FROM THE NEW YORK TIMES

For all you computer nerds and Sci Fi aficionados
A good history/re-cap/crystal ball gaze at the world of artificial intelligence.

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How a parasite my increase the incidence of HIV infection in Africa
And how an inexpensive drug can break the cycle.

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Do you really need that referral?
More on the econonmics of our health care system.

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A sack of flour, a bowl of grapes and … a fungus?
A world-wide parasitic family.
 
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Could it be that medications are over-prescribed in America?
Be sure to read the last sentence of this article.

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More on looking for health insurance.
Knowing the options helps.

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Birth Rates

In the US in 2007, 4 out of 10 births were to unmarried mothers. That’s an increase from 18% in 1980 to 40% in 2007. Think that 40% is outrageous and SOMETHING HAS TO BE DONE!? Maybe so, but the US does not have the highest birth rate among unmaried mothers. That statistic belongs to Iceland. What is more astounding is that Spain, with one of the lowest rates, saw an increase from 4% to 28%.

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FROM THE FDA

Consumer Education

Health Fraud Awareness

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FROM THE NEW ENGLAND JOURNAL OF MEDICINE

 
An overview written by a physician
A review of the various options for funding healthcare reform.

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FROM THE NEW YORK TIMES

Another one for the “what should I do” category
Exercising and dieting to lose weight, but getting nowhere? Look at your dietary supplement intake. Vitamins C and E seem to negate the effects of diet and exercise.

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Looking for health insurance?
There’s no easy answer. However, knowing the options helps.

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FROM THE NEW ENGLAND JOURNAL OF MEDICINE

For confidentiality, accessibility and ease of communication …

The NEJM has aligned itself with integrated personal health records.

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One physician/attorney’s opinion on conscientious objection in medicine

This is a perspective article on the recent steps to rescind the Bush administration “provider conscience regulation.”

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FROM THE NEW YORK TIMES

First reported on Positive Deviance

How one person’s simple idea has made a significant impact on infection control in hospitals.

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There are no pockets in shrouds

Need I say it again? I guess so – balance. BALANCE. BALANCE!!!

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It’s about lifestyle

Change is the word, not a quick fix. The benefits of an exercise program after heart attack all but disappear if the exercise is stopped.

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Calculate your risk of developing Type 2 diabetes

This is from a British study.

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Relationships are important – in every aspect of life

People who do not have a connected relationship to their doctors are less likely to receive guideline-consistent care. A large study published in the Annals of Internal Medicine validates what patients know intuitively. This Times article validates it from the physician’s perspective.  

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The big news from the NEJM this week is about the PSA test

Two very large studies reported that routine screening for prostate cancer does not save many lives. The PSA (protein-specific antigen) blood test does its job of reporting the presence of prostate cancer. However, there is no way of knowing whether the cancer found should or should not be treated.

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European study

American study

NEJM Editorial

FROM THE NEW YORK TIMES

The PSA studies made the front page of the NY Times

This article summarizes the study results about what the NEJM calls “The Controversy That Refuses To Die.”

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Peanut allergies may eventually be treated by small doses of peanuts

***DO NOT ATTEMPT THIS AT HOME***

Under strict medical supervision, children’s allergies to peanuts were reduced by administering very small doses of peanuts in gradually increasing doses over long periods of time. THIS REQUIRES STRICT MEDICAL SUPERVISION.

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Off label use of botulinum toxin helps reduce post-stroke spasticity

Deep muscle injections of the toxin most often associated with reducing age-related facial wrinkles can make activities of daily living easier for individuals who have suffered a stroke.

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Allergies transfer from pollen to foods

Allergic to ragweed? You may also be allergic to zucchini.

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Pre-eclampsia may be a harbinger of heart disease

Pre-eclampsia, a serious disease of pregnancy, may indicate a higher than normal risk of developing heart disease.

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Another reason to keep that belt notched in

Waist circumference was found to have an inverse relationship to lung function.

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The results of this study seem counter intuitive

The more religious a person is, the more aggressive the treatment at the end of life is desired. Perhaps this is really an artifact of a belief in an individualized life after death rather than a relationship to just religious belief.

