Posts by Heidi Godman
For the past 25 years, US News and World Report has been listing the “best hospitals” in the United States. In a Viewpoint article in this week’s JAMA, the magazine’s top health analysts describe how they are expanding and changing the way they rate hospitals. The current ratings aren’t designed for use by patients in need of typical hospital care. That’s changing. The US News team has spent more than a year analyzing more than 5 million patient records regarding more than a dozen common procedures and medical conditions from more than 4,300 hospitals. Ratings for five of these — hip replacement, knee replacement, coronary artery bypass surgery chronic obstructive pulmonary disease, congestive heart failure — were published online today. The new ratings use only performance measures such as patient safety, technology, and survival rates after admission. Keep in mind that ratings like these can help, but they’re mostly limited to data, and aren’t the whole picture. Other organizations also provide hospital rankings and ratings.
Fainting can be alarming. Sometimes it’s a signal of a heart or other problem that needs to be fixed. But sometimes it is nothing to worry about, caused by not eating, having blood drawn, or even laughing too hard. Up to one-third of people at low risk for serious short-term problems after fainting end up being hospitalized. A research letter in this week’s JAMA Internal Medicine points out that hospitalization for low-risk fainting can do more harm than good. Just because you’re in the emergency department after fainting doesn’t mean you need to be admitted to the hospital. Ask your physician if you’re at risk for a worse event if you go home, and make sure that if you’re admitted it’s because there’s a potential serious cause for your fainting that can’t be fully assessed in the emergency department.
Looking for ways to ward off colorectal cancer? According to a new study, a pescovegetarian diet — that’s a vegetarian diet that includes fish — was linked to a 43% reduction in the risk of developing colorectal cancer. The study, published in JAMA Internal Medicine, adds more support to the notion that something in red meat, or the way it is cooked, encourages the growth of colorectal cancer. It’s also possible that eating more plant foods provides extra beneficial nutrients such as folate, calcium, and fiber that may protect against colorectal cancer. Fish contain healthful omega-3 fats and vitamin D. Another good strategy for preventing harm from colorectal cancer, the second leading cause of cancer death in the United States? Have colonoscopies as needed.
There are many reasons why you might want to give someone chocolate on Valentine’s Day. There’s the tradition of it, and the idea of sweets for your sweetheart. Here’s another tempting reason: certain compounds in chocolate, called cocoa flavanols, have recently been linked with improved thinking skills. Italian researchers found people who drank a daily cocoa brew with a lot of flavanols (more than 500 milligrams) significantly improved their scores on tests that measured attention, executive function, and memory. How might cocoa flavanols boost thinking skills? They may help brain cells connect with each other. Dark chocolate is a good source of flavonols. It’s also a good source of calories. Adding it to your diet without taking out other foods can lead to weight gain, which may wipe out any health gain.
Feeling young may be one way to keep getting older. In a new study, a pair of researchers from University College London found that older people who felt three or more years younger than their actual age were more likely to be alive eight years later than those who felt more than one year older than their actual age. Does a youthful feeling keep people alive? Possibly: feeling younger may lead to better health habits, like exercising and eating healthfully. Feeling younger may also inspire a sense of resilience that keeps people young.
The expression that something is “a hard pill to swallow” isn’t just a metaphor. Swallowing pills can be difficult and downright unpleasant. It causes one in three people to gag, vomit, or choke. That may keep people from sticking to their medication routines, which can make them sicker. A new study by researchers from the University of Heidelberg in Germany may help people with pill swallowing difficulties. They suggest two techniques — the pop-bottle method and the lean-forward method — that can help people swallow pills more easily. Both methods were tested among people with self-professed difficulty swallowing medicine, and offered improvements of 60% to 90%.
Smells and tastes are often sources of great pleasure. They can also spark wonderful memories. But like memories, these senses can fade, or even disappear, with age. A new study suggests that loss of smell may be a canary in the coal mine—an early warning that something else is wrong in the body. In the study, published in PLoS ONE, older people who lost their sense of smell were more likely to have died over a five-year period. Previous research has linked loss of smell to the onset of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. What to do If your sense of smell has faded? Don’t jump to conclusions. Diminished smell function is usually caused by problems in the nose, not in the brain.
New guidelines from the American College of Physicians offer drug-free ways women can use to reduce or stop urinary incontinence, a potentially embarrassing condition that affects millions of women. The guidelines recommend that women first try Kegel exercises, bladder training, exercise, and weight loss if needed. These approaches can work for both of the leading types of urinary incontinence: stress incontinence (leakage with laughter, sneezing, or other things that put pressure on the bladder) and urge incontinence, also known as overactive bladder, which is caused by unpredictable contractions of muscles in the bladder wall. Other lifestyle changes, like watch fluid intake and minimizing bladder irritants like caffeine, alcohol, carbonated drinks, and other may also help. If these approaches aren’t effective, the next step might be treatment with medication, surgery, or even an injection of botulinum toxin to relax overactive bladder muscles.
Obstructive sleep apnea is a common cause of daytime sleepiness. It occurs when the muscles in the back of the throat relax too much during sleep. This lets the tissues around the throat close in and block the airway. People with obstructive sleep apnea can wake up gasping for breath scores of times a night, usually without knowing it. Obstructive sleep apnea can boost blood pressure and increases the risk of stroke. New guidelines from the American College of Physicians recommends an overnight sleep test to diagnose, or rule out, obstructive sleep apnea for individuals with unexplained daytime sleepiness. These are usually done in a sleep center, but home tests can also be done using a portable monitor.
Every day, millions of Americans use the Nutrition Facts labels on food packages to make healthy choices. The U.S. Food and Drug Administration has recently proposed changes to make the labels even more useful. It’s an important move that could help curb the skyrocketing number of Americans with type 2 diabetes, osteoarthritis, and other weight-related conditions. The proposed new label will list information about added sugars, update daily values for sodium and dietary fiber, list the amount of potassium and vitamin D, and remove the “Calories from Fat” category while continuing to list types of fat. For foods that come in larger packages but could be consumed in one sitting, manufacturers would have to use a two-column label showing calorie and nutrition information for both a single serving and the entire package. These changes are a step in the right direction, but don’t go far enough with sugar, ingredient listing, and nutrient claims.