What Doctors Don’t Tell You: No. 100 - 30 September 2004

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WDDTY e-News Broadcast - 30 September 2004

Thu, 30 Sep 2004 22:52:02 +0100

 

WHAT DOCTORS DON'T TELL YOU - E-NEWS BROADCAST No. 100 - 30 September 2004

 

Please feel free to email this broadcast to any friends you feel would

appreciate receiving it.

 

 

 

CONTENTS

 

News Section

 

 

Drugs for the elderly: Too many 'danger drugs' are being prescribed

Sports injuries: The secrets of a speedy recovery

UTIs: Standard therapy doesn't work, so let's double it

Painkillers: Is it more in the mind than we realize?

Diabetes: Possible link to Alzheimer's

Diabetes: Junk drinks affect adults,too

 

 

 

DRUGS FOR THE ELDERLY: Too many 'danger drugs' are being prescribed,

and inappropriately

 

At least one in 10 elderly people is prescribed a drug that they

shouldn't be taking, and the true picture may easily be twice as bad.

Worse, many of the drugs that are being inappropriately prescribed

have a high chance of causing a side effect.

 

This worrying picture has emerged from a study into drug prescribing

for the elderly, based on data from a health insurer in the USA. It

included the medical records of over 760,000 people aged over 65 years

who were not in hospital.

 

Researchers from Duke University in North Carolina compared

prescription records with a list known as Beers, which itemizes those

drugs generally believed to commonly cause side effects in the

elderly, and so which should be avoided.

 

They found that 21 per cent of patients had been prescribed one or

more drugs on the Beers list, and prescriptions for amitriptyline and

doxepin accounted for 23 per cent of these.

 

More than 15 per cent of prescriptions were for two drugs on the list,

and 4 per cent for three or more drugs on Beers.

 

An accompanying editorial commented: " If even half the number of

elderly subjects is taking potentially inappropriate medications, one

in 10 of all older persons are receiving a drug that is potentially

not appropriate. "

 

(Source: Archives of Internal Medicine, 2004; 164: 1621-5).

 

 

 

SPORTS INJURIES: The secrets of a speedy recovery

 

Many of us like to try and keep fit, either by taking part in a sport,

or visiting a gym. Unfortunately this increased activity has also

caused a rise in sports-related injuries. Around 11 per cent of all

injuries in hospital emergency rooms are sports-related.

 

Doctors may advise physiotherapy or an NSAID, perhaps, but there's so

much more that you can also do to speed your recovery. There is a

range of supplements that enhance the body's healing processes, and

there are many therapies that are more effective than standard sports

physiotherapy. Then there are the best enzymes to employ that can

quicken the recovery time.

 

 

 

UTI: Standard therapy doesn't work, so let's double it

 

Go to the doctor with a simple case of urinary tract infection (UTI),

and you'll probably walk out with a prescription for a three-day

course of antibiotics. Trouble is, it's a treatment regime that may

well not work.

 

It's something that doctors have noticed for some time, but it's only

now been backed up by a full study.

 

A population-based study in the Netherlands found that over 14 per

cent of women treated with trimethoprim and nitrofurantoin didn't

improve after three days' treatment, and the same was the case for

nearly 10 per cent of patients given norfloxacin.

 

The researchers conclude that five-day or even seven-day courses may

be more effective. Alternatively, they could turn instead to

cranberry juice, but the researchers forgot to mention that.

 

(Source: British Journal of Clinical Pharmacology, 2004; 58: 184-9).

 

 

 

PAINKILLERS: Is it more in the mind than we realize?

 

We all know that painkillers such as paracetamol and NSAIDs can

provide quick relief from osteoarthritis - or do we? This most basic

level of medical care has been questioned by the results of several

studies recently, which suggest that neither is as effective as we

thought.

 

The most surprising is the effectiveness - or otherwise - of

paracetamol, whose painkilling qualities have been a given for the

longest time. But when researchers tested the effectiveness against a

placebo on people with arthritic knees, 52 per cent in both groups

reported an easing of their pain.

 

Similarly, those who used a topical NSAID cream to help their

osteoarthritis fared no better than those who rubbed in a placebo cream.

 

Looking at it another way, placebo was as good as any drug, which

indicates that mental suggestion could be a powerful painkiller. This

is supported by another study of 40 rheumatoid arthritis sufferers

whose pain was reduced by meditation. They were taught a form of

meditation called mindfulness, which focuses on the breath. As they

reduced their stress levels, so their pain decreased, researchers

discovered.

 

(Sources: Paracetamol study - Annals of Rheumatic Diseases, 2004; 63:

923-30; NSAID cream study - British Medical Journal, 2004; 329: 324-6;

Meditation study - MSNBC report, 13 September 2004).

 

 

 

 

A CUTE ANGINA: Letters from your doctor

 

Over-stretched doctors in England have been using a secretarial agency

in London that, in turn, has been sending dictation tapes to India for

transcribing as letters to patients. And that's where the problems

have started. Letters have included phrases such as 'he had a cute

angina' and 'Euston Station tube malfunction'. We're sure you can add

some of your own favourites.

 

 

 

DIABETES, PART I: It could lead to Alzheimer's

 

Diabetes has been associated with a range of more serious conditions,

such as heart disease, stroke and even blindness. But researchers are

beginning to think it could also lead to Alzheimer's disease and to a

general decline in cognitive functions.

 

Researchers found that those who had diabetes were also 65 per cent

more likely to develop Alzheimer's. Diabetes was also associated with

a deterioration of memory, cognition, speech memory, working memory

and visual-spatial skills.

 

The research team followed 824 Catholic priests and nuns (don't ask

why) for nine years, 127 of whom had diabetes and 151 went on to

develop Alzheimer's.

 

(Source: Archives of Neurology, 2004; 61: 661-6).

 

 

 

DIABETES, PART II: Junk drinks are bad for adults too

 

Still on the subject of diabetes, there's been a lot of talk recently

about sugar-sweetened drinks causing obesity - and eventually diabetes

- in children.

 

But is the effect the same for adults who drink cans of junk juice?

Researchers tracked the medical histories of 91,249 women who did not

have diabetes or any other chronic disease in 1991. In the following

eight years 51,603 women gained significant weight and 741 went on to

develop type II diabetes. Those who drank at least one

sugar-sweetened drink a day were nearly twice as likely to develop

diabetes than someone who didn't consume any of the drinks.

 

(Source: Journal of the American Medical Association, 2004; 292: 927-34).

 

 

* Babies born to women who are obese or have type II diabetes are more

likely to suffer from a spectrum of abnormalities that occur during

fetal development. Many of these effects, such as fetal obesity and

neural tube defects, can have lifelong repercussions.

 

Neural tube defects are among the most common abnormalities that are

associated with maternal obesity, and with the mother's poor

nutritional status. This latter issue has been known for some times,

and has been treated by medicine with folic acid supplementation.

It's also been known for a while that maternal obesity increases the

risk of spina bifida and anencephaly in the child.

 

But while obesity is a general catch-all condition, doctors are not

sure what about it - whether it's glucose metabolism, hypertension, or

lipid abnormalities - causes the damage to the fetus.

 

(Source: Journal of the American Medical Association, 2004; 292: 789-90).