Meds

June 11, 2010

Adding fat-lowering drug no help for diabetic hearts

Filed under: Heart — admin @ 7:43 am

Adding a drug that lowers blood fats known as triglycerides to cholesterol-fighting statins provided no additional protection from heart attack, stroke and death from heart disease in patients with Type 2 diabetes, according to data from a large study.

The study run by the National Institutes of Health, dubbed Accord, aimed to see if the dual-drug therapy could reduce heart disease and stroke-related events in diabetes patients at particularly high risk of serious heart problems due to additional risk factors, such as obesity and high blood pressure.

All subjects in the 5,518-patient trial took Zocor, which is available generically as simvastatin.

One group also received TriCor, which is designed to lower the blood fats known as triglycerides and raise “good” HDL cholesterol. TriCor belongs to a class of drugs called fibrates.

There was an 8 percent risk reduction from the combination therapy compared with the statin plus dummy pill, but researchers said the result could have been a statistical fluke.

“Although our analysis suggests that certain patients may benefit from combination therapy, this study provides important information that should spare many people with diabetes unneeded therapy with fibrates,” said Dr. Henry Ginsberg, the study’s lead investigator, who presented the data at the American College of Cardiology scientific meeting in Atlanta.

Based on the results, Dr. Steven Nissen, a prominent cardiologist with the Cleveland Clinic, predicted that “the use of fenofibrates will decline precipitously. It’s another troubling example of a drug that was approved that didn’t work.”

The U.S. Food and Drug Administration on Sunday said the data will undergo close scrutiny.

“The FDA will conduct a thorough review of the primary Accord data as soon as they become available,” said agency spokeswoman Karen Riley.

“The results of Accord were widely expected and not surprising given that two-thirds of patients in the trial would not be treated with fibrates under current guidelines,” Eugene Sun, Abbott’s vice president for global pharmaceutical development, said in a statement.

“The results support how fibrates are used in treatment today.”

LOWERING BLOOD PRESSURE NO HELP, EITHER

A second prong of the NIH Accord program tested 4,733 patients with Type 2 diabetes and elevated blood pressure.

It found that more intensive blood pressure lowering failed to cut the risk of heart attacks, strokes and cardiovascular death significantly more than the current standard of care.

There were 208 heart disease or stroke-related events in patients whose systolic blood pressure was reduced to below 120, compared with 237 among patients whose target goal was less than 140 – results researchers deemed a potential statistical fluke.

Current guidelines recommend that adults with Type 2 diabetes maintain systolic blood pressure – the top number of a blood pressure reading – at less than 130.

The risk of stroke alone was significantly cut by about 40 percent in the intensive treatment group, although the total numbers were low – 36 versus 62 in the standard care group.

Researchers also noted higher incidence of complications in the intensive group, including abnormally high levels of blood potassium, and some measures of kidney function were worse.

“Both of these studies provide evidence that going beyond the standard of care provides no substantive additional benefit in this population of adults with diabetes at especially high risk of cardiovascular events,” said Denise Simons-Morton, the NIH’s Accord project officer.

June 4, 2010

Stenting May Save Legs

Filed under: Uncategorized — admin @ 7:42 am

When angioplasty fails, patients with severe peripheral arterial disease may now have another option.

A drug-releasing stent placed in the blocked artery below the knee might re-establish blood flow, new research shows.

Critical limb ischemia, the most severe form of peripheral arterial disease (PAD), causes more than 100,000 leg amputations in the United States each year. Now, researchers from Mount Sinai Medical Center in New York City say insertion of a stent can prevent many of these amputations.

“Traditional balloon angioplasty is plagued by high incidence failure, restenosis [recurrence] and inability to elevate the patient’s symptoms,” said lead researcher Dr. Robert A. Lookstein, associate director of Mount Sinai’s division of interventional radiology.

Patients with critical limb ischemia have leg pain even when resting and sores that don’t heal because of lack of circulation, Lookstein said. They are at risk of gangrene and amputation.

But placing a stent in the affected artery during angioplasty greatly improves these problems, Lookstein added. The drug-eluting stent keeps the narrowed artery open and releases a medication for several weeks after implantation, preventing the artery from closing again, he said.

