Dr. Buttery's Public Health BLOG

Researchers supported in part by the National Institute of Mental Health, part of the National Institutes of Health, found an association between the disorder and variation in two genes that make components of channels that manage the flow of the elements into and out of cells, including neurons. "A neuron’s excitability — whether it will fire — hinges on this delicate equilibrium, "explained Pamela Sklar, M.D., Ph.D., of Massachusetts General Hospital (MGH) and the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, who led the research. "Finding statistically robust associations linked to two proteins that may be involved in regulating such ion channels — and that are also thought to be targets of drugs used to clinically to treat bipolar disorder — is astonishing."

Posted by at 11:08 AM | Permalink | Comments (0)

A study reported in this week's JAMA suggested that ``stemming the pandemic of type 2 diabetes is a public health priority and will require a multi-faceted approach,'' wrote Molly Kile and David Christiani, Comment: The evidence is not terribly good. The data is from a crossectional study which can demonstrate association but NOT causality. No background data on exposures is provided, only data on blood levels that provide no evidence of length of exposures and whether arsenic exposure preceded onset of diabetes.

Posted by at 10:52 AM | Permalink | Comments (1)

In today's BMJ Dr. Olshansky and others suggested a new model for research on Health Promotion and Disease Prevention in which he states"The potential of fundamental research into ageing to contribute practical benefits to improve health at all ages, but particularly at older ages, has been under-recognised by most of the scientific establishment" and "The pursuit of extended healthy life through slowing ageing has the potential to yield dramatic simultaneous gains against many if not all of the diseases and disorders expressed in later life. The most efficient approach to combating disease and disability is to pursue the means to modify the key risk factor that underlies them all—ageing itself."

Posted by at 2:18 PM | Permalink | Comments (0)

June 11, 2008 | Ann Arbor, Mich. – Strong bones, a healthy immune system, protection against some types of cancer: Recent studies suggest there’s yet another item for the expanding list of Vitamin D benefits. Comment: Now the media circus for another Vitamin. We went through this with Vitamin C twenty years ago. After a couple of years we will find that what we knew, we still know, and that it will still remain an essential vitamin, but not the cure all now being toted. Of course the vitamin manufacturers will have a field day!.

Posted by at 10:35 AM | Permalink | Comments (1)

Reuters (6/12, Fox) reports that a team of Baxter International researchers led by Hartmut J. Ehrlich, M.D., has developed Celvapan, a "new-style bird flu vaccine," which is "made using" African green "monkey cells instead of chicken eggs," according to a research published in the June 12 issue of the New England Journal of Medicine. The use of "cells in a lab dish" is an important element in creating the vaccine, "because the right type of chicken eggs are difficult to obtain." Furthermore, "H5N1 kills chickens rapidly." The process also "could cut production time roughly in half, to as little as 12 weeks," Comment: First you have to be sure you have the outbreak, then define the type & subtypes, then after production is started the product has to be tested, then it has to be distributed, all of which will extend the 12 weeks to at least 24 weeks, by which time the ‘pandemic’ will have saturated the population. Also see next snippet.
Genome Of 150 Different Avian Influenza Viruses Released (June 11, 2008) -- The complete genetic coding sequences of 150 different avian influenza viruses have been released. The information improves scientific understanding of avian influenza, a virus that mainly infects birds but that can also infect humans.

Posted by at 10:27 AM | Permalink | Comments (0)

In an article in this week's JAMA [JAMA. 2008;299(21):2543-2549. ] the authors report that the majority of "diabetes studies fail to track the results patients care about the most, including pain, ability to function, and survival," according to lead author Victor M. Montori, M.D., who conducted an analysis "of clinical trials planned or under way," he and "found that 77 percent were designed to report on levels of glucose, or sugar, in the blood, cholesterol levels, kidney function, and other laboratory tests." In contrast, the researchers found that "stroke, myocardial infarction, amputation, visual disturbance or blindness, end-stage renal disease, hypoglycemic events, delayed wound healing, infection, pain, and functional status," were most important to diabetes patients, Comment: This is the problem with Academic studies that rarely reflect the real world. This phenomenon of performing research on the small fraction of patients who enter teaching hospitals has been criticized for more than 40 years, without a response from most Academics. The first report was published by Kerr White MD as "The Ecology of Public Health" NEJM 1961:263: 18, 885 - 892. Much more research needs to be performed at primary care sites, not in teaching centers.

