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Friday, May 31, 2002
Wine Good for Your Lungs Research presented at the American Thoracic Society meeting recently in Atlanta showed that drinking one to three glasses of white wine a day improved lung function. Comment: another benefit of moderate drinking. Note, however, the previous pearl discussing research on whether it helped to take up drinking in middle or old age. That research found that starting to drink at a later age was not beneficial, although those who drank moderately since their 20's did benefit from moderate drinking. [ article ] Nurse Initiated Thrombolysis Safe and Effective Nurses working under guidelines and exclusions determined by consultant cardiologists were able to reduce the time from hospital presentation to initiation of thrombolytics in patients with an acute heart attack. Out of the 93 patients studied, 74 received thrombolytics within 30 minutes (80%) and in no case were thrombolytics given appropriately. Comment: medicine is a team sport. The problem with this study was that it compared administration of thrombolytics during different years. Over the entire study period from 1989 - 2001, more and more research became available stressing the need to give thrombolytics early. Thus, the improvement found may be simply due to greater awareness rather than anything the researchers did. [ article ] Thursday, May 30, 2002
Hollywood Continues to Have Leading Actors Smoke Hollywood continues to have a full quarter of all the major characters smoke cigarettes. The lead author of the research article on this subject, Dr. James D. Sargent of Dartmouth University, states that the movies (i.e. Hollywood) are giving tobacco firms free advertising, and promoting cigarette smoking especially among teens. Comment: earlier pearls document the connection between cigarette smoking by leading characters and an increase in teen smoking. [ article ] Beating Alzheimer's Disease This study in rats from the University of California Irvine found that "exercise-happy" rats had healthier brains. The researchers speculate that this is further proof of the benefits of exercise, and suggests that exercise may help prevent Alzheimer's Disease. Comment: the link to Alzheimers is purely hypothetical, but sounds plausible. [ article ] Wednesday, May 29, 2002
More Evidence for Screening for Depression This review of the literature dating back to 1966 found support for the US Preventive Services Task Force recommendation that screening adults for depression in primary care settings improves overall health care. Comment: this is a multi-center study from the University of North Carolina, University of Michigan, Research Triangle Institute, Robert Wood Johnson Foundation, and the University of Texas in San Antonio. [ article ] US Preventive Task Force: New Recommendation for Depression Screening The US Preventive Services Task Force has made a change from earlier recommendations from 1996, and now recommends screening for depression provided there are systems in place to facilitate accurate diagnosis, effective treatment, and proper follow-up. Comment: now that fluoxetine (Prozac) is a generic medication, getting patients to take an SSRI antidepressant is much easier. The recent governmental push to cover more mental health services will also help. [ article ] Asthma Linked to High Ozone Levels This study of 3535 children in 12 communities in southern California found that in communities with high ozone levels, children participating in strenuous outdoor activities were 2.5 to 4.7 times more likely to develop asthma. In communities with low ozone levels, participation in stenuous outdoor sports had little effect upon the development of asthma. Comment: this is another study that shows the harmful effects of air pollution in California. [Article] D-dimer Test Negative Predictive Value = 99% The semiquantitative D-dimer blood test in this study of 704 outpatients with suspected deep venous thrombosis had a sensitivity of 99% and a negative predictive value of 98%. The test is almost always positive (and thus not very helpful) in patients on anticoagulants and those over 70 years old. Comment: patients with a negative semiquantitative D-dimer test will only rarely need ultrasonography. A positive D-dimer test isn't very helpful, but a negative test will provide strong evidence against a deep venous thrombosis. [ article ] California Seeks Fines Against Internet Pharmacy The state of California is seeking $88.7 million in fines against a Los Angeles pharmacy for filling prescriptions without a good faith prior medical examination by a California licensed physician. The online pharmacy used online questionnaires to substitute for an examination by a licensed physician.Comment: I anticipate that this will be the first in a wave of lawsuits against Internet pharmacies. [ article ] Tuesday, May 28, 2002
