Response to acute concussive injury in soccer players: is gender a modifying factor?


Several studies have suggested a gender difference in response to sports-related concussion (SRC). The Concussion in Sport group did not include gender as a modifying factor in SRC, concluding that the evidence at that point was equivocal. In the present study the authors endeavored to assess acute neurocognitive and symptom responses to an SRC in equivalent cohorts of male and female soccer players. The authors hypothesized that female athletes would experience greater levels of acute symptoms and neurocognitive impairment than males.

Methods

Baseline symptom and neurocognitive scores were determined in 40 male and 40 female soccer players by using the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) scale prior to any SRC. After sustaining an SRC, each athlete completed postconcussion ImPACT tests and was carefully matched on a wide array of biopsychosocial variables. Baseline symptom and neurocognitive test scores were compared, and their acute symptoms and neurocognitive responses to concussive injury were assessed.

Results

Specific a priori hypotheses about differences between males and females at baseline and at postconcussion measurements of verbal and visual memory ImPACT scores were evaluated according to simple main effects of the gender variable and according to baseline-to-postconcussion main effect and interaction of 2 × 2 split-plot ANOVA. Neither the interaction nor the main effects nor the simple main effects for either ImPACT variable were found to be statistically significant. Exploratory ANOVAs applied to the remaining ImPACT variables of visualmotor speed, reaction time, impulse control, and symptom total scores revealed only a single statistically significant baseline-to-postconcussion main effect for the symptom total.

Conclusions

The results failed to replicate prior findings of gender-specific baseline neurocognitive differences in verbal and visual memory. The findings also indicated no differential gender-based acute response to concussion (symptoms or neurocognitive scores) among high school soccer players. The implications of these findings for the inclusion of gender as a modifying factor in this tightly matched cohort are addressed. Potential explanations for the null findings are discussed.

Source: Journal of Neurosurgery

Not Getting Sleepy? Why Hypnosis Doesn’t Work for All.


Not everyone is able to be hypnotized, and new research from the Stanford University School of Medicine shows how the brains of such people differ from those who can easily be.

The study, published in the October issue of Archives of General Psychiatry, uses data from functional and structural magnetic resonance imaging to identify how the areas of the brain associated with executive control and attention tend to have less activity in people who cannot be put into a hypnotic trance.

“There’s never been a brain signature of being hypnotized, and we’re on the verge of identifying one,” said David Spiegel, MD, the paper’s senior author and a professor of psychiatry and behavioral sciences. Such an advance would enable scientists to understand better the mechanisms underlying hypnosis and how it can be used more widely and effectively in clinical settings, added Spiegel, who also directs the Stanford Center for Integrative Medicine.

Spiegel estimates that one-quarter of the patients he sees cannot be hypnotized, though a person’s hypnotizability is not linked with any specific personality trait. “There’s got to be something going on in the brain,” he said.

Hypnosis is described as a trance-like state during which a person has a heightened focus and concentration. It has been shown to help with brain control over sensation and behavior, and has been used clinically to help patients manage pain, control stress and anxiety and combat phobias.

Hypnosis works by modulating activity in brain regions associated with focused attention, and this study offers compelling new details regarding neural capacity for hypnosis.

“Our results provide novel evidence that altered functional connectivity in [the dorsolateral prefrontal cortex] and [the dorsal anterior cingulate cortex] may underlie hypnotizability,” the researchers wrote in their paper.

For the study, Spiegel and his Stanford colleagues performed functional and structural MRI scans of the brains of 12 adults with high hypnotizability and 12 adults with low hypnotizability.

The researchers looked at the activity of three different networks in the brain: the default-mode network, used when one’s brain is idle; the executive-control network, which is involved in making decisions; and the salience network, which is involved in deciding something is more important than something else.

The findings, Spiegel said, were clear: Both groups had an active default-mode network, but highly hypnotizable participants showed greater co-activation between components of the executive-control network and the salience network. More specifically, in the brains of the highly hypnotizable group the left dorsolateral prefrontal cortex, an executive-control region of the brain, appeared to be activated in tandem with the dorsal anterior cingulate cortex, which is part of the salience network and plays a role in focusing of attention. By contrast, there was little functional connectivity between these two areas of the brain in those with low hypnotizability.

