December 27, 2005

Steroids Increase Death Risk

The common use of anti-inflammatory steroids for traumatic head injuries like those from car crashes may actually increase the risk of death, according to a new review of studies about the therapy.

A prior review found there was not enough evidence to recommend that routine use of steroids be stopped. This newer analysis published by the British-based Cochrane Library draws heavily from a recent study of corticosteroid therapy for brain injury, including coma and concussion, that included 10,008 patients, more than all similar studies combined.

The large study found that patients treated with corticosteroids were 18 percent more likely to die from their brain injury than those who did not take the drugs. Among the patients who received steroid therapy, 21 percent ,or 1,052 of the 4,985 treated, died, compared to 18 percent who received a placebo.

"The significant increase in death with steroids found in this trial suggests that steroids should no longer be routinely used in people with traumatic head injury," says Dr. Phil Alderson, lead author of the Cochrane study.

The review appears in the recent issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Corticosteroids are anti-inflammatory hormones used to treat all kinds of inflammation, from joint injury to asthma. They differ from anabolic steroids, the sex hormones like androgen, which are typically used to increase muscle mass and improve athletic performance.

Corticosteroids are "widely used in medicine to treat inflammation," Alderson explains. "It is thought that some of the damage after a brain injury results from inflammation following the initial injury and that reducing inflammation might reduce this secondary injury".........

Daniel      Permalink


December 27, 2005

Depression And Heart Disease Death

Depression can double the risk of death or repeat heart disease in heart attack patients, according to two reviews of more than 40 studies that examine the link between depression and heart disease. The reviews are published in the journal Psychosomatic Medicine.

In the first analysis of 22 studies, patients who were depressed after their heart attacks had a twofold increase in the risk of dying or suffering a new heart problem two years after their heart attack, according to Joost van Melle, M.D., and his colleagues of University Hospital Groningen in the Netherlands.

In the second analysis of 20 studies by Jürgen Barth, Ph.D., of University of Freiburg in Gera number of and his colleagues, the scientists concluded that depressed patients were twice as likely to die within two years after their first heart disease episode compared with non-depressed patients.

According to van Melle, post-heart attack depression is common, affecting nearly 20 percent of all heart attack patients.

The two research teams found that the relationship between depression and a higher risk of death and disease stayed consistent despite a variety of ways to measure depression.

The finding "may have important clinical implications for the identification of post-heart attack patients with poor prognosis, because questionnaires are easier, faster and cheaper than psychiatric interviews," van Melle says.

In their study, van Melle and his colleagues also noticed a stronger link between depression and higher risk of death in studies published before 1992.

"It may be possible that improvements in cardiac care for hospitalized and rehabilitating heart attack patients are responsible for this finding, but this would need further research," van Melle says.........

JoAnn      Permalink


December 27, 2005

Daily Weighing Helps People Lose Weight

People who are trying to either lose weight or avoid gaining do better by weighing themselves daily, according to a new study in the recent issue of Annals of Behavioral Medicine.

The research team evaluated self-weighing practices of more than 3,000 people participating in either a weight-loss or a weight-gain prevention program. The study's key finding: "Higher weighing frequency was associated with greater 24-month weight loss or less weight gain".

When people weigh themselves daily, "something is going on. It's independent of things such as diet and exercise, so it may be worth recommending," said lead researcher Jennifer Linde, an associate professor at the University of Minnesota. "If people see that their number has gone up they may realize it's time to do something. It's probably easier to make that small correction," Linde said, than to try to compensate after gaining a lot of weight.

The first study group consisted of 1,800 obese or overweight adults enrolled in a weight-loss program. Participants all had a body mass index (BMI) of at least 27. They were randomly divided into three groups: a telephone-based weight-loss intervention, a mail-based weight loss intervention or a usual-care control condition. The scientists weighed them every six months for two years.

"The average 12-month and 24-month weight losses of 1.3 and 2 BMI units respectively ..... were in the clinically significant range," reported the researchers.

The other group consisted of 1,226 overweight adults - BMI above 25 - enrolled in a weight-gain prevention program. They were randomly divided into either an educational weight-control intervention, the same educational intervention plus a reward for returning self-monitoring postcards or a minimal-contact control condition. The scientists weighed the participants at the study's outset and every year for three years.........