Posted by at 9:43 AM | Permalink | Comments (1)

According to research from the University of Texas Health Science Center at Houston a new study provides added justification that a thiazide-type diuretic is the best first-choice drug for hypertensive patients. Why do we have to keep reinventing the wheel? A study on Veteran's completed 50 years ago showed similar findings. The public always wants New Technology or New Drugs in the mistaken belief that new is always better. Had we applied the information from the original VA study and the Framingham study as carefully as the 'Joint National Committee on High Blood Pressure' wants to do today we would have saved millions of lives, reduced disability and saved billions of dollars. As I have noted in other blogs population data often take years to collect. In the arena of chronic diseases, in particular, we should require that before new drugs are put on the market that the outcome of their use is evaluated in 10's of thousands of people, as tends to be the case in studies in Europe before approval. We have to keep recalling new drugs not because they were ineffective, but once let out into the general population of 300 million people the deficits became evident. No new drugs should be approved without population based studies which could assure us that only useful drugs, with minimal side effects (all drugs have side effects), that perform better than current medicines be approved. Part of the problem can be laid at the doors of 'research" universities and the publish or perish demand on their scholars, while drug companies are allowed to advertise prescription medicine to the public. We are one of only 2 countries that sllow such a travesty..

Posted by at 9:28 AM | Permalink | Comments (5)

Some fascinating research published in the New England Journal of Medicine this week has identified social links may either enhance your likelihood of smoking or lead to quitting smoking. It all depends on your peer group. Both are important. The editorial [n engl j med 358;21 may 22, 2008] states that increasingly smoking behavior is marginalized to smaller peer groups, while larger peer groups have influenced their members to stop smoking, and that smoking is not accepted among their peers. The journal states that adult smoking is now down to 19%, a significant decrease over the last 30 years. Behavioral changes occurs slowly, As we move to change behaviors that lead to chronic diseases, such as heart disease and diabetes from overeating we must realize that these are strategic policies that may take decades. We must not panic if change is not seen next year or the year after. This message needs to be translated for politicians who only want to fund programs that have results during their current incumbency.

Posted by at 10:24 AM | Permalink | Comments (0)

A new study published in Nature Nanotechnology Online today suggests that it was not the chemical composition of asbestos but the physical characteristics, and that other chemicals may be just as bad. Carbon nanotubules are similar physically to asbestos and are now being reported a likely to cause lung cancer and mesothelioma, just as asbestos does. There have been similar suggestions about the physical effects for the last 20 years. This is one of the reasons that fibreglass insulation installers are required to wear masks as they work. The data from the past also show that asbestos was much more dangerous when used by smokers. We should expect similar results with physically similar compounds.

Posted by at 9:39 AM | Permalink | Comments (0)

According to a Cincinnati Children’s Hospital Medical Center study children are more vulnerable to the harmful effects of lead exposure at the age of 6 than they are in early childhood. For parents this means it is just as important to know about lead in your home and yard when your children reach school age as it was when they were toddlers. It also should raise the concern of parents everywhere to ensure their children are protected by community codes that require that all housing units are made lead safe, particularly rental units.
Approximately 310,000 U.S. children age 1 to 5 years have blood lead levels greater than 10 micrograms per deciliter, the level at which the Centers for Disease Control and Prevention recommends public health actions be initiated. But research has consistently shown that blood lead levels considerably lower than 10 micrograms per deciliter are associated with adverse effects.

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From the Guttmacher Institute today research, which surveyed women and family planning providers nationwide, uncovered a number of factors that impede women’s ability to use contraceptives consistently and correctly over the long term. “Helping women who do not want to become pregnant to use contraceptives more effectively is sound public policy that will reduce unintended pregnancy,” says study author Jennifer Frost, asenior research associate. Half of teh women seeking to avoid pregnancy remain at risk—some use no contraceptive at all (8%), some have periods of nonuse (15%) and some use their method inconsistently or incorrectly (27%). “Finding the ‘right’ contraceptive method is not a one-time decision—rather it’s a series of choices as women’s life circumstances and contraceptive needs change,” says Dr. Frost.