“Patients with the least severe form of the [severe] disease, those with pain at rest, as well as the patients with minor skin infection of their legs, were able to avoid major amputation,” he said.

But some patients with severe disease and those with gangrene still lost a limb, said Lookstein, who was scheduled to present the finding Monday at the Society of Interventional Radiology’s annual meeting in Tampa, Fla.

For the study, Lookstein’s team followed 53 patients with critical limb ischemia who had a total of 94 drug-eluting stents implanted to treat leg arteries that would not stay open after angioplasty alone. These are the same stents commonly used to open blocked coronary arteries.

The treatment was effective in all the patients, the researchers said.

A year after the procedure, 81.8 percent of the stented arteries were still open, allowing blood to flow freely, the researchers found. And, over an average of 17 months’ follow-up, fewer than 10 percent of the patients required a major amputation, Lookstein noted.

“These results show that when angioplasty doesn’t work, this is an excellent option,” Lookstein said. “Patients should know that if angioplasty fails, there are treatment options that offer excellent outcomes.”

Dr. Juan Pablo Zambrano, an assistant professor of clinical medicine at the University of Miami Miller School of Medicine, said a downside of stent insertion is the need to take blood-thinning drugs for at least a year after surgery.

“The current recommendations for drug-eluting stents require taking antiplatelet drugs for one year,” Zambrano said. This is usually a combination of a drug like Plavix and aspirin, he said.

Not taking them greatly increases the chances of clotting in the stent, which can cause a thrombosis (a blood clot), and the likelihood that a clot will break loose and travel to the heart or lungs, Zambrano said.

“If you leave these patients without treatment, you get very early amputations,” he said. “If you can change the fate of the disease by stenting those vessels and keeping them open for longer, then you are going to have a significant impact,” he said.

About 10 million Americans suffer from peripheral arterial disease, but only one in four is diagnosed and treated, according to background information with the study. The condition results from plaque build-up, which hardens in the arteries, blocking and reducing blood flow to the legs, arms, brain and other organs.

Bypass surgery, the standard treatment to open an artery, isn’t an option for many patients because of other medical problems, Lookstein said. He said their results show that stent insertion is as effective as bypass surgery.

The alternative is angioplasty, which involves threading a catheter through the artery and inflating a balloon at the tip of the catheter to open the vessel. But arteries below the knee often close up again after angioplasty.

Those patients would be candidates for a stent in the artery, Lookstein said.

May 26, 2010

Think You’re Lactose Intolerant? Maybe Not

Filed under: Uncategorized — admin @ 10:21 pm

Many people who think they’re lactose intolerant may not be.

This suggestion, released Wednesday in a U.S. National Institutes of Health draft consensus statement, could pave the way for more people to eat more dairy products, thus helping to ensure they get adequate nutrition in their diet.

Not enough data is available to estimate the prevalence of true lactose intolerance in the United States, the report stated, but it’s likely the numbers are lower than those reported, said Natalie J. Miller, a member of the panel that issued the draft statement and a graduate student at the University of Pennsylvania School of Veterinary Medicine, at a Wednesday teleconference.

People with lactose intolerance usually are told to avoid milk and milk-containing products, but this can deprive them of needed nutrients, particularly calcium and vitamin D.

“Particularly in children and adolescents, it’s very difficult for them to receive enough calcium and vitamin D if they avoid diary completely. The same thing may hold true for adults,” said Dr. Frederick J. Suchy, chairman of the conference preceding the statement and professor and chief of pediatric hepatology at Mount Sinai School of Medicine in New York City.

“Vitamin D and calcium have important effects, for certain for bone health, and may have implications in other areas such as cardiovascular health, hypertension and maybe even colon cancer,” he said.

Lactose is a sugar found in both human and cow’s milk.

“In order to be absorbed as a nutrient, lactose has to be digested by lactase, an enzyme present in the lining of the small intestine,” Suchy explained. “It’s well recognized that during the period of suckling in the infant, levels of lactase in the intestine are at their highest in order to be able to digest and absorb an important food source.”

By age of 3 or 4, however, lactase production usually decreases, and most people become “lactase nonpersisters.”

