2006 Archives

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2006 Archives:
Featured InfoMedLinks

Recent archived links on top:

Uncovering an Epidemic — Screening for Mental Illness in Teens

Familial Pathways to Suicidal Behavior — Understanding and Preventing Suicide among Adolescents

The Antidepressant Quandary — Considering Suicide Risk When Treating Adolescent Depression

As Minds Age, What’s Next? Brain Calisthenics "Certainly most brain-healthy recommendations are not considered bad for people. They do not have the potential risks of drugs or herbal supplements. And things like physical exercise and Omega-3 fatty acids help the body, even if they do not end up bettering the mind."

Dark chocolate: A bittersweet pill to take "With a few exceptions, most of the studies have been relatively small, and very few have involved eating drugstore delights such as Snickers. For the most part, minimally processed, high-cocoa-content products — not commercially available — have been consumed by study subjects. And much of the research has been funded by chocolate makers. … Don't go gobbling up large amounts of chocolate, though, Lichtenstein says. Diet-busting amounts of butter, sugar and cream, common in chocolate confections, can raise the risk for obesity, diabetes and tooth decay. … There are other health reasons to keep chocolate at a minimum, doctors say. For GERD (gastroesophageal reflux disease) patients and other sufferers of chronic heartburn, chocolate can be irritating to the stomach and esophagus. And people who have heart arrhythmias should stay away from the caffeine in chocolate, especially if they consume other caffeinated foods. And don't assume that because it's darker chocolate, it's healthier chocolate. That's a widely held misconception…"

Older women with bad vision at greater death risk "Older women with poor eyesight have a greater likelihood of dying over a given period than similar women with better vision, a new study shows. Vision loss occurs with aging, and is known to increase the risk of falls and fractures, Kathryn L. Pedula of Kaiser Permanente Northwest in Portland, Oregon and colleagues note in the Journal of the American Geriatrics Society."

Aerobic exercise training increases brain volume in aging humans. (J Gerontol A Biol Sci Med Sci. 2006) " Conclusions. These results suggest that cardiovascular fitness is associated with the sparing of brain tissue in aging humans. Furthermore, these results suggest a strong biological basis for the role of aerobic fitness in maintaining and enhancing central nervous system health and cognitive functioning in older adults."

Pregnant Women Need to Avoid Rodents "Pregnant women who come in contact with rodents run the risk of becoming infected with a virus that causes severe brain damage to unborn children. Doctors at the University of Iowa are recommending expectant mothers make sure their homes are winterized because rodents tend to take shelter in homes during the colder months. Sealing up cracks and crevices to keep wild mice and rats out of the house can cut down on the risk of exposure to the harmful virus."

Prenatal Smoking Exposure and Dopaminergic Genotypes Interact to Cause a Severe ADHD Subtype. (Biol Psychiatry. 2006) "CONCLUSIONS: Results indicate that smoking during pregnancy is associated with specific subtypes of ADHD in genetically susceptible children."

Reported Residential Pesticide Use and Breast Cancer Risk on Long Island, New York. (Am J Epidemiol. 2006) "Lawn and garden pesticide use was associated with breast cancer risk, but there was no dose response. Little or no association was found for nuisance-pest pesticides, insect repellants, or products to control lice or fleas and ticks on pets. This study is the first known to suggest that self-reported use of residential pesticides may increase breast cancer risk."

Whole grains and fish may protect against asthma "Children who eat goodly amounts of whole grain products and fish seem to have a reduced risk of developing asthma, according to findings published in the medical journal Thorax. … whole grains and fish were linked to a reduction of 54 percent and 66 percent, respectively, in the likelihood of having asthma, and similar reductions of 45 percent and 56 percent for wheezing."

Long-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults (JAMA. 2006) "Conclusions Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention."

Olive oil 'can cut cancer risk' "A study of 182 European men found those who had 25 millilitres of olive oil per day had reduced levels of a substance which indicates cell damage. The Danish team said it may explain why many cancer rates are higher in northern Europe than the south, where olive oil is a major part of the diet."

Physical Activity and Breast Cancer Risk: The European Prospective Investigation into Cancer and Nutrition. (Cancer Epidemiol Biomarkers Prev. 2006) "This study provides additional evidence for a protective effect of physical activity on breast cancer risk."

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure. (Eur Spine J. 2006) "There is no clear relationship between the structural changes represented by MRI and the measured mobility tests used in this study. Our findings suggest that close observation of spinal motion may provide at least equal information about the influence of spinal structures on motion than the commonly used measured mobility tests do."

Frequently Asked Questions (FAQs) About Falls "Falls and their resulting injuries are a serious public health issue among older adults. Falls are associated with a considerable number of deaths, a considerable number of complications, reduced functioning and premature nursing-home admission. Both the incidence of falls and the severity of fall-related complications rise steadily after age 60. In the United States, one in three people aged 65 years and older falls each year. After age 75, the rates are even higher. A key concern for older people is not simply the high incidence of falls but their high susceptibility to injury."

Good Nutrition May Help Prevent Disability in the Elderly "In the current study, older women in the lowest quartiles of levels of serum vitamin B6, vitamin B12, and selenium were at increased risk for incident ADL disability."

Height Loss in Older Men (Arch Intern Med. 2006) "Conclusion Marked height loss ( 3 cm) in older men is independently associated with an increased risk of all-cause mortality and coronary heart disease."

Sudden Decline in Breast Cancer Could Be Linked to HRT "Breast cancer rates appear to be dropping — especially in women over the age of 50 years — and new research presented today suggests this surprising decline may be due to recent changes in hormone replacement therapy (HRT) use."

Trans Fats Up Heart Disease Risk: Study Shows Tripled Risk for Heavy Users; Doctors Call for Ban "Trans fats have jumped out of the deep fryer into a public grilling once again, with new research suggesting even small amounts can harm the heart. An analysis of data from the large Nurses' Health Study shows that women who ate the most trans fats were more than three times as likely to develop heart diseaseheart disease as those who consumed the least."

Moderate-Intensity Exercise Reduces the Incidence of Colds Among Postmenopausal Women (The American Journal of Medicine 2006) "This study suggests that 1 year of moderate-intensity exercise training can reduce the incidence of colds among postmenopausal women. These findings are of public health relevance and add a new facet to the growing literature on the health benefits of moderate exercise."

Circumcision Shown to Slow Spread of HIV in Africa "The studies, in Kenya and Uganda, found that circumcised men are about 50 percent less likely to contract HIV than those who are not, a result that echoed similar research last year from South Africa. In all three studies, the results were so persuasive that researchers stopped their experiments several months early and offered circumcisions to all of the subjects, deeming it unethical to withhold a procedure that might prevent an often-fatal disease. … Circumcision, which removes the foreskin from a man's penis, eliminates the cells most vulnerable to HIV infection, researchers say. A circumcised penis also develops thicker skin that's resistant to infection."

Diabetes control maintained with exercise training "Resistance training at a community center is helpful for maintaining control of blood sugar levels in adults with type 2 diabetes, an Australian study suggests."

Definition of Trans fat "Trans fat: An unhealthy substance, also known as trans fatty acid, made through the chemical process of hydrogenation of oils. Hydrogenation solidifies liquid oils and increases the shelf life and the flavor stability of oils and foods that contain them.… In the realm of dietary dangers, trans fats rank very high. It has been estimated that trans fats are responsible for some 30,000 early deaths a year in the United States. Worldwide the toll of premature deaths is in the millions."

Airborne Mold and Endotoxin Concentrations in New Orleans, Louisiana, after Flooding, October through November 2005 (Environ Health Perspect. 2006) "Conclusions: The high concentration of mold measured indoors and outdoors in the New Orleans area is likely to be a significant respiratory hazard that should be monitored over time. Workers and returning residents should use appropriate personal protective equipment and exposure mitigation techniques to prevent respiratory morbidity and long-term health effects."

Body mass index and the risk of Parkinson disease (NEUROLOGY 2006) "Conclusion: Body mass index is associated with a risk of Parkinson disease. The effect is graded and independent of other risk factors."

NIH Researcher Pleads Guilty to Conflict of Interest "National Institute of Mental Health scientist Trey Sunderland pled guilty today to violating conflict-of-interest rules when he accepted nearly $300,000 for drug company consulting services--without getting required approval from his superiors or disclosing the income to the National Institutes of Health (NIH) …"

The European Youth Heart Study — Physical Activity Is a Medical Necessity "For their cardiovascular health, children should be involved in physical activity of at least moderate intensity for at least 1 hour per day, and they may need as much as 90 minutes of daily activity to prevent insulin resistance, according to a new European study."

The risk of dementia with increased body mass index: a systematic review. (Age Ageing. 2006) "CONCLUSION: this systematic review supports the hypothesis that increased BMI is independently associated with increased risk of dementia. Long-term studies to examine the mechanisms underlying the relationship between obesity and dementia are needed."

Traffic-Related Air Pollution and Otitis Media "Conclusions: These findings indicate an association between exposure to traffic-related air pollutants and the incidence of otitis media. Given the ubiquitous nature of air pollution exposure and the importance of otitis media to children's health, these findings have significant public health implications."

Eating slowly really does make people eat less "A new study provides the first-ever scientific proof that if you eat slowly, you will eat less -- and you will enjoy the meal more. Women consumed about 70 fewer calories when they were told to take their time eating a meal of pasta and sauce, compared to when they were instructed to eat it as quickly as possible. They also rated the meal as more pleasant when they ate slowly."

Staph infections rising among athletes "Staph infections, in varying and sometimes deadly forms, are being reported in greater numbers across Ohio and nationwide as more virulent and resilient strains are infecting high school, college and professional athletes. Football players, wrestlers and even fencers have contracted methicillin-resistant staphylococcus aureus, or MRSA, a serious superbug once isolated to hospitals and health-care settings that has found its way into locker rooms, weight rooms and athletic training facilities. Despite widely available information about the dangers of skin infections, staph has continued spreading."

Doctor charged with criminal conflict of interest "Federal prosecutors on Monday charged a leading government Alzheimer’s researcher with engaging in a criminal conflict of interest by earning $285,000 in private consulting fees from a pharmaceutical giant. In a rare criminal case against a government scientist, the National Institutes of Health’s Dr. Trey Sunderland was accused of performing consulting work for Pfizer Inc. that improperly overlapped with his government duties."

Exposure to marijuana during pregnancy alters neurobehavior in the early neonatal period. (J Pediatr. 2006) "CONCLUSIONS: Marijuana exposure during pregnancy alters the neurobehavioral performance of term newborn infants of adolescent mothers."

Opening blocked arteries not always good idea "In a surprise finding, heart attack survivors with mild or no symptoms who wait three days or more to seek medical help will not benefit from widely used procedures to open clogged arteries, U.S. researchers said Tuesday. Artery-clearing procedures called angioplasties are recommended for almost all heart attack patients with completely blocked arteries who seek treatment within the first 12 hours of a heart attack."

Pesticide Exposure and Self-reported Parkinson's Disease in the Agricultural Health Study. (Am J Epidemiol. 2006) "This study suggests that exposure to certain pesticides may increase PD risk."