Posted by at 9:57 AM | Permalink | Comments (1)

One more article that indicates the value of breast feeding. In an article titled, Breastfeeding and Child Cognitive Development Dr. Michael S. Kramer, Scientific Director of the Canadian Institutes of Health Research (CIHR), Institute of Human Development, reports the results from following the same group of 14,000 children for 6.5 years.
The study provides the strongest evidence to date that prolonged and exclusive breastfeeding makes kids smarter," said Kramer, a Professor of Pediatrics and of Epidemiology & Biostatistics in the McGill University Faculty of Medicine and lead investigator in the study.
"The effect of breastfeeding on brain development and intelligence has long been a popular and hotly debated topic,” says Dr. Kramer. "While most studies have been based on association, however, we can now make a causal inference between breastfeeding and intelligence – because of the randomized design of our study.”

Posted by at 10:18 AM | Permalink | Comments (0)

Today the National Academies of Science released a report on links between Ozone Exposure and Premature Motality. The crux of the information is in Chapter 5, which explains the biological plausibility and the problems with analyses of previous studies comparing cities and even countries, over time. Ozone can be seriously considered as an adverse contributor to chronic heart and lung disease, but while it is possible to describe associations there are so many confounding variables and demographic differences between the various study groups, and changes in variables such as obesity and lack of exercise over time make it is very difficult to separate out the effect of ozone from all the other contributors to early mortality. Much more definitive research is needed. There is no test that identifies the contribution of ozone to death from chronic heart and lung diseases.

Posted by at 11:25 AM | Permalink | Comments (0)

The tendency for do-gooders amd politicans to write laws "for our own good" is typical of the new law in New York which prohibits the use of 'trans-fats' in preparation of meals. Now from University of Alberta researcher Flora Wang found that a diet with enriched levels of trans vaccenic acid (VA) -- a natural animal fat found in dairy and beef products -- can reduce risk factors associated with heart disease, diabetes and obesity. When it comes to diet, whatever 'research' shows today, wait another month, and you will find other research that shows something different. The dangers of trying to change behavior by law is that when new research shows your original stand may need modifying you cannot just turn around and tweak the law. We should be careful about those states such as New York and California who think the anwsers to all ills is to pass a new law.

Posted by at 10:47 AM | Permalink | Comments (1)

The news that scientists report, in three papers in two journals today, that they have found evidence of genes that promote addiction to tobacco and thus to lung cancer, adds to evidence that tobacco. alcohol and narcotic addictions all seem to have genetic bases. However, it will take years before this research translates into effective treatment and prevention. In the meantime it could bring better understanding to policies that try inhibit exposure to, and treatment for, addicton. There is little evidence that punishment changes addictive behaviors.. Current punishment of addicts is probably counterproductive and should change we learn more about the role genes play in addiction.

Posted by at 10:39 AM | Permalink | Comments (0)

A very useful paper from MIT discusses recent research on the humane genome and its potential for identifying contributors to disease, which may lead to preventive interventions. Despite the ballyhoo in the newsmedia much work remains to be done before the research is translated to useful practice. The authors note that "a dramatic increase in the number of genome-wide association studies, in which the genomes of many people are scanned to locate genetic variations that contribute to disease." Also, "work published last year by Broad researchers and others in the Diabetes Genetics Initiative identified several genetic changes that influence a person’s level of cholesterol — a known risk factor for heart disease.." A key Issue is "to prove that their model has real value in the clinic. “There’s an assumption that predicting risk automatically means health will improve,”

Posted by at 9:34 AM | Permalink | Comments (1)

The study, by researchers from Imperial College London and the University of Oxford, shows that doctors can determine that a patient does not have tuberculosis with 99% accuracy when using the new blood test, ELISpot-Plus, in conjunction with a skin test known as tuberculin skin testing, already in use. The new study showed that ELISpot-Plus alone was accurately able to determine TB infection in 89% of cases and tuberculin skin testing alone was able to determine TB infection in 79% of cases. However, using both tests together was able to rule out TB infection with an accuracy of 99%.
This would lead to much better evaluatioof TB status than Chest X-rays and be particularly useful for screening iimmigrants, Professor Ajit Lalvani, from the National Heart and Lung Institute at Imperial College London, who led the study team, said: "Our new test could revolutionise the way we manage people with suspected TB."

