| Thursday, November 30, 2006
| THE YEAR IN MEDICINE FROM A TO Z
HOPING TO SHARPLY CUT HIV/AIDS transmission rates in the U.S., the Center for Disease Control and Prevention took the unusual step of recommending that doctors ask all patients from ages 13 to 64 whether they want to be tested or the virus. One in four Americans living with HIV don't know they are infected; for them, early diagnosis could mean early treatment and longer lives. Antiretroviral drug therapy has already saved nearly 3 million years of life in the U.S. alone. Meanwhile, the number of people living with HIV/AIDS around the world continues to grow, to 40 million, according to estimates released last week by the U.N.
WHEN MADRID BARRED ULTRATHIN MODELS from the city's fashion week in the aftermath of a model's death, it was clear acknowledgem,ent that culture can fuel unhealthy body images. But genes play a role too. Researchers studying 31,406 identical and fraternal twins born in Sweden from 1935 to 1958 found that if one identical twins suffered from Anorexia, the odds were significantly higher that the other did as well. Just because someone is genetically predisposed to anorexia, however, doesn't mean she or he will develop the disorder. The next step will be to figure out which genes are involved andhow they affect the brain.
BACTERIA ARE ON THE MARCH. Researchers found that nearly 75% of serious skin infections treated at clinics in Atlanta were resistant to the antibiotics that are normally used to cure such infections. The bacteria responsible, known as methicillin resistant Staphyococcus aureus (MRSA), used to be seen mostly in hospitals but are now turning up all across the U.S. MRSA can still be treated with other antibiotics, but the Infectious Diseases Society of America has called for Congress to pressure the pharmaceutical industry to develop new, stronger drugs to fight the superbugs.
NEARLY 5,000 DEATHS A YEAR IN THE U.S. ARE ATTRIBUTED TO ASTHMA. But on the basis of as statistical analysis of 19 trials involving 35,000 patients, researchers believe that 4,000 of these deaths are actually being triggered by two drugs found in inhalers sold under the names Serevent, Advair and Foradil. The drugs relieve symptoms but can, without warning increase dangerous bronchial inflammation. Asthma, on the rise since the 1980s, afflicts more than 20 million Americans.
WOMEN WHO PUT ON POUNDS AS ACULTS HAVE NOW REASON TO BE WORRIED ABOUT BREAST CANCER. As study of 44,161 postmenopausal women linked adult weight gain to a higher lifetime risk for all types, stages and grades of breast cancer, particularly advanced malignancies. The risk for women who gained more than 60 lbs, was three times as great. Reason: breast cancer risk is linked to lifetime levels of the hormone estrogen. Fat tissue increases circulating estrogen, thereby adding to the risk.
BACON MAY BE STAPLE OF THE AMERICAN BREAKFAST, but it's probably not a terrific idea to eat it everyday. Or sausage or corned beef hash, for that matter. Researchers from the Karolinska Institute in Stockholm pooled data from 15 students and found that eating just over an ounce of these smoked and processed delicacies each day increased the risk of developong stomach cancer from 15% to 38%. The culprit may be the high salt content pf such meats,which could irritate the lining of the stomach, or perhaps the nitrate and nitrate additives, which are known to have cancer promoting qualities.
COUGH SYRUPS CAN DAMAGE CHILDREN'S TEETH, and it's not necessarily the sweetness in them that do it. Many over the counter remedies that contain antihistamines are slightly acidic in nature, and a new study showed that this acid can cause cavities in healthy tooth enamel. Fortunately, flouride counteracts the problem, so make sure your children brush their teeth after swallowing cough syrup, Also try giving the medication with meals, when the body's natural production of saliva hleps protect the teeth.
THINK YOU'RE SAFER BECAUSE YOU TALK ON A HANDS-FREE CELL PHONE WHILE DRIVING? Think again. Using either type of phone while trying to drive a car is roughly equivalent to driving with a blood-alcohol concentration of 0.08%, which is high enough to get you arrested in any of the 50 states and the District of Columbia for driving under the infleunce. Folks who used hands free cell phones in simulation trials also exhibited slower reaction times and took longer to hit the brakes than drivers who weren't otherwise distracted. Data from real life driving tests show that cell phone use rivals drowsy driving as a major cause of accidents. SUV drivers, it turns out, are more likely to talk on a cell phone - and to resist wearing their seat belt.