Spiegel said he was pleased that he and his team found something so clear. “The brain is complicated, people are complicated, and it was surprising we were able to get such a clear signature,” he explained.

Spiegel also said the work confirms that hypnotizability is less about personality variables and more about cognitive style. “Here we’re seeing a neural trait,” he said.

The authors’ next step is to further explore how these functional networks change during hypnosis. Spiegel and his team have recruited high- and low-hypnotizable patients for another study during which fMRI assessment will be done during hypnotic states. Funding for that work is being provided by the National Center for Complementary and Alternative Medicine.

Funding for this study came from the Nissan Research Center, the Randolph H. Chase, MD Fund II, the Jay and Rose Phillips Family Foundation and the National Institutes of Health.

The study’s first-author is Fumiko Hoeft, MD, PhD, who was formerly an instructor at Stanford’s Center for Interdisciplinary Brain Sciences Research and is now an associate professor of psychiatry at UCSF. Other co-authors are John Gabrieli, PhD, a professor at MIT (then a professor of psychology at Stanford); Susan Whitfield-Gabrieli, a research scientist at MIT (then a science and engineering associate at Stanford); Brian Haas, PhD, an assistant professor at the University of Georgia (then a postdoctoral scholar in the Center for Interdisciplinary Brain Sciences Research at Stanford); Roland Bammer, PhD, associate professor of radiology; and Vinod Menon, PhD, professor of psychiatry and behavioral sciences.

Source: http://www.sciencedaily.com

A tax on indoor tanning would reduce demand in Europe.


The use of indoor tanning beds has been established to be a serious risk to human health.1 In the European Union, Northern Ireland is the latest country to pass legislation that prohibits under 18s from using indoor tanning equipment. Although this will protect children from this risk, more needs to be done if we are to respond to the International Agency for Research on Cancer’s suggestion that we need also to “discourage young adults from using indoor tanning equipment.”1

Globally, the incidence of cutaneous melanoma has increased faster than any other common cancer, with an approximate doubling of rates every 10-20 years in countries with predominantly white populations.2 For instance, in 2008 there were about 70 000 incidences of, and more than 14 000 deaths from, melanoma in the European Union.3 Although attempts at public education by health agencies and charities have increased, these are being obscured by spurious claims by the indoor tanning industry of the benefits of indoor tanning.4

Recent lessons from tobacco control in the EU teach us that tax increases are the single most effective intervention to reduce demand for harmful products.5 The EU needs to follow the example of the United States by introducing a so called tan tax; an excise on indoor tanning services. A new EU directive for the taxation of indoor tanning services would complement existing directives focused on product safety.6 Importantly, these excise duties would provide additional revenue for governments and reduce numbers of melanomas and other skin cancers—something that would also subsequently reduce governments’ healthcare costs. All or a portion of this revenue could be earmarked for public health education initiatives warning of the dangers of ultraviolet radiation exposure.

Source: BMJ

Indoor tanning and non-melanoma skin cancer: systematic review and meta-analysis.


Abstract

Objective To synthesise the literature on indoor tanning and non-melanoma skin cancer.

Design Systematic review and meta-analysis.

Data sources PubMed (1966 to present), Embase (1974 to present), and Web of Science (1898 to present).

Study selection All articles that reported an original effect statistic for indoor tanning and non-melanoma skin cancer were included. Articles that presented no data, such as review articles and editorials, were excluded, as were articles in languages other than English.

Data extraction Two investigators independently extracted data. Random effects meta-analysis was used to summarise the relative risk of ever use versus never use of indoor tanning. Dose-response effects and exposure to indoor tanning during early life were also examined. The population attributable risk fraction for the United States population was calculated.

Results 12 studies with 9328 cases of non-melanoma skin cancer were included. Among people who reported ever using indoor tanning compared with those who never used indoor tanning, the summary relative risk for squamous cell carcinoma was 1.67 (95% confidence interval 1.29 to 2.17) and that for basal cell carcinoma was 1.29 (1.08 to 1.53). No significant heterogeneity existed between studies. The population attributable risk fraction for the United States was estimated to be 8.2% for squamous cell carcinoma and 3.7% for basal cell carcinoma. This corresponds to more than 170 000 cases of non-melanoma skin cancer each year attributable to indoor tanning. On the basis of data from three studies, use of indoor tanning before age 25 was more strongly associated with both squamous cell carcinoma (relative risk 2.02, 0.70 to 5.86) and basal cell carcinoma (1.40, 1.29 to 1.52).