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Smile, kids! This dentist brings a fire truck not a drill

Dr. Robert Grunstein drives his red fire truck to schools to provide dental exams to children who would otherwise go without.

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African-Americans are at much higher risk for heart failure

There is no clear-cut reason. It may be a combination of limited access to healthcare and lifestyle.

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An alternative to deep brain stimulation for the treatment of Parkinson’s disease

Rather than stimulating the brain, researchers are heartened by the results of stimulation to the spinal cord. So far, only in rodents.

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Consumers should beware if wearing transdermal medication patches

Many of these patches have metal in the backing. If you are advised to have an MRI, tell your healthcare provider that you are wearing a patch (even if it’s over-the counter for smoking cessation). The patches can overheat and cause burns.

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Are you taking a GERD medication containing metoclopramide?

There is now a “black box” warning on its long-term use. A side-effect, that was formerly only in the product insert, is now on the side of the box. The side-effect in question is tardive dyskinesia.

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FROM THE NEW YORK TIMES

Too much cost for too little gain

This article would have been more appropriate for my daily blog. However, I have been on a soapbox a bit lately. So, I’m going to just give you the link without comment.

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And in a similar vein, an article to stimulate thought

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Thought you’d skip the shot and take the spray? Think again.

A large study of military personnel indicates that taking the intramuscular flu vaccine prevents flu better than does the nasal spray UNLESS this is your first attempt at preventing the flu. In that case, take the spray. But next year, take the shot!

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FDA approval is not a protection against a lawsuit

This is another article that requires thought. Therefore, I’m presenting it without comment.

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Just because it’s “free” doesn’t mean you should take it

Colds and flu are viral in origin and can not be treated by antibiotics – even if they are free. At best they are useless for these illnesses at worst they will increase bacterial resistance to antibiotics.

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Researchers are closer to a treatment for Parkinson’s disease

Skin cells have been converted into dopamine secreting cells. The skin cells were taken from individual’s with Parkinson’s disease. The study is very small and treatment is still in the distant future. However, this is an interesting advance and one that circumvents any auto-immune issues.

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MISCELLANEOUS

FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES

Medicare will now cover testing for obstructive sleep disorder

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Maps related to the social determinants of health

The social determinants of health include:

• Socioeconomic status
• Transportation
• Housing
• Access to services
• Discrimination by social grouping (e.g., race, gender, or class)
• Social or environmental stressors

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African-American women at higher risk for pregnancy and birth complications

These complications often result in premature birth and neurological illness in the baby.

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Asthma is more likely to cause death in African Americans than in non- African Americans

The reason for this disparity is unknown.

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FROM THE FDA

Voluntary recalls of peanut products this week – only 27 (and one of them was for dog biscuits)!

Still no national brand peanut butter in jars on the list.

Searchable Website

Consumer Education

A guide to the Safer Use of Pain Medication

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FROM THE NEW ENGLAND JOURNAL OF MEDICINE

Protein, Fats, Carbs or Calories

This study was also picked up by the New York Times. But I think the original is worth a look. In summary: 811 healthy but overweight or obese adults (30 – 70, 40% men) were put on one of four diets (either low fat, low carb or low protein in various percentage combinations) with the common factor that all diets were calorie restricted (a 750 kcal deficit from baseline).

At 6 months, the average weight loss for all groups was 6kg. At 12 months all participants began to re-gain weight. At 2 years (the end of the study), the average weight loss for all groups was 4 kg.

The moral of the story? When it comes to losing weight, calories count more than the type of calories.

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An Editorial in the same issue of NEJM suggests that perhaps the only approach to the problem of obesity is a community approach.

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FROM THE NEW YORK TIMES

A forever flu vaccine?

Maybe. In the future. So far it’s only in the conceptual stage, with an “Achilles’ heel” of the virus having possibly been found. Clinical trials in humans “could” begin as early as three years from now.

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And another research team makes a similar announcement

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Dementia – Can it be linked to vitamin D

Slight evidence, but every little bit helps.

