Thursday, June 13, 2019

News you can use

Several studies reported this week in medical journals had useful findings that should be widely known.
Beware of bats! The CDC reported on human rabies in the United States. Between 1960 and 2018, a total of 125 human rabies cases were reported. 36 were attributed to dog bites, all of which were bites that happened when the victims were travelling abroad. Since universal vaccination for pets was adopted decades ago, rabies in domestic pets has almost vanished. 89 cases were acquired in the U.S, and 62 (70%) of these were contracted from bats, that are by far the leading carriers of rabies in this country. Racoons were a far distant second, and foxes are also possible carriers.
Moving away from rabid bats to the much less scary but much more common problem of cardiovascular disease are findings from a number of important studies.
You don’t need to come back fasting. Traditionally, your blood lipids were always checked after an overnight fast. If you showed up having eaten breakfast, you were asked to come back to have your blood drawn. This requirement has been under question, and a recent study showed that non-fasting lipids were just as reliable a predictor of coronary disease as a fasting sample.
“White coat” hypertension needs to be taken seriously. It has long been known that some people have elevated blood pressure in the doctor’s office but normal BP when checked at home. There has been conflicting advice about whether this was a problem needing treatment. A careful analysis of many studies was published in the Annals of Internal Medicine that showed that people with so-called “white coat” hypertension ARE at increased risk if they are not on BP medication. Those on treatment for HBP who were well-controlled everywhere except in the office did not seem to be at increased risk.
Do you really need the “energy?” So-called energy drinks, which contain large amounts of caffeine among other ingredients, have been linked to increased emergency department visits, and were felt to be the cause of 34 deaths in recent years. About 30% of teenagers and 45% of deployed military personnel consume at least one of these drinks daily. Investigators had young healthy volunteers drink one of two widely sold drinks and monitored their vital signs and ECGs before and after. They reported their findings in the Journal of the American Heart Association. The energy drinks significantly raised pulse and BP in the volunteers and also prolonged the QT interval on the ECG, a change that may make the subjects more likely to have serious rhythm disturbances.
More on how diet affects health. The British Medical Journal reported on findings from the long-running Nurses Health Study. They found that increases in red meat consumption were associated with a higher risk of death, particularly so with processed meat. It is not clear that changing to “white meat” is any better. A study on healthy adults looked at cholesterol on three different diets: beef, chicken and no meat. Plant proteins had by far the most benefit, while chicken and beef were equally bad. Finally, a nutritionist from Tufts, speaking at the annual meeting of the American Society of Nutrition this month, presented evidence that inadequate intake of fruits and vegetables contributed to over 2.5 million excess deaths world-wide. Eat your fruits and veggies, folks!

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