Archive for November, 2006
Many women who are postmenopausal must deal with the silent condition of osteoporosis, or bone density loss. Unless she has had bone density scans, a woman may not realize she is at risk until she suffers a hip or wrist fracture after falling.
Physicians have varying opinions as to when to begin treatment with a bisphosphonate such as Actonel or Fosamax. Some prescribe one of these drugs when the first signs of bone loss become evident for a condition called ostopenia. When bone density has been reduced to a certain level, the diagnosis is osteoporosis. At that point, drug therapy is definitely needed on a long-term basis to strengthen bones and help prevent fractures.
In a recent study, researchers analyzed insurance records for 12,215 postmenopausal women taking Actonel and 21,615 women on Fosamax. All were 65 or older and were starting their drug regimen for the first time.
After treatment for a year, the group taking Actonel had 43% fewer hip fractures and 18% fewer non-spine fractures than women taking Fosamax. Even at six months, significantly lower rates of fracture were found in the women given Actonel.
Researchers concluded that Actonel works faster, although Fosamax may give equal benefits over the long term. This study was not a true clinical trial and therefore does not provide conclusive proof. Actonel was rated number one, with Fosamax a near second. The once-a-month pill Boniva was a distant third, as it has not been shown to reduce hip fracture.
Some women tolerate one drug better than the other. For this reason, those with distressing symptoms on Actonel might be placed on Fosamax as a comparison. Sometimes insurance will cover one and not the other, which is another consideration.
These drugs should not be discontinued simply because they do not cause a woman to feel better. Most persons with bone density problems will need to take them well into old age for maximum protection. Men can develop osteoporosis, too, but it is far less common. Getting adequate calcium and vitamin D are important, but if these measures do not prevent bone thinning, treatment with a bisphosphonate is needed.
For many women, scrupulous long-term use of the medication results in building more bone mass, not just preventing more thinning. Regular walking for exercise can help to maintain bone density or slow the demineralization process. A hip fracture can be a life-threatening event if the hip doesn’t heal properly and the individual cannot resume the ability to walk or get out of bed.
Source:Â WebMD
November 28th, 2006
In early studies, an experimental device resembling a tiny pacemaker has been shown to control blood pressure more effectively than medications. For 10 to 15% of patients with high blood pressure, medications are not helpful.
High blood pressure consists of a reading of 140/90 mm Hg or higher. Also called hypertension, high blood pressure is a major risk factor for heart disease or stroke.
The new “pacemaker-type†device is currently being studied by the chief of vascular surgery at the University Hospital in Berne, Switzerland, in patients who do not respond to available medications.
Surgeons place electrodes outside the carotid artery and implant an internal pulse generator into the chest wall. Using electrical current to stimulate the carotid sinus, messages are sent to receptors in the brain. Preliminary results have shown remarkable results in a swift drop of blood pressure.
The first 16 patients experienced an average drop of 29 millimeters of mercury after receiving the new device. In patients taking drugs, reducing their blood pressure by
9 millimeters is considered an outstanding result. Researchers call the device, developed by Minneapolis-based CVRx, “very promising.â€
Source: Oakland Tribune    November 2006
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November 24th, 2006
An inexpensive new test uses computer technology to gauge the risk of sudden cardiac death. The test of the heart’s electrical system in individuals with history of heart damage helps doctors decide who needs an implanted cardioverter defibrillator (ICD).
When a person with an ICD experiences dangerously abnormal cardiac rhythm, the device delivers an electrical jolt that shocks the heart back to normal rhythm. Sudden cardiac death kills about 325,000 adults in the U.S. each year – primarily persons who do not have the implanted device.
Until now, cardiac screening of large populations for risk of sudden cardiac death has been expensive and impractical. This new technology could make such screenings more affordable and feasible.
A study involving 500 patients with some heart damage using the more invasive electrophysiological screenings as well as the new, computerized technology came to a close recently. The new testing techniques proved to be just as accurate, according to a professor of medicine at the American Heart Association’s annual meeting.
In the older test, a catheter is inserted through a small incision in the vein and threaded to the heart to measure electrical activity. The new test, called the microvolt T wave alternans (MTWA), measures the electrical discharge of a person’s T-waves from one beat to the next. This individualized risk information allows doctors to determine which patients might benefit from an implanted ICD.
The predictive accuracy of both tests is comparable. The main difference is that the latest test is simple, noninvasive and cheap, while the other is invasive, expensive and risky. In complicated cases, some doctors use both tests. When both technologies confirm the need for an ICD, the surgery is performed.
Physicians hope that in the future, the newer technology may be able to replace electrophysiological screening altogether. At this point, two tests are still better than one.
Source:Â WebMD
November 22nd, 2006
Doctors were surprised at the results of a five-year study of over 2,000 patients in 27 countries. All had one blocked artery and received either an angioplasty or medications to reopen a closed artery within 3 to 28 days after a heart attack. The consensus reached was that angioplasty should be performed very early in the course of a heart attack, preferably within the first 12 hours, to be most effective.
Four years after the heart attack, in study participants who had a delayed angioplasty, 17% of them had died, suffered another heart attack or developed heart failure. Nearly 16% of the group taking drugs without the surgery had the same adverse effects as the group receiving angioplasty. Results could be considered statistically the same.
When angioplasty is performed during the first 72 hours of a heart attack, the procedure saves many lives, especially when clot-dissolving drugs are not effective. But angioplasty performed weeks or months after a vessel becomes blocked apparently produces results no better than taking standard medications.
