Harvard Health Blog

More than 17,000 American youths end up in emergency departments each year with injuries from a falling television set. Two-thirds of them are under age 5, according to a report published online today in the journal Pediatrics. From 1996 to 2011, nearly 400,000 children under 18 years old were treated in emergency departments for TV-related injuries. In 1996, most of the injuries occurred when kids ran into television sets. By 2011, injuries from falling TVs dominated. The rate of TVs falling from dressers, bureaus, chests of drawers, and armoires nearly quadrupled. The authors of the study suggest that adding TVs to the list of furniture types that come with anti-tip devices “would be an important step in decreasing the number of injuries resulting from falling TVs.”

The radioactive element radium has been used to treat cancer since soon after its discovery in 1898 by Marie Curie and her husband, Pierre. And it’s still finding new uses—a recently approved form of radium, radium-223 (Xofigo), is now being used to treat prostate cancer that has spread to the bones. Researchers say that Xofigo addresses “an unmet need” in men with this type of prostate cancer, since current therapies don’t work very well against it.

Aspirin has many uses, from easing a headache or cooling a fever to preventing heart attacks and the most common kind of stroke. It may be time to add “preventing colorectal cancer” to the list. New results from the Women’s Health Study, a clinical trial that evaluated the benefits and risks of low-dose aspirin and vitamin E among nearly 40,000 women, show that aspirin reduces the risk of developing colorectal cancer by 20%. The effect isn’t immediate, but instead takes ten to 20 years to be seen. Aspirin isn’t without its drawbacks, including gastrointestinal bleeding and ulcer formation. Both occurred slightly more often among women taking aspirin. Although the Women’s Health Study results sound promising, don’t go reaching for the aspirin bottle just yet. Taking aspirin—and any other drug—is really a balancing act between benefits and risks.

Is it possible for a gene test to identify whether a prostate that’s healthy today is sure to develop cancer down the road? And should results of such a test be the basis for removing a seemingly healthy prostate gland? Those are questions raised by recent press reports of a British man who had his prostate gland removed because he carried a faulty gene called BRCA2.

An old, aspirin-like drug called salsalate could help control blood sugar in people with type 2 diabetes. In the TINSAL-T2D trial, 286 volunteers took pills containing either salsalate or a placebo for nearly a year. Over the course of the trial, those in the salsalate group had lower blood sugar levels, and some were even able to reduce dosages of other diabetes medications they were taking. Experts aren’t exactly sure how salsalate helps control blood sugar, but its effectiveness supports the idea that inflammation plays a role in type 2 diabetes. Although the results are promising, what we really need to know about salsalate (or any new or repurposed drug) is how its long-term benefits and risks stack up against each other. The trial was too small and too short to determine those risks. According to the researchers, such “outcomes require continued evaluation before salsalate can be recommended for widespread use” by people with type 2 diabetes.

The sudden hospitalization yesterday of Teresa Heinz Kerry, wife of U.S. Secretary of State John Kerry, while vacationing on Nantucket Island is high-profile testimony that illness can happen at any time—even during a vacation. Heinz Kerry was taken by ambulance on Sunday afternoon to Nantucket Cottage Hospital. She was accompanied by her husband. After being stabilized, she and the Secretary of State were flown to Massachusetts General Hospital in Boston. Neither the hospital nor Heinz Kerry’s family has commented on the nature of her illness. News reports say she is in critical but stable condition. Heinz Kerry’s situation highlights the value of electronic medical records, and the hazards of not having, or being able to access, medical information when you are travelling or on vacation.

Summer’s heat is as predictable as winter’s chill. Heat-related illnesses—and even deaths—are also predictable. But they aren’t inevitable. In fact, most are preventable. Most healthy people tolerate the heat without missing a beat. It’s not so easy for people with damaged or weakened hearts, or for older people whose bodies don’t respond as readily to stress as they once did. There are three different levels of heart-related illness: heat cramps, heat exhaustion, and heat stroke. Some simple choices can help you weather the weather. Drinking water and other hydrating fluids is essential. Putting off exercise or other physical activity until things cool down also helps. Chilled air is the best way to beat the heat. Sticking with smaller meals that don’t overload the stomach can also help.

Do-it-yourselfers, take heart. Here’s something else to do at home that can have a substantial benefit on your health: measure your blood pressure. It’s easy, inexpensive, and helps control blood pressure better than visits to the doctor. The latest evidence for the benefits of home blood pressure monitoring comes from researchers in Minnesota. In a 12-month clinical trial, 72% of those doing home monitoring had their blood pressure under control compared to 57% who received usual care. The benefits persisted six months after the program had ended. Anyone can monitor blood pressure at home. You can buy a good home blood pressure monitor at a pharmacy or online merchant for anywhere from $50 to $100. Some insurance companies cover the cost.

Long-awaited results from a nearly 10-year trial exploring the effect of changes in diet and exercise among people with diabetes weren’t what most people expected. The Look AHEAD trial found that intensive efforts to lose weight by eating less and exercising more didn’t provide any more protection against heart disease—a common co-traveler with diabetes—than standard diabetes support and education. The spin from some media reports is that weight loss doesn’t reduce heart disease risk among people with type 2 diabetes, but I think that’s the wrong interpretation. The results of the Look AHEAD trial don’t contradict the value of lifestyle changes. People in the intensive change group improved their blood sugar with fewer drugs, saving an estimated $600 per year, they were also less likely to have developed chronic kidney disease and less self-reported vision problems. The Look AHEAD results reinforce for me that diabetes care needs to be tailored to the individual.

