Wednesday, February 27, 2008
Symptoms of Not Knowing
A CDC study found that the vast majority of Americans (75%) don't know the signs of a heart attack, and only a few of those who do would know how to respond. Since heart disease is still the number one cause of death in the US, it's important to know the signs:
- Chest pain (usually squeezing or pressure)
- Pain in neck, shoulder, or jaw, arms or back
- Shortness of breath
- Others - nausea, cold sweat, light headedness.
Even if you're not sure a person with the signs is having a heart attack, call 911 immediately. Time to treatment is a top determinant of survival.
Speaking of not knowing, we really don't know what causes depression. Aside from the serotonin hypothesis, which is at best a gross oversimplification, and more likely a bad theory, research indicates that much of the effect of antidepressant medications may be placebo. The meta-analysis of numerous trials of the drugs found only marginal effects beyond placebo in all but the most severely depressed patients - a much smaller group indeed than those who take these drugs every day.
These results could well have some spectacular impacts on much of the field of health care, since so many patients are on antidepressants, and the costs are staggering. What if it's all a waste?
- Chest pain (usually squeezing or pressure)
- Pain in neck, shoulder, or jaw, arms or back
- Shortness of breath
- Others - nausea, cold sweat, light headedness.
Even if you're not sure a person with the signs is having a heart attack, call 911 immediately. Time to treatment is a top determinant of survival.
Speaking of not knowing, we really don't know what causes depression. Aside from the serotonin hypothesis, which is at best a gross oversimplification, and more likely a bad theory, research indicates that much of the effect of antidepressant medications may be placebo. The meta-analysis of numerous trials of the drugs found only marginal effects beyond placebo in all but the most severely depressed patients - a much smaller group indeed than those who take these drugs every day.
These results could well have some spectacular impacts on much of the field of health care, since so many patients are on antidepressants, and the costs are staggering. What if it's all a waste?
Labels: depression, drugs, education, health, health care, heart attack, heart disease, knowledge, medication, placebo, SSRI
Monday, May 07, 2007
Chronic
Finals are finally over (yay!), and so much has been going on that I want to catch up about. So, some highlights:
My epidemiology professor said at one point that "chronic diseases are those things that, should we live long enough, we will all enjoy." So, in honor of the discovery of a gene responsible for the increased longevity seen from calorie-restricted diets, a few bits on chronic disease.
Two groups of researchers have found (separately) that an allele appears to be responsible for as much as a 60% increase in heart disease risk. The gene, which is especially common in white people, is not determinant: you still need lifestyle and other risk factors, but having one or two copies of this gene is no good either!
Diabetic ulcers are just one of the many complications of that potentially debilitating chronic disease, whose incidence is likely to begin really skyrocketing soon, as the world's population gets older and fatter. And now, of course, we have super-bugs, which are resistant to antibiotic treatment, which can infect these ulcers and make amputation more likely. Two new treatments may be on the horizon: honey and maggots. Both have shown promise in preliminary and anecdotal studies, the former helping healing by sterilizing the area with peroxide and dehydration, the latter doing a number of (not entirely clear) things to kill even MRSA infections.
Another chronic, but more annoying than debilitating, disease is herpes. US researchers claim to have found the gene responsible for HSV's ability to 'hide' in the body, a promising discovery for future improvements in treatment.
Once you've gotten old and have managed your diabetes and heart disease risks, living in a walkable neighborhood may be another good thing to do for yourself: US researchers found that elderly men who lived in walkable neighborhoods (those with things like sidewalks, crosswalks, and nearby shops and cafes) were less likely to be depressed than those living in nonwalkable areas. I live in a dreadfully unwalkable area, and I know I think it's depressing!
Finally: too much of a good thing. Green tea's supposed to be all kinds of good for you, right? Well yes, unless you're overdoing it. Rutgers researchers found that people who take 'green tea supplements' may be at risk of liver and kidney damage. I always say, don't take as a pill that which you can get in real life...it's just never quite right.
My epidemiology professor said at one point that "chronic diseases are those things that, should we live long enough, we will all enjoy." So, in honor of the discovery of a gene responsible for the increased longevity seen from calorie-restricted diets, a few bits on chronic disease.
