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Marathon Runners May Benefit From A Carbohydrate Calculator

boston-marathon

Recently, about 27,000 runners began the annual 26-mile, 385-yard (42.195 kilometers) mass run from suburban Hopkinton to Boston.

But if past marathons in Boston and elsewhere are any indication, perhaps up to 40% of these optimistic and determined souls will slam into a sudden sensation of overwhelming, can’t-do-this fatigue several miles (typically about five) before they get a chance to experience the glory of crossing the finish line.

It’s called “hitting the wall.”

Getting through, around, or over hitting the wall is part of the mystique of marathon running, although there’s a physiological explanation that’s not all that mysterious: when runners hit the wall, their bodies have run out of the carbohydrates needed to sustain intense physical activities like long-distance running.

Benjamin I. Rapoport believes many runners could avoid hitting the wall if they put a few key facts about themselves and their target marathon time into the online calculator he created, which can be found at www.endurancecalculator.com. The calculator will tell them how many extra calories they should get from pasta, rice, or other high-carbohydrate food or drink before (and in some cases, during) running a marathon. Read more »

*This blog post was originally published at Harvard Health Blog*

Statin Use Is Increasing Dramatically – Are Americans Healthier For It?

Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.

For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.

One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).

Here is the graph I am talking about:

Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning. Read more »

*This blog post was originally published at Harvard Health Blog*

Baseball Safety: Should We Ban Non-Wood Bats?

Baseball-bat_240

Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.

Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.

But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.

Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.

But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »

*This blog post was originally published at Harvard Health Blog*

Shingles Recurrence: Can The Vaccine Help?

This month’s Harvard Health Letter has an article about getting shingles a second or even a third time. (Click here to read the full article.) The bottom line is that recurrence is a) certainly possible and b) if some recent research is correct, much more common than previously thought and about as likely as getting shingles in the first place if you’re age 60 or older.

I talked to Barbara Yawn, M.D., director of research at the Olmsted Medical Center in Rochester, Minn., for the article and mentioned results that she and her colleagues first presented at a conference several years ago.

Yawn reported a more complete version of those results in last month’s issue of the Mayo Clinic Proceedings (a favorite journal of mine). Full text of the study isn’t available unless you have a subscription to the journal, but here’s a summary (in medical publishing, such summaries are called abstracts.)

Melinda Beck, a health columnist for the Wall Street Journal,  had a column about shingles last week and this how she neatly summed up Yawn’s research:

For the new study on shingles recurrence, researchers at the Olmsted Medical Center in Rochester, Minn., examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of them were treated for a second episode within an average of eight years—about the same rate as would typically experience a first case.

And here is a link to the Journal Watch item of the study and a short comment by the Journal Watch editor. Journal Watch is a monthly newsletter published by the Massachusetts Medical Society that summarizes and comments on recently published research.

In the Mayo Clinic Proceedings paper, Yawn and her colleagues report that 95 of the 1,669 people with an “index” case of shingles got shingles again over the course of a follow-up period that averaged 7.3 years, which works out to about 5.6 percent of the shingles sufferers. Six people had two recurrences and two had three! The timing of recurrence varied from 96 days to 10 years after the initial episode. In 45 percent of those who got shingles again, the site of the recurrence was in a different region of the body than the site of the first case. They also noted that the single biggest risk factor for having a second case of shingles was having pain that lasted 30 days or longer during the first case. Read more »

*This blog post was originally published at Harvard Health Blog*

What “The King’s Speech” Teaches Us About Stuttering

The film “The King’s Speech” won the Academy Award for Best Picture [on Sunday night.] The movie has come in for some criticism for its depiction of the political machinations surrounding the abdication of Edward VIII  and Britain’s appeasement of Hitler. The British-born writer Christopher Hitchens, unsparing and deliciously eloquent as always, puts the politics of  George VI in a far less favorable light than the movie does.      

But “The King’s Speech” has won almost universal praise for its portrayal of the reluctant monarch’s stuttering, a speech pattern that includes involuntary repetition of sounds and syllables and “speech blocks” that cause prolonged pauses. Many young  children who stutter grow out of the problem, but perhaps as many as one in every 100 adults are affected by the condition, 80 percent of whom are men. Stuttering clusters in families, so researchers have been searching for inherited genes that might cause the condition. Last year, in The New England Journal of Medicine, NIH researchers reported some success with results showing an association between three mutated genes and stuttering, although those mutations are probably responsible for a very small minority of cases. 

It’s been said that “The King’s Speech” will do for stuttering what “Rain Man” did for autism: Plant a sympathetic view of a disability in the public consciousness. One danger of such a quick infusion of awareness, however, is that it can harden into a fixed, if largely favorable, stereotype. We are finding out — or are being reminded — about all the famous people who have stuttered (many of them writers). First-person accounts are popping up all over the place because of the film. The best I’ve come across is by Philip French, a British film critic, who describes vividly what it was like to listen to the radio broadcasts of the real King George VI, wondering if he would make it to the end “like a drunken waiter crossing a polished floor bearing a tray laden with wine glasses.” Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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