Critics have knocked the recently updated guidelines on statins for patients at risk of heart disease. While some heart specialist spent years putting together advice for the high risk, others said the guidelines will result in massive overtreament.
Still, health monitoring apps are hot,. The American College of Cardiology is now offering an iPhone/ iPad risk calculator, the Globe’s Daily Dose reports. This paragraph from the Boston.com post was cut off the print version of the story.
The app does instruct doctors to have a discussion about the risks and benefits of statins and to consider patient preferences; whether busy primary care providers will make the time to have that discussion, rather than simply prescribing the drugs, remains to be seen.
The headlines were different as well.
Print: App Calculates Heart Disease
Boston.com: Heart disease risk app may increase statin prescriptions
Don’t like the ACC app? There are already a handful of others.
The Globe isn’t sharing much with Boston.com these days. But, you can still access most of the blogs.
Today’s Daily Dose is on the mammography debate. We all thought early detection was key. For breast cancer, maybe not.
In a research finding that will add to doubts about the value of breast cancer screening, Canadian researchers determined that women ages 40 to 59 who had yearly mammograms enjoyed no added survival benefit up to 25 years later compared with those who skipped the screening X-rays….
The latest finding, published Tuesday in the British Medical Journal, confirms earlier results from the Canadian trial, which first came out two decades ago and is unlikely to discourage many doctors from recommending screening…
But the researchers also determined that 22 percent of breast cancers initially detected on mammograms in the early 1980s were “over-diagnosed”—meaning they never would have been found otherwise and would not have become life-threatening. Most of these women had surgery to remove these tumors which, in hindsight, was unnecessary…
Such findings haven’t, though, swayed the opinions of most women and doctors, who remain more concerned about a life-threatening cancer going undetected than a harmless one being over-treated
Two local docs defend the procedure:
“Mammography is an imperfect test at best, but at this point, it’s the best test we have,” said Dr. Ann Partridge, a breast oncologist at Dana-Farber Cancer Institute. She and others highlighted some potential methodological flaws of the Canadian study.
For example, Partridge said, technology has improved significantly over the past 30 years with X-ray machines and digitized film that yield clearer images….
Some radiologists have sharply attacked the study investigators, accusing them of having a bias against mammography by designing a study in which the control group of women in their 50s received breast exams performed by skilled nurses every year instead of mammograms.
“The principal investigator set out to prove that all you needed to do was a physical examination,” said Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital, in an e-mail responding to the new study finding. “The nurse examiners were highly trained while the radiologists and technologists [who performed the mammograms] had no training.”
Not everyone is sticking with mammography. The advocates at Breast Cancer Action have long questioned its usefulness.
“It will make women uncomfortable, and they should be uncomfortable,” said Dr. Russell P. Harris, a screening expert and professor of medicine at the University of North Carolina, Chapel Hill, who was not involved in the study. “The decision to have a mammogram should not be a slam dunk.”
The BHN local health Twitter list served up this last week:
A growing body of evidence suggests that women who have high urine levels of bisphenol-A—a chemical used in some hard plastics and to coat metal cans—are more likely to suffer from infertility, and now researchers have found a possible reason why. BPA may disrupt eggs from maturing properly, according to a study from Brigham and Women’s Hospital researchers.
“As many as 20 percent of infertile couples have unexplained infertility, and this might just shed a glimmer of light on a contributing factor that plays a role,” said study co-author Catherine Racowsky, director of the hospital’s assisted reproductive technologies laboratory.
So, what to do to reduce you BPA levels? The Silent Spring Institute, a Newton research program looking a the links between breast cancer and the environment, did a study looking at just that in 2011. They found that by families that were willing to give up canned food, food packaged in plastic, and restaurant meals for three days. “When study families switched to the fresh food diet, their levels of the hormone disruptors BPA and DEHP dropped by half.”
While scientists continue to study the health effects of these chemicals, here
are simple steps to play it safe and reduce your exposure:
Fresh is best
BPA and phthalates can migrate from the linings of cans and plastic
packaging into food and drinks. While it’s not practical to avoid food
packaging altogether, opt for fresh or frozen instead of canned food as
much as possible.
Studies have shown that people who eat more meals prepared outside
the home have higher levels of BPA. To reduce your exposure, consider
cooking more meals at home with fresh ingredients. When you do eat
out, choose restaurants that use fresh ingredients.
Store it safe
Food and drinks stored in plastic can collect chemicals from the
containers, especially if the foods are fatty or acidic. Next time, try
storing your leftovers in glass or stainless steel instead of plastic.
While scientists continue to study the health effects of these chemicals, here
Don’t microwave in plastic
Warmer temperatures increase the rate of chemicals leaching into food and drinks. So use heat-resistant glass or ceramic containers when you microwave, or heat your food on the stove. The label “microwave safe” means safety for the container, not your health.
Brew the old-fashioned way
Automatic coffee makers may have BPA and phthalates in their plastic containers and tubing.
When you brew your coffee, consider using a French press to get your buzz without the BPA.
Dealing with the housing and care issues that come with aging and disability is, at best, discouraging. When assisted living came along, those who could afford a spot found a comfortable, dignified place to age. These homes look more like hotels than hospitals and offer care for those who need help, but don’t need a nursing home.