For-Profit Hospitals Shown to Have Higher Death Rates This Canadian meta-analysis of 15 studies looking at 26 000 hospitals in the US found that private for-profit hospitals had a 2% higher risk of death compared with private non-profit hospitals.Comment: there are a lot of uncontrolled variables present in this type of meta-analysis and the conclusion of the study has to be looked at very skeptically. Nonetheless, it is suggestive, and the hypothesis is reasonable- that for-profit hospitals cut corners on staffing and supplies, which in result leads to a slightly higher risk of death. [ article ] Diet Rich in Fruits and Vegetables Found to Decrease Blood Pressure This Oxford study of 700 adults aged 25 to 64 found that those who ate at least five servings of fruits and vegetables a day resulted in a lowering of the systolic blood pressure by 4 mm Hg and the diastolic blood pressure by 1.5 mm Hg. Comment: this change in blood pressure is pretty small, however, it adds to the body of evidence that has show that a diet high in fruits and vegetables is good for you. [ article ] Tadalafil Treats Erectile Dysfunction for up to 36 Hours Tadalafil, promoted as a second-generation sildenafil (Viagra), has been shown in early research studies to allow men with erectile dysfunction to have intercourse up to 36 hours after taking the pill. Furthermore, as many as 40% of the patients who do not respond to sildenafil will respond to the newer medication. [ article ] Children of Caring Mothers Less Likely to Use Drugs This study from England found that a caring mother was the single most important factor in preventing children from taking drugs. of the 3984 teens studied, those with a close relationship to their mother, lived with both parents, and had good family relationships were much less likely to use drugs or alcohol. [ article ] Depression Linked to Parkinson's Disease A 25 year study from the Netherlands found that people with depression are three times more likely to develop Parkinson's disease. Comment: it is unclear whether depression can be a contributory factor causing Parkinson's disease, or whether depression is an early sign of Parkinson's. The researchers speculate that the latter is the case. [ article ] Chemical in Broccoli Kills H.Pylori H.Pylori, the bacteria that can cause stomach ulcers and even stomach cancer, can be killed by a chemical found in broccoli- sulforaphane. Comment: another reason to eat a diet high in vegetables. [ article ] Saturday, May 25, 2002
Prevention is the best cure As we've said all along here at the Internet Medical Journal, prevention is the best cure. Now, a study in the Lancet has come to the same conclusion regarding HIV infection in Africa- that prevention will save more lives than treating those who already have HIV. Comment: no kidding. It's really mind boggling that this study was published in such a prestigious journal. Their study basically said that preventing a lethal, incurable disease will save more lives than treating an incurable, lethal disease. [ article ] Oral Anti-Viral Medication Kills Smallpox Cidofivir, when combined with lecithin, has been shown in animal studies to kill the smallpox virus. It can be taken orally in pill form. It has been tested on the cellular level and also in mice. [ article ] Genetic Engineering Makes Mosquitoes Unable to Transmit Malaria A team of German and American researchers have genetically modified mosquitoes, making them unable to transmit malaria. Between 300 and 500 million people are infected with malaria each year, and one to three million people die each year from the disease. [ article ] Malpractice Lawsuits a Lottery? A man was awarded a $250 000 USD award from a medical malpractice lawsuit. The case was due to problems the man received as a result of doctors leaving a surgical tool inside of his abdomen after surgery. Comment: this plaintiff in this case certainly deserved compensation. However, what is interesting is that the article headline states that he *won* $250 000. Are lawsuits simply lotteries that are won or lost? I would have liked to have seen that the man was awarded $250 000 *and* that the hospital surgical program was forced to make changes in their quality control procedures. [ article ] Friday, May 24, 2002
Medical News Goes Multimedia You may now listen and view online the articles reviewed by Dr. Heston in a convenient multimedia presentation. [ Click Here to View ] Wednesday, May 22, 2002
18000 Die Prematurely Due to No Medical Insurance A report from the US Institute of Medicine estimates that 18 000 uninsured American adults die prematurely due to their lack of proper medical care. [ article ] Mild Depression Associated With Longevity in Women This study from Duke University looked at 2401 women and 1269 men 65 years of age and older. It found that women with mild depression were less likely to die over the three to four year followup period. The researchers speculate that mild depression may lead to adaptive behaviors.[ article ] Tuesday, May 21, 2002
Stress Inhibits Blood Vessel Relaxation This study of 23 healthy individuals found that mental stress resulted in a 50% decrease in the ability of the blood vessel endothelium to increase blood flow. This decreased ability to expand could be the reason why stressful events have been associated with an increased risk of a heart attack. Comment: note the earlier pearl that found that exercise increases the ability of blood vessels to relax. Thus, at the level of the blood vessel, exercise is a good antidote to stress. [ article ] Monday, May 20, 2002
