May 2nd, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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For the first time in 30 years, an expert panel has updated guidelines for the diagnosis of Alzheimer’s disease. The long overdue facelift should favorably impact care for millions and accelerate badly needed research on the disease.
The guidelines were produced by representatives from the National Institute on Aging and the Alzheimer’s Association. They portray Alzheimer’s for the first time as a three-stage disease. In addition to ‘Stage 3,’—the full-blown clinical syndrome that had been described in earlier versions of the guidelines—the new guidelines describe an earlier ‘Stage 2,’ of mild cognitive impairment due to Alzheimer’s, and a ‘Stage 1, or preclinical’ phase of the disease. The latter can only be detected with biochemical marker tests and brain scans.The guidelines legitimize years’ worth of observations by the family members of Alzheimer’s patients, who recognize in retrospect that Grandpa had a slowly progressive cognitive disorder long before he was diagnosed. The guidelines also reflect progress on the research front, where it has now been established that the disease begins years before patients become symptomatic.
Alzheimer’s patients and their families, and the teetering US health system that supports them, would have been better served by the publication of these guidelines 2-3 years ago. Read more »
*This blog post was originally published at Pizaazz*
April 29th, 2011 by Bongi in True Stories
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The consultants didn’t always need to know what was happening on the floor. But sometimes keeping things away from them became downright clandestine.
I was a senior registrar at Kalafong (hell). An old friend of mine had just taken up a post as consultant in the department of Internal Medicine. One day he approached me.
“Bongi, what are the chances you can do the occasional open lung biopsy for me?” Now there was no thoracic department in Kalafong so it seemed to me to be a reasonable request. In fact I was quite excited. It would give me a chance to do a few thoracotomies, something us general surgeons don’t do all that regularly.
“Sure! Anytime. Just let me know and I’ll book them on my list.”
“Uhmmm, there is just one small problem,” he continued, “I’ve already asked your consultant when the previous registrar was here and he bluntly refused, so I suppose you would need to convince him.” Read more »
*This blog post was originally published at other things amanzi*
April 27th, 2011 by Dr. Val Jones in Opinion, Primary Care Wednesdays, True Stories
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A friend of mine is in great physical shape but her husband (we’ll call him “Mr. B”) has gained 40 pounds since they were married five years ago. He also has familial hypercholesterolemia, and several of his relatives have had heart attacks at young ages. Mrs. B is distraught – she is worried about her husband’s health, and has tried to gently nudge him towards healthier eating habits and regular exercise (as well as taking a statin for his cholesterol). Unfortunately, the nudges were received as nagging, and a wedge has formed between them in their relationship.
Last week my friend planned a trip to a primary care physician in the hopes that he would educate Mr. B about the dangers of being overweight and not treating his high cholesterol. “Surely Mr. B will listen to an expert” she thought, “then perhaps he’ll realize that he has to change his behavior.”
Unfortunately, the primary care physician didn’t offer any health counseling to Mr. B. Not only did he not mention that Mr. B should lose weight, but he didn’t provide any warnings about the dangers of untreated, very high cholesterol levels. He merely reported that Mr. B’s total cholesterol was 300, and that a statin was indicated.
Mrs. B was crestfallen. She was depending on the physician’s authoritative input to help her come up with a strategy to steer her husband towards better health. Now Mr. B was left with the impression that things were more-or-less ok, and that his wife’s concerns were exaggerated. Read more »
April 25th, 2011 by PeterWehrwein in News, Research
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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*
April 18th, 2011 by Medgadget in Research
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A study published in journal Chest has shown that novel intra-sleep pulse oxymetry can be an effective modality in identifying cardiovascular disease risk in patients. In the study, a modified version of Weinmann‘s SOMNOcheck micro oximeter was used to observe pulse wave attenuation, heart rate acceleration, pulse propagation times, as well as respiration-related pulse oscillations and oxygen desaturation episodes. All the collected data was analyzed by an algorithm, and the prognostic results were checked against European Society of Hypertension/European Society of Cardiology (ESH/ESC) risk factor matrix.
Some details from the study abstract: Read more »
*This blog post was originally published at Medgadget*