But, long-term care is a challenge for both residents and owners. And when the owner is an off-site corporation, efforts to contain costs can lead to poor care for residents.
That’s what the investigative reporters at Frontline and ProPublica found when they started digging. The FRONTLINE series — starts tonight, Tuesday, and the ProPublica series is running this week on the group’s website. Here’s what they found:
With America’s population of seniors growing faster and living longer than ever before, more and more families are turning to assisted living facilities to help their loved ones age in comfort and safety.
But are some in the loosely regulated, multibillion-dollar assisted living industry putting the lives of those loved ones at risk?
From the Texas assisted living resident who froze to death on Christmas morning to the Hall of Fame football player who drank unsecured toxic dishwashing liquid and died 11 days later, this major investigation raises questions about fatal lapses in care and a quest for profits at one of America’s best known assisted living companies.
Here in Massachusetts, assisted living facilities have to be certified by the state Office of Elder Affairs. State law requires the homes to have:
The home staff members are not allowed to deliver medical care and the homes are barred from accepting residents who need “skilled nursing care” unless that care is provided by an “employee of a Certified Provider of Ancillary Health Services. Those caregivers can include physician, pharmacist, restorative therapist, podiatrist hospice and home health aides.
In other words, assisted living is housing, not health care. This series did not look at homes here. But a former aide at a Massachusetts assisted living program makes some serious charges in the comment section of the ProPublica story.
This seems huge, although the questions about the overdiagnosis of cancer have been bubbling up for a while.
A group of experts advising the nation’s premier cancer research institution has recommended sweeping changes in the approach to cancer detection and treatment, including changes in the very definition of cancer and eliminating the word entirely from some common diagnoses.
The recommendations, from a working group of the National Cancer Institute, were published on Monday in the Journal of the American Medical Association. They say, for instance, that some premalignant conditions, like one that affects the breast called ductal carcinoma in situ, which many doctors agree is not cancer, should be renamed to exclude the word carcinoma so that patients are less frightened and less likely to seek what may be unneeded and potentially harmful treatments that can include the surgical removal of the breast.
The “Susan G Komen for the Cure” take is quite a bit different:
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer. In DCIS, abnormal cells are contained in the milk ducts. It is called “in situ” (which means “in place”) because the cells have not left the milk ducts to invade nearby breast tissue. …. You may also hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS.
Update 7/18 :The folks at WGBH’s Boston Public Radio took calls after an interview with David DeSteno, the author of this meditation study. Note: Jim Braude does not mediate: his co-host Margery Eagan does.
7/7: This piece in the NYTimes magazine, “The Morality of Meditation” is of interest for two reasons. It was written David DeSteno is a professor of psychology at Boston’s Northeastern University. And, this reporter has spent the past five weeks in a brace and on crutches with a fractured tibia plateau — top of the shin bone. Anecdotally, that 16 percent of people would give up a seat for a person on crutches seems about right.
Buddha: “I teach one thing and one only: that is, suffering and the end of suffering.” For Buddha, as for many modern spiritual leaders, the goal of meditation was as simple as that….
Here’s how they tested that concept:
When a participant entered the waiting area for our lab, he (or she) found three chairs, two of which were already occupied. Naturally, he sat in the remaining chair. As he waited, a fourth person, using crutches and wearing a boot for a broken foot, entered the room and audibly sighed in pain as she leaned uncomfortably against a wall. The other two people in the room — who, like the woman on crutches, secretly worked for us — ignored the woman, thus confronting the participant with a moral quandary. Would he act compassionately, giving up his chair for her, or selfishly ignore her plight?
The results were striking. Although only 16 percent of the nonmeditators gave up their seats — an admittedly disheartening fact — the proportion rose to 50 percent among those who had meditated.
The Science and Cooking lectures at Harvard have been SRO since launched a few years ago. They tend to be more about about chemistry than nutrition, as in the science of the deep-fried hamburger. Still, the more you know about your food — like those carcinogens you cooked up on the grill yesterday — the better. (Footnote – The Globe just published some non-carcinogenic approaches to grilling.)
Here’s a post from Nature Network Boston on a session by Nathan Myhrvold, physicist, Microsoft millionaire, patent defender and author of the 2,428-page, 42-pound,$625 cookbook: Modernist Cuisine: The Art and Science of Cooking.
ABOUT THIS COURSE
During each week of the course, you will watch as chefs reveal the secrets behind some of their most famous culinary creations — often right in their own restaurants. Inspired by such cooking mastery, the Harvard team will then explain, in simple and sophisticated ways, the science behind the recipe.
Topics will include: soft matter materials, such as emulsions, illustrated by aioli; elasticity, exemplified by the done-ness of a steak; and diffusion, revealed by the phenomenon of spherification, the culinary technique pioneered by Ferran Adrià.
To help you make the link between cooking and science, an “equation of the week” will capture the core scientific concept being explored. You will also have the opportunity to be an experimental scientist in your very own laboratory — your kitchen. By following along with the engaging recipe of the week, taking measurements, and making observations, you will learn to think both like a cook and a scientist. The lab is also one of the most unique components of this course — after all, in what other science course do you get to eat your lab?