Great Britain to License Doctors The UK plans to require doctors to submit evidence to their General Medical Council that they are getting the continuing medical education they need to stay up to date. Those doctors that are not maintaining proper continuing education will not be licensed. Comment: most US states- but not all- require that doctors get continuing medical education in order to be licensed to practice medicine. Although many older doctors who became board certified a long time ago no longer need to retake an exam to maintain their board certification status, almost all of the younger doctors do. For example, to maintain my status as a board-certified family physician, I need to retake and pass the board exam every 7 years. Furthermore, to maintain my status as a member in the American Academy of Family Physicians, I need to have at least 50 hours of continuing medical education a year. This is becoming standard practice for nearly all of the certification boards in the US. Individual states, however, vary considerably in the number of hours of continuing education required to be licensed. [ article ] Heat Treatment for Breast Cancer A team from the Duke Comprehensive Cancer Center has developed a heat treatment system to treat breast cancer. The treatment was tested on 21 women with newly diagnosed breast cancer. The trial lasted 12 weeks. The heat treatment was combined with chemotherapy. Most of the women in the trial had been told their cancer was inoperable. The outcome of the trial was positive, with many patients no longer having evidence of any cancer and others being able to undergo lumpectomy rather than radical mastectomy. Comment: these findings were presented at a meeting-- and not yet publication quality. The statistics given in the news article don't add up correctly. For example the article states that 11% of the women hand no cancer found when the breast tissue was analyzed. This is equal to 2.31 patients (11% of 21 = 2.31). They also state that 17% of the patients were now suitable for lumpectomies as opposed to radical mastectomies. Well, 17% of 21 = 3.57. I wonder how 3.57 patients underwent lumpectomies. This highlights the problem with putting too much credence on research presented at meetings. I've been told that approximately 50% of the research papers presented at a meeting never make it to publication in a peer reviewed journal. Nevertheless, I believe that this is really exciting research! The hypotheses and science behind this work is very solid, and it comes from an excellent medical center - Duke. [ article ] Wednesday, May 15, 2002
Access to Healthcare Hardest in US A five nation survey found that Americans report the most problems securing access to healthcare. In the US, 21% of people reported having a problem paying medical bills. However, all countries had their own unique problems. Adults in the UK reported the longest waiting times for elective surgery, 16% of Canadians had problems seeing a specialist, 19% of Australians said they did not fill a prescription over the last year due to cost, and New Zealanders had more income-related inequities in the care they received. The US, however, had the greatest number of problems according to the questions asked on this survey. Comment: I'm not sure if this measures *true* problems, or just the willingness of people to complain. Self-reported dissatisfaction rates would be naturally higher in nations where there is a high willingness to complain-- which certainly is very high in the US as evidenced by our outrageous number of lawsuits. [ article ] African-Caribbeans Genetically at an Increased Risk for Stroke The Stroke Association in Great Britain is launching a campaign to raise awareness among people of African-Caribbean descent that they are at an increased risk for stroke. There are many different possible reasons why, however, there is believed to be a stong genetic component predisposing them to strokes. [ article ] Vegetable Intake Linked to Decreased Breast Cancer Risk This study compared 240 women with breast cancer with 477 healthy control patients. All women were South Asian, and had immigrated to England. Those who adopted a Western diet were more likely to develop breast cancer than those who maintained their original vegetarian diet rich in vegetables and legumes. Comment: the study did not show that meat consumption was linked to an increased breast cancer risk, but rather that a diet rich in vegetables decreased the risk. [ article ] Radiation Therapy Combined With Angioplasty Linked to Improved Outcomes This study found that when radiation therapy was combined with angioplasty, there was a 74% decreased risk of vessel stenosis at 6 months and a 48% decreased risk at 5 years after the angioplasty procedure. [ article ] Light Drinking Healthy Women drinking one or two drinks a day were