Harvard Health Blog
These days, more and more adults bike to work, combining their daily workout with their daily commute, all while helping the environment. Unfortunately, biking is getting riskier. A study in this week’s Journal of the American Medical Association found that, between 1998 and 2013, the rate of bike injuries rose by 28% and the rate of people admitted to the hospital because of bike injuries rose by 120%. People over 45 had the greatest increase in injuries. And the majority of bike accidents now happen on city streets. The good news is that you can help protect yourself by learning and following the rules of the road, staying alert, and keeping some common-sense safety tips in mind.
Do the long hours in the hospital, often with little sleep, make doctors in training more prone to making mistakes? Over the past decade, concerns regarding trainee doctors’ sleep loss and the potential for medical errors have brought about limits on the number of consecutive hours a resident can work in the hospital. Do the same concerns apply to fully licensed surgeons? A recent study in The New England Journal of Medicine suggests that the answer is no. Comparing the data on patients whose surgeons were on call the night before with that of patients whose surgeons were not working the night before showed virtually no difference in how well the patients did after surgery. It is not clear, however, whether these doctors anticipated the effects of being on call and compensated for them, or whether these results would be the same for less-experienced surgeons-in-training.
Consumers are barraged by ads for prescription drugs on television and in print. Twenty years ago, people who knew the names of the drugs available for their health conditions, and knew to ask for new drugs by name, were few and far between. But today, direct-to-consumer ads encourage patients to ask their doctors for new (and often pricey) medications. While it isn’t bad to inform people about new and potentially better medications, this tidal wave of advertising has a downside. Potential side effects and risks are not always completely and plainly explained and the cost of these drugs is often not made clear. While it is fine to ask your doctor about a drug you’ve seen on TV or elsewhere, be aware that a new medicine is not necessarily a better medicine — or the right one for you.
Study after study has shown that Americans don’t get enough activity. In fact, many of us don’t even get our recommended 10,000 steps a day. Could pedometers or digital fitness trackers help? Pedometers are simple gadgets that measure how many steps you take. Digital fitness trackers also measure the pace, distance, duration, and intensity of your activity, and often have accompanying web applications that can evaluate and even graph this information. In a small study published in the American Journal of Preventive Medicine, researchers gave either a standard pedometer or a Fitbit brand digital fitness tracker to 51 overweight postmenopausal women who had been getting about 33 minutes per week of moderate to vigorous physical activity. The pedometer group did not have any significant change to their activity levels. But the fitness tracker group increased their physical activity by an additional 38 minutes per week.
Statistics show that one out of every 68 children in the United States meets the criteria for autism spectrum disorder (ASD). What these figures don’t show is that early intervention and treatment can make a huge difference in the lives of these children and their families. Routine well-child visits are important to monitor health and growth, but they also provide an opportunity to keep an eye on a child’s development. While most children do not have ASD, and some kids are just “late bloomers,” others may show signs of any number of developmental challenges or delays — all of which benefit from therapies at home or at school. Of course, all children benefit from mindful observation of their development and advice and support from their pediatricians, should concerns arise.
Weight gain might be one of the most dreaded “side effects” of quitting smoking. Constant reminders of the health dangers of being overweight lead some smokers to think that smoking is “safer” than the weight they might gain if they quit. But that’s just not the case. It’s true that people tend to gain 5-10 pounds in the first six months after they stop smoking. But a recent study suggested that for those who quit, weight gain slows down over the following 10 years after quitting. Over that same time period, people who continued to smoke also gained some weight, though not as much. Over all, kicking the habit doesn’t have to mean a larger waistline, especially if you plan ahead.
Women of all ages have questions and concerns about their sex lives. These issues often come up after having a baby, during perimenopause, and well into later life, too. Women’s sexuality is very complex. Brain chemistry, mood, hormones, and the nature of a woman’s relationship with her sexual partner are all important influences. This week, the FDA approved the drug flibanserin for treatment of low sex drive in premenopausal women. This drug is no “pink Viagra,” and its effect on women’s sexual function may be small, but it may be a step in the right direction simply because it draws attention to the value of a satisfying sex life for women and acknowledges it as a legitimate health concern.
If you’re a man, you’ve undoubtedly heard that lack of energy or sex drive, trouble concentrating, or feeling down or not quite yourself could be related to low testosterone, or “low T” — and that a little testosterone replacement could have you back on your game. But testosterone replacement is tricky business, and its safety and effectiveness remain controversial. Further, there can be many other causes for the symptoms of “low T.” A thorough evaluation to determine whether low testosterone is really the problem, along with a careful weighing of the potential risks and benefits of testosterone replacement, are essential before considering this drug.
Websites that rate doctors and their practices can offer valuable information, but it’s often incomplete. Narrative reviews, in which patients describe in their own words their experiences with clinicians, are usually the most helpful — but could be even more so if they were collected in a standardized format. What’s more, only 40% of doctor-rating sites list information on how well a provider performs in terms of offering timely appointments and following guidelines for preventive screening tests. If you’re looking for a new clinician, it may be most helpful to ask trusted friends and family members for recommendations.
Vitamin D holds promise for many things, like building bone, preventing heart attacks and strokes, reducing cancer risk, and more. But that promise isn’t fully backed by science. For example, a controlled clinical trial published this week in JAMA Internal Medicine found that a vitamin D supplements didn’t build bone in postmenopausal women with blood levels of vitamin D below the threshold generally considered necessary for good health. Many researchers are looking ahead to results from an ongoing trial called VITAL, which aims to gather the kind of solid evidence that will let us know for sure whether taking relatively high doses of vitamin D can ward off heart attack, stroke, or cancer. The results are expected by the end of 2017. It’s also possible to get vitamin D the old-fashioned way: go out in the sun between 10 a.m. and 3 p.m. with at least 10% of your skin exposed. Stay out long enough to absorb the sun but not long enough to be burned.