April 14th, 2012
Podcast 151: Most people above age 10 have at least some cross-reactive antibodies to variant influenza
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Influenza A (H3N2)v — a novel flu virus that emerged last summer and shows signs of being able to transmit itself from person to person — is our topic this week.
The virus carries genes from swine and avian flu viruses, and the few cases found in the U.S. all made complete recovery.
We talk with CDC epidemiologists involved in assessing the threat, and they’re reassuring on two fronts: first of all, most of the population shows at least some cross-reactive antibody to the virus; and second, they’ve isolated a candidate vaccine virus that they would use in the event that A (H3N2)v started showing increased ability for person-to-person transmission.
Links:
March 29th, 2012
Podcast 150: Depression (and antidepressant use) after stroke or TIA
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After stroke or transient ischemic attack, depression is more common than among the general population, and the risk for depression extends beyond the early time period after the event.
More alarmingly, less than a third of those with persistent depression — defined as depression detected both at 3 and 12 months after the cerebrovascular event — receive antidepressant medication.
We offer an interview with Dr. Nada El Husseini, first author of a study published online in Stroke that presents the data supporting those observations.
Link:
Stroke abstract (free)
March 15th, 2012
Podcast 149: High levels of white rice consumption seem linked to higher risks for type 2 diabetes
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A BMJ meta-analysis suggests that people with the highest levels of white rice consumption are at increased risk for type 2 diabetes.
The authors examined four studies, together comprising some 350,000 subjects. Two were done in Asian populations and two among Westerners. They found a much higher intake of white rice among Asians, and a strong association between consumption level and risk. In Western populations, the association was suggestive, but not as strong.
The effect may possibly derive from the higher glycemic load with increasing consumption, or from the nutrients stripped away with the rice husk during milling.
The senior author, Dr. Qi Sun, discusses his findings with us in a brief interview.
Links:
BMJ article (free)
February 29th, 2012
Podcast 148: Smoking cessation during pregnancy is probably more effective with behavioral approaches than with relying on nicotine replacement
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In the largest study of its kind, UK researchers find that helping pregnant women to quit smoking until at least delivery isn’t helped much by nicotine replacement therapy.
The primary outcome, self-reported cessation lasting between the start of therapy and delivery, differed little between the active treatment group and those randomized to placebo (9% versus 8%).
In addition, compliance was low in both groups.
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February 24th, 2012
Podcast 147: Proof that colonoscopy with polypectomy saves lives
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Everyone “knows” that colonoscopy reduces risks of death from colorectal cancer, but it’s good to have your knowledge actually verified, and a new bit of research seems to do that in this case.
Long-term follow-up of a group of patients who underwent colonoscopy and polypectomy in the 1980s shows that removal of adenomatous polyps brought with it a risk of dying from colorectal that was half the risk found in the general population. About 80% of these patients, it should be mentioned, underwent strict surveillance for 10 years after their adenomatous polyps were excised.
This is good news, no? And it offers clinicians a “teaching moment” with their patients who are reluctant to undergo the procedure.
Listen in as we interview Dr. Ann Zauber, first author on the New England Journal of Medicine paper.
Links:
Physician’s First Watch coverage of the research (free)
New England Journal of Medicine abstract (free)
New England Journal of Medicine editorial (subscription required)
February 17th, 2012
Podcast 146: Cognitive impairment in primary care — screen or not?
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Current guidelines find no compelling therapeutic benefit to screening for cognitive impairment and dementia in primary care. The Journal of the American Geriatrics Society has published some research that, if not compelling, certainly suggests that clinical approaches should change.
In actively screening some 8000 veterans over age 70 during routine primary care visits for cognitive impairment, researchers found a quarter to have signs suggesting further investigation was needed. When all was said and done, 11% had cognitive impairment; that’s two to three times the rate found in settings where physicians waited for impairment to manifest itself clinically.
We interview the lead author, who offers reasons why he thinks simple screening should be routine in elderly populations, despite the current absence of treatments for mild cognitive impairment and dementia.
Links:
Physician’s First Watch coverage (free)
Journal of the American Geriatrics Society abstract (free)
USPSTF current screening guidelines (free)
Mini-Cog screening test (free)
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