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Featured InfoMedLinks

Common Food Additive Found To Increase Risk And Speed Spread Of Lung Cancer “New research in an animal model suggests that a diet high in inorganic phosphates, which are found in a variety of processed foods including meats, cheeses, beverages, and bakery products, might speed growth of lung cancer tumors and may even contribute to the development of those tumors in individuals predisposed to the disease. … "Our results clearly demonstrated that the diet higher in inorganic phosphates caused an increase in the size of the tumors and stimulated growth of the tumors," Dr. Cho said. Dr. Cho noted that while a moderate level of phosphate plays an essential role in living organisms, the rapidly increasing use of phosphates as a food additive has resulted in significantly higher levels in average daily diets. Phosphates are added to many food products to increase water retention and improve food texture. "In the 1990s, phosphorous-containing food additives contributed an estimated 470 mg per day to the average daily adult diet," he said. "However, phosphates are currently being added much more frequently to a large number of processed foods, including meats, cheeses, beverages, and bakery products. As a result, depending on individual food choices, phosphorous intake could be increased by as much as 1000 mg per day."“

"Doctor, will that x-ray harm my unborn child?" (CMAJ. 2008)

Epilepsy Drugs Get Suicide Risk Warning

Even a tiny bit of flab raises heart failure risk “"The lean and active group had the lowest risk and the obese and inactive group had the highest risk," Kenchaiah said in a telephone interview. "As far as vigorous physical activity is concerned, even if somebody said they exercised one to three times per month — which is a very low level of exercise — they had an 18 percent reduction in the risk of heart failure after accounting for all other established risk factors," Kenchaiah added. The benefit of exercise in cutting heart failure risk was seen in lean, overweight and obese men, the researchers found. But regardless of the level of activity, higher body mass index also meant higher heart failure risk. “

First Trimester Smoking Linked To Oral Clefts “Oral clefts are one of the most common birth defects. Closure of the lip occurs about 5 weeks into pregnancy, followed by closure of the palate at week 9. If this does not happen, a cleft lip and/or cleft palate are the result, requiring surgery. The researchers wanted to see if smoking or exposure to passive smoking play a role in these defects and whether genes influence the oral cleft risk through the way toxic chemicals in cigarette smoke are processed.”

In Several States, A Push to Stem Cyber-Bullying “Willard said it is a mistake for school officials not to pay attention to cyber-bullying outside of school because escalating harassment often spills onto campus. Research also shows that such bullying leads to students failing in school, avoiding class and contemplating suicide, she said. As it is, schools may discipline students for actions outside of class if they disrupt the educational process, said Kim Croyle, a West Virginia lawyer who represents several school boards and lectures nationally on cyber-bullying. If, for instance, a student calls in a bomb threat from outside school or threatens another student so badly that they avoid school, the school could take action.“

Large waist size a good predictor of stroke risk “A large waist circumference, which is known to raise the risk of cardiovascular disease, may also raise the risk of stroke or mini-stroke, researchers from Germany report. A large waistline seems to be a better indicator of a person's risk for suffering a stroke or mini-stroke, also known as "transient ischemic attack" or TIA, than a person's overall body weight, they report. “

Osteoporosis Drugs Work, but How? “Millions of people with osteoporosis take bisphosphonates like the drug Fosamax to make their bones stronger. The drugs work well, but a new study shows that they probably don't work in the way experts have thought. It has been widely believed that bisphosphonates work by targeting and impairing the action of cells known as osteoclasts -- and reducing their number. These cells break down bone in a process known as bone resorption. But in the new study, many postmenopausal women who took Fosamax showed increases in osteoclast numbers compared to women who took a placebo. The longer the women were on the drug, the more osteoclasts they tended to have.“

Third-hand Smoke: Another Reason To Quit Smoking “"When you smoke – anyplace – toxic particulate matter from tobacco smoke gets into your hair and clothing," says lead study author, Jonathan Winickoff, MD, MPH, assistant director of the MGHfC Center for Child and Adolescent Health Policy. "When you come into contact with your baby, even if you're not smoking at the time, she comes in contact with those toxins. And if you breastfeed, the toxins will transfer to your baby in your breastmilk."“

