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Lakewood Ranch Medical Complex celebrated their grand opening on Saturday morning. Pictured above are the medical groups from the complex.

 
Provided by MedicineNet

Odor testing helps diagnosis of Parkinson's disease

A test of olfactory functioning can be used to distinguish Parkinson's disease from similar conditions, researchers say.
A key feature of Parkinson's disease is an impaired sense of smell. This can be used as part of diagnosis, according to a study from doctors in London. It could be especially important when it comes to distinguishing Parkinson's from a similar condition called vascular parkinsonism, which has some of the same symptoms.

In this study, 18 patients with Parkinson's disease, 14 with vascular parkinsonism and 27 controls were given a smell identification test that involves sampling 40 different odors on paper strips. Those who had Parkinson's had lower test scores than either of the other groups. The olfactory test is easy to carry out, so it's to be hoped it might be adopted for a more accurate diagnosis of Parkinson's disease. Other research has suggested that many with vascular parkinsonism are sometimes wrongly diagnosed with Parkinson's disease.

Source
Journal of Neurology, Neurosurgery and Psychiatry December 2004 Volume 75 pages 1749-1752

 

Computer over-use may lead to glaucoma

People who are short-sighted and also use computers a lot may be at increased use of glaucoma.
Glaucoma is an eye condition in which there is a build-up of pressure within the eyeball. This leads to damage of the optic nerve and visual impairment - even blindness. Japanese researchers looked at around 10,000 workers in four different companies and found that around five per cent had some visual abnormalities.

Of these people, around a third had suspected glaucoma. The participants had been asked about computer use - how many years they'd used a computer and how long they spent at the screen at any one time. Heavy computer use - many years and several hours at one time - were risk factors for glaucoma, especially if the person was already short-sighted. The study suggests that those at risk might monitor their computer use to protect their eyesight.


Source
Journal of Epidemiology and Community Health November 2004 Volume 58 pages 1021-1027
 

Fatty acid does not
 delay eye condition

Treatment with vitamin A and the fatty acid DHA did not retard the progression of retinitis pigmentosa.
Around one person in 4,000 around the world has retinitis pigmentosa, a disease of the eye where there is a defect in the light-gathering cells of the retina. Previous work shows that vitamin A can retard the decline in retinal function. A team at the Massachusetts Eye and Ear Infirmary, USA, now reports on whether the addition of the fatty acid DHA to this treatment can add any benefit.

They studied 221 patients with retinitis pigmentosa already on vitamin A. They were given either 1,200 milligrams a day of DHA or a placebo. There were no significant differences between the two groups after four years. Further analysis showed that DHA did benefit a sub-group of patients - those not taking vitamin A therapy at the start of the trial - for the first two years of the trial. The researchers conclude that vitamin A is certainly required for all with retinitis pigmentosa but the addition of DHA will only benefit a few.

Source
Archives of Ophthalmology September 2004

 

Corneal thickness can affect glaucoma management

Thickness of the cornea may be important in making treatment decisions in glaucoma.
Central corneal thickness (CCT) is already known to have an impact on intraocular pressure measurements. Raised intraocular pressure can damage the optic nerve, leading to glaucoma - an eye disorder that is a leading cause of vision loss.

Researchers at the Edward S. Harkness Eye Institute, Columbia University, New York, looked at how CCT measurements might affect treatment decisions in a group of 188 patients with glaucoma or suspected glaucoma. They found that 56 per cent of the group had a measurement of CCT that led to the need for an adjustment in intraocular pressure reading. This, in turn lead to changes in therapy - for eye drop medication, laser therapy or even glaucoma surgery. Clearly CCT should be an important factor in determining how glaucoma should best be managed.

Source
Archives of Ophthalmology September 2004 Volume 122 pages 1270-1275

Obese women run higher colorectal cancer risk

A new study reveals that a high body mass index among women increases their risk of colorectal cancer.
Scientists at Stony Brook University in the USA looked at a group of 2,300 patients attending for regular colonoscopy exam. This showed that increasing body mass index (BMI) was linked to increasing risk of polyps that indicated cancer.

The link, however, was only significant for women. Those with a BMI over 40 had a 5.2 times greater risk of colon cancer compared to those with a BMI of 25 or less. The difference between men and women might be explained by women having more body fat, the researchers say. More work is needed to clarify this. In the meantime, doctors should take this risk into account when advising overweight or obese women about attending for colonoscopy.