found to respond to insulin better than were nondrinkers. Comment: another benefit of light drinking. Moderation is the key. [ article ] Walk Away From Your Chores As Janice Billingsley so aptly puts it, "Your best bet for physical activity is to walk away from your chores, and the faster the better." In a British study of 200 women from 60 to 79 years old, brisk walking was linked with less obesity and a lower resting heart rate-- but heavy housework offered no benefit. Comment: other studies have found housework beneficial in decreasing mortality. [ article ] Thank Lawyers for Your High Medical Bills Reprinted With Permission from NewsMax.com Tuesday, May 7, 2002. LOS ANGELES – Doctors who specialize in delivering babies and treating pregnant women are closing their offices, leaving states such as Florida and New York, or abandoning their profession because they can't get liability insurance, even at sky-high rates. "One New Jersey specialist, without a legal blemish on his practice record, was finally able to secure insurance at the cost of $300,000 a year," Dr. Thomas Purdon, president of American College of Obstetricians and Gynecologists (ACOG), told United Press International on Monday. "We are in a crisis situation," Purdon said at the annual meeting of ACOG. Organization leaders issued a "Red Alert" warning that without relief from state and federal legislation, many rural areas will be without obstetricians. Not only are doctors leaving the field, but hospitals are closing their maternity wards. Purdon said the "ripple effect" was reaching into academic institutions, where recruiting experts to teach obstetrics and gynecology could be hamstrung as well. ACOG leaders cited Florida, Mississippi, Nevada, New Jersey, New York, Pennsylvania, Texas, Washington and West Virginia as being most in danger of losing obstetric care because of difficulty in getting insurance. For example, in Florida obstetricians have an average cost that exceeds $200,000 a year for insurance premiums if they practice in populous Dade (Miami) and Broward (Fort Lauderdale) counties, said Purdon, professor of obstetrics and gynecology at Arizona Health Sciences Center, Tucson. In Nevada, Purdon said, 70 obstetricians in the Las Vegas area are about to leave the state because of the withdrawal from the market of one of Nevada's largest liability insurers. "In Mississippi, a pregnant woman in Yazoo City, which has a population of 14,000, has to travel 150 miles to get prenatal care," Purdon said. "When a woman has to travel that far to get care, she isn't going to get care." Tort Reform Needed One solution, Purdon said, would be creation of national legislation to establish legal reforms such as those in place in California. Those laws impose a cap on non-economic damage: "pain and suffering" or punitive. "Insurance rates in California have remained stable for years," he said. Purdon said the "Red Alert" was issued to let the public and legislators know there is a crisis that is going to have a severe effect on obstetric care. He said similar crises exist for neurosurgeons and orthopedists and are evidence that "we need to have legal reform. We have to look for better solutions." "Unlike previous crises in the 1970s and 1980s," said Dr. Albert Strunk, an administrative vice president for ACOG, "where cost was the issue, this time around there's the obstacle of finding any insurance coverage at all." "When you enter the field of obstetrics and gynecology, you have to love what you do with a passion," said Dr. Charles Hammond, president-elect of ACOG and chairman of the department of obstetrics and gynecology at Duke University Medical Center, Durham, N.C., "because the liability threat will always be there, no matter how outstanding the care you provide." Thank Lawyers for Your High Medical Bills Purdon said the New Jersey doctor he cited had left eastern Pennsylvania because insurance was not available. Re-establishing his office in New Jersey, the doctor searched for 90 days before he could find insurance liability coverage, at $300,000 a year. That kind of liability insurance means the doctor "has to pay about $1,000 a day before he can even turn on the lights in his office and doesn't reflect what it costs for paying his nurses and rent," Purdon said. "A lot of doctors are finding that these types of expenses make it difficult to stay in business." Hammond noted that 15 years have passed since Institute of Medicine warned that high liability costs were compromising delivery of obstetric care. "We still need reform at the federal and state levels," he said. "Band-Aid solutions won't work." Copyright 2002 by United Press International. Reprinted with permission from NewsMax.Com All rights reserved. Foot Care More Important Than Therapeutic Footwear This study of 400 diabetic patients found that special footwear did not decrease the risk of a foot ulcer. Comment: this study reinforces the need for regular, objective foot examinations in diabetics. [ article ] Tuesday, May 14, 2002