PSA Screening Among Elderly Men With Limited Life Expectancies (JAMA. 2006) "Conclusions Prostate-specific antigen screening rates among elderly veterans with limited life expectancies should be much lower than current practice given the known harms of screening. More attention to prognosis is needed when making screening PSA recommendations to elderly men."

Smoking, High HPV Levels Could Spell Cervical Cancer

Specific Environmental Risks

Infertility: a global perspective. (Minerva Ginecol. 2006) "It is generally believed that, overall, in the general population a persistent form of infertility affects some 7-8% of all couples; in Europe the prevalence of infertility has been estimated at around 14%. There are important regional differences in the incidence and causes of sterility. Whereas the best known factor in western countries is an increase in the age in which women attempt to conceive, in Africa, the most important cause is represented by sexually transmitted infections. … if attempts to conceive fail over a period of three years, even in women 30 years or younger, the probability of pregnancy decreases to about 40%."

Macronutrients, aluminium from drinking water and foods, and other metals in cognitive decline and dementia. (J Alzheimers Dis. 2006) "Healthy diets, antioxidant supplements, and the prevention of nutritional deficiencies or exposure to foods and water with high content of metals could be considered the first line of defence against the development and progression of cognitive decline."

Food allergy: nuts and tree nuts. (Br J Nutr. 2006) "In natural history investigations carried out in peanut-allergic children, approximately 20 % of the cases outgrew their allergy or developed oral tolerance. The treatment of nut allergies should include patient and family education about avoiding all presentations of the food and the potential for a severe reaction caused by accidental ingestion. Patients and families should be instructed how to recognise early symptoms of an allergic reaction and how to treat severe anaphylaxis promptly."

High Sugar Intake May Increase Risk for Pancreatic Cancer "Consumption of foods and drinks with high sugar content were associated with increased risk for pancreatic cancer…"

Hospital boards too closely tied to industry: Panels that oversee experiments tainted by conflicts of interest, study finds "A survey of hospital review boards that watchdog experiments on patients shows that one in three members takes money from companies that make drugs and medical devices that come under study. What’s more, many of those with conflicts rarely or never disclose their financial ties, researchers found. … The question: Do medical researchers always act in the best interest of science — or patients — if they are also getting royalties, consulting fees or other benefits from the makers of the products being tested?"

Americans Surprised, Concerned that 90% of Flu Shots Contain Mercury

Back surgery often no better than waiting "Two big government-funded studies on back surgery for painful herniated disks show no clear-cut reason to choose an operation over other treatment. The pain and physical function of the patients, who were suffering from a condition called sciatica, improved significantly after two years whether or not they had surgery. However, neither strategy offered complete relief."

Can lung scans really prevent cancer deaths?

Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial. (Pediatrics. 2006) "CONCLUSIONS: Findings confirmed psychopathologic conditions as a serious health concern in obese and morbidly obese adolescents. Our study is the first randomized, controlled trial to demonstrate that a brief supervised exercise therapy intervention has the potential to improve psychopathologic outcomes significantly and to increase physical activity in obese adolescents, relative to usual care."

Current Recommended Vitamin D Intake May Not Be Optimal "After comparing vitamin D intakes with achieved serum concentrations of 25(OH)D for the purpose of estimating optimal intakes, the authors suggest that an increase in the currently recommended intake of vitamin D is warranted for better bone health in younger adults and for all studied outcomes in older adults."

Dietary Measures and Exercise Training Contribute to Improvement of Endothelial Function and Atherosclerosis Even in Patients Given Intensive Pharmacologic Therapy. (Journal of Cardiopulmonary Rehabilitation 2006) " … dietary and exercise variables, such as increasing fiber intake and reducing body weight and body fat percentage, were independent predictors of improvements in endothelial function and carotid plaque burden. …CONCLUSIONS: Even in the setting of intensive pharmacological therapy, lifestyle interventions, including exercise training and dietary changes, are important determinants of improved endothelial function and atherosclerosis."

Cardiovascular risk factors for physician-diagnosed lumbar disc herniation. (Spine J. 2006 ) "CONCLUSIONS: Cardiovascular risk factors are significantly and independently associated with symptomatic lumbar disc herniation. These findings provide further confirmation that atherosclerosis may be involved in spinal disc degeneration. Modification of risk factors, particularly smoking, may also prove to be beneficial."

Cigarette smoking affects uterine receptiveness. (Hum Reprod. 2006) "RESULTS: Pregnancy rate (PR) in non-heavy smokers (0-10 cigarettes/day) was significantly higher than in heavy smokers (>10 cigarettes/day) (52.2 versus 34.1%, respectively). Interestingly, multiple PR was significantly higher in heavy smokers (60 versus 31%). CONCLUSION: Tobacco consumption determines reduced uterine receptiveness and an increased risk of multiple pregnancie"

Are first-time episodes of serious LBP associated with new MRI findings? (Spine J. 2006) "BACKGROUND: Magnetic resonance (MR) imaging is frequently used to evaluate first-time episodes of serious low back pain (LBP). Common degenerative findings are often interpreted as recent developments and the probable anatomic cause of the new symptoms. … CONCLUSION: Findings on MR imaging within 12 weeks of serious LBP inception are highly unlikely to represent any new structural change. Most new changes (loss of disc signal, facet arthrosis, and end plate signal changes) represent progressive age changes not associated with acute events. Primary radicular syndromes may have new root compression findings associated with root irritation."

Eating Walnuts With High-fat Meals Helps To Protect Arteries Against Short-term Damage " 'Each time we eat a high-fat meal, the fat molecules trigger an inflammatory reaction that, among other ill effects, reduces the elasticity of the arteries,' Dr. Ros said. 'Over time, this repeated damage is thought to contribute to hardening of the arteries and, in turn, to heart disease. Our latest research shows that eating walnuts helps to maintain the elasticity of the arteries.'"

Exercise Could Lower Age-Linked Eye Disease Risk: More active types had fewer cases of severe age-related macular degeneration, study found

High BMI Tied To Poor Cognitive Function In Middle-Aged Adults "Cournot says the prevalence of both dementia and obesity is increasing in epidemic proportions, and the link between BMI and cognitive function could serve as a tool in dementia prevention by managing obesity in middle-age adults."

Falls Spell Health Danger for Elderly "In older people, even a simple fall can cause a serious fracture of the arm, hand, ankle or hip. For example, only about half of older adults who are hospitalized for a broken hip return home or are able to live on their own after the injury."

Full Breast-feeding May Lower Hospitalizations for Infections During First Year of Life "Full breast-feeding reduces the rate of hospital admissions for infections in the infant by one half during the first year of life, according to the results of a study reported in the July issue of Pediatrics."

Omega-3 Supplements Delay Cognitive Decline in Mild Alzheimer's Disease "According to the current authors, in many previous trials of supplementation with omega-3 fatty acids, EPA has been the predominant acid over DHA. However, in the current study, there was 2.8 times more DHA than EPA. The rationale for this, the current authors explain, is based on previous research that has shown AD-affected brains are deficient in DHA. Furthermore, studies in transgenic mouse models of AD have shown that dietary DHA reduced total amyloid in the brain in a dose-dependent way, particularly in the hippocampi and parietal cortices."

Progression of mild cognitive impairment to dementia: a challenge to current thinking (The British Journal of Psychiatry (2006)) "Results Approximately 60–65% of people with mild cognitive impairment develop clinical dementia during their life. Progression from mild cognitive impairment to dementia appears to be time dependent, occurring primarily within the initial 18 months."

Vaccine for Girls Raises Thorny Issues "The vaccine, known as Gardasil, protects against human papillomavirus (HPV), a ubiquitous sexually transmitted virus that causes genital warts and cervical cancer. In June, the Food and Drug Administration approved Gardasil for women and girls ages 9 to 26, making it the first vaccine marketed specifically to prevent a cancer."

Exercise for overweight or obesity. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: The results of this review support the use of exercise as a weight loss intervention, particularly when combined with dietary change. Exercise is associated with improved cardiovascular disease risk factors even if no weight is lost."

Liver damage high in fat teens "ALMOST one in 10 boys in year 10 have liver damage because they are too fat, and one in five have high blood pressure, a new study shows."

In medicine, evidence can be confusing "Critics condemn evidence-based medicine as "cookbook medicine" that devalues the doctor's experience and the patient's preference. Proponents argue that evidence from randomized controlled trials has stanched the flow of private and public dollars for useless or even harmful treatments. More important, they say, the information has saved countless lives. Both sides agree on one point: Keeping up with the latest evidence is virtually impossible. … Doctors have always had to juggle what they learned in their training, what they're seeing in their own patients and what they read in medical journals … Today, though, an average of 82 randomized controlled trials are published each day in the medical literature. … McMaster University physician Gordon Guyatt, a professor of clinical epidemiology and biostatistics who coined the term 'evidence-based medicine' in 1990, says doctors should have a "healthy respect" for the evidence, but should not be tyrannized by it.."

Associations of vegetable and fruit consumption with age-related cognitive change (NEUROLOGY 2006) "Conclusion: High vegetable but not fruit consumption may be associated with slower rate of cognitive decline with older age."

DHEA in Elderly Women and DHEA or Testosterone in Elderly Men (NEJM 2006) "Conclusions Neither DHEA nor low-dose testosterone replacement in elderly people has physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life."

Doctors Rethink Widespread Use of Heart Stents " … some doctors are rethinking their faith in the devices, driven by emerging evidence that the newest and most common type — drug-coated stents — can sometimes cause potentially fatal blood clots months or even years after they are implanted. … There is no question that stents have saved countless lives in the short term by preventing impending heart attacks or opening arteries while an attack is being treated. But neither type of stent, no matter how much better it may make a patient feel, has been shown in rigorous clinical trials to improve long-term survival compared with other forms of treatment."

'Mediterranean' Diet May Cut Alzheimer's Risk "People who eat a "Mediterranean" diet rich in fruits, vegetables, olive oil, legumes, cereals and fish have a lower risk of developing Alzheimer's disease, U.S. researchers report."

NICE says anti-dementia drugs should be used only for moderate Alzheimer’s disease "The National Institute for Health and Clinical Excellence (NICE) confirmed its decision this week to recommend the use of cholinesterase inhibitors only for moderate Alzheimer’s disease and not for mild disease."

Preventing Cardiovascular Disease in Women (Am Fam Physician 2006)

Psychiatric comorbidity of migraine. (Headache. 2006) "This review will focus on the relationships between migraine and depression, generalized anxiety disorder, panic disorder, and bipolar disorder. In large scale population-based studies, persons with migraine are from 2.2 to 4.0 times more likely to have depression. In longitudinal studies, the evidence supports a bidirectional relationship between migraine and depression, with each disorder increasing the risk of the other disorder."

Alzheimer’s Drugs Offer No Help, Study Finds "The drugs most commonly used to soothe agitation and aggression in people with Alzheimer’s disease are no more effective than placebos for most patients, and put them at risk of serious side effects, including confusion, sleepiness and Parkinson’s disease-like symptoms, researchers are reporting today. … Spokesmen for Lilly, AstraZeneca and Johnson & Johnson, which owns Janssen, noted that the drugs were not approved by the Food and Drug Administration for use in Alzheimer’s patients, and that the companies did not market them for that purpose."

