Healthsifter by mary desmond pinkowish, since 2003

Paper Linking Virus to Chronic Fatigue Partially Retracted - WSJ.com

The authors of a controversial 2009 paper that found a possible link between the retrovirus XMRV and chronic-fatigue syndrome partly retracted their findings Thursday, though some of them still believe there is a connection between a retrovirus and the disease.

via online.wsj.com

This is a setback for people who hope for progress against chronic fatigue syndrome. We wrote about this several months ago, but as the Wall Street Journal reported this week, a 2009 study published in the journal Science that implicated a retrovirus, XMRV, in the mysterious disorder has been retracted. Despite the efforts of 9 other labs, the findings could not be replicated.
Possible silver lining: people with chronic fatigue may be able to resume donating blood. Because of fears that a retrovirus associated with this illness could enter the blood supply, patients had been asked to stay away from blood banks. The Red Cross may lift that restriction.

Licking Listeria in Your Kitchen

You know about the cantoloup-related Listeria outbreak, but melons aren't the only possible sources of this dangerous organism. What's even stranger is that unlike many food-borne pathogens, Listeria can thrive in the fridge. So please cast your eyes over this latest guidance from the FDA on keeping your kitchen, and especially your refrigerator, clear of this bacterial menace. 

Lookin' good

Hormone Replacement Therapy During Menopause: Pros and Cons - WSJ.com

The 25 million American women turning 50 in the next decade face a vexing decision: Hormone replacement therapy? Or not.

via online.wsj.com

...Just in case you thought this issue had been settled--it hasn't. This an excellent overview of where hormone therapy for women is at today. As always, it's complicated.

Doctor to the Stars: Not a Cake Walk

If you thought that being a doctor to the stars was an enviable scene, the trial this week of Conrad Murray, MD, Michael Jackson's personal physician, has probably changed your mind. No thank you. AMEDNews, a publication by the American Medical Association, has a great article today in which they interview docs who serve the stars. It's tricky, as Drew Pinsky, MD, explains in this excerpt:

"You really have to assess your own liability," Dr. Pinsky said. "Are you seduced by the opportunity to bask in the glow of celebrity? Is it particularly appealing to you to have a powerful person say you did a good job? Will you be able to sustain that same person saying, 'I can't believe you won't give me what I want'? You had better be prepared, because that is exactly what you'll get. You have to do what's best for the patient and not be seduced by the fame."

Gary Brazina, MD, an orthopedic surgeon for some of the LA teams, reports on his experiences, too:

Some celebrities "are really, really nice" but "others are extremely manipulative, and there is a lot of drug-seeking behavior," Dr. Brazina said. "They have a true sense of entitlement where there's a sense of, 'I'm special, I'm different; I don't have to follow the rules.' "

Dr. Brazina recalled one famous patient who refused to fill out paperwork, saying, "Oh, my assistant does that." The physician took a stand.

"Well, then, I guess I'll have to treat your assistant, because I'm not going to treat you until you fill it out," he told the star.

Still, the doctor admits to getting starstruck at times. "Sometimes you do just pinch yourself," Dr. Brazina said. "I'm a small-town kid from eastern Pennsylvania and I have movie stars coming into the office. ... You have to be wary of not being caught up in the celebrity."

The stories are as old as Hollywood itself. Sad.

Coffee Linked to Lower Depression Risk

I admit to a strong pro-coffee bias, and I think that if coffee had just been invented, it might be a medication, or at least a health food of some sort. Writing in today's Archives of Internal Medicine, researchers from the Harvard School of Public Health and the Mailman School of Public Health at Columbia University report on their 10-year study, in which they followed more than 50,000 women who did not have clinical depression when the study started. They examined their coffee consumption during that time to see if there was any correlation with new-onset depression. This isn't a cause-and-effect demonstration, but it's interesting that there seemed to be a dose-response relationship between the amount of coffee women drank daily and the risk of depression: the more coffee, the lower the risk. The effect was pretty modest, with about a 20% decreased risk in women who drank at least 4 cups a day (yes, that would include me) compared to women who drank no more than 1 cup of caffeinated coffee each week. Decaf was not associated with depression in any way. Click here to read the study summary. This is not the first time that coffee has been associated with a mental health benefit of this type. A recent study suggested that coffee may slow the progression of Alzheimer's disease in women, but not men. A study from Finland, where they drink lots of coffee and have fairly high depression rates suggested the possibility that men who drink the most coffee have the lowest depression risk. Of course, if you let coffee ruin your sleep, you may not get depressed, but you will be exhausted. If it just doesn't agree with you, don't push it. And maybe depressed people just don't want to drink coffee...