Bariatric Surgery Lecture We have added another lecture to our archives. This one is a recording of a live lecture on bariatric surgery by Dr. John Pennings. Visit http://radio.medjournal.com to listen. Friday, May 10, 2002
What to Do at a Crash If you are untrained in prehospital care, give basic first aid under the direction of the ambulance staff. Focus upon airway problems and stopping bleeding. Safety for yourself is the first priority. Rapid transport to the hospital is recommended. Comment: this whole issue of the British Medical Journal is a must read. [ article ] Seat Belts More Effective Than Air Bags This study from the University of Washington found that compared with un-seat belted drivers, those who wore a seatbelt were 65% less likely to die in a crash. If there was also an airbag, the reduction was 68%, just 3% more than only wearing a seat belt. Comment: this whole issue of the British Medical Journal (11 May 2002, vol 324 issue 7346) is devoted to road safety. [ article ] Thursday, May 09, 2002
ADV: Williams Obstetrics Listeners of the Internet Medical Journal Radio Program will want to know about the new 21st edition of Williams Obstetrics, which is from the University of Texas Southwestern Medical Center and Parkland Hospital -- not Baylor as mentioned on the webcast. This edition maintains its strong evidence-based approach and includes more than 4,000 new references, updated guidelines, and a new easy access format in a 2-color design. Rigorously referenced and cohesively written, the hallmarks of Williams Obstetrics are its thoroughness, scientific basis, and practical applicability for the obstetrician at the bedside. The book maintains its strong evidence based approach whereby management guidelines and recommendations are evaluated on analysis of the scientific literature. New features include: * New Editors John Hauth and Katharine Wenstrom bring special expertise in the field of evidence-based clinical medicine and state-of-the art application of CLINICAL and MOLECULAR GENETICS as they pertain to obstetrics * UPDATED GUIDELINES and STANDARDS of CARE reflect the current scope of practice * New Streamlined format features QUICK-READ CHAPTER OUTLINES and highlighted key sentences that pinpoint critical information * NEW CHAPTERS inform on hot topics: preconceptional counseling, induction and augmentation of labor, chronic hypertension, more * 250 NEW FIGURES AND TABLES illuminate key information. [ Click Here for Williams Obstetrics ] Smallpox Vaccination Risk: 1 Death per 400,000 Immunized Mass immunization against smallpox in the United States of those under 30 years old (82.5 million people) would result in approximately 190 deaths due to the vaccine. Comment: this is approximately a chance of 1 death per 400,000 people immunized. [ article ] Internet Medical Journal Radio Start of the Internet Medical Journal radio. [ Listen Now ] To listen to our webcast you need the free Real Player or the WinAmp Player Condom Use a Risk Factor for Pre-eclampsia In this study of 113 women with preeclampsia and 226 women without, a history of condom usage as a contraceptive method was linked to the development of preeclampsia during pregnancy. [ article ] Internet Medical Journal Live Broadcast COMPLETED: Medical News and Commentary 8-May-2002. [ Listen Now ] To listen to our live broadcast you will need the Real Player or the WinAmp Player Wednesday, May 08, 2002
Home Births Associated With Increased Infant Mortality This study looked at home births versus hospital births in the state of Washington between 1989 and 1996. The home birth infant mortality rate was 3.3 deaths per 1000 deliveries, versus 1.7 deaths per 1000 deliveries that occurred in the hospital. Comment: no kidding. A hundred and fifty years ago the top cause of death among women was childbirth. The modern medical system has dramatically decreased both maternal and infant death rates. [ article ] Tuesday, May 07, 2002
Prenatal Vitamins Cut Risk of Birth Defect This preliminary study found that prenatal vitamin intake, started 3 months before conception and continued throughout the pregnancy, was associated with a reduction in the risk of an omphalocele. This is a rare birth defect affecting the baby's abdominal wall. Comment: it is already recommended that women take a prenatal vitamin containing the proper amount of folic acid. This study confirms the idea that regular intake of a prenatal vitamin for a few months before conception and throughout pregnancy is a good plan. [ article ] Controversy Continues on Antipsychotic Medication The pharmaceutical company Eli Lilly, maker of the medication Zyprexa (olanzapine), disputed the claim by Britain's Medicine Control Agency that Zyprexa causes blood sugar problems. The company states that schizophrenia patients have a two to four fold increased risk of diabetes irrespective of the anti-psychotic prescribed. Comment: overall, I believe that Zyprexa is a fantastic medication. In general, it is very effective and associated with fewer side-effects than older antipsychotic medications. But it still seems clear that we need to watch blood sugars closely in patients with schizophrenia, regardless of the medical treatment they are on. [ article ] MP3 of First Live Broadcast Available If you missed the Internet Medical Journal's first ever live broadcast, you can listen to it now with your MP3 player (e.g. Media Player, Real, Winamp). Click Here for the MP3 Broadcast on 20020506. The broadcast is also available in http streaming QuickTime Movie Internet Medical Journal to Begin Live Broadcasting The Internet Medical Journal is pleased to announce the live webcasting of medical news and commentary tonight beginning immediately. [ Click Here for the Live Broadcast ] Monday, May 06, 2002