IS COFFEE DESTINED TO HE THE NEXT HEALTH FOOD? Researchers found more evidence that drinking coffee - with or without caffeine - decreases the risk of Type 2 daibetes in those who are prone to develop the condition, perhaps by boosting the body's metabolism a bit. (Excercise is, of course, even more effective, but maybe you need that extra jolt to get yourself moving). Coffee also seems to decrease slightly the risk of liver damage in patients with a history of alcoholism,perhaps because coffee contains lots of antioxidants. But the news isnt' all good. Drinking lots of coffee during pregnancy increase the risk of having a stillborn child.
NOT ONLY IS THE AIR CLEANER IN THE CENTENNIAL STATE, but the people there also live longer. A Harvard study showed that the seven U.S. counties with the greatest average life expectancy - 81/3 years - were in Colorado. (Clear Creek, Eagle, Gilpin, Grand, Jackson, Park and Summit, for those of you thinking about packing a U-Haul). exactly what's so special about Colorado is nit entirely clear, since the study authors controlled for any bias cause by race or income. Perhaps the residents good fortune has to do with the fact that they all live in mountainous areas, where being physically active is easy, as opposed to more lowland, sedentary portions of the U.S.
NOBODY LOOKS FORWARD TO A COLONOSCOPY, but there's still no better way to detect and prevent colon cancer. There may however, be a less intrusive alternative to the dreaded test. Researchers at Mount Sinai School of Medicine in New York City tested a newly improved version of a noninvasive fecal DNA test to screen for early signs of the deadly cancer. Fecal samples from 162 patients eho had undergone colonoscopies in the previous 14 days (compared with 40 detected in the colonoscopies). That trasnlates into an impressive 88% sensitivity rate. The fecal screen, however, also mistakenly indicated cancer in 22 individuals who had been properly given a clean bill of health by their colonoscopy. Not perfect yet, but still potentially lifesaving.
RESEARCHERS STILL DON'T UNDERSTAND WHY SEVERELY DEPRESSED teen-agers are more likely than adults to commit suicicie while taking antidepressant drugs like PAXIL, but a major study out of UCLA concluded that the drugs do more good than harm. Starting in the early 1960s, the annual U.S. suicide rate held fairly steady at 12 to 14 instances per 100,000 - until 1988, when the first of a new generation of antidepresants, the selective serotonin reuptake inhibitors, was introduced. The suicide rate has been falling ever since, to around 10 per 100,000. The investigators estimate that nearly 34,000 lives have been saved.
DOCTORS HAVE LONG KNOWN THAT AN ACTIVE LIFESTYLE and sensible eating habits can help keep peopl who are at high risk of Tyoe 2 diabetes from developing the condition. But takng diabetes medication before you hae symptoms also helps. A study of more than 5,000 predibetic men and women found that treatment with rosiglitazone, a drug aht controls blood sugar levels, decreased their risk of progressing to diabetes 62%. About half the participants who were given the drug returned to normal blood sugar levels, compared with 30% of those who relied on diet and exercise alone. About 41 million Americans are thoguht to be prediabetic.
THINGS GOT EVEN MORE CONFUSING for women considering hormone-replacement therapy. Studies had shown that a combination of estrogen and progesteroner increased the risk of breast cancer, heart attack, stroke and blood clots. A new study found that estrogen-only treatments appear safer, with no increase in breast cancer risk but some increased risk of stroke or clots. A later study found a breast cancer risk from estrogen therapy, however, among some postmenopausal women. If you must have hormone therapy, get it in small doeses for short periods.
PEOPLE SEEKING THE HEART PROTECTIVE POWERS OF OMEGA-3 fatty acids in fish have been warned about the mercury, dioxins and PCBs thatthey might be consuming withe their meal. But a study from the Harvard School of Public Health showed that while those contaminants pose a danger, particularly for women of chilbearing age, for most people the benefits of fish outweigh the risks. Eat modest serving of fish each week - particularly salmon and bluefish and you may reduce your risk of coronary heart disease 36%. Elsewhere, researchers at Louisiana State University reported that omega-3 s can help protect cells in the retina, slowing the damage caused by such blinding diseases as retinities pigmentosa and macular degeneration.