Source
American College of Gastroenterology meeting 1st November 2004

Osteoporosis drugs useful
 in knee arthritis

A new study of older women shows that drugs taken for osteoporosis can also help with knee arthritis.
Many people with osteoarthritis of the knee opt for a replacement of the joint, because drugs taken to relieve pain and stiffness do not actually cure the disease. Now, however, researchers at the University of Tennessee reveal how drugs taken for osteoporosis may also slow the progress of knee osteoarthritis.

They looked at a group of 818 women, average age 75, of whom around a quarter were taking the bone antiresorptive drugs estrogen or alendronate. Those on these osteoporosis treatments had fewer bone abnormalities as revealed by magnetic resonance imaging of the knee than those not on these drugs. They also had less knee pain. However, there was no benefit to cartilage, which is usually worn away in arthritis. The study suggests that estrogen and alendronate may be of some value in slowing down the progress of arthritis.

Source
Arthritis & Rheumatism November 2004 Volume 50 pages 3516-3525

 

Drug reduces prostate cancer risk

A drug which reduces an enlarged prostate gland also reduces the risk of prostate cancer, a study finds.
Finasteride is commonly used to treat benign prostatic hyperplasia (BPH), a condition involving the enlargement of the prostate gland. BPH leads to urinary problems. Finasteride blocks the conversion of testosterone into dihydrotestostone (DHT) which helps to shrink the prostate gland and so relieve symptoms.

Researchers at the University of Texas have now found that finasteride also reduces the risk of prostate cancer. They report from the Prostate Cancer Prevention Trial, a seven year study involving nearly 10,000 men showed that finasteride can reduce the risk of prostate cancer by 25 per cent. However, the drug can also have some significant sexual side effects, which should be taken into account when balancing the benefit risk equation. It may also increase the risk of high-grade prostate cancer in some patients.

Source
New England Journal of Medicine on-line 24th June 2003

 

Simpler procedure for detecting breast cancer spread

Analysis of a single lymph node is as good as more extensive investigation for assessing the spread of breast cancer.
When cancer cells spread from the primary tumor in breast cancer, they do so through the lymph glands in the armpit. That is why this area is investigated as part of ongoing monitoring. The usual procedure is called axillary lymph node dissection (ALND) and involves the actual removal of these glands.

But ALND is associated with complications such as painful swelling and infection. An alternative procedure called sentinel lymph node (SLN) biopsy could be preferable, according to a new study from researchers at the Mayo Clinic. They studied a group of 1,253 women with invasive breast cancer and compared SLN alone with SLN followed by ALND.

They found that SLN alone was as effective at tracking any spread of cancer. And those who had ALND as well reported a high rate of complications during the average 2.4 year follow up time. The study suggests that SLN could become the follow-up procedure of choice in this form of breast cancer.

Source
Archives of Surgery May 2003



 

 


 

 

 

 

 

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Breaking News: A promising new cancer treatment that may one day replace radiation and chemotherapy is edging closer to human trials.

Kanzius RF therapy attaches microscopic nanoparticles to cancer cells and then "cooks" tumors inside the body with harmless radio waves.

Based on technology developed by Pennsylvania inventor John Kanzius, a retired radio and TV engineer, the treatment has proven 100 percent effective at killing cancer cells while leaving neighboring healthy cells unharmed. It is currently being tested at M.D. Anderson Cancer Center in Houston.

 

 


Meet Gwen MacKenzie who came on board as the new CEO of Sarasota Memorial Hospital in May of 2005. She is the first CEO who has an RN background to assume the post. Born in London, Ontario, she moved to Detroit at age 3.
She is a naturalized U.S. citizen. Gwen is pictured in the middle along with nurses, Shannon Hall (right) and Lisa Torres (left), reviewing their electronic medical record system. This is the first part of a mini series on Meeting SMH new CEO. Our next mini-briefing will cover Gwen MacKenzie's goals.

* Bradenton homeless coalition hopes to have new shelter open for families with children.

Overweight increases kidney stone risk

A new report from two long-running studies shows that obesity and weight gain increase the risk of developing a kidney stone.
Around ten per cent of men and five per cent of women get kidney stones, an extremely painful condition. Now researchers at Brigham and Women's Hospital and Harvard Medical School say that being overweight could increase the risk of kidney stones.