Poor Women Hurt Most by Liability Costs The American College of Obstetricians and Gynecologists (ACOG) issued a call for reforming the tort system in America. According to ACOG President, Dr. Thomas Purdon, rural women and Medicaid patients are at the highest risk of reduced access to care that results when malpractice insurance premiums are so high that doctors have to stop delivering babies. Comment: in certain parts of Florida, malpractice insurance costs $208,000 US dollars a year for obstetricians. The reason costs are so high is that the court system acts more like a lottery than medical justice. Many studies have shown that there is no correlation between true medical malpractice and winning or losing in court. Medical insurance companies are going bankrupt trying to keep up with the lottery/justice system. For example, Pennsylvania is having serious problems, especially after a malpractice award of $100 million US dollars. Unless something is done, the US is going to experience the same problems Australia is currently having. In Australia, the major medical malpractice insurance company went bankrupt, leaving doctors without malpractice insurance. Due to the unpredictable (lottery) nature of the legal system, many surgeons have stopped operating until the government gives them malpractice insurance, or makes it available through a private company. [ article ] Antidepressant Use During Pregnancy Linked to Newborn Complications Use of the antidepressent paroxetine (Paxil) during pregnancy was associated with an increased risk of complications in the newborn requiring prolonged hospitalization after birth according to data presented at the Pediatric Academic Societies meeting by Canadian researchers. Twelve babies born to 55 women who took the medication had complications including respiratory distress (9), hypoglycemia (2), and jaundice (1). Comment: the effects are postulated to be secondary to a withdrawal syndrome in the baby. Paroxetine is well known to have a short half-life and needs to be tapered when discontinuing the medication. This would suggest that other selective serotonin reuptake inhibitors with a long half-life (e.g. Prozac) may not be associated with these complications. [ article ] Breast Feeding for Six Months Prevents More Infections Data presented at the Pediatric Academic Societies meeting suggests that breast feeding babies until six months of age significantly reduces the rate of pneumonia and recurrent ear infections compared with babies who had breast fed for four months. Comment: breast feeding is clearly the best option if the mom is able to do it. [ article ] Tea Drinking Helps Heart Attack Survivors This study from Harvard found that regularly drinking tea during the months to years after a heart attack seemed to help protect against getting another heart attack. Comment: the lead author urges caution stating that this is just a preliminary finding. [ article ] Flu Vaccine for Infants? The CDC and the American Academy of Pediatrics (AAP) may be recommending that healthy infants receive the flu vaccine for the 2002-2003 flu season. A new intranasal vaccine may be available this coming fall, making inoculating infants easier. Comment: this sounds a bit far fetched at the current time, but who knows? With the vaccine being delivered through a nose spray, it would be pretty painless and easy to get infants vaccinated. The strategy is to reduce the overall rate of influenza in the entire population, not just adults. Right now I'm skeptical about this, especially given the recent concern that the mass vaccination against chickenpox (as recommended by the CDC and AAP) may not be a good idea. For more about the concerns over chickenpox, click here. [ article ] Teenagers Leading the Way to Increase in HIV / AIDS Irresponsible behavior by teenagers will likely lead to a new wave of HIV according to a report from Datamonitor, a consultancy in London. Although most of the 50 million HIV-positive people currently live in underdeveloped countries, the disease is predicted to spread rapidly worldwide unless there is a change in behavior by teenagers. [ article ] Sunday, May 05, 2002
