Archive for February 4th, 2013

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Little House on the Prairie

These are my health links for January 31st through February 4th:

  • How did ‘Little House’ sister really become blind? -Any fan of Laura Ingalls Wilder’s beloved “Little House” books knows how the author’s sister Mary went blind: scarlet fever. But turns out that probably wasn’t the cause, medical experts say, upending one of the more dramatic elements in the classic stories.An analysis of historical documents, biographical records and other material suggests another disease that causes swelling in the brain and upper spinal cord was the most likely culprit. It was known as “brain fever” in the late 1800s, the setting for the mostly true stories about Wilder’s pioneer family.Scarlet fever was rampant and feared at the time, and it was likely often misdiagnosed for other illnesses that cause fever, the researchers said.
  • Battles Erupt Over Filling Doctors’ Shoes -As physician assistants and other midlevel health professionals fill growing gaps in primary health care, turf battles are erupting in many states over what they can and can’t do in medical practices.One of the bitterest fights is in Kentucky, where physician assistants are lobbying the state legislature to repeal a law that says that for the first 18 months after certification, physician assistants are allowed to treat patients only when a supervising physician is on site. Being in phone contact isn’t deemed sufficient.The Kentucky Medical Association, which represents doctors in the state, says it is still evaluating the bill. But it helped push for an on-site requirement in 2003 and helped block two previous attempts to rescind the 18-month rule, on the grounds that physician assistants have far less experience than physicians and benefit from more supervision.
  • Effective Addiction Treatment – Make that Evidence Based -Countless people addicted to drugs, alcohol or both have managed to get clean and stay clean with the help of organizations like Alcoholics Anonymous or the thousands of residential and outpatient clinics devoted to treating addiction.But if you have failed one or more times to achieve lasting sobriety after rehab, perhaps after spending tens of thousands of dollars, you’re not alone. And chances are, it’s not your fault.Of the 23.5 million teenagers and adults addicted to alcohol or drugs, only about 1 in 10 gets treatment, which too often fails to keep them drug-free. Many of these programs fail to use proven methods to deal with the factors that underlie addiction and set off relapse.

    According to recent examinations of treatment programs, most are rooted in outdated methods rather than newer approaches shown in scientific studies to be more effective in helping people achieve and maintain addiction-free lives. People typically do more research when shopping for a new car than when seeking treatment for addiction.

    A groundbreaking report published last year by the National Center on Addiction and Substance Abuse at Columbia University concluded that “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.” The report added, “Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.”

  • Key TB vaccine trial fails; more waiting in the wings -A highly anticipated study of the first new tuberculosis vaccine in 90 years showed it offered no added benefit over the current vaccine when it came to protecting babies from TB infections, a disappointing but not entirely unexpected outcome, researchers said on Monday.The vaccine, known as MVA85A, is the most advanced of more than a dozen TB vaccines now in clinical trials in people, and scientists are poring over the results to learn why the trial failed and how the results can inform future studies.MVA85A was developed by researchers at the University of Oxford in Britain with support from Aeras, the Wellcome Trust, the European Commission and the Oxford-Emergent Tuberculosis Consortium, a joint venture between Oxford and Emergent Biosolutions Inc.

    “Obviously, we all would have liked to see greater protection,” said Dr Ann Ginsberg of Aeras, a non-profit biotech based in Rockville, Maryland and funded in large part by the Bill & Melinda Gates Foundation.

    The current TB vaccine, known as Bacille Calmette-Guérin, or BCG, was developed in 1921, and is given routinely to babies in countries with high rates of TB to prevent severe disease.

    However, protection wears off in just a few years, and BCG does nothing to protect against the most common form of tuberculosis that invades the lungs of adults and adolescents, and can be transmitted through coughing and sneezing.

  • Vitamin C supplements tied to men’s kidney stones -Men who take vitamin C supplements are at higher-than-average risk of developing kidney stones, a new study from Sweden suggests.The findings don’t prove the vitamin itself triggers stones to form. But researchers said that because there are no clear benefits tied to taking high-dose vitamin C, people who have had stones in the past might want to think before taking extra supplements.”I don’t think I would hold this up and say, ‘You shouldn’t take vitamin C, and here’s the evidence,’” said Dr. Brian Matlaga, a urologist who studies kidney stones at Johns Hopkins Medicine in Baltimore.

    But, “When you talk to patients, a lot of times you’ll find patients are taking non-prescribed medications, like vitamin supplements… and there may not be great evidence that there’s an actual health benefit associated with these,” he told Reuters Health.

    The new finding “suggests that stone formers who take regular vitamin C may actually place themselves at increased risk,” said Matlaga, who wasn’t involved in the study.

  • Myths of Weight Loss Are Plentiful, Researcher Says -If schools reinstated physical education classes, a lot of fat children would lose weight. And they might never have gotten fat in the first place if their mothers had just breast fed them when they were babies. But be warned: obese people should definitely steer clear of crash diets. And they can lose more than 50 pounds in five years simply by walking a mile a day.Those are among the myths and unproven assumptions about obesity and weight loss that have been repeated so often and with such conviction that even scientists like David B. Allison, who directs the Nutrition Obesity Research Center at the University of Alabama at Birmingham, have fallen for some of them.Now, he is trying to set the record straight. In an article published online today in The New England Journal of Medicine, he and his colleagues lay out seven myths and six unsubstantiated presumptions about obesity. They also list nine facts that, unfortunately, promise little in the way of quick fixes for the weight-obsessed. Example: “Trying to go on a diet or recommending that someone go on a diet does not generally work well in the long term.”
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