Don't hyperventilate: Breathing less is best for asthmatics
Filed under: Alternative therapies
When having an asthma attack, the bodies first instinct is to breathe more. But according to That's Fit, the key for asthmatics -- and everyone else for that matter -- is breathing less. Hyperventilation is linked to a number of health problems and it's believed that if people can slow their breathing, they'll be healthier overall especially asthmatics. The solution? It's called The Buteyko method and it's a series of exercises that people can do to improve their breathing. And in clinical trials, use of broncodilators dropped 90% and use of inhaled steroids dropped by 50% when the method was employed. That's pretty promising, huh?
If you're interested in learning more about the method, check out this article.
New treatment: Freeze the heart
Filed under: Research, Alternative therapies
My friends often joke that because I didn't cry at the Notebook, my heart is ice-cold, frozen from all compassion and feeling. But as That's Fit has reported, there's a new treatment out there that will involve freezing the heart -- literally.A condition called Atrial Flutter may respond to treatment using Nitrous Oxide to freeze the heart for a few seconds. Freezing the heart, in turn, treats the areas around the heart that are responsible for abnormal rhythms. It sounds interesting ... and dangerous. Even if it's only frozen for seconds, the thought of intentionally stopping a heart gives me ... well .... heart flutters. What about you?
The FDA hasn't approved the treatment yet, but their advisers are recommending they do.
The barbershop is a great place for hypertension treatment
Filed under: Alternative therapies, Services, Men Heart Health
I always love a story about the unusual or fantastical aspects of life. One such story I recently encountered entails a study revealing that African-American men who frequent barbershops are more apt to seek treatment for hypertension than those who do not. An eight month study conducted by Dr. Paul L. Hess of the University of Texas Southwestern Medical Center in Dallas revealed that black men who are faithful barbershop attendees are more open and willing to control their high blood pressure. The study also concluded that the barbers might be a perfect venue for hypertension education and monitoring for their clients.
Although this study is a bit off the beaten path, it gets to the core of many communities that traditional medical efforts might not effectively reach. Since many barbershops in African-American communities are social gathering places as well as places of business, they present a perfect opportunity to spread the word about high blood pressure in a population where nearly 40% of the men suffer from hypertension.
Pine Tree Extract Delays Glucose Absorption
Filed under: Type 2, Adult Onset, Drugs, Research, Products
A new study reveals that French maritime pine tree extract (known as Pycnogenol) delays the uptake of glucose from a meal 190 times more than prescription medications, preventing the typical high-glucose peak in the blood stream after a meal.
The study revealed the pine bark is more potent for suppressing carbohydrate absorption in diabetes than synthetic prescription alpha-glucosidase inhibitors such as Precose. Researchers reviewed the interaction of Pycnogenol with alpha-glucosidase, an enzyme responsible for the breaks down of carbohydrates in a meal. Results revealed Pycnogenol is 190 times more potent for inhibition of alpha-glucosidase than the synthetic inhibitor acarbose, a common prescription medication for treatment of type 2 diabetes. These drugs are sold in Europe under the name Glucobay and the United States under the name Precose. The bark contains a unique combination of procyanidins, bioflavonoids and organic acids. The alpha-glucosidase breaks down carbohydrates into glucose molecules which are then absorbed into the blood stream.
In two separate studies Pycnogenol was found to significantly lower blood sugar in type 2 diabetes patients. One study showed that patients who supplemented with Pycnogenol experienced lower blood sugar after meals and lower fasting blood sugar. Another study revealed a significantly lowered blood glucose level in patients who supplemented with Pycnogenol while continuing their anti-diabetic medication with acarbose and metformin. This study opens new avenues for product development of Pycnogenol in the field of diabetes, metabolic syndrome and obesity.
[RESEARCH] Equitable utilisation of Indian community based health insurance scheme among its rural membership: cluster randomised controlled trial
Objective To evaluate alternative strategies for improving the uptake of benefits of a community based health insurance scheme by its poorest members.
Design Prospective cluster randomised controlled trial.
Setting Self Employed Women's Association (SEWA) community based health insurance scheme in rural India.
Participants 713 claimants at baseline (2003) and 1440 claimants two years later among scheme members in 16 rural sub-districts.
Interventions After sales service with supportive supervision, prospective reimbursement, both packages, and neither package, randomised by sub-district.
Main outcome measures The primary outcome was socioeconomic status of claimants relative to members living in the same sub-district. Secondary outcomes were enrolment rates in SEWA Insurance, mean socioeconomic status of the insured population relative to the general rural population, and rate of claim submission.
Results Between 2003 and 2005, the mean socioeconomic status of SEWA Insurance members (relative to the rural population of Gujarat) increased significantly. Rates of claims also increased significantly, on average by 21.6 per 1000 members (P<0.001). However, differences between the intervention groups and the standard scheme were not significant. No systematic effect of time or interventions on the socioeconomic status of claimants relative to members in the same sub-district was found.
