tag:blogger.com,1999:blog-56626736030947469052024-03-14T00:27:42.403-04:00Dr. Perry HookmanDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.comBlogger267125tag:blogger.com,1999:blog-5662673603094746905.post-48977020623689670802012-09-14T08:49:00.000-04:002012-09-25T08:50:22.966-04:00 Exercise training increases size of hippocampus and improves memory Aerobic exercise may help improve memory in older people <!--[if gte mso 9]><xml>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">A year of modest aerobic exercise reversed normal
brain shrinkage by one to two years in older adults and improved their memory
function, according to a study published in the Proceedings of the National
Academy of Sciences. As people age, the hippocampus, the brain's memory center,
loses 1% to 2% of its volume annually, affecting memory and possibly increasing
the risk for dementia. A growing body of evidence has pointed to aerobic
exercise as a low-cost hedge against neurocognitive decline. In this study,
magnetic resonance imaging was used to measure the effects of aerobic exercise
on the hippocampus in 120 Americans in their late 50s to early 80s. Half the
group walked three times a week for 40 minutes, aiming for their target heart
rate, while the other half did yoga and toning exercises. The hippocampus in
walkers increased by 2% after a year and shrank by 1.4% in controls. Both
groups showed significant improvements on spatial memory tests conducted before
and after the study. This could be due to taking the test repeated times, the
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<br /></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">Caveat: The study found that exercise had a selective
effect on the brain, influencing the volume of the anterior hippocampus but not
the posterior. Researchers suspect aerobic exercise might have the most effect
on regions of the brain that show the largest decline in late adulthood, such
as the anterior hippocampus. </span></div>
<br />
Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you
must visit your local doctor, with or without our article[s]. These
articles are not to be taken as individual medical advice.Please
remember, as <br />
with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com6tag:blogger.com,1999:blog-5662673603094746905.post-10500748565786543762012-08-13T08:47:00.000-04:002012-09-25T08:48:19.642-04:00Enterovirus infection and type I diabetes mellitus: systematic review and meta-analysis of observational molecular studies <!--[if gte mso 9]><xml>
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<br />
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">Type I diabetes: A virus that causes a host of
ailments ranging from mild respiratory illnesses to meningitis and polio was
found to be associated with the development of type I diabetes, especially in
children under 5, according to a meta-analysis in the British Medical Journal.
The global incidence of type I diabetes has been steadily increasing,
particularly the juvenile form of the disease. Previous studies have associated
enterovirus infections with type I diabetes and pre-diabetes autoimmunity but the
findings weren't conclusive. In this study, Australian researchers analyzed 24
studies and two abstracts published from 1965 to 2010 that involved a combined
total of 4,448 subjects who had undergone molecular testing for enteroviruses.
They found type I diabetics were almost 10 times as likely to have had a recent
enterovirus infection as non-diabetics and to experience persistent enterovirus
infections. Children with recent enterovirus infections had three times higher
risk for pre-diabetes. Researchers recommended further studies of the
environmental, geographical and genetic factors believed to play a role in the
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">Caveat: Other factors that weren't measured may have
influenced the risk of developing diabetes, such as cow's milk, vitamin D and
weight gain in infancy, researchers said. Also, there was uneven reporting
among the various studies of the methodology used to detect enteroviruses.</span></div>
<br />
Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you
must visit your local doctor, with or without our article[s]. These
articles are not to be taken as individual medical advice.Please
remember, as <br />
with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-82180552306764842792012-07-31T08:44:00.000-04:002012-09-25T08:45:31.671-04:00Jewish Ethnicity and Pancreatic Cancer Mortality in a Large United States Cohort Pancreatic Cancer: <br />
<br />
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">American Jews may be genetically predisposed to
developing pancreatic cancer, according to a study in Cancer Epidemiology,
Biomarkers and Prevention. Jewish ethnicity and pancreatic cancer have been
examined in four previous studies dating to the 1950s, three of which reported
higher mortality among Jews than non-Jews. This study is the first to consider
the known risk factors for pancreatic cancer—smoking, obesity and diabetes—and
the birthplace of Jews and their parents. Data were analyzed from an American
Cancer Society study that followed 1,014,625 men and women from 1982 to 2006.
Of the 6,727 deaths from pancreatic cancer during this period, 480 were among
Jewish participants. Deaths were 43% higher among Jews than non-Jews and didn't
vary significantly by age, family history or immigration background. Genetic
factors and non-O blood type may contribute to the higher mortality, the study
suggests. About 65% of U.S. Jews have non-O blood compared with 55% of white
non-Jews. Understanding the reasons why Jews are at greater risk for pancreatic
cancer may provide clues to its cause and lead to screening techniques,
researchers said.</span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: major-bidi;">Caveat: The study lacked information on Ashkenazi or
Sephardic Jewish origin. As the U.S. Jewish population is predominantly
Ashkenazi, the results may not generalize to Sephardic Jews, researchers said.
