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Do You Really Need That Antidepressant?
Tweet Share on Facebook January 6, 2010 Comment (7)Consider this: Antidepressants are the most widely prescribed drugs in the United States, with 10 percent of women and 4 percent of men taking them. Yet a new review published Tuesday in the Journal of the American Medical Association finds that some of the most popular drugs actually don't work better than a sugar pill in the majority of these folks. The study did find, however, that the medications do work effectively in those with really bad depression, the kind that completely interferes with the ability to work, feel any pleasure, sleep, eat normally, and engage in the normal routines of life.
What's shocking to me is how many people—especially women—are put on these drugs for mild mood problems that don't fall into the category of truly, utterly "black dog" depression. That's probably the fault of primary-care physicians, who often don't screen properly for depression before writing a prescription. Correct screening involves asking patients a series of questions about their symptoms in order to categorize the condition as mild, moderate, severe, or very severe. To assess the effectiveness of antidepressants in the new review of six studies, researchers relied on the Hamilton Depression Rating Scale, which defines "mild" as a score from 8 to 13, "moderate" as a score from 14 to 18, "severe" as a score from 19 to 22, and "very severe" as a score above 23.
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5 Barely Noticeable New Year's Resolutions
Tweet Share on Facebook January 5, 2010 Comment (8)I'm not a big fan of sweeping New Year's resolutions, given that I have little faith in my ability to actually sustain those promises. I'm not alone: Half of Americans break their resolutions in the first six months, and just 10 percent stick with them throughout the year. That said, I would like to make some effort to improve my and my family's health.
Resolved: Make tiny healthful lifestyle tweaks so barely noticeable that I won't be tempted to untweak them.
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Thinning Bones? How to Tell if You Need an Osteoporosis Medication
Tweet Share on Facebook December 30, 2009 Comment (6)To hear Sally Field tell it, reversing bone loss with the drug Boniva is important because you have only "one body and one life." And the 63-year-old actress—who looks around 45 in commercials for the bone-building drug—implies that many, if not most, healthy and fit middle-aged women are on the road to osteoporosis.
They're not.
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H1N1 Vaccine Available, But Will Americans Get It?
Tweet Share on Facebook December 18, 2009 Comment (8)I predicted a few months ago that the H1N1 vaccine was going to come too late for many Americans to be protected from the virus. Indeed, the Centers for Disease Control and Prevention estimates that 1 in 6 Americans has already been infected and that the epidemic is actually on the wane. But now finally there's enough vaccine to go around. Available doses are expected to top 100 million in our country by today. At least 24 states and some other counties and towns have enough to open distribution to everyone.
The question is: Will we actually make an effort to get the immunization after our government shelled out billions to buy it? I probably won't since I already had the classic symptoms (fever, chills, dry cough, headache) back in October. Yet the government tells me I should, because I can't tell with 100 percent certainty whether I had H1N1, given that doctors didn't test for it during the fall outbreak.
The CDC's big worry is that H1N1 will return with a vengeance in January after college kids come home for the holidays, infecting the rest of their family. They'd like to see those families vaccinated before their germinators return. And this is a legitimate point. After all, there have a number of documented H1N1 infections that have shown to be resistant to Tamiflu—possibly a sign that the virus is mutating into a drug-resistant bug.
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Statins May Soon Be Given to Those With Excess Inflammation
Tweet Share on Facebook December 17, 2009 Comment (4)The Food and Drug Administration is considering expanding the use of cholesterol-lowering statin Crestor to those who have increased levels of inflammation—but not high cholesterol. The agency moved one step closer on Tuesday after an advisory panel voted 12 to 4 (with one abstention) to approve Crestor for this expanded use, which could open the door for 6.5 million more Americans to take statins.
Have statins replaced aspirin as the new wonder drug? Should they?
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Yes, It's Safe to Eat Soy if You Have Breast Cancer
Tweet Share on Facebook December 9, 2009 Comment (5)Any woman who's been diagnosed with breast cancer asks her doctor what she can do to avoid a recurrence. Sometimes the answer is nothing, since aggressive cancers can quickly spread throughout the body regardless of what a woman does. She can, though, lower her chances of having a relapse by taking steps to reduce levels of estrogen, thought to trigger the growth of the most common breast tumors. This can be achieved by minimizing alcohol, adding exercise, and shedding excess body fat. But one recommendation—to avoid soy foods—can probably be stricken from this list, according to a new study published in the Journal of the American Medical Association.