Cochrane reviews compared with industry-supported meta-analyses and other meta-analyses of the same drugs: systematic review (BMJ 2006) BMJ review statement: "Of seven industry-supported reviews, all recommended the experimental drug without reservation, whilst none of the corresponding Cochrane reviews reached the same conclusion. Six of the eight Cochrane reviews analysed had reservations about the quality or relevance of the trials or their findings and two of them noted that the effect decreased with increasing number of patients in the trial. Seven mentioned higher cost of the experimental drug as a problem. In contrast, none of the industry-supported reviews mentioned higher cost as a problem, and two claimed that the experimental drug was cost-effective."

Physical fitness and lifetime cognitive change. (Neurology. 2006) "CONCLUSIONS: Physical fitness is associated with cognitive reserve. Intervention studies aimed at making older people fitter are good candidates to improve cognitive aging."

Physical Fitness Contributes to Successful Mental Aging "A Scottish study found that 79-year-old individuals who were more physically fit had greater mental acuity, even after accounting for childhood IQ."

Memory loss may be first sign of dementia "Older adults with memory complaints, despite normal test results, may actually be exhibiting the earliest sign of dementia, according to a study conducted at Dartmouth Medical School in Hanover, New Hampshire."

Diet Linked to Women's Stress Fractures "The old-school prescription for sore legs -- running less or wearing different shoes -- doesn't really help alleviate the pain, Reinking said. Diet appears to be the single most important factor, he said."

Nutrition Journal Hid Contributors' Ties to Food Industry "A nutrition journal published by the American College of Nutrition failed to tell readers that a special supplement on salt intake was written and edited by consultants to the salt industry. The editors also failed to inform the National Library of Medicine (NLM), which included the abstracts from the supplement in MEDLINE. NLM rules state MEDLINE will not carry abstracts from sponsored supplements unless conflict-of-interest disclosure statements are prominently featured in the supplement."

Cholesterol and Triglycerides: What You Need to Know "Elevated triglyceride levels can lead to heart disease, kidney disease, and pancreatitis. National guidelines suggest normal triglycerides levels should be less than 150 milligrams per deciliter."

Environmental Toxins Passed Down Through Generations "Imagine this: Your great-grandmother was exposed to an environmental toxin while she was pregnant with your grandmother. Now you and your children are suffering consequences like cancer and kidney disease even though you were never exposed to the toxin yourself."

Chlorinated Pool Attendance, Atopy, and the Risk of Asthma during Childhood (Environ Health Perspect 2006) "These findings further support the hypothesis implicating pool chlorine in the rise of childhood asthma in industrialized countries."

Nationwide E. Coli O157:H7 Outbreak: Questions & Answers

Food Poisoning

How Ready-to-Eat Spinach Is Only Part of the E. Coli Problem "When the Food and Drug Administration (FDA) issued a warning to consumers on Thursday about E. coli contamination in bagged spinach, it didn't come as a surprise to Michael Doyle. So far, about 100 people have fallen ill and one death has been connected to the dangerous E. coli 0157:H7 bacterial infection, and the director of food safety at the University of Georgia says that outbreaks like this one will only continue if produce manufacturers don't change their practices. … These outbreaks, warns Doyle, are an inevitable by-product of the way that many fruit and vegetable manufacturers have streamlined their production — and cut costs — by doing some of the processing of their ready-to-eat produce right in the fields, and not in the more controlled atmosphere of a factory. He sees it as a dangerous practice that could contribute to contamination."

Stroke Trials' History Shows Bias Toward Good News "Negative and even neutral findings from stroke trials are less likely to be published than positive findings, according to new research. What makes the new study especially noteworthy is that stroke research in general has a more negative track record than other areas of medicine, the researchers noted. … The findings reflect an earlier study published in May in the Journal of the American Medical Association, which showed that clinical trials funded by drug companies and other for-profit entities were more likely to report positive findings than similar trials funded by nonprofit groups."

Weight loss is the best way to prevent diabetes "Weight loss is the key factor in reducing diabetes risk for high-risk, overweight individuals, a new study shows. Participants in the intensive lifestyle intervention portion of the Diabetes Prevention Program, which involved cutting fat and calories with the goal of reducing by weight by 7 percent, reduced their likelihood of developing diabetes by 58 percent over a 3-year period…"

Portion distortion: typical portion sizes selected by young adults. ( Am Diet Assoc. 2006) "CONCLUSIONS: Portion distortion seems to affect the portion sizes selected by young adults for some foods. This phenomenon has the potential to hinder weight loss, weight maintenance, and/or health improvement efforts. Thus, to ensure more effective nutrition counseling, food and nutrition professionals must develop ways to "undistort" what clients perceive to be typical portion sizes and help them recognize what is an appropriate amount to eat at a single eating occasion."

Protect Yourself From Food-Borne Illness "E. coli bacteria gets the headlines, but the CDC estimates that there are more than 250 food-borne diseases causing as many as 80 million cases of food poisoning each year."

JAMA patient page. Evidence-based medicine. "In the 1990s, evidence-based medicine emerged as a way to improve and evaluate patient care. It involves combining the best research evidence with the patient's values to make decisions about medical care. Looking at all available medical studies and literature that pertain to an individual patient or a group of patients helps doctors to properly diagnose illnesses, to choose the best testing plan, and to select the best treatments and methods of disease prevention. Using evidence-based medicine techniques for large groups of patients with the same illness, doctors can develop practice guidelines for evaluation and treatment of particular conditions."

Lingering Pesticides Linked to Parkinson's "The team found evidence that free radicals had damaged certain brain cells that produce dopamine, a neurotransmitter that plays a key role in Parkinson's disease. People who sustain damage to these same brain cells start to develop the symptoms of Parkinson's, such as a shuffling walk, Miller says. He believes Parkinson's is kicked off by a combination of factors, including genes, but then the disease speeds up as a result of exposure to pesticides such as dieldrin. … Ascherio says pesticides still in use, such as those for a home garden, also might pose some risk to these sensitive brain cells."

Findings of and treatment for high levels of mercury and lead toxicity in ground zero rescue and recovery workers and lower Manhattan residents. (Explore (NY). 2006) "Of those tested for heavy metal toxicity, using a challenge urine test, 85% had excessively high levels of lead and mercury. Chelation treatment using dimercaptuosuccinic acid (DMSA), a Food and Drug Administration (FDA)-approved sulfur compound, was the primary treatment prescribed. After three to four months of treatment, the first cohort of 100 individuals reported significant (greater than 60%) improvement in all symptoms."

Vitamin D deficiency in obesity and health consequences. (Current Opinion in Endocrinology & Diabetes 2006) "Summary: Obese children and adults are often less active and suffer from muscle weakness and bone aches and pains which further decrease their activity and increase their potential for being more obese. Vitamin D sufficiency has been linked to insulin secretion and insulin sensitivity, and, thus, vitamin D deficiency may exacerbate type II diabetes. Monitoring for serum 25-hydroxyvitamin D and treatment with pharmacologic doses of vitamin D typically 50 000 IU of vitamin D2, once a week for 8 weeks followed by every other week will often correct vitamin D deficiency and maintain a normal vitamin D status. Patients with a body mass index of over 30 may require higher doses or more frequent dosing with vitamin D."

Seniors at greater risk of medicine mix-ups "Mistakes with prescription drugs are a leading cause of death or injury in the United States, and a new study finds that older patients are most at risk because they typically have more medicines and more doctors."

Infection risk in kids living near landfills "Living near a hazardous waste site containing persistent pollutants such as dioxins, polychlorinated biphenyls (PCBs) and chlorinated pesticides, seems to increase the risk of hospitalization for respiratory infections and asthma in children, a study suggests. Dr. David O. Carpenter, director of the Institute for Health and the Environment, at the State University of New York at Albany, said these results are consistent with the hypothesis that simply living near a waste site constitutes a risk of exposure to contaminants, presumably by air transport, and that these chemicals can reduce immune system function and lead to more infections."

Accelerated Weight Loss May Precede Diagnosis in Alzheimer Disease (Arch Neurol. 2006) "Conclusions Aging with and without DAT is associated with weight loss; however, weight loss may accelerate before the diagnosis of DAT. Specific factors contributing to weight loss are unknown, but these data suggest they operate before the development of DAT. Hence, weight loss may be a preclinical indicator of Alzheimer disease."

Excess weight gain during pregnancy bad for baby "Excessive weight gain was associated with poor Apgar scores, a gauge of how well the baby looks and responds immediately after birth. In addition, excessive weight gain was linked to infant seizures, low blood sugar levels, and a potentially serious breathing condition called meconium aspiration. Excessive weight gain was also associated with a decreased risk of having a small baby, whereas low weight gain was tied to an increased risk. Based on the study findings, the researchers recommend that public health efforts emphasize the prevention of excessive weight gain during pregnancy."

New Heart Strategy Focuses on Lifestyles " … evidence of the impact lifestyle changes alone can have on preventing cardiovascular problems. Euroaction's community-based strategy for avoiding heart disease is based on the premise that lifestyle, in most cases, is more important than genetics in determining susceptibility to heart disease. Euroaction focused on improving the behavioral choices of 10,972 patients and their partners and families."

Epidemic influenza and vitamin D. (Epidemiol Infect. 2006) "Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson's 'seasonal stimulus'."

Rethinking the dementia diagnoses in a population-based study: what is Alzheimer's disease and what is vascular dementia?. A study from the kungsholmen project. (Dement Geriatr Cogn Disord. 2006) "Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases."

Infection may raise MS relapse risk: study "Results of a study of adults with relapsing remitting multiple sclerosis point to a significant association between viral and bacterial infections and increased risk of relapse … The team found a threefold increase in the rate of MS exacerbations during the "at-risk period" ranging from 2 weeks prior to 5 weeks after the onset of symptoms of infection, compared with time periods outside this window."

Fruit and Vegetable Juices and Alzheimer’s Disease: The Kame Project (The American Journal of Medicine 2006) "Fruit and vegetable juices may play an important role in delaying the onset of Alzheimer’s disease, particularly among those who are at high risk for the disease. These results may lead to a new avenue of inquiry in the prevention of Alzheimer’s disease."

Drugs Aren't the Only Option "Our health-care system—really, a disease-care system—is set up to make it difficult for doctors to counsel patients about alternatives to drugs and surgery. This system is enormously frustrating for both doctors and patients. Usually, the doctor has only about five minutes to meet with you, and, besides, we doctors learn very little about nutrition as part of our medical training. Drugs and surgery are reimbursable, but diet and lifestyle training are usually not (although my colleagues and I are working to change that). … Most doctors believe that taking a pill is easy, but changing a lifestyle is really difficult, if not impossible. It turns out that the conventional wisdom is wrong—two thirds of patients who are prescribed statin drugs are not taking them just 12 months later, according to a 2002 study published in JAMA. Why? Because they don't make you feel better. In contrast, people are often able to make and maintain significant changes in diet and lifestyle because they feel so much better so quickly: sustained weight loss, improved sexual function, increased energy, decreased blood pressure, dramatic reductions in angina (chest pains) and better control of diabetes—none of which results from cholesterol-lowering drugs. For many people, these are choices worth making—not only to live longer, but also to feel better."