Information on the number of Jewish converts involved in the study wasn't
available.</span></div>
Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you
must visit your local doctor, with or without our article[s]. These
articles are not to be taken as individual medical advice.Please
remember, as <br />
with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-52291774540331680762012-07-16T07:24:00.000-04:002012-09-25T08:39:27.754-04:00Drug Deals with Medical Insurance Carriers Tie Prices to How Well Patients Do.<span style="font-family: Times New Roman;">So What’s in it for us?</span><br />
<br />
<span style="font-family: Times New Roman;">Pressed by insurance companies, some drug makers
are beginning to adjust what they charge for their drugs, based on how well the
medicines improve patients’ health, reports A. Pollack. “Think of it as product
guarantees by the drug industry.”</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">Traditionally, discounts and rebates that drug
companies offer insurers have been based on how much drug is used, not how well
patients do. But the emerging, outcomes-based contracts would — in theory —
better align the incentives of insurers, drug companies and the employers that
provide health coverage toward improving people’s health. Johnson &
Johnson set what is considered the prototype deal in 2007 with Britain’s
national health system, which had tentatively decided not to pay for the cancer
drug Velcade. To avert that decision, the company offered essentially a
money-back guarantee. If Velcade did not shrink a patient’s tumors after a trial
treatment, the company would reimburse the health system for the cost of that
patient’s drug.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">In a current deal Merck will agree to peg what
the insurer Cigna pays for the diabetes drugs Januvia and Janumet to how well
Type 2 diabetes patients are able to control their blood sugar. Also the two
companies that jointly sell the osteoporosis drug Actonel agreed to reimburse
the insurer Health Alliance for the costs of treating fractures suffered by
patients taking that medicine. “We’re standing behind our product,” said Dan
Hecht, general manager of the North American pharmaceutical business of Procter
& Gamble, which sells Actonel with Sanofi-Aventis. “We’re willing to put
our money where our mouth is.” Under the Actonel deal, if a patient insured by
Health Alliance suffers a nonspinal fracture despite faithfully taking Actonel,
the drug makers will help pay for the medical care — spending $30,000 for a hip
fracture, for instance, and $6,000 for a wrist fracture.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">This clearly lowers the cost of the drug to
Health Alliance, a small insurer in Illinois and Iowa. But Procter &
Gamble and Sanofi-Aventis might benefit as well. The deal could reduce the
pressure on the insurance company to move patients off Actonel, which costs
about $100 a month, to less-expensive generic versions of Fosamax. And the
insurer has kept Actonel in a tier of its drug list that requires a smaller
co-payment than for a competing brand-name drug, Boniva.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">Some experts hail such arrangements as a welcome
step toward health care that rewards good outcomes for patients. “We’re going to
see a growth in outcomes guarantees for pharmaceuticals, and it’s very healthy,”
said Robert Seidman, a consultant who was formerly the chief pharmacy officer
for WellPoint, an insurance company.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">Such contracts started to take hold a few years
ago in countries with national health systems, in which the government could
effectively block a drug from being used if it was too costly. In the United
States, where insurance companies do not have national monopolies — and where
Medicare, by law, is precluded from negotiating drug prices — insurers have less
leverage with drug makers. Even so, they can give favorable treatment to certain
drugs, by reducing the required co-payments, for example.</span><br />
<br />
<span style="font-family: Times New Roman;">The deal between Cigna and Merck is more
complex.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">Rather than getting paid more for good results,
Merck will actually give Cigna bigger discounts on Januvia and Janumet. Some
discounts will be granted if more people diligently take the drugs as
prescribed. This helps both Cigna, because people who take their pills are
likely to have fewer complications from the disease, and Merck, because it sells
more pills. The assumption is that Cigna will push for patient-compliance
programs that urge people to take their medicine at the right times and in the
proper doses.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">Moreover, in an unusual move, Merck will offer
even greater discounts to Cigna on Januvia and Janumet if patients’ blood sugar
is better controlled — regardless of whether the improvement comes through
Merck’s drugs or other medications. In effect, though, Merck is betting not only
that its drugs prove superior but that Cigna’s incentives to reap the benefits
of the deeper Januvia and Janumet discounts will prompt the insurer to try to
keep patients on those drugs. Januvia, approved in 2006, costs about $150 a
month. Janumet, approved a year later, is a combination of Januvia and
metformin, a widely used generic drug.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">As part of the agreement, too, Merck will get
better placement for Januvia and Janumet on Cigna’s formulary, meaning a lower
co-payment for patients than for some other branded drugs. The deal was made
with the pharmacy benefit management division of Cigna, which manages
prescriptions for 7.1 million people.</span><br />
<br />
<br />
<span style="font-family: Times New Roman;">So what’s in it for us patients?</span><br />
<br />
<span style="font-family: Times New Roman;">If this does not translate to our pocketbooks
there will be problems.</span><br />
<br />
<span style="font-family: Times New Roman;">We’ll wait and see if and how much this will
save we patients. </span><br />
<br />
<span style="font-family: Times New Roman;"> </span>Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you
must visit your local doctor, with or without our article[s]. These
articles are not to be taken as individual medical advice.Please
remember, as <br />
with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-21920889155085710592012-06-29T11:21:00.000-04:002012-07-30T11:22:39.590-04:00TOO MANY X-RAYS ARE HARMFUL<span style="font-family: Times New Roman;">CT scans is associated with significant radiation
exposure in some patients; the risks should be considered carefully when imaging
for chronic disease and when screening asymptomatic individuals .It is estimated
that 1.5-2.0% of US population cancers may be caused by CT radiation exposure. A
retrospective, cohort study at a tertiary academic medical center identified
31,462 patients undergoing diagnostic CT during 2007; and 190,712 CTs over 22
years. Estimated lifetime attributable risk (LAR) for cancer was calculated. In
this cohort, baseline cancer rates predicted 13,214 cancers and 6,292 fatal
cancers; 98 additional cancers (62 fatal) were predicted from CT.</span><span style="font-family: Times New Roman;"><span><strong> <br /><br />REFERENCE:
</strong></span>“Recurrent CT, Cumulative Radiation Exposure and Associated
Radiation-Induced Cancer Risks from CT of Adults” by Sodickson A et al.
