MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'archives of internal medicine'. Sat, 03 Sep 2011 02:17:27 +0100 http://www.medworm.com/index.php?rid=5174617&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-history-found-to-be-key-element-in-making-a-diagnosis%2F2011.08.28 Four out of five doctors agree that they don’t need scans to make the right diagnosis. It’s an old-fashioned concept frequently discussed among ACP members, but the history and physical combined with basic tests is way more important to diagnosis than ordering scans and advanced tests. A recent research letter in the Archives of Internal Medicine makes the case. In the letter, Israeli researchers described a prospective study of 442 consecutive patients admitted from the emergency department in 53 days. A senior resident examined all patients within 24 hours of admission (mean=14), including a history, physical, and review of ancillary test findings done at the emergency department, such as blood and urine tests, electrocardiography, and chest radiography. The resident also rev... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174617 Sun, 28 Aug 2011 18:30:00 +0100 5174617 http://www.medworm.com/index.php?rid=4714746&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-it-yourself-health-care-a-new-form-of-outsourcing%2F2011.04.14 The outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years.  It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free.  It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and service reps. This was particularly salient to me this week: I spent an hour online browsing, comparing prices, reading customer reviews and filling out the required billing and shipping information to get a great deal on a new lamp.  An airline would charge me 99 cents to talk to a person but provides information for free online.  Calls to Amtrak to make train reservations... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714746 Thu, 14 Apr 2011 12:00:54 +0100 4714746 http://www.medworm.com/index.php?rid=4411527&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstress-in-life-respond-differently-and-live-longer%2F2011.01.28 This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up. Definitely less suffering. Maybe less deaths. The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work dist... Better Health blogs http://www.medworm.com/rss/comments.php?id=4411527 Fri, 28 Jan 2011 17:00:39 +0100 4411527 http://www.medworm.com/index.php?rid=4349515&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freferral-communication-what-happens-to-handoffs-between-primary-care-physicians-and-specialists%2F2011.01.14 Far more primary care doctors report detailed referrals than do specialists report receiving them. The same applies in reverse. Specialists report returning quality consultations, while primary care physicians report receiving them far less often. Researchers reported in Archives of Internal Medicine that perceptions of communication regarding referrals and consultations differed widely. While 69.3 percent of primary care physicians reported “always” or “most of the time” sending a patient’s history and the reason for the consultation to specialists, only 34.8 percent of specialists said they “always” or “most of the time” received the information. And, while 80.6 percent of specialists said they “always” or “most o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4349515 Fri, 14 Jan 2011 18:00:00 +0100 4349515 http://www.medworm.com/index.php?rid=4337937&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F%25e2%2580%259cjust-in-case%25e2%2580%259d-heart-tests-can-they-do-more-harm-than-good%2F2011.01.12 Here’s an important equation that all of us — doctors include — should know about healthcare, but don’t: More ≠ Better “More does not equal better” applies to diagnostic procedures, screening tests meant to identify problems before they appear, medications, dietary supplements, and just about every aspect of medicine. That scenario is spelled out in alarming detail in the Archives of Internal Medicine. Clinicians at the Cleveland Clinic describe the case of a 52-year-old woman who went to her community hospital because she had been having chest pain for two days. She wasn’t having symptoms of a heart attack, such as shortness of breath, unexplained nausea, or a cold sweat, and her electrocardiogram and other tests were fine. The woman’s doctors concluded that her ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337937 Wed, 12 Jan 2011 16:00:10 +0100 4337937 http://www.medworm.com/index.php?rid=4304875&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffalse-positives-in-medical-tests-how-they-can-kill-patients%2F2011.01.03 I’ve written in the past that more medicine and tests do not necessarily reflect better care. There is no test that is 100 percent specific or sensitive. That means tests may be positive, when, in fact, there is no disease (“false positive”), or tests may be negative in the presence of disease (“false negative”). It’s the latter that often gets the most media attention, often trumpeted as missed diagnoses. But false positives can be just as dangerous. Consider this frightening case report from the Archives of Internal Medicine: A 52-year-old woman presented to a community hospital with atypical chest pain. Her low-density lipoprotein cholesterol and high-sensitivity C-reactive protein levels were not elevated. She underwent cardiac computed tomography angiography, which showed... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304875 Mon, 03 Jan 2011 18:00:49 +0100 4304875 http://www.medworm.com/index.php?rid=4287415&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpainkiller-safety%2F2010.12.24 Perhaps as many as one in every five American adults will get a prescription for a painkiller this year, and many more will buy over-the-counter medicines without a prescription. These drugs can do wonders — getting rid of pain can seem like a miracle — but sometimes there’s a high price to be paid. Remember the heavily marketed COX-2 inhibitors? Rofecoxib, sold as Vioxx, and valdecoxib, sold as Bextra, were taken off the market in 2004 and 2005, respectively, after studies linked them to an increased risk of heart attack and stroke. The nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen (sold as Advil and Motrin), and naproxen (sold as Aleve) seem like safe bets. But taken over long periods, they have potentially dangerous gastrointestinal side effect... Better Health blogs http://www.medworm.com/rss/comments.php?id=4287415 Fri, 24 Dec 2010 16:00:34 +0100 4287415 http://www.medworm.com/index.php?rid=4281314&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fabout-weightlifting-and-breast-cancer%2F2010.12.22 Last August, Kathryn Schmitz, PhD, MPH and colleagues published the results of their study Weightlifting in Women with Breast-Cancer–Related Lymphedema (BCRL) in the New England Journal of Medicine. They have now published a similar study in the Archives of Internal Medicine (see full reference below). While the NEJM article focused on breast cancer survivors with lymphedema, the Archives article focuses on breast cancer survivors without lymphedema. The new study adds weight for the need to change historic dogma which cautions breast cancer patients to avoid weight training after a mastectomy and or axillary dissection. (more…) *This blog post was originally published at Suture for a Living* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4281314 Wed, 22 Dec 2010 17:00:00 +0100 4281314 http://www.medworm.com/index.php?rid=4275325&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freassuring-patients-about-ct-scans-and-radiation-risks%2F2010.12.20 Emergency patients with acute abdominal pain feel more confident about medical diagnoses when a doctor has ordered a computed tomography (CT) scan, and nearly three-quarters of patients underestimate the radiation risk posed by this test, reports the Annals of Emergency Medicine. “Patients with abdominal pain are four times more confident in an exam that includes imaging than in an exam that has no testing,” said the paper’s lead author. “Most of the patients in our study had little understanding of the amount of radiation delivered by one CT scan, never mind several over the course of a lifetime. Many of the patients did not recall earlier CT scans, even though they were listed in electronic medical records.” Researchers surveyed 1,168 patients with non-traum... Better Health blogs http://www.medworm.com/rss/comments.php?id=4275325 Mon, 20 Dec 2010 22:00:00 +0100 4275325 http://www.medworm.com/index.php?rid=4230199&cid=t_103381_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F12%2Fmedical-errors-discuss-them-or-switch.html Patients won’t confront doctors if they think there’s been a mistake. They’ll just find a new doctor, even if there’d been no medical error. Researchers looked at adult visits to seven primary care practices in North Carolina during 2008. They asked patients about their perceptions of medical mistakes and how did it influence the choice to switch doctors. Of 1,697 patients, 265 (15.6 percent) reported a mistake had been made, 227 (13.4 percent) reported a wrong diagnosis, 212 (12.5 percent) reported a wrong treatment, and 239 (14.1 percent) reported changing doctors as a result. Results appeared in the Archives of Internal Medicine. But anecdotes cited by patients as mistakes were often normal diagnostic or therapeutic challenges. A typical scenario might be the patient reported sy... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4230199 Sun, 05 Dec 2010 18:44:00 +0100 4230199 http://www.medworm.com/index.php?rid=4205932&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-patients-choose-a-good-doctor-online%2F2010.11.27 The following op-ed was published on October 27th, 2010 in USA Today: When I ask new patients how they found me, frequently they say on the Internet through search engines such as Google. Out of curiosity, I recently Googled myself. Numerous ads appeared, promising readers a “detailed background report” or a “profile” of me. Among the search results was information about my practice, whether I was board certified, had any lawsuits against me, and reviews from online doctor rating sites. Thankfully, most were favorable, but some were not. Can patients reliably choose a good doctor online? People already choose restaurants, movies, and their college professors based on what they read on the Internet, so it’s inevitable that many will research