Earlier this month the US Preventive Services Task Force (USPSTF), an independent panel of respected experts in primary care and prevention, caused an uproar when they presented evidence that routine mammogram screening for breast cancer should not begin until the age of 50. The group based their recommendation on evidence showing that the “additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age”. Essentially, the number of women we need to screen in order to extend one woman’s life is far higher for the group between the ages of 40 to 49 than for the group aged 50 to 59. However, current US Health and Human Services secretary, Kathleen Sebelius, issued a statement yesterday stating that there will not be any changes to government policy on mammography: screening mammograms should continue to start at the age of 40. [via Medical News Today]
Additional USPSTF recommendations include:
Regular biennial screening mammography for women aged 50 to 74.
No teaching of breast self-examination (BSE).
There is not enough evidence to assess whether clinical breast examination (CBE) does more harm than good, beyond screening mammography in women 40 years or older.
Current evidence is not enough to assess whether digital mammography or magnetic resonance imaging (MRI) would be better or worse than film mammography.
In the midst of the U.S. healthcare debate comes another reason why everyone of us should have basic health coverage. A new study by Harvard University researchers found that uninsured patients with traumatic injuries (such as car crashes, falls and gunshot wounds) were almost twice as likely to die in the hospital as similarly injured patients with health insurance. Taking into account injury severity, race, gender and age uninsured patients were still 80% more likely to die than those with insurance, including Medicaid. It’s shocking and unclear just why the uninsured fare worse in terms of ER care, since it’s largely assumed – and federally mandated – that all unstable patient receive equal care in ERs. One reason this might occur is that private hospitals can transfer uninsured patients to public hospitals once patients are stable. A transfer could then worsen a patient’s condition by delaying treatment. The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals. [via New York Times]
Here’s some good news for patients with chronic obstructive pulmonary disease (COPD) and other conditions with chronic mucus production. A new device called the Lung Flute, which has just been approved by the FDA, can vibrate away mucus by simply blowing into it. Blowing into the instrument sends a steady 16-hertz vibration into the user’s chest which breaks up mucus and allows the body to better expel the sticky substance. Although there are other devices that also use vibration to loosen mucus, the Lung Flute costs a great deal less at $40 a piece, making it much more accessible. See a video of the device in action here. [via PopSci.com]
Swedish researchers are reporting positive outcomes in a study examining the use of a device called RhinoChill, which cools the brains of heart attack patients by pumping coolant into the patient’s nose during CPR. In patients where resuscitation efforts began within 10 minutes of cardiac arrest researchers found that 59.1% of cooled patients and 29.4% of standard care patients survived to hospital discharge; 45.5% of cooled patients and 17.6% of standard care patients were neurologically intact at hospital discharge. The results also suggest that the earlier the cooling is started the better. When cooling efforts were delayed, there was no significant difference in survival when compared to those who did not receive nasal cooling. During a heart attack the heart is unable to properly pump blood to the brain (and other vital organs) which can lead to subsequent brain injury. [via Medline Plus]
On November 13, 2009 the FDA issued notification to 30 manufacturers of caffeinated alcoholic beverages that it intends to look into the safety and legality of their products. “The increasing popularity of consumption of caffeinated alcoholic beverages by college students and reports of potential health and safety issues necessitates that we look seriously at the scientific evidence as soon as possible,” said Dr. Joshua Sharfstein, principal deputy commissioner of food and drugs. The problem is that caffeine has not been approved by the FDA to be added to alcoholic beverages. However, some substances which are Generally Recognized As Safe (GRAS), or have been subject to prior sanction, are legality able to be used as food additives. For a substance to be GRAS, there must be evidence of its safety at the levels used and a basis to conclude that this evidence is generally known and accepted by qualified experts. Thus, the FDA is giving these companies 30 days to produce data to support that the use of caffeine in their products is GRAS or have been previously sanctioned. Click here for a full list of companies and products affected. [via FDA]
