficiencies and performance errors were the most frequent cause of preventable ADEs. The mean costs of defending malpractice claims due to ADEs were comparable for nonpreventable inpatient and outpatient ADEs and preventable outpatient ADEs (mean, $64 700-74 200), but costs were considerably greater for preventable inpatient ADEs (mean, $376 500).

Conclusions: Adverse drug events associated with malpractice claims were often severe, costly, and preventable, and about half occurred in outpatients. Many interventions could potentially have prevented ADEs, with error proofing and process standardization covering the greatest proportion of events.

California nurses do not go into the hospital without a buddy nurse who watches their treatment, and particularly their medications. One of my colleagues recently had a young child in for surgery who would have been overdosed on morphine if a family member was not logging every medication dose at the bedside. There have been many retrospective studies of historical data that have clearly identified the problem. Some new studies are prospective. They look at the problem as it is happening, resulting in more accurate measurement of the frequency and severity of the error.



Medication Errors Observed in 36 Health Care Facilities. Arch Intern Med. 2002;162:1897-1903

Kenneth N. Barker, PhD; Elizabeth A. Flynn, PhD; Ginette A. Pepper, PhD; David W. Bates, MD, MSc; Robert L. Mikeal, PhD

Background: Medication errors are a national concern.

Objective: To identify the prevalence of medication errors (doses administered differently than ordered).

Design: A prospective cohort study.

Setting: Hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations, nonaccredited hospitals, and skilled nursing facilities in Georgia and Colorado.

Participants: A stratified random sample of 36 institutions. Twenty-six declined, with random replacement. Medication doses given (or omitted) during at least 1 medication pass during a 1- to 4-day period by nurses on high medication–volume nursing units. The target sample was 50 day-shift doses per nursing unit or until all doses for that medication pass were administered.

Methods: Medication errors were witnessed by observation, and verified by a research pharmacist (E.A.F.). Clinical significance was judged by an expert panel of physicians.



Main Outcome Measure: Medication errors reaching patients.

Results: In the 36 institutions, 19% of the doses (605/3216) were in error. The most frequent errors by category were wrong time (43%), omission (30%), wrong dose (17%), and unauthorized drug (4%). Seven percent of the errors were judged potential adverse drug events. There was no significant difference between error rates in the 3 settings (P = .82) or by size (P = .39). Error rates were higher in Colorado than in Georgia (P = .04)

Conclusions: Medication errors were common (nearly 1 of every 5 doses in the typical hospital and skilled nursing facility). The percentage of errors rated potentially harmful was 7%, or more than 40 per day in a typical 300-patient facility. The problem of defective medication administration systems, although varied, is widespread.

In futher support of my argument that 50% of hospital days and clinic visits can be eliminated by nutrition and/or exercise, consider the considerable impact of nutrition on the immune system of older people.

“In the elderly, impaired immunity can be enhanced by modest amounts of a combination of micronutrients. These findings have considerable practical and public health significance.” Chandra, RK. Nutrition and the Immune System: An Introduction. Am J Clin Nutr 1997 Aug;66(2):460S-463S

For example, giving elderly subjects a low potency multivitamin/mineral supplement vs. a placebo for 12 months showed enhanced immune response in the supplement group. This was correlated with direct clinical benefit. The mean number of days for infectious illness was 23 days in the supplement group and 48 for the placebo group. And antibiotic use in the supplement group was an average of 18 days vs. 32 days in the placebo group. So minimal vitamin supplementation in the elderly directly enhances immune function leading to elimination of over 50% of illness and 50% of drug use. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992 Nov 7;340(8828):1124-7

Your physician will not ensure that you take advantage of this benefit. You must take responsibility for your own health.

Last week at the eHealth Developers Summit, I made the point that nutrition and exercise can eliminate 50% of disease, alternative medicine another 35%, and electronic frequency instruments at least another 10%. Hospitals admissions and clinic visits could be reduced by 95%. It takes knowledge, committment, and ability to change behaviors. This is a very good number, because Brent Lowensohn, Director of IT Advanced Technologies at Kaiser Foundation Health Plan and Hospitals, predicts a 15-fold increase in clinic visits over the next decade due to aging baby boomers, a problem that the current health system cannot possibly handle (see MIT Media Lab Future of Health Technology Summit).

A senior staff member of the Kellogg Foundation asked me for examples to support my argument and I gave a few. To my surprise, I returned home and found a recent New England Journal article showing that a 7% decrease in body weight and 150 minutes of exercise per week reduced the incidence of type 2 diabetes by 58%. The best drugs could do was a 31% reduction and this does not take into account the negative side effects of drugs or the positive side effects of lower weight and exercise on everything else except type 2 diabetes.