their doctors on the Web as well. But t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4205932 Sat, 27 Nov 2010 21:00:36 +0100 4205932 http://www.medworm.com/index.php?rid=4159241&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-doctors-are-refusing-industry-perks-and-gifts%2F2010.11.12 Physicians and particularly primary care doctors are reporting fewer industry ties than five years ago, according to a survey. While 94% of doctors reported some type of perk from a drug or device maker in 2004, 83.8% did in 2009, researchers reported in the Nov. 8 Archives of Internal Medicine. Researchers surveyed a stratified random sample of 2,938 primary care physicians (internal medicine, family practice, and pediatrics) and specialists (cardiology, general surgery, psychiatry and anesthesiology) with a 64.4% response rate. (more…) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4159241 Fri, 12 Nov 2010 15:00:00 +0100 4159241 http://www.medworm.com/index.php?rid=4139236&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhigh-cholesterol-and-red-yeast-rice-supplements%2F2010.11.05 People are always on the search for “natural” ways to stay healthy and reduce cholesterol. Chinese red yeast rice supplements have been touted as a natural, safer way to lower cholesterol compared to statin medications. The yeast that grows on a particular type of rice contains a family of substances called monocolins, which lower cholesterol by inhibiting cholesterol production in the liver in the same manner as prescription statin drugs. Some studies have shown as much as a 15 percent drop in cholesterol. All of this sounds good until you dig a little deeper. Supplements are not regulated by the Food and Drug Administration (FDA), and a new study in the Archives of Internal Medicine showed that different brands of red yeast rice supplements have dramatic variation in le... Better Health blogs http://www.medworm.com/rss/comments.php?id=4139236 Fri, 05 Nov 2010 16:00:00 +0100 4139236 http://www.medworm.com/index.php?rid=4125283&cid=t_103381_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fz4r5rINz09I%2F Much attention has been paid to conflicts of interest relating to the pharmaceutical industry, but where do medical journals fit in this equation? A new study notes that journals also have vested interests that warrant disclosure. Specifically, industry-supported clinical trials can boost a journal’s so-called impact factor by generating greater distribution of reprints that increase citation rates and, of course, revenue. The trials are often supported by drugmakers, which purchase reprints. What is an impact factor? The researchers defined it this way: a measure of a journal’s importance based on how often its articles are cited. This is not just about prestige, of course, but the potential for greater circulation (there is a formula contained in the study, which was publishe... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4125283 Mon, 01 Nov 2010 12:41:53 +0100 4125283 http://www.medworm.com/index.php?rid=4118937&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprimary-care-doctors-how-valued-are-they%2F2010.10.27 Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists. As reported by Reuters, and provocatively titled, Do specialist doctors make too much money?, the study gives a per-hour breakdown of how much doctors make. I think this is a good approach, since annual salary figures do not account for the number of hours doctors work — and in the case of primary care doctors, this includes uncompensated time doing paperwork and other bureaucratic chores. Here’s what they found: … the lowest wages — amounting to $60.48 an hour — [were] paid to primary care physicians. In other broad categories of practice, surgeons took home the highest average hourly wage of $92. Internal medicine and pediatric docs earned about $85 an hour, the re... Better Health blogs http://www.medworm.com/rss/comments.php?id=4118937 Wed, 27 Oct 2010 22:00:56 +0100 4118937 http://www.medworm.com/index.php?rid=4086267&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-comparing-the-performance-of-doctors-is-trouble%2F2010.10.20 Who do you think is likely to be a better doctor: A board certified graduate of one of the top medical schools in America, or a non-certified doctor trained in a foreign country? If your answer is “I have absolutely no idea,” then you’re probably spending a lot of time looking at the “report cards” that pass for measures of health care quality. And you’re probably confused. Researchers in Pittsburgh studied 124 process-based quality measures in 30 clinical areas. These process measures are the state-of-the-art ways in which government and private insurers are checking up on the quality of medical care. They include things like making sure patients with heart problems are prescribed aspirin, and that women get Pap smears. The researchers compared these measures against other,... Better Health blogs http://www.medworm.com/rss/comments.php?id=4086267 Wed, 20 Oct 2010 20:00:37 +0100 4086267 http://www.medworm.com/index.php?rid=3980829&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-errors-discuss-them-or-switch-doctors%2F2010.09.17 Patients won’t confront doctors if they think there’s been a mistake. They’ll