Friday, May 31, 2002

Wine Good for Your Lungs
Research presented at the American Thoracic Society meeting recently in Atlanta showed that drinking one to three glasses of white wine a day improved lung function. Comment: another benefit of moderate drinking. Note, however, the previous pearl discussing research on whether it helped to take up drinking in middle or old age. That research found that starting to drink at a later age was not beneficial, although those who drank moderately since their 20's did benefit from moderate drinking. [ article ] posted by the Internet Medical Journal  22:15 GMT © medjournal.com

Nurse Initiated Thrombolysis Safe and Effective
Nurses working under guidelines and exclusions determined by consultant cardiologists were able to reduce the time from hospital presentation to initiation of thrombolytics in patients with an acute heart attack. Out of the 93 patients studied, 74 received thrombolytics within 30 minutes (80%) and in no case were thrombolytics given appropriately. Comment: medicine is a team sport. The problem with this study was that it compared administration of thrombolytics during different years. Over the entire study period from 1989 - 2001, more and more research became available stressing the need to give thrombolytics early. Thus, the improvement found may be simply due to greater awareness rather than anything the researchers did. [ article ] posted by the Internet Medical Journal  21:51 GMT © medjournal.com

Thursday, May 30, 2002

Hollywood Continues to Have Leading Actors Smoke
Hollywood continues to have a full quarter of all the major characters smoke cigarettes. The lead author of the research article on this subject, Dr. James D. Sargent of Dartmouth University, states that the movies (i.e. Hollywood) are giving tobacco firms free advertising, and promoting cigarette smoking especially among teens. Comment: earlier pearls document the connection between cigarette smoking by leading characters and an increase in teen smoking. [ article ] posted by the Internet Medical Journal  20:49 GMT © medjournal.com

Beating Alzheimer's Disease
This study in rats from the University of California Irvine found that "exercise-happy" rats had healthier brains. The researchers speculate that this is further proof of the benefits of exercise, and suggests that exercise may help prevent Alzheimer's Disease. Comment: the link to Alzheimers is purely hypothetical, but sounds plausible. [ article ] posted by the Internet Medical Journal  15:48 GMT © medjournal.com

Wednesday, May 29, 2002

More Evidence for Screening for Depression
This review of the literature dating back to 1966 found support for the US Preventive Services Task Force recommendation that screening adults for depression in primary care settings improves overall health care. Comment: this is a multi-center study from the University of North Carolina, University of Michigan, Research Triangle Institute, Robert Wood Johnson Foundation, and the University of Texas in San Antonio. [ article ] posted by the Internet Medical Journal  23:18 GMT © medjournal.com

US Preventive Task Force: New Recommendation for Depression Screening
The US Preventive Services Task Force has made a change from earlier recommendations from 1996, and now recommends screening for depression provided there are systems in place to facilitate accurate diagnosis, effective treatment, and proper follow-up. Comment: now that fluoxetine (Prozac) is a generic medication, getting patients to take an SSRI antidepressant is much easier. The recent governmental push to cover more mental health services will also help. [ article ] posted by the Internet Medical Journal  22:27 GMT © medjournal.com

Asthma Linked to High Ozone Levels
This study of 3535 children in 12 communities in southern California found that in communities with high ozone levels, children participating in strenuous outdoor activities were 2.5 to 4.7 times more likely to develop asthma. In communities with low ozone levels, participation in stenuous outdoor sports had little effect upon the development of asthma. Comment: this is another study that shows the harmful effects of air pollution in California. [Article] posted by the Internet Medical Journal  22:19 GMT © medjournal.com

D-dimer Test Negative Predictive Value = 99%
The semiquantitative D-dimer blood test in this study of 704 outpatients with suspected deep venous thrombosis had a sensitivity of 99% and a negative predictive value of 98%. The test is almost always positive (and thus not very helpful) in patients on anticoagulants and those over 70 years old. Comment: patients with a negative semiquantitative D-dimer test will only rarely need ultrasonography. A positive D-dimer test isn't very helpful, but a negative test will provide strong evidence against a deep venous thrombosis. [ article ] posted by the Internet Medical Journal  22:11 GMT © medjournal.com

California Seeks Fines Against Internet Pharmacy
The state of California is seeking $88.7 million in fines against a Los Angeles pharmacy for filling prescriptions without a good faith prior medical examination by a California licensed physician. The online pharmacy used online questionnaires to substitute for an examination by a licensed physician.Comment: I anticipate that this will be the first in a wave of lawsuits against Internet pharmacies. [ article ] posted by the Internet Medical Journal  03:41 GMT © medjournal.com

Tuesday, May 28, 2002

For-Profit Hospitals Shown to Have Higher Death Rates
This Canadian meta-analysis of 15 studies looking at 26 000 hospitals in the US found that private for-profit hospitals had a 2% higher risk of death compared with private non-profit hospitals.Comment: there are a lot of uncontrolled variables present in this type of meta-analysis and the conclusion of the study has to be looked at very skeptically. Nonetheless, it is suggestive, and the hypothesis is reasonable- that for-profit hospitals cut corners on staffing and supplies, which in result leads to a slightly higher risk of death. [ article ] posted by the Internet Medical Journal  17:10 GMT © medjournal.com

Diet Rich in Fruits and Vegetables Found to Decrease Blood Pressure
This Oxford study of 700 adults aged 25 to 64 found that those who ate at least five servings of fruits and vegetables a day resulted in a lowering of the systolic blood pressure by 4 mm Hg and the diastolic blood pressure by 1.5 mm Hg. Comment: this change in blood pressure is pretty small, however, it adds to the body of evidence that has show that a diet high in fruits and vegetables is good for you. [ article ] posted by the Internet Medical Journal  17:00 GMT © medjournal.com

Tadalafil Treats Erectile Dysfunction for up to 36 Hours
Tadalafil, promoted as a second-generation sildenafil (Viagra), has been shown in early research studies to allow men with erectile dysfunction to have intercourse up to 36 hours after taking the pill. Furthermore, as many as 40% of the patients who do not respond to sildenafil will respond to the newer medication. [ article ] posted by the Internet Medical Journal  03:25 GMT © medjournal.com

Children of Caring Mothers Less Likely to Use Drugs
This study from England found that a caring mother was the single most important factor in preventing children from taking drugs. of the 3984 teens studied, those with a close relationship to their mother, lived with both parents, and had good family relationships were much less likely to use drugs or alcohol. [ article ] posted by the Internet Medical Journal  03:16 GMT © medjournal.com

Depression Linked to Parkinson's Disease
A 25 year study from the Netherlands found that people with depression are three times more likely to develop Parkinson's disease. Comment: it is unclear whether depression can be a contributory factor causing Parkinson's disease, or whether depression is an early sign of Parkinson's. The researchers speculate that the latter is the case. [ article ] posted by the Internet Medical Journal  03:11 GMT © medjournal.com

Chemical in Broccoli Kills H.Pylori
H.Pylori, the bacteria that can cause stomach ulcers and even stomach cancer, can be killed by a chemical found in broccoli- sulforaphane. Comment: another reason to eat a diet high in vegetables. [ article ] posted by the Internet Medical Journal  03:06 GMT © medjournal.com