Trying To Eat Less Becomes More Important To Fend Off Middle-Age Weight Gain ““Because the body's energy requirements progressively decline with age, energy intake must mirror that decrease or weight gain occurs,” said Davidson, a research fellow at Columbia’s Obesity Research Center. “Dr. Tucker's observation that women who practice eating restraint avoid the significant weight gain commonly observed in middle age is an important health message.” Tucker says watching what you eat is not about physical appearance – it’s a direct investment in your health. “Weight gain and obesity bring a greater risk of diabetes and a number of other chronic diseases,” Tucker said. “Eating properly is a skill that needs to be practiced.”“

Virginity Pledge Doesn't Stop Teen Sex “The results showed that five years after taking the virginity pledge: • 82% of pledgers denied ever having taken the pledge. • Pledgers and matched non-pledgers did not differ in rates of premarital sex, sexually transmitted disease, and oral and anal sex behaviors. • Pledgers had 0.1 fewer sexual partners in the past year but did not differ from non-pledgers in the number of lifetime sexual partners and the age of first sex. The biggest difference between the two groups came in the area of condom and birth control use. The study showed that fewer pledgers used birth control or condoms in the past year or any form of birth control the last time they had sex. Researcher Janet Elise Rosenbaum, PHD, of Harvard University, says the findings suggest that health care providers should provide birth control information to all teenagers, especially virginity pledgers. “

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Healthy Living

Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status (Arch Intern Med. 2008) “Conclusion A traditional MedDiet enriched with nuts could be a useful tool in the management of the MetS.”

Fruits and Veggies May Strengthen Bones: Could join calcium and vitamin D in fight against osteoporosis, study finds

Incident Hypercholesterolemia in Relation to Changes in Vigorous Physical Activity. (Medicine & Science in Sports & Exercise. 2008) “Conclusions: The odds for hypercholesterolemia 1) decrease in runners who increase their running mileage and 2) decline in association with the higher dose of vigorous activity even in the absence of any change in exercise. These effects are associated in part to the runners' BMI.”

Is regular exercise a friend or foe of the aging immune system? A systematic review. (Clin J Sport Med. 2008) “CONCLUSIONS: Overall, in healthy older adults, regular, particularly aerobic, exercise appears to be a friend of the immune system, helping to offset diminished adaptive responses and chronic inflammation. The possibility exists that particularly strenuous exercise may cause acute immunologic changes, such as diminished NK cell activity, which could predispose to infection in certain individuals. However, given the possible benefits of regular exercise on the immune system and the many definite benefits on other systems, the evidence presented here should not dissuade practitioners from suggesting regular exercise to otherwise healthy older adults.”

Many elderly can improve their walking ability “They conclude: "Interventions to reduce smoking and to increase physical ability may improve walking in older Americans." “

Older Adults Who Exercise Boost Blood Flow in Brain “Older adults who exercise regularly have increased blood flow and more small blood vessels in the brain, a new study shows.”

Physical Activity and Incidence of Atrial Fibrillation in Older Adults. The Cardiovascular Health Study (Circulation 2008) “Conclusions—Light to moderate physical activities, particularly leisure-time activity and walking, are associated with significantly lower AF incidence in older adults.”

Physical Activity and Postmenopausal Breast Cancer: Effect Modification by Breast Cancer Subtypes and Effective Periods in Life. (Cancer Epidemiol Biomarkers Prev. 2008) “These findings suggest that leisure-time PA after menopause may reduce postmenopausal breast cancer risk at least in part via hormonal pathways and not solely by changing body composition. Inactive postmenopausal women should be encouraged to become physically active even later in life.”

Prolonged Breast-Feeding May Improve Subsequent Lung Function “Infants who received prolonged breast-feeding have improved lung function at age 10 years vs those who are not breast-fed, according to the results of a prospective birth cohort study reported in the November 10 Online First issue of Thorax.”

