Archive for 2013

Patrick J. Skerrett

Wellocracy aims to help trackers choose and use health apps and devices

There’s something satisfying about getting immediate feedback about exercise, sleep, and other activities. That’s why more and more people are joining the “quantified-self” movement. It involves formal tracking of health and habits, usually using apps and devices that feed data to them—from heart rate, activity, and sleep monitors to Bluetooth connected scales. But with so many apps and connected devices on the market, it can be hard to decide which ones are worth trying. Wellocracy, a website launched by the Harvard-affiliated Center for Connected Health, aims to give people impartial information about fitness trackers, mobile health apps, and other self-help technologies. It reviews dozens of sleep trackers, wearable activity trackers, mobile running apps, and mobile pedometer apps, lets you compare apps and devices in each category, provides a guide for beginners and offers tips for adding activity “bursts” throughout the day.

Michael Craig Miller, M.D.

For fans, World Series is a marathon, not a sprint

Millions of baseball fans will tune in tonight for the opening game of the World Series. Boston Red Sox versus St. Louis Cardinals. Sportswriters are saying it will be an interesting series between two well-matched teams. Football fans have it easy. They have to sit through just one big game to decide the year’s champion. For us baseball fans, it could take seven games spread over nine days to determine this year’s champion. That means fans need to approach the series as a marathon, not a sprint. Pay attention to sleep, exercise, food, alcohol, and emotions. The Red Sox and Cardinals are two very likable teams. Commentators point out that these guys play the game the “right way.” The players themselves say it’s going to be fun. Let’s see if we fans can remember that baseball is a game. This World Series should be fun to watch. Whoever you’re rooting for, have fun watching.

Julie Corliss

Flu shot linked to lower heart attack, stroke risk

Getting the flu shot may do more than protect against the flu and its lingering aftermath. It also lowers a person’s odds of a having heart attack, stroke, heart failure, or other major cardiac event—including death—by about a third over the following year. What’s the connection between flu and cardiovascular problems? The body mounts an impressive immune response against the flu. That causes a lot of inflammation, which destabilizes cholesterol-filled plaque inside blood vessels. Plaque rupture can cause a heart attack or stroke. Experts recommend a flu shot for everyone six months of age and older. It is especially important for those who face the highest risk of complications: young children; adults over age 50; those of all ages with serious health conditions such as cardiovascular disease, asthma or other lung disease, liver or kidney disease, or diabetes; and those who care for young children or other individuals at high risk of flu complications.

Howard LeWine, M.D.

Doctors often don’t reveal cancer test overtreatment and harms

There’s no question that tests to detect cancer before it causes any problems can save lives. But such tests can also cause harm through overdiagnosis and overtreatment. A study published yesterday in JAMA Internal Medicine indicates that the majority of people aren’t informed by their doctors that early warning cancer tests may detect slow-growing, or no-growing, cancers that will never cause symptoms or affect health. Undergoing surgery, chemotherapy, or radiation for such cancers provides no benefits and definite harms. The researchers found that only 9.5% of people were informed by their doctors of the risk of overdiagnosis and possible overtreatment. Compare that to 80% who said they wanted to be informed of the possible harms of screening before having a screening test. Informing patients about the risks of screening isn’t easy to do in a brief office visit. It’s complicated information. And the researchers suggest that many doctors don’t have a good grip on relative benefits and harms of screening.

Patrick J. Skerrett

Stopping nosebleeds: a pinch will usually do the trick

Most nosebleeds (the medical term is epistaxis) stop quickly. Some, though, need medical attention. An article posted online yesterday in JAMA Otolaryngology-Head & Neck Surgery looks at treatment options for serious nosebleeds. The bottom line: Conservative options, like packing the nose with gauze, work just as well as more invasive efforts, have negative fewer side effects, and cost less. It makes sense to treat every nosebleed as if it is one that can be fixed at home. A good, strong pinch in the right place will often do the trick.

Daniel Pendick

PET scans peer into the heart of dementia

What’s bad for the heart is often bad for the brain. High cholesterol, high blood pressure, diabetes, and unhealthy “hardening” of the arteries increase the risk of mental decline or dementia later in life. A study published online today in Neurology shows that older people with the stiffest arteries are more likely to show the kinds of damage to brain tissue often seen in people with dementia. The study adds support to the “two hit” theory of dementia. It suggests that the accumulation of Alzheimer’s-linked amyloid protein in the brain may not pose problems until damage to small blood vessels that nourish the brain nudges them over into dementia. There may be a silver lining to this line of research: Efforts to improve cardiovascular health can also protect the brain.

Howard LeWine, M.D.

Letters from an obese president tell a familiar story of struggling with weight

William Howard Taft was America’s heaviest president. He would have preferred being seen and remembered for something else, and took steps to lose weight. Taft’s story of weight loss and regain, described in today’s Annals of Internal Medicine, sounds completely familiar today, more than 100 years later. Using correspondence and archival sources, Deborah Levine, an assistant professor at Providence College in Rhode Island, tells the story of Taft’s struggles with his weight. In 1905, with the help of a British physician, Taft went from 314 pounds to 255. He was pleased with his accomplishment. But three years later, when Taft was inaugurated as the nation’s 27th President, he tipped the scales at 354 pounds. His story and struggle with weight are no different than what many people experience today.

Anthony Komaroff, M.D.

Harvard Health and Orca Health launch heart-focused iBook series

The ability of today’s electronic books to display videos, images explained by a spoken voice, animations, interactive tools, and quizzes gives doctors new ways of explaining things. Harvard Health Publications and Orca Health have created a series of ten interactive iBooks focused on heart disease. Currently, these are available only as iBooks. Need to know what happens in the heart when a heart attack is underway, how doctors open up cholesterol-clogged arteries, or how to cope with the irregular heart rhythm known as atrial fibrillation? The answers are in these iBooks. They let users view the heart in ways and detail they’ve never seen before to learn about common heart conditions and procedures.

Heidi Godman

For borderline underactive thyroid, drug therapy isn’t always necessary

A slowdown in the output of the thyroid gland can cause many problems, ranging from extreme fatigue and depression to intolerance to cold, weight gain, dry skin, and dry hair. Millions of Americans have an underactive thyroid, a condition known as hypothyroidism. The symptoms can usually be controlled with a daily dose of synthetic thyroid hormone called levothyroxine. Who actually benefits from taking levothyroxine is being called into question. New evidence suggests that many people with borderline hypothyroidism may be taking this medication unnecessarily.

Daniel Pendick

5 steps for preventing kidney stones

If you’ve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones aren’t a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures. Preventing kidney stones isn’t complicated but it does take some determination. Prevention efforts include drinking plenty of water, getting enough calcium from food, cutting back on salt (sodium), limiting animal protein, and avoiding stone-forming foods like beets, chocolate, spinach, rhubarb, tea, and others.