Archive for December 2008

Is it new year resolutions time again? Researchers from Norway report that patients who were scheduled for colonoscopies around the December-January holiday season were one and a half times more likely to keep their appointments. Similarly, patients who were given medical appointments in the weeks immediately subsequent to their birthdays had higher attendance rates. The researchers believe that reminders of aging triggered by annual milestones may be the underlying mechanism for the increased compliance. This certainly sounds logical. Screening programs – and physicians at large – should keep this in mind as a cost-effective way of improving patient compliance.

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New findings published in the Proceedings of the National Academy of Sciences this week points to a gene that may be present in 20% of caucasians with high blood pressure. The STK39 gene directs the production of a protein that controls how kidneys process salt – a key factor in blood pressure fluctuation. When the body retains too much salt it also retains water, which is why those with hypertension are always advised to eat a low salt diet. Although this discovery will likely lead to new treatments, hypertension is a complex disease that can have many contributing factors – family history, diabetes, poor diet, lack of exercise, smoking, obesity, just to name a few. So as you can see, even if you don’t have the STK39 gene there are plenty of ways to get hypertension. And if you do have the gene there are likely other risk factors which you can do something about.

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New research from San Francisco State University is thought to be the first to show that sighted and blind people use the same facial expressions in response to certain emotional states. By studying both sighted and blind Olympic athletes the researchers found that 85 percent of silver medalists, regardless of visual ability, showed the same “social smile”, where only the mouth smiles – compared with a “real” or Duchenne smile (named after the 19th century French neurologist who discovered that a smile which results from true happiness involves not only the mouth but also the eyes). “Individuals blind from birth could not have learned to control their emotions in this way through visual learning so there must be another mechanism,” said the researchers. This is why they believe that some facial expressions may be intrinsic, not learned.

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The American Chemical Society reports new evidence that humans can make their own salicylic acid (SA), the compound largely responsible for aspirin’s effects on pain, fever, and inflammation. SA is a naturally occurring substance that can be obtained directly from eating fruits and vegetables. Researchers have previously shown that vegetarians have much higher levels of SA in their bodies (sometimes as high as in those who take low doses of aspirin). Now, the same research group claims that new evidence suggest that our bodies can actually manufacture SA from compounds we consume in our diet. Could SA be one of the chemicals responsible for the health benefits of a vegetarian diet? Numerous studies have shown that vegetarians seem to have a lower risk of obesity, coronary heart disease (which can cause heart attacks), high blood pressure, and diabetes.

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Drinking too much this holiday season can do more than cause a bit of inebriation. Consuming relatively large amounts of alcohol can cause what physicians term “holiday heart syndrome“, a condition where alcohol stimulates the heart to go into arrhythmias (an abnormal heart rhythm) – even in healthy individuals without cardiac problems. Symptoms of holiday heart syndrome typically include palpitations, shortness of breath, lightheadedness, and chest pressure/pain or discomfort. This condition can occur during any periods of increased alcohol consumption – binge drinking on weekends, during vacations, and, of course, during holidays. It’s usually self-limited and benign. But if you feel any of the symptoms above for an extended amount of time (minutes to hours), you should get checked out by your physician or seek medical attention at the emergency room. The only way to prevent holiday heart is to use your judgment in exercising moderation.

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Does America have a sociocultural obsession with food? You be the judge. On a recent trip to the mall I happened upon a myriad of food scented products, mostly in the form of moisturizers. Some of the flavors included pumpkin pie, strawberry shortcake, vanilla bean, cinnamon bun, and hot chocolate. And now Burger King is marketing their very own fragrance – with the scent of meat. Called “Flame” the spray is, according to the company, “the scent of seduction with a hint of flame-broiled meat”. Why would anyone want to smell like charbroiled meat? I will not place judgment until I’ve sniffed it myself. But, I do wonder why anyone would want to eat a cinnamon bun, then turn around and lather themselves with cinnamon bun-flavored cream. Perhaps it just appeals to us on a gustatory level. I can’t complain, I love to eat. But, I also can’t help but wonder if this is a healthy obsession.

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A British baby due this week will become the first child to be born with certainty that it does not have the BRCA1 gene mutation. Approximately 5% to 10% of breast cancers are believed to be due to genetic mutations inherited from parents – the most common being the BRCA1 and BRCA2 genes.  Because the British couple conceived through in virto fertilization, they were able to screen for cystic fibrosis, Huntington’s disease, and now BRCA1, at the 6 to 8 cell stage prior to implanting the embryo into the mother’s womb. All the women on the father’s side of the family have developed breast cancer, which is why the couple decided on genetic screening. Women who inherit the BRCA1 gene have up to an 80% increase in risk of developing breast cancer.

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Is it true that up to 45 percent of your body heat is lost through your head? Apparently not. The British Medical Journal reports this week that this myth has be debunked by researchers at Indiana University. The medical myth was traced back to advise published in a US Army Field Manual from 1970 which was based on flawed interpretation of US Military experiments in which subjects dressed in arctic survival suits (without hats) were exposed to cold temperatures. Since their heads were the only part of their bodies left uncovered, scientists wrongfully assumed that the head was the source of the majority of heat loss when, in fact, heat loss can occur through a variety of thermoregulatory mechanisms – conduction, convection, radiation. If the myth were true, they say, humans would be just as cold if they went without a hat as if they went without pants. The actual amount of heat loss depends roughly on the body surface area that is exposed.

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Creutzfeldt-Jakob disease (CJD) was widely pulicized in the 1990s as the human form of the cow disease bovine spongiform encephalopathy (BSE), which is contracted from eating contaminated beef. However, there are sporadic forms of CJD that can occur for unknown reasons – unrelated to eating meat. Now, researchers have found a new variant of this fatal disease that appears to advance faster, causing dementia and even the loss of ability to speak and move. It is yet unclear what the cause is, but scientists speculate that an interaction with a genetic component may be likely.

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Beginning January 2009 the US Medicare system will be offering bonuses to physicians who prescribe medications electronically.  Why the push? The most important reason is patient safety – no more indecipherable handwriting means less risk that your pharmacist will dole out the wrong prescription. Also, e-prescribing sends the prescription instantly, directly to the pharmacy, so scripts do not get lost or stolen. When e-prescribing, computers can remind docs about potential interactions amongst drugs, in addition to helping physicians choose the cheapest drugs which, in the end, saves the patient money. Only about 10 percent of US doctors are actively e-prescribing. This is due, in part, to the cost associated with setting up the necessary technology and apprehension about adopting new technology. However, the benefits are clear. Ever since I personally started e-prescribing, there’s just no going back to paper.

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