MedNews

You are here: Home / Archives for Health & Medical News

Male Medicare Patients Get Implantable Cardioverter-Defibrillator 2-3x More Often Than Females

By Leave a Comment

Male Medicare patients are 2-3 times more likely than females to receive an implantable cardioverter-defibrillator for the prevention of sudden cardiac death, according to a study in the October 3 issue of JAMA.
Sudden cardiac death is a leading cause of death in the United States. Overall, the risk of sudden cardiac death increases with age and is higher in men than in women, although the sex difference narrows and eventually disappears after age 85 years, according to background information in the article.

Research has shown the effectiveness of implantable cardioverter-defibrillators (ICDs) in preventing sudden cardiac death, and Medicare coverage of ICDs has expanded, but many eligible patients still do not receive them.
Lesley H. Curtis, Ph.D., of Duke University School of Medicine, Durham, N.C., and colleagues examined the differences between men and women in the receipt of ICDs for the primary and secondary prevention of sudden cardiac death. Data for the study came from a five percent national sample of files from the U.S. Centers for Medicare & Medicaid Services for the period 1991 through 2005.

Patients in the study were age 65 years or older with Medicare fee-for-service coverage and diagnosed with a heart attack and either heart failure or cardiomyopathy (a disorder of the heart muscle), the primary prevention cohort: 136,421 patients; n = 65,917 men and 70,504 women; or with cardiac arrest or ventricular tachycardia (a cardiac arrhythmia), the secondary prevention cohort: 99,663 patients; n = 52,252 men and 47,411 women, from 1999 through 2005.
In the 2005 primary prevention group, 32.3 per 1,000 men and 8.6 per 1,000 women received ICD therapy within 1 year of entering the study.

Men in this group were about 3.2 times more likely than women to receive an ICD. Among men and women alive at 180 days after group entry, the risk of death in the subsequent year was not significantly lower among those who received ICD therapy.
In the 2005 secondary prevention group, 102.2 per 1,000 men and 38.4 per 1,000 women received ICD therapy. After controlling for various factors, men in this group were about 2.4 times more likely than women to receive ICD therapy. Among men and women alive at 30 days after entry in this group, the risk of death in the subsequent year was 35 percent lower among patients who received ICD therapy.
Findings in this cohort of elderly patients differ from an earlier study that suggested a narrowing of the gap between men and women, and they highlight the need for an improved understanding of sex differences in patterns of care," the authors conclude.
Source: JAMA. 2007;298(13):1517-1524.

Flu Shot Decreases Elderly Death Risk by Half Says Study

By Leave a Comment

A recent study published in The New England Journal of Medicine indicates that seniors over 65 who get the flu vaccine cut their risk of influenza death in half, and that vaccination lowers hospitalization rates by 27 percent.

Approximately 36,000 deaths and 200,000 hospitalizations are attributed to the flu each year in the United States.

The study, lead by Dr. Kristin Nichol, from the Minneapolis VA Medical Center, was conducted on approximately 300,000 unvaccinated and 415,000 vaccinated seniors over the age of 65 from three different HMO’s over 10 years.

Interestingly, this study contradicts one that was released just last week that indicated results of flu vaccine effectiveness were exagerated. Dr. Nichol’s study attempted to address some of the discrepancies.

 

Source: The New England Journal of Medicine, October 4,
2007.

 

Conscientiousness May Help Protect Against Alzheimer’s Disease

By Leave a Comment

Results of a recent study about the link between conscientiousness and Alzheimer’s disease may provide yet another strategy for delaying the symptoms of Alzheimer’s, according to a study published in the October issue of Archives of General Psychiatry.


Conscientiousness, which generally refers to a person’s ability to be goal-directed and control impulses, has been associated with various mental and physical disorders. In the published study, which ran from 1994 to 2006 and studied nearly 1,000 older individuals, participants were evaluated for medical history, neurologic examinations and cognitive testing.

The "conscientiousness score" was determined with a 12-items evaluation where participants rated their agreement with a number of statements, such as: “I am a productive person who always gets the job done." Those who had conscientiousness scores in the top 10% had an 89% lower risk of developing Alzheimer’s disease than those whose scores ranked in the bottom 10% of the conscientiousness score.

The study’s author’s posit that conscientious people are more likely to be succesful in education and work, both of which have been associated with a reduced risk of Alzheimer’s disease. In addition, conscientiousness has been linked to resilience and to coping actively with difficulties. “These factors might lessen the adverse consequences of negative life events and chronic psychological distress, which have been associated with risk of dementia in old age,” the researchers note.