Telomeres have been a focus of anti-aging research for quite sometime. Unfortunately, no breakthroughs have yet revealed any glimmer of the fountain of youth. Telomeres are pieces of DNA that cap the ends of our chromosomes. Each time a cell divides (which is required for us to stay alive) telomeres get shorter and shorter until they reach a point where division is halted, thus putting bodily cells into a state where they can no longer renew themselves – thus is part of the aging process. However, new research focusing on Ashkenazi Jews has found that those who lived the longest had inherited a hyperactive version of an enzyme called telomerase that is able to rebuild telomeres. “In effect, centenarians tend to have a top-notch body mechanic at work 24/7 repairing the hardware that runs the body, versus a normal person whose body’s cellular control center is left to wear out with time.” Will this startling research lead to future advances in the pursuit of longevity? Only time will tell. [via Yahoo! News]
The National Heart, Lung and Blood Institute (NHLBI) has published an update to their popular cookbook entitled “Keep The Beat.” It’s a collection of recipes that are limited in saturated fats, trans fats, cholesterol, and sodium, as well as being moderate in calories. The majority of the recipes were created in collaboration with Culinary Institute of America-trained chef and instructor David Kamen and a James Beard Foundation award-winning registered dietitian based on guidelines from NHLBI. For those with heart disease, or those who simply want to eat healthier, it’s often difficult to find nutritionally sound recipes that are delicious at the same time. Costing only a nominal $5 it may just be the healthiest pocket change you spent in a while. The book can be purchased at the NHLBI website. [via NIH News]
Today’s Daily Dose comes from the current issue of Neurology, the medical journal of the American Academy of Neurology. Researchers found, after following over 238 thousand women over the course of 40 years, that women who had a BMI of 30 or greater at the age of 18 had more than twice the risk of developing multiple sclerosis (MS), compared to women with a BMI between 18.5 and 20.9. “Our results suggest that weight during adolescence, rather than childhood or adulthood, is critical in determining the risk of MS,” said study author Kassandra Munger, ScD, of the Harvard School of Public Health. The study authors theorize the link between obesity and MS may be that obese women tend to have lower vitamin D levels (higher vitamin D levels are thought to reduce the risk of MS). In addition, fatty tissue can produce substances thought to affect immune and cellular function which may be associated with MS. [via Medical News Today]
The journal Cancer reports on a new study which shows that women previously treated for breast cancer have a higher risk of cancer recurrence if they have highly dense breasts. Women who were classified as having highly dense breasts had a 21% chance of cancer recurrence, compared to 5% among women with low-density breasts. Because of this the study authors suggest that women with highly dense breasts may benefit from additional therapies, such as radiation, after breast and lymph node surgery. [via Medical News Today]
The Sahlgrenska Academy at the University of Gothenburg, Sweden released the latest results from the Prospective Population Study of Women, which has been following the health status of 1,500 women since the 1960s. Blood analysis has shown that middle-aged women with high levels of the amino acid homocysteine are twice as likely to develop Alzheimer’s disease years later. As well, the risk of any type of dementia for these women was 70% higher than women with the lowest levels of homocysteine. It’s unclear whether the relationship between Alzheimer’s and homecysteine is direct or indirect. If, in fact, future studies support this claim homocysteine levels may be an easy way to determine those at risk even before the onset of symptoms. [via EmaxHealth]
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About Dr. Steven Chang
Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.
Dr. Steven Chang, the author of DailyDose, is a staff physician with Kosmix RightHealth. Dr. Chang practices Family Medicine at the University of California Davis Medical Center, where his medical interests include both pediatric and geriatric care, public health, gay and lesbian health, and sleep medicine. Dr. Chang trained at the Stanford University affiliated O'Connor Hospital, and was a research fellow at the National Institute of Health. He holds an M.D. from McGill University and a BA in Public Health from Johns Hopkins University.