Posted by at 9:46 AM | Permalink | Comments (0)

While changes in biopsy practice patterns have improved cancer detection, these very changes “have negatively influenced the predictive value of PSA in men with a normal digital rectal exam such that, using current biopsy practice patterns, PSA no longer correlates with positive biopsy rate,” note the authors. They cite the urgent need for new blood or urinary markers to better determine who needs a prostate biopsy, adding that aside from family history or prior atypical biopsy findings, there is little other information available to help physicians decide who needs a biopsy and who does not.
From Article: “Negative Influence of Changing Biopsy Practice Patterns on the Predictive Value of Prostate-specific Antigen for Cancer Detection on Prostate Biopsy.” Michael J. Schwartz,et al. CANCER; Published Online: March 10, 2008 (DOI: 10.1002/cncr.23353);

Posted by at 11:13 AM | Permalink | Comments (0)

From the University of Michigan better medical care and more education—not positive life-style changes—are the major reasons for a decades-long decline in disability rates among older Americans according to a new study funded by the National Institute on Aging that provides one of the first comprehensive looks at the factors fueling the welcome trend. according to a new study funded by the National Institute on Aging that provides one of the first comprehensive looks at the factors fueling the welcome trend."
A substantial share of the decline in disability can be accounted for by changes in cardiovascular disease, musculoskeletal conditions, and vision problems. These conditions are less likely to result in disability presumably due to improvements in treatment, especially for the first two conditions, which have become more common among older adults. Further:
• Education had a major impact. "Half of the decline in disability can be accounted for by the rise in educational attainment of older Americans,"

Posted by at 11:03 AM | Permalink | Comments (2)

From Emory Medical School is a fascinating glance into potential future prevention of Fragile X-syndrome and some forms of Autism. Dr. Warren led an international group of scientists that discovered the FMR1 gene responsible for fragile X syndrome in 1991. Fragile X syndrome is caused by the functional loss of the fragile X mental retardation protein (FMRP). Currently there is no effective drug therapy for fragile X syndrome, and previously no assays had been developed to screen drug candidates for the disorder. "Our discovery of glutamate toxicity in the Drosophila model of fragile X syndrome allowed us to develop this new screen for potential drug targets," notes Dr. Warren. "We believe this is the first chemical genetic screen for fragile X syndrome, and it highlights the general potential of Drosophila screens for drug development.
"Most importantly, it identifies several small molecules that significantly reverse multiple abnormal characteristics of FMR1 deficiency. It also reveals additional pathways and relevant drug targets. These findings open the door to development of effective new therapies for fragile X syndrome."

Posted by at 10:57 AM | Permalink | Comments (0)

In ScienceDaily today is a report from the Department of Family Medicine at the Medical University of South Carolina, researchers found that middle-aged non-drinkers who began consuming moderate amounts of alcohol saw an immediate benefit of lower cardiac disease morbidity with no change in mortality after four years. Even more interesting When comparing non-drinkers to wine-only drinkers, drinkers of other types of alcohol, and heavy drinkers, the wine-only drinkers had the most significant reduction in cardiovascular events. Drinkers of other types of alcohol also had an advantage over non-drinkers, but the difference did not reach statistical significance.

Posted by at 10:49 AM | Permalink | Comments (0)

In ScienceDaily today Case Western Reserve University School of Medicine researchers published a study identifying the hereditary components of colorectal cancer (CRC.) The genome-wide scan used in this study will help physicians elucidate the genetic factors in CRC in the future. Once the genes are identified, physicians will be able to use these genetic markers to identify "at risk" patients and to develop better cancer screening strategies, such as colonoscopies well before standard screening begins at age 50. Currently, without new gene tests, family history is the only tool to determine a person's risk for CRC. Knowing the exact gene will allow physicians to better take care of CRC patients and lead to earlier screening.
While the translationof this research into practice will be a major step forward for CRC and other cancers, It will be years before we know how many false positives and false negatives will occur.

Posted by at 10:43 AM | Permalink | Comments (0)

The issue of vitamin use, along with other dietary suplplements gets murkier and murkier. Look at the following headlines from studies of vitamin use
Certain Vitamin Supplements May Increase Lung Cancer Risk, Especially In Smokers
Vitamin Supplement Use May Reduce Effects Of Alzheimer's Disease
Task Force Finds Little Evidence To Support Use Of Vitamin Supplements To Prevent Cancer Or Heart Disease
Widespread Vitamin And Mineral Use Among Cancer Survivors: Benefits Of Such Use Remain Unclear
Vitamins May Decrease Pancreatic Cancer Risk Among Lean People
The one thing in common is that all these studies use memory recall over years. Memory recall over weeks has been shown to be faulty. But the NIH and other grantors keep shovelling out money for inconsequential studies that feed the supplementary diet producers. Too costly a fellowship!