Radiology 2009;251:175-184 Colonoscopy Prevents 15,000 Cancer Cases</span><br />
<br />
<span style="font-family: Times New Roman;"> </span>Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you
must visit your local doctor, with or without our article[s]. These
articles are not to be taken as individual medical advice.Please
remember, as <br />
with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-49466526401923665942012-06-13T09:45:00.000-04:002012-07-23T09:47:12.916-04:00Use Genetic Tests To Help Make Prescription Decisions<br />
<div style="line-height: 100%; margin-bottom: 0in;">
Medco Health
Solutions Inc. "is encouraging doctors to use genetic tests to
determine whether drugs will work for particular patients -- saving
money and reducing harm caused when prescriptions are wrong."
Medco and CVS Caremark Corp. also have increased their investments in
providers of genetic testing services. Bloomberg notes that the FDA
requires genetic testing for six drugs, "recommends testing
before prescribing for more than two dozen medicines, and mentions
diagnostic tests in the labels...of more than 150 others."
</div>
<br />
Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as <br />
with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
<br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-69418368601866429082012-05-28T07:00:00.000-04:002012-07-23T09:43:53.936-04:00Whole-genome sequencing may soon become clinically useful.<br />
<div style="line-height: 100%; margin-bottom: 0in;">
Two newly published
papers may reignite the once-"disappointing" search for the
"genetic roots of major killers like heart disease, diabetes,
and Alzheimer's." In the seven or so years "since first
full genetic code of a human was sequenced for some $500 million,
less than a dozen genomes had been decoded, all of healthy people."
Now, researchers at Baylor College and the Institute for Systems
Biology were able to demonstrate that it is "possible to
sequence the entire genome of a patient at reasonable cost and with
sufficient accuracy to be of practical use to medical researchers."
</div>
<div style="line-height: 100%; margin-bottom: 0in;">
</div>
<div style="line-height: 100%; margin-bottom: 0in;">
What makes the technology even more impressive, she said, is that
these were whole genomes of people that provided 'very interesting
stories about rare diseases.'" </div>
<div style="line-height: 100%; margin-bottom: 0in;">
<br /></div>
<div style="line-height: 100%; margin-bottom: 0in;">
University of Utah researchers, "used gene sequencing technology
to take a closer look at a "four-member family. After
completing and comparing the genomes, investigators were able to tell
that the "two parents passed recessive genes to their two
children, each of whom had a condition called Miller Syndrome that
may cause cleft palates, misshapen ears, and short stature."
According to the <span style="color: blue;"><u><a href="http://mailview.custombriefings.com/mailview.aspx?m=2010031101ama&r=1783658-4907&l=005-734&t=c"><span style="color: black;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;">paper</span></span></span></a></u></span>
in Science, the children also had "a lung disorder called
primary ciliary dyskinesia that can lead to pneumonia, bronchitis and
other respiratory infections." </div>
<div style="line-height: 100%; margin-bottom: 0in;">
<br /></div>
Indeed, "experts have long known that Miller syndrome is
genetic."But they had never been able to pinpoint the gene."