Etanercept Shown to Help Ankylosing Spondylitis A medication used for rheumatoid arthritis, etanercept, has recently been shown to help slow the progression of ankylosing spondylitis, an incurable hereditary condition that causes progressive stiffening of the spine. Etanercept works by alpha blockade of Tumor Necrosis Factor. The study showing benefit of etanercept was performed at the University of California San Francisco. Comment: German researchers have found similar results with infliximab. [ article ] Hormone Therapy and Birth Control Pills Have an Increased Clotting Risk According to a report by the Club Direct travel insurance company, those at increased risk of developing a blood clot in the deep veins (a deep venous thrombosis, DVT) are pregnant women, women on birth control pills, and women on hormone replacement therapy. The company reports more than 40 long haul airline passengers have died due to a DVT. The report also notes that it is impossible to prevent all deaths from DVT's (since the cause is multifaceted). Comment: naturally, lawyers have already launched lawsuits, stating that the airline companies are to blame. [ article ] Olanzapine Linked to Development of Diabetes Olanzapine (trademark Zyprexa), which is used primarily for schizophrenia, has been linked to the development of diabetes according to a warning from Britain's Medicines Control Agency (BCMA). This side-effect appears to be rare, but can be serious. The BCMA stated that forty reports haved been received documenting blood sugar problems, including one death. Last month, the Japanese Health and Welfare Ministry also issued an emergency warning, stating that doctors should closely monitor any diabetic patients already on the medicine. Furthermore, any schizophrenic, diabetic patients not on the medication should not be started on it. Comment: this certainly appears to be a valid association. Olanzapine is an excellent medication overall, but these warnings alert doctors and all patients on the medication to monitor their blood sugars more closely. [ article ] Childhood Obesity Dramatically Increasing Hospitalization Rates Over the last 20 years the rates of hospitalizations among American children for diabetes has nearly doubled and there has been a fivefold increase in sleep apnea. Also, the number of overweight or obese kids has doubled over the last 20 years. The tennis superstar Martina Navratilova helped publicize the findings, advising kids to give up all the video games. "You're not going to become Michael Jordan by playing Space Invaders." Comment: this is becoming a serious epidemic. Obesity is almost always due to a sedentary lifestyle and too many calories. It's surprising how many parents blame the obesity on hormones when what's needed is more activity. [ article ] California Tops List of Most Air Pollution The top four areas with the worst air pollution in the US according to the EPA is found in Los Angelas, Bakersfield, Fresno, and Visalia-Tulare-Porterville, metropolitan areas all in the state of California. The EPA estimates that a full 50% of Americans are breathing unhealthy amounts of pollution. Comment: the state run by the Democratic party needs to stop preaching to the rest of the country and start cleaning up their own backyard. [ article ] Adult Beds Not Safest for Babies Cribs are safer for babies to sleep in than adult beds. There is an increased risk of sudden infant death syndrome among babies sleeping in adult beds compared to cribs due to the increased risk of suffocation from excess bedding material. Comment: also recommended is to place babies to sleep on their back; use a clean, firm, tight fitting mattress in the crib; and avoid excess soft bedding. There is also some concern that bacterial growth in old bedding can increase the risk of SIDS. [ article ] Saturday, May 04, 2002
ADV: the Fat Flush Plan The keys to overweight are liver toxicity, waterlogged tissues, fear of eating fat, excess insulin, and stress, asserts nutritionist Ann Louise Gittleman. Her Fat Flush Plan addresses these problems with a targeted diet. [ more... ] Schools Urged to Decrease Kid's Midday Sun Exposure The US CDC has released guidelines that urge schools to decrease midday sun exposure in an effort to decrease skin cancer. Also recommended is increased availability of shade by planting more trees around schools or similar measures. [ article ] Bupropion More Effective Than Nicotine Patches This study from the Oregon Health Sciences University suggests that bupropion works better than nicotine patches in helping women quit smoking. Comment: this study relies heavily on comparing different studies to another, which in this case is very problematic. The study was supported by GlaxoSmithKline, the pharmaceutical company that makes buproprion. I would call this study interesting, but not definitive at all. [ article ] Friday, May 03, 2002
Social Ties Healthy for Men This study from Harvard found that men with a larger social network lived longer. Comment: this confirms earlier findings and makes sense. [ article ] Guggulsterone and Blood Cholesterol The mode of action of guggulsterone, a compound used for more than 2000 years in India to treat a variety of diseases, has been discovered. It lowers cholesterol by increasing excretion of cholesterol from the body. In the US, the most common medications to lower cholesterol (statins) act in the opposite way- they decrease cholesterol production. Comment: guggulsterone is widely available in health food stores and is approved as a cholesterol lowering drug in India. The compound comes from the guggul tree. Side effects of the medication aren't widely known in the US. [ article ] Computer Chip Analyzes Blood DNA in Minutes A research team in Great Britain has announced the development of a computer chip that can analyze blood in just a few minutes in a doctor's office. A wide range of diagnostic tests can be performed with the chip, including testing for HIV. The test can be performed by a relatively unskilled staff. [ article ] Most Kids Don't Wear Helmets When Bicycling A new national survey has found that less than half of all US kids where helmets when riding their bikes, and only a third wear a helmet when using in-line skates or scooters. Comment: only 19 states and the District of Columbia currently have bike helmet laws. This needs to be changed. [ article ] Folic Acid Intake Linked to Lower Stroke Risk This study of nearly 10 000 adults found that increased dietary folate was linked to a lower stroke risk. Comment: in a way this study may do more harm than good. The message should be that dietary fruits and vegetables (the primary source of folate in the diet) are associated with a reduced risk of stroke. Taking folate in the form of supplements may cause people to overlook the primary finding that we see over and over again: a diet that emphasizes whole foods is associated with less disease. [ article ] Chickenpox Vaccination Puts Elderly at Risk Vaccinating children against chickenpox may actually increase the overall years of life lost due to the chickenpox (varicella) organism. There is concern that early vaccination may increase deaths from the complications associated with shingles. The team from Britain's Public Health Laboratory Service recommends a re-evaluation of the policy to mass vaccinate against chickenpox. Comment: I consciously decided not to vaccinate my children against chickenpox, although they have received all of the other recommended vaccinations. I believe that the rush to mass vaccinate the US population with the chickenpox vaccine was a hasty decision based upon poor science. [ article ] Wednesday, May 01, 2002
Recommended Sports After Hip or Knee Replacement A group of Mayo Clinic doctors was surveyed as to the best sports to participate in after knee or hip surgery. The recommendations are swimming, scuba diving, cycling, golf, and bowling. [ article ] Australian Medical System in Chaos Many doctors are closing their doors and doctors are cancelling operations after the nation's major medical malpractice insurer went bancrupt. The nation's prime minister notes that the crisis is due to the "litigious mentality of the Australian community" and also stated "We can't have an unlimited right to sue, yet complain if doctors are not available because they can't afford the premiums." Typical malpractice insurance costs are $100,000 a year for surgical specialists and obstetricians. The Royal Australasian College of Surgeons of Surgeons advised its members not to work until the situation was clarified. Comment: this is what happens with an out-of-control legal system. Isn't it time we enacted tort reform in the US? [ article ] Brushing Your Teeth Can Help Your Heart A University of Minnesota study suggests that bacteria that accumulate in the absence of regular brushing of your teeth can enter the bloodstream and increase the risk of blood clots and high blood pressure. Comment: this study was an animal study and indirectly makes the link between oral hygiene and cardiac disease. An earlier pearl discusses the link found between regular brushing and a reduced risk of pneumonia. [ article ] Norway Proposes Nationwide Ban on Smoking The government in Norway has proposed a nationwide ban on smoking in restaurants and bars. To date, no country has outlawed smokers in every restaurant and bar. [ article ] Institute of Medicine Panel Gives Soccer Recommendations A US Institute of Medicine expert panel released a report stating that soccer players experience concussions nearly as often as American football players. It supported recommendations that children 10 and under not use their head to redirect the soccer ball. Note was made of a study from the Netherlands that found evidence of learning disorders among soccer players as compared with a group of swimmers and track athletes. Comment: the panel stated that it was too early to recommend for or against head protection for soccer athletes. There's no doubt that the soccer athletes do suffer repeated blows (from the ball) to their head. They also suffer collisions with other players. It only makes sense that some form of head protection would help reduce the rate of concussions, and frequent concussions undoubtedly cause brain damage. I believe that eventually soccer players will wear soft helmets. Almost all other contact sports have made the transition to requiring head protection. Most likely soccer will as well, but it is likely to be in the distant future. [ article ] click here for more medical news and commentary...
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