Conclusions Indoor tanning is associated with a significantly increased risk of both basal and squamous cell skin cancer. The risk is higher with use in early life (<25 years). This modifiable risk factor may account for hundreds of thousands of cases of non-melanoma skin cancer each year in the United States alone and many more worldwide. These findings contribute to the growing body of evidence on the harms of indoor tanning and support public health campaigns and regulation to reduce exposure to this carcinogen.

Source: BMJ

 

 

Electronic cigarettes: medical device or consumer product?


As the UK considers regulating e-cigarettes as a medicinal product, Jonathan Gornall asks if this is good news for public health

Electronic cigarettes hit the headlines in July when a concerned member of the public travelling on a coach on the M6 toll motorway in the Midlands called police to say he had seen “smoke” issuing from a bag into which a fellow passenger had been pouring an unknown liquid.

Fearing this was a terror incident, armed police stopped the coach, evacuated the passengers, and closed the motorway before finally declaring the bag and its contents—an e-cigarette and associated paraphernalia—harmless.

It is taking the UK Medicines and Healthcare Products Regulatory Agency rather longer to come to the same conclusion—or, rather, to determine whether the devices should be treated as medicinal products, regulated accordingly, and subject to MHRA medicines marketing authorisation.

The e-cigarette is designed to look and behave like a cigarette but delivers only vaporised nicotine and none of the toxins associated with tobacco to its users, who call themselves vapers rather than smokers. When the user sucks on the device, an atomiser powered by a battery heats and vaporises a mixture of nicotine and propylene glycol, an organic compound with a wide range of commercial uses, including in theatrical “smoke” machines. A written Commons statement by health minister Simon Burns in July suggested they were used by as many as 650 000 in the UK.

Source: BMJ

 

Top 10 Drug Company Settlements.


There were a record 4.02 billion prescriptions written in the United States in 20111 – that’s more than ever before.

There are 314 million people in the United States, and with 4.02 billion prescriptions, that amounts to roughly 12.74 prescriptions per person.

The cost for all these prescriptions? $308.6 billion, a hefty sum that is likely to continue to soar even higher as Americans grasp at what they believe to be the solution to their failing health.

Sadly, many will have their hopes go unanswered, as most of the top-selling drugs treat conditions that are better treated with lifestyle changes, healthy food and other forms of natural healing.

Putting your health, your very life, in the hands of drug companies is a frightening prospect when you consider the leading pharmaceutical companies are also among the largest corporate criminals in the world, behaving as if they are little more than white-collar drug dealers.

As these companies have shown time and again, they consistently put profits above human health.

Top 10 Drug Company Settlements

Big Pharma lawsuits, especially those that settle in the hundreds of millions or billions, are intended to make these criminal corporations start to straighten out, abandon their fraud and deception, their kickbacks, price-setting, bribery and all other illegal sales activities in favor of looking out for public health, which to date has been clearly ineffective.

Most of these settlements amount to a mere slap on the wrist for the drug company, which typically will continue right along with their deceitful behaviors. As reported in Time,2 an editorial in the New England Journal of Medicine3 echoed these sentiments, calling for change:

“…levy large enough fines against drug companies for illegal behavior, so that the payouts can’t be dismissed as merely “the cost of doing business;” offer more protections for whistleblowers; and perhaps most importantly, file criminal charges against drug company executives for misconduct that could put them in prison.”

Time recently compiled a list of the top 10 drug company settlements,4 and while they are significant, they seem to be of little deterrent to the companies’ unethical, and dangerous, behaviors:

10.  2007: Bristol-Myers Squibb paid $515 million for illegally promoting its atypical antipsychotic drug Abilify to kids and seniors (despite a black box warning that warned of potentially fatal side effects in the elderly). Other accusations included giving payments, kickbacks and expensive vacations to medical professionals and pharmacist to dispense its drugs.