just find a new doctor, even if there’d been no medical error. Researchers looked at adult visits to seven primary care practices in North Carolina during 2008. They asked patients about their perceptions of medical mistakes and how did it influence the choice to switch doctors. Of 1,697 patients, 265 (15.6 percent) reported a mistake had been made, 227 (13.4 percent) reported a wrong diagnosis, 212 (12.5 percent) reported a wrong treatment, and 239 (14.1 percent) reported changing doctors as a result. Results appeared in the Archives of Internal Medicine. But anecdotes cited by patients as mistakes were often normal diagnostic or therapeutic challenges. A typical scenario might be the pa... Better Health blogs http://www.medworm.com/rss/comments.php?id=3980829 Sat, 18 Sep 2010 04:32:24 +0100 3980829 http://www.medworm.com/index.php?rid=3965409&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Feating-a-food-based-approach%2F2010.09.14 The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts -– a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical –- be it vitamin E, fish oil or omega-3. Instead we are being asked to call a potato a potato and a piece of steak — well, a piece of steak. If you haven’t heard about this sea change yet, you are not alone. The food science industry that markets “food products” for our consumption has done a good job giving their laboratory creations a semblance of health with phrases like “low fat” and “high in vitamin C.” For our part, the medical community i... Better Health blogs http://www.medworm.com/rss/comments.php?id=3965409 Tue, 14 Sep 2010 12:00:27 +0100 3965409 http://www.medworm.com/index.php?rid=3924902&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctor-patient-communication-much-room-for-improvement%2F2010.09.01 In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted. If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap. Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patients’ fears and anxieties with them, only 54 perc... Better Health blogs http://www.medworm.com/rss/comments.php?id=3924902 Thu, 02 Sep 2010 01:00:00 +0100 3924902 http://www.medworm.com/index.php?rid=3880861&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcommunication-gap-widens-between-doctors-and-patients%2F2010.08.18 In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted. If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap. Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patient’s fears and anxieties with them, only 54 per... Better Health blogs http://www.medworm.com/rss/comments.php?id=3880861 Wed, 18 Aug 2010 16:00:00 +0100 3880861 http://www.medworm.com/index.php?rid=3714444&cid=t_103381_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FJSU5gTPTZaE%2F Earlier this week, the Archives of Internal Medicine published a few articles and editorials about statins, although one, in particular, generated some heat - a review of the controversial Jupiter study from 2008. The study, which focused on AstraZeneca’s Crestor cholesterol pill, measured levels of a protein called CRP that can indicate arteries are inflamed and point toward heart disease. The results prompted debate over the extent to which CRP should be used as a guideline for treating cholsterol and the wisdom in prescribing Crestor and other statins to people with low cholesterol. This week’s revisitation (see here) stirred anew the controversy, but also focused on allegations of poor methodology, bias and conflicts of interest (see here). However, as was noted yesterday, two ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3714444 Wed, 30 Jun 2010 13:42:30 +0100 3714444 http://www.medworm.com/index.php?rid=3662672&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fless-is-more-in-medicine-why-patients-arent-buying-it%2F2010.06.14 In a recent article, the editors of the Archives of Internal Medicine make the case that too much unneeded care is being delivered in physician’s offices these days. According to the authors, “patient expectations” are a leading cause of this costly problem. Their solution? Get physicians to share with patients the “evidence” for why their requests are crazy, wrong, ill-informed or just plain stupid. But getting patients to buy into the “less is more” argument is a daunting task as most physicians already know. The problem is complicated by the fact that patients have a lot good reasons for not buying it. (more…) *This blog post was originally published at Mind The Gap* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3662672 Mon, 14 Jun 2010 20:00:18 +0100 3662672 http://www.medworm.com/index.php?rid=3662674&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Funnecessary-tests-and-treatments-responsible-reporting-can-help%2F2010.06.14 Just when I’ve lost hope that mainstream media will stop perpetuating the myth the more medicine equals better care, the Associated Press came up with this excellent piece. The article states, rightly, that “anywhere from one-fifth to nearly one-third of the tests and treatments we get are estimated to be unnecessary,” and that, “it may lead to dangerous side effects.” Regular readers of this blog should be familiar with those concepts. I wrote recently that patients often reject evidence-based medicine. One reason is that there aren’t enough clinical guidelines available for patients to make an informed decision. (more…) *This blog post was originally published at KevinMD.