Marion County Medical Center

Health Shorts

August 2007

Fit Better than Fat at Any Weight
Even with regular exercise, some persons still carry a little excess weight. And their efforts may not be going to waste. A Canadian study of 169 healthy males found that those with the highest level of fitness had the lowest levels of abdominal fat regardless of weight or body mass index.
Abdominal fat, as evidenced by waist circumference or waist-hip ratio, is considered a risk factor for both heart disease and diabetes.
[SOURCE: Jean-Pierre Despres, Archives of Internal Medicine, July 23, 2007]

Head Lice More Prevalent?
If you think the head lice problem is a bigger issue than it was when you were a child, you’re right. In the United Kingdom, the number of prescriptions written for head lice shampoo increased 37-fold between 1980 and 1995. It’s believed that a similar increase occurred in the United States.

Six to twelve million American children are bothered by head lice each year. Some of the increased prevalence can be attributed to the evolution of strains of lice that are resistant to available medications.
[SOURCE: Rachel Nowak, “Hair Wars: They Have Sucked Our Blood for Millenia, Resisting All Efforts To Defeat Them,” New Scientist, December 25, 2004]

ED May Be Marker for Diabetes
Men who develop erectile dysfunction before age 65 are at higher than average risk of diabetes. A study of 1.8 million males published in the Journal of Urology found that such men were 60 percent more likely than other males to have type 2 diabetes.

For men developing ED before age 45, the risk was double that of other men. No association was found between diabetes and ED diagnosed after age 65.
Erectile dysfunction is also linked to high blood pressure and an increased risk of heart disease and stroke.
[SOURCE: “Wellness Made Easy,” University of California Berkeley Wellness Letter, August, 2007]

Who Gets Head Lice?
Head lice are more commonly found on children than adults because youngsters are more likely to have close physical contact with each other at school or play. Most likely to be infested are white girls, age 3 to 12, not because of their personal hygiene but due to their behavior which is more likely to result in direct contact or sharing of hair care items.

Because of the oval shape of their hair shafts, African Americans are rarely infested with head lice prevalent in the United States.
[SOURCE: Gregg M. Kirchofer, James H. Price and Susan K. Telljohann, “Primary Grade Teachers’ Knowledge and Perception of Head Lice,” Journal of School Health, May, 2001]

ED Drugs Not Covered by Medicare
Erectile dysfunction (ED) drugs are no longer covered by most Medicare-approved prescription drug plans. Up to four pills per month of Viagra, Cialis or Levitra were covered during 2006, but an amendment to the Social Security Act that became effective on January 1, 2007 ended this coverage for what it labeled “lifestyle drugs.” These drugs are still covered for the treatment of pulmonary hypertension and other disorders.
[SOURCE; “Who Pays for ED Drugs?” Johns Hopkins Medical Letter, August, 2007]

Effectiveness of Lice Drugs Declines
Head lice are rapidly developing resistance to many of the most common medications used to treat them. Permethrin 1%, a common over-the-counter treatment, demonstrated 96 percent efficacy after a single application a in study conducted in 1985 but only 45 percent efficacy in a similar study conducted in 2006.
[SOURCE: Mark Lebwohl, Lily Clark and Jacob Levitt, “Therapy for Head Lice Based on Life Cycle, Resistance, and Safety Considerations,” Pediatrics, May, 2007]

Don’t Blame Your Dog or Cat
Head lice require human hair to live and breed. Since they can’t fly or jump, they are passed along primarily by head-to-head contact and sometimes by sharing of hats or hair care products.

Household pets or other animals can’t catch head lice; nor can they transmit them to humans. Body lice, pubic lice and the lice sometimes encountered on plants or birds are different species and do not live in human hair.
[SOURCE: Barbara P. Homeier, M.D., “Head Lice,” KidsHealth, reviewed April, 2005; Richard J. Pollack, Anthony Kiszewski and Andrew Spielman, “Head Lice: Information and Frequently Asked Questions,” Harvard School of Public Health]

Don’t Use Kerosene or Gasoline
Home remedies for head lice recommend applying mayonnaise, petroleum jelly, olive oil, vinegar and other substances to the hair to suffocate lice. Reports regarding the effectiveness of these treatments are mixed and have not been proven in clinical studies. Gasoline, kerosene or insecticides–on their own or in combination with other substances–are dangerous and should never be used.
[SOURCE: Kosta Y. Mumcuoglu, et al, “International Guidelines for Effective Control of Head Louse Infestations,” Journal of Drugs in Dermatology, April, 2007]

Appetite Suppressants Pose Danger
Appetite suppressants such as fenfluramine and dexfenfluramine have been implicated in many cases of pulmonary hypertension and heart valve problems. According to one European study, subjects reporting use of any appetite suppressant within the previous year had a 10-fold increased risk of pulmonary hypertension. Use of an appetite suppressant for longer than three months resulted in a risk more than 20 times that of other subjects.