Report: Vermont Is Healthiest State “Vermont is the healthiest state and Louisiana the unhealthiest, according to the "America's Health Rankings 2008" list.”

Simple Exercise in Children Yields Long-Term Skeletal Benefit “Recent studies funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) have shown that jumping exercises for just one school year in early childhood can trigger increases in bone mineral density (BMD) that are sustained for several years. The studies demonstrate the value of even simple high impact activities – like jumping – on BMD, while providing added support for the notion that the bone mass attained in youth can be an important determinant of lifelong skeletal health.”

Strength training good for the aging brain: study “Results of a new study converge with recent evidence that certain types of non-aerobic exercise, such as strength training, benefit cognitive function in older adults. In the study, researchers found an improvement in higher-order thinking skills among elderly men and women with a history of falling who participated in a falls-prevention exercise program. "In older adults, impaired central executive functioning is associated with falls," Dr. Teresa Liu-Ambrose, of University of British Columbia in Vancouver, Canada, told Reuters Health. The older men and women who did the strength and balance training showed a 13 percent improvement in an executive function task after 6 months. This group of elders, for example, was better able to name the ink color of the word "blue" printed in red ink. By contrast, non-participants' skills deteriorated 10 percent, the investigators report in the Journal of the American Geriatrics Society. After one year, 43 percent of participants, compared with 67 percent of non-participants, had repeat falls, Liu-Ambrose and colleagues report.“

Tea Drinking May Help Protect Against Cognitive Impairment and Decline “Regular tea consumption was associated with lower risks for cognitive impairment and cognitive decline, according to the results of a study reported in the July issue of the American Journal of Clinical Nutrition.”

Ten Medical Reasons To Exercise: What Does Exercise Really Do For Us?

The Mediterranean Diet and Incidence of Hypertension: The Seguimiento Universidad de Navarra (SUN) Study. (Am J Epidemiol. 2008) “These results suggest that adhering to a Mediterranean-type diet could contribute to the prevention of age-related changes in blood pressure.”

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Inflammation and Oxidative Stress

How Chronic Inflammation Can Lead To Stomach Cancer “Stomach (gastric) cancer is the second (after lung cancer) most common cause of cancer-related mortality worldwide with 900,000 deaths this year. Stomach cancer is much more common in South America, Japan, Korea and Iceland than in the United States, which represents just two percent (25,500) cases of all new stomach cancer diagnosed yearly. It is associated with a diet that is high in salt and low in fruits and vegetables, as well as with smoking, and is more common in men. Infection with the bacterium Helicobacter pylori (H. pylori) is the main risk factor in about 80 percent or more of stomach cancers. H. pylori is typically acquired in childhood through person to person transmission, and the bacterium lives within the stomach just above the stomach cells, where it induces a mild inflammatory response known as gastritis. H. pylori infection is generally associated with low socioeconomic status and poor hygiene. New H. pylori infection is gradually disappearing from most industrialized countries such as the United States and is now seen predominantly in underdeveloped countries, particularly in Asia and South America. H. pylori infection can lead to both stomach cancer and stomach ulcers but in the vast majority (more than 80 percent) of infected people, it causes no health problems.”

Fatness 'ups inflammatory activity' “Fatness increases the level of inflammatory activity in the body, something which is recognised as being a strong risk factor for illness and death from coronary heart disease, a new study indicates.”

Inflammation“ … persistent inflammation is associated with many chronic human conditions and diseases, including allergy, atherosclerosis, cancer, arthritis and autoimmune diseases.”

Inflammation and Alzheimer's disease: possible role of periodontal diseases. (Alzheimers Dement. 2008) “Recently, chronic periodontitis has been associated with several systemic diseases including AD. In this article we review the pathogenesis of chronic periodontitis and the role of inflammation in AD. In addition, we propose several potential mechanisms through which chronic periodontitis can possibly contribute to the clinical onset and progression of AD. Because chronic periodontitis is a treatable infection, it might be a readily modifiable risk factor for AD.”

