Heavy drinking shrinks brain
Following years of chronic alcohol misuse, alcoholics suffer from alcohol-related dementia due to severe brain damage. Evaluation of postmortem effects of alcohol on the brain has shown atrophy of the brain leading to a classical ?pickled walnut? effect as evident on MRI.
Choose a healthy neighborhood
According to a new study published in October 12 issue of JAMA, people who live in healthy neighborhoods may have a lower risk of developing type 2 diabetes. A team examined 2285 adults aged 45 to 84 years from three neighborhoods. Blood glucose levels were obtained from study participants at baseline and three follow-up examinations. Measures for neighborhood were rated by the suitability of the environment for physical activity i.e. if it was pleasant to walk in their neighborhood including access to healthy foods in the form of large, high-quality fruits, vegetables and other low-fat foods. Scores were calculated on scales of one to five, with five representing the healthiest areas. Better neighborhood resources were associated with a 38% lower incidence of type 2 diabetes.
The diabetes epidemic: India maintains lead
In its annual report, the 20th annual World Diabetes Congress of the International Diabetic Federation (IDF) has warned the diabetic epidemic in India is in the danger of becoming uncontrollable. India has the highest number of diabetic population in the world, 50.8 million followed by China with 43.2 million and USA with 26.8 million. In India, this number is expected to increase to 58.7 million by the year 2010, about 7 % of its adult population. Due to the increasing life expectancy and urbanization, more than 8.4 % of the Indian adult population will suffer from by 2030. Sounding a note of caution to the authorities, the report said that the rural prevalence is higher than in less affluent rural areas in more affluent parts of the country, indicating that increasing economic growth will raise diabetes prevalence in India even more than these possibly conservative estimates have indicated. This not only means squandering away billions in lost productivity but that India would also be spending $2.8 billion every year on diabetes control measures by 2010. The estimated global healthcare expenditures to treat and prevent diabetes and its complications are expected to total at least $376 billion in 2010. The incoming president of IDA, Jean-Claude Mbanya said that the epidemic was getting out of control and if the trend continues unchecked, there will be 435 million people with diabetes worldwide by 2030.
Connection between blood counts and human disease
Genetic variations that are crucial to formation of blood cells have now been discovered, a development that may significantly affect common diseases. Researchers from UK carried out routine blood tests viz. hemoglobin, red and white cell count and platelet counts. They found 22 regions of the human genome implicated in the development of these blood cells, of which 15 were earlier unidentified. The team also said that one of the genetic variants associated with platelet counts increases risk of heart disease. This new variant was in a region of the genome that has been recognized to impact risk of type 1diabetes, high blood pressure and celiac disease. The researchers are hopeful that this characterization of the regions has the potential to improve the understanding of formation of blood cells and how blood cell development is linked with human diseases, including blood cell cancers.
FDA Approves Asacol HD for Moderately Active Ulcerative Colitis
Asacol HD, mesalamine delayed-release tablets from Procter & Gamble Pharmaceuticals, indicated for the treatment of moderately active ulcerative colitis (UC), has been approved by the FDA. The approval was based on evaluations from the ASCEND (Assessing the Safety and Clinical Efficacy of a New Dose of 5-ASA [4.8 g/d, 800 mg tablet]) studies. In six-week clinical studies of patients with moderately active UC flares, Asacol HD at 4.8 g per day helped many patients reduce their UC symptoms, including number of bowel movements and rectal bleeding, for some as early as three weeks. Asacol HD decreased the number of trips to the bathroom (i.e., number of bowel movements) in approximately three out of four of patients by six weeks and decreased rectal bleeding for approximately 80% of patients by six weeks. The recommended dose of Asacol HD for adults is two 800-mg tablets, three times per day, with or without food, for a total daily dose of 4.8 g. Asacol HD is the newest addition to Procter & Gamble?s gastrointestinal product line, which also includes Asacol 400 mg delayed-release tablets, the number one most-prescribed oral 5-ASA therapy, according to information derived from IMS National Prescription Data. If for any reason a patient is dissatisfied with the first course of therapy, Procter & Gamble will refund the receipted cost of the original prescription. Receipted cost includes only the amount actually paid by the patient. Procter & Gamble will not refund costs covered by third-party payers, including Medicaid.
Source: Gastroenterology and Endoscopic News October 2009
FRAX®, a new online tool in osteoporosis management
World Osteoporosis Day was observed on October 20, 2009. To mark the event, the International Osteoporosis Foundation (IOF) issued a new 16-page report on FRAX®. FRAX® or ?WHO Fracture Risk Assessment Tool?, is a free online tool developed by the WHO available at http://www.shef.ac.uk/FRAX/. The FRAX® tool uses many several known clinical risk factors to calculate 10-year fracture probability and helps identification of high-risk individuals who require interventions. It is especially useful in areas where DXA scan is not available. According to John Kanis, President IOF, with this new easy-to-read report, the IOF hopes to bring understanding of FRAX® to a broad audience of health professionals so that it is possible to identify and treat more people at risk of debilitating fractures before these fractures occur. Dr. Eugene McCloskey of the University of Sheffield and author of the IOF report said that clinicians should feel encouraged to make FRAX® a part of their clinical assessment of patients.