Balloon angioplasty is done by threading a catheter through the groin to the blocked artery to reopen it and putting in place a mesh stent to keep the vessel open.
Nearly 1 million heart attacks occur in the U.S. annually. If you suspect a heart attack, don’t stay home and take antacids. Go immediately to emergency, and do not try to drive yourself there.  Â
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Source:Â WebMD
November 20th, 2006
An advanced radiation therapy called intensity modulated radiation therapy (IMRT) appears to cause fewer side effects in men with early prostate cancer. With IMRT, multiple radiation beams target the prostate from many directions, while doctors adjust the strength and intensity of the beams. Sensitive surrounding organs such as the bladder and rectum are less likely to be affected using the newer technology.
A study at a Philadelphia Cancer Center compared results in 216 men who received IMRT to 158 men who received the more traditional radiation seed implant therapy. Before treatment, all had a cancer at low risk of spreading beyond the prostate.
In radiation seed implant therapy, or brachytherapy, tiny radioactive seeds are implanted by surgeons into the prostate glad where high-dose radiation is delivered for a specified length of time.
Both treatments are effective and safe. The side effects and quality of life are important factors in choosing a therapy. In general, men with enlarged prostates or who have poor urinary function or diabetes do better with IMRT than radiation seed implants.
Men treated with the newer method of therapy were less likely to need catheters to help them urinate, researchers determined. After three months, only 0.5% of men on IMRT compared to 4% with radioactive seeds still needed a urinary catheter.
In another comparison, 97% of those receiving IMRT were cancer-free four years later, compared to 86% of men who had radioactive seeds. These results were measured by blood tests for prostate specific antigen (PSA), in which rising levels can signal a recurrence of cancer. The PSA levels in the second group were negligible or not significant.
Both IMRT and seed implant therapy offer excellent outcomes with low toxicity, according to a lead researcher at the Cancer Center.
Source:Â WebMD
November 15th, 2006
We have known for some time that steroid abuse causes behavior changes such as aggressiveness, uncontrollable rages and suicidal tendencies. A recent study using brain cells in lab dishes showed that too much testosterone can kill brain cells through a process called apoptosis.
Testosterone in large doses can cause cells to self-destruct and produce a process similar to brain deterioration in Alzheimer’s Disease or Huntington’s Disease.
Athletes or others who resort to steroids may risk incurring damage to their minds and body functions that can’t be reversed. High levels of steroids are converted to extra testosterone in the body, and large doses of testosterone can destroy nerve cells.
Athletes who wish to gain a competitive advantage through steroid use should have second thoughts, even though it can build muscle mass and aid in quicker recovery after exertion.
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Source:Â CNN.com
November 14th, 2006
Over 500 new energy drinks, similar to industry-leader Red Bull, entered the worldwide market this year. In the U.S. alone, about 7.6 million teens – about one in three adolescents – admit to consuming energy drinks. Most brand names are advertised to attract males in their twenties.
Some young people report downing several cans in a row to get high. They run the risk of getting hooked on an unhealthy jolt-and-crash cycle. Numerous poison centers report getting calls from young people who became sick from too much caffeine. Undesirable side effects can include heart palpitations (rapid or irregular heartbeat), or numbness and tingling in hands and feet.
The most alarming new trend is mixing caffeine with alcohol in new “energy beers.†Some bartenders mix Red Bull and vodka for their customers who request a Friday Flattener. A high potential exists for accidents and alcohol poisoning from consuming these types of beverages. Studies of college students show that may not feel as drunk as they actually were.
Other dangerous combinations are alertness pills such as NoDoz and energy drinks, sometimes mixed with alcohol or other drugs. A trip to the hospital emergency department may result.
Consumers need to remember that caffeine is a drug and should be used with caution. Although energy drinks are in smaller cans than Coke, they contain two to four times the amount of caffeine than the 12-ounce Coke. Even more dangerous, some energy drinks are now being produced in ever larger sizes – up to 24 ounces.
These energy drinks are the equivalent of Starbuck for kids. Loaded with caffeine, they give you essentially a legal form of speed – but not without health risks.
Source:Â CNN.comÂ
November 5th, 2006
The Center for Disease Control voted in October to make vaccination with the FDA-approved Zostavax shingles vaccine routine for all Americans 60 and older.
The older generation did not have the benefit of the chicken pox vaccine, now available to children and teens or older persons who never had the viral disease. Chicken pox was once a common disease of childhood.
Shingles will afflict about 20% of people who had chicken pox. For those who live to be 85, their chance of getting shingles rises to 50%.
A major clinical trial indicated that Merck’s Zostavax vaccine is more than 60% effective in minimizing shingles symptoms. It reduces painful PHN by 60% or more.
Shingles is caused by a herpes-type virus that remains dormant in the nerves until the individual’s immune system is suppressed due to aging, disease or immunity-suppressing drugs. An outbreak appears as clusters of red blisters above an underlying nerve path. It can vary considerably in size, severity, and length of time before it heals.
In about 30% of cases, shingles turns into an excruciatingly painful disease called postherpetic neuralgia (PHN). A smaller number get a painful disease called ophthalmic zoster which can cause blindness in one or both eyes. The worst part is not going blind, but the accompanying all-consuming pain experienced every moment without relief for years.
The patient’s and family’s lives are profoundly affected by this horrible affliction.
Severe cases of PHN pain can cause some to commit suicide to escape the unremitting pain.
Everyone 60 and over should welcome the opportunity to get the vaccination.
Medicare and Medicaid Part D are expected to cover the cost of the vaccination.
Source:Â WebMD
November 1st, 2006