WANT TO GET OUT OF THE HOSPITAL QUICKER? Chew gum. People who undergo abdominal surgery often suffer from postop ileu, essentially an intestinal shutdown, leading to pain, vomiting and other problems. The sooner the digestive engine gets up and running, the sooner patients can go home. Researchers at Santa Barbara Cottage Hospital in California found that chewing sugarless gum can help things along, probably by stimulating nerves and hormones associated with eating. No word on whether any flavor works better than others.
NEWS FROM THE FRONTIERS OF HEART RESEARCH WAS MIXED. Researchers discovered two genes that appear to contribute to early heart attacks, in part by causing blood to clot abnormally. A small emergency-room study found that drugs used to break up clots may help revivie cardiac-arrest patients when such methjods as CPR and electrical shock have failed. There were murkier findings regarding people with high elevels of homocysteine, an amino acid linked to heart disease. Folic acid and B vitamins help bring homocysteine down, but one study cast doubt on whethere this actually improves heart health.
SCIENCE FOUGHT BACK AGAINST AVIAN FLU with a successful test of a new vaccine. In a study of 451 subjects, the preparation caused no significant side effects and produced antibodies at a level that is usually sufficient to protect against common strains of flu - a good sign that it will work against the avian flu variety too. It's the common strains, of course, that ought to cause us concern,since avian flu has yet to kill anybody in the U.S. and the common flu kills 36,000 each year. Girding for this winter's assault,the Food and Drug Administration (FDA) approved a new vaccine against several flu strains likely to cause infections n North America, bringing to five the number of vaccines in this season's anti-influenza arsenal.
WE'VE ALL SHARED IN THE PAIN OF A BAD JOKE, but can good laugh help the heart? Watching 15-to-30-min. clips of comedies- one used by researchers was There's Something About Mary - increased blood flow to the heart up to 50%, compared with, say, the opening battle scene of Saving Private Ryan. Watching a funny film was like a jolt of activity; a sad film triggered the same vascular response as doing a match problem or remembering an incident that made one angry.
DOCTORS DIAGNOZE 173,000 CASES OF LUNG CANCER in patients each year, 95% of whom will die from it - more than from breast, prostate and colon cancer combined. But New York - Presbyterian Hospital/Weill Cornell Medical Center researchers found that low-dose, spiral-computed tomography (CT) screening drastically improved the odds. In a study of 31,567 people, annual CT screening (about 600 images per scan) detected Stage 1 lung cancer in 412 patients, and when the cancer was surgically removed within one month of diagnosis, their 10-year survival rate was an impressive 92%.
AMERICANS MAY BE MEETING MORE PEOPLE ONLINE, but the number we count among our closest friends - the ones with whome we discuss important - matters - shrank over the past 20 years, from three friends to two. At the same time, the number of Americans who have no one at all to confide in more than doubled, to 1 in 4. Sociologists from Duke Universoty and the University of Arizona report that we increasingly rely solely on family members (80%) and spouses (9%). There could be health consequences; other studies link robust social networls to lower blood pressure, reduced risk of Alzheimer's disease and greater longevity.
THE FACT THAT THE DIET FAVORED BY THE GREEKS IS GOOD for the heart seems as ancient as Greece itself. But now the mediterranean diet-high in fruit, vegetables, cereals, fish, olive oil and topped with a glass of two of wine daily-has been linked to a lower risk of Alzehimer's, even in patients with vaccular disease. When researchers from Columbia University Medical Center scored the diet of nearly 2,000 subjects on a 0-to9 scale depending on their adherence to a Mediterranean-style food plan-each additional point on the scale corresponded to a 19% to 24% lower rish of developing Alzheimer's. The one-third of patiients with the best score reduced their risk 68%, compared with the bottom third.
CHOCOLATE in small quantities is known to be good for the heart and blood vessels, but in a new biochemical analysis, researchers have identified a component in cocoa that reduces platelet clumping, helping blood flow smoothly.
CINNAMON AND CLOVES two related studies suggest cinnamon and cloves can reduce risk factors for diabetes and heart disease up to 30% by controlling glucose levels in Type 2 diabetics and reducing inflammation and cholesterol levels.
FRUIT JUICE antioxidants in the skins of fruits and vegetables seem to have reduced risk of Alzheimer's 76% among Japanese Americans who drank juice more than three times a week.
GINGER known to reduce inflammation and ease nausea, ginger powder was also found to kill ovarian-cancer cells in the laboratory at a rate of comparable to conventional chemotherapy drugs.