Wiser use of prescription medications by everyone—doctors and their patients—could save the U.S. health care system more than $200 billion a year. That’s the conclusion of a new report, Avoidable Costs in U.S. Healthcare, from the IMS Institute for Healthcare Informatics. Inefficient or ineffective use of medications lead to six million hospitalizations, four million trips to the emergency room and 78 million visits to doctors and other care providers each year, according to the report. Those are huge numbers. Although $213 billion represents less than 8% of what Americans spend on health care each year, it’s still a staggering sum. It also exacts human costs that aren’t reflected in the estimates. The report identifies 6 things that can be improved to address the problem: 1) not taking medications as directed, 2) taking too many medications, 3) delayed treatment, 4) overuse of antibiotics, 5) medication errors, and 6) underuse of generic medications.

City dwellers often think of rural America as a throwback to past “good old days.” But when it comes to obesity and diabetes, people living outside urban areas offer a frightening glimpse of the future. While more than 8% of Americans now have diabetes, in some rural counties 20% of the residents have diabetes. Those counties also tend to have high rates of obesity. Barriers to healthy living contribute to both obesity and diabetes. So does lack of primary care physicians. One answer may be greater reliance on community health workers—lay people trained to provide diabetes education and outreach. In Birmingham, Alabama, the Cities for Life program has doctors refer people with diabetes to “patient navigators” who help them find local resources such as nearby exercise classes or mobile farmers’ markets.

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. A new study from Denmark suggests that a serious infection or autoimmune disease could trigger a mood disorder. How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

Each year, nearly a quarter of a million American men learn they have prostate cancer. Most are diagnosed with early-stage cancer that has not spread beyond the prostate gland. Traditional treatments include surgery, radiation therapy, and a “watch and wait” strategy called active surveillance. A new study published online this week in JAMA Internal Medicine indicates that diet may be an important add-on. The study, part of the ongoing Harvard-based Health Professionals Follow-up Study, suggests that eating more foods that deliver healthy vegetable oils can help fight the second leading cause of cancer death in men. Earlier studies have implicated the traditional Western diet, which is relatively high in red meat and other sources of animal fats, with a higher risk for developing prostate cancer in the first place, while eating more vegetable oils and vegetable protein may help prevent it.

The Mediterranean diet has been getting a lot of press as being the very best for health. But there’s another diet that appears to be equally good: a vegetarian diet. A study published in JAMA Internal Medicine found that people who ate a vegetarian diet were 12% less likely to have died over the course of the five-year study than nonvegetarians. The benefits were especially good for men, who had a significant reduction in heart disease. This study underscores the idea that meat consumption influences long-term health, and not in a good way. Should you consider ditching the Mediterranean diet and becoming a vegetarian instead? Either one is healthier than the typical American diet, so it’s really a matter of personal choice.

Actress Angelina Jolie recently went public with her double mastectomy to prevent breast cancer. Governor Chris Christie told us his reasons for gastric bypass surgery. And now actor Michael Douglas is shining the spotlight on the human papilloma virus (HPV)—the number one cause of mouth and throat cancer. In an interview published in The Guardian newspaper in London, Douglas mentioned that his own throat cancer could have been brought on by oral sex, a common way to become infected with HPV. HPV transmitted by sexual contact often doesn’t become active enough to cause symptoms. When it does become active, it tends to invade mucous membranes, such as those covering the lining of the vagina, cervix, anus, mouth, tongue, and throat. An HPV infection can cause warts in and around these tissues. Most people sexually exposed to HPV never develop symptoms or health problems, and most HPV infections go away by themselves within two years. But the infection can persist and cause long-term problems. These include cervical cancer in women, penis cancer in men, and in both sexes some cancers of the anus and oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils).

We are taught to share at an early age, and sharing is encouraged and praised across the life span. One area in which there has been a lack of sharing is medicine. Doctors have traditionally made decisions for their patients with little or no discussion about the preferences of the person who will ultimately have to live with the decision. That’s changing. More and more, doctors are trying to implement a model known as shared decision making or informed decision making. These terms refer to a process that includes a thoughtful, informed conversation between you and your doctor aimed at making a decision that’s right for you. Shared decision making is gaining acceptance as a medical “best practice.” Many studies suggest that it improves health outcomes, taking medications as directed and following other instructions, and satisfaction with a treatment or course of action.

A lot is known about diabetes. But a discovery that could change how this disease is treated shows just how much more there is to learn. A team of Harvard Medical School researchers has discovered a hormone called betatrophin made by liver and fat cells that signals the body to make more insulin-producing beta cells. A report of their work appears in this month’s issue of the prestigious scientific journal Cell. In mice with diabetes, experimentally turning on the production of betatrophin inside liver and fat cells caused an increase in beta cells and a dramatic improvement in blood sugar. It will, of course, take much more research in mice—and then in humans—to determine if this newly discovered hormone can serve as a treatment for diabetes. So it’s too soon to get excited that the discovery of betatrophin will translate directly into a new treatment for diabetes. But it is another example of the human body’s power to naturally repair itself.

My twice-daily walks with my border collie, Clair DeNoon, are the highlights of my day. A new report from the American Heart Association will put an extra spring in my steps on these walks. A panel of experts from the American Heart Association has weighed all the available evidence on pet ownership and cardiovascular disease. The verdict: Having a pet—a dog in particular—likely lowers the risk of heart disease. Some of the connection can be attributed to the extra walks dog owners take. Companionship also contributes. If dog ownership is heart healthy, should everyone who cares about heart health have a dog? No. According to the heart association panel, “the primary purpose of adopting, rescuing, or purchasing a pet should not be to achieve a reduction in cardiovascular risk.”