“The majority of the world’s population, after weaning and gradually over childhood, lose lactose activity,” Suchy said. “It’s a normal state. Only those people that are largely from northern European descent have retained lactase and have the ability to ingest and process lactose later in life.”

But even most “nonpersisters” aren’t really intolerant to lactose and could consume more dairy products.

It’s first important to distinguish whether symptoms attributed to lactose intolerance — diarrhea, abdominal pain, bloating and flatulence — result from another, potentially serious gastrointestinal condition, such as irritable bowel syndrome or celiac disease.

But, said Suchy, even “if it is a problem with lactose, there may be strategies to cope with that.”

Right now, when lactose intolerance is suspected, “the reflex response oftentimes is to tell the patient to stop taking dairy products completely,” Suchy said. “There may be some patients where that has to be done and whatever nutritional deficiencies could be made up with supplements.”

But for others, alternative strategies like taking small amounts of milk throughout the day or with meals or including yogurt and hard cheeses, especially low-fat hard cheeses, in the diet might be tolerable.

“This is not an allergic condition where if you take a little bit of milk you get sick. That’s quite rare,” noted Dr. Marshall A. Wolf, a panel member and professor of medicine at Harvard Medical School in Boston. “This is a quantitative condition and most people, even those with malabsorption, can take a certain amount of milk products without any symptoms, and there is some evidence to suggest that if you take milk products on a regular basis, you can build up your tolerance for milk.”

SOURCES: teleconference with Frederick J. Suchy, M.D., panel and conference chairperson, and professor and chief of pediatric hepatology, Herbert H. Lehman Professor and Chair, Department of Pediatrics and Pediatrician-in-Chief, Mount Sinai School of Medicine; Natalie J. Miller, graduate student, School of Veterinary Medicine, University of Pennsylvania, Philadelphia; Marshall A. Wolf, M.D., professor, medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston; U.S. National Institutes of Health Consensus Development Conference: Lactose Intolerance in Health draft consensus

May 21, 2010

Third of Young U.S. Adults Lack Health Insurance

Filed under: Uncategorized — admin @ 10:21 pm

Almost one-third of young adults in their 20s lacked health insurance in the United States in 2008, new statistics show.

The problem was more pronounced among men 20 to 29 years of age, 35 percent of whom went without coverage for medical care. As a result, these uninsured 20-somethings are less likely to visit a doctor on a regular basis, less likely to fill prescriptions and more likely to arrive at the emergency room.

“The highest uninsured rate is among people in their 20s and even though this is a relatively healthy group, they do need some access to health care,” said Robin A. Cohen, lead author of a data brief just released by the National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention.

“If you don’t have insurance you’re less likely to have a usual source of medical care. You’re also less likely to have visited a doctor and you’re more likely to have an unmet medical need,” Cohen added.

“This is a problem that’s existed for some time, and it’s worsened over the last few years,” said Sara Collins, vice president of the Affordable Health Insurance Program at The Commonwealth Fund in New York City. “We have an employer-based health insurance system so to the extent that you are without strong connections to that system when you have a transitional period, you’re going to be at risk of losing your health insurance coverage.”

And people in their 20s generally are in transition, moving from home where they could be on their parents’ plan, to college where they could be on a college plan or to the workforce, where they may be on no plan.

And children who had been covered under Medicaid aren’t likely to be eligible for that program when they turn 19, Collins added.

Based on data collected from more than 13,000 adults aged 20 to 29, the researchers discovered that:
U.S. adults in their 20s were almost twice as likely as adults aged 30 to 64 to go without health coverage (31 percent versus 17 percent).
Seventy percent of adults in their 20s had a “usual source” of medical care, although only 44 percent of young adults without insurance had such a source.
Women were more likely to have regular health-care practitioners than young men: 91 percent of women among those with private coverage versus 70 percent of men in the same category. Fifty percent of women without coverage had a regular doctor, compared with 39 percent of men in this category.
Adults in this age group without insurance were four times as likely as those with private insurance and twice as likely as those with Medicaid to have “unmet medical need.”
One-quarter of uninsured people in this age group did not fill a needed prescription, compared with 6 percent of those with private insurance and 12 percent of those on Medicaid. Women were more likely than men to have an unmet need in this area.
About 10 percent of adults in their 20s reported at least two visits to an emergency room in the past year, with women twice as likely to have visited compared with men (12 percent versus 6 percent).