Managing Sleep Problems Can Decrease Cancer Pain
Sleep disruptions, depressed mood and pain contribute to fatigue in patients with cancer, according to a new study in the Journal of Clinical Sleep Medicine. Data also suggest that resolving sleep problems should improve pain management in this group. ?It is very common for cancer patients to experience the symptom cluster of depression, pain, insomnia and fatigue, yet it is not well understood how all of these factors interact,? said lead author Edward Stepanski. Responses by 11,445 patients to the Patient Care Monitor, a validated software package for assessing oncology-related symptoms, were analyzed using structural equation modeling techniques. Data were split into two groups, with one set used to develop the model and the other to cross-validate the information. Moderate to strong associations were seen between trouble sleeping and physical pain as well as physical pain and fatigue. Although the relationship between pain and sleep was thought to be reciprocal, a model of reciprocal causation could not be fit to the data. Fatigue ratings increased as trouble sleeping, depressed mood and pain worsened. Although depression acted directly to increase fatigue, there was an indirect impact by worsening pain and trouble sleeping. According to Dr. Stepanski, the study results suggest that if a cancer patient has an abrupt change in pain control, one of the first things to be asked is, ?How are you sleeping? If that has worsened, one must keep in mind that the pain has gotten worse because of the insomnia and not just assume the pain is causing the sleep disturbances. That is important clinically because managing sleep can also help manage the pain.
Source: Clinical Oncology News 2009
H1N1 flu: Initial chest x-rays may be deceptive
A retrospective study has noted that though chest x-rays are quite often normal in patients with H1N1 flu, but it can quickly evolve into extensive, bilateral air-space disease in severely ill patients. The study is published in the Oct. 15 online issue of the American Journal of Roentgenology. The records of 222 patients hospitalized with confirmed H1N1 flu were examined; 66 of whom underwent chest x-ray. Taken as a whole, the initial chest x-rays were normal in 58% of the group. But major differences were noted when the patients were grouped on the basis of severity. These initial images were abnormal in 100% of those who went on to develop severe disease. According to the researchers, in view of the imminent flu season, it is important to know the radiologic features of H1N1, as well as the virus?s likely complications. CT scans were more valuable in identifying those patients at risk of developing more serious complications as a possible result of the H1N1 virus
FDA gives its nod to Berinert to treat acute hereditary angioedema
The US FDA has approved Berinert for the treatment of acute abdominal or facial manifestations of hereditary angioedema in adults and adolescents. Berinert is a plasma-derived concentrate of C1 esterase inhibitor (human). Hereditary angioedema is a genetic disorder due to a deficiency of the C1 inhibitor (C1-INH). Symptoms include episodes of edema (swelling) in the face and the abdomen. Patients who develop intestinal wall swelling may have severe pain, diarrhea, nausea, and vomiting. Hereditary angioedema involving the face can cause painful distortions and swelling. Berinert, a plasma-derived intravenous therapy, is used to treat the primary cause of the disease by providing the human protein to patients who lack C1-INH in their systems. The drug is contraindicated in individuals who have a history of an anaphylactic reaction to C1-INH preparations. Patients should be monitored for early signs of allergic or hypersensitivity reactions. The safety and efficacy of Berinert for prophylactic use has not been established.
This is life
A short history of medicine: Doctor, I have an earache.
2000 B.C. - Here, eat this root.
1000 B.C. - That root is heathen, say this prayer.
1850 A.D. - That prayer is superstition, drink this potion.
1940 A.D. - That potion is snake oil, swallow this pill.
1985 A.D. - That pill is ineffective, take this antibiotic.
2000 A.D. - That antibiotic is artificial. Here, eat this root!
Thought of the Day
You can never cross the ocean unless you have the courage to lose sight of the shore?. Christopher Columbus
DFSICON 2009, 8TH Annual National Conference of Diabetic Foot Society of India, November 27-29th, Hotel Lalit New Delhi (www.dfsicondelhi2009.com)
Medinews Doctor of the Year Award
IJCP group will starting 10th Jan 2010 this year will award 20 Medinews Doctor of the Year Award to eminent doctors who have done outstanding work in the year 2009. The award will be distributed during a day long CME: MEDINEWS 2009- Revisiting 2009. This will be a yearly event. The award will carry a citation, shawl, coconut kalash, scenery and a memento.