Having the entire family's genomes in their hands, however, "helped
shrink the genetic haystack from thousands of genes to four likely
targets," and investigators were also able to calculate the odds
of inheriting the variants. <br />
<br />
Please remember, as with all our articles we provide information, not
medical advice. For any treatment of your own medical condition you must
visit your local doctor, with or without our article[s]. These articles
are not to be taken as individual medical advice.Please remember, as
with all our articles we provide information, not medical advice. For
any treatment of your own medical condition you must visit your local
doctor, with or without our article[s]. These articles are not to be
taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-71502660950621075632012-05-15T21:20:00.000-04:002012-07-23T09:43:09.608-04:00GARLIC CAN CAUSE INCREASED BLEEDING. RISKS OF “NATURAL” MEDICINES<br />
<div style="line-height: 100%; margin-bottom: 0in;">
<span style="font-family: Times New Roman,serif;"><span style="font-size: small;">Herbal
medicines are not always the harmless nostrums that many patients and
even some physicians think, but may actually contribute to
cardiovascular morbidity and mortality, researchers warned in a
review published in the </span></span><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><i>Journal
of the American College of Cardiology[JACC]</i></span></span><span style="font-family: Times New Roman,serif;"><span style="font-size: small;">.<br />Many
such products, including aloe vera, ginkgo biloba, ginseng, and green
tea, can interact with conventional cardiovascular drugs and lead to
serious adverse reactions, according to the Mayo Clinic.<br /><br />The
</span></span><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><i>JACC</i></span></span><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"> article
also listed 15 common herbal medicines known to interact adversely
with conventional cardiovascular drugs.In many cases, the herbal
products compete with the regular medicines for the same
drug-metabolizing cytochrome P450 enzymes, potentiating the latter's
effects. In other cases, the herbal products have their own
cardiovascular effects.</span></span></div>
<div style="line-height: 100%; margin-bottom: 0.19in; margin-top: 0.19in;">
<span style="font-family: Times New Roman,serif;"><span style="font-size: small;">Many physicians
already know that even “natural” grapefruit juice occupies the
CYP3A4 enzyme, leading to slower-than-expected metabolism and,
therefore, higher blood levels of a host of pharmaceuticals.These
include the statins, calcium channel antagonists, several common
anti-arrhythmic drugs, and the angiotensin receptor blocker
irbesartan (Avapro), Jahangir and colleagues noted.</span></span></div>
<div style="line-height: 100%; margin-bottom: 0.19in; margin-top: 0.19in;">
<span style="font-family: Times New Roman,serif;"><span style="font-size: small;">Garlic is one of
several common herbal remedies with specific cardiovascular effects
in its own right (others include ginkgo biloba, ginseng, and saw
palmetto). Garlic inhibits platelet aggregation and thus can lead to
increased bleeding risks when combined with aspirin, clopidogrel
(Plavix), or warfarin (Coumadin), the researchers noted.</span></span></div>
<span style="font-family: Times New Roman,serif;"><span style="font-size: small;">The Mayo group
identified 10 herbal products that increase bleeding risks with
anticoagulant and antiplatelet drugs, and listed 27 herbal products
that patients with cardiovascular diseases would do well to avoid.
These include such common and harmless-seeming products as green tea,
capsicum pepper, licorice, and kelp, as well as grapefruit juice and
garlic.</span></span> <br />
<br />
Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br />
<br />
Deepen your understanding of "medical malpractice"... <a href="http://www.medmalbook.com/">www.MedMalBook.com</a><br />
For more health info and links visit the author's web site <a href="http://www.hookman.com%20/" target="_blank">www.hookman.com </a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-44564840442315452752012-04-30T12:16:00.000-04:002012-05-10T12:16:25.879-04:00Boxed Warning Added to Clopidogrel [PLAVIX] LabelPrescribing information for clopidogrel (Plavix) will now include a boxed warning that the drug can be less effective in poor metabolizers, the FDA indicated.
The new warning suggests that many if not all patients on clopidogrel should undergo genetic testing to determine whether they have variants of the CYP2C19 gene associated with poor metabolism of the antiplatelet drug.
Clopidogrel is actually a prodrug that requires metabolic activation by the CYP2C19 enzyme to become effective. Poor metabolizers get little or no benefit from the drug at standard doses, and therefore are at increased risk for thrombotic events and death, the FDA said.
The drug's label has carried a similar warning since May 2009, but the FDA said today that "it was important to highlight this risk in a boxed warning" in light of a subsequent review of data.
Seven different variants of the CYP2C19 gene are associated with poor metabolism of clopidogrel. According to the FDA, patients with two loss-of-function alleles, which do not have to be identical, will be poor metabolizers.
The agency estimated that 2% to 14% of patients are poor metabolizers, with some racial-ethnic groups more likely to be affected than others. Whites have the lowest prevalence of poor metabolism and Asians have the highest.
The boxed warning also includes this advice to healthcare providers: "Tests are available to identify a patient's CYP2C19 genotype and can be used as an aid in determining therapeutic strategy."
A Cardiologist at Brigham and Women's Hospital and Harvard Medical School in Boston, claims the warning effectively means every patient on clopidogrel needs to be tested, although the new label does not say so directly.
Some 25 million prescriptions for clopidogrel were written in 2008, according to Drugs.com.
The FDA also recommended that physicians "consider alternative dosing" if patients are found to be poor metabolizers.
The FDA urged patients currently taking clopidogrel not to stop the drug unless told to do so by their physician. Concerned patients should discuss the new information with their doctors before making any change.
Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.comDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-40518412209372607952012-04-13T12:12:00.000-04:002012-05-10T12:13:21.559-04:0040,000 Former Clinic Patients Notified About Possible Exposure To Blood-Borne Diseases Because Of Unsafe Injection Practices.Nurse anesthetists reusing single-dose medicine vials among different patients led to as many as 115 people who contracted hepatitis C because of these unsafe injection practices at two Endoscopy centers.
Officials notified 40,000 former clinic patients about possible exposure to blood-borne diseases because of unsafe injection practices.
The Clinic’s staff told health investigators they were ordered by administrators, principally the physician owner, to reuse supplies and medications to save money, according to a Las Vegas letter suspending the center’s business license The police investigation ended late last year. Hundreds of former patients have sued the physician, his clinics and the manufacturers of the anesthetic, propofol, that was used during their colonoscopies.
Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
Deepen your understanding of "medical malpractice"... www.MedMalBook.com
For more health info and links visit the author's web site www.hookman.comDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-78309749948686851842012-03-30T07:13:00.000-04:002012-04-02T17:15:16.367-04:00HOW ACCURATE ARE NUTRITION PACKAGE LABELS?According to a study published in the Journal of the American Dietetic Association, "prepared foods may contain an average of 8% more calories than their package labels own up to, and restaurant meals may contain a whopping 18% more." The misleading labels are also said to be "perfectly o.k." with the Food and Drug Administration, which "plays no role in checking the calorie claims in restaurants." Without federal regulation, "it's up to the states to handle the job - with the predictable patchwork results." Susan Roberts, who conducted the study, described the unregulated menu counts as "the Wild West when it comes to this." <br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... www.MedMalBook.com<br />For more health info and links visit the author's web site www.hookman.comDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-84282423304275522702012-03-15T07:03:00.000-04:002012-04-02T17:06:05.361-04:00Sharing hospital room may increase infection risk during staySharing a hospital room increases your risk of picking up an infection during your stay, a new study shows." The work, by researchers from Queen's University in Kingston, Ont., "found that each new roommate raised a patient's risk of picking up an infection in hospital by about 10 percent." The study's senior author, Dr. Dick Zoutman, said in a statement, "That's a substantial risk, particularly for longer hospital stays when you can expect to have many different roommates." <br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-36931678531066627212012-02-27T07:44:00.001-05:002012-03-03T19:56:33.567-05:00Autism increases in the USAlmost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."<br /><br />Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.<br /><br />Among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said. Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls. <br /><br />From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both). <br /><br />The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old which is especially important, as early recognition and treatment improves outcomes.<br /><br />ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3. Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br /><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-43429601581895831012012-02-07T07:51:00.001-05:002012-03-03T19:57:29.211-05:00Abdominal surgeries riskier for older adults than previously thoughtAbout 2 million older adults undergo abdominal surgeries in the U.S. every year, a number that's expected to grow as the proportion of older adults increases rapidly: by 2020, one in six adults is expected to be older than 65, and 15% will be over 85.<br /><br />The patient records came from the Comprehensive Hospital Abstract Reporting System, a state-wide database that contains information on the age, sex, zip code, and billed charges of patients, as well as the codes for their diagnosis and procedures.<br /><br />The study focused on complications that occurred within 90 days of discharge and deaths within 90 days of hospital admission.<br /><br />After adjusting for various factors, including hospital volume and patient characteristics, the study found that the odds of early death after abdominal surgery increased considerably for each five-year increase in age beyond 65. These associations held for patients with cancer and other diagnoses, and for both elective and nonelective procedures (P<0.001).<br /><br />The likelihood of complications increased as patients aged beyond 65 years, with the researchers finding the following associations between age and complication frequency (trend test, P<0.001): <br /><br />65 to 69 years, 14.6%<br />70 to 74 years, 16.1%<br />75 to 79 years, 18.8%<br />80 to 84 years, 19.9%<br />85 to 89 years, 22.6%<br />90 and older, 22.7%<br /><br />Similarly, older patients were at higher risk of mortality. Death rates by age group were (trend test, P<0.001): <br /><br />65 to 69 years, 2.5%<br />70 to 74 years, 3.8%<br />75 to 79 years, 6.0%<br />80 to 84 years, 8.1%<br />85 to 89 years, 12.6%<br />90 and older, 16.7%<br />http://www.blogger.com/img/blank.gif<br />Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Archttp://www.blogger.com/img/blank.gifh Surg 2009; 144: 1108-14.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-66514804353693713412012-01-31T08:02:00.000-05:002012-02-02T08:03:22.617-05:00RECURRENT CLOSTRIDIUM DIFFICILE INFECTION (CDI) ARE DIFFICULT TO TREATEpisodes of recurrent Clostridium difficile infection (CDI) are difficult to treat for several reasons. Foremost, data are lacking to support any particular treatment strategy. In addition, treatment of recurrent episodes is not always successful, and repeated, prolonged treatment is often necessary. Identification of subgroups at risk for recurrent CDI may aid in diagnosing and treating these patients. Two likely mechanistic factors increasing the risk of recurrent CDI are an inadequate immune response to C. difficile toxins and persistent disruption of the normal colonic flora. Important epidemiologic risk factors include advanced age, continuation of other antibiotics, and prolonged hospital stays. Current guidelines recommend that the first recurrent episode be treated with the same agent (i.e., metronidazole or vancomycin) used for the index episode. However, if the first recurrence is characterized as severe, vancomycin should be used. A reasonable strategy for managing a subsequent episode involves tapering followed by pulsed doses of vancomycin. Other potentially effective strategies for recurrent CDI include vancomycin with adjunctive treatments, such as Saccharomyces boulardii, rifaximin “chaser” therapy after vancomycin, nitazoxanide, fecal transplantation, and intravenous immunoglobulin. New treatment agents that are active against C. difficile, but spare critical components of the normal flora, may decrease the incidence of recurrent CDI.