Greg Scandlen, founder of Consumers for Health Care Choices, pointed out that the situation has probably worsened since 2008 as a result of the deteriorating economy, but that there was little new in the idea that many 20-somethings lack health insurance.

“It’s always been young adults who are most likely to be uninsured, and most of the people who are employed do have workers’ comp and do have auto insurance so they are actually covered for things most likely to happen to them in that age group,” he said.

“The implication here is that everyone should see a doctor once a year. I think that’s crazy. The whole notion of an annual physical exam is just a waste of money,” Scandlen said. “Women are far more likely to see a doctor more regularly because of ob/gyn issues, but the fact that young men in their 20s don’t see a doctor doesn’t bother me at all.”

SOURCES: Robin A. Cohen, Ph.D., statistician, National Center for Health Statistics, Division of Health Interview Statistics, U.S. Centers for Disease Control and Prevention; Greg Scandlen, founder, Consumers for Health Care Choices; Sara Collins, vice president, Affordable Health Insurance Program, The Commonwealth Fund, New York City; Access to and Utilization of Medical Care for Young Adults Aged 20-29 Years: United States

April 29, 2010

New Guidelines Suggest Botox for Cerebral Palsy

Filed under: Uncategorized — admin @ 12:53 am

In children and teens with cerebral palsy, botulinum toxin injections can be an effective treatment for spasticity and muscle tightness that interferes with movement, new guidelines from the American Academy of Neurology and the Child Neurology Society state.

The guidelines, which stem from a review of available research on drug treatments for cerebral palsy, also said that botulinum toxin type A, nicknamed Botox, is generally safe but does pose some risk.

“In reviewing this drug for treatment of spasticity in children, the [U.S.] Food and Drug Administration is investigating isolated cases of generalized weakness following use of botulinum toxin type A for spasticity,” Dr. Mauricio R. Delgado, of the University of Texas Southwestern Medical Center in Dallas and lead author of the guidelines, said in a news release from the academy.

The guidelines also recommend consideration of the drug diazepam for short-term treatment of spasticity, although generalized side effects have been linked to its use. Another drug, tizanidine, might also be considered but carries a risk of liver toxicity, according to the guidelines.

Delgado and his colleagues also looked at several other drug treatments but concluded there wasn’t enough evidence to make a recommendation.

“There is an urgent need for more research to establish the effectiveness of the current treatments for generalized spasticity and to find additional, safer and more effective medications,” Delgado said.

Most children with cerebral palsy have spasticity. Although the disease cannot be cured, treating its effects has been shown to improve a child’s capabilities.

The guidelines are published in the issue of Neurology.

April 25, 2010

Opiate painkillers raise fracture risk

Filed under: Health — admin @ 12:52 am

Older adults who take powerful prescription painkillers known as opioids face an increased risk of bone fractures, especially at moderately high medication doses, a new study finds.

Opioids are powerful narcotic pain medications that include morphine, oxycodone (Oxycontin and other brands) and hydrocodone (Vicodin and others).

The drugs work well against severe pain in the short term, but their longer-term effectiveness for chronic pain is less clear. Moreover, with longer use comes the risk of addiction, in addition to side effects such as nausea, constipation, dizziness and sedation.

That dizziness and sedation can also set opioid users up for falls, which, in older people especially, may result in serious fractures.

The new study, published in the Journal of General Internal Medicine, confirms the risk of fracture associated with opioids, and also shows that moderately higher drug doses further the hazard.

Researchers found that among more than 2,300 older adults with chronic pain, the risk of suffering a bone fracture was higher when patients were using an opioid for a prolonged period than when they were opioid- free.

The individuals in the study were 60 years of age or older. None of the patients was suffering from cancer-related pain. (Guidelines for treating severe cancer pain are often different than guidelines for non-cancer pain.)

The annual rate of fractures among study participants who were not currently using opioids was just under 4 percent, while current users showed a fracture rate of 6 percent. And among patients currently taking opioid doses of at least 50 milligrams per day, the annual fracture rate was 10 percent.

According to the researchers, 50 milligrams is considered to be in the moderate range for opioid doses.

