DC On Line (Research)
By Brian Sutton, DCUlcer Patients Not Warned about NSAIDS
A study published in the Journal of the American Medical Association reports that most Medicare patients being treated for peptic ulcers are not warned about the dangers of taking over-the-counter nonsteroidal anti-inflammatory medications.Drugs such as aspirin and ibuprofen can create or increase the severity of ulcers and lead to increased hospitalizations or death from internal hemorrhage. Guidelines issued by the National Institutes of Health in 1994 recommended that doctors determine if their ulcer patients use NSAIDs and, if so, have them discontinue their use. However, this study says that there was no such change in clinical practice. Less than one third of patients are warned that NSAIDs could cause or aggravate their problem.1
1. JAMA, October 24, 2001.
A new study published in the Journal of Agricultural and Food Chemistry2 reports that coffee is a good source of antioxidants. The work compares antioxidant activity of coffee, green tea, cocoa, and herbal teas. Coffee beat out all the other contenders on a per-cup basis. The method of preparation appeared to affect the outcome, as well as the type of coffee and amount of roasting.
2. JAFC, September, 2001.
Fiber and Colon Cancer Revisited
A new study is reviving the theory that a dietary fiber may help prevent cancer of the colon. This research, judged by a number of experts to be more reliable than past works that discounted the connection, found a 40-percent decrease in colon cancer in patients on a high-fiber diet. Just over 406,000 people from nine European countries participated in the study, which began in 1993.3
3. Associated Press, June 23, 2001, reporting on the research of Dr. Sheila Bingham, of Cambridge University.
Hospitals Owning Up
The Joint Commission on Accreditation of Healthcare Organizations4 adopted a rule in the summer of 2001 that requires hospitals to tell a patient when he or she has been the victim of a medical error. Under the rule, hospitals risk losing their accreditation if they fail to keep patients so informed. Contrary to some hospital administrators' fears, the move may actually help prevent lawsuits: at least one study suggests that patients sue less often if they're kept informed.5 The rule is in response to congressional figures that indicate that 777,000 people each year are injured or killed by medication errors.
4. Joint Commission (www.jcaho.org/news/nb333.html)
According to Dutch researchers, the thrill of the drug "ecstasy" comes at the expense of long-term memory. The drug appears to act by causing a flood of seratonin, to which the body reacts by decreasing the number of seratonin receptors on nerve cells. After about a year of abstention, these receptors return to normal numbers. However, memory tests on these ex-users indicate a permanent loss of some memory function.6
6. Archives of General Psychiatry, October 2001.
Starch and Colon Cancer
Research from Australia suggests that resistant starches, compounds that are not completely digested, play an important role in preventing colon cancer. Resistant starch is found in undercooked vegetables and rice, as well as other foods. Scientists theorize that some of these foods that escape digestion release compounds in the large intestine that protect against colorectal cancer. The research was prompted by observations that populations consuming large amount of starch had lower incidences of the cancer than those who consumed more fiber, but less starch.7
7. OTC (COMTEX Newswire), July 3, 2001, reporting on research by Commonwealth Science and Industrial Research Organisation health sciences and nutrition in Adelaide, Australia.
More Caesarian Births
Britain's Royal College of Obstetricians and Gynecologists reports that record numbers of women have been undergoing the surgical birth procedure in recent years. The latest figures show that twenty percent of expectant mothers undergo Caesarian section to deliver their children. This compares to just three percent only 30 years ago. About half of the obstetricians surveyed in this study said that the rate was higher than it should be. The World Health Organization suggests that levels of 10-15 percent are reasonable. Critics of the procedure cite serious health risks to both the mother and baby, often just for the sake of convenience. About 37 percent of the surgeries are nonemergency choices made by the patient.8
8. Reuters, October 26, 2001.
A study published in the New England Journal of Medicine9 reports that one in five samples of ground meat purchased in supermarkets was contaminated with salmonella bacteria. Most of the germs were resistant to antibiotics. The findings, which are similar to earlier Food and Drug Administration studies, add to the concern created by indiscriminate antibiotic use in farm animals. About 20 million pounds of antibiotics are given to farm animals each year. In contrast, humans take about 15 percent of that amount, or three million pounds. Some estimates suggest that as little as 10 percent of these medications go to sick animals; the rest are for prevention or other reasons.
9. NEJM, October 18, 2001.
Alcohol and the Brain
Research published in the journal Stroke10 concludes that moderate alcohol consumption has both positive and negative effects on the human brain. On the positive side, the study confirms previous research that suggests a lowered risk of stroke and subsequent brain scarring when compared to total abstainers.
Included in the stroke category is a type called a silent stroke, which goes unnoticed by the patient. The effects of silent strokes accumulate over time to produce gradual impairments of intellectual ability or motor skill function. The white matter scarring produced by such strokes is visible on MRI scans.
Unfortunately, the study also suggests that each alcoholic drink contributes to brain atrophy, which is associated with dementia. Previously, it was assumed that this shrinkage only occurred in heavy drinkers, such as alcoholics, but this study suggests a more linear relationship. The authors are reluctant to speculate on which is the less desirable outcome.
10. Stroke, September 7, 2001.
Newborns in the Car
Doctors from the Children's Hospital in St. Paul and the University of Minnesota School of Medicine recently issued a warning to new parents, in response to the outcome of a research project in Minnesota. The study, published in the journal Pediatrics,11 concludes that infants should not be placed in car seats or other upright-seated positions for long periods of time.
The researchers found that oxygen saturation began to decline in such positions because of immature head righting and breathing reflexes. The infant's head tends to flop excessively away from the midline, impairing the child's ability to breathe. The warning includes swings and other upright seating devices during the first few months of life.
11. Pediatrics, September 2001.
Sentinel Lymph Nodes
Women undergoing surgery for early breast cancer often are told they should have their axillary lymph nodes removed to see if the cancer has spread. Most of the time, it has not, but the surgery can lead to permanent swelling, disability, and recurring infections in about 20 percent of these patients. New evidence has recently come to light12 that supports the hypothesis that the removal of only one node for biopsy (a procedure called sentinel node biopsy) is just as accurate. Proponents of this alternative procedure say that removing the other immunologically active lymphatics offers no additional benefit and is probably harmful to the patient.
12. Presented to the Federation of European Cancer Societies by Dr. Umberto Veronesi (www.fecs.be/Conferences/ecco11/index.shtml).
Two different studies published in the Journal of the National Cancer Institute13 report that women who work nights appear to be somewhat more prone to breast cancer. One of the studies found a 60-percent increased risk when women worked nights for more than three years of their life. Both studies suggest that the problem may be related to suppressed melatonin secretion and subsequent hormonal imbalances.
13. JNCI, October 2001.Brian Sutton,DC
Colorado Springs, Colorado
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