9.  2010: AstraZeneca settled for $520 million for trying to persuade doctors to prescribe its psychotropic drug Seroquel for unapproved uses ranging from Alzheimer’s disease and ADHD to sleeplessness and post-traumatic stress disorder (PTSD). Using Seroquel for improper use has been linked to an increased risk of death.

Company executives also promoted the drug for weight loss, highlighting one favorable study while burying others that linked it to substantial weight gain.

8.  2007: Purdue Pharma paid $634.5 million for fraudulently misbranding Oxycontin, and suggesting it was less addictive and less abused than other painkillers. The company was charged with using misleading sales tactics, minimizing risks and promoting it for uses for which it was not appropriately studied.

7.  Currently pending: Amgen, the makers of anemia drugs Aranesp and Epogen, has been accused of handing extra profits to doctors who prescribe the drugs (by overfilling vials, then allowing doctors to charge insurance companies for drugs they got for free). Other accusations include misconduct involving claims of safety and efficacy, marketing, pricing and dosing of the drugs. Amgen has set aside $760 million to settle the suits.

6.  2011: Merck settles for $950 million to resolve fraudulent marketing allegations and safety claims related to Vioxx. Vioxx was pulled from the market in 2004, after it was shown to double the risk of heart attack and stroke. In addition to the $950 million, Merck paid hundreds of millions more to harmed patients and their families (Vioxx contributed to causing heart attacks in up to 140,000 people, half of which were fatal).

5.  2009: Eli Lilly pays $1.4 billion for promoting Zyprexa for off-label uses, often to children and the elderly, and not properly divulging side effect information. For instance, Zyprexa was marketed as a sleeping aid for the elderly because one of its side effects is sedation, even though the drug also increases the risk of death.

4.  2012: Abbott Laboratories settles for $1.5 billion for aggressively promoting their seizure drug Depakote for off-label use in elderly dementia patients, despite lacking evidence of safety or effectiveness (and a known increase of serious side effects, like anorexia, in the elderly).

3.  Currently pending: Johnson & Johnson will pay anywhere from $1.5 to $2 billion for illegal marketing of Risperdal and other drugs. The company not only heavily marketed drugs to children and the elderly despite inadequate evidence of safety or efficacy, they also hid data about drugs’ side effects.

2.  2009: Pfizer pays $2.3 billion for marketing fraud related to Bextra, Lyrica and other drugs. Charges included marketing drugs to doctors for uses for which they had not been approved and giving kickbacks to doctors and other health care professionals for prescribing their drugs. This was Pfizer’s fourth settlement numbering in the multimillions in less than a decade.

1.  2012: GlaxoSmithKline (GSK) to pay $3 billion for illegal marketing of Paxil and Welbutrin and downplaying safety risks of Avandia, among other charges. The company hid data about drug risks, marketed drugs for unapproved uses, and paid doctors (or gave them lavish gifts like expensive vacations) for prescribing their drugs. One of the most high-profile accounts involved tv’s Dr. Drew, who reportedly received $275,000 from GSK to promote Welbutrin to treat sexual dysfunction associated with depression even though it hasn’t been proven effective for this purpose.

How Many of the Top 10 Most Prescribed Drugs Are Unnecessary?

IMS Health has recently released the top U.S. prescription drugs of 2011, and an editorial in ACS Chemical Neuroscience has analyzed some of the statistics.5 The most-used drugs in America are, primarily, used to treat conditions that can be better treated without drugs. Let’s take a closer look:

Statin Cholesterol Drugs

Lipitor and Crestor, used to treat high cholesterol, came in at number 1 and 8 on the list, respectively. This class of drugs, used to lower cholesterol, has been linked to over 300 devastating side effects, including muscle pain and weakness, muscle atrophy, rhabdomyolysis, increased plaque deposits, increased cancer risk, immune system suppression, decreased liver function, CoQ10 depletion, diabetes and death.6

The fact that statin drugs cause side effects is well established, but very few people realize that not only is your total cholesterol level not a great indicator of your heart disease risk, but you could be getting told you have high cholesterol when your levels are actually perfectly normal for you. You can make sense of your cholesterol numbers by reading this article, and also get tips for keeping your levels in the healthy range here. To normalize your cholesterol level naturally, four primary strategies work well 99 percent of the time if properly implemented:

