Harvard Health Blog

Read posts from experts at Harvard Health Publishing covering a variety of health topics and perspectives on medical news.

Articles

Should kids have their cholesterol checked?

New guidelines for from the American Academy of Pediatrics recommend that all kids between the ages of 9 and 11 have their LDL (bad) cholesterol levels checked. The rationale is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. Atherosclerosis is fed by high LDL. The guidelines aren’t aimed at getting kids to take cholesterol-lowering statins. Instead, they are about getting kids, their parents, and their doctors to talk about making healthy lifestyle choices. The hope is that more doctor time spent coaching and counseling now will mean less time treating cardiovascular disease later.

Do you want to see your doctor’s medical notes?

As paper medical records give way to electronic health records, it is becoming increasingly possible to view your medical history. Yet experts are debating whether the electronic health record should include the notes that doctors make in them. The Open Notes project is designed to test the consequences of giving patients access to doctors’ notes. Results of a survey of the expectations that doctors and patients have for note sharing, reported in the Annals of Internal Medicine, suggest that while physicians are generally optimistic about doing this, many believe it could cause patients to worry or generate unnecessary questions. Patients who filled out the survey thought that seeing their doctor’s notes would provide a clearer understanding of their medical condition, improve self-care, and give them a greater sense of control.

Studies hint at limits when reducing salt

“Limit salt” has been a key part of dietary advice for decades. Once aimed at individuals, the FDA is hoping to persuade food companies to cut back on salt added to prepared foods. That’s probably a good idea, since the average American gets more salt—and thus sodium—than needed, most of it from prepared foods. But the question of how low we should go with sodium hasn’t been answered. Two studies suggest that getting too little sodium could pose problems, just as eating too much does. Trials to determine the safest range for sodium aren’t in the offing. What to do in the interim? Aiming for the recommended target of 2,300 milligrams per day from all sources is probably good for most people.

Social networks can affect weight, happiness

The new science of social networks is demonstrating how personal interconnections can affect our health. Ideas and habits that influence health for better or for worse can spread through social networks in much the same way that germs spread through communities. An article in the December issue of the Harvard Men’s Health Watch explores how social networks can affect weight and mood. A study of people taking part in the Framingham Heart Study found that among participants who had a friend become obese, their chance of becoming obese rose by 57%. A different study from Framingham showed that happiness can also spread across social networks. Research into social networks could help experts some day use them to improve public health.

Making health decisions: mindsets, numbers, and stories

How do people make decisions about their health and medical treatment? Husband and wife doctor team Jerome Groopman and Pamela Hartzband, both faculty members at Harvard Medical School and physicians at Beth Israel Deaconess Medical Center, explore this topic in a new book called Your Medical Mind. They say three basic influences drive our medical decisions: our mindset or general approach to medical matters, numbers (medical data and how they are presented), and stories. Groopman and Hartzband interviewed scores of patients to arrive at general mindsets that shape medical decisions: maximalists and minimalists, naturalists and technologists, believers and doubters. These mindsets can change in the face of new numbers, well-framed advice from physicians, compelling stories from friends and family, and direct-to-consumer advertising.

Treating neck pain with a dose of exercise

For neck and shoulder pain, doctors once recommended rest, maybe the use of a neck brace, and waiting until the pain had ebbed away. Today there are recommending movement instead of rest. As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publishing, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain) results from controlled studies show that exercise provides some relief. Exactly how much exercise to do, what types are best, and how often it should be done have yet to be completely hashed out.

Long-term survivors are helping unlock the mysteries of type 1 diabetes

Type 1 diabetes, once called juvenile-onset diabetes, takes a toll on health and longevity. Some people, though, have managed to live with the disease for decades. Since 1970, almost 3,500 men and women who have lived with type 12 diabetes for a half century have been recognized by the Joslin Diabetes Center in Boston with bronze 50-year medals. Forty-five of them have passed the 75-year mark. A study that includes several hundred 50-year Medalists is changing experts’ understanding of type 1 diabetes. Many of the 50-year Medalists have no signs of diabetes-induced eye or kidney damage, and some still continue to make small amounts of insulin. This work may uncover new ways to protect people from the damage diabetes can cause and point ways to new treatments for it.