TUMERIC (a spice used in curry sauces) and phenethyl isothiocyanate (a phytochemical found in broccoli, kale and cabbage), alone or in combination, significantly reduced prostate tumor growth in mice.
THE EPIDEMIC SHOWS NO SIGN OF ABATEMENT, in act, it's spreading. The Chinese government reports that 60 million Chinese people are overweight in a country that never had that problem before. The culprit: prosperity, which permist Chinese people to eat more fats and junk food, fewer grains and vegetables. In short, they can now eat just as irresponsibly as Americans. High blood pressure and diabetes are also up. In teh U.S., the epicenter of the problem, a study in the Journal of the American College of Cardiology offered the isturbing news that heart problems can be seen in obese teens, in the form of coronary enlargement. Another study, meanwhile, in Annals of Internal Medicine, found that being overweigth at age 18 correlates with a higher risk of early death in youn and middle-age women.
MOST WOMEN KNOW THAT OSTEOPOROSIS, or thinning of the bones, is a big risk after menopause. Probably most don't know that drinking cola increases the risk. A study in the American Journal of Clinical Nutrition looked at 1,125 men and 1,413 women ages 29 to 86. Among the women - but not the men - there was significant loss of bone density in cola drinkers, whether they drank diet or regular. It's not the first eveidence, but it's the strongest to date linking cola to bone loss.
YOU MIGHT THINK RIDING IN A TAXI WOULD EXPOSE YOU TO LESS AIR pollution than you would get walking down a city sidewalk, but that doesn't seem to be the case. Researchers at Imperial College London gave volunteers particulate detectors and had them walk, bike, drive, bus or taxi their way up and down streets in central London, taking a total of 584 individual trips. To everyone's surprise, riding in a taxi resulted in the worst exposure - nearly twice as much as walking. The suggested explanation: taxis tend to get studk in traffic surrounded by other pollution-belching vehicles; pedestrians are a little father from the exhaust pipes.
WHEN RUSH LIMBAUGH ACCUSED MICHAEL J. FOX of going off his Parkinson's meds to make a political ad in favor of embryonic stem-cell research - and against Republican candidates who oppose it - the insult backfired. A pro-stem-cell law passed in Missouri, and Democrat Claire McCaskill was elected to the Senate in a tight contest.But it isn't just celebrity endorsements that make people favor embryonic cells as a possible treatment for Parkinson's (and a long list of other diseasee); clinical results are starting to come in too, including those from a 10-year study of implanted embryonic cells in human patients. Preliminary findings suggest the cells can survive, divide and moderate symptoms, without rejection although significant clinical trials have yet to be done.
AFTER YEARS OF BACK-AND-FORTH DELIBERATIONS, the FDA finally approved over-the-counter sales of Plan B, a contraceptive that can be taken after sex to prevent a fertilized egg from implanting in the uterus. The drug had been available by prescription since 1999. In a 2003 ruling, the agency refused to change thedrug's status, over the objections of its own scientific advisory committee. That ruling angered pro-choice groups. The reversal predictably infuriated right-to-lifers, but those who favor reproductive rights weren't thirlled eigher; the FDA allowed over-the-counter sales only to women over 18. Anyone younger will still need a prescription. Barr Pharmaceuticals, which makes Plan B, had proposed prescription-free purchases for girls over 16, and will challenge the latest ruling.
IN AN ATTEMPT TO NAIL DOWN the question of whether prayer really can heal, six hospitlas had strangers say prayers for 1,800 coronary-bypass patients and then studied the post-operative complications. Patients who were told they might or might not be prayed for had roughly the same complication rate, whatever their prayers status turned out to be. But those who were told for certain that they were in someone's prayers actually did worse. The doctor's tentative explanation: people who know they were being prayed for might have thought they were sicker than they reaslized, which could have made their outcomes worse. But anyone tempted to think this study disporves the power of prayer should think again. The doctors and clergy who ran the study had no control over whether friends and family were also praying for the patients - and they certainly couldn't have forbidden persoanl prayers even if they know about them. Beyond that, the prayers said by strangers were provided by the clergy and were all identical. Maybe that prevented them from being truly heartfelt. In short, the possible confounding factors in this study made it extraordinarily limited.