“Some of these fractures were significant,” said senior researcher Dr.

Michael Von Korff, of the Group Health Research Institute in Seattle.

In an interview, he noted that 37 percent of fracture victims ended up in the hospital and nearly one-quarter entered a nursing home within one month of the accident.

The findings come at a time when long-term opioid use for non-cancer- related pain is coming under increased scrutiny.

About 8 million Americans are using opioids to control chronic pain, Von Korff said, yet the long-term effectiveness of the drugs is uncertain, and may vary widely from person to person. Some people find relief, while others find their pain actually worsens, Von Korff noted.

A report published in October by the Cochrane Collaboration, an international medical research organization, concluded that for older adults with osteoarthritis, the risks of long-term opioids may outweigh the modest pain relief.

And in a separate study published this week in the Annals of Internal Medicine, Von Korff’s team highlights the potential for overdose among people with legitimate prescriptions.

The researchers found that among 10,000 patients on opioids for at least three months, 51 suffered at least one overdose, with fatal results for six. As in this latest study, higher medication doses conferred a greater risk.

The bottom line, Von Korff said, is that “these drugs need to be taken cautiously and under close medical supervision.”

The current study included 2,341 older adults who, at some point between 2000 and 2005, were prescribed opioids for at least 90 days — most commonly for chronic back pain, osteoarthritis or pain in the extremities.

To limit the risks of falls and other side effects, Von Korff said that patients on opioids should work with a single physician who is aware of all the medications they are taking. That will help avoid any potentially hazardous drug interactions.

And given the importance of dosage, Von Korff said, “never use more medication than your doctor has prescribed.”

He also advised opioid users who feel overly sedated or have had dizziness or falls to tell their doctors about it.

SOURCE: Journal of General Internal Medicine

April 21, 2010

Newborns of Smokers Have Abnormal Blood Pressure

Filed under: Health — admin @ 12:51 am

Babies of women who smoked during pregnancy have blood pressure problems at birth that persisted through the first year of life, a new study finds.

“What is of concern is that the problems are present at birth and get worse over time,” said Gary Cohen, a senior research scientist in the department of women and child health at the Karolinska Institute in Stockholm, and lead author of a report in the Jan. 25 online edition of Hypertension. “They’re not going away, they’re getting worse.”

The study led by Cohen compared 19 infants of nonsmoking couples with 17 infants born to women who smoked an average of 15 cigarettes a day during pregnancy. At one week of age, the infants of nonsmoking mothers experienced a 2 percent increase in blood pressure when tilted upright, with a 10 percent increase at one year. The pattern for the children of smoking mothers was reversed: a 10 percent blood pressure increase at one week, a 4 percent increase at one year.

And the heart rate response to tilting of the children of mothers who smoked was abnormal and exaggerated, the report said.

It’s not possible to say whether the abnormalities seen in the babies will lead to trouble later in life, Cohen said. But, he noted, “the extent of the condition at one year suggests that it is not going to disappear quickly.”

The reason why exposure to tobacco in the womb affects blood pressure is not clear, Cohen said. A leading possibility is that “smoking might damage the structure and function of blood vessels,” he said, mainly by damaging the endothelium, the delicate layer of cells that line the interior of blood vessels.

Whether that damage will persist is not known. “We’re only up to 12 months at the moment,” he said. “We plan to follow them.”

The damage seen in the Karolinska study is similar to that observed in babies born to mothers whose pregnancies were marked by such abuses as drug use, said Barry M. Lester, a professor of psychiatry and pediatrics at Brown Medical School, and director of the Brown Center for the Study of Children at Risk.

“Early kinds of natal insults can cause reprogramming of brain circuitry,” Lester explained. He has led studies of the long-term effects of cocaine and amphetamine use during pregnancy. Many women who take such drugs also smoke, Lester added.

“When we isolated tobacco effects, we showed that there are inborn neural effects of tobacco exposure similar to what we see in cocaine and methamphetamine abuse,” he said.

Some research has connected such problems to overproduction of cortisol, a “stress hormone” that plays an important role in regulation of blood pressure and the immune system, Lester said. “Cortisol overexposure is one hypothesis,” he said. “There is a lot of evidence showing that too much cortisol is damaging.”

