HHAL.MEDICAL NEWS SEPTEMBER08
Trans
fats linked to pre-cancerous colon growths
http://www.reuters.com/articlePrint?articleId=USHAR96380620080829
Heavier People Have Heart Attacks Earlier
12 years sooner for the most obese, new research finds
A study of more than 111,000 people found that the risk of an early heart attack increased as people got progressively
more overweight. The average age of a first heart attack was 74.6 years for people with a BMI of 18.5 or under and 58.7 years for people with a BMI of 40 or over, the Journal of the American College
of Cardiology study found. HealthDay News (9/9)
http://healthday.com/Article.asp?AID=619118
Late mortality and major adverse cardiac events predicted by perioperative uric acid levels
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=555284
Among patients abstaining from tobacco, periodic
fasting further lowers cardiac risk
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=555190
Family history is the strongest predictor of eczema during first year of life
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=554324
Short Sleep Duration and Risk for Childhood Obesity
Each 1-hour reduction in sleep was associated with a 40% increase in the risk for obesity.
http://www.ncbi.nlm.nih.gov/pubmed/18552704?dopt=Abstract
Brachial flow-mediated
dilatation and C-reactive protein improve with isoflavone therapy
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=553732
Laboratory study shows that simvastatin reduces satellite cell viability by up to 60 percent
http://www.the-aps.org/press/journal/08/32.htm
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=553735
Case study documents orbital inflammatory disease
in patient who received zoledronic acid
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=553193
Black patients undergoing screening colonoscopy have higher prevalence of colon polyps
Abstract
Full Text
Editorial
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=552504
Blacks at Greater Risk of Precancerous
Colon Polyps
Difference is most pronounced among black women, study finds
Blacks more likely to get large colon polyps than whites
A study published in the
Journal of the American Medical Association
shows blacks, especially black women, have a higher risk of having one or more large colon polyps when compared with whites. The study shows black women are 62% more likely, and black men
16% more likely, than their white counterparts to have such polyps.
http://health.usnews.com/articles/health/healthday/2008/09/23/blacks-at-greater-risk-of-precancerous-colon-polyps.html
Cutting Calories Can
Promote Weight Loss Without
Compromising Bone Health
Young adults who cut back on calories can lose weight
without putting their bone health at risk, reports the Archives of Internal Medicine.
Researchers randomized nearly 50 overweight adults (mean age, 37) to one of four groups for 24 weeks:
· 25% reduction in caloric intake;
·
caloric
restriction plus exercise (total energy deficit, 25%);
· low-calorie diet (890 calories/day; goal: 15% weight loss), with weight maintenance thereafter;
·
healthy
diet with weight maintenance (controls).
For
the first 3 months and last 3 weeks, all intervention meals were provided by the study kitchen.
At 6 months, weight loss was greater in the intervention groups (10% to 14% below baseline) than in the control group
(1%). Bone mineral density,
however, did not differ between intervention subjects and controls (despite some changes in bone markers within the intervention
groups).
The authors call for longer-term studies to make certain that bone quality
remains intact
http://archinte.ama-assn.org/cgi/content/short/168/17/1859
Sustained hypertension leads to more deaths
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=552261
First demyelinating
events linked to vitamin D insufficiency and residence in higher latitudes
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=552098
Small
study also shows significant reduction in sympathetic nervous system activity.
These preliminary results
suggest that oxidative stress may influence the sympathetic hyperactivity characterizing essential hypertension.
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551820
USPSTFU.S. Preventive Services Task Force Recommends Against Screening for Prostate Cancer in Older Men
The evidence also is insufficient to recommend screening in younger men.
RECOMMENDATIONS:
Current evidence is insufficient to assess the balance of benefits and harms of screening for prostate cancer in men younger
than age 75 years (I statement). Do not screen for prostate cancer in men age 75 years or older (Grade D recommendation).
http://www.ncbi.nlm.nih.gov/pubmed/18678845?dopt=Abstract
Practice Guideline
Increased blood pressure is secondary to intravascular
fluid retention, vascular resistance
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551821
More research needed on the effects of cranberry on asymptomatic bacteriuria and urinary tract infections
Abstract
http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=551679&contextCategoryId=40131
a Natural Polyphenol Compound in Red Wine
Possible axonal-sparing activity observed in mice with an animal model of multiple sclerosis
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551677
Intake related
to risk of p53-overexpressing colon cancers, but not wild-type tumors. Reduced intake of folate and
vitamin B6 is associated with an elevated risk of p53-overexpressing colon cancers
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551682
Telomerase activity positively associated with
comprehensive interventions on diet and lifestyle
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551105
IL-20, IL-1β may play role via inflammation, chemotaxis, matrix degradation
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=551104
Healthy living cuts premature death risk in half
Study
data on more than 80,000 women over two decades show those who didn't smoke, ate a healthy diet, maintained a proper weight
and exercised cut in half their risk of premature
death. Smoking was the biggest factor in premature death, and alcohol consumption was the smallest predictor,
the study, published in the British Medical
Journal, found. Some 28% of deaths in the group could have been avoided if the women had never smoked, researchers.
