March 12th, 2011 by Toni Brayer, M.D. in Health Tips, Research
Tags: American Heart Journal, Cardioloy, Dr. Toni Brayer, Everything Health, Gender and Heart Attacks, Healthy Aging, Heart Attack Deaths, Heart Disease, Heart Health, Higher Mortality Rate, Lifestyle Choices, Living Longer, Longevity, Women's Health, Women's Heart Attack Risk
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Several studies have shown that women have a higher mortality rate than men if they have a heart attack. A study published in the American Heart Journal helps to explain why. The researchers looked at data from 2,542 women who had a heart attack. Compared to men, the women were older, less likely to be white, and less likely to smoke. They also had more serious health conditions than the men. They had diabetes, high blood pressure (hypertension), congestive heart failure, and chronic obstructive pulmonary disease (COPD).
We’ve known for a long time that women are about 10 years older than men at the time of their first heart attack. The authors believe that the reason women are more likely to die is because of these other conditions that are present. Women in the study were also more likely to receive a blood transfusion and experience gastrointestinal bleeding, strokes, and vascular complications which lead to death.
They didn’t find any gender difference when they controlled for these other conditions. The number of diseased vessels were the same as was the severity of stenosis.
So what does this tell women? The guidelines for longevity and good health haven’t changed: Don’t smoke, control high blood pressure, and make sure your weight is healthy to prevent diabetes and other vascular problems. Stay active. Heart attacks can be prevented by good lifestyle choices.
*This blog post was originally published at EverythingHealth*
March 12th, 2011 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Research
Tags: Automobile Accidents, Dr. Glenn Laffel, Driver Safety, Drivers' Privacy, Governors Highway Safety Association, Insurance Institute for Highway Safety, Pizaazz, Rear-End Collisions, Red-Light Cameras, Red-Light Running Car Crashes, Right-Angle Crashes, Safe Driving Behaviors, Safe Roads, Traffic Accidents, Traffic Fatalities, Traffic Safety
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Most people don’t like them. Privacy advocates abhor them. But, really– how many things can you name that save lives AND generate revenues for cash-strapped local and state governments? Red-light cameras are one such item.
A recent study by the Insurance Institute for Highway Safety has shown that red-light cameras saved 159 lives over a four-year period in the 14 large U.S. cities where the study took place. The scientists claimed that more than 800 traffic fatalities would have been prevented during the course of the study if the cameras had been deployed in all large U.S. cities.
The scientists compared fatal car crash rates in U.S. cities with populations of at least 200,000 for two four-year periods: 1992 to 1996 and 2004 to 2008. They excluded cities that had already deployed red-light cameras in the earlier period, and cities that instituted cameras during the later period.
In the 14 cities that used red-light cameras during 2004 to 2008, the rate of fatal red-light running crashes was 35 percent lower than in 1992 to 1996. The crash rate did drop in cities that never deployed camera programs, but only by 14 percent.
Based on these data, the scientists determined that the rate of fatal red-light running crashes was 24 percent lower in cities with cameras in 2004 to 2008 than it would have been had they not deployed the cameras. In fact, the benefits of red-light cameras were actually larger than this. The rate of all fatal crashes at intersections with signals (not just red light running crashes) dropped by 14 percent in cities that deployed red-light cameras, whereas it increased by 2 percent in other cities. Read more »
*This blog post was originally published at Pizaazz*
March 11th, 2011 by PeterWehrwein in Health Tips, Research
Tags: Dr. Barbara Yawn, Harvard Health Blog, Harvard Health Letter, Harvard Health Publications, Harvard Medical School, Harvard University, Herpes Zoster, HZ, Journal Watch, Massachusetts Medical Society, Mayo Clinic Proceedings, Melinda Beck, Merck, Olmsted Medical Center, Peter Wehrwein, Shingles Recurrence, Shingles Vaccine, Skin Rash, Varicella Zoster Virus, Wall Street Journal, Zostavax
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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*
March 11th, 2011 by DavedeBronkart in Research, True Stories
Tags: Dave deBronkart, e-Patient Dave, e-Patients.net, Empowered Patients, Health Information on the Web, Internet Geologist, National Public Radio, NPR, Online Health Conversations, Online Patient Communities, Online Support Groups, Pat Furlong, Patient Networks, Patient Stories, Patients On The Internet, Peer-To-Peer Healthcare, Pew Internet & American Life Project, Social Networking For Patients, Society for Participatory Medicine, Susannah Fox, Talk of the Nation
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[Recently] NPR’s popular program “Talk of the Nation” covered something we discuss often: How e-patients find information and find each other online. Featured guests were Pat Furlong, mother of two boys with a rare disease who started an online community, and Susannah Fox of the Pew Internet and American Life Project, a frequent contributor here. The audio is here.