JoAnn      Permalink


December 27, 2005

Alcohol Over-consumption By Glass Shapes

Your eyes can play tricks when it comes to pouring drinks. People - even professional bartenders - inadvertently pour 20 to 30 percent more alcohol into short, wide glasses than tall, slender ones of the same volume, according to a new research study published in the BMJ (British Medical Journal).

"People focus their attention on the height of the liquid they are pouring and insufficiently compensate for its width," explains Koert van Ittersum, an assistant professor of marketing at Georgia Tech College of Management.

Even educating people about this human perceptual tendency and encouraging them to be careful doesn't eliminate alcohol over-pouring, find van Ittersum and Brian Wansink, a professor of marketing, applied economics and nutrition science at Cornell University, in their study, "Reducing Alcohol Over-pouring and Underreporting".

They consider their findings relevant to policymakers and law-enforcement officials who want to increase public safety, groups wanting to promote responsible drinking and decrease alcohol abuse, and people in the hospitality industry who want to cut costs (via serving size) without decreasing customer satisfaction.

"If short tumblers lead people - even bartenders - to pour more alcohol than highball glasses, then there are two easy solutions," van Ittersum says. "Either use tall glasses or ones with alcohol-level marks etched on them as is done in some European countries".

The scientists conducted their study using 198 students of legal drinking age at the University of Illinois at Urbana-Champaign who poured mock mixed drinks into both tall and short glasses from liquor bottles filled with water or tea instead of alcohol. Study subjects also included eighty-two bartenders in Philadelphia who had an average of 6.3 years of bartending experience.........

Janet      Permalink


December 27, 2005

Lifestyle Changes Have Major Health Impact

New Year's resolutions to lose weight, stop smoking and exercise are made by countless people every January. Unfortunately, these goals seldom seem attainable and good intentions often fall by the wayside after a few weeks. Is there really a way to keep your resolutions and transform your body and your health? .

The results of a two-year study involving the Department of Human Services (7,500 employees) of the State of Oklahoma conclude the answer is "yes". A lifestyle management program using step-by-step attainable goals was shown to successfully translate good intentions to live a healthier lifestyle into reality.

The study participants were enrolled in INTERVENTUSA, a scientifically-based lifestyle management program offered in the Atlanta area through the Emory Heart Center. Individualized programs to help participants implement and adhere to exercise, nutrition, weight management, stress management, and smoking cessation resolutions were implemented and administered via the telephone and the Internet.

Not only did a number of of the participants in the program, named OK Health, reach their goals but the health claim costs of the employees who completed one year of program participation were lowered by a staggering 31 percent, according to the Oklahoma Employees Benefits Council and Oklahoma Department of Human Services.

"In employees with abnormal risk factor values at the start of the study, one year of program participation resulted in impressive improvements in blood pressure and cholesterol levels, with increases in HDL ('good' cholesterol) and decreases in the 'bad' lipids (LDL cholesterol and triglycerides). In addition, on average, there was a weight loss of 11 pounds and a significant reduction of fasting blood glucose levels," says Neil F. Gordon, MD, PhD, clinical professor of medicine in the Emory University School of Medicine and INTERVENTUSA founder.........

Janet      Permalink


December 26, 2005

Traditional Risk-factor Scoring And Women

Traditional risk-factor scoring fails to identify approximately one-third of women likely to develop coronary heart disease (CHD), the leading cause of death of women in the United States, according to a pair of reports from cardiologists at Johns Hopkins.

"Our best means of preventing coronary heart disease is to identify those most likely to develop the condition, and intervene with changes in lifestyle and drug therapy before symptoms start to appear," says the senior author of both studies, cardiologist Roger Blumenthal, M.D., an associate professor and director of the Ciccarone Preventive Cardiology Center at The Johns Hopkins University School of Medicine and its Heart Institute. "The goal is to strongly consider therapies, such as aspirin, cholesterol-lowering medications and, possibly, blood pressure medications for individuals at higher risk, so that heart attacks will be less likely to occur in the future".

The Hopkins findings, the latest of which appear in the American Heart Journal online Dec. 16, is believed to be one of the first critical assessments of the Framingham Risk Estimate (FRE) as the principal test for early detection of heart disease. The scientists wanted to determine why a number of of these women at risk for heart disease are not identified earlier.

The FRE is a total estimate of how likely a person is to suffer a fatal or nonfatal heart attack within 10 years, and it is based on a summary estimate of major risk factors for coronary heart disease, such as age, blood pressure, blood cholesterol levels and smoking.

