Health ShortsJune 2005Workouts Help Angina
Many Americans undergo balloon angioplasty each year to get relief from angina–brief episodes of heart-related chest pain. As an initial option, however, doctors recommend medication, exercise, diet and other lifestyle changes. German researchers recently found that the latter approach was not only cheaper and safer but more effective. In a year-long study, 100 men with stable angina were randomly chosen for treatment with either angioplasty or an exercise program consisting of 20 minutes daily on an exercise bike. At the end of the year, 21 of the 50 treated with angioplasty but only 6 of those performing exercise had suffered a heart attack, stroke or other problem caused by inadequate blood flow to the heart or brain. The subjects riding exercise bikes also had higher levels of physical fitness.
[SOURCE: Circulation, March 23, 2004; “Sweat Can Set You Free,” Harvard Health Letter, June, 2004] Angina: Don’t Deny or Ignore It
More than 6.8 million Americans are diagnosed with angina–brief episodes of heart-related chest pain brought on by several minutes of exercise, walking up stairs or emotional stress. Because the pain goes away quickly with rest, many individuals never report the problem to their doctors, joining what researchers call “the submerged clinical iceberg” of angina. A British study of 10,000 government workers found that persons with undiagnosed angina were twice as likely to die or suffer physical limitations as other subjects. They had a risk higher even than that of heart attack survivors.
[SOURCE: “Heart Beat–Hidden Angina,” Harvard Heart Letter, January, 2004; Harry Hemingway, et al, “Prognosis of Angina with and without a Diagnosis: 11-Year Follow Up in the Whitehall II Prospective Cohort Study, British Medical Journal, October 18, 2003] Angina Hurts Women More
Women with angina were more likely than men to suffer progressively increasing physical limitations over a period of 10 years or longer, according to a study of 128 heart patients. The authors theorized that women “may be avoiding physical activities and situations that trigger anginal episodes,” leading to onset of chest pain at progressively lower levels of activity.
[SOURCE: “Women’s Physical Function Suffers More than Men’s from Cardiac-Related Chest Pain,” Women’s Health Weekly, March 13, 2003] Psoriasis Problems Run Deep
Persons with the skin disorder psoriasis have a level of disability comparable to that of individuals with chronic heart problems such as angina or hypertension. With psoriasis, the disability involves mostly social and psychological distress whereas the limitations associated with angina and hypertension are primarily physical.
[SOURCE: “Clinical Pitfalls,” Pulse, September 13, 2004] Is It Psoriasis or Dandruff?
Nearly half of psoriasis patients have scaly patches on the scalp, sometimes confused with seborrheic dermatitis, better known as dandruff. Whereas seborrheic dermatitis creates itching and flaking affecting all or most of the scalp, psoriasis has thickened, palpable, well defined patches of plaque.
[SOURCE: “GP Clinical: Psoriasis,” GP, September 24, 2004] Sunlight, Sea Water May Help Psoriasis
Sunlight is known to help psoriasis, and some scientists have also found a positive effect from sea water, particularly water from the Dead Sea. Many patients, however, are reluctant to take advantage of these natural treatments–primarily because they feel ashamed of exposing their bodies. Even though psoriasis is not contagious, about half of respondents to a recent European survey indicated they would not kiss, hug, swim with or eat food prepared by someone with psoriasis.
[SOURCE: Barbara Jankowiak, et al, “The Need for Health Education Among Patients with Psoriasis,” Dermatology Nursing, October, 2004; Mary Ellen Schneider, “Psoriasis: Still a Scarlet Letter,” Skin & Allergy News, December, 2004] Psoriasis Inflammation Increases Risk of Diabetes, Heart Disease
Psoriasis patients have a higher than normal incidence of arthritis, diabetes, cardiovascular problems, Crohn’s disease and other disorders. Many scientists attribute this increased risk to the effects of chronic inflammation of the skin. This inflammation may also lead to development of syndrome X, characterized by high blood pressure, abnormal cholesterol, abdominal obesity and insulin resistance, a precursor of type 2 diabetes.