PET and PET/CT using (18)F-FDG in the diagnosis and management of cancer patients. (Int J Clin Oncol. 2006) "Positron emission tomography (PET) using 2-(18)F-fluoro-2-deoxy-D-glucose (FDG), a radioactive derivative of glucose, is an advanced imaging tool, based on the increased glucose consumption of cancer cells. … there are some limitations, such as low FDG uptake in some cancers, substantial FDG uptake in inflammatory cells, and the lack of anatomical information and poor imaging quality of PET. A recently developed integrated PET/computed tomography (CT) system, which combines a PET camera and CT scanner in a single session, has overcome these drawbacks by providing both anatomical and functional imaging at the same position. PET and/or PET/CT using FDG is clinically useful in the detection of cancer, the differentiation of malignant and benign lesions, the staging of cancer before therapy, and the assessment of cancer therapy, as well as for determining the recurrence after therapy of most cancers, including lung cancer, gastrointestinal cancer, breast cancer, and malignant lymphoma. PET/CT has become the new standard approach to imaging in the diagnosis and management of many cancer patients."

Trigger factors of migraine and tension-type headache: experience and knowledge of the patients. (J Headache Pain. 2006) "The most common trigger factors experienced by the patients were weather (82.5%), stress (66.7%), menstruation (51.4%) and relaxation after stress (50%). The vast majority of triggers occurred occasionally and not consistently."

Orange Juice Best at Stopping Kidney Stones "Experts have long known that potassium citrate -- found in citrus juice -- can slow stone formation in people with a history of the condition."

Exercise: The Antidote for a High-Fat Meal "So, you've just polished off a meal high in fat, and now you're feeling guilty? Wait an hour or two, then get a little exercise, and you can reverse the potential damage to your arteries, a new study suggests. And you don't even have to head to the gym for that exercise. "We're talking about a walk, we're not talking about changing your clothes and sweating," said Janet P. Wallace, a professor of kinesiology at Indiana University, and lead investigator for the study."

Study rings alarm bell on ultrasound exposure risks " … link prenatal ultrasound exposure to brain damage. … Based on the new data, women with normal pregnancies should not take the risk of continuous ultrasound exposure for nonmedical purposes…"

Back-to-school asthma tips for parents

Airborne Mold and Endotoxin Concentrations in New Orleans, Louisiana, after Flooding, October through November 2005 (Environ Health Perspect 2006) "Conclusions: The high concentration of mold measured indoors and outdoors in the New Orleans area is likely to be a significant respiratory hazard that should be monitored over time. Workers and returning residents should use appropriate personal protective equipment and exposure mitigation techniques to prevent respiratory morbidity and long-term health effects."

What you can do to lower your colon cancer risk "Having a close relative with colon cancer or an adenoma (noncancerous growth) clearly marks you as someone who needs to be extra watchful. Lack of family history, however, is no reprieve. Seventy-five percent of colon cancer patients seem to have no inherited risk.…"

Nutrition and cancer: the current epidemiological evidence. (Br J Nutr. 2006) "Consumption of fruit is negatively associated with cancer of the lung and stomach, possibly with colorectal cancer, but probably not with prostate cancer and breast cancer. Consumption of vegetables probably reduces the risk of colorectal and stomach cancer, but probably is not associated with cancer of the lung, prostate and breast. Consumption of red and processed meat is positively associated with colorectal cancer and probably with stomach cancer. Animal fat is possibly associated with colorectal cancer and probably with prostate and breast cancer. High alcohol intake increases the risk of colorectal and breast cancer, while dairy products and calcium seem to decrease the risk of colorectal cancer. Obesity is a recognised risk factor of colorectal cancer and breast cancer in postmenopausal women, while foods with a high glycaemic index and glycaemic load possibly increase the risk of colorectal and prostate cancer."

The likely role of vitamin D from solar ultraviolet-B irradiance in increasing cancer survival. (Anticancer Res. 2006) "CONCLUSION: These results provide additional support for an increase in cancer survival rates linked with natural vitamin D."

[Risk factors in a young population with acute myocardial infarction: one year prospective study] (Ann Cardiol Angeiol (Paris). 2006) "The found traditional risk factors are: smoking (92.6%), absence of regular physical activity (81.5%), dyslipidaemia (66.7%), family history of cardiovascular disease (48.2%), hypertension (37.0%), obesity (18.5%), oral contraception (11.1%), diabetes (7.4%), personal thrombotic history (7.4%). The principal emergent risk factors highlighted are: stress (66.7%), inhibitor of the activation of the plasminogene (57.1%), C-reactive protein (50%), lipoprotein a (41.7%), fibrinogen (33.3%), elevated plasma homocysteine (25%), excessive alcohol use (22.2%)."

Sexual dysfunction in major depression. (CNS Spectr. 2006) "Loss of libido has been reported in various studies to affect from 25% to 75% of patients with unipolar depression, and its prevalence appears to be correlated with the severity of depression. Disorders of arousal also appear to be relatively common in both men and women with major depression, of whom approximately 25% may experience problems with erection or lubrication. The scant available data regarding orgasmic difficulties in patients with depression who have not yet taken antidepressant medication suggest that they are more common than in the general population."

Exercise shrinks abdominal fat cells "Exercise may be especially helpful in reducing the size of fat cells around the waistline -- more so than diet alone, a study suggests. That's important, because fat specifically in the abdomen has been linked to the risk of heart disease and diabetes."

Low vitamin D linked to seniors' risk of falling "Older men and women with vitamin D deficiency are more likely to fall multiple times in the course of a year than their peers with adequate vitamin D levels, researchers in The Netherlands have found. Vitamin D may be best known for its role, along with calcium, in maintaining bone health. However, vitamin D is also important for muscle mass and strength, and compromised muscle function may explain the fall risk seen in this study, according to the researchers."

Breast cancer patients face harsh chemo effects "Roughly one in six of such women wind up at the emergency room or hospitalized because of such side effects as infection, low blood counts, dehydration or nausea…"

Differences in circadian variation of cerebral infarction, intracerebral haemorrhage and subarachnoid haemorrhage by situation at onset. (J Neurol Neurosurg Psychiatry. 2006) "CONCLUSIONS: Sleep or status in sleep tends to promote ischemic stroke and suppress hemorrhagic stroke. Some triggers or factors that promote ischemic stroke and prevent hemorrhagic stroke in the morning cause different variations in the waking state between ischemic and emorrhagic stroke."

Spending to death: How much is living worth?

Strokes in Children: A Medical Dilemma

Fatal complications of bariatric surgery. (Obes Surg. 2006) "BACKGROUND: Bariatric surgery is an increasingly used method to treat morbid obesity. The mortality rate among patients undergoing bariatric operations is generally quoted as between 0.05-2.0%. Our focus was not on mortality rates but rather on the reasons patients die following the procedures. … The most common complication was an anastomotic leak with subsequent infection. A high percentage of deaths occurred after discharge (40%) and/or >30 days after surgery (37%). There were 8 deaths from complications of bariatric surgery that occurred >1 year after surgery.CONCLUSIONS: Studies that report the mortality rate during hospitalization or within 30 days of surgery, underestimate the actual incidence. Bariatric surgery carries both short- and long-term risks."

Active adults stay active in golden years " 'Our study shows that greater physical activity in your 30's, 40's, and 50's has beneficial effects well into the future by helping us maintain our ability to walk and function at older ages,' study co-author Dr. Kushang V. Patel, of the National Institute on Aging in Bethesda, Maryland, told Reuters Health."

Adult Obesity and Number of Years Lived with and without Cardiovascular Disease. (Obesity (Silver Spring). 2006) "DISCUSSION: In addition to reducing life expectancy, obesity before middle age is associated with a reduction in the number of years lived free of CVD and an increase in the number of years lived with CVD. Such information is paramount for preventive and therapeutic decision-making by individuals and practitioners alike."

Pesticide Exposure Damages Nervous System, Brain "In laboratory tests with rats, the researchers found that pesticide exposure caused changes in the same areas of the brain involved in multiple sclerosis, epilepsy, Parkinson's disease and Alzheimer's disease. Pesticides can also cause severe damage to the gastrointestinal system and cause neurological dysfunction, the researchers said."

High prevalence of vitamin D deficiency in pregnant non-Western women in The Hague, Netherlands. (Am J Clin Nutr. 2006) "BACKGROUND: Vitamin D deficiency is common in dark-skinned persons living in northern countries. Vitamin D deficiency during pregnancy may have serious consequences for both mother and child. … CONCLUSIONS: The prevalence of vitamin D deficiency in pregnant non-Western women in the Netherlands is very high, and screening should be recommended."

Vitamin D often low in seemingly healthy girls "In a study of healthy adolescent girls, researchers found that insufficient vitamin D levels were a relatively common finding, with non-white girls more severely affected. According to the UK-based study team, 'reduced sunshine exposure rather than diet explained the difference in vitamin D status of white and non-white girls' in the study, reported in the Archives of Disease in Childhood. …In an editorial, Dr. N. J. Bishop, from the University of Sheffield, UK, expresses concern that 'failure to supply an essential nutrient during a period of rapid growth and development is likely to result in problems across the population as a whole.' He writes, 'We need to take simple, practical measures to reduce the burden of early bone disease and other later problems.' These include reminding women that breast milk lacks vitamin D and that totally breastfed infants should be supplemented (irrespective of skin color) until receiving a full mixed diet."

Family history of prostate cancer means little "Contrary to some earlier studies, the results of more recent studies no longer support the notion that prostate cancers in men with a family history of the disease behave more aggressively than "sporadic" cancers in men with no family history."

Sexually Transmitted Diseases Treatment Guidelines, 2006 "These guidelines for the treatment of persons who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta, Georgia, during April 19--21, 2005. … Physicians and other health-care providers play a critical role in preventing and treating sexually transmitted diseases (STDs). These guidelines for the treatment of STDs are intended to assist with that effort. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed."

Keep it Cool with Hot Weather Advice for Older People "Heat stroke is especially dangerous for older people and requires emergency medical attention. A person with heat stroke has a body temperature above 104 and may have symptoms such as confusion, combativeness, bizarre behavior, faintness, staggering, strong rapid pulse, dry flushed skin, lack of sweating, possible delirium or coma. The temperature does not have to hit 100 for a person to be at risk for hyperthermia. Both an individual’s general health and/or lifestyle may increase the threat of a heat-related illness."