Alas, people continue to argue about the impact of nutrition and exercise as they did with smoking years ago. The smoking argument has largely stopped now that R.J. Reynolds was fined $144.9B in July 2000, and Phillip Morris was fined $28B last month (see today’s New York Time business section). But I digress, let’s look at the New England Journal of Medicine on diabetes.

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group.

Diabetes Prevention Program Coordinating Center, Biostatistics Center, George Washington University, 6110 Executive Blvd., Suite 750, Rockville, MD 20852, USA.

BACKGROUND: Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors–elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle–are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes.

METHODS: We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups.

RESULTS: The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin.

CONCLUSIONS: Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

I take flaxseed oil and cottage cheese regularly as a cancer preventative based on the excellent results that Dr. Budwig reported in Germany over 50 years ago. She is an excellent example of a researcher whose information has been repressed by vested interests. Of course, the beauty of good research is that anyone can replicate it any time they want, so the truth comes out eventually. Duke University scientists have replicated her work. Some complain that Duke researchers did not cite Dr. Budwig properly.

.

Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery: exploring the effects on hormonal levels, prostate-specific antigen, and histopathologic features.

Urology 2001 Jul;58(1):47-52

Demark-Wahnefried W, Price DT, Polascik TJ, Robertson CN, Anderson EE, Paulson DF, Walther PJ, Gannon M, Vollmer RT. Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina, USA.

OBJECTIVES: Dietary fat and fiber affect hormonal levels and may influence cancer progression. Flaxseed is a rich source of lignan and omega-3 fatty acids and may thwart prostate cancer. The potential effects of flaxseed may be enhanced with concomitant fat restriction. We undertook a pilot study to explore whether a flaxseed-supplemented, fat-restricted diet could affect the biomarkers of prostatic neoplasia.

METHODS: Twenty-five patients with prostate cancer who were awaiting prostatectomy were instructed on a low-fat (20% of kilocalories or less), flaxseed-supplemented (30 g/day) diet. The baseline and follow-up levels of prostate-specific antigen, testosterone, free androgen index, and total serum cholesterol were determined. The tumors of diet-treated patients were compared with those of historic cases (matched by age, race, prostate-specific antigen level at diagnosis, and biopsy Gleason sum) with respect to apoptosis (terminal deoxynucleotidyl transferase [TdT]-mediated dUTP-biotin nick end-labeling [TUNEL]) and proliferation (MIB-1).

RESULTS: The average duration on the diet was 34 days (range 21 to 77), during which time significant decreases were observed in total serum cholesterol (201 +/- 39 mg/dL to 174 +/- 42 mg/dL), total testosterone (422 +/- 122 ng/dL to 360 +/- 128 ng/dL), and free androgen index (36.3% +/- 18.9% to 29.3% +/- 16.8%) (all P <0.05). The baseline and follow-up levels of prostate-specific antigen were 8.1 +/- 5.2 ng/mL and 8.5 +/- 7.7 ng/mL, respectively, for the entire sample (P = 0.58); however, among men with Gleason sums of 6 or less (n = 19), the PSA values were 7.1 +/- 3.9 ng/mL and 6.4 +/- 4.1 ng/mL (P = 0.10). The mean proliferation index was 7.4 +/- 7.8 for the historic controls versus 5.0 +/- 4.9 for the diet-treated patients (P = 0.05). The distribution of the apoptotic indexes differed significantly (P = 0.01) between groups, with most historic controls exhibiting TUNEL categorical scores of 0; diet-treated patients largely exhibited scores of 1. Both the proliferation rate and apoptosis were significantly associated with the number of days on the diet (P = 0.049 and P = 0.017, respectively). CONCLUSIONS: These pilot data suggest that a flaxseed-supplemented, fat-restricted diet may affect prostate cancer biology and associated biomarkers. Further study is needed to determine the benefit of this dietary regimen as either a complementary or preventive therapy.

Medical error is the third leading cause of death in the United States and the medication error component is the 4th leading cause of death. This is largely caused by systemic problems in the management of our healthcare system and lack of deployment of available information technologies. I have been doing presentations at major conferences for years on medical error pointing out that poor financial performance (due to lack of automation) leads to nursing shortages which directly leads to patient death. This week, the Journal of the American Medical Association published the numbers. Every additional patient for a nurse increases the risk of death for all patients by 7%.

Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

Linda H. Aiken, PhD, RN; Sean P. Clarke, PhD, RN; Douglas M. Sloane, PhD; Julie Sochalski, PhD, RN; Jeffrey H. Silber, MD, PhD

JAMA. 2002;288:1987-1993

Context: The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice.

Objective: To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention.

Design, Setting, and Participants: Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania.

Main Outcome Measures: Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job dissatisfaction and job-related burnout.

Results: After adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction.

Conclusions: In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.

Nature Science Update: Superbug Strikes Again
“A drug-resistant superbug has resurfaced, doctors announced today, leaving researchers scrabbling for the next line of antibiotic defence. The rogue Staphylococcus aureus bacteria, identified in the foot ulcer of a Pennsylvania patient, are resistant to vancomycin, one of the last lines of antibiotic defence. More cases were widely anticipated after reports of the first such strain earlier this year. Today’s announcement coincided with confirmation of the case by the US Centers for Disease Control and Prevention in Atlanta, Georgia.”

When antibiotics fail, these bugs can be dealt with using a frequency generator such as the FSCAN or F100, or by a rife plasma tube device such as the EM6C. They typically cover a spectrum of frequencies that must be treated at 1HZ increments through the entire spectrum. Misuse of antibiotics has caused these pathogens to generate a broad spectrum of strains. For resistant strains, virtually any conventional treatment affects only part of the spectrum and the infection regrows no matter what you treat it with.

Most people are lightly infected with these organisms. Using a microscopic slide of the organism, I identified the frequency for the pathogen and tested postive for hosting a strain of the organism. I then treated myself for a couple of minutes to get rid of it. Serious infections require more extended treatment across a wide band of frequencies.

© 2002 Kenneth Todar University of Wisconsin-Madison Department of Bacteriology
Pathogenesis of S. aureus infections
“Staphylococcus aureus causes a variety of suppurative (pus-forming) infections and toxinoses in humans. It causes superficial skin lesions such as boils, styes and furuncles; more serious infections such as pneumonia, mastitis, phlebitis, meningitis, and urinary tract infections; and deep-seated infections, such as osteomyelitis and endocarditis. S. aureus is a major cause of hospital acquired (nosocomial) infection of surgical wounds and infections associated with indwelling medical devices. S. aureus causes food poisoning by releasing enterotoxins into food, and toxic shock syndrome by release of pyrogenic exotoxins into the blood stream.”

CDC Fact Sheet
Eight cases of infection caused by vancomycin-intermediate Staphylococcus aureus (VISA) have been detected in the United States (Michigan, New Jersey, New York, and Illinois, Minnesota, Nevada, Maryland, Ohio. Some of the VISA infections developed in persons with previous infections with methicillin-resistant Staphylococcus aureus (MRSA). Normally, vancomycin is the most reliable and effective drug for treating MRSA. The appearance of Staphylococcus aureus with reduced susceptibility to vancomycin is concerning. The patients with VISA infections were chronically ill and probably developed their VISA infection in a healthcare setting. No spread to family members, household contacts, other patients, or healthcare workers was detected.

Sequencing the Genome
The Sanger Institute has been funded to sequence the 2.8 Mb genomes of two strains of Staphylococcus aureus in collaboration with Prof. Tim Foster of the Department of Microbiology, Trinity College, Dublin, Prof. Brian Spratt of the Department of Infectious Disease Epidemiology, Imperial College School of Medicine, Mark Enright of the Department of Biology and Biochemistry, University of Bath, and Dr. Nicholas Day and Dr. Sharon Peacock of the John Radcliffe Hospital, Oxford.

FDA Bacteriological Analytical Manual
Staphylococcus aureus is highly vulnerable to destruction by heat treatment and nearly all sanitizing agents. Thus, the presence of this bacterium or its enterotoxins in processed foods or on food processing equipment is generally an indication of poor sanitation. S. aureus can cause severe food poisoning. It has been identified as the causative agent in many food poisoning outbreaks and is probably responsible for even more cases in individuals and family groups than the records show.