[SOURCE: Betsy Bates, “Psoriatic Inflammation Tied to Diabetes,” Internal Mecicine News, January 1, 2005] MRI Detects Early Breast Cancers
For women with a genetic mutation that puts them at high risk for breast cancer, magnetic resonance imaging (MRI) is more sensitive than mammography or ultrasound in detecting tumors at an early stage. In a surveillance study involving 236 Canadian women with BRCA1 or BRCA2 mutations, MRI detected 17 of 22 cancers while mammography detected 8, ultrasound 7 and clinical breast exam 2 cancers.
[SOURCE: “Might MRI Save Lives in Women at High Risk for Breast Ca?” Contemporary OB/GYN, January, 2005; Warner E. Rewes, et al, “Surveillance of BRCA1 and BRCA2 Mutation Carriers with Magnetic Resonance Imaging, Ultrasound, Mammography, and Clinical Breast Examination,” JAMA, 2004;292:1317-1325] Imaging Rarely Needed for Back Pain
Most patients with lower back pain will get better with conservative measures, and imaging studies are generally required only to rule out cancer, infection or other serious problems. When imaging is performed, MRI has been demonstrated to be superior to x-ray in detecting abnormalities and giving an accurate diagnosis, even when a less expensive rapid MRI test is used. In terms of outcome, however, one recent study found no difference between patients diagnosed with MRI and those having x-rays. And the patients diagnosed with MRI were more likely to undergo lumbar spine surgery–increasing the cost even more with no corresponding benefit in terms of pain reduction or ability to function.
[SOURCE: MRI versus X-Ray in Low Back Pain,” GP, April 19, 2004] MRI Improves Pre-Natal Diagnosis
In cases involving suspected brain or spinal abnormalities in a fetus, one study found that MRI provided more information than ultrasound 48 percent of the time. In the other 52 percent of cases, the MRI and ultrasound diagnoses were in agreement. The authors of the study recommended that any woman counseled to terminate a pregnancy because of a brain or spinal abnormality detected on ultrasound should get a second opinion through MRI.
[SOURCE: Robert Finn, “Better Prenatal Diagnostic Accuracy with MRI over Ultrasound: For Brain, Spine Problems,” Family Practice News, February 15, 2004] Kids Not Tested for Lead Exposure
When 539 children were tested in two inner city Chicago communities considered high risk for lead exposure, 27 percent of the subjects were found to have high blood lead levels, mostly attributed to chipped exterior house paint. Yet 61 percent of children in these neighborhoods had never been tested previously.
[SOURCE: “High-Intensity Targeted Screening for Elevated Blood Lead Levels among Children in 2 Inner-City Chicago Communities,” The American Journal of Public Health, November, 2004] Lead Risk Hits Middle Class Kids Too
Lead poisoning is most prevalent among poor children living in deteriorating inner city housing, but children from middle class and upper class families are also at risk if they live in houses built before 1978. For lead exposure, the age of the home is the number one risk factor. Renovations performed on an older home are a frequent reason for high blood lead levels–even if these renovations were completed before the child was born.
[SOURCE: Sarah Karp, “Put Off: Middle-Class Children Often Don’t Get Tested for Lead, Despite the Damage It Can Do,” The Chicago Reporter, September, 2004] Lead Levels Correlate with IQ
A child with a serum lead level of 10 micrograms/dL or greater is considered to be at risk of learning impairment. One study found that even at lower levels, lead exposure correlated directly with IQ–a curve equal to a seven-point drop in IQ for levels ranging from no lead to 10 mcg/dL. The Centers for Disease Control estimated that in 2000 more than 400,000 American children had a lead concentration greater than 10 mcg/dL.
[SOURCE: Timothy F. Kirn, “Last Year Marked by Findings on Lead, Obesity,” Family Practice News, June 1, 2004] Tapping into Lead Filters
Lead in drinking water introduced through corrosion of plumbing materials can be effectively removed through various types of filters that can be mounted on the tap. Such products should be tested and certified to ANSI/NSF standards. Users should be careful to follow the manufacturer’s recommendations for replacing filters or cartridges.
[SOURCE: Mark V. Rowzee, “Lead in Water: An Old Enemy Gets New Press; The Problem of Lead in the Water in Washington, D.C. Could Occur (Or May Already Be Happening) in a Number of Other U.S. Cities,” Environmental Design & Construction, November, 2004] | 