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What every parent knows

If they’re getting fidgety and need help focusing, send them out to play.

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A drug to prevent prostate cancer?

Read the fine print and talk with your doctor before making your decision.

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New Cancer Statistics (1999 – 2005 Results)

Most common cancer among men:

            Prostate cancer: First among men of all races and Hispanic origin populations.

Most common cancer among women:

            Breast cancer: First among women of all races and Hispanic origin populations.

Leading cause of cancer death among men:

            Lung cancer: First among men of all racial and Hispanic origin populations.

Leading cause of cancer death among women:

            Lung cancer: First among white, black, Asian/Pacific Islander and American Indian/Alaska Native women. Second among Hispanic women (breast cancer is first).

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FROM THE FDA

Voluntary recalls of peanut products this week – 71!

National brands of peanut butter sold in jars still NOT affected. However, the recalls (while fewer than last week) have expanded to whole, shelled peanuts in various combinations.

Searchable Website

Ever wonder why you have side effects to a drug and others don’t?

It may be in your genes. In conjunction with the FDA, the International Serious Adverse Event Consortium released data that indicate that, at least for serious skin reactions to drugs, there is a genetic basis.

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FROM THE NEW ENGLAND JOURNAL OF MEDICINE

A Physician’s Perspective on foodborne infection

Dr. Maki, a professor of medicine at the University of Wisconsin School of Medicine and Public Health, is strongly in favor of increseing the scope of the irradiation of food.

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FROM THE NEW YORK TIMES

It may help the medicine go down, but it may also make you fat

Twelve ounces of soda or 20 ounces of vitamin water – when it comes to sugar content, they’re both the same. And both will put you well over the recommended daily intake of sugars. What about high-fructose corn syrup? No better (but also no worse).

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Obesity during pregnancy is tied to major birth defects

If there isn’t already enough reason to keep your weight under control here’s another one. Women! Listen up.

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Assess your risk of colon cancer … but only if you’re white

An online colon cancer risk assessment tool was based on data that did not include information on Americans of Hispanic or African-American ethnicity. Some of this is explainable by the lack of sufficient data on those who aren’t white. However, given that African-Americans are at increased risk of colorectal cancer.

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Amazing!

Each day there are more technological advances. While not all of them are without drawbacks, assistive devices that return people to near normal functioning are among the advances without drawbacks. Amanda Kitts can now tie shoelaces. Not bad for a woman with an artificial arm.

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FROM THE FDA

Voluntary recalls of peanut products this week – 113!

National brands of peanut butter sold in jars still NOT affected.

Approval of First Drug Produced by Human Gene Livestock

The animal is the goat and the drug, an anti-coagulant named ATryn, is made from a human protein extracted from the milk of the goats. Before you think “Phew”, look up the source of Premarin.

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FROM THE NEW ENGLAND JOURNAL OF MEDICINE

Spending on Cancer Drugs

We all know that the cost of healthcare has risen and continues to rise. The cost of cancer drugs may be leading this increase. The cost of cancer drugs far outstrips the cost of other healthcare products in Medicare part B. Some, but not all, of the fault lies with the profit-driven pharmaceutical companies. Many Medicare regulations that counterbalance these forces are often disabled for medications to treat life-threatening illness. It’s a difficult problem.

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FROM THE NEW YORK TIMES

How Smart Is Your Pill?

If your pill is the Dutch prototype, your pill is very smart.

The iPill can be programmed to travel through the digestive tract and deliver medication to a specific location or locations. Furthermore, it tells the doctor where it is and gives progress reports as it travels.

The iPill, developed by Philips Research in Eindhoven, the Netherlands, is taken with food or water and travels naturally through (and out) the digestive system in 24 hours.

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More Evidence That Diabetes and Dementia Are Linked.

A Swedish twin study resulted in this latest correlation.

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Genetic Link to Thyroid Cancer

Finding genetic variations that are associated with various illnesses is neither new nor of immediate use. However, finding two such variations on the same site on the genome is quite unusual. In fact, this is so unusual that these two variants account for 57% of cases of thyroid cancer.

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