Neuropathic pain: a practical guide for the clinician. (CMAJ. 2006) "Neuropathic pain, caused by various central and peripheral nerve disorders, is especially problematic because of its severity, chronicity and resistance to simple analgesics. The condition affects 2%–3% of the population, is costly to the health care system and is personally devastating to the people who experience it. The diagnosis of neuropathic pain is based primarily on history (e.g., underlying disorder and distinct pain qualities) and the findings on physical examination (e.g., pattern of sensory disturbance); however, several tests may sometimes be helpful. … Although many patients with neuropathic pain pursue complementary and alternative treatments, rigorous evidence supporting efficacy of nondrug therapy is limited. Some reports suggest benefits of conservative interventions such as exercise,76 transcutaneous electrical nerve stimulation,77 percutaneous electrical nerve stimulation,78 graded motor imagery79 and cognitive behavioural therapy or supportive psychotherapy. … No single drug works for all neuropathic pain states, and given the diversity of pain mechanisms, patient responses and diseases, treatment must be individualized. Other than analgesia, factors to consider when individualizing therapy include tolerability, other benefits (e.g., improved sleep, mood and quality of life), low likelihood of serious adverse events and cost-effectiveness to the patient and the health care system.61 The evidence-based approach presented here may require revision as newer treatments and clinical evidence become available. … For some neuropathic pain syndromes, available treatments are tolerable and afford meaningful relief to a considerable proportion of patients. Nevertheless, many patients report intractable and severe pain, and better treatment strategies are desperately needed.132"

Conversion to dementia from mild cognitive disorder: The Cache County Study (NEUROLOGY 2006) "Conclusions: Individuals with all types of mild cognitive impairment have an elevated risk of dementia over 3 years, more so in those with an APOE 4 allele. These results suggest value in dementia surveillance for broad groups of cognitively impaired individuals beyond any specific category, and utility of APOE genotyping as a prognostic method."

Dietary and physical activity behaviors among adults successful at weight loss maintenance. (Int J Behav Nutr Phys Act. 2006) "CONCLUSION: Self-monitoring strategies such as weighing oneself, planning meals, tracking fat and calories, exercising 30 or more minutes daily, and/or adding physical activity to daily routine may be important in successful weight loss maintenance. Leisure-time activities such as lifting weights or cooking/baking for fun are common strategies reported by those who were successful weight losers."

An informed decision? Breast cancer patients and their knowledge about treatment. (Patient Educ Couns. 2006) "OBJECTIVE: Although involving women in breast cancer treatment decisions is advocated, there is little understanding of whether women have the information they need to make informed decisions. The objective of the current study was to evaluate women's knowledge of survival and recurrence rates for mastectomy and breast conserving surgery (BCS) and the factors associated with this knowledge. … CONCLUSION: Previous explanations for poor knowledge, such as irrelevance of knowledge to decision making and lack of access to information, were not shown to be plausible explanations for the low levels of knowledge observed in this sample. PRACTICE IMPLICATIONS: These results suggest a need for fundamental changes in patient education to ensure that women are able to make informed decisions about their breast cancer treatment. These changes may include an increase in the use of decision aids and in decreasing the speed at which treatment decisions are made."

Inflammatory markers and particulate air pollution: characterizing the pathway to disease. (Int J Epidemiol. 2006) "BACKGROUND: Increased concentrations of particles in air have been related to changes in inflammatory markers that in turn are hypothesized in mediating the particle effects on cardiovascular disease. The present work examined this association in an elderly cohort in the Greater Boston area and addresses the relative role of particles from different sources. … CONCLUSIONS: The findings of the study support the hypothesis that particles can induce cardiovascular disease through inflammatory pathways, suggestive of a greater toxicity of traffic-related particles."

Vegan diet reverses diabetes symptoms, study finds "People who ate a low-fat vegan diet, cutting out all meat and dairy, lowered their blood sugar more and lost more weight than people on a standard American Diabetes Association diet …"

Why are physicians not persuaded by scientific evidence? A grounded theory interview study (BMC Health Services Research 2006) "Physicians occasionally provide treatment without expecting remarkable therapeutic effectiveness, as exemplified by the use of eye drops. This finding highlights that scientific evidence alone cannot easily change physicians clinical practices, unless evidence-based practices are accepted by the general public and supported by health policy."

Caloric Restriction Increases Longevity Substantially only When the Reaction Norm is Steep. (Biogerontology. 2006) "Evolutionary theory leads to the general expectation that dietary restriction will often result in increased survival probabilities, and thus increased lifespan. …Our previous work crudely estimates that the dietary reaction norms of rodents and humans have diverged substantially, with a very flat dietary reaction norm for human longevity. These general principles and our specific results suggest that the benefits from human caloric restriction would be minor."

Transient Exposure to Coffee as a Trigger of a First Nonfatal Myocardial Infarction. (Epidemiology. 2006) "CONCLUSIONS:: The findings indicate that coffee intake may trigger myocardial infarction. The association is particularly strong among people with light/occasional intake of coffee (coffee ... with sedentary lifestyle, or with 3 or more risk factors for coronary heart disease."

Two Weeks of Lifestyle Changes Improve Cognitive Function "Simple lifestyle changes, including memory exercises, daily exercise, relaxation techniques, and a healthy diet, significantly improve cognitive function and brain efficiency in as little as 2 weeks, a small pilot study suggests."

Health Problems That Diabetes Can Cause "The most important health impacts of type 2 diabetes are the long-term complications it can cause. Most of these health problems are related to the effects of type 2 diabetes on arteries or nerves. … Why does diabetes lead to artery damage? Part of the answer is that diabetes usually occurs in the company of other diseases that place the heart and arteries at risk. People with diabetes are more likely than other people to develop high blood pressure, obesity and high cholesterol. When several heart- or artery-health risks occur together in one person, they present a powerful health threat and are known as the metabolic syndrome. … Type 2 diabetes also injures nerves. About 60 percent to 70 percent of diabetics develop diabetic nerve damage.…"

Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP) (The Lancet 2006) "Prevalence of autism and related ASDs is substantially greater than previously recognised. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear. Services in health, education, and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population."

Involvement of Oxidative Stress in Alzheimer Disease. (J Neuropathol Exp Neurol. 2006) "Although some antioxidants have been shown to reduce the incidence of AD, the magnitude of the effect may be modified by individual factors such as genetic predisposition (e.g. apolipoprotein E genotype) and habitual behaviors. Because caloric restriction, exercise, and intellectual activity have been experimentally shown to promote neuronal survival through enhancement of endogenous antioxidant defenses, a combination of dietary regimen of low total calorie and rich antioxidant nutrients and maintaining physical and intellectual activities may ultimately prove to be one of the most efficacious strategies for AD prevention."

Fish in diet may help maintain heart rhythm "Eating tuna or other broiled or baked fish appears to have a beneficial effect on the electrical system of the heart, which may help prevent life-threatening heart rhythm disorders, according to a new report. Previous reports have linked fish intake with a reduced risk of sudden death and irregular heart beats, but the mechanisms responsible for this association were unknown. However, evidence from animal studies has suggested a direct effect from fish oil intake on the hearts electrical circuitry. … Intake of fried fish was not associated with any ECG changes."

Mediterranean beats low-fat diet for heart health "Spanish researchers found that the traditional Mediterranean diet bested a low-fat diet in helping older adults improve their cholesterol, blood pressure and blood sugar levels. The findings, published in the Annals of Internal Medicine, add to evidence that diets rich in healthy fats offer a better heart prescription than diets that limit fat altogether. Mediterranean-style eating generally means plenty of fruits, vegetables and whole grains, limited amounts of red meat and processed foods, and a relatively high amount of fat from olive oil and nuts. Studies have shown that people living in the Mediterranean region have lower rates of heart disease, despite their high fat intake. … Olive oil is mostly monounsaturated fat, and virgin olive oil -- which is minimally processed -- retains the fruit's natural antioxidants, as well as nutrients that may help reduce inflammation in the blood vessels. Similarly, nuts contain unsaturated fats and other nutrients thought to be heart-protective."

Obesity Surgery Complication Rates Higher Over Time "Four of every 10 obesity surgery patients develop a complication, such as a hernia, within 6 months of leaving the hospital … The researchers found that the complication rate among non-elderly obesity surgery patients with private insurance increased by 81 percent following hospital discharge—from 21.9 percent while they were still hospitalized to 39.6 percent by the end of the 180-day study period. … The five most common complications were dumping syndrome, which includes vomiting, reflux, and diarrhea (nearly 20 percent); anastomosis complications (complications resulting from the surgical joining of the intestine and stomach), such as leaks or strictures (12 percent); abdominal hernias (7 percent); infections (6 percent); and pneumonia (4 percent). The overall death rate for entire the 180-day postoperative period studied was low—0.2 percent."

Aerobic exercise for women during pregnancy. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: Regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness. Available data are insufficient to infer important risks or benefits for the mother or infant. Larger and better trials are needed before confident recommendations can be made about the benefits and risk of aerobic exercise in pregnancy."

Age should not be a factor in stroke rehab "People over 80 recover as well from a stroke as younger patients do and should not be excluded from intensive rehabilitation programmes, a study in Hong Kong has found. … It is commonly believed, even among medical staff, that the older a stroke victim, the less he or she will benefit from post-stroke rehabilitation. But the study by researchers at the University of Hong Kong has found no basis for this belief."

Air pollution linked to fatal heart attacks: 40 percent greater risk for people living in areas with dirty air, report finds "The researchers also found that people who had ever lived in pollution “hot spots” with particularly dirty air had a 23 percent increased risk of heart attack, and a 40 percent increased risk of fatal heart attack."

n-3 Fatty acids from fish or fish-oil supplements, but not {alpha}-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. (Am J Clin Nutr. 2006) Evidence suggests that increased consumption of n-3 FAs from fish or fish-oil supplements, but not of alpha-linolenic acid, reduces the rates of all-cause mortality, cardiac and sudden death, and possibly stroke. The evidence for the benefits of fish oil is stronger in secondary- than in primary-prevention settings. Adverse effects appear to be minor.

Overweight Kids Have High Blood Pressure as Adults

Prevalence and bother of nocturia, and causes of sleep interruption in a Danish population of men and women aged 60-80 years. (BJU Int. 2006) "The prevalence of nocturia increased with age. The overall prevalence of nocturia was 77% and there was no difference between men and women (P = 0.11), but men had slightly more severe nocturia than women. The bother caused by nocturia in men and women increased with the severity of nocturia, and women were slightly more bothered than men when the degree of nocturia was >2 voids/night. Nocturia was the most frequent self-reported reason for waking at night, followed by thirst."

High-intensity exercise improves HDL and fasting glucose levels in metabolic syndrome " … showed that among patients with the metabolic syndrome, those randomized to a high-intensity exercise program had significantly improved HDL-cholesterol levels, whereas those performing aerobic exercise did not, and there was a greater improvement in fasting glucose levels when compared with those undergoing a moderate-exercise training program."

Health Tip: If You Find Mold in the House

Healthy Lifestyle Factors in the Primary Prevention of Coronary Heart Disease Among Men. Benefits Among Users and Nonusers of Lipid-Lowering and Antihypertensive Medications. (Circulation. 2006) "CONCLUSIONS: A majority of CHD events among US men may be preventable through adherence to healthy lifestyle practices, even among those taking medications for hypertension or hypercholesterolemia."

Aspirin use not seen linked to stroke severity "When a stroke occurs, its severity does not seem to be related to whether the patient had be taking aspirin previously or not, according to a large, international study."

Healthy Lifestyle and the Risk of Stroke in Women (Arch Intern Med. 2006) "Conclusions In this large prospective cohort of apparently healthy women, a healthy lifestyle consisting of abstinence from smoking, low body mass index, moderate alcohol consumption, regular exercise, and healthy diet was associated with a significantly reduced risk of total and ischemic stroke but not of hemorrhagic stroke. Our findings underscore the importance of healthy behaviors in the prevention of stroke."

