February 10th, 2011 by PJSkerrett in Health Tips, Research
Tags: AARP, AHA, American Heart Association, Baby Boomers, Cardiovascular Disease, Cardiovascular Health, Cardiovascular Risk, CHD, Coronary Heart Disease, Harvard Health Blog, Harvard Health Publications, Harvard Heart Letter, Harvard Medical School, Harvard University, Healthy Aging, Heart Attack, Heart Disease Prevention, Heart Failure, Heart Health, High Blood Pressure, PJ Skerrett, Preventing Heart Disease, Preventive Health, Preventive Medicine, Stroke
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As a youngster, I loved being part of the baby boom — it meant there were dozens of kids on my block who were ready to play hide-and-seek or join mysterious clubs. Now that I’m of an AARP age, there’s one club I don’t want to join: The one whose members have bypass scars, pacemakers, or other trappings of cardiovascular disease. The American Heart Association’s (AHA) gloomy new forecast on cardiovascular disease tells me it won’t be easy to avoid.
The AHA foresees sizeable increases in all forms of cardiovascular disease (see table) between now and 2030, the year all of the boomers are age 65 and older. Those increases will translate into an additional 27 million people with high blood pressure, eight million with coronary heart disease, four million with stroke, and three million with heart failure. That will push the number of adult Americans with some form of heart disease to 110 million.
(Percentages refer to the percentage of Americans aged 18 years and older.)
If the AHA’s projections are accurate, the cost of treating cardiovascular disease would balloon from $272 billion today to $818 billion in 2030. Add in the cost of lost productivity, and it jumps to more than $1 trillion. Yikes!
Although obesity and inactivity are part of the problem, much of the increase comes from the graying of the baby boom. We can’t stop boomers from aging, but we can fight cardiovascular disease, a condition the AHA calls “largely preventable.” Read more »
*This blog post was originally published at Harvard Health Blog*
February 10th, 2011 by Medgadget in Better Health Network, Research
Tags: Assisted Reproductive Technology, Embryo Transfer, Fertility and Sterility, In Vitro Fertilization, Israel, IVF-ET, Medgadget, Medical Clowning, Patch Adams, Reproductive Health, Reproductive Medicine, Shlomi Algussi, Stress and Reproduction
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Following from the somewhat common sense idea that women who were less stressed during in vitro fertilization and embryo transfer (IVF-ET) had better outcomes, the journal Fertility and Sterility published a study out of Israel that claims “medical clowning” improved pregnancy rates compared to a group not exposed to a clown on the day of implantation.
From the abstract:
This experimental prospective quasi-randomized study examining the impact of a medical clowning encounter after ET after IVF found that the pregnancy rate in the intervention group was 36.4%, compared with 20.2% in the control group (adjusted odds ratio, 2.67; 95% confidence interval, 1.36–5.24). Medical clowning as an adjunct to IVF-ET may have a beneficial effect on pregnancy rates and deserves further investigation.
In the methods section, the researchers describe the study design. For the intervention group (n=110) a “professional medical clown” visited the patient immediately after the procedure for about 15 minutes and performed the same routine including “jokes, tricks, and magic” while dressed as a chef.
While the study itself only uses one routine, presumably similar effects could be experienced by a patient bringing in a personal media device and watching something they know will amuse them right after their own procedure. Hopefully, no need to bring your own clown if the office won’t provide one for you. Read more »
*This blog post was originally published at Medgadget*
February 10th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Tips, Research
Tags: Consumer-Driven Lab Testing, Direct Laboratory Services, Do-It-Yourself Lab Tests, Do-It-Yourself Medicine, Dr. Glenn Laffel, Healthcare Consumerism, HealthOne, Interpreting Lab Results, Lab On A Chip, Laboratory Studies, Online Lab Tests, Pathology, Personalabs, Pizaazz, Preventive Health, Preventive Screening, PrivateMD Labs
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Traditionally, people get blood tests when their doctor recommends it, an event that usually occurs at the conclusion of an office visit. But nowadays, patients are deciding to get lab tests on their own.
Their reasons vary. Some want to keep track of cholesterol or hemoglobin A1C levels. Others want to assure their blood will test negative prior to a job search, to test for the presence of a disease like hepatitis C or AIDS, or obtain a chemistry panel that provides a broad picture of their overall health.
The biggest reason for consumer-directed lab testing however, is an economic one. Growing numbers of uninsured people, and those with high-deductible insurance plans find it cheaper to do-it-themselves, since it avoids the cost of an office visit.
The savings can add up. A lipid profile (including cholesterol levels) obtained from an online lab testing company costs about $40. A hemoglobin A1C test usually runs a bit less. A visit to the doctor’s office typically costs $150 or more.
