Heart problems often worse in diabetic women
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Women younger than 65 with diabetes tend to have worse heart problems than diabetic men of the same age, leading to higher death rates following a heart attack, the results of a Swedish study indicate.
“The female advantage with fewer cardiovascular events than in men at younger ages is attenuated once a woman has the diagnosis of diabetes,” Dr. Anna Norhammar and associates write in the journal Heart. In fact, they add, “the risk is increased about twofold in men and up to four times in women.”
Their goal in the current study was to identify gender-related differences in prognosis, risk factors, or treatment among 25,555 patients younger than 65 years old who were treated between 1995 and 2002 for a heart attack.
Inhaled Corticosteroids Raise Pneumonia Risk for Lung Disease Sufferers
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Lung disease experts at Johns Hopkins are calling for physicians to show much greater caution in prescribing inhaled corticosteroid drugs for people with chronic obstructive pulmonary disease after finding evidence that the widely used anti-inflammatory medications increase the risk of pneumonia by a full third.
More than 11 million Americans, the vast majority former or current smokers, are living with so-called COPD, marked by the potentially fatal, lung-diminishing conditions of emphysema and chronic bronchitis. The inhalers in question greatly relieve such symptoms as shortness of breath, wheezing, phlegm and physical exhaustion from light exercise.
The call for caution is based on the Johns Hopkins team’s review and analysis of adverse events recorded in 11 clinical studies that in total involved more than 14,000 men and women with COPD. The team’s review, believed to be the largest and most comprehensive performed in the last decade among COPD sufferers, compared adverse events among those who took inhaled corticosteroids and others who did not.
Cancer incidence and mortality drops among American men and women, according to annual report
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The overall incidence of cancer and death due to cancer dropped for the first time in men and women in the United States, according to a report published in the November 25 online issue of the Journal of the National Cancer Institute.
Each year the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries provide a report on current cancer trends in the United States. Because smoking accounts for approximately 30 percent of all cancer deaths nationwide, this year’s report includes state-by-state information on lung cancer incidence and mortality, as well as on trends of tobacco use and control.
The overall decline in incidence and mortality is due largely to decreases in the three most common cancers in men (prostate, lung, and colorectal) and in two of the three most common in women (breast and colorectal cancer). Although lung cancer mortality in women has stabilized nationally since 2003, the only state to show a statistically significant decline was California. By contrast, lung cancer incidence or mortality increased in 18 states, most of which are in the Midwest or South.
People wasting billions of dollars on ‘quack’ health food products
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Globally every year, obese people waste billions of pounds on food products that ‘imply’ that they aid weight loss, but are totally ineffective, says a nutritional expert on bmj.com today.
Professor Lean from the University of Glasgow, is hopeful that a new European Union (EU) Directive on Unfair Commercial Practices, adopted this year in UK, will finally protect vulnerable consumers who are tricked into to buying useless food products or supplements in attempts to combat their disease.
Unlike medicines, food products that are marketed for health reasons are not subject to the same stringent research trials and control, and consumers are often misled.
Pregnancy study finds strong association between two antidepressants and heart anomalies
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Women who took the antidepressant fluoxetine during the first three months of pregnancy gave birth to four times as many babies with heart problems as women who did not and the levels were three times higher in women taking paroxetine.
Although some of the conditions were serious, others were not severe and resolved themselves without the need for medical intervention, according to a three-country study in the November issue of the British Journal of Clinical Pharmacology.
Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant. But they are being urged to give up smoking, as the study also found that more than ten cigarettes a day was associated with a five-fold increase in babies with major heart problems.
Health care reform: No revolution in sight
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A new study involving health care systems in 21 countries—and the prospects for change in response to such common pressures as rising costs and aging populations—casts doubt on the possibility of major overhauls of any of these systems because of the history and traditions that created them.
The findings, published on Friday in the online issue of the Journal of Health and Social Behavior, comes as the election of President-elect Barack Obama and his cabinet choices concerning health have increased speculation of substantial changes ahead for the unwieldy U.S. health care system.