However, Blumenthal says, a number of women with cardiovascular problems go undetected despite use of the Framingham score. While the death rate for men from cardiovascular disease has steadily declined over the last 20 years, the rate has remained relatively the same for women, he says.........

Daniel      Permalink


December 26, 2005

March of Dimes New Year's Resolutions for a Healthy Baby

January is Birth Defects Prevention Month and some premature births and birth defects may be avoided with a healthy lifestyle before and during pregnancy. The March of Dimes recommends seven New Year's resolutions to help give babies a healthy start.

   
• Stop smoking and avoid second hand smoke. Smoking may make it harder to get pregnant and can increase the risk of premature birth.


   
• Stop using alcohol and illegal drugs. They can cause lifelong health problems.


   
• Check with your doctor before taking any medication, including herbal products.


   
• Take a multivitamin containing 400 micrograms of folic acid daily previous to conception to help reduce the chance of a birth defect of the brain or spine called neural tube defects. NTDs, such as spina bifida and anencephaly, occur in the first few weeks after conception, often before a woman knows she's pregnant.


   
• Maintain a healthy weight. Being very overweight or underweight can increase the risk of prematurity and birth defects.


   
• Get a preconception checkup and ask your doctor how you can help give a baby 9 months of pregnancy.


   
• Eat healthy -reduce caffeine, avoid fish high in mercury, raw and undercooked meat and unpasteurized juice and dairy products.
........

Emily      Permalink


December 25, 2005, 10:32 AM CT


Merry Christmas To All Our Readers


Medicineworld wishes all our readers merry Christmas.

Oh, jingle bells, jingle bells

Jingle all the way

Oh, what fun it is to ride

In a one horse open sleigh

Jingle bells, jingle bells

Jingle all the way

Oh, what fun it is to ride

In a one horse open sleigh........

Daniel      Permalink


December 23, 2005


How To Control The Christmas Alcohol Craving


Festive Season drinkers who feel they are losing control of their alcohol consumption can join an innovative drug-free program run by scientists at The University of Queensland.

Professor David Kavanagh of UQ's School of Medicine is piloting a program that is free for participants and especially useful for people who find that their drinking is damaging other areas of their lives.

The program involves "owning and managing" your alcohol craving, rather than fighting it, Professor Kavanagh said.

"For most of us there is nothing wrong with small or moderate amounts of alcohol," he said.

"However, at least once a year 35 percent of Australians drink in a way that puts them at short-term risk of physical harm.

"Alarmingly, 40 percent of teenagers aged 14-19 and 61 percent of 20-29 year-olds risk their health in this way.

"For a number of, Christmas-New Year is a really perilous time because it is easy to lose track of alcohol consumption when you are out partying."

Professor Kavanagh said the program, at the Royal Brisbane and Women's Hospital at Herston, is designed for people who want to stop drinking altogether, as well as those who want to cut back.

"It is never easy to kick a habit like drinking, particularly when we are surrounded by alcohol and images that promote drinking.........

Janet      Permalink


December 22, 2005


Troubling Behavior In Medical School And Practice


In a first-of-its-kind study, scientists at Jefferson Medical College in Philadelphia have found that doctors who are disciplined by state medical boards, were three times as likely as their colleagues to have exhibited unprofessional behavior in medical school. Investigators who conducted this national inquiry say it reinforces the need to stress the vital importance of professionalism from the time a student enters medical school all the way through his or her professional career.

Published this week in The New England Journal of Medicine, the study is the work of a team of scientists including Susan Rattner, M.D., and J. Jon Veloski, MS, both of Thomas Jefferson University. The effort was led by Maxine Papadakis, M.D., of the University of California-San Francisco School of Medicine.

"Unprofessional behavior among students was defined as including irresponsibility, diminished capacity for self-improvement, poor initiative and impaired interpersonal relationships," said Dr. Rattner, clinical associate professor of Medicine and Senior Associate Dean for Undergraduate Medical Education at Jefferson.

These students were nearly nine times more likely than their colleagues to be disciplined when they became practicing physicians.

Emphasizing that this is "a rare problem affecting only a very small group of practicing physicians," Dr. Rattner nonetheless concluded that "because professionalism is a fundamental core value in the practice of medicine, it must be taught and modeled in all of our educational and clinical activities. It is imperative that technical standards for admission to medical school and outcome objectives for graduation address professional behavior."

The study recommends standardized methods be implemented for both assessing the personal qualities of medical school applicants and predicting their performance as doctors.........

JoAnn      Permalink