It’s a good combination: Pat speaks from the heart about her own experience and her passion for community, and Susannah, as usual, speaks as an “internet geologist” — as she once put it, “A geologist doesn’t have opinions about the rocks, she just observes and describes them.” Susannah spoke about her newly-released report “Peer-To-Peer Healthcare,” about which she recently wrote here.
Listener comments begin around 13:00. Examples:
— A woman describes how she started a Facebook group for her painful chronic condition (ankylosing spondylitis) and it’s grown into a website, HurtingButHelpful.org. (Spoonies, take note!) What drove her to create a patient community? “There’s no one else who can understand what I’m talking about.”
— The mother of a newborn with a heart defect found similar parents online. Hearing their stories — and even seeing an upsetting photo — helped her prepare for the surgery.
— On the downside, the daughter of an ovarian cancer patient said her now-cured mom keeps going online to patient communities and getting scared by what she reads. (Host Neal Conan’s observation: “There other parts of the computer that can be addictive, and I guess this one can, too.”)
It’s heartening to hear coverage of online patient communities, including the risks and challenges, in a respected outlet like NPR. (Time covered it, too, a year ago.) And there’s no equal for the reality check of Pew’s data. Some patient activists suggest (and some people fear) that the Internet “frees” patients from doctors, but Pew says that’s not what people are doing. Read more »
*This blog post was originally published at e-Patients.net*
March 10th, 2011 by Harriet Hall, M.D. in Opinion, Research
Tags: Annual Pelvic Exam, Better Use of Doctors' Time, Birth Control, Cervical Cancer Screening, Chlamydia, Doctor Patient Relationship, Dr. Harriet Hall, Gonorrhea, Hormonal Contraception, Journal of Women's Health, Nonproductive Healthcare Rituals, OB/GYN, Obstetrics And Gynecology, Ovarian Cancer Screening, Overscreening, Overtesting, Pap Smears, Routine Pelvic Examination, SBM, Science Based Medicine, Sexually Transmitted Disease, Sexually Transmitted Infections, STD, STI, Unnecessary Medical Care
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A new article in the Journal of Women’s Health by Westhoff, Jones, and Guiahi asks “Do New Guidelines and Technology Make the Routine Pelvic Examination Obsolete?”
The pelvic exam consists of two main components: The insertion of a speculum to visualize the cervix and the bimanual exam where the practitioner inserts two fingers into the vagina and puts the other hand on the abdomen to palpate the uterus and ovaries. The rationales for a pelvic exam in asymptomatic women boil down to these:
- Screening for chlamydia and gonorrhea
- Evaluation before prescribing hormonal contraceptives
- Screening for cervical cancer
- Early detection of ovarian cancer
None of these are supported by the evidence. Eliminating bimanual exams and limiting speculum exams in asymptomatic patients would reduce costs without reducing health benefits, allowing for better use of resources for services of proven benefit. Pelvic exams are necessary only for symptomatic patients and for follow-up of known abnormalities. Read more »
*This blog post was originally published at Science-Based Medicine*