Have a cup of coffee?

You've Heard of Restless Legs--But Restless Abdomen?

French researchers writing in the journal Neurology have described a condition they call restless abdomen, which seems to be associated clinically and genetically with the more familiar restless legs syndrome. Who knew? People with restless abdomen, of whom just 3 are reported in this case, experience strange gut symptoms when they try to rest. The feelings pass--or at least get better--when they move around. Strange stuff. Some of these patients also had a condition called period leg movements of sleep (which may be related to restless legs) but their guts were completely normal--at least in the imaging studies that were performed.  Pramipexole, a drug sometimes used to treat restless legs, helped these folks, all of whom also carried a gene associated with restless legs. Click here to read the summary of this study.

Have you--or someone you know--ever experienced sensations like these?

Medical News: Dying Slow or Dying Fast -- Cancer and the Heart - in Oncology, Other Cancers from MedPage Today

Kara Kennedy was a cancer success story: diagnosed with lung cancer almost a decade ago she sought out treatment for a cancer that is often a killer. Nonetheless, Kennedy's hope for a long life came to an end when she died following a workout at her gym, the apparent cause a heart attack, not cancer.

via www.medpagetoday.com

This is an interesting summary of what's known about the possible link between some forms of cancer treatment and heart disease.

It's Not the Bedbugs--It's the Pesticides

Bed bugs are gross--no doubt about it. But unlike other common insects, including mosquitos and flies, they don't usually carry diseases. So this report from the CDC is disturbing because it suggests that people face more potential danger from insecticides used to kill bed bugs than the insects themselves. The culprits: improper use of the chemicals and use by people who haven't been trained/licensed to use them. Here's an excerpt from the CDC report describing some non-chemical solutions:

Nonchemical methods to effectively control bed bugs include heating infested rooms to 118°F (48°C) for 1 hour or cooling rooms to 3°F (-16°C) for 1 hour by professional applicators; encasing mattresses and box springs with bed bug--excluding covers; and vacuuming, steaming, laundering, and disposing of infested items. Any effective control measure for bed bugs requires support from all residents in affected buildings and ongoing monitoring for infestation from other housing units. Often, multiple inspections and treatments are needed to eradicate bed bugs.

Go Away

Book Review: Your Medical Mind - WSJ.com

With more medical information than ever before at their fingertips, patients increasingly feel empowered to make their own decisions about care—or overpowered by all that data.

via online.wsj.com

Dizzied by the huge volume of information that's available to you when you try to make a decision about your own medical care? You're not alone. Here's a review of what may be a helpful book by oncologist and author Jerome Groopman and his wife Pamela Hartzband, an endocrinologist.

A Genetic Step Forward in Understanding Two Ghastly Neurologic Disorders

Two different groups of scientists have independently found what may be the genetic culprit associated with two neurologic disorders: amyotrophic lateral sclerosis (ALS), probably more familiar to you as Lou Gehrig's disease, and a common dementing illness called frontotemporal dementia (FTD). The teams are from the Mayo Clinic in Florida and the National Institute on Aging in Maryland. Both papers were published in the journal Neuron. (Both are available without charge at that site.)

The possibility of a genetic link between the two conditions was suggested by circumstantial evidence. The diseases share some features, and some people seem to suffer from features of both illnesses. Also, these diseases sometimes run in families, and some families seem to be afflicted with both ALS and FTD. A region of a particular chromosome got on the researchers' radar several years ago, and this week's publications from the two groups seemed to confirm that mutations in the gene C9ORF72 may be involved. While a certain pattern of repeats in this gene may occur occasionally in healthy people, hundreds or thousands of repeats were observed in people with ALS or FTD.

It's important to understand that this is an essential but small first step. The ScienceNow blog had a good post about these studies today, and they put some perspective on the road ahead. Here's an excerpt:

Still, many important questions remain. Neither team has found an explanation for why some people with C9ORF72 mutations get ALS whereas others get FTD. And it's not clear how the mutations would cause either disease. It may be that the protein encoded by C9ORF72 performs some yet-to-be-discovered essential function that gets disrupted, Traynor says. Or maybe the function of C9ORF72 doesn't matter. Another possibility, Traynor says, is that the repeated nucleotides cause a toxic buildup of messenger RNA, a key player in the cellular machinery for reading out DNA to make protein.