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3662674 Mon, 14 Jun 2010 16:00:37 +0100 3662674 http://www.medworm.com/index.php?rid=3635746&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fis-red-meat-hazardous-to-your-health%2F2010.06.06 Red meat consumption has been linked to diabetes, cardiovascular disease, and several types of cancer (breast, colorectal, stomach, bladder, prostate, and lymphoma). There are plausible mechanisms: Meat is a source of carcinogens, iron that may increase oxidative damage, and saturated fat. But correlation and plausibility are not enough to establish causation. Is red meat really dangerous? If so, how great is the risk? A couple of recent studies have tried to shed light on these questions, but they have raised more questions than they have answered. (more…) *This blog post was originally published at Science-Based Medicine* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3635746 Sun, 06 Jun 2010 16:00:39 +0100 3635746 http://www.medworm.com/index.php?rid=3545442&cid=t_103381_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdepression-and-chocolate%2F2010.05.07 Depressed people ate about 60 percent more chocolate compared with others, and major depression more than doubled consumption, reported researchers in the usually-more-reliable Archives of Internal Medicine. Now researchers want to further delve into the issue. “Whether there is a causal connection, and if so in which direction, is a matter for future prospective study,” the authors wrote. We wonder if Hershey’s would provide samples for the treatment arm of such studies, and if so, how people can sign up? *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3545442 Fri, 07 May 2010 18:00:00 +0100 3545442 http://www.medworm.com/index.php?rid=2287228&cid=t_103381_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F03%2F24%2Fwant-to-cut-your-risk-of-death%2F We often talk about happiness and well-being on the blog, or how to reduce your depression or cope with anxiety here. But none of that’s going to do you a whole lot of good if your life is cut short by making daily unhealthy food choices. So while I don’t usually write about general health topics here, occasionally a piece of research rises to the level of demanding our attention. And the research published yesterday linking red meat to a higher risk of death over the study’s 10 year period of time is just such research. The study of more than 500,000 middle-aged and elderly (aged 50 to 71) Americans found that those who consumed about four ounces of red meat a day (the equivalent of about a small hamburger) were more than 30 percent more likely to die during the 10 year... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2287228 Wed, 25 Mar 2009 00:56:31 +0100 2287228 http://www.medworm.com/index.php?rid=1380542&cid=t_103381_105_f&fid=34950&url=http%3A%2F%2Fmedblog.wordpress.com%2F2008%2F04%2F17%2Fyes-statins-do-everything-even-lower-bp%2F What could be crazy enough to end a 4 month hibernation of CTE? Archives Int Med 4/08 - The UCSD Statin study yielded further evidence that statin treatment reduces blood pressure (although not by much) The RCT enrolled over 900 subjects without known CVD or diabetes. The idea was to independently assess the effect on BP. There was no inclusion / exclusion criteria regarding baseline BP. Subjects were randomized to pravastatin, simvastatin, or placebo. Treatment with a statin resulted in about a 2-2.5 point drop in SBP and DBP. The treatment was stopped at 6 months, and the blood pressures returned to baseline by month 8 - further suggesting that this was a true effect. Beatrice A. Golomb; Joel E. Dimsdale; Halbert L. White; Janis B. Ritchie; Michael H. Criqui Reduction in Blood Pressure... Consider The Evidence: Med/Peds Journal Roundup blogs http://www.medworm.com/rss/comments.php?id=1380542 Thu, 17 Apr 2008 22:08:17 +0100 1380542 http://www.medworm.com/index.php?rid=2510812&cid=t_103381_105_f&fid=34950&url=http%3A%2F%2Fmedblog.wordpress.com%2F2008%2F04%2F17%2Fyes-statins-do-everything-even-lower-bp%2F What could be crazy enough to end a 4 month hibernation of CTE? Archives Int Med 4/08 – The UCSD Statin study yielded further evidence that statin treatment reduces blood pressure (although not by much) The RCT enrolled over 900 subjects without known CVD or diabetes. The idea was to independently assess the effect on BP. There was no inclusion / exclusion criteria regarding baseline BP. Subjects were randomized to pravastatin, simvastatin, or placebo. Treatment with a statin resulted in about a 2-2.5 point drop in SBP and DBP. The treatment was stopped at 6 months, and the blood pressures returned to baseline by month 8 – further suggesting that this was a true effect. Beatrice A. Golomb; Joel E. Dimsdale; Halbert L. White; Janis B. Ritchie; Michael H. Criqui Reduction in Bl... Consider The Evidence: Med/Peds Journal Roundup blogs http://www.medworm.com/rss/comments.php?id=2510812 Thu, 17 Apr 2008 22:02:18 +0100 2510812 http://www.medworm.com/index.php?rid=1344614&cid=t_103381_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F262163176%2F