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... www.MedMalBook.com<br />For more health info and links visit the author's web site www.hookman.comDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com2tag:blogger.com,1999:blog-5662673603094746905.post-75628733092658594852012-01-15T07:55:00.000-05:002012-02-02T07:57:53.924-05:00Best Treatment for Patients with Both Heart Disease and Diabetes? No Clear AnswerFor patients with both coronary artery disease and type 2 diabetes, outcomes are similar regardless of whether revascularization or medical therapy is used — and whether insulin sensitization or insulin provision is used — reports an industry-supported study published online in the New England Journal of Medicine.<br /><br />Researchers randomized some 2400 patients to either prompt revascularization or medical treatment, and to either insulin-sensitization or insulin-provision therapy. At 5 years, all-cause mortality did not differ between the revascularization and medical-therapy groups or between the insulin-sensitization and insulin-provision groups. Similarly, major cardiovascular events did not differ between groups. <br />Patients were stratified before randomization according to type of revascularization, and patients in the CABG (but not PCI) group had fewer major cardiovascular events with revascularization but a similar mortality rate.<br /><br />Asked to comment, Journal Watch Cardiology Editor-in-Chief Dr. Harlan Krumholz said that the failure of the study to show clear superiority of revascularization and insulin sensitization "reinforces the need to incorporate the patient's preferences, values, and goals — and costs — into decisions about which strategy to pursue."<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-10646300632166838582011-12-29T07:51:00.000-05:002011-12-29T14:53:02.417-05:00Cancer Incidence And Mortality Continue To DeclineCancer incidence and mortality continue to decline, with the most dramatic decreases in lung, prostate, and colorectal cancers among men, and breast and colorectal cancers in women, according to the latest national report card.<br /><br />"Overall cancer incidence rates for all racial/ethnic groups combined decreased by 0.7% per year during 1999-2006 for both sexes combined, by 1.3% per year during 2000-2006 for men, and by 0.5% per year during 1998-2006 for women," authors from the American Cancer Society, the CDC, the National Cancer Institute, and the North American Association of Central Cancer Registries concluded. The report, was published online in the ACS journal, Cancer.<br /><br />There has been a decline in cancer death rates since the early 1990s and that trend appears to be durable.The decreases were slightly larger for men, who had declines of 1.5% per year during 1993-2001 and 2.0% per year during 2001-2006 compared with women, whose cancer death rates declined 0.8% per year during 1994-2002 and 1.5% per year during 2002-2006," the authors wrote.<br /><br />But the news was not all good. As men saw decreased rates of prostate, lung, oral, stomach, brain, and colorectal cancers, there was a concurrent increase in the cancers of the kidney, renal, liver, and esophagus -- as well as increases in leukemia, myeloma, and melanoma of the skin.<br /><br />For women the story was similar -- decreased rates of breast, colorectal, ovarian, cervical, uterine corpus, and oral cancers, but an uptick in lung, thyroid, pancreas, bladder, and kidney cancers, as well as increases in non-Hodgkin lymphoma, melanoma, and leukemia.<br /><br />Colorectal cancer [CRC] is a focus of this year's report, not a surprising choice because the news here is good: "CRC death rates have declined since 1984 in both men and women, with an accelerated rate of decline since 2002 (for men) and 2001 (for women)."<br /><br />And a "microsimulation model" suggests that death rates from colorectal cancer could be reduced by 36% over the next decade if "1995-2000 trends for risk factor prevalence, screening, and treatment continue."But the authors point out that increased obesity among younger Americans could derail this trend.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-72969937690390470682011-12-15T07:48:00.001-05:002011-12-29T14:50:38.234-05:00Americans living longer than everAmericans living longer than ever. And every year that gets tacked on to the average life expectancy costs an extra trillion dollars in expenditures by Social Security and Medicare. <br /><br />Americans are living a record 77 years and 11 months on average...according to two studies that led researchers to suggest raising the retirement age." The first study, from the CDC's National Center for Health Statistics, found that in the "US in 2007, the latest year for which figures are available," the "0.76 percent death rate is the lowest ever," driven by "a decline in deaths from heart disease and other ailments." Meanwhile, a second study published Dec. 14 in the health journal Milbank Quarterly, found that "every year that gets tacked on to the average life expectancy costs an extra trillion dollars in expenditures by Social Security and Medicare." <br /><br /> Overall, the 2007 data "show continued improvements in life expectancy for all Americans, although women are faring better than men, and whites fare better than other racial groups" by a "race differential" of about "4.6 years." But, even amid this progress, vast geographical discrepancies remain -- with people in southern states still facing higher death rates than those living in other parts of the country." And, "even though Americans can expect to live longer than their parents, life expectancy in the" US "is still lower than in many other industrialized countries, including Canada and Japan. Even so, the "dramatic improvements in the health of Americans over the last 20 years" will "have unforeseen effects on the country. The Social Security and Medicare "programs weren't designed to support people for that long." <br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-14959633551880954832011-11-30T07:28:00.000-05:002011-11-30T19:29:28.901-05:00Maternal Use of Sertaline, Citalopram Linked to Septal Heart Defects in OffspringWomen who use the antidepressants sertraline (Zoloft) or citalopram (Celexa) early in pregnancy face increased risk for septal heart defects in their offspring, BMJ reports online.