The data come from the long-running Health Professionals Follow-Up study, involving over 45,000 men, and the Nurses' Health Study which covers nearly 94,000 women. Men weighing more than 220 pounds had a 44 per cent greater chance of kidney stones than those weighing less than 150 pounds.

For women in these weight categories, the increased risk was about 90 per cent - the exact figure dependent on age. When it came to weight gain, those who had put on more than 35 pounds since age 21 had a 39 per cent increased risk, compared to those who had stayed the same weight. For women, the equivalent risk was 70 per cent for older women and 82 per cent for younger women. It looks as if there is no specific dietary component that promotes - or protects from - kidney stones. Rather, it is overweight itself that is the risk factor.

Source
Journal of the American Medical Association 26th January 2005 Volume 293 pages 455-462

 

Anticoagulant gives moderate but useful benefit after heart attack

The new anticoagulant, reviparin, reduces the rate of death, heart attack or stroke after a heart attack.
It is known that a number of drugs or treatments can improve the outcome for patients after a heart attack. Now a team at Hamilton General Hospital and McMaster University, Canada, reveal benefit from a new drug too. Reviparin is an anticoagulant, which prevents the blood from clotting.

A group of over 15,000 patients received either reviparin or placebo after a heart attack and the combined outcome of a further heart attack, stroke or death was measured. At seven days, those on reviparin had a 13 per cent reduced risk of one of these events compared to placebo. The benefit persisted up to 30 days.

Further analysis revealed that the results were best when reviparin was given early - two hours after symptom onset. The benefit may be modest but there are other advantages to this new drug. It can be given subcutaneously rather than as an infusion and it is rather less expensive than some other drugs in its class. The researchers believe it could be used to help people in both developed and less developed countries.

Source
Journal of the American Medical Association 26th January 2005 Volume 293 pages 427-436

New drug treats pulmonary hypertension


A clinical trials shows that an oral drug, bosentan, can improve survival in patients who have pulmonary arterial hypertension.
It is only recently that there has been any treatment for pulmonary arterial hypertension (PAH), a condition where the blood pressure in the lungs goes up causing breathlessness, fatigue and increasing disability. Half of all patients die within two years if they go untreated.

Now there is a new drug for pulmonary hypertension - the first in pill form - called bosentan. In a trial reported by researchers at the University of Michigan, bosentan has been found to improve survival among those with PAH. Survival in treated patients was 96 per cent at one year and 89 per cent at two years. On past clinical experience, these survival rates would have been put at 67 per cent and 58 per cent. After two years follow up, 70 per cent of patients were coping on bosentan alone. This adds to earlier, more short-term, work that shows that bosentan improves patient's walking ability and quality of life.

Source
European Respiratory Journal February 2005


 

How marriage affects men's health

In some ways, men stop taking care of their health when they re-marry, although they improve in other ways.
Re-marriage is often a time when people change their health habits - for good or for bad. According to researchers at Harvard School of Public Health, with a new report from the Male Health Professionals Study, men who re-marry tend to put on weight and take less exercise.

On the other hand, those who re-married also had a better diet, with a higher vegetable intake, compared to widowed or divorced/separated men. Men whose wives died tended to both increase alcohol intake and increase alcohol consumption. The conclusion is that marriage break-up - whether through death or divorce - can have a negative impact on a man's health, because it can trigger an unhealthy lifestyle.

Source
Journal of Epidemiology and Community Health December 2004

Sunshine may protect against lymphoma

Sun exposure can protect against non-Hodgkin's lymphoma according to a new study.
It has been previously assumed that sun exposure might increase the risk of non-Hodgkin's lymphoma (NHL). However, a team at the University of Sydney has now shown that the opposite might be the case.

The researchers looked at a group of over 700 people with NHL, comparing them with a similar group of healthy controls. They learned that with the highest level of sun exposure, the risk of NHL went down by 35 per cent, compared to the lowest exposure level. It may be that the vitamin D that is activated with sun exposure helps protect against NHL. This study adds to increasing evidence that vitamin D helps to prevent various kinds of cancer.

Source
International Journal of Cancer 10th December 2004
 

Oral antiseptic as effective as dental floss

A study shows that rinsing with an oral antiseptic removes at least as much plaque as using dental floss.
We know that dental floss removes plaque from between the teeth that might otherwise cause gum disease. And this, in turn, may lead to tooth loss and various health problems.