Two groups of researchers have found (separately) that an allele appears to be responsible for as much as a 60% increase in heart disease risk. The gene, which is especially common in white people, is not determinant: you still need lifestyle and other risk factors, but having one or two copies of this gene is no good either!
Diabetic ulcers are just one of the many complications of that potentially debilitating chronic disease, whose incidence is likely to begin really skyrocketing soon, as the world's population gets older and fatter. And now, of course, we have super-bugs, which are resistant to antibiotic treatment, which can infect these ulcers and make amputation more likely. Two new treatments may be on the horizon: honey and maggots. Both have shown promise in preliminary and anecdotal studies, the former helping healing by sterilizing the area with peroxide and dehydration, the latter doing a number of (not entirely clear) things to kill even MRSA infections.
Another chronic, but more annoying than debilitating, disease is herpes. US researchers claim to have found the gene responsible for HSV's ability to 'hide' in the body, a promising discovery for future improvements in treatment.
Once you've gotten old and have managed your diabetes and heart disease risks, living in a walkable neighborhood may be another good thing to do for yourself: US researchers found that elderly men who lived in walkable neighborhoods (those with things like sidewalks, crosswalks, and nearby shops and cafes) were less likely to be depressed than those living in nonwalkable areas. I live in a dreadfully unwalkable area, and I know I think it's depressing!
Finally: too much of a good thing. Green tea's supposed to be all kinds of good for you, right? Well yes, unless you're overdoing it. Rutgers researchers found that people who take 'green tea supplements' may be at risk of liver and kidney damage. I always say, don't take as a pill that which you can get in real life...it's just never quite right.
Labels: amputation, chronic, depression, diabetes, diet, exercise, geneitcs, green tea, healing, heart disease, herpes, honey, HSV, infection, longevity, maggots, MRSA, pills, ulcers
Monday, April 02, 2007
Go Play in the Mud
While the BBC article is short on details, some UK researchers have apparently found that playing in the dirt could be good for both your mood and you immune system. An interesting finding, and one that I'd really love to wave in the faces of all those obnoxiously over-clean mothers out there. You know who I mean - the ones who hover over their child's every move, waving antibacterial wipes (breeding resistant strains) and then go home to scream at the maid because there might be three molecules of dust in the nursery (where the 8-year-old still lives).
These are often the same people who demand that the pediatrician prescribe antibiotics for everything, again helping to evolve super-bugs resistant to all treatment. Sinusitis, it seems, may be a big contributer to this problem: US doctors are prescribing antibiotics at a very high rate, relative to the proportion of infections likely to be bacterial as opposed to viral. Much of this is due to a combination of provider ignorance, but a substantial chunk is that patients demand drugs, and providers have neither the time nor the expertise to explain why they don't need them.
On the upside, doctors worldwide may soon have two major concerns fewer to worry about, as researchers move to neutralizing donated blood types and growing organs for transplant. In the former case, a US team has identified a pair of enzymes for removing the A and B antigens from blood, effectively rendering it type O - the universal donor type. While not solving the blood shortage entirely, this would take immense pressure off of the supplies of rarer types.
Second, UK doctors say that they've grown heart valves in culture from marrow cells. If this technology can be applied to human hearts, and is effective, it would set the stage for a major revolution in transplant treatments. Cool!
These are often the same people who demand that the pediatrician prescribe antibiotics for everything, again helping to evolve super-bugs resistant to all treatment. Sinusitis, it seems, may be a big contributer to this problem: US doctors are prescribing antibiotics at a very high rate, relative to the proportion of infections likely to be bacterial as opposed to viral. Much of this is due to a combination of provider ignorance, but a substantial chunk is that patients demand drugs, and providers have neither the time nor the expertise to explain why they don't need them.
On the upside, doctors worldwide may soon have two major concerns fewer to worry about, as researchers move to neutralizing donated blood types and growing organs for transplant. In the former case, a US team has identified a pair of enzymes for removing the A and B antigens from blood, effectively rendering it type O - the universal donor type. While not solving the blood shortage entirely, this would take immense pressure off of the supplies of rarer types.
Second, UK doctors say that they've grown heart valves in culture from marrow cells. If this technology can be applied to human hearts, and is effective, it would set the stage for a major revolution in transplant treatments. Cool!
Labels: antibiotic resistance, antibiotics, blood, depression, dirt, enzymes, hearts, immunity, play, serotonin, sinusitis, transplantation