<br /><br />Researchers examined data on more than 490,000 infants born in Denmark between 1996 and 2003. They found that women who filled prescriptions for sertraline and citalopram (but not other SSRIs) during their first trimester were significantly more likely to have children with septal heart defects (but not other malformations) than those who didn't use SSRIs (odds ratios: 3.2 and 2.5, respectively).<br />The authors and an editorialist (both with ties to SSRI manufacturers) note that the absolute risks for septal heart defects were low: 0.9% in children exposed to at least one SSRI and 2.1% in those exposed to more than one. <br />The editorialist concludes: "Clinicians and patients need to balance the small risks associated with SSRIs against those associated with undertreatment or no treatment."<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-66809239743913329312011-11-15T07:30:00.000-05:002011-11-30T19:32:03.927-05:00Patient Balance ProblemsMillions of people may suffer from inner-ear disorders that affect their balance but not be aware that they have a problem, a new study has found.Writing in The Archives of Internal Medicine, researchers noted the connection between balance problems and falls, especially among the elderly. The findings of the study, they said, suggest that doctors should make balance tests a routine part of checkups. This is especially true in nursing and assisted-living homes, they said.<br /><br />“The big deal here really is falls,” the lead author, Dr. Yuri Agrawal of Johns Hopkins, said in an e-mail message, adding that a serious fall can be the beginning of the end for an older patient.The researchers drew on data from a federal study in which more than 5,000 people age 40 and over were surveyed about their history of falls and balance problems. They were then given examinations to determine how well they could maintain their balance in a variety of situations, including with their eyes closed.<br /><br />More than a third of the subjects, the researchers found, had the balance disorder known as vestibular dysfunction — a figure that would translate to 69 million Americans.They also found that 32 percent of the volunteers who did not report problems with dizziness showed evidence of balance problems. Though they did not experience symptoms, they were still at higher risk for falls, the study said.<br />For doctors, Dr. Agrawal said, detecting balance problems in a patient is not very complicated. And treatment is available, including exercises that help people compensate for inner-ear problems that lead to poor balance.The cost of the treatment, they said, would most likely be less than medical costs associated with falls.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-79114216587893672732011-10-30T08:31:00.000-04:002011-11-11T08:32:25.519-05:00Banned Herbal Ingredient Linked to Urinary Tract CancerNatural does not equal safe, and any herb strong enough to have a potential benefit is strong enough to have potential to cause harm."<br />Exposure to aristolochic acid, found in some Chinese herbal products such as Mu Tong and Fangchi, significantly increased the risk for urinary tract cancer, according to a retrospective study.Researchers in Taiwan found prescription of more than 60 grams of Mu Tong and consumption of more than 150 mg aristolochic acid were independently associated with an increased risk for urinary tract cancer.<br /><br />• Mu Tong, 61 to 100 g: OR 1.6, 95% CI 1.3 to 2.1<br />• Mu Tong, >200 g: OR 2.1, 95% CI 1.3 to 3.4<br />• Aristolochic acid, 151 to 250 mg: OR 1.4, 95% CI 1.1 to 1.8<br />• Aristolochic acid, >500 mg: OR 2.0, 95% CI 1.4 to 2.9<br /><br />Used in Chinese herbal preparations taken for weight loss or urinary tract infections, aristolochic acid has been banned in several countries, including in Taiwan and in the U.S.The latest study found a linear, dose-dependent relationship between the amount of aristolochic acid consumed and an increased risk for urinary tract cancer (P<0.001). This was independent of arsenic exposure through drinking water, which has also been associated with bladder and urinary tract cancers.Among the more than 4,000 patients analyzed, 57% had bladder cancer and 43% had upper urinary tract cancer.<br />The International Agency for Research on Cancer has classified herbal remedies containing high concentrations of aristolochic acid as carcinogenic. Traces of aristolochic acid may still be found in adulterated remedies currently on the market.<br />Wang, et al "Population-based case-control study of chinese herbal products containing aristolochic acid and urinary tract cancer risk" J Nat Can Inst 2009; DOI:10.1093/jnci/djp467. <br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com1tag:blogger.com,1999:blog-5662673603094746905.post-85256275924251389732011-10-18T06:13:00.000-04:002011-10-18T18:15:00.179-04:00About 2 million older adults undergo abdominal surgeries in the U.S. every year, a number that's expected to grow as the proportion of older adults increases rapidly: by 2020, one in six adults is expected to be older than 65, and 15% will be over 85.<br />The patient records came from the Comprehensive Hospital Abstract Reporting System, a state-wide database that contains information on the age, sex, zip code, and billed charges of patients, as well as the codes for their diagnosis and procedures.<br />The study focused on complications that occurred within 90 days of discharge and deaths within 90 days of hospital admission.<br /><br />After adjusting for various factors, including hospital volume and patient characteristics, the study found that the odds of early death after abdominal surgery increased considerably for each five-year increase in age beyond 65. These associations held for patients with cancer and other diagnoses, and for both elective and nonelective procedures (P<0.001).<br /><br />The likelihood of complications increased as patients aged beyond 65 years, with the researchers finding the following associations between age and complication frequency (trend test, P<0.001): <br /><br />• 65 to 69 years, 14.6%<br />• 70 to 74 years, 16.1%<br />• 75 to 79 years, 18.8%<br />• 80 to 84 years, 19.9%<br />• 85 to 89 years, 22.6%<br />• 90 and older, 22.7%<br /><br />Similarly, older patients were at higher risk of mortality. Death rates by age group were (trend test, P<0.001): <br /><br />• 65 to 69 years, 2.5%<br />• 70 to 74 years, 3.8%<br />• 75 to 79 years, 6.0%<br />• 80 to 84 years, 8.1%<br />• 85 to 89 years, 12.6%<br />• 90 and older, 16.7%<br /><br />Massarweh N, et al "Impact of advancing age on abdominal surgical outcomes" Arch Surg 2009; 144: 1108-14.