A survey shows that Americans do not, on the whole, have time or energy for flossing. Only a quarter thought their dentist would give them an 'A' grade for oral hygiene. But there may be another way. A comparison of rinsing twice a day with Listerine mouthwash and using floss showed that both remove plaque - and antiseptic might remove a bit more. However, the dentist is not about to suggest antiseptic as an alternative to floss - it is best to use both to ensure you get rid of the maximum amount of plaque.

Source
Journal of the American Dental Association 7th June 2004

 

Hardening of leg arteries is a danger sign

People with blocked arteries in their legs probably have a similar problem in other vessels, which could lead to heart disease or stroke.
Peripheral arterial disease (PAD) is a condition where the arteries in the legs become blocked and hardened. Experts in the US are now warning that PAD is a danger sign for heart disease and stroke. For if vessels in the legs are blocked, then those serving the brain and heart probably are as well, putting the individual at risk.

PAD may lead to some pain in their legs and problems with walking. The trouble is that many people assume this is a normal sign of aging and don't do anything about it. And, quite often, PAD doesn't give rise to any symptoms at all. But it's possible to screen those at risk using a painless procedure called the ankle brachial index (ABI) test. This involves measuring the blood pressure in the legs and comparing it with the blood pressure in the arms. If PAD is found, it can be managed by many of the same measures we use to protect against heart disease - smoking cessation, dietary changes, physical activity and maybe certain medications.

Source
Journal of Vascular and Interventional Radiology November 2004

 

Get the Facts on Surgery for Obesity

About two-thirds of people in the USA are overweight, and of these, almost half are obese. And the groups showing the most rapid increase in numbers are the very obese (those with a BMI over 35) and the morbidly obese
(BMI over 40)1. In fact, the morbidly obese encompass 8 million people in the USA.

Morbid obesity is accompanied by an increased likelihood of type 2 diabetes, high cholesterol, high blood pressure, heart disease, stroke, and several other serious conditions. Morbidly obese men and women aged 22 have a reduced life span of 12 and 8 years, respectively.

Diet and medication are unsuccessful in morbid obesity. However, over the last 10 years bariatric surgery2 has offered new hope for the management of this condition. A report in the Journal of the American Medical Association has analyzed the results of over 22,000 individual surgeries to assess the benefits and risks of this approach. Here's a summary of the main findings.

The analyzed patients

The data from 136 published studies were pooled for analysis (i.e. this was a meta-analysis). About 4 out of 5 of the patients were women; their average age was 39, and their average BMI was 47. There were 4 kinds of bariatric surgery: gastric banding, gastric bypass, stomach stapling (gastroplasty), and other procedures involving diversion of the bile duct, etc.

The results of the meta-analysis are given in this table:
 

  All Patients Gastric Banding Gastric Bypass Stomach Stapling Bile Duct Diversion
Avg. wt. loss 39.7 kg 28.6 kg 43.5 kg 39.8 kg 46.4 kg
% wt. loss 61.2% 47.5% 61.6% 68.2% 70.1%
BMI decrease 14.2 10.4 16.7 14.2 18.0
Mortality   0.1% 0.5% 0.1% 1.1%
Diabetes 'cure' 77% 48% 84% 68% 98%
(by diabetes 'cure' was meant ability to discontinue all medications, maintain blood glucose at normal levels, and normalization of HbA1c levels)

 

Other beneficial results of bariatric surgery included improvement of high blood cholesterol in 70% of patients, normalization of high blood pressure in 62%, and resolution of sleep apnea in 84% of patients. There is no doubt that such improvements in these and other related conditions will result in longer lives for these patients.

What this analysis means

It's clear that bariatric surgery in morbidly obese patients results in effective weight loss, coupled with improvements or resolution of diabetes as well as a number of serious conditions. And it seems to be relatively safe, with postoperative mortality ranging from 0.1% for the simpler procedures (gastric banding and stapling), with 0.5% for gastric bypass, to as high as 1.1% for the more complicated procedures.

Obviously it would be best if nobody developed morbid obesity in the first place. Correct nutrition and plenty of physical activity should begin in childhood, hopefully becoming habitual. But obesity in adolescents and young adults can be reversed in a proportion of cases, given sufficient support and resources. For those who have progressed to morbid obesity, with all the complications that follow, bariatric surgery offers real hope of a longer and more comfortable life.

Source

  • Bariatric surgery: a systematic review and meta-analysis. H. Buchwald, Y. Avidor, E. Braunwald,  et al., JAMA, 2004, vol. 292, pp. 1724--1737