This week's New England Journal of Medicine has an interesting study about how differently emergencies are handled outside of normal working hours. The study looked at every patient in New Jersey hospitalized with his or her first heart attack between the years of 1987 and 2002. The authors separated the patients into two groups: those who were admitted on a Saturday or Sunday, and those admitted on a w...
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Garlic Doesn’t Lower Cholesterol
Garlic is frequently touted as a natural treatment for high cholesterol, and many garlic extracts are sold with the suggestion that they improve cholesterol levels. The current issue of the Archives of Internal Medicine has an article reporting the most definitive study yet looking at the effects of garlic on cholesterol. Volunteers were randomized into four groups: raw garlic, powdered garlic suppl...
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Preventive Care Recommendations at Your Fingertips
Preventive medicine is a rapidly growing field. Testing that detects diseases in early stages, treatments that prevent diseases before they occur, and behaviors that make diseases less likely all hold the promise to keep us healthy and let us live longer. Unfortunately the field is also increasingly marred by tests and services that are recommended to patients without any scientific evidence that they work, or worse, despite much evidence that they are useless.
That's why I've long been a dis...
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An Interaction between Aspirin and Ibuprofen
About a month ago the FDA released a warning about an interaction between very commonly used medications: aspirin and ibuprofen.
Many patients have been instructed to take low dose aspirin (81 mg daily) for heart attack or stroke prevention. Aspirin prevents heart attacks and strokes by binding to an enzyme in platelets called cyclooxegenase (COX) and preventing its normal function. COX is essential for...
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Lipitor Helps Prevent a Second Stroke
An important study in this week's New England Journal of Medicine expands what we know about the benefits of cholesterol lowering medications. Statins, a family of cholesterol lowering medications which include Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Zocor (simvastatin), have already been proven to have many benefits. We al...
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Many Americans Unaware They Have Diabetes
A new study from the National Institutes of Health (NIH) and Centers for Disease Control highlights how common type II diabetes is among American adults. The study is summarized in this NIH news release. 6.5% of American adults have diabetes. Even more alarming is that a third of them don't know they have it.
Type II diabetes has serious potential consequences, and its high prevalence makes it a common cause of disabi...
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Homocysteine: A Risk Factor Worth Ignoring
Last month's New England Journal of Medicine has a great lesson about how we should think about risk factors.
It's been long known that homocysteine is a risk factor for heart disease. That means that, when looking at large numbers of people, those with high levels of homocysteine have more heart attacks on average than those with low levels. Too frequently, we confuse a risk factor with a cause, and we jump to the conclusion that homocysteine causes heart attack. A risk factor, howeve...
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American Death Rate Drops Sharply
The National Center for Health Statistics released the statistics on the number of deaths in 2004. The results document the biggest drop in the American death rate in almost 70 years.
The findings are summarized in this AP article.
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The center said drops in the death rates for heart disease, cancer and stroke accounted for most of the decline. "We were surprised by the sharpness of the decrea...
Coenzyme Q10 — Some Good News about a Supplement
The recent clinical studies about dietary supplements have been largely negative, important reminders that most supplements can't deliver on the expectations that patients have for them.
Given this bleak background, I wanted to share with you some good news about Coenzyme Q10 (CoQ10). The Medical Letter, one of the best unbiased sources of reviews of medical studies, reviewed CoQ10 in last week's issue. Since the article is available on...
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A Single Episode of Exercise Can Improve Your Mood
This Washington Post article reviews a recent study in which depressed patients were randomized to either rest quietly for 30 minutes or to walk on a treadmill for 30 minutes at 60 to 70 percent of their maximum heart rate. The people who exercised reported higher scores of well-being afterwards.
This post-exercise sense of accomplishment and vigor is familiar to anyone who does c...
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