Lifestyle trumps drugs for a healthy heart "Middle-aged men on these medications can reduce their chances of heart problems by 57 percent by eating right, not smoking, drinking in moderation and maintaining a healthy weight while exercising regularly, the researchers said. Those who do not take the drugs can cut their risk of heart ailments by 87 percent if they adopt these lifestyle choices."

Impact of Physical Activity on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803 (Journal of Clinical Oncology 2006) "Conclusion: Beyond surgical resection and postoperative adjuvant chemotherapy for stage III colon cancer, for patients who survive and are recurrence free approximately 6 months after adjuvant chemotherapy, physical activity appears to reduce the risk of cancer recurrence and mortality."

Physical Activity and Survival After Colorectal Cancer Diagnosis (Journal of Clinical Oncology 2006) "Conclusion: Recreational physical activity after the diagnosis of stages I to III colorectal cancer may reduce the risk of colorectal cancer-specific and overall mortality."

First Signs of Dementia May Be Physical "The first physical indicators of a risk for dementia in people without cognitive impairment seemed to be problems with walking and balance. And among people with apparent mild cognitive impairment, a weak handgrip suggested they would progress to dementia, the study found."

Fruit and vegetables: the unexpected natural answer to the question of osteoporosis prevention? (Am J Clin Nutr 2006) " … study examining the association between fruit and vegetable consumption and bone mineral status in 5 age and sex cohorts. Intriguingly, the results indicate significant positive associations between fruit and vegetable intakes and both spine size-adjusted bone mineral content and whole-body bone mineral density in adolescent boys and girls aged 16–18 y. In the older women, aged 60–83 y, significant positive associations were found between spine size-adjusted bone mineral content and fruit intake. The size of the effect in the older women was impressive: doubling the fruit intake would have resulted in a 5% increment in spine bone mineral content."

Parents' cigarette smoke harms kids for years "A new international study of more than 20,000 children confirms that exposure to cigarette smoke before and after birth impairs their lung function, and that parental smoking remains a serious public health issue. The effects of smoking during pregnancy last up to age 12, while exposure to cigarette smoking after birth further worsens lung function…"

Vitamin D Status and Cancer Incidence and Mortality: Something New Under the Sun "Sunlight generally is an effective means of generating large amounts of vitamin D, but it may not be safe for all persons. For many individuals, including those who are darkly pigmented or who live at northern latitudes, sunlight exposure may also be insufficient to generate adequate vitamin D. Conversely, vitamin D supplements are widely available, inexpensive, and believed to be safe over a large dosing range. As is often pointed out, the present recommended allowance for vitamin D—400 IU—for individuals aged 50–70 years is inadequate even to maintain skeletal health and is probably too low for meaningful anticancer effects (25)."

Individual and family household smoking habits as risk factors for wheezing among adolescents. (Prev Med. 2006) "CONCLUSION.: Individual, maternal and other family members' indoor smoking habits may increase the risk of wheezing among adolescents."

Effects of Early Treatment With Statins on Short-term Clinical Outcomes in Acute Coronary Syndromes (JAMA. 2006) "There were no statistically significant risk reductions from statins for total death, total MI, total stroke, cardiovascular death, fatal or nonfatal MI, or revascularization procedures (percutaneous coronary intervention or coronary artery bypass graft surgery). … Conclusion Based on available evidence, initiation of statin therapy within 14 days following onset of ACS does not reduce death, MI, or stroke up to 4 months."

Chronic Aspirin Therapy for the Prevention of Cardiovascular Events: A Waste of Time, or Worse? "Few therapies in cardiovascular medicine have been studied so intently and adopted so widely into clinical practice as aspirin, especially with so little evidence of long-term benefit for people with or at risk of coronary artery disease. A series of studies has shown that long-term aspirin therapy is ineffective, or worse, for the primary, secondary or tertiary prevention of cardiovascular events; however, distorted reporting of these studies, in a way that would not be tolerated for other pharmacologic agents, has led many readers to misinterpret neutral studies as showing benefit with aspirin … Aspirin should be used to treat or prevent medical problems only when the effective dose and duration of therapy is known—that is, for short-term treatment of acute vascular events and relief of pain. Aspirin should not be given to patients to achieve misguided health-service targets. International guidelines now recommend aspirin withdrawal in some patients with coronary disease, and such recommendations should be extended to other patient groups after scientific review of the relevant evidence."

Use of First- and Second-Generation Cyclooxygenase-2-Selective Nonsteroidal Antiinflammatory Drugs and Risk of Acute Myocardial Infarction. (Circulation. 2006) "BACKGROUND: The cardiovascular safety of cyclooxygenase (COX)-2-selective nonsteroidal antiinflammatory drugs (NSAIDs) has come under scrutiny after the withdrawal of rofecoxib and halting of the Adenoma Prevention with Celecoxib trial. Whether the newer second-generation COX-2 inhibitors (etoricoxib, valdecoxib) also increase the cardiovascular risk is unknown. … CONCLUSIONS: Our study supports the hypothesis that the elevated risk of AMI is a class effect of COX-2 inhibitors. The increase in risk appears to be dose dependent, but further data are needed to verify this observation."

Health benefits of physical activity: the evidence (CMAJ 2006) "We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death. We also reveal that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people. There appears to be a linear relation between physical activity and health status, such that a further increase in physical activity and fitness will lead to additional improvements in health status."

Study Finds a Link of Drug Makers to Psychiatrists "More than half the psychiatrists who took part in developing a widely used diagnostic manual for mental disorders had financial ties to drug companies before or after the manual was published, public health researchers reported yesterday. … n recent years, critics have said that the manual has become too expansive, including diagnoses, like social phobia, that they say appear tailor-made to create a market for antidepressants or other drugs."

What Are the Public Health Effects of Direct-to-Consumer Drug Advertising? (PLoS Med. 2006) "Background to the debate: Only two industrialized countries, the United States and New Zealand, allow direct-to-consumer advertising (DTCA) of prescription medicines, although New Zealand is planning a ban [1]. The challenge for these governments is ensuring that DTCA is more beneficial than harmful. Proponents of DTCA argue that it helps to inform the public about available treatments and stimulates appropriate use of drugs for high-priority illnesses (such as statin use in people with ischemic heart disease). Critics argue that the information in the adverts is often biased and misleading, and that DTCA raises prescribing costs without net evidence of health benefits."

Top mental health guide questioned "The study is the first to document extensive monetary connections between drug companies, psychiatrists and other scientists responsible for the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The DSM, as it's commonly called, defines all the mental illnesses recognized by psychiatry and outlines the criteria used to determine whether a person has one of these conditions. Medical professionals refer to it as the "bible of mental health" in the U.S. The current version, the DSM-IV, was published in 1994 and modified in 2000. The manual is of enormous importance to pharmaceutical firms, as the Food and Drug Administration will not approve a drug to treat a mental illness unless the condition is in the DSM. Drug companies then can market approved medications to physicians and consumers."

Should we lower cholesterol as much as possible? Rapid Responses

Statins: beware during pregnancy. (Prescrire Int. 2006) "(2) Central nervous system and limb defects have been reported in newborns exposed to statins in utero. Several case reports describe similar malformations that are very rare in the general population. (3) Animal toxicity studies also suggest that statins are teratogenic. (4) The data are not conclusive, but they suggest that statins should be avoided during pregnancy and that pregnant women exposed to cholesterol-lowering drugs should be monitored very closely."

Sciatica in the female patient: anatomical considerations, aetiology and review of the literature. (Eur Spine J. 2006) "Review of the literature showed that the lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Physiological processes in the female patient and gynaecological diseases may be the source of sciatica, often not readily searched for, leading to fruitless investigations and surgical treatments. The aim of the paper is to highlight gynaecological and obstetrical causes of sciatica and sciatica-like symptoms. To prevent unproductive expenses and morbidity, a thorough gynaecological examination should be done even though neurological examination may be suggestive of a herniated intervertebral disc, and the cyclic pattern of pain related to menses should be routinely asked for."

Poor Sources Guide Prostate Cancer Treatment Decisions "Too many men with prostate cancer are basing important treatment decisions on biased information rather than scientific evidence, a new study finds. … Cancer eradication or control was the primary treatment objective for prostate cancer patients, the review found, while minimizing side effects played a minor role in patients' treatment decisions. However, in selecting a treatment, patients didn't consistently rely on the scientific evidence of a therapy's effectiveness in either controlling the cancer or prolonging life, the review found."

Prospective Study of Physical Activity and Depressive Symptoms in Middle-Aged Women (American Journal of Preventive Medicine 2006) "These data suggest that there is a clear relationship between increasing PA and decreasing depressive symptoms in middle-aged women, independent of pre-existing physical and psychological health."

Olfaction in neurodegenerative disorder. (Adv Otorhinolaryngol. 2006) "There has been gradual increase of interest in olfactory dysfunction since it was realised that anosmia was a common feature of idiopathic Parkinson's disease (IPD) and Alzheimer-type dementia. It is an intriguing observation that a premonitory sign of a disorder hitherto regarded as one of movement or cognition may be that of disturbed sense of smell. In this review of aging, IPD, parkinsonian syndromes, tremor, Alzheimer's disease (AD), motor neuron disease (MND), Huntington's chorea (HC) and inherited ataxia, the following observations are made: (1) olfactory senescence starts at about the age of 36 years in both sexes and accelerates with advancing years, involving pleasant odours preferentially; (2) olfactory dysfunction is near-universal, early and often severe in IPD and AD developing before any movement or cognitive disorder; (3)…"

omega-3 Fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. (Surg Neurol. 2006) "BACKGROUND: The use of NSAID medications is a well-established effective therapy for both acute and chronic nonspecific neck and back pain. Extreme complications, including gastric ulcers, bleeding, myocardial infarction, and even deaths, are associated with their use. An alternative treatment with fewer side effects that also reduces the inflammatory response and thereby reduces pain is believed to be omega-3 EFAs found in fish oil. We report our experience in a neurosurgical practice using fish oil supplements for pain relief. … CONCLUSIONS: Our results mirror other controlled studies that compared ibuprofen and omega-3 EFAs demonstrating equivalent effect in reducing arthritic pain. omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain in this selective group."

Long-Term Risk Factors for Stroke (Stroke. 2006) "Conclusions— High blood pressure and diabetes retain their importance as stroke risk factors also over an extended follow-up into old age. A family history of cardiovascular disease was not significantly related to outcome. Transient ischemic attacks, atrial fibrillation, stress, smoking, and a history of chest pain were associated with outcome only for the first or the first 2 periods. High body mass index and antihypertensive medication at baseline emerged as risk factors in the second and third decades."

No canned tuna, magazine warns pregnant women "Pregnant women should not eat canned tuna because it may contain harmful levels of mercury, Consumer Reports magazine said Monday, taking a more cautious approach than that recommended by the U.S. government."

Intake of Fish and n3 Fatty Acids and Risk of Coronary Heart Disease Among Japanese. The Japan Public Health Center-Based (JPHC) Study Cohort I (Circulation 2006) "Conclusions--Compared with a modest fish intake of once a week or 20 g/d, a higher intake was associated with substantially reduced risk of coronary heart disease, primarily nonfatal cardiac events, among middle-aged persons."