http://www.reuters.com/article/healthNews/idUSN1650682620080916
Premixed insulin analogues may offer better glycemic control than long-acting insulin
analogues, non-insulin diabetes meds
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=550679
But two-week study shows no effect on collagen production in sun-damaged skin
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=550332
Neutrophil/lymphocyte
ratio independently predicts in-hospital, six-month mortality rates
The neutrophil/lymphocyte ratio (NLR)
is a comparatively inexpensive marker of inflammation that identifies high-risk patients and may allow for risk stratification
of patients with acute coronary syndromes, according to a report in the Sept. 15 issue of the American Journal of Cardiology.
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=550011
The new analysis
found both age groups tolerated the regimen well and experienced a similar reduction in LDL cholesterol. Younger patients
had a 26% reduction in their risk of another stroke, the older patients a 10% reduction.
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=550065
Second study finds two gene variants associated with bladder cancer
Abstract - Firestein
Abstract - Kiemeney
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=550014
It also reduces the risk of developing Parkinson's and Alzheimer's
Adherence to a Mediterranean diet rich in fruits, vegetables, legumes, cereals and fish, and involving a
moderate intake of red wine with meals is associated with a lower risk of death, cancer and Parkinson's and Alzheimer's
disease, according to research published online Sept. 11 in BMJ
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=549497 .
Good news about achieving blood sugar control
Exenatide
once weekly resulted in significantly greater improvements in glycaemic control than exenatide given twice a day, with
no increased risk of hypoglycaemia and similar reductions in bodyweight.
http://www.thelancet.com/journals/lancet/article/PIIS0140673608612064/abstract?isEOP=true
Activatable dyes, paints kill various types of bacteria
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=549053
10-Year Follow-up
of Intensive Glucose Control in Type 2 Diabetes
Conclusions Despite an early loss of glycemic differences, a
continued reduction in microvascular risk and emergent risk reductions for myocardial infarction and death
from any cause were observed during 10 years of post-trial follow-up. A continued benefit after metformin
therapy was evident among overweight patients. (UKPDS 80; Current Controlled Trials number,
http://content.nejm.org/cgi/content/full/NEJMoa0806470?query=TOC
Does Magnesium Sulfate Prevent Cerebral Palsy?
This placebo-controlled trial provides further evidence for the neuroprotective effect
of magnesium sulfate.
Conclusions Fetal exposure to magnesium sulfate before anticipated early preterm delivery
did not reduce the combined risk of moderate or severe cerebral palsy or death, although the rate of cerebral
palsy was reduced among survivors. (ClinicalTrials.gov number, NCT00014989 [ClinicalTrials.gov] .)
http://content.nejm.org/cgi/content/abstract/359/9/895
Vitamin B12 Status Predicts Brain Atrophy in Elderly
Findings suggest that a low level is an important modifiable risk factor for cognitive decline
In older community-dwelling
adults, plasma vitamin B12 status may be an early marker of brain atrophy, according to a study published in the
Sept. 9 issue of Neurology.
Abstract
http://www.neurology.org/cgi/content/abstract/71/11/826
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=548645
Cognition and brain pathology improved in mouse model of disease
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=564069
Calcium and vitamin D supplements
didn't slow physical decline over seven-year study period
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=548466
http://www.adajournal.org/article/S0002-8223(08)01262-5/abstract
While interventions may slow or
halt aging in evolutionary models, the findings may not translate into slowing of human senescence
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=548467
Aspirin/Dipyridamole
vs. Clopidogrel to Prevent Recurrent Stroke: A Toss-Up?
Aspirin/dipyridamole
and clopidogrel were similarly effective.
Commonly prescribed treatment options to prevent recurrent stroke include aspirin, clopidogrel, and an aspirin/dipyridamole
combination. In the double-blind randomized PRoFESS trial, 20,332 clinically stable patients (age, 50)
with recent ischemic strokes
received either the fixed combination of aspirin (25 mg) plus extended-release dipyridamole (200 mg) given twice daily, or
clopidogrel (75 mg) given once daily. The study was sponsored by the maker of the aspirin/dipyridamole combination (Aggrenox).
During a mean follow-up of 2.5 years, recurrent stroke occurred in 9.0% of aspirin/dipyridamole recipients and in
8.8% of clopidogrel recipients — a nonsignificant difference. The incidence of a secondary composite outcome (stroke,
myocardial infarction, or death
from vascular causes) was 13.1% in both groups. A slight excess incidence of major hemorrhage with aspirin/dipyridamole compared
with clopidogrel (4.1% vs. 3.6%) was of borderline significance, but a composite endpoint of stroke or major hemorrhage was
similar in the two groups. Aspirin/dipyridamole recipients were significantly more likely than aspirin recipients to discontinue
study medication, mainly because of headaches.