Posted by at 9:48 AM | Permalink | Comments (4)

The hardy characteristics of the pathogen Escherichia coli O157:H7 "have prompted food microbiologists to rewrite the rule book on food safety," according to the Institute of Food Technologists'. This is due to its low infectious dose, its unusual acid tolerance, and its apparent special but inexplicable association with ruminants [cattle, deer, and sheep] that are used for food," wrote Robert L. Buchanan, Ph.D., and Michael P. Doyle, Ph.D., the document's authors. Less than ten E. coli O157:H7 cells may cause foodborne illness in people. Ionizing radiation is a promising technology because it can eliminate E. coli O157:H7 while maintaining the raw character of foods. The only way to eliminate E. coli O157:H7 is by cooking ground beef and venison to at least 160 F at home and in foodservice kitchens.

Posted by at 12:11 PM | Permalink | Comments (0)

University of Minnesota School of Pubic Health finds nearly one in six children are already alcohol users. Sixth-grade users of alcohol were significantly different from the non-users on almost all risk factors examined. For example, users were more likely to be male, engage in violent or delinquent behavior, and have friends who used alcohol. Researchers suggest a prevention program prior to sixth grade in which parent involvement is central. Students should receive developmentally-appropriate messages that correct inaccurate perceptions that 'drinking is normal' and that provide tweens with the skills to refuse alcohol. In addition, interventions should include parental involvement in order to help create opportunities for increased parent-child communication and provide parents with the skills to increase monitoring. But how many of these children have a stable family life with two parents in the home? We are not given that information.

Posted by at 11:24 AM | Permalink | Comments (0)

With support from the Welcome Institute in the UK researchers have been mapping Malaria in an effort to understand how to limit its spread and focus limited resources more carefully. About 35 percent of the world's population is at risk of contracting deadly malaria. This new map (the first in several decades) is important in part because it offers hope that malaria could be eliminated in certain areas using currently available tools, such as bed nets treated with insecticide that kills mosquitoes, the researchers said. It will also help donors and international agencies target investments in control measures where they are most likely to achieve the biggest gains.
More than 500 million cases of malaria are reported annually. Of those afflicted, about one million die; 80 percent of them are children in sub-Saharan Africa.

Posted by at 9:56 AM | Permalink | Comments (0)

In a study published in PLoS Medicine today, psychologists at the University of Hull in the UK, found that antidepressants have no clinically significant effects in all cases apart from a small group of the most severely depressed patients. Their analysis showed that in comparison to placebo effects, antidepressants do not have clinically significant effects in mildly depressed patients or in most patients who suffer from very severe depression. Furthermore, the apparent clinical effectiveness of antidepressants in the small group of extremely depressed patients is somewhat distorted. The seemingly good result came from fact that these patients’ response to the placebo decreased, rather than any notable increase in their response to antidepressants.
Is this just one more case of overmedication due to irrespossible advertising and the need of doctors to "do something"?

Posted by at 9:58 AM | Permalink | Comments (1)

From the NIH today we find that getting older is less likely to be associated with declining memory. Rates of cognitive impairment among older Americans are on the decline, according to a new study supported by the National Institutes of Health (NIH) comparing the cognitive health of older people in 1993 and 2002. Higher levels of education were associated with better cognitive health.
The report appears in Feb. 20, 2008, issue of Alzheimer's & Dementia (now online). The National Institute on Aging (NIA), part of the National Institutes of Health (NIH), and Harvard University, funded the study conducted by Kenneth M. Langa, M.D., Ph.D., and colleagues at the University of Michigan, University of Pennsylvania, and Group Health Cooperative of Puget Sound in Seattle. The National Institute of Mental Health (NIMH), also part of NIH, provided additional support.