It is a reasonable hypothesis, Cohen said. Babies born preterm have problems with blood pressure that have been linked to overproduction of cortisol by the adrenal glands, he noted, “and there are some parallels between tobacco smoke exposure and preterm babies of the same age.”

Whatever the mechanism of damage, treatment to eliminate the problems after birth does not seem possible, Cohen added.

“What we know from studies in older kids is that even if you remove them from an environment of exposure to tobacco smoke, it is unlikely you will get full restoration of normal function,” he said. “The best intervention to solve these problems is prevention. Women who are pregnant need to avoid exposure to tobacco smoke in the air. Passive smoke exposure can be as bad as being an active smoker.”

SOURCES: Gary Cohen, Ph.D., senior research associate, department of women and child health, Karolinska Institute, Stockholm, Sweden; Barry M. Lester, Ph.D., professor, psychiatry and pediatrics, Brown Medical School, and director, Brown Center for the Study of Children at Risk, Providence, R.I.

March 28, 2010

Marijuana, Alcohol Addiction May Share Genes

Filed under: Health — admin @ 12:44 pm

The genes that make people susceptible to alcoholism also make them prone to becoming addicted to marijuana, a new study suggests.

Researchers interviewed almost 6,300 men and women aged 24 to 36, including almost 2,800 sets of twins who were part of the Australian Twin Registry, about their use of alcohol and marijuana over their lifetime.

Twins are valuable to researchers in determining the role of genetics in various diseases or conditions because identical twins share 100 percent of their genes, while fraternal twins share 50 percent of their genes, the same as other siblings.

About 60 percent of the likelihood of becoming a heavy drinker, a frequent marijuana user or of becoming dependent on marijuana can be attributed to genes, according to the study, while about half of the likelihood of being an alcoholic can be traced to genetics.

“We know there is a high likelihood of alcohol addiction-related problems among people who smoke marijuana heavily and vice versa,” said study author Carolyn E. Sartor, a research instructor at Washington University School of Medicine in St. Louis. “What we found is that some of the same genetic influences that impact alcohol use and dependent symptoms also impact marijuana use and dependent symptoms.”

Still, that means between 40 percent and 50 percent of the cause of alcohol or marijuana dependence may be due to environmental influences. Despite a genetic tendency, no one is predestined to abuse either substance, Sartor noted.

And even though a common set of genes appear to influence marijuana and alcohol addiction, there are also likely specific genes that influence addiction susceptibility to individual substances, Sartor added.

The study will be published in the upcoming March issue of Alcoholism: Clinical & Experimental Research.

Marijuana is the most commonly used illegal drug, according to the study, citing a 2008 survey that found about 42 percent of high school seniors reported having tried marijuana. About 5 percent said they had used it daily during the previous month.

Though generally believed to be less addictive than nicotine in tobacco products, about 12 percent of marijuana users meet the criteria for dependency, according to the study. Symptoms of marijuana or alcohol dependency include using more heavily or more frequently than intended, giving up important activities to smoke or drink and building a tolerance or needing to use more to get the same effect.

Marijuana’s active ingredient, THC, acts on the brain’s cannabinoid system, which is involved in learning, memory, appetite and pain perception, explained Dr. Christian Hopfer, an associate professor at the University of Colorado School of Medicine. Medical uses for marijuana including alleviating pain and boosting appetite in people with cancer and other serious illnesses.

But marijuana has its downsides. Other research has shown marijuana use increases the risk of developing mental illnesses, Hopfer added.

Far less research has been done about marijuana than on tobacco or alcohol products, Hopfer said. That needs to change. Not only is marijuana use widespread, but THC levels in pot have increased in recent years, making the drug’s effects more potent.

“We are quasi-legalizing it due to medical marijuana, yet we really don’t know that much about it except a lot of people are self-administering it,” Hopfer said. “Marijuana addiction is a subtler addition than with some other drugs, but it can be a big focus of their life and interfere with their functioning.”

In the past, researchers have often studied the addictive properties of drugs such as tobacco, cocaine, marijuana, heroin and alcohol separately, Hopfer said. But studies such as this suggest there can be similar genes underlying a propensity toward many types of substance abuse.

