More on the Stroke Belt study

The Stroke Belt study does raise new questions about timing and whether there might be something about being born and spending your early childhood in the American Southeast that leads to a greater chance of having a fatal stroke later in life. Maria Glymour and her colleagues at the Harvard School of Public Health conducted their study of the Stroke Belt by using data from the 1980, 1990, and 2000 censuses and mortality data from the National Center for Health Statistics for those same years. They defined the Stroke Belt as being the states of North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, and Arkansas. Using the census and mortality data, the researchers created four “exposure” categories. (Locked) More »

The respiratory tract and its infections

Respiratory tract infections include the common cold, sinusitis, pharyngitis, bronchitis, and pneumonia. Hand washing is the most effective action people can take to prevent getting one of these infections. Antibiotics are important arrows in the treatment quiver, but they've been overused, especially for sinusitis and bronchitis. (Locked) More »

In brief: Acrylamide: No longer such a hot potato

The chemical acrylamide, which forms as a byproduct of cooking many baked and fried foods, was thought to cause cancer, but subsequent research has not supported this view. Researchers have rummaged through diet and cancer data, looking for an association with bladder, colorectal, esophageal, gastric, pancreatic, and prostate cancer, and have emerged empty-handed. Harvard researchers didn't find a connection to premenopausal breast cancer. A Danish group did, but it was only among smokers, and the exposure to acrylamide from tobacco smoke dwarfs the intake from diet. (Locked) More »

Does stroke risk begin with the stork?

Several years ago, M. Maria Glymour, an assistant professor at the Harvard School of Public Health, started investigating whether the Stroke Belt mystery could be solved by looking at early-life exposures, not just snapshots of the risk profiles of adults. In a 2007 paper cleverly titled "Is the ‘stroke belt' worn from childhood?" she and her colleagues found that people who lived in the Stroke Belt as children were 25% more likely to have a stroke in adulthood than those who had never lived there, and that their risk was actually a bit higher than people who lived in the region as both children and adults. In 2009, Glymour reported findings from a follow-up study that used a larger database, which puts the statistics on a firmer footing. The gist of the results was similar. This time, though, people with "double exposure" — birth and adulthood in the Stroke Belt — had the highest stroke mortality rate. More »

Choices for hipsters

Hip replacements are common procedures, and their popularity is expected to increase as baby boomers age. Some younger patients opt for hip resurfacing, but there's one serious problem that hip resurfacing patients have that hip replacement patients don't. Sometimes the femoral neck of the resurfaced hip breaks, and a second operation — a hip replacement — is needed. Several reports have put the incidence of femoral neck fracture at between 1% and 2%. Some data suggest that the fractures are more likely to happen in women than in men, perhaps because of low bone density. Some surgeons say, therefore, the ideal hip resurfacing patient is not only young and thin, but also male. Poor surgical technique (hip resurfacing is a technically demanding operation to perform) and the shape and angle of the femoral neck have been blamed for the fractures. So while it's helpful to be familiar with the options, the skill and experience of the surgeon is often going to be more important than the type of replacement.  (Locked) More »