Diabetes Archive

A portable ultrasound device that detects plaque buildup in arteries may offer a simple, cost-effective way to detect heart disease before it causes any symptoms. A report in the December 2014 Global Heart journal describes findings from a large-scale test of the technology in India, the United States, and Canada.

The innermost layer of an artery's wall (the intima) provides a smooth surface for blood to flow through. The middle layer (the media) contains muscle and elastic fibers that let the vessel expand and contract with each heartbeat. The thicker the intima and the media, the more likely the artery is choked with cholesterol-filled plaque. Using ultrasound, a doctor can easily measure the intima-media thickness in the arteries of the neck and upper leg.

The telltale sign is leg pain and fatigue that comes on with activity and goes away with rest.

Although these powerful pain relievers can be addictive, opioids are safe for most people when used properly.

Q. My doctor has recommended a bone density screening, but the medical center with the full-body scanner is a 45-minute drive from my house. A health fair at a neighborhood church offers a bone density test using a foot scanner. Would that be as accurate?

A. The foot scan is called a quantitative ultrasound, and it usually measures the bone density of the heel bone.
It appears to be at least as good as clinical risk factors—such as older age, family history of bone fractures, low body mass index, smoking, corticosteroid use, and excessive alcohol consumption—for identifying people at high risk for osteoporosis.

For most people, there is no advantage to tests that measure cholesterol and triglyceride particle size.

Long trips come with an increased risk of blood clots deep in the leg veins, which can have serious complications.

Q. My doctor, an internist, just retired, and my health plan is asking me to designate a new primary care physician. I'm 75. Would there be advantages to choosing a geriatrician as my new doctor?

A. First, a disclaimer: I am a geriatrician. So my short answer is, "Yes, of course!" But my reasoned, unbiased answer would be, "It depends." If you are a generally healthy 75-year-old woman, a family physician or internist will be able to take excellent care of you. Geriatricians are trained to care for older adults with complex illnesses and are expert in managing the care of people who are frail. Improving your ability to function, and the quality of your life, are the guiding principles of geriatric medicine. We are expert at managing complexity and uncertainty, working with families, and caring for people with serious illnesses who are approaching the end of life. A geriatrician would be a good choice if you have physical or cognitive impairment, if you take a lot of medications, or if your friends and family are involved in your medical care. For people who have several medical problems, we emphasize the role of patient and family preference in making medical decisions, with the patient's goals as our primary focus.

Few women realize how common pelvic prolapse is—and how easily treated. Here are five things you should know.

Q. Do the protective effects of alcohol extend to dessert wines and liqueurs, or do those have too much sugar?

Keep hydrated, and empty your bladder often to stave off these risky infections.