Health ShortsSeptember 2008Retinopathy Predicts Heart Failure
As a disease involving the small blood vessels in the eye, diabetic retinopathy has previously been linked with cardiovascular disease. A recent analysis of data from Atherosclerosis Risk in Communities (ARIC) study found that over a nine-year period patients with retinopathy had a risk of heart failure double that of other persons.
Among 1,021 ARIC subjects, aged 45 to 64, who had no clinical signs of heart disease or kidney dysfunction, 106 were hospitalized or died of heart failure over a nine-year period. The unadjusted heart failure rate was 21.6 percent for those with diabetic retinopathy and 8.5 percent for others.
[SOURCE: Steve Stils and Desiree Lie, “Diabetic retinopathy independently predicts new heart failure,” Medscape Medical News CME, April 29, 2008]
Share Same Risk Factors
Researchers have found that persons with diabetic eye disease are more likely to die early because of heart disease or any cause compared to other persons. One reason may be that persons with heart disease and diabetic retinopathy share the same risk factors: high blood sugar, high blood pressure, high cholesterol and high triglycerides.
[SOURCE: M.V. van Hecke, et al, “Diabetic retiniopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB prospective complications study,” Diabetes Care, 2005;28:1383-1389]
Referral to Eye Specialist Important
To protect against the development of diabetes-related eye disorders, diabetics need regular dilated examinations by an eye specialist. Since most patients get their care from a family practice physician, accurate and timely referral is not always made.
One recent study found that family doctors given four hours of education in diabetic eye disorders and taught how to use an ophthalmoscope (a tool for examining the eyes) were more accurate than other physicians in making a timely referral to a specialist.
[SOURCE: J.M. Gill, D.M. Cole, H.M. Lebowitz, et al, “Accuracy of screening for diabetic retinopathy by family physicians,” Annals of Family Medicine, 2004;(2):218-220]
Early Action Prevents Vision Loss
Diabetic retinopathy is the number one cause of vision loss among American adults age 20 to 74, but 98 percent of cases of severe vision loss could be prevented with early diagnosis and treatment.
The Diabetes Control and Complications Trial determined that patients with optimal control of blood sugar had a 76 percent reduction in retinopathy compared to those receiving conventional therapy.
[SOURCE: Eric A. Rosenberg and Laura c. Sperazza, “The visually impaired patient,” American Family Physician, May 15, 2008]
MRSA Strikes Quickly, Often Fatal
MRSA (methicillin-resistant staphylococcus aureus) usually starts as a small skin lesion that appears to be a pimple or insect bite. Yet within a year, according to a Canadian study, 20 percent of patients with community acquired MRSA infections were dead.
Subjects in the study, conducted from 2001 to 2004, were all 18 years of age or older and none had been in the hospital in the previous two years. After one year, 21.8 percent of MRSA patients had died, compared to five percent in the non-MRSA control group.
The Centers for Disease Control estimated that there were 94,360 invasive infections and 18,650 deaths from MRSA in the United States in 2005.
[SOURCE: “Community-acquired MRSA often fatal,” Reuters Health, February 19, 2008; from BMC Medicine 2008;6]
Don’t Blame MRSA on Your Pet
Although about one percent of Americans are carriers of MRSA (methicillin-resistant staphylococcus aureus), these bacteria are rarely found on domestic pets unless they have acquired it from their owners.
Reports from other countries such as Canada and Denmark have found pigs to carry MRSA, and there is a relatively higher incidence of MRSA infections among pig farmers.
[SOURCE: Susan Sanchez, “What are the risks of contracting MRSA from domesticated animals?” Medscape Infectious Diseases, May, 2008]
MRSA Infections and the Five C’s
MRSA skin infections can occur anywhere, but risk factors include the five C’s:
• Crowding,
• Contact (skin-to-skin),
• Cuts, abrasions and compromised skin,
• Contaminated surfaces and
• lack of Cleanliness.
These factors are often found in schools, day care centers, camps, dormitories, military barracks and prisons.