Posted by at 11:30 AM | Permalink | Comments (0)

In an editorial in the current Archives of Internal Medicine William J Hall discussed papers by Dellara F. Terry, Yates and himnself, and others. about more people living to 100 through a combination of genes and personal habits such as moderate diet and alcohol use, not smoking, moderate exercise, sufficient rest, an active brain and early secondary prevention of common chronic diseases. There were no magic potions, no magic pills, no complementary medicine. Just a careful approach to living. At the same time we must consider the impact of large numbers of nonagenarians and cetenarians who may not have good retirement plans and will need social support systems which are inneffective at best, currently. This is a two edged blessing.

Posted by at 9:10 AM | Permalink | Comments (1)

In a study researchers report in the current issue of Obstetrics and Gynecology that more women are happier with the ring than the patch. “Although oral contraceptives are the most commonly used reversible form of contraception in the United States, continuation rates are only 40 percent at six months of use,” the authors write. In addition, prior studies have shown that in the third month of use, about half of women miss three or more pills each cycle, likely decreasing contraceptive effectiveness.

Posted by at 10:26 AM | Permalink | Comments (0)

The potential for analysis of the individual human genome is advancing rapidly, according to a report in the NY Times today. If the cost of sequencing a human genome can drop to $1,000 or below, experts say it would start to become feasible to document people’s DNA makeup to tell what diseases they might be at risk for, or what medicines would work best for them. A DNA genome sequence might become part of each newborn’s medical work-up, while sequencing of cancer patients’ tumors might help doctors look for ways to attack them. This would be a great translation of research into prevention practice.

Posted by at 9:28 AM | Permalink | Comments (0)

A Japanese study, published in the British Journal "Cancer" today, again refutes the claims by health activists that using cell phones will cause cancer. Researchers found that regular mobile phone users were not at an increased risk of three types of brain cancer. Although a few studies have shown an association between mobile phones and cancer, the majority found no link. The largest study to date, involving 420,000 people, showed no link with any type of cancer, even after 10 years of use.

Posted by at 9:52 AM | Permalink | Comments (0)

New research shows that cigarette smokers are four times as likely as nonsmokers to report feeling unrested after a night’s sleep. The study, appearing in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians

Posted by at 9:22 AM | Permalink | Comments (0)

The Washington Post today reports on a medical economist's research in Holland that purports to show that healthy people are a drain on the state's economy! The reason being that smokers and obese people die early and thair overall cost to the state is less!. So, what are we supposed to do? All smoke and overeat so we die sooner? SIlly research and bad policy, but Aldous Huxley would love it.

Posted by at 9:10 AM | Permalink | Comments (0)

Two news researach projects have found significant ways toi improve pregnancy outcome.
Researchers at the University of North Carolina-Chapel Hill found that administering magnesium sulfate intravenously could not only "halt [early] contractions" and preeclampsia, but it is also believed to reduce blood vessel constriction in the infants' brains. Treatment was associated with a 50% reduction in cerebral palsy.
A University of Texas Medical Branch team has found that folic acid "might cut the chances of delivering a premature baby by half or more.

Posted by at 9:35 AM | Permalink | Comments (1)

Yet another study, this one from the University of Rochester, has demonstrated rapid clearance of ethyl mercury from the body and total lack of harm from use fo thimerasol in vaccines. The study showed that blood levels of ethyl mercury in children who received vaccines with thimerosal were "only a tenth as high as expected." While we do not know the cause of autism yet, it is time for parents of children with autism to stop blaming the health system for causing it.

Posted by at 9:18 AM | Permalink | Comments (1)

Do we really need another poor study on how coffee can harm us? All the previous studies, on further follow-up showed such studies were flawed. Coffee consumption is almost universal, the use of recall is inneffective, biological plausability is minimal, and controlling for varied use while mathematically possible does not work in practice. Of course it makes headlines for activists who want something to shout about, and wastes resources in replication with better studies which will fail to show any effect.

Posted by at 11:40 AM | Permalink | Comments (0)

An article in this week's JAMA [JAMA. 2008;299(3):316-323] and an accompanying editorial [JAMA. 2008;299(3):341-343] are worth reading. They a provide a balance to the newsmedia hoopla. We all know that Type 2 diabetes is mainly the result of obesity. With stomach surgery to restrict food intake it is hardly surpriing that diabetes tests should indicate rapid improvement. Prior intervention included sromach stapling which is more intrusive than banding.As expected, the surgical group lost more weight than the medical/behavioral group (20.7% vs 1.7%), and the amount of weight lost was the dominant predictor of diabetes remission. The percentage weight loss generally required for diabetes resolution was 10%, which was achieved in 86% of surgical patients but in only 1 patient in the medical group. Behavioral intevention continues to be disappointing. The JAMA editorial notes that It is time for a major shift in the way the health care community considers diabetes treatment goals.
This is an instance in which surgery may be more effective and lasting than medical treatment.