Inflammation and lung cancer: roles of reactive oxygen/nitrogen species. (J Toxicol Environ Health B Crit Rev. 2008) “During inflammation, enhanced ROS/RNS production may induce recurring DNA damage, inhibition of apoptosis, and activation of proto-oncogenes by initiating signal transduction pathways. Therefore, it is conceivable that chronic inflammation-induced production of ROS/RNS in the lung may predispose individuals to lung cancer. This review describes the complex relationship between lung inflammation and carcinogenesis, and highlights the role of ROS/RNS in cancer development.”

Inflammation and Plaque Vulnerability. (Cardiovasc Drugs Ther. 2008) “Development of a thrombus at the site of an atherosclerotic plaque initiates abrupt arterial occlusion and is the proximate event responsible for the vast majority of acute ischemic syndromes. In nearly 75% of cases thrombus overlies a disrupted or ruptured plaque whereas the remainder of the thrombi overly an intact plaque with superficial endothelial erosion. Over the past several years, it has been recognized that plaque composition rather than plaque size or stenosis severity is important for plaque rupture and subsequent thrombosis. Ruptured plaques, and by inference, plaques prone to rupture, tend to be large in size with associated expansive arterial remodeling, thin fibrous cap with a thick or large necrotic lipid core with immuno-inflammatory cell infiltration in fibrous cap and adventitia and increased plaque neovascularity and intraplaque hemorrhage. The size of the necrotic lipid core and extent and location of plaque inflammation appear to be key factors in determining plaque instability. Inflammation and immune cell activation appears to play a key role in the loss of collagen in the fibrous cap, a prelude to fibrous cap rupture, through release of collagen degrading enzymes.”

Inflammation in the vascular bed: Importance of vitamin C. (Pharmacol Ther. 2008) “For endothelial cells, ascorbate helps to prevent endothelial dysfunction, stimulates type IV collagen synthesis, and enhances cell proliferation. For vascular smooth muscle cells, ascorbate inhibits dedifferentiation, recruitment, and proliferation in areas of vascular damage. For macrophages, ascorbate decreases oxidant stress related to their activation, decreases uptake and degradation of oxidized LDL in some studies, and enhances several aspects of their function. Although further studies of ascorbate function in these cell types and in novel animal models are needed, available evidence generally supports a salutary role for this vitamin in ameliorating the earliest stages of atherosclerosis.”

Oxidative Stress and Inflammation Are Associated with Adiposity in Moderate to Severe CKD. (J Am Soc Nephrol. 2008) “We conclude that increased adiposity may amplify the oxidative stress and inflammation that accompany moderate to severe CKD. Interventions focused on weight loss may decrease the inflammatory and oxidative burden in CKD, which may ultimately attenuate cardiovascular risk in this population.”

Polyunsaturated fatty acids, inflammatory processes and inflammatory bowel diseases. (Mol Nutr Food Res. 2008)

Smoking and Lung Cancer: The Role of Inflammation (The Proceedings of the American Thoracic Society 2008)

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Patient Safety

Aggressive drug marketing may endanger people “Quicker drug approvals and sophisticated marketing campaigns may be putting more patients at risk of dangerous side effects but the same techniques might be put to use to protect them, a researcher argued on Tuesday. New U.S. Food and Drug Administration procedures have clearly sped up some drug approvals, said Dr. David Kao of the University of Colorado Health Sciences Center. For example, Merck & Co Inc's anti-inflammatory drug Vioxx, or rofecoxib, had been tried by 20 million patients before it was withdrawn in 2004 because of its heart dangers. Writing in the British Medical Journal, Kao said the 1992 Prescription Drug User Fee Act, or PDUFA, which authorizes fees from companies to beef up the FDA and speed drug approvals, cut the time needed to review a new drug from 33.6 months during 1979-86 to 16 months by the 1997-2002 period. … New drugs are usually tested on a few thousand people at most, with rarer side-effects becoming evident only when they are used in the wider population. Watching for these effects is called post-approval surveillance. "We just have very poor post-approval surveillance now," Kao said. "People are going to want new drugs and it is going to be impossible to guarantee their safety before a lot of people get them."”