[SOURCE: Centers for Disease Control, “Methicillin-resistant staphylococcus aureus (MRSA) in schools,” October, 2007]
MRSA Carriers at Long-Term Risk
Many individuals are carriers of MRSA (methicillin-resistant staphylococcus aureus) bacteria without having an active infection. A study that followed 281 subjects identified as MRSA-positive between 2002 and 2005 found that these individuals remained at substantial risk of MRSA-related illness or death. The risk was higher among subjects who were simply carrying the bacteria rather than among those who had been treated for a symptomatic infection.
[SOURCE: Scott Baltic, “Risk of infection, death from MRSA persists in long-term carriers,” Reuters Health, July 25, 2008, from Clinics in Infectious Diseases 2008;47:176-181]
How Not To Get AIDS
Contrary to popular belief, you can’t get HIV (the virus that causes AIDS) by hugging, dancing, shaking hands or living in the same house with someone who is infected.
In order for infection to occur, the blood, semen or vaginal secretions of the infected person must enter your body. This may occur through
• having unprotected sex (without use of a condom) with someone who is HIV-positive,
• sharing needles through intravenous drug use or
• having a needle stick accident in a health care setting.
[SOURCE: “HIV/AIDS,” MayoClinic.com,, January 30, 2008]
Pill May Prevent AIDS Transmission
A drug now being developed may be able to prevent transmission of HIV, the virus that causes AIDS. The drug has been found effective in primates and is now being tested on humans–2,400 drug injectors in Thailand, 1,200 heterosexual men and women in Botswana and 3,000 homosexual men in the United States, Africa and Asia.
Results are promising, but more research is needed regarding side effects and the development of resistant strains of HIV. The drug may also be controversial, raising issues regarding who should be given access to the pill.
Similar antiretroviral drugs are already being used to prevent transmission of AIDS from infected mothers to their children during birth.
[SOURCE Tom Peterkin, “Anti-AIDS pill that can be taken before sex under development,” London Daily Telegraph, August 6, 2008]
Perinatal AIDS Transmissions Down
A major achievement in the battle against AIDS is the dramatic decrease in the number of mother-to-child transmissions in the United States–from 1,650 a year during the early 1990s to less than 236 during 2002.
The reduction has been attributed to:
• routine voluntary testing of pregnant women for HIV,
• the use of rapid HIV tests at delivery for women of unknown status and
• the use of antiretroviral therapy by pregnant women and their new-born children.
[SOURCE: K.A. Fenton and R.O. Valdiserri, “Twenty-five years of HIV/AIDS–United States, 1981-2006, Morbidity and Mortality Weekly Report, June 16, 2006]
Those Who Don’t Know Pose Risk
The Centers for Disease Control believes that as many as 300,000 Americans are infected with the AIDS virus without knowing it. A survey of men who have sex with men (MSM) in five U.S. cities found that 25 percent were infected but nearly half (48 percent) were unaware of their infection.
Since the period from infection to the development of AIDS may take a decade or longer, the risk of transmitting the disease to others is great.
[SOURCE: “Epidemiology of HIV/AIDS–United States, 1981-2005,” Morbidity and Mortality Weekly Report, June 16, 2006]
Mom, I Don’t Feel Good
When a child feels sick, parents have to decide whether the illness is serious enough to keep the child home from day care or school. Keeping a child home may mean scrambling to find child care or the parent having to take time off work.
The American Academy of Pediatrics recommends keeping a child home if the child:
• has a fever over 101 degrees Fahrenheit;
• isn’t well enough to take part in usual class activities;
• has a contagious illness.
[SOURCE: American Academy of Pediatrics, www.aap.org]
More Kids Should Get Flu Shots
This year’s flu caccine contains three flu strains that experts project as most likely to circulate this season. Last season’s vaccine was a poor match with circulating strains and was only 44 percent effective. That’s one reason last year’s flu season was the worst in four years. When the vaccine is a good match, it’s estiamted to be 70 percent effective.
New this year: The Centers for Disease Control now recommends vaccination for children and teens from ages 5 to 19. Previously, it has recommended vaccinating children from six months to four years. The reason for expanding the recommendation is that infection rates are highest among children and teens.
[SOURCE: “Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008,” Morbidity and Mortality Weekly Report, July 17, 2008]
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