The study concludes that the "level of conscientiousness is associated with incidence of mild cognitive impairment and Alzheimer’s disease but not with the pathologic hallmarks of these conditions."

 

Source: Arch Gen Psychiatry. 2007;64(10):1204-1212.

Vision and Hearing Impairment May Contribute to Depression in Seniors

By Leave a Comment

It is commonly known that hearing and vision impairment are much more pronounced in the elderly population. With the gradual onset of hearing and vision loss, certain tasks become more difficult for seniors.

In addition to the direct difficulties, such as having trouble reading smaller type or understanding conversations, hearing and vision loss is also associated with the development of mood disorders, according to Dennis Norman, Chief of Psychology at Massachusetts General Hospital.

"Vision and hearing loss are major public health issues because they affect so many older individuals, and because they have an adverse impact on mental health," says Norman. "If the senses are limited, everything is affected, including interaction with surroundings, relationships, activities, and feelings of self-worth. Impairment can lead to depression, anxiety, social isolation and many other problems."

According to the Centers for Disease Control, approximately 3.6 million Americans over the age of 70 have impaired vision, and 6.7 million older adults report impaired hearing.

The CDC also indicates that these individuals also are more likely to experience problems in other activities of daily life, such as walking, going outdoors, getting in and out of chairs or bed, or managing their prescription medications. They are also less likely to socialize than individuals without sensory impairment.

A recent study reported in Archives of Ophthalmology (April 2006) also suggests that there’s a significant link between visual problems and thinking, memory and learning.

Hearing impairment has also been linked to cognitive decline. Brandeis University researchers suggest that mental resources are expended toward efforts to hear, at the expense of memory.

Preventive Measures to Protect from Hearing and Vision Impairment

  • Wear sunglasses to reduce exposure to UV radiation
  • Protect ears by avoiding loud noises, wearing earplugs, and keep earphone volume down
  • Stay healthy with regular medical checkups, quitting smoking, and managing conditions such as diabetes and high blood pressure that can damage eyes and/or ears.
  • Maintain a healthful diet: Get plenty of vitamin C through citrus fruits and juices; eat carrots and dark-green leafy vegetables such as spinach for beta-carotene; eat whole grains, nuts, and eggs for vitamin E; and get needed zinc from fish, meats, whole grains and dairy products. For nutrients that strengthen or protect hearing, eat foods rich in: vitamin D (fortified dairy products, seafood, fortified cereals); vitamin B12 (meat, poultry, eggs, dairy products and shellfish); and folate (liver, eggs, beans, fortified cereals, leafy green vegetables, and fruits).
  • Consider supplements. Ask your doctor about taking supplements such as bilberry (huckleberry), ginkgo biloba and vinpocetine.

Helpful Resources
These groups offer support and information to help people cope with hearing and vision impairment:

Source: Newswise

Pregnancy After Breast Cancer

By Leave a Comment

While many women who go through breast cancer do so in their 50’s and are no longer considering childbirth, women who are treated for breast cancer at a younger age are often left wondering whether or not they will be able to have children afterwards.

Breast cancer treatments often involve chemotherapy regimens that can affect ovarian function, but according to Daniel F. Hayes, an M.D. and clinical director of the breast cancer oncology program at the University of Michigan, many women can still safely conceive after breast cancer treatments.

Fertility is certainly a concern for women undergoing breast cancer treatment and Dr. Hayes points out that fertility is definitely something that should be discussed before treatment. "That discussion is going to be specific for each patient," he notes, "because it depends how old she is, whether she should get chemotherapy, what kind of chemotherapy, and whether she cares about maintaining fertility."

Ovarian function can be affected by multiple factors in breast cancer treatment—particularly chemotherapy. While most chemotherapies negatively affect ovarian function, younger women have a better chance of regaining their periods after treatment than their older counterparts who may be closer to menopause.

Other therapies that affect fertility are the newer hormone-based therapies, which are often given for up to five years. To become pregnant, women would have to stop taking the hormone therapy for a period of time before conception. Dr. Hayes discourages this course however, because, he says, the benefits of the therapy are so great.

 Studies have shown that there should be little worry that breast cancer treatment therapies have an adverse effect on the newborn children. The risk of birth defects or miscarriages was not shown to be elevated among women who have undergone chemotherapy.

Some Breast Cancer Facts

  • Number of American breast cancer diagnosis in 2007: 180,510
  • U.S. deaths from breast cancer in 2007: 40,910
  • Breast cancer is the #3 leading cause of female deaths in the United States.
  • With early detection, breast cancer can be cured in 80 percent of women.
  • It is recommended that women over 50 get a mammogram every 12 months.
  • Never ignore a lump or change in the look or feel of your breast.