In another study, persons diagnosed with pulmonary hypertension associated with fenfluramine or dexfenfluramine had a median survival of 2.5 years.
[SOURCE: Leung Ying Ying, et al, “Pulmonary Hypertension, Hyperthyroidism, and Fenfluramine: A Case Report and Review,” Medscape General Medicine, November 8, 2006]

Pulmonary Hypertension: Stay Safe
Pulmonary hypertension is a serious disorder involving chronic high blood pressure in the arteries of the lungs. Although patients being treated can live fairly normal lives, there are some things they must avoid:

Pregnancy and delivery produce demands on the body that endanger the life of a person with pulmonary hypertension. Oral contraceptives can aggravate the condition, so surgical sterilization is usually recommended.
Smoking.
Air travel and visits to high altitude locales.
Certain activities such as isometric exercises that produce shortness of breath or chest pain. Exercise is important, but it should be monitored.

[SOURCE: American Heart Association, “Pulmonary Hypertension: What It Is,” 2007]

Neuropathy Causes Sexual Dysfunction
Diabetic neuropathy is a major cause of sexual dysfunction in both men and women. The autonomic nervous system controls the involuntary dilation of blood vessels that lead to the male erection and female sexual arousal. Damage to these nerves causes gradual loss of function.

Diabetic nerve damage can also lead to over-active bladder, urinary incontinence and urinary retention.
[SOURCE: Jeremiah John Duby, et al, “Diabetic Neuropathy: An Intensive Review,” American Journal of Health System Pharmacy, 61(2):160-176, 2004]

Altered Heart Disease Patterns for Diabetics
Persons with both type 1 and type 2 diabetes have a high rate of heart disease, and it often presents itself in altered patterns. Patients with diabetic nerve damage, for example, may fail to recognize a heart attack because of reduced perception of chest pain or shortness of breath. Whereas the majority of heart attacks occur in the morning, diabetics often have attacks during the evening hours.
[SOURCE: Aaron I. Vinik, Roy Freeman and Tomris Erbas, “Diabetic Autonomic Neuropathy,” Seminars in Neurology, 23(4):365-372, 2003]

Diabetes Epidemic: The Consequences
Fueled in part by increased levels of obesity, the prevalence of type 2 diabetes is increasing dramatically. There are now 150 million persons worldwide diagnosed with the disorder, and that number is projected to double over the next 25 years.

The consequences: during the period from 1990 to 2000, the rate of heart attack and stroke among non-diabetic patients in New York declined by 14 percent while the rate among type 2 diabetics increased by 54 percent.

Recent studies indicate that many cases of diabetes can be prevented through modest reductions in body weight coupled by regular exercise.
[SOURCE: Muhammad A. Abdul-Ghani, et al, “What Is the Best Predictor of Future Type 2 Diabetes?” Diabetes Care, June, 2007]

Eating To Prevent Diabetes
Eating a diet that includes plenty of salads and cooked vegetables while avoiding meats and other fatty foods appeared to be an effective way of reducing the risk of type 2 diabetes, according to data from 36,787 Australian adults in the Melbourne Collaborative Cohort Study.
[SOURCE: Allison Hodge, American Journal of Epidemiology, March, 2007; Michelle Rizzo, “Dietary Patterns Linked to Type 2 Diabetes Risk,” Reuters Health, March 21, 2007]

Ethnicity and Its Role in Diabetes Risk
The bad news, according to data from 78,400 women in the Nurses’ Health Study, is that American blacks, Asians and Hispanics have a higher risk of type 2 diabetes. The good news: these groups have a better chance than whites of lowering their risk through better eating habits. Although weight and increased body mass index is a factor in this increased risk of these groups, it is not the only factor, the study found.

While Asians had the lowest average body mass index, they showed the greatest increase in risk with any weight gain after age 18.
[SOURCE: Irish Shai, Diabetes Care, July, 2007]