FDA Bad Bug Book
Foods that are frequently incriminated in staphylococcal food poisoning include meat and meat products; poultry and egg products; salads such as egg, tuna, chicken, potato, and macaroni; bakery products such as cream-filled pastries, cream pies, and chocolate eclairs; sandwich fillings; and milk and dairy products. Foods that require considerable handling during preparation and that are kept at slightly elevated temperatures after preparation are frequently involved in staphylococcal food poisoning.
Staphylococci exist in air, dust, sewage, water, milk, and food or on food equipment, environmental surfaces, humans, and animals. Humans and animals are the primary reservoirs. Staphylococci are present in the nasal passages and throats and on the hair and skin of 50 percent or more of healthy individuals. This incidence is even higher for those who associate with or who come in contact with sick individuals and hospital environments. Although food handlers are usually the main source of food contamination in food poisoning outbreaks, equipment and environmental surfaces can also be sources of contamination with S. aureus. Human intoxication is caused by ingesting enterotoxins produced in food by some strains of S. aureus, usually because the food has not been kept hot enough (60°C, 140°F, or above) or cold enough (7.2°C, 45°F, or below).

Medication error rates in hospitals are well known to be the fourth leading cause of death in the United States. Outpatient errors are probably much higher than inpatient errors, although little data exists for outpatient studies in the literature. I have argued for years that the number of unnecessary deaths is increasing every year from medication error because more drugs are given and they have more dramatic impact on the patients physical system. This combined with nursing shortages and underfunding of information techologies to prevent these errors have doubled the rate of medication error from 1996 to 2000 in the study below.



Prescribing Errors Involving Medication Dosage Forms

Timothy S. Lesar, Pharm D

Journal of General Internal Medicine, Volume 17 Issue 8 Page 579 – August 2002

CONTEXT: Prescribing errors involving medication dose formulations have been reported to occur frequently in hospitals. No systematic evaluations of the characteristics of errors related to medication dosage formulation have been performed.

OBJECTIVE: To quantify the characteristics, frequency, and potential adverse patient effects of prescribing errors involving medication dosage forms .

DESIGN: Evaluation of all detected medication prescribing errors involving or related to medication dosage forms in a 631-bed tertiary care teaching hospital.

MAIN OUTCOME MEASURES: Type, frequency, and potential for adverse effects of prescribing errors involving or related to medication dosage forms.

RESULTS: A total of 1,115 clinically significant prescribing errors involving medication dosage forms were detected during the 60-month study period. The annual number of detected errors increased throughout the study period. Detailed analysis of the 402 errors detected during the last 16 months of the study demonstrated the most common errors to be: failure to specify controlled release formulation (total of 280 cases; 69.7%) both when prescribing using the brand name (148 cases; 36.8%) and when prescribing using the generic name (132 cases; 32.8%); and prescribing controlled delivery formulations to be administered per tube (48 cases; 11.9%). The potential for adverse patient outcome was rated as potentially “fatal or severe” in 3 cases (0.7%), and “serious” in 49 cases (12.2%). Errors most commonly involved cardiovascular agents (208 cases; 51.7%).

CONCLUSIONS: Hospitalized patients are at risk for adverse outcomes due to prescribing errors related to inappropriate use of medication dosage forms. This information should be considered in the development of strategies to prevent adverse patient outcomes resulting from such errors.

There are a lot of reasons based on published experimental evidence to worry more about homocysteine in heart disease than cholesterol. This month it looks like it is correlated with Alzheimer disease as well. Homocysteine is easily controlled by nutritional supplements, particularly B vitamins and folic acid. See Life Extension Foundation protocol.



Moderately Elevated Plasma Homocysteine, Methylenetetrahydrofolate Reductase Genotype, and Risk for Stroke, Vascular Dementia, and Alzheimer Disease in Northern Ireland.

McIlroy SP, Dynan KB, Lawson JT, Patterson CC, Passmore AP.

Stroke 2002 Oct 1;33(10):2351-2356

Background and Purpose- Elevated plasma homocysteine level has been associated with increased risk for cardiovascular and cerebrovascular disease. Variation in the levels of this amino acid has been shown to be due to nutritional status and methylenetetrahydrofolate reductase (MTHFR) genotype. METHODS: Under a case-control design we compared fasting levels of homocysteine and MTHFR genotypes in groups of subjects consisting of stroke, vascular dementia (VaD), and Alzheimer disease patients and normal controls from Northern Ireland. RESULTS: A significant increase in plasma homocysteine was observed in all 3 disease groups compared with controls. This remained significant after allowance for confounding factors (age, sex, hypertension, cholesterol, smoking, creatinine, and nutritional measures). MTHFR genotype was not found to influence homocysteine levels, although the T allele was found to increase risk for VaD and perhaps dementia after stroke. CONCLUSIONS: We report that moderately high plasma levels of homocysteine are associated with stroke, VaD, and Alzheimer disease. This is not due to vascular risk factors, nutritional status, or MTHFR genotype.