Comment: Aspirin/dipyridamole and
clopidogrel appear to be similarly efficacious in preventing recurrent stroke. Headaches are more common with aspirin/dipyridamole
but usually diminish with time. Editorialists discuss the dilemma of interpreting the PRoFESS trial in the context of previous
studies. Two previous large trials showed aspirin/dipyridamole to be superior to aspirin alone (JW Jun 9 2006); in contrast, the one previous large trial in which clopidogrel was compared
with aspirin monotherapy did not show a convincing advantage for clopidogrel in stroke patients (JW Dec 10 1996). Based on previous results, aspirin/dipyridamole should have been superior to
clopidogrel in PRoFESS, but was not. Using a technique called "network meta-analysis" (in which dissimilar trials
are analyzed together), the editorialist s conclude that aspirin/dipyridamole and clopidogrel are equally efficacious and
that both are somewhat, but not quite significantly, better than aspirin alone. Thus, cost and side-effect profiles should
probably factor into physicians’ choices among these treatments.
Published
in Journal Watch General Medicine September 4, 2008
Carotid Stenting and
Endarterectomy Yield Similar Long-Term Outcomes
Long-term outcomes with carotid
stenting and endarterectomy are similar, although stenting may carry higher periprocedural risks, according to follow-up reports
from the SPACE and EVA-3S studies published online in Lancet Neurology.
In
SPACE, some 1200 adults with symptomatic carotid
stenosis were randomized to stenting or endarterectomy. Although stenting failed to prove noninferior to endarterectomy
at 30 days, clinical cerebrovascular endpoints were similar in the two groups at 2 years. The long-term restenosis rate, however,
was higher with stenting (11% vs. 5%).
Meanwhile, in a study among roughly 525 adults, EVA-3S researchers
found that the composite outcome — stroke or death within 30 days of stenting or endarterectomy, or ipsilateral stroke
within 4 years — occurred more often with stenting (11% vs. 6%). This difference was due largely to a higher rate of
periprocedural stroke with stenting
http://www.thelancet.com/journals/laneur/article/PIIS1474442208701960/abstract?isEOP=true
Higher risk of left ventricular hypertrophy and left atrial dilation
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=548119
A
recent study shows that the human body produces chemical compounds similar to the active ingredient in marijuana, and these
compounds, called endocannabinoids, play an important part in maintaining healthy
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547619
Results from three trials don't associate drug with significant reduction in emotional well-being
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=548003
Structure
of Protein Involved in Aging and Cancer Solved
Telomerase structure resembles some viral enzymes
The three-dimensional structure of
the telomerase enzyme, which is necessary to maintain proper chromosome length and is implicated in cancer and aging, has
been solved and resembles some viral enzymes, according to the results of a study published online Aug. 31 in Nature.
Abstract
Telomerase structure resembles some viral enzymes
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547813
Greater risk of developing and dying from the disease
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547820
Individuals
had higher serotonin transporter binding potential values in fall and winter
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547748
Birth weight and rate of postnatal growth are associated with blood pressure in young
adults
Abstract
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547573
Vytorin
(Simvastatin + Ezetimibe) Shows Little Benefit for Aortic Stenosis
The lipid-lowering tandem of simvastatin and ezetimibe (Vytorin)
shows little clinical benefit for older patients with aortic stenosis despite lowering cholesterol levels impressively, according to the SEAS trial published
online early in the New England Journal
of Medicine.
Researchers supported by the manufacturer randomized
nearly 1900 patients (mean age, 67 years) with aortic stenosis to receive either Vytorin or placebo. After a median follow-up
of more than 4 years, LDL
cholesterol levels fell by more than 50% in the treatment group compared with about 4% in the placebo group. Fewer patients receiving
Vytorin underwent coronary-artery bypass surgery compared with those receiving placebo. However, no significant differences
were observed for the combined endpoint of aortic valve replacement and cardiovascular events.
The surprise finding from the study was an increased cancer incidence with Vytorin compared with placebo (see story
below).
NEJM SEAS study (Free
Conclusions The available results from these
three trials do not provide credible evidence of any adverse effect of ezetimibe on rates of cancer.
Follow-up of longer duration will permit the balance of risks and benefits to be determined more reliably.
Long-term follow-up needed to clarify findings
http://content.nejm.org/cgi/content/full/NEJMsa0806603?query=TOC
Abstract - Rossebo
Full Text
Abstract- Peto
Full Text
Editorial
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547209
Males with hypertension saw risk fall with alcohol use
in a dose-response manner
Abstract
Full Text
http://www.modernmedicine.com/modernmedicine/content/printContentPopup.jsp?id=547098