For some prostate cancers, waiting beats treatment

Many prostate cancers grow very slowly and never escape the prostate. They cause no symptoms, and never threaten health or life. Yet almost 90% of men told they have prostate cancer opt for immediate treatment with surgery or radiation therapy—which often cause trouble getting or keeping an erection and an assortment of urinary problems. Yesterday, a panel of experts convened by the National Institutes of Health recommended that many men with localized, low-risk prostate cancer be closely monitored, and that treatment be delayed until there was evidence that the disease was progressing.

Does fitness offset fatness?

At least for men, being more fit may have a bigger health payoff than losing weight, according to a new study of more than 14,000 well-off middle-aged men who are participating in the Aerobics Center Longitudinal Study. Researchers followed their health, weight, and exercise habits for 11 years. Compared with men whose fitness declined over the course of the study, those who maintained their fitness levels reduced their odds of dying from cardiovascular disease or any other cause by about 30%, even if they didn’t lose any excess weight. Those who improved their fitness levels saw a 40% reduction. For optimal health, being fit and maintaining a healthy weight are best. But if you are overweight and inactive, this study and others suggest that getting more activity is the best place to start to improve your health.

Obama going gray: Do presidents age faster?

It’s more than just a few flecks. President Barack Obama, who turned 50 in August, is definitely going gray. He’s said the color change runs in his family and has mentioned a grandfather who turned gray at 29. Dr. Michael Roizen, of RealAge.com fame, says presidents age twice as fast as normal when they’re in office. Not so, says new study of presidential longevity. According to an article in the Journal of the American Medical Association, there’s no evidence that American presidents die sooner than other American men of their time. In fact, quite the opposite: most of them lived long lives and beat the longevity expectations for their time. Seven of the first eight presidents lived to a ripe old age, with average life spans of 81.5 years. These men probably had some inborn hardiness, as well as fortunate circumstances.

Denosumab delays bone metastases in prostate cancer trial

Most men with advanced prostate cancer are at high risk for developing bone metastases, the process by which cancer spreads to and weakens the bones. A serious health and financial concern, bone metastases can lead to fractures, spinal cord compression, pain and a need for radiation therapy or bone surgery. These complications are referred to […]

New York City pushes earlier treatment for AIDS

In an effort to halt the spread of AIDS, health officials in New York City recommended yesterday that treatment with anti-AIDS drugs should begin as soon as an individual is diagnosed with the human immunodeficiency virus (HIV), the virus that causes AIDS, rather than waiting for it to begin harming the immune system. Early treatment also lessens the likelihood of passing HIV to someone else.

World AIDS Day 2011: Is the HIV/AIDS glass finally half full?

On the 13th annual World AIDS Day, there’s cause for hope. The epidemic seems to have peaked. Drug therapy has turned HIV/AIDS into a manageable chronic disease. Drug therapy appears to prevent transmission of HIV from infected to uninfected individuals. And HIV cures are under investigation. Yet there is also cause for continued alarm. The AIDS epidemic is far from over, and the downward trends in infection rates could plateau or head up if prevention and treatment efforts slack off. The overalI trends don’t apply to everybody. In the United States, new HIV infections are still increasing among young black men, both gay and bisexual. And despite all the research into HIV and over two dozen ongoing trials of candidate agents, there’s still no HIV/AIDS vaccine.

Consumers could save as generic Lipitor hits the market

The patent on Lipitor, the world’s best-selling brand name prescription drug, expired on November 30th. That opens the door for less expensive generic versions of the drug, called atorvastatin, which are now available. In addition to atorvastatin, six other statins are currently available in the United States. Generic drugs are chemical clones of their brand-name counterparts. By law, generic drugs must contain the same active ingredients as the brand-name drug, work the same way in the body, and meet the same standards the FDA has set for the brand-name drug. One big difference is cost. Generic atorvastatin should be less expensive than brand-name Lipitor, although Pfizer, the company that makes Lipitor, is striking deals with insurers and pharmacy benefit managers to price brand-name Lipitor at or under the generic alternatives in order to keep sales of Lipitor as strong as possible for as long as possible.