A federal judge in Boston has denied a motion by the drugmaker to compel The New England Journal of Medicine to hand over confidential peer reviews and editorial notes, The Chronicle of Higher Education reports. The decision comes two weeks after a federal judge in Chicago agreed with two other journals - including the Journal of the American Medical Association and the Archives of Internal Medicine - that Pfizer couldn’t force them to reveal confidential info. In January, Pfizer filed a motion asking for peer-review documents it had subpoenaed from 11 studies on the drugs published by the various journals, including the NEJM, and also sought rejected studies, arguing the manuscripts might contain data that could be useful for its defense. The drugmaker is currently being sued in fed... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1344614 Tue, 01 Apr 2008 19:34:13 +0100 1344614 http://www.medworm.com/index.php?rid=682749&cid=t_103381_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F06%2F19%2Fscreen-for-depression-in-older-adults-with-diabetes%2F Filed under: Type 1, Type 2, Adult Onset, Research, Support Depression is often underdiagnosed and untreated in the elderly population, and for those with diabetes mellitus, the risk is greater. Researchers from the University of Florida in Gainesville found elevated depression among older diabetic adults in the Health, Aging and Body Composition (Health ABC) study published this month in Archives of Internal Medicine. Health ABC, a cohort study, examined community-dwelling 70 to 79-year-old adults living in Memphis and Pittsburgh. Participants reported no depression at baseline, and were assessed annually for an average of nearly six years. Diabetes mellitus was associated with a 30% increased risk for depressed mood, and participants with poor glycemic control were associated with a... The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=682749 Tue, 19 Jun 2007 04:00:00 +0100 682749 http://www.medworm.com/index.php?rid=675452&cid=t_103381_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F06%2F14%2Fnumbers-game-predicting-risk-for-type-2-diabetes%2F This study took a 3,140-strong sample of middle-age persons, identifying them as having an average age of fifty-four, the majority overweight and over twelve percent exhibiting pre-diabetic blood sugar irregularities. Critical personal data for each patient (height, weight etc.) was recorded, then clinical models were developed through the addition of metabolic syndrome traits - that is, conditions increasing the risk for cardio trouble etc. All of this data was combined with results of the patients' responses to tests (such as the fasting insulin test). From this mass of data, these incredible people were able to pull the following fact: simple tests are all that are needed to predict Type 2 diabetes risk in middle-age. That is, basic personal variables such as whether or not you are obes... The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=675452 Thu, 14 Jun 2007 04:00:00 +0100 675452 http://www.medworm.com/index.php?rid=480029&cid=t_103381_105_f&fid=34950&url=http%3A%2F%2Fmedblog.wordpress.com%2F2006%2F11%2F20%2Fthiazides-increase-diabetes-allhat-says-dont-worry%2F Archives IM 11/13- ALLHAT data first made news with the conclusion that older, thiazide type diuretics were just as effective at reducing hypertension related disease as newer types of anti-hypertensives. One result of the study that is less well known is that thiazides appeared to increase the risk of incident diabetes. In the last issue of Archives, the ALLHAT investigators addressed this issue more directly.[Article] The investigators performed post hoc analyses on the subgroups assigned to Ca-channel blockers, ACE-Is, and thiazides. Patients with known diabetes prior to start of therapy were excluded from analysis, as were those without baseline fasting blood glucose(FG) levels. The data shows that all subjects had an increase in FG, but the thiazide group had a significantly greater i... Consider The Evidence: Med/Peds Journal Roundup blogs http://www.medworm.com/rss/comments.php?id=480029 Tue, 21 Nov 2006 04:08:08 +0100 480029 http://www.medworm.com/index.php?rid=480034&cid=t_103381_105_f&fid=34950&url=http%3A%2F%2Fmedblog.wordpress.com%2F2006%2F09%2F28%2Fzzzzzzall-about-sleep%2F So I’m an issue behind, but I had to blog on the sleep-themed Sept 18th issue of Archives of Int Med. (one of my favorite subjects). Just how important is it? Steptoe et al. found that young adult subjects that slept less than 6 hours per night were almost twice as likely to report their health as being poor - even after adjustment for socioeconomic factors, physical activity, BMI and Beck Depression Inventory scores. However, I cant help be a little cautioned by the fact that both sleep time and health status were based on self-report. From the basic science side, Irwin et al. found that monocyte production of the proinflammatory cytokines IL-6 and TNF-alpha was significantly higher on the morning after sleep deprivation. (sounds like a bad thing) Arzt et al warn of a condition that... Consider The Evidence: Med/Peds Journal Roundup blogs http://www.medworm.com/rss/comments.php?id=480034 Fri, 29 Sep 2006 01:43:21 +0100 480034