Deaths Linked to Cephalon’s Cancer Pain Drug, Fentora

By 1 Comment

After receiving reports of deaths and other serious side effects, FDA is alerting consumers and health care professionals to concerns about the use of Fentora (fentanyl buccal) tablets, a potent opioid pain medication.

Fentora is used only for treating breakthrough pain in cancer patients receiving opioid treatment and who have become tolerant to it—those who take a regular, daily, around-the-clock narcotic pain medicine. Breakthrough pain is intense increases in pain that occur rapidly, even when opioid pain-control medication is being used.

People who develop tolerance to narcotic pain medicines are more resistant to the dangerous side effects of these medications than those who take narcotic pain medication less frequently.

The deaths reported indicate that some cancer patients

  • should not have been prescribed this medicine
  • were prescribed the wrong Fentora dose
  • took too many Fentora doses
  • received Fentora as a substitute for another fentanyl-containing product that is not equal to Fentora

Important Safety Information

  • Ask your doctor if you are opioid-tolerant before taking Fentora. The drug should only be used for breakthrough pain in opioid-tolerant patients with cancer.
  • Fentora should not be used to treat any type of short-term pain, including headaches or migraines, pain after an operation, or pain due to injury.
  • People who only take narcotic pain medications occasionally should not use Fentora.
  • Do not substitute Fentora for other fentanyl medicines, including Actiq. The dosage strength of fentanyl in Fentora is NOT equal to the same dosage strength of fentanyl in other fentanyl-containing products. Using the same dose can result in a fatal overdose.
  • Read the Medication Guide that comes with Fentora,and follow the directions exactly.

Watch For These Signs

Get medical attention right away if you have any of these signs:

  • trouble breathing or shallow breathing
  • tiredness, extreme sleepiness, or sedation
  • inability to think, talk, or walk normally
  • feeling faint, dizzy, or confused

FDA Actions

  • requested the manufacturer, Cephalon Inc., strengthen warnings and improve the dosing instructions in the drug’s product labeling and Medication Guide for patients
  • requested the company improve their education plan for prescribers and pharmacists
  • published a Public Health Advisory and Health Care Professional Sheet warning health care professionals that it is critical to follow Fentora’s product labeling
  • monitoring the Fentora issue closely and reviewing available information, including adverse events
  • working with the manufacturer to ensure the safest use of the medicine
  • providing updates as new information is available

Adverse events related to Fentora should be reported to MedWatch, the FDA’s voluntary reporting program.

Source: FDA

The Eating Disorder Center of Denver Appoints New Medical Director

By Leave a Comment

(Denver) — The Eating Disorder Center of Denver is pleased to announce the appointment of Carolyn C. Ross, MD, MPH, as medical director. Prior to joining the Eating Disorder Center of Denver, Dr. Ross was the chief of the eating disorders program and head of integrative medicine at Sierra Tucson, AZ.

"The medical director position at the Eating Disorder Center of Denver offers a unique opportunity for me to offer patients their distinctive partial hospitalization experience,” said Dr. Ross. “The ‘real world/empowerment’ model at the center is very much in line with my own philosophy and what I have seen to be effective in treating eating disorders. I’m excited about joining such a well respected program as the Eating Disorder Center of Denver and am looking forward to working with the qualified staff there,” she continued.

Dr. Ross received her medical degree from the University of Michigan and completed a residency in preventative medicine at Loma Linda University of California. She also completed a two-year fellowship at Dr. Andrew Weil’s program in integrative medicine at the University of Arizona and served as medical director for The Rader Institute’s inpatient eating disorders program at Sharp Cabrillo Hospital in San Diego.

Specializing in women’s health issues, Dr. Ross opened three women’s integrative medicine centers in San Diego, CA, offering both primary care for women and complementary and alternative medicine modalities. She is a nationally known speaker, researcher and writer, authoring numerous articles and two books titled Miracles in Healing and Healing Body, Mind and Spirit: An Integrative Approach to the Treatment of Eating Disorders.

“Dr. Ross’s interest in integrative approaches to the treatment of eating disorders, which take into account mind, body and spirit in the healing process, works well with the treatment model used at the Eating Disorder Center of Denver,” said the Center’s Clinical Director Tamara Pryor, PhD. “We receive referrals from all over the country of patients who have very severe eating disorders. Our bio-psycho-social and spiritual treatment approach empowers our patients to change their eating disordered behaviors and begin the recovery process,” she explained.