High in plant estrogens, soy-rich foods like soybeans, tofu, soy milk, and tempeh have been considered by some experts to be no-no's for breast cancer patients because they were thought to proliferate the growth of tumor cells and possibly to negate the effects of antiestrogen drugs like tamoxifen. But the new research, which involved more than 5,000 Chinese breast cancer survivors, found that those who had the highest intake of soy foods (more than 15 grams of soy protein a day) had about a 30 percent lower death rate and nearly a 30 percent lower rate of recurrence than those who ate the least amount of soy (5 grams or less per day). That's probably because soy also contains compounds that have anticancer effects. The researchers controlled for confounding factors like body mass index, exercise habits, tumor stage, and other differences in diet.
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Women's Preventive Health Amendment Added to Senate Reform Bill
Tweet Share on Facebook December 4, 2009 Comment (7)Women's health issues continue to be at the forefront of the political debate as the health reform bill gets bandied about in the Senate. On Thursday, the Senate approved the addition of a women's preventive care amendment "to ensure patients receive doctor recommendations for preventive health services, including mammograms and cervical cancer screening, without interference from government or insurance company bureaucrats."
And just in case anyone wondered whether this amendment was linked to the bitterly controversial mammography screening guidelines proposed last month by the U.S. Preventive Services Task Force, the amendment states specifically that the secretary of health and human services shall not use any recommendation made by the USPSTF "to deny coverage of an item or service" under any kind of federal healthcare program. I'm assuming that this also applies to task force recommendations made for men—like a 2008 decision to recommend against screening men over 75 with the prostate-specific antigen blood test—or for other screening tests used by both sexes. But that's not clear from this amendment, which specifically applies to women. (I also don't remember the same level of outcry from men's activists when those PSA recommendations were issued last year.)
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Loneliness Is Contagious: 4 Ways to Stay Connected as You Age
Tweet Share on Facebook December 1, 2009 Comment (5)"All the lonely people, where do they all come from?" the Beatles sang in "Eleanor Rigby." Well, now researchers know: Loneliness is contagious, according to a new study published in the Journal of Personality and Social Psychology, and can spread from person to person. Just as researchers have previously shown that happy people can make others feel exuberant, so, too, can lonely people make others feel desolate.
And this loneliness network can extend up to three degrees of separation. As the study authors write, "A person's loneliness depends not just on his friend's loneliness but also extends to his friend's friend and his friend's friend's friend." You might think: If someone has friends, how can she be lonely? But, speaking from experience, friends may talk about how "out of the loop" and disconnected they feel—even while they're conversing with each other. That sort of conversation can leave both people feeling down.
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Mammography Screening: Clearing Up Some of the Confusion
Tweet Share on Facebook November 25, 2009 Comment (11)For the past 10 days, I've been struggling to make sense of the new mammography guidelines recommending a delay in the onset of routine screening from age 40 to age 50. I've wondered whether I should skip the mammogram when I turn 40 next year and have been poring over the scientific data with my colleague Bernadine Healy. (Here's why she's against the new guidelines issued by the U.S. Preventive Services Task Force.)
Women have certainly gotten the message that these guidelines are controversial and haven't been embraced by a majority of health professionals. As I previously blogged, heavyweights like the American Cancer Society and American College of Obstetricians and Gynecologists have stated that women in their 40s should continue to have regular mammograms. And women seem to agree. A USA Today/Gallup poll yesterday showed that 84 percent of women ages 35 through 49 said they planned to have a mammogram before age 50 despite the new guidelines. But the respondents also overestimated the risk of breast cancer for women in their 40s, with 40 percent saying that a 40-year-old's chance of developing breast cancer in the next 10 years was between 20 to 50 percent; the actual risk is just 1.4 percent.
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Get Your Pap Smear to Screen for Cervical Cancer—But Less Often
Tweet Share on Facebook November 20, 2009 Comment (6)I'm heading to the gynecologist next month for my annual checkup and am expecting not to get my usual Pap smear. That's because the American College of Obstetricians and Gynecologists issued new recommendations today advising women not to be screened so frequently. Women like myself who are over 30 and have had three consecutive negative test results should be tested just once every three years. Those ages 21 to 30 should be tested every two years instead of every year. Those who've had an abnormal Pap smear or who've been treated for cervical precancers should continue to have annual screening.
The medical group also stated that women shouldn't start screening until age 21 because "earlier onset of screening may increase anxiety, morbidity, and expense from the test itself and overuse of follow-up procedures." (The old recommendation was to start screening by age 21 or within three years of becoming sexually active, whichever came first.) The guidelines' authors make a strong case for delaying screening. Only 0.1 percent of cervical cancer cases occur in women under 21, yet teenagers have a very high prevalence of infection with the sexually transmitted human papilloma virus. While HPV infections can cause abnormal cervical cell changes—and ultimately, cervical cancer—in teenagers, about 90 percent of the time the infection and cell changes clear up on their own within three years, according to a 2004 study published in Lancet.
