Archive for 2012
Many medical studies confirm what we know or suspect. Every once in a while, though, one surprises us, turning “conventional wisdom” on its head. That just happened with the sudden shutdown of a long-running diabetes trial called Look AHEAD (Action for Health in Diabetes). Begun in 2001 and scheduled to last another two years, Look AHEAD was designed to see if an intensive diet and weight loss program could reduce the number of heart attacks, strokes, and other cardiovascular problems in people with type 2 diabetes. An early peek at the data showed that the program had little apparent effect, and the investigators concluded it would be futile to continue. This does not mean that we should ignore diet and exercise in treating of type 2 diabetes. Instead, the details of the study results, which haven’t yet been published, are likely to reveal other explanations.
Two years ago, new research showed that American girls were hitting puberty at younger ages than ever. The same thing is happening with boys: they are starting puberty almost two years earlier than they did 30 to 40 years ago. Why this is happening isn’t clear, but it could affect social and sexual behaviors. A new study shows that the average age of puberty is now 10 years for white boys (about one-and-a-half years earlier than what has long been considered “normal”), 9 years for African-American boys (about two years earlier than expected), and 10 years for Hispanic boys, which is unchanged from before. Although early puberty is increasingly common, it can be a signal of a tumor in the brain, pituitary glands, or elsewhere; an underactive thyroid gland; or other medical problems.
Depression can strike at any age. Children can develop it, as can octogenarians. No matter when it starts, depression can drain the joy and pleasure from life. The first appearance of depression later in life may also be a signal of memory loss or dementia down the road. According to a study in the Archives of General Psychiatry, dementia is more common among people who become depressed in middle age or later in life than among those who aren’t depressed. Depression is often overlooked in older adults, so it’s important to be on the lookout for warning signs, like feelings of hopelessness, loss of interest in activities, trouble sleeping, and more. It’s important to treat depression in individuals with the beginning of dementia, and older individuals who are depressed should be evaluated for dementia.
Americans’ love affair with vitamins—more than half of us take one a day—isn’t well supported by science. Trials of single vitamins, like E, C, and beta carotene, have been a bust. Whether multivitamins offer any health benefits has been something of a mystery. Now a new report indicates that taking a standard multivitamin-multimineral pill every day for more than a decade reduces the odds of developing cancer by 8%. The finding comes from the Physicians’ Health Study II, a Harvard-based trial in which nearly 15,000 male physicians took a daily pill containing 31 vitamins and minerals (Centrum Silver) or a placebo. The reduction could be due to fixing micronutrient deficiencies. It’s also possible that low doses of several vitamins and minerals might work together in other ways to prevent cancer. A daily multivitamin-multimineral supplement can provide some nutritional insurance, but it’s no replacement for vegetables, fruits, whole grains, and other healthful foods.
For all too many people, using a tablet computer is a pain in the neck, shoulders, and back. Why? Widely popular tablets like the iPad, Nook, Kindle Fire, and Xoom are so light and easy to handle that you can hold one on your lap or in your hand. That can put you in a position that’s bad for your neck, shoulders, and back. In a study of 15 experienced tablet users, Harvard School of Public Health researchers found that working with a tablet held on the lap or placed flat on a table makes the neck bend much more than does working with a desktop or notebook computer. Neck-wise, the best tablet orientation was having it propped up on a table. Next time you expect to be working with a tablet computer for more than a few minutes, place it on a table and use a case that holds it at a comfortable viewing angle. Shift your hands, your weight, or even stand up when you can. And take a break every 15 minutes.
A report in this week’s Journal of the American Medical Association describes an outbreak of tattoo-related infections in four states: New York, Washington, Iowa, and Colorado. All involved Mycobacterium bacteria. Infection with these fast-growing bugs can cause problems ranging from a mild rash around the tattoo site to severe abscesses that require surgery and several months of antibiotic therapy. This isn’t the first such report. An outbreak in Ohio, Kentucky, and Vermont involved methicillin-resistant Staphylococcus aureus (sometimes known as MRSA), a hard-to-treat bug that can cause substantial damage to the skin and the rest of the body. Tattoo-related infections have three main sources: unsterile practices by the tattoo artist and his or shop, the ink used for tattooing, and poor after-care. Don’t hesitate to ask a tattoo artist directly what the shop’s sterilization processes are. And follow instructions afterward for caring for the tattoo.
Succulent tomatoes are far more than just a delicious fruit. Eating them may also help lower your risk of stroke, likely due to the lycopene they contain. Lycopene is a powerful antioxidant that eliminates dangerous free radicals that can damage DNA and other fragile cell structures. Past research has shown that a diet rich in lycopene-containing foods may help lower the risk of prostate and other cancers. Now, in a report just published in the journal Neurology, a team of Finnish researchers has linked higher lycopene levels in the blood to protection against stroke. The researchers suggested that lycopene, in addition to its ability to attack free radicals, may also reduce inflammation and cholesterol, improve immune function, and prevent blood from clotting. All of these may help reduce ischemic strokes, which are caused by clot-caused blockages in blood flow to the brain. It’s best to get lycopene from food—tomatoes and watermelon are excellent sources—not supplements.
Sometimes, the Nobel Prize in Physiology or Medicine is awarded for a discovery or invention that already is improving the practice of medicine and saving lives. Sometimes it is awarded for very basic research that might someday affect medical practice and human health. Such is the case with this year’s Nobel Prize in Physiology or Medicine, which was awarded to Sir John Gurdon of Great Britain and Dr. Shinya Yamanaka. If I had to put into one sentence the message of today’s Prize, it would be this: our cells are a lot smarter and more flexible than we once imagined, and capitalizing on that fact could greatly improve the treatment of many human diseases. The work of Gurdon and Yamanaka led the way to today’s work on stem cells, which could someday be used to treat human diseases. The 2012 Nobel Prize in Medicine, like many before it, demonstrates that people with the curiosity and courage to ask what appear to be ridiculous questions, and a society that supports their work, can change our world for the better.
October is Breast Cancer Awareness Month. Sponsored by national public service organizations, professional medical associations, and government agencies, it aims to make sure women all across America have the information they need to identify breast cancer early and take all of the steps needed to fight it. This year, Harvard Health Publications, where I am the Chief Editor of Books, offers a unique contribution to Breast Cancer Awareness Month: our newest book, Hope and Healing for Your Breast Cancer Journey. This book, part of the Chicken Soup for the Soul Health series, weaves the stories of more than 25 women diagnosed with breast cancer and their family members with practical information about managing a support team, getting through treatment, healing body and soul, and more. In this post, I share a moving story from the book, “I Miss My Breasts,” written by Linda A. Fiorenzano, a project and risk management professional who was diagnosed with breast cancer at age 36.
As part of its 200th anniversary celebration, today’s New England Journal of Medicine carries an article called “The Past 200 Years in Diabetes.” It describes some of the advances made in understanding and treating this disease, like the discovery of insulin and the development of personal blood-sugar monitors. But it doesn’t tell much about how living with diabetes has changed. Just 50 years ago, checking blood sugar and administering insulin were big ordeals, and people with diabetes weren’t expected to live more than a few years after their diagnoses. today, it’s a cinch to check blood sugar with a quick finger prick, and pen-like devices almost painlessly deliver insulin, and people with diabetes who take care of themselves have almost normal life expectancies. Advances in protecting and treating the heart, eyes, kidneys, and limbs have helped reduce complications from diabetes.