Founded in 2001, the Eating Disorder Center of Denver offers the highest level of care for adults with anorexia nervosa, bulimia nervosa and related eating disorders in the State of Colorado. Services include a partial hospitalization program, which consists of 11 hour days, 7 days a week. This highly structured program provides medical and psychiatric evaluation and follow-up, individual therapy, family/couples therapy, group therapy, psycho-educational groups and nutrition therapy, including three meals and two snacks per day. Housing is available. In addition to partial hospitalization, the Center provides an evening intensive outpatient program four hours a night, three days a week, and outpatient services for patients who do not need as much structure and support in the treatment of their eating disorders.

For more information on the Eating Disorder Center of Denver, call 866.771.0861 or visit the Center’s web site at www.edcdenver.com.

Turtles as Pets Increase Risk of Salmonella

By Leave a Comment

The Centers for Disease Control reported a series of incidents in which pet turtles infected individuals with Salmonella, including one death. All of the incidents were linked to small turtles, which are particularly risky since their size makes them "ideal" gifts to children by well-meaning parents who understand little of the risks they pose.

In the CDC’s MMWR, twenty two cases of Salmonella were reported during the years 2005 and 2006. The fatality occurred in a three month old infant.

According to the CDC, basic hand-washing after turtle contact is a public health necessity (as is the obvious precaution of not letting the turtles get anywhere near food prep areas), The best precaution is not getting the turtles at all.

Source: CDC MMWR – 2007

HPV Vaccine Not Effective for Treating Genital Warts in Women

By Leave a Comment

For women with human papillomavirus (HPV) infection, use of the HPV-16/18 vaccine will not accelerate reduction of the virus and should not be used to treat the infection, according to a study in the August 15, 2007 issue of JAMA.

HPV vaccines were designed to prevent HPV infection and the development of cervical precancers and cancer. Some research has suggested that HPV vaccines could help clear the virus in women already infected, according to background information in the article.

Allan Hildesheim, Ph.D., of the National Cancer Institute, Bethesda, Md., and colleagues conducted a study to address the question of whether women positive for HPV DNA should be encouraged to receive HPV-16/18 vaccination to induce or accelerate clearance of their infections. The trial was conducted in two provinces of Costa Rica and included 2,189 women age 18 to 25 years who were positive for HPV DNA. Participants were randomly assigned to receive three doses of HPV-16/18 vaccine (n = 1,088) or a control hepatitis A vaccine (n = 1,101) over 6 months.

There was no evidence that HPV vaccination significantly altered rates of viral clearance. At the 6-month visit, rates of clearance were 33.4 percent vs. 31.6 percent for HPV-16/18 among participants who received the HPV vaccine and the control vaccine, respectively. At the 12-month visit, rates of clearance among participants in the HPV group and the control group, respectively, were 48.8 percent vs. 49.8 percent for HPV-16/18.

There was no evidence of vaccine effects with further analysis on selected study entry characteristics reflective of disease extent, including HPV-16/18 antibody results, cytologic results, and HPV viral load. Similarly, no evidence of vaccine effects was observed in analyses stratified by other study entry parameters thought to potentially influence clearance rates and efficacy of the vaccine, including time since sexual initiation, oral contraceptive use, cigarette smoking, and concomitant infection with Chlamydia trachomatis or Neisseria gonorrhoeae.

"These findings have important clinical implications. For example, in countries where HPV DNA testing is incorporated in cervical cancer screening and prevention efforts, adult women who have abnormal Papanicolaou test results induced by HPV infection and/or who test positive for an oncogenic HPV type using the clinically available HC2 test might be interested in receiving the HPV vaccine to treat their existent infection," the authors write. "…our results demonstrate that in women positive for HPV DNA, HPV-16/18 vaccination does not accelerate clearance of the virus and should not be used for purposes of treating prevalent infections."


Source: JAMA. 2007;298(7):743-753.

Taking Zinc for colds? Think Again

By Leave a Comment

In a paper by Stanford University Department of Pediatrics and Medicine, with the University of Virginia School of Medicine, and published in the Journal of Clinical Infectious Diseases, 105 published reports of zinc efficacy in warding off the common cold were studied.

Of the 105 articles reviewed, fourteen were randomized placebo-controlled studies—in other words, proper scientific studies. Of these fourteen studies, eleven featured the qualities of inquiry representative of a proper clinical trial.

In reviewing these eleven trials, the author’s concluded "this structured review suggests that the therapeutic effectiveness of zinc lozenges has yet to be established. One well-designed study did report a positive effect of zinc nasal gel."