Posted by at 11:03 AM | Permalink | Comments (1)

A new study at Johns Hopkins Chidren's Center suggests that people exposed to toxoplasma had a 24 percent higher risk of developing schizophrenia. The study was small. Not an unbiased population sample, and needs repicating in a large population that is representative. Don't rush out to kill all the cats yet.

Posted by at 9:41 AM | Permalink | Comments (2327)

Forty years ago Anne Somers and Lester Breslow published an important study carried out in Alameda County which showed the relationship between longevity and habits among men wiht an increased longevity of 11 years.. Now a similar study has been carried out at the University of Cambridge Institute of Public Health with similar results; four health behaviours combined predict a 4-fold difference in total mortality in men and women, with an estimated impact equivalent to 14 years in chronological age. These behaviors were not smoking, moderate use of alcohol, regular exercise and eating 5 servings of fruit and vegetables a day. Even after forty years, as a population we cannot learn to change our behaviors.

Posted by at 10:35 AM | Permalink | Comments (1)

Researchers at The Warren Alpert Medical School of Brown University have created a first-ever educational video on rapid HIV testing. The video – available for free online – is aimed at increasing testing rates and slowing the spread of HIV/AIDS, one of the deadliest epidemics in recorded history

Posted by at 9:37 AM | Permalink | Comments (0)

Another study, published this week in the Annals of Internal Medicine [NIH-AARP Diet and Health Study; Arch Intern Med. 2007;167(22):2461-2468], again confirms the value of a mediterranean style diet and exercise in reducing the chance of death within the next 5 years.

Posted by at 10:51 AM | Permalink | Comments (2)

A 'Perspective' article in today's NEJM [Volume 357:2321-2324 December 6, 2007 Number 23] expresses concern about the inabiity of the FDA to stop the marketing of products determined to be useless, compared to placebo, but dangerous to children, and is worth reading carefully. In recent weeks, over-the-counter cough and cold medications for children have received unprecedented attention from regulators, physicians, the media, and parents. This scrutiny represents a long-overdue reassessment of products that were purchased by 39% of U.S. households during the past 3 years.1 It also reflects an important evolution in the standard of evidence for medications used in children.

Posted by at 2:10 PM | Permalink | Comments (0)

From the American Institute for Cancer Research, a document developed over five years and involving the work of nine teams of researchers, a panel of 21 experts and 82 peer reviewers, the expert report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, presented evidence from 7,000 studies recommends.
1. Choose Mostly Plant Foods, Limit Red Meat and Avoid Processed Meat.
2. Be Physically Active Every Day in Any Way for 30 Minutes or More.
3. Aim to Be a Healthy Weight Throughout Life.

Posted by at 11:10 AM | Permalink | Comments (0)

The use of a pedometer and a Web site that tracked physical activity levels proved to be powerful motivators for people with diabetes who participated in a recent walking study conducted by researchers from the University of Michigan Health System and VA Ann Arbor Healthcare System. The study also suggests that certain types of goal-setting may be more effective than others.

Posted by at 11:21 AM | Permalink | Comments (0)

Despite news media excesses and actions of tort lawyers, women who receive silicone gel-filled breast implants do not have a higher risk of breast cancer or other cancers and do not experience lower survival rates after breast cancer diagnosis, according to a new report published in the November issue of Annals of Plastic Surgery. This is the first exhaustive review in almost a decade of the health effects of cosmetic breast implants. This is one more study that should caution the public and the courts about a rush to judgement based on mass media hysteria and activist statements. The courts are not the place to test scientific data.

Posted by at 9:28 AM | Permalink | Comments (0)

The quantity of alcohol consumed, and not the type consumed, is an indicator of increased breast cancer risk in women, according to Kaiser Permanente researchers who presented their findings Sept. 27 at the European CanCer Organization’s annual conference. In addition, the increased breast cancer risk fro