Italian Stroke Guidelines (SPREAD): evidence and clinical practice. (Neurol Sci. 2006) "Evidence-based medicine's aims are to retrieve, screen and compound the best external evidence with the experience of the physician, and to best respond to the specific medical need of each individual patient. Clinical questions are better answered when good systematic reviews of randomised trials or good randomised clinical trials are available. On the other hand, in a clinical scenario, difficulties in applying the evidence may be amplified due to variability of disease conditions, feasibility of intervention and patient's preferences. Guidelines are recommendations, based as much as possible on evidence, aimed at supporting clinical judgement/diagnostic skills/treatment decisions in everyday practice. … Professionals should not forget that clinical decisions often reflect several issues, not only scientific ones, including personal experience, applicability of intervention and patient's preferences."

High prevalence of vitamin D inadequacy and implications for health. (Mayo Clin Proc. 2006) "Vitamin D inadequacy has been reported in approximately 36% of otherwise healthy young adults and up to 57% of general medicine inpatients in the United States and in even higher percentages in Europe. Recent epidemiological data document the high prevalence of vitamin D inadequacy among elderly patients and especially among patients with osteoporosis. Factors such as low sunlight exposure, age-related decreases in cutaneous synthesis, and diets low in vitamin D contribute to the high prevalence of vitamin D inadequacy. Vitamin D production from cutaneous synthesis or intake from the few vitamin D-rich or enriched foods typically occurs only intermittently. Supplemental doses of vitamin D and sensible sun exposure could prevent deficiency in most of the general population."

Have ALLHAT, ANBP2, ASCOT-BPLA, and So Forth Improved Our Knowledge About Better Hypertension Care? (Hypertension. 2006) "One of the major milestones in medicine during the last 40 years has been strong evidence from well-designed clinical trials showing that blood pressure–lowering interventions reduce hypertension-related morbidity and mortality.1 Whereas initially these results were in most cases achieved with high-dose thiazide diuretics, subsequent research demonstrated that dose reduction, including combination with potassium-sparing agents, is effective and decreases the risk of adverse effects.2,3 Since then, several new antihypertensive agents have been developed, but meta-analyses have not indicated a superior beneficial effect of these agents over conventional ones.4,5 However, many hypertension experts do not recommend thiazide diuretics as first-line treatment for hypertension, and guidelines are inconsistent.6–8"

Donations tie drug firms and nonprofits "The American Diabetes Association, a leading patient health group, privately enlisted an Eli Lilly & Co. executive to chart its growth strategy and write its slogan. The National Alliance on Mental Illness, an outspoken patient advocate, lobbies for treatment programs that also benefit its drug-company donors. The National Gaucher Foundation, a supporter of people suffering from a horrific rare disease, gets nearly all its revenue from one drugmaker, Genzyme Corp. Although patients seldom know it, many patient groups and drug companies maintain close, multimillion-dollar relationships while disclosing limited or no details about the ties. At a time when people are making more of their own health-care decisions, such coziness raises questions about the impartiality of groups that patients trust for unbiased information. It also poses a challenge for groups trying to hold patients' trust and still raise money to serve them. An Inquirer examination of six groups, each a leading advocate for patients in a disease area, found that the groups rarely disclose such ties when commenting or lobbying about donors' drugs. They also tend to be slower to publicize treatment problems than breakthroughs. And few openly questioned drug prices."

Crisis Seen in Nation's ER Care "Emergency medical care in the United States is on the verge of collapse, with the nation's declining number of emergency rooms dangerously overcrowded and often unable to provide the expertise needed to treat seriously ill people in a safe and efficient manner. … Long waits for treatment are epidemic, the reports said, with ambulances sometimes idling for hours to unload patients. Once in the ER, patients sometimes wait up to two days to be admitted to a hospital bed"

Blood pressure pill doubles risk of birth defects "Babies whose mothers took ACE inhibitors in their first trimester were more than twice as likely to be born with serious heart and brain problems than those not exposed to any pressure-lowering medicines, a large study in Tennessee found."

Young tennis players warned against overtraining "The most common site of stress fractures was the midfoot, followed by the spine and the forefoot. Time to diagnosis averaged 7 weeks, and players had to wait around 15 weeks before returning to sports."

UK male deaths from melanoma skin cancer rising fast "The charity urged people to be aware of changes in the skin including a new growth or a spot or mole that itches, hurts, bleeds or won't heal."

Surgical treatment of obesity. (Curr Treat Options Gastroenterol. 2006) "Medical interventions for achieving and maintaining significant weight loss have generally failed, leaving surgery as the only effective treatment for durable weight loss. A number of surgical options are available today and can be grouped into two categories based on the mechanism of how the weight loss is achieved. Restrictive procedures include vertical banded gastroplasty (VBG), adjustable gastric banding (AGB), and Roux-en-Y gastric bypass (RYGB), although the latter does have some altered absorption as well. Largely malabsorptive procedures include biliopancreatic diversion (BPD) and biliopancreatic diversion with duodenal switch (BPD-DS). Whereas VBG has largely fallen out of favor due to inadequate long-term weight loss, the other procedures have proven successful in achieving and maintaining adequate weight loss."

Study warns of cleaning product risks "When used indoors under certain conditions, many common household cleaners and air fresheners emit toxic pollutants at levels that may lead to health risks, according to a new study by researchers at the University of California, Berkeley, and Lawrence Berkeley National Laboratory."

Epidemiology of disease risks in relation to vitamin D insufficiency. (Prog Biophys Mol Biol. 2006) "The strongest links to the beneficial roles of UVB and vitamin D to date are for bone and muscle conditions and diseases. There is also a preponderance of evidence from a variety of studies that vitamin D reduces the risk of colon cancer, with 1000 IU/day of vitamin D or serum 25-hydroxyvitamin D levels >33ng/mL (82nmol/L) associated with a 50% lower incidence of colorectal cancer. There is also reasonable evidence that vitamin D reduces the risk of breast, lung, ovarian, and prostate cancer and non-Hodgkin's lymphoma. There is weaker, primarily ecologic, evidence for the role of vitamin D in reducing the risk of an additional dozen types of cancer. There is reasonably strong ecologic and case-control evidence that vitamin D reduces the risk of autoimmune diseases including such as multiple sclerosis and type 1 diabetes mellitus, and weaker evidence for rheumatoid arthritis, osteoarthritis, type 2 diabetes mellitus, hypertension and stroke."

AHRQ - Understanding Cervical Cancer: A Woman's Guide

Cardiovascular outcomes in new users of coxibs and nonsteroidal antiinflammatory drugs: High-risk subgroups and time course of risk. (Arthritis Rheum. 2006) "CONCLUSION: We found an increased cardiovascular event rate among users of rofecoxib, and a decreased rate with naproxen use. Other coxibs and NSAIDs did not appear to be associated with a difference in event rate compared with users of other drugs. The increase in rate associated with rofecoxib was seen within the first 60 days and persisted. There was no important modification of the event rate based on the patient's baseline cardiovascular risk."

Why olanzapine beats risperidone, risperidone beats quetiapine, and quetiapine beats olanzapine: an exploratory analysis of head-to-head comparison studies of second-generation antipsychotics. (Am J Psychiatry. 2006) " … The authors reviewed results of head-to-head studies of second-generation antipsychotics funded by pharmaceutical companies to determine if a relationship existed between the sponsor of the trial and the drug favored in the study's overall outcome. … RESULTS: Of the 42 reports identified by the authors, 33 were sponsored by a pharmaceutical company. In 90.0% of the studies, the reported overall outcome was in favor of the sponsor's drug. This pattern resulted in contradictory conclusions across studies when the findings of studies of the same drugs but with different sponsors were compared. Potential sources of bias occurred in the areas of doses and dose escalation, study entry criteria and study populations, statistics and methods, and reporting of results and wording of findings. CONCLUSIONS: Some sources of bias may limit the validity of head-to-head comparison studies of second-generation antipsychotics. Because most of the sources of bias identified in this review were subtle rather than compelling, the clinical usefulness of future trials may benefit from minor modifications to help avoid bias."

Unseen danger in bagged salads

The Claim: You Can Keep Yourself Alive by Coughing During a Heart Attack " … experts say the "cough CPR" claim is largely untrue. It may have started because patients having angiograms are sometimes asked to cough forcefully when they have sudden abnormal heartbeats. Coughing deeply can help a person on the verge of passing out — a sign of cardiac arrest — until treatment can be given. But for someone having a heart attack that does not result in cardiac arrest, coughing can be extremely dangerous. And since most people are not able to tell the difference, coughing during a heart attack is almost always a bad idea, according to the American Heart Association. … THE BOTTOM LINE Coughing during a heart attack can be dangerous."

Scientists Suggest Alternative to COX-2 Drugs "Cox-2s work by suppressing a key enzyme called cyclooxegenase-2 (cox-2), which in turn dampens the production of two cox-2-derived compounds, prostacyclin (PGI2) and prostaglandin 2 (PGE2). Trouble is, both PGI2 and PGE2 are thought to help maintain cardiovascular health by preventing platelets in blood vessels from clumping together. So researchers speculated that cox-2 suppression might keep PGI2 and/or PGE2 from doing their job, boosting risks for stroke or heart attack.…"

Preeclampsia And Eclampsia "Preeclampsia is a condition that occurs only during pregnancy, after the 20th week. A woman with preeclampsia develops high blood pressure and protein in the urine, and she often has swelling (edema) of the legs, hands, face or entire body. When preeclampsia becomes severe, it can cause dangerous complications for the mother and the fetus. One of these complications is eclampsia, the name for seizures or coma that are caused by severe preeclampsia."

Groups Want Sodas With Benzene Out Of Schools "… Food and Drug Administration findings that some soft drinks contain benzene, a carcinogen."

Grapefruit and Prescription Drugs: Mix Carefully "… more than 30 commonly prescribed drugs carry a warning against mixing their use and grapefruits or grapefruit juice. This is not innocuous, because so many Americans have grapefruit for breakfast at a time when they also take their medications."

Assessment of the longer-term effects of a dietary portfolio of cholesterol-lowering foods in hypercholesterolemia (American Journal of Clinical Nutrition 2006) "Conclusions: More than 30% of motivated participants who ate the dietary portfolio of cholesterol-lowering foods under real-world conditions were able to lower LDL-cholesterol concentrations >20%, which was not significantly different from their response to a first-generation statin taken under metabolically controlled conditions."

Air pollution and type 1 diabetes in children. (Pediatr Diabetes. 2006) "Conclusion: Cumulative exposure to ozone and sulfate in ambient air may predispose to the development of type 1 diabetes in children. Early infant formula feeding and passive smoking in the household may precipitate or accelerate the onset of type 1 diabetes."

Abdominal adiposity is a stronger predictor of insulin resistance than fitness among 50-95 year olds. (Diabetes Care. 2006) "CONCLUSIONS: Adiposity and fitness continue to be significant predictors of insulin sensitivity into old age, with abdominal obesity being the most important single factor. These findings support the measurement of waist circumference to assess health risk among older adults."

