Sunday, April 24, 2011

Journal Watch/News 4/24/11

Patients with do-not-resuscitate (DRN) orders fare worse: A study of 120 hospitals across the country found that overall, nearly a fourth of the DNR patients died in the month following their surgery -- about three times as many as in the comparison group. That difference remained even after taking into account that DNR patients are usually sicker to begin with. DNR patients also had slightly more complications, such as pneumonia or stroke. But the outcomes depended on the type of surgery. For instance, half the DNR patients having a kind of abdominal surgery called exploratory laparotomy died within a month of the surgery, compared to one in five of the patients without the order. Archives of Surgery, online April 18, 2011.

Lifestyle Changes Can Slash Blood Fat Levels: Healthy lifestyle changes can significantly lower elevated levels of triglycerides, a type of blood fat associated with heart disease and other health problems. A healthy diet for people with high triglycerides should include more vegetables; lower-fructose fruits, such as cantaloupe, grapefruit, strawberries, peaches and bananas; whole-grains; and healthier unsaturated fats, such as omega-3 fatty acids found in fatty fish. Circulation April 18

Women Taking Calcium Supplements May Risk Heart Health: For this analysis, the authors looked only at the 16,718 women in the Women’s Health Initiative who had not been taking personal calcium supplements before entering the trial. In this case, women who were randomized to take calcium and vitamin D as part of the study protocol had a modest 13 to 22 percent increased risk of cardiovascular problems, particularly heart attacks. Women in the control arm had no change in risk. The case against calcium became stronger when researchers added in data from 13 other, unpublished trials involving almost 30,000 women. Now the increased risk for heart attack was 25 to 30 percent and, for a stroke, 15 to 20 percent. "It is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. Clearly further studies are needed and the debate remains ongoing." British Medical Journal April 19, 2011 l

For non-smokers, healthy living cuts death rate in half. Diet and lifestyle questionnaires were filled out in 1992 and 1993 by almost 112,000 non-smoking women and men in the Cancer Prevention Study. The participants were scored based on their adherence to American Cancer Society prevention guidelines regarding body mass index, physical activity, diet and alcohol consumption. After 14 years of follow-up, participants who were highly compliant with the recommendations had a 42 percent lower risk of death vs. those who were the least compliant. Among those with higher compliance scores, the risk of cardiovascular-related death was 58 percent lower for women and 48 percent lower for men, and the risk of cancer death was 24 percent lower in women and 30 percent lower in men. The findings were similar for both never and former smokers. Cancer Biomarkers, Epidemiology, and Prevention

Aspirin cuts heart attacks, not deaths or strokes: Small doses of aspirin can lower the risk of heart attack in people who never had heart disease, a new look at the medical evidence shows. But the blood-thinning drug doesn't appear to cut the chances of dying from the disease, at least not enough that researchers can say for certain. And experts warn people to consult their doctor before taking the medication, which increases the risk of bleeding ulcers. American Journal of Cardiology, online April 11, 2011.

High Deductible Health Plans Bring Equal Savings to All: Poor people and those with chronic health problems are no more likely than others to cut back on health care when they're enrolled in high-deductible health plans, according to a new study. Conducted by the RAND Corporation, the study found that so-called "medically vulnerable" people were more likely to slash their spending while they were on the plans. High-deductible plans are health insurance policies that require the person who's insured to pay for most medical care out-of-pocket before coverage kicks in after a certain dollar amount has been spent each year. About 20 percent of Americans with employer-sponsored health insurance had a high-deductible plan in 2009, according to the researchers. Forum for Health Economics & Policy

How much did you pay for prescriptions: According to Consumer Reports, in 2010 the top ten medications prescribed were as follows:
1. Pfizer’s Lipitor (for high cholesterol): $7.2 billion
2, AstraZeneca’s Nexium (for heartburn, gastroesophageal reflux, and ulcers): $6.3 billion
3. Bristol-Myers’ Plavix (blood thinner for heart attack and stroke prevention): $6.1 billion
4. GlaxoSmithKline's Advair Diskus (for asthma): $4.7 billion
5. Otsuka's Abilify (for bipolar disorder, schizophrenia, and severe depression): $4.6 billion
6. AstraZeneca’s Seroquel (for schizophrenia, bipolar disorder, and severe depression): $4.4 billion
7. Merck’s Singulair (for allergies and asthma): $4.1 billion
8. AstraZeneca’s Crestor (for high cholesterol): $3.8 billion
9. Takeda’s Actos (for type 2 diabetes): $3.5 billion
10. Amgen’s Epogen (for people on dialysis with anemia): $3.3 billion. h


No Evidence Coffee Ups Risk of High Blood Pressure Despite earlier concerns, downing lots of coffee doesn't seem to increase the risk of high blood pressure, according to a new report -- but the evidence isn't conclusive. The American Journal of Clinical Nutrition, online March 30, 2011

Hand Sanitizers Carry Unproven Claims they Prevent MRSA Infections

Mindfulness Meditation regulates the brain’s alpha rhythm, which turns down the volume on distracting information. A key value of meditation, which can help improve pain and working memory, may be helping the brain deal with an often-over stimulating world. Brain Research Bulletin

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