No-surgery valve replacement a game changer—for some

The FDA has approved a nonsurgical alternative to open-heart surgery for replacing a failing aortic valve. For now, though, it is only available for people who can’t, or shouldn’t, have open-heart surgery.

Implants, tattoos, and tears could measure blood sugar without pain

Today, the only reliable way to check blood sugar is by pricking a finger, squeezing out a drop of blood, and placing it on a small test strip attached to a meter. For some people, this means five to ten finger sticks a day. Researchers across the country are exploring pain-free ways to measure blood sugar. University of California, San Diego researchers have developed a titanium sensor the diameter of a quarter that would be implanted under the skin and wirelessly send blood sugar readings to an external monitor. At Northeastern University in Boston, researchers are working on a blood sugar “tattoo” by injecting glucose-detecting nanosensors under the skin. Arizona State University researchers are working to perfect a device that measures blood sugar using tears instead of blood.

Medications most likely to put older Americans in the hospital

Some medications are well known for being risky, especially for older people. Certain antihistamines, barbiturates, muscle relaxants—take too much of them, or take them with certain other medications, and you can wind up in serious trouble (and possibly in the back of ambulance). But researchers from the federal Centers for Disease Control and Prevention (CDC) […]

Yoga may help feet, ease migraine

If exercise is good medicine, then yoga is, too. Research published recently suggests that yoga can be a useful therapy for lower back pain. An article in the November 2011 Harvard Health Letter indicates that yoga may also be a good way to keep feet strong and flexible, and so prevent falls. It can also help people who suffer from migraines. In The Migraine Solution, which will be published in January by Harvard Health Publishing and St. Martin’s Press, coauthor Paul B. Rizzoli, M.D., says that yoga can be a useful treatment for migraine because it is widely available, affordable, and very likely has benefits beyond migraine.

Avastin loses FDA approval for breast cancer

The FDA today revoked its 2008 approval of the drug Avastin to treat breast cancer, concluding that the drug does little to help women with breast cancer while putting them at risk for potentially life-threatening side effects. Avastin will remain on the market (and so be potentially available to women with breast cancer) because it has also been approved to treat other types of cancer.

Whole-body vibration doesn’t slow bone loss

Good vibrations may work for dancing on the beach or for romance, but they don’t seem to do much to strengthen bones. Results of a clinical trial published in the Annals of Internal Medicine showed that older women who stood on a vibrating platform for 20 minutes a day experienced just as much bone loss over the course of the year-long trial as women who didn’t use the platform.

The dangers of hospital delirium in older people

Many older people develop delirium when they are hospitalized. Delirium is a sudden change in mental status characterized by confusion, disorientation, altered states of consciousness (from hyperalert to unrousable), an inability to focus, and sometimes hallucinations. Hospital delirium is especially common among older people who’ve had surgeries such as hip replacement or heart surgery, or those who are in intensive care. Inflammation, infection, and medications can trigger hospital delirium as can potentially disorienting changes common to hospital stays, including sleep interruptions, unfamiliar surroundings, disruption of usual routines, separation from family and pets, and being without eyeglasses or dentures. Although delirium often recedes, it may have long-lasting aftereffects, including premature death and poorer outcomes, such as dementia and institutionalization.

Three reports to help with holiday health and emotional challenges

With Veterans Day and Halloween behind us, we are moving full steam ahead to the holidays, the stretch from Thanksgiving to New Year’s Day (or Super Bowl Sunday, depending on your perspective). The holidays can be a wonderful time, full of friends, family, and fun. But they can also generate pressures and situations that undermine health. To help you enjoy a healthy and happy holiday season, Harvard Health Publishing is offering three Special Health Reports that focus on common holiday challenges: depression, overuse of alcohol, and healthy eating.

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