Subjective Complaints Precede Parkinson Disease (Arch Neurol. 2006) "Conclusions Subjective complaints of stiffness, tremors, and imbalance are associated with an increased risk of future Parkinson disease and may reflect early effects of dopamine shortage, even when standard neurological testing cannot yet demonstrate any motor symptoms."

Lay perceptions of evidence-based information - a qualitative evaluation of a website for back pain sufferers. (BMC Health Serv Res. 2006) "Possible explanations for participants' lack of trust in research and their apparent difficulties in applying this research to their own situations include aspects that may be typical for the general public including the media's presentation of research, and a lack of familiarity with and feelings of distance to research evidence. Other aspects may be typical for patient groups with chronic and unclear medical conditions, such as a lack of trust in the health care establishment in general."

Newer antidepressants linked to serious lung disorder in newborns "Health Canada is advising women who are taking antidepressants known as Selective Serotonin Re-uptake Inhibitors (SSRI) and who are pregnant or intend to become pregnant to discuss the situation with their doctor due to potential risks to the baby. Health Canada stresses that patients should not stop taking SSRI medication without first consulting their doctors, as they could experience serious side effects."

Evidence-based medicine: What it is and what it is not. (Injury. 2006) "Although surgeons may perceive that evidence-based medicine mandates a strict adherence to randomised trials, it more accurately involves informed and effective use of all types of evidence (from meta-analysis of randomised trials to individual case series and case reports. With the ever-increasing amount of available information, surgeons must consider a shift in paradigm from traditional practice to one that involves question formulation, validity assessment of available studies and appropriate application of research evidence to individual patients."

Fish oil: what the prescriber needs to know. (Arthritis Res Ther. 2005) "There is a general belief among doctors, in part grounded in experience, that patients with arthritis need nonsteroidal anti-inflammatory drugs (NSAIDs). Implicit in this view is that these patients require the symptomatic relief provided by inhibiting synthesis of nociceptive prostaglandin E2, a downstream product of the enzyme cyclo-oxygenase (COX), which is inhibited by NSAIDs. However, the concept of 'safe' NSAIDs has collapsed following a multiplicity of observations establishing increased risk for cardiovascular events associated with NSAID use, especially but not uniquely with the new COX-2-selective NSAIDs. … Fish oils contain a natural inhibitor of COX, reduce reliance on NSAIDs, and reduce cardiovascular risk through multiple mechanisms. Fish oil thus warrants consideration as a component of therapy for arthritis, especially rheumatoid arthritis, in which its symptomatic benefits are well established."

Maternal caffeine consumption and fetal death: a case-control study in Uruguay. (Paediatr Perinat Epidemiol. 2006) "… the category of mean caffeine intake of >/=300 mg/day showed a significantly increased risk of fetal death (OR 2.33 [1.23; 4.41]) compared with no caffeine consumption during pregnancy."

Food News Blues "To really understand what's going on, you also have to follow the money. The government pays for much of basic science, but industries with a stake in the outcome often fund food and drug studies. An industry connection doesn't necessarily mean a study is wrong. ... 'when corporate sponsors fund research, it's more likely to show beneficial effects.' For example, industry-funded studies have consistently concluded that soda can be part of a healthy diet. But non-industry studies find that sugary beverages contribute to obesity. The National Dairy Council pays for research on the link between dairy food and weight loss. The California Raisin Marketing Board underwrote a study showing that raisins fight oral bacteria. ... Industry-funded studies with negative results are often not published. … From the beginning, the WHI was controversial. Scientists especially questioned the diet trial, ... committee members were concerned about the design. Cancer and heart disease can take decades to develop. Would an eight-year trial be long enough? Would the women in the test group fully report their eating habits? Self-reports of dietary intake are notoriously inaccurate. … The calcium and vitamin D study also had its critics. When it was designed, calcium was considered so important that researchers thought it would be unethical to tell women in the control group to stop taking supplements. In the end, the test subjects and the placebo group were both taking in roughly the same amount of calcium. So when the final results showed little difference in the fracture rate between the two groups, some scientists blamed the study design. The amount of vitamin D they were given is considered inadequate today. Most doctors still recommend calcium supplements if women can't get enough in their diets. … At a conference last week at the National Institutes of Health, which sponsors the WHI, researchers were even more direct, saying that they hoped women would not start eating fat because of this study, but that message got lost in the headlines. … 'These studies are more complicated than a simple headline or sound bite can convey, and that's an important lesson for all of us,' says Dr. Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute, which administers the WHI."

Aspirin resistance: definitions, mechanisms, prevalence, and clinical significance. (Curr Pharm Des. 2006) "A meta-analysis of secondary prevention trials indicated that aspirin reduced major cardiovascular or cerebral events by 25%. This led to the widespread use of aspirin for prevention of cardiovascular events. However, it appears that aspirin antiplatelet effect is not uniform in all patients and previous studies estimated that 8-45% of the population were aspirin resistant."

Asthma in every fifth child in Oslo, Norway: a 10-year follow up of a birth cohort study*. (Allergy. 2006) "Results: Lifetime prevalence of asthma was 20.2%; current asthma 11.1%, doctor diagnosis of asthma 16.1% and wheezes ever 30.3%. Allergic sensitization (29.3% overall) was more common among children with current (56.3%) compared to asymptomatic (last 12 months) (26.0%) or no asthma (27.6%) (P < 0.001). Boys more often than girls had current asthma (14.4 vs 7.1%, P = 0.004), wheeze ever (36.9 vs 22.5%, P = 0.002) and allergic sensitization (36.2 vs 22.1%, respectively, P < 0.001). Conclusion: Childhood asthma apparently continues to increase in Oslo, having affected every fifth 10-year-old child."

Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. (Am J Cardiol. 2006) "In conclusion, if the total energy expenditure of exercise is held constant, exercise performed at a vigorous intensity appears to convey greater cardioprotective benefits than exercise of a moderate intensity."

Early, Unproven Findings Changing Doctors' Practice "Too many American doctors are jumping the gun when it comes to how they treat patients -- switching to new, largely unproven therapies on which there is only early, incomplete data. That's the conclusion of a study in the March 15 issue of the Journal of the National Cancer Institute that discovered early findings presented at a national cancer conference rapidly changed the way doctors treated breast cancer -- even though the trial needed much more data and time to offer up conclusive results."

Neonatal Abstinence Syndrome After In Utero Exposure to Selective Serotonin Reuptake Inhibitors in Term Infants (Arch Pediatr Adolesc Med. 2006) "Conclusions Neonatal abstinence syndrome occurs in 30% of neonates exposed to SSRIs in utero. These neonates should be monitored for at least 48 hours after birth. The long-term effects of prolonged exposure to SSRIs, particularly in neonates who develop severe symptoms, have yet to be determined."

Organic Diets Significantly Lower Children's Dietary Exposure to Organophosphorus Pesticides (Environ Health Perspect 2006) "In conclusion, we were able to demonstrate that an organic diet provides a dramatic and immediate protective effect against exposures to organophosphorus pesticides that are commonly used in agricultural production. We also concluded that these children were most likely exposed to these organophosphorus pesticides exclusively through their diet."

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review. (Eur Spine J. 2006) "Facet joint, epidural, trigger point and sclerosant injections have not clearly been shown to be effective and can consequently not be recommended. There is no scientific evidence on the effectiveness of spinal stenosis surgery. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapses that fail to resolve with the conservative management. Cognitive intervention Combined with exercises is recommended for chronic low back pain, and fusion surgery may be considered only in carefully selected patients after active rehabilitation programmes during 2 years time have failed. Demanding surgical fusion techniques are not better than the traditional posterolateral fusion without internal fixation."

Environmental mercury release, special education rates, and autism disorder: an ecological study of Texas. (Health Place. 2006) "There was a significant increase in the rates of special education students and autism rates associated with increases in environmentally released mercury. On average, for each 1,000 lb of environmentally released mercury, there was a 43% increase in the rate of special education services and a 61% increase in the rate of autism. The association between environmentally released mercury and special education rates were fully mediated by increased autism rates."

Red Meat Enhances the Colonic Formation of the DNA Adduct O6-Carboxymethyl Guanine: Implications for Colorectal Cancer Risk (Cancer Research 2006) "Red meat is associated with increased risk of colorectal cancer and increases the endogenous formation of N-nitrosocompounds (NOC)… This study has shown that fecal NOC arising from red meat include direct acting diazopeptides or N-nitrosopeptides able to form alkylating DNA adducts in the colon. As these O6CMG adducts are not repaired, and if other related adducts are formed and not repaired, this may explain the association of red meat with colorectal cancer."

Short-term efficacy of intravenous pulse glucocorticoids in acute discogenic sciatica. A randomized controlled trial. (Spine. 2006) "CONCLUSIONS: Although an IV bolus of glucocorticoids provides a short-term improvement in leg pain in patients with acute discogenic sciatica, its effects are transient and have small magnitude."

The effect of infections and vaccinations on stroke risk. (Expert Rev Neurother. 2006) "Chronic infectious diseases that may increase the risk of stroke include periodontitis, chronic bronchitis and infections with microbial antigens, such as Helicobacter pylori and Chlamydia pneumoniae. From observational studies, there is evidence that vaccination against influenza is associated with a reduced risk of stroke, myocardial infarction and all-cause mortality."

Teflon chemical likely carcinogen, review finds "A chemical used in the manufacture of Teflon and other nonstick and stain-resistant products should be considered a “likely” carcinogen, according to an independent scientific review panel advising the Environmental Protection Agency."

Head Lice Shampoo Linked To Leukemia "French scientists are warning parents not to use chemical shampoos to rid their children of head lice. The results, they say, could be an increased risk of developing leukemia."

Fine Particulate Air Pollution and Mortality in Nine California Counties: Results from CALFINE. (Environ Health Perspect. 2006) "Many epidemiologic studies provide evidence of an association between daily counts of mortality and ambient particulate matter < 10 µm in diameter (PM10). Relatively few studies, however, have investigated the relationship of mortality with fine particles [PM < 2.5 µm in diameter (PM2.5)], especially in a multicity setting. … This analysis adds to the growing body of evidence linking PM2.5 with daily mortality."

Body mass index and cancer: results from the Northern Sweden Health and Disease Cohort. (Int J Cancer. 2006) "Our study provides further evidence that BMI is positively associated with cancer risk. In women from northern Sweden, up to 7% of all cancers were attributable to overweight and obesity and could be avoided by keeping BMI within the recommended range."

Effect of Physical Activity on Women at Increased Risk of Breast Cancer: Results from the E3N Cohort Study (Cancer Epidemiology Biomarkers & Prevention 2006) "Conclusion: A risk reduction of breast cancer was particularly observed with vigorous recreational activity."

Effects of prenatal exposure to cigarette smoke on offspring tumor susceptibility and associated immune mechanisms. (Toxicol Sci. 2006) "This study provides biological plausibility for the epidemiologic data indicating that children of mothers who smoke during pregnancy have a greater risk of developing cancer in later life."

Use of Hippocampal and Amygdalar Volumes on Magnetic Resonance Imaging to Predict Dementia in Cognitively Intact Elderly People (Arch Gen Psychiatry. 2006) "Conclusion Atrophy of the hippocampus and amygdala on MRI in cognitively intact elderly people predicts dementia during a 6-year follow-up."

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