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-28080621524562505132011-09-26T08:34:00.001-04:002011-09-26T08:37:00.842-04:00Certain dietary supplements Selenium and Omega-3s may reduce colorectal cancer riskCertain dietary supplements appear to affect the development of colorectal cancer or its recurrence," according to two new studies presented during a medical conference. In one, "researchers from the US National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount." <br /><br />In one study, researchers from the U.S. National Institute for Environmental Health Sciences found that eating a diet high in omega-3 fatty acids cut the risk of developing colorectal cancer by nearly 40 percent. In the other study, from cancer researchers in Italy, consumption of a dietary supplement containing selenium was found to reduce the chances of having polyps recur by a similar amount.<br /><br />In the selenium study, 411 people, 25 to 75 years old, who'd had one or more colorectal polyps removed took either a supplement or a placebo. The supplement, described as an antioxidant compound, contained 200 micrograms of selenomethionnine (a combination of selenium and methionnine), 30 milligrams of zinc, 6,000 international units of vitamin A, 180 milligrams of vitamin C and 30 milligrams of vitamin E.<br /><br />Participants had a colonoscopy one year, three years and five years after starting the regimen.<br /><br />The researchers estimated that, after 15 years, about 48 percent of those taking the supplement were free of polyps, versus about 30 percent of those not taking the supplement.<br /><br />Among the white participants, those whose diets were in the highest fourth of omega-3 fatty acid consumption were 39 percent less likely to have colorectal cancer than those in the lowest fourth. However, for reasons the authors said they did not know, no association was noted between omega-3s and a reduction of colorectal cancer risk among black participants. The disease occurs at a higher rate among blacks than whites.<br />"Our finding clearly supports the evidence from previous experimental and clinical studies showing that long-chain omega-3 fatty acids inhibit tumor growth," said the study's lead author, Sangmi Kim, a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences in Research Triangle Park, N.C.<br /><br />Kim said the research supports boosting omega-3 intake through diet or perhaps by taking an omega-3 supplement. Omega-3 fatty acids are found in fish, especially oily fish such as salmon, mackerel, herring, anchovies, sardines and tuna. Plant-based sources include flax and flaxseed oil, Brussels sprouts, soybeans and soybean oil, canola oil, spinach, walnuts and kiwi.<br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com2tag:blogger.com,1999:blog-5662673603094746905.post-89382382896499662672011-09-02T08:33:00.001-04:002011-09-26T08:38:02.386-04:00HOW TO LOWER PROSTATE CANCER RISKHarvard scientists have discovered that "drinking coffee may lower the risk of developing the deadliest form of prostate cancer." In fact, "the five percent of" study participants "who drank six or more cups a day had a 60 percent lower risk of developing the advanced form of the disease than those who didn't consume any."." <br /> <br />A Frontiers in Cancer Prevention Research conference" also touched on the "role that exercise...could play in the fight against prostate cancer. An analysis of activity levels among 2,686 prostate cancer patients showed that men who jogged, played tennis, or participated in other comparable exercise for an average of three or more hours per week had 35% lower mortality rates than those who exercised less frequently or not at all." As for walking, those who did so "for four or more hours per week" had "overall mortality rates [that] were 23% lower than those of men who walked for fewer than 20 minutes per week." <br /><br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... <a href="http://www.MedMalBook.com">www.MedMalBook.com</a><br />For more health info and links visit the author's web site <a href="http://www.hookman.com">www.hookman.com</a>Dr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0tag:blogger.com,1999:blog-5662673603094746905.post-12785637876644018162011-08-21T07:51:00.000-04:002011-09-08T08:52:52.308-04:00Autism increases in the USAlmost one percent of American children had an autism spectrum disorder (ASD) in a large CDC surveillance study whose lead author called the condition a "significant public health issue."<br /><br />Across 11 sites in the U.S., ASD prevalence in 2006 ranged from about one out of 80 children to one out of every 240 children, with an overall prevalence of one in 111 youngsters, according to a report by investigators from the CDC's Autism and Developmental Disorders Monitoring (ADDM) Network.<br /><br />Among 10 ADDM sites that reported data in both 2002 and 2006, there was an average 57% increase in ASD prevalence. No single factor could explain the rise, researchers said. Overall ASD prevalence was 4.5 times higher in boys than in girls: about one in every 70 boys and one in every 315 girls. <br /><br />From 2002 to 2006, prevalence increased 60% in boys and 48% in girls (P<0.001 for both). <br />The American Academy of Pediatrics has recommended that all children be screened for autism when they are 18 and 24 months old which is especially important, as early recognition and treatment improves outcomes.<br /><br />ASD diagnosis was made at a slightly younger age in 2006 than in 2002, but it was still delayed to an average age of 53 months. That was so despite the fact that anywhere from 70% to 95% of children had developmental concerns noted in their records before age 3. <br /><br />Please remember, as with all our articles we provide information, not medical advice. For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.<br /><br />Deepen your understanding of "medical malpractice"... www.MedMalBook.com<br /><br />For more health info and links visit the author's web site www.hookman.comDr. Perry Hookmanhttp://www.blogger.com/profile/04886686329693908056noreply@blogger.com0