American Values Blamed For U.S Health-care Crisis

Branson Slams Britain's "Horrific" MRSA Problem “The Virgin Group chairman, speaking in his role as vice-president of the Patients Association, said one in 10 people who go into hospital suffer an "adverse event". He said more action was needed to deal with the spread of infection. "In the airline industry, if we had that kind of track record we would have been grounded years ago," he told the BBC. "Therefore the airline industry has a spectacularly good track record and that certainly... doesn't apply to the NHS." Branson called for all staff to be checked for the superbug MRSA and those who were carriers of the infection -- which he said could be up to 30 percent of people working in hospitals -- should be treated before they dealt with patients again. He said the disruption would be better than the pain and misery caused by an unnecessary death.“

Canada Sets New Limits on Cold Medicine for Children “Canadian health officials urged parents on Thursday not to give over-the-counter cold medicines to children under the age of six, citing concern over misuse and overdoses. The federal health agency, Health Canada, which had earlier this year recommended the medicines not be given to children less than two years old, said there is limited evidence that the medications have any effectiveness for young children.”

Cleveland Clinic discloses doctors' business ties “The move, announced Wednesday, is the clinic's latest effort to guard against medical conflicts of interest and follows a rising national debate in recent years on the issue. The clinic is posting on its Web site the names of its physicians and researchers and the companies with which they have collaborations. “

The epidemic of overmedication “Here's what I learned: The use of multiple, often unnecessary medications — especially among older people — is an entrenched, escalating, frightening, and mostly unexamined problem in modern health care. Although medications can ease many conditions, multiple-drug use often exacerbates existing ailments and causes troubling side effects that are treated with yet more drugs. Many doctors, researchers, and pharmacists I talked to agree. "Overmedication is a true epidemic," says Armon B. Neel Jr., PharmD, a clinical pharmacist in Georgia who evaluates medication plans for private and nursing home clients. "It's completely out of hand."”

This Case Couldn't Wait Six Months “"I'm going to be blunt," he told the Nelsons, according to Jason's recollection. "Your son does not have asthma. He's had a heart attack and is in heart failure, and he's going to have surgery within 24 hours." Matthew had "cardiac asthma," wheezing associated with heart failure. The seizure he'd had during circumcision was actually a heart attack, Nelson said.”

U.S. 'Not Getting What We Pay For' “As much as half of the $2.3 trillion spent today does nothing to improve health, he says. Not only is American health care inefficient and wasteful, says Kaiser Permanente chief executive George Halvorson, much of it is dangerous. … The United States today devotes 16 percent of its gross domestic product to medical care, more per capita than any other nation in the world. Yet numerous measures indicate the country lags in overall health: It ranks 29th in infant mortality, 48th in life expectancy and 19th out of 19 industrialized nations in preventable deaths. One way to reconfigure health spending is to shift large sums into prevention and wellness, said Reed Tuckson, a physician and executive vice president at UnitedHealth Group in Minneapolis. The idea is to tackle the handful of preventable, chronic illnesses such as heart disease and diabetes that account for 75 percent of health-care costs. Each year, for example, the United States spends $450 billion treating heart and artery disease. The "good news," Tuckson said, is that former certain killers such as heart attacks, strokes and aneurysms can now be treated. But the price -- of maintenance drugs, ongoing tests and procedures such as stents -- is high. It would be wiser, he argued, to attack underlying problems such as smoking, diabetes, high cholesterol and high blood pressure.”

U.S. study weighs lifetime risks from CT scans “A typical CT scan can deliver 50 to 100 times more radiation than a conventional X-ray, depending on the site being examined and the age and brand of the machine. Some 62 million CT scans are done in the United States each year, and some studies estimate they may soon account for as much as 2 percent of all cancers.”

Which chest pain patients initially suspected of acute coronary syndrome after ED evaluation can be safely discharged from the emergency department?

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