Conclusions Neither intervention was sufficient to ensure that the poorer members in each sub-district were able to enjoy the greater share of the scheme benefits. Claim submission increased as a result of interventions that seem to have strengthened awareness of and trust in a community based health insurance scheme.
Trial registration Clinical trials NCT00421629.
[RESEARCH] Impact of rapid screening tests on acquisition of meticillin resistant Staphylococcus aureus: cluster randomised crossover trial
Objective To determine whether introducing a rapid test for meticillin resistant Staphylococcus aureus (MRSA) screening leads to a reduction in MRSA acquisition on hospital general wards.
Design Cluster randomised crossover trial.
Setting Medical, surgical, elderly care, and oncology wards of a London teaching hospital on two sites.
Main outcome measure MRSA acquisition rate (proportion of patients negative for MRSA who became MRSA positive).
Participants All patients admitted to the study wards who were MRSA negative on admission and screened for MRSA on discharge.
Intervention Rapid polymerase chain reaction based screening test for MRSA compared with conventional culture.
Results Of 9608 patients admitted to study wards, 8374 met entry criteria and 6888 had full data (82.3%); 3335 in the control arm and 3553 in the rapid test arm. The overall MRSA carriage rate on admission was 6.7%. Rapid tests led to a reduction in median reporting time from admission, from 46 to 22 hours (P<0.001). Rapid testing also reduced the number of inappropriate pre-emptive isolation days between the control and intervention arms (399 v 277, P<0.001). This was not seen in other measurements of resource use. MRSA was acquired by 108 (3.2%) patients in the control arm and 99 (2.8%) in the intervention arm. When predefined confounding factors were taken into account the adjusted odds ratio was 0.91 (95% confidence interval 0.61 to 1.234). Rates of MRSA transmission, wound infection, and bacteraemia were not statistically different between the two arms.
Conclusion A rapid test for MRSA led to the quick receipt of results and had an impact on bed usage. No evidence was found of a significant reduction in MRSA acquisition and on these data it is unlikely that the increased costs of rapid tests can be justified compared with alternative control measures against MRSA.
Trial registration Clinical controlled trials ISRCTN75590122.
[RESEARCH] New point of care Chlamydia Rapid Test bridging the gap between diagnosis and treatment: performance evaluation study
Objective To evaluate the performance of a new Chlamydia Rapid Test with vaginal swab specimens as a potential tool for chlamydia diagnosis and screening.
Design Performance evaluation study.
Settings A young people's sexual health centre (site 1) and two genitourinary medicine clinics (sites 2 and 3) in the United Kingdom.
Participants 1349 women aged between 16 and 54 attending one of the three clinics.
Main outcome measures Sensitivity, specificity, positive predictive value, and negative predictive value of the Chlamydia Rapid Test versus polymerase chain reaction and strand displacement amplification assays; correlation between the Chlamydia Rapid Test visual signal and organism load; acceptability to participants of self collected vaginal swabs as the specimen type for Chlamydia testing.
Results Polymerase chain reaction positivity rates for Chlamydia trachomatis infection were 8.4% (56/663) at site 1, 9.4% (36/385) at site 2, and 6.0% (18/301) at site 3. Compared with polymerase chain reaction assay, the resolved sensitivity, specificity, positive predictive value, and negative predictive value of the Chlamydia Rapid Test were 83.5% (91/109), 98.9% (1224/1238), 86.7% (91/105), and 98.6% (1224/1242). Compared with strand displacement amplification assay, sensitivity and specificity of the Chlamydia Rapid Test were 81.6% (40/49) and 98.3% (578/588). Organism load of self collected vaginal swabs ranged from 5.97x102 to 1.09x109Chlamydia plasmids per swab, which correlated well with the Chlamydia Rapid Test's visual signal (r=0.6435, P<0.0001). Most (95.9%) surveyed participants felt comfortable about collecting their own swabs.
Conclusions The performance of the Chlamydia Rapid Test with self collected vaginal swabs indicates that it would be an effective same day diagnostic and screening tool for Chlamydia infection in women. The availability of Chlamydia Rapid Test results within 30 minutes allows for immediate treatment and contact tracing, potentially reducing the risks of persistent infection and onward transmission. It could also provide a simple and reliable alternative to nucleic acid amplification tests in chlamydia screening programmes.
Crestor shown to reverse artery blockages in study
Filed under: Prevention, Research, Drugs
Atherosclerosis, better known as the buildup of plaque in the arteries, was thought to be an irreversible problem. The only option for actually reopening arteries was angioplasty or stents, and medication could only slow or arrest the gradual narrowing. But, doctors at the Cleveland Clinic found that by using the max dosage of the cholesterol drug Crestor, the fat clogs blocking their patients' arteries were reduced by 7 percent over 2 years.