  1. Reduce fructose intake to less than 25 grams per day
  2. Regular exercise, especially Peak Fitness
  3. Eat a low-grain, low-sugar diet according as outlined in my nutrition plan
  4. Taking a high-quality, animal-based omega-3 supplement

Heart Disease

Plavix, which is manufactured by Bristol-Myers Squibb and used to help prevent strokes and heart attacks, has serious side effects you many not be aware of. When combined with aspirin, the drug nearly doubled the death rate from heart disease among patients who had not had heart attacks but were at risk for them.7

Many medications commonly prescribed to heart disease patients can also be avoided, as in the case of heart disease, the healthy lifestyle strategies discussed here – strategies like proper food choices, stress reduction, exercise, and optimizing vitamin D – are not only effective as prevention, they’re also useful for treatment.

Additionally, there is compelling evidence that grounding or earthing will thin your blood very effectively and provide the benefit that Plavix and these types of drugs provide with none of the dangerous side effects or costs. Grounding has been shown to be such a potent blood thinner that if a person is taking Coumadin, they need to adjust their dose lower under the guidance of a physician as the grounding will decrease the need for it.

Acid Reflux Drugs

Nexium came in at #3. If you have heartburn, acid reflux, gastroesophageal reflux disease (GERD), peptic ulcer disease or any acid-related condition, chances are very high that you’ve been offered a prescription for a proton pump inhibitor (PPI) like Nexium.

But acid-reducing drugs are actually the opposite of what many people with acid reflux need, as heartburn and GERD are almost often caused by a LACK of stomach acid, rather than an overproduction thereof. Further, when you take PPIs, which significantly reduce the amount of acid in your stomach, it both impairs your ability to properly digest proteins in food and diminishes your stomach acid barrier – your primary defense mechanism for food-borne infections – thereby increasing your risk of food poisoning.

These drugs have also been linked to an increased risk of pneumonia, and result in an elevated risk of bone loss, likely by interfering with the absorption of minerals like calcium and magnesium. Acid-reducing medications also actually induce acid-related symptoms like heartburn and acid regurgitation once treatment is withdrawn. Because of this you have to wean yourself off them gradually or else you’ll experience a severe rebound of your symptoms, As I explained in my acid reflux video below, while you wean yourself off these drugs (if you’re already on one), you’ll want to start implementing a lifestyle modification program that can eliminate this condition once and for all.

The key to addressing the underlying cause of the problem is to limit fructose to below 25 grams per day as this will tend to create a micro-environment that allows beneficial bacteria to thrive. Remember, sugar and fructose tend to act as fertilizer for pathogenic bacteria, fungi and yeast, so stay away from it. Additionally it will be good to include some fermented foods, such as fermented vegetables, and a high-quality probiotic.

Antidepressants / Antipsychotics

Abilify, Seroquel and Cymbalta all made the top 10 list. Most of the atypical antipsychotics like Abilify and Seroquel were approved in the 1990’s, at which time they were reserved for a very small minority of serious mental illnesses – primarily schizophrenia and bipolar disorder, diseases afflicting an estimated 3 percent of Americans. More recently, some atypical antipsychotics have also been approved for the treatment of severe depression. Shockingly, children as young as 18 months are now receiving antipsychotic drugs, despite the fact that the diseases they’re designed to treat rarely develop before adolescence.

There has been a massive increase in off-label use of atypical antipsychotics, which are now being prescribed for ailments such as anxiety, insomnia, and behavioral problems in children.

Abilify (aripiprazole), for example, is a newer psychotropic medication, licensed for the treatment of bipolar disorder, schizophrenia, autism – and major depression when taken with antidepressants. i.e. it is used to augment the effects of the antidepressants – because, of course, antidepressants have also been found to be about as effective as a placebo, and sometimes less effective than a sugar pill… Abilify has upwards of 75 different side effects associated with it, including GERD, arthritis, impotence, yeast infections, thyroid problems and more.

As for the antidepressant Cymbalta, which also made the list, research has confirmed that antidepressant drugs are typically no more effective