“Our findings explain, to the dismay of many who would like to see more radical change in the U.S., why President-elect Obama’s campaign proposal regarding health care reform was pretty much a center proposal, compared to Sen. McCain’s to the right,” said Indiana University sociologist Bernice Pescosolido.
Sealing off portion of intestinal lining treats obesity, resolves diabetes in animal model
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Lining the upper portion of the small intestine with an impermeable sleeve led to both weight loss and restoration of normal glucose metabolism in an animal model of obesity-induced diabetes. Investigators from the Massachusetts General Hospital (MGH) Weight Center and Gastrointestinal Unit report in the journal Obesity that the procedure reproducing several aspects of gastric bypass surgery led to a significant reduction in the animals’ food intake and a resolution of diabetes symptoms. The study, which has received early online release, is the first controlled test of a new procedural approach to treating obesity.
“This is a clear proof of principle that the human version of this device may be an effective treatment for obesity and diabetes. The clinical device would be placed endoscopically, making it far less invasive than surgical therapies,” says Lee Kaplan, MD, PhD, director of the MGH Weight Center, who led the study. “The next step will be to complete large-scale controlled trials of this procedure in human patients. We also need to learn more about how this device affects the complex interplay between receptors that line the stomach and intestine – which are stimulated by ingested food – and the brain, pancreas, liver and other organs involved in metabolism and in eating behavior.”
Several surgical procedures have been developed to treat obesity and its complications, such as type 2 diabetes. The most common operation – Roux-en-Y gastric bypass – has five key components: isolation and reduction in size of the upper portion of the stomach, exclusion of the rest of the stomach from the flow of ingested food, exclusion of the upper portion of the small intestine (the duodenum and upper jejunum) from the flow of food, delivery of undigested nutrients to the middle portion of the small intestine, and partial severing of the vagus nerve, a key conduit between the gastrointestinal system and the brain in the control of appetite, digestion and glucose metabolism.
Telephone as Effective as Face-to-Face Counseling in Keeping Weight Off
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Face-to-face and telephone follow-up sessions appear to be more effective in the maintenance of weight loss for women from rural communities compared with weight loss education alone, according to a report in the November 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, telephone counseling appears to be just as effective as face-to-to face counseling for weight loss management.
“Rural counties in the United States have higher rates of obesity, sedentary lifestyle and associated chronic diseases than nonrural areas, yet treatment of obesity in the rural population has received little research attention,” according to background information in the article. Studies have shown that diet, exercise and behavior changes can produce significant weight loss and that extended care programs such as clinic-based follow-up sessions can improve weight loss maintenance. “However, in rural communities, distance to health care centers represents a significant barrier to ongoing care.”
Michael G. Perri, Ph.D., of the University of Florida, Gainesville, and colleagues conducted a randomized trial involving 234 obese women (age 50 to 75) who completed a six-month weight loss program in six medically underserved rural communities. The women were randomly assigned to three different extended-care programs consisting of 26 biweekly sessions for one year; 72 participants received telephone counseling, 83 received face-to-face counseling and 79 received biweekly newsletters containing weight loss maintenance tips. Estimated program costs were also assessed.
Iressa Proves Just as Effective as Chemotherapy for Lung Cancer
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Gefitinib, also known as Iressa, the once-promising targeted therapy for the treatment of non-small cell lung cancer, has proven as effective as chemotherapy as a second-line therapy for the disease with far fewer side effects, according to an international Phase III clinical trial, led by researchers at The University of Texas M. D. Anderson Cancer Center.
However, in contrast to earlier Iressa findings, the study showed that there was no additional survival benefit for patients who expressed an elevated level of the epidermal growth factor receptor (EGFR) mutation.
The Iressa in Non-small cell lung cancer Trial Evaluating REsponse and Survival versus Taxotere (INTERST) study, published today in The Lancet, represents a paradigm shift for the treatment of the disease, according to lead author Edward S. Kim, M.D., assistant professor in M. D. Anderson’s Department of Thoracic Head and Neck Medical Oncology. It marks the first time in lung cancer that an oral pill has proven as effective as chemotherapy in a head-to-head trial.
Latinas more likely to regret breast cancer treatment decisions
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Latina women who prefer speaking Spanish are more likely than other ethnic groups to express regret or dissatisfaction with their breast cancer treatment, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center.
Despite receiving similar treatment, Latina women were 5.6 times more likely than white women to report high levels of dissatisfaction and regret about their breast cancer treatment decision.
The researchers found that Latinas and other ethnic groups had similar levels of involvement with their doctor in deciding the treatment plan. But Latinas were more likely to say they would have preferred to be more involved in the decision making.
Cancer survival rates impact type of Web communities used by patients
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Online support communities for high survival rate cancers contain a greater amount of emotional support content than online support communities for cancers with low survival rates, according to a new study from the University of Michigan Health System and the VA Ann Arbor Healthcare System.
The researchers also found that support communities for low survival rate cancers contain a greater amount of informational support content than online support communities for high survival rate cancers.
“Online communities have become an important resource for individuals seeking emotional and informational social support related to cancer,” says senior author Caroline Richardson, M.D., assistant professor in the Department of Family Medicine at the University of Michigan Health System.
Prevent a Common Childhood Foot Problem
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Parents can help prevent a common and painful foot problem in children by following a few simple tips, according to the American College of Foot and Ankle Surgeons (ACFAS).
Foot and ankle surgeons say ingrown toenails are a common condition they treat in children. The doctors blame tight shoes, tight socks and incorrect nail trimming for most cases. In other cases, children may inherit the tendency for nails to curve, according to http://FootPhysicians.com.
Surgeons say many kids hide their ingrown toenails from their parents, even though the condition can cause significant pain. Over time, the nail may break the skin and lead to dangerous infections. The ACFAS gives these recommendations to help parents prevent ingrown toenails in their children.
International Team Finds Gene Associated with Epilepsy
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A University of Iowa-led international research team has found a new gene associated with the brain disorder epilepsy. While the PRICKLE1 gene mutation was specific to a rare form of epilepsy, the study results could help lead to new ideas for overall epilepsy treatment.
The findings, which involved nearly two dozen institutions from six different countries, appear in the Nov. 7 issue of the American Journal of Human Genetics.
In epilepsy, nerve cells in the brain signal abnormally and cause repeated seizures that can include strange sensations, severe muscle spasms and loss of consciousness. The seizures may not have lasting effects but can affect activities, such as limiting a person’s ability to drive. Most seizures do not cause brain damage but some types of epilepsy lead to physical disabilities and cognitive problems. Medications can control symptoms, but there is no cure.
Hypertension Develops Early, Silently, in African-American Men
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Young and healthy African-American men have higher central blood pressure and their blood vessels are stiffer compared to their white counterparts, signs that the African American men are developing hypertension early and with little outward sign, according to a new study. While the study found that central blood pressure—the pressure in the aorta, near the heart—was higher in the African-American men, the study found no difference in brachial blood pressure—measured on the arm—between the two groups.
Taken together, the findings suggest that hypertension (high blood pressure) may be developing undetected in young African-American men and that measuring central blood pressure may be a better means of detecting the problem as it develops.
“Central blood pressure holds greater prognostic value than conventional brachial blood pressure as central pressure more aptly reflects the load encountered by the heart,” the authors explained. “Thus, brachial blood pressure may neglect important information on cardiovascular burden and response to therapy in African-American men.”
No Protective Effect on Cancer from Long-Term Vitamin E or Vitamin C Supplementation
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Data from a large-scale prevention trial presented at the American Association for Cancer Research’s Seventh Annual International Conference on Frontiers in Cancer Prevention Research show no protective effect from vitamin E on prostate cancer or vitamin C supplementation on total cancer.
The Physicians’ Health Study II is a large-scale, long-term, randomized clinical trial that included 14,641 physicians who were at least 50 years old at enrollment. These physicians were given 400 IU of vitamin E every other day or its placebo, or 500 mg of vitamin C daily or its placebo.
Researchers followed these patients for up to 10 years for the development of cancer with high rates of completion of annual questionnaires, and the confirmation of reported cancer endpoints.