Although hundreds of tests can be obtained in this manner, the most commonly sought-after tests are lipid profiles, C-reactive protein (a new measure of cardiac risk), liver and kidney function tests, vitamin D levels, and hormone levels including estrogens and testosterone. Read more »
*This blog post was originally published at Pizaazz*
February 9th, 2011 by IsisTheScientist in Opinion, Research
Tags: ADA, AJCN, American Dietetic Association, American Journal of Clinical Nutrition, Artificial Sweetener, Aspartame, Birth Defects, Communication Gap, Diet Soda, Doctor-Patient Communication, Dr. Isis, Fetal Exposure, Fetal Health, Food and Drink, Food Safety, Healthy Pregnancy, High Blood Pressure, Hypertension, In Moderation, Isis the Scientist, Maternal-Fetal Medicine, Methanol, NutraSweet, OB/GYN, Obstetrics And Gynecology, Patient Education, Pre-Term Delivery, Pre-Term Labor, Pregnancy and Childbirth, Premature Birth, Saccharin, Safe Diet During Pregnancy, Splenda, Sucralose, Sweet N' Low, The Brain Confounds Everything
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I can already tell that this pregnancy is different from my first. When I was pregnant with Little Isis, I drank no caffeine and took no over-the-counter medication. I remember having a few headaches and Mr. Isis fighting with me to take a headache pill. I would then proclaim dramatically, “But I can’t! What if it hurts the baby?!”
This morning, now pregnant with my second, I washed down a Zyrtec and two Tylenol with a cup of coffee. The little bugger is going to have to grow up with Little Isis. He might as well start building up his tolerance to exogenous substances at some point. I figure, now that its got a closed neural tube and a beating heart, we might as well begin.
Still, you can’t blame a pregnant woman for being a bit neurotic. The feeling that one is solely responsible for the well-being of a developing creature, combined with often contradictory advice, is enough to make anyone nuts. Most online advice is completely and utterly useless. Take this answer from Russell Turk, M.D. on the popular pregnancy website BabyCenter in response to the common question, “Is it safe to drink diet soda during pregnancy?” He answers:
Diet sodas often contain both caffeine and an artificial sweetener. There are several types of artificial sweeteners you may see on nutrition labels:
Aspartame (NutraSweet): Seems to be okay when consumed in moderation (the amount found in one or two 12-ounce servings of soda per day).
Saccharin (Sweet’n Low): Saccharin was found to cause birth defects in laboratory rats when consumed in very high amounts. Because its safety in smaller amounts is hard to prove, I would advise avoiding it.
Sucralose (Splenda): This relatively new sweetener, a modified form of regular table sugar, appears to be safe. But because it hasn’t been extensively studied, it’s best used in moderation.
It’s generally bad advice and leaves one wondering: “What is moderation? Will one soda hurt my baby? Will two sodas hurt my baby? How about three?” The default answer when we don’t know seems to be to tell women to do things in “moderation.” This places the sole responsibility on her to know what moderation means, and allows her to feel the guilt if something goes wrong. I think that these imprecise answers leave many women feeling helpless and afraid. Read more »
*This blog post was originally published at The Brain Confounds Everything*
February 8th, 2011 by Harriet Hall, M.D. in Better Health Network, Research
Tags: AAFP, AAP, Acute Otitis Media, American Academy of Family Physicians, American Academy of Pediatrics, Antibiotics, AOM, Children's Health, Clinical Trials, Dr. Harriet Hall, Ear Infections, Family Medicine, NEJM, New England Journal of Medicine, OME, Otitis Media With Effusion, Pharmaceuticals, Primary Care, Science Based Medicine
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Ear infections used to be a devastating problem. In 1932, acute otitis media (AOM) and its suppurative complications accounted for 27 percent of all pediatric admissions to Bellevue Hospital. Since the introduction of antibiotics, it has become a much less serious problem. For decades it was taken for granted that all children with AOM should be given antibiotics, not only to treat the disease itself but to prevent complications like mastoiditis and meningitis.
In the 1980s, that consensus began to change. We realized that as many as 80 percent of uncomplicated ear infections resolve without treatment in three days. Many infections are caused by viruses that don’t respond to antibiotics. Overuse of antibiotics leads to the emergence of resistant strains of bacteria. Antibiotics cause side effects. A new strategy of watchful waiting was developed.
Current Medical Guidelines
In 2004, the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) collaborated to issue evidence-based guidelines based on a review of the published evidence. Something was lost in the transmission: The guidelines have been over-simplified and misrepresented, so it’s useful to look at what they actually said. There were six parts:
1. Criteria were specified for accurate diagnosis.
- History of acute onset of signs and symptoms
- Presence of middle ear effusion (ear drum bulging, lack of mobility, air-fluid level)
- Signs and symptoms of middle ear inflammation: Either red ear drum or ear pain interfering with normal activity or sleep
They stressed that AOM must be distinguished from otitis media with effusion (OME). OME is more common, occurs with the common cold, can be a precursor or a consequence of AOM, and is not an indication for antibiotic treatment. Read more »
*This blog post was originally published at Science-Based Medicine*