This of course does not mean that people with clogged arteries should start downing bottles of Crestor, but it does sheds more light on the fact that lowering bad (LDL) cholesterol is the best way to prevent heart attacks. But, from this study it is possible to consider the future use of Crestor, and how it appears to actually reverse the plaque accumulation in blood vessels, something that starts as early as childhood.
Again, this is still further studies that need to be done, but this is promising information for people who thought that medication could only slow the eventual narrowing of vessels. In time, it's very possible that this method of using Crestor to clear blockages could be an alternative to surgery.
[RESEARCH] Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review
Objectives To determine the diagnostic accuracy of duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography, alone or in combination, for the assessment of lower limb peripheral arterial disease; to evaluate the impact of these assessment methods on management of patients and outcomes; and to evaluate the evidence regarding attitudes of patients to these technologies and summarise available data on adverse events.
Design Systematic review.
Methods Searches of 11 electronic databases (to April 2005), six journals, and reference lists of included papers for relevant studies. Two reviewers independently selected studies, extracted data, and assessed quality. Diagnostic accuracy studies were assessed for quality with the QUADAS checklist.
Results 107 studies met the inclusion criteria; 58 studies provided data on diagnostic accuracy, one on outcomes in patients, four on attitudes of patients, and 44 on adverse events. Quality assessment highlighted limitations in the methods and quality of reporting. Most of the included studies reported results by arterial segment, rather than by limb or by patient, which does not account for the clustering of segments within patients, so specificities may be overstated. For the detection of stenosis of 50% or more in a lower limb vessel, contrast enhanced magnetic resonance angiography had the highest diagnostic accuracy with a median sensitivity of 95% (range 92-99.5%) and median specificity of 97% (64-99%). The results were 91% (89-99%) and 91% (83-97%) for computed tomography angiography and 88% (80-98%) and 96% (89-99%) for duplex ultrasonography. A controlled trial reported no significant differences in outcomes in patients after treatment plans based on duplex ultrasonography alone or conventional contrast angiography alone, though in 22% of patients supplementary contrast angiography was needed to form a treatment plan. The limited evidence available suggested that patients preferred magnetic resonance angiography (with or without contrast) to contrast angiography, with half expressing no preference between magnetic resonance angiography or duplex ultrasonography (among patients with no contraindications for magnetic resonance angiography, such as claustrophobia). Where data on adverse events were available, magnetic resonance angiography was associated with the highest proportion of adverse events, but these were mild. The most severe adverse events, although rare, were mainly associated with contrast angiography.
Conclusions Contrast enhanced magnetic resonance angiography seems to be more specific than computed tomography angiography (that is, better at ruling out stenosis over 50%) and more sensitive than duplex ultrasonography (that is, better at ruling in stenosis over 50%) and was generally preferred by patients over contrast angiography. Computed tomography angiography was also preferred by patients over contrast angiography; no data on patients' preference between duplex ultrasonography and contrast angiography were available. Where available, contrast enhanced magnetic resonance angiography might be a viable alternative to contrast angiography.
The Dilemma: which disease is more worth treating?
Filed under: Research
Fight infectious diseases or treat chronic illnesses? Which of the two do you choose? This is the very dilemma faced by many third world nations, with economic shortfall being the cause for such a decision to be made. So, with little alternative but to make a choice, many poor countries have focused their medical attention to preventing the spread of communicable diseases. As expected, this has left people suffering from chronic non-communicable conditions such as cardiovascular disease and cancer with few treatment options.
In the January 18, 2007 issue of the New England Journal of Medicine, Gerard Anderson, PhD, a professor from the Johns Hopkins Bloomberg School of Public Health, addressed the dire need for more international aid for chronic, non-communicable diseases in these poorer countries. He cites facts surrounding the dangers of not properly treating such diseases, and also highlights statistics showing cardiovascular disease as being the cause of 27 percent of all deaths in poor countries, whereas HIV/AIDS, malaria, and tuberculosis combined only account for 11 percent of deaths in poor countries.
The professor is quick to point out that he does not feel as though aid for communicable diseases should be cut. Rather, he feels that an equal amount of resources should be made available for chronic, non-communicable diseases, as well. As for a reason why the former receives more attention than the latter, he posits that it may be related to the fact that the world fears the world fears the global spread of communicable diseases, a danger that is not attributed to chronic, non-communicable disease. Also, in many cases chronic, non-communicable diseases are not viewed as being of great urgency, so they do not receive an equal amount of media attention.
For more information, review Dr. Anderson's article, "Expanding Priorities -- Confronting Chronic Disease in Countries with Low Income" in the January edition of the New England Journal of Medicine.