STUDIES HAVE SUGGESTED THAT DRINKING modest amounts of red wine can hlep the heart. The key appears to be an antioxidant called resveratrol found in grape skins (and in fact, grape juice seems to be just as effective if not a much fun). Now researchers at Harvard Medical School and the National Institute on Aging say that high doses of resveratrol fed to obese mice seemed to prevent problems usually seen in chubby rodents (and people), including diabetes, liver damage and premature death. But you would need more than 100 glasses of wine a day to get that much resveratrol. And even if you took it in supplement form, there is no proof it woild work as well in humans as in mice.
NOBODY HAS EVER FULLY EXPLAINED WHAT USED TO BE CALLED CRIB DEATH and is now known as sudden infant death (SIDS), but a report in teh Journal of American Medical Association may point to at least part of the answer. In a study of 31 babies who died of SIDS and 10 who died from other causes, the SIDS babies had many more abnormalities among the neurons in their brain stem than did the other infants. The defect involved the processing of serotonin, a neurotransmitter that, among other things, controls aropusal from sleep. When SIDS babies get into a position in which their access to fresh air is blocked, they can fail to wake up and move.
THAT MORNING CUP OF COFFEE MIGHT SMELL BETTER after you get up from bed. It has been shown that lying down can dampen such senses as hearing and spatial perception, and now researchers have found that reclining can also smother your ability to pick up odors. More than 60% of test subjects sniffing rose odor had decreased sensitivity tot he smell when recumbent. The phenomenon could be the body's way of turning off potential distractions while you're trying to fall asleep, or itmight be the result of fluids that rush thorugh thebrain while you're supine. Either way, the shifting effect may be an important consideration for reading MRI or PET scans, which take images of the body while lying down.
FIRST, THE BAD NEWS, AFTER DROPPING OVER THE PAST EIGHT YEARS, rates of smoking in the U.S. leveled off in 2005 at 1 in 5 adults, according to the CDC. The good news is that the FDA has approved a new drug - only the second to get its' OK - to help smokers quit. This one, Chantix, was designed specficially to address nicotine cravins thatmake the habit so hard to break. Chantix mimics the active ingredient in nicotine and can fool the brian into thinking it has had its nicotine fix - without nicotine's addictive qualities or all the damage smoking popping a few pills will make you kick the habit; the most successful long term quitters also participated in counselingang and cognitive behavior therapy.
YOU TAKE YOUR WORK HOME WITH YOU, the whole family feels the effects - especially your kids. A Canadian study analyzed the employment history and psychosocial work conditions of nearly 30,000 sawmill workers and found that there was a direct correlation between teh stress fathers, left on the job and their children's mental health. The most striking result; 252 of the approximately 20,000 children in the survey whose fatehrs had stressful jobs attempted or committed suicide from 1985 to 2001. Girls were more likely to attept suicide when their fathers had little control over their work; biys when fathers had jobs that didn't last long and demanded a lot of them psychologically.
IN JUNE THE FDA APPROVED A VACCINE to protect against cervical cancer, the second most common cancer in women. The vaccine, called Gardasil, immunizes against four of the most prevalent strains of the human papillomavirus (HPV), the most common sexually transmitted infection and the cause of 70% of cervical cancer cases. Because the vaccine is most effective when administered before gilrs become sexually active, a government committee recommended that it be given routinely to girls ages 11 and 12 - which immediately triggered cries of alarm from pro-abstinence groups that feared doing so would encourage promiscuity. Some health advocates were also worried that women might see the vaccine as a substitute for yearly screenings like Pap smears.
DO BABIES FEEL ANTIDEPRESSANT-WITHDRAWAL SYMPTOMS? Researdhers at the Rabin Medical Center in Israel think they do. A study of 120 newborns found that among those whose motehrs took the antidepressants known as selective serotonin reuptake inhibitors (SSRIS), nearly one-third experienced neonatal-abstinence syndrome drug withdrawal characterized by such symptoms as tremors, gastrointestinal distress and sleep disturbances. Depression wil affect between one tenth and one fourth of women and is often exacerbated by pregnancy. Doctors arent telling severely depressed mothers-to-be to stop taking antidepressants, but they should be aware that doing so poses certain risks for newborns. The researchers recommend thatnewborns exposed to SSRIS in utero be monitored for at least 48 hours.
(Source:TIMEMAG/The Year in Medicine by :David Bjerklie,Christine Gorman,Jeffrey Kluger, Michael Lemonick, Coco Masters, Alice Park and Carolyn Sayre)
|posted by infraternam meam @ 11:04 AM