“There is a lot of evidence that if you have trouble with one substance you will have trouble with others,” Hopfer said. “Twin data shows that the genetic effects may be across substances.”

While there are legal drugs available to help treat nicotine and alcohol addiction, there are no drugs to treat marijuana addiction. For marijuana dependency, behavioral modification, family therapy, cognitive behavioral therapy and 12-step programs are among the programs that may help, Hopfer said.

March 21, 2010

Hangover impairs judgment in young adults

Filed under: Health — admin @ 12:43 pm

It’s not enough to “sleep it off” after a night of drinking.

According to a study released today, the effects of intoxication last long after the booze is out of the blood, not only leaving a nasty hangover but also slowing reaction times and the ability to concentrate the next morning.

Rhode Island and Massachusetts researchers found that it didn’t matter whether the liquor consumed was clear or dark; the level of brain impairment was the same the next morning.

“People will be impaired the morning after – after the alcohol leaves the system,” Dr. Damaris Rohsenow of the Brown University Center for Alcohol and Addiction Studies in Providence, Rhode Island noted in a telephone interview with Reuters Health.

The findings are based on a study looking at the effects of heavy drinking on 95 young adults between the ages of 21 and 33. The subjects spent two nights at the Boston test facility. One night they were given alcohol (either vodka or bourbon mixed in cola) and the other night they were given a placebo. The researchers determined their blood alcohol levels, sleep patterns and ability to think quickly and over a long period of time.

To approximate the effects of drinking on an empty stomach, Rohsenow and colleagues gave test subjects a standardized meal three hours before the test liquids were given until subjects reached a minimum blood alcohol level of 0.09 grams percent. (In all 50 states, 0.08 grams percent is considered legally drunk.)

Previous research shows that symptoms of a hangover (headache, nausea, sleepiness) usually lift within a few hours of waking. While this study did not measure how long impairment lasted, Rohsenow told Reuters Health: “It’s likely that the performance effects probably lift within a few hours,” too.

Vodka and bourbon appear on each extreme of alcohol purity: vodka is the most free of impurities while bourbon has the highest level – all other alcohols are somewhere in between.

Previous research shows that the higher the impurities the lousier a drinker is likely to feel the next day, but this study showed that impairment was the same.

“Bourbon versus vodka didn’t make a difference; the biggest thing was the alcohol itself,” Rohsenow said.

Subjects given alcohol the night before “thought their ability to drive a car was as good as or better” than those who were administered placebo, Rohsenow said.

It “might be a good rule of thumb (to) wait until they don’t feel so lousy the next morning before doing any activities that might involve operating dangerous equipment,” Rohsenow said.

The researchers chose to study young adults because there are more heavy drinkers among this age group, it’s safer, and they have more time to devote to the overnight stays required by the study. As a result, the findings can only be applied to people between the ages of 21 and 33.

March 14, 2010

Post-Surgery Infection Can Add $60,000 to Hospital Bill

Filed under: Health — admin @ 12:40 pm

Surgical patients whose incisions become infected with antibiotic-resistant bacteria are at greatly increased risk for hospital readmission and death, claims a new study that found that treating this type of infection can cost as much as $60,000 per patient.

Duke University Medical Center researchers examined the 90-day postoperative outcomes of 659 patients. Some had surgical site infections caused by methicillin-resistant Staphylococcus aureus (MRSA), some were infected with methicillin-susceptible Staphylococcus aureus (MSSA), and others had no infection.

“We found that patients with surgical site infections due to MRSA were 35 times more likely to be readmitted and seven times more likely to die within 90 days compared to uninfected surgical patients,” lead author Dr. Deverick J. Anderson, an infectious diseases specialist, said in a news release. “These patients also required more than three weeks of additional hospitalization and accrued more than $60,000 in additional charges.”

The study also found that patients with MRSA averaged six more days of hospitalization and $24,000 more in additional hospital charges than those with MSSA. However, the researchers were surprised that those infected with MRSA didn’t have a higher risk of death than those with MSSA.

“For the seven hospitals we looked at, the total estimated cost resulting from surgical site infections due to MRSA was more than $19 million. That’s a staggering amount, which demonstrates an area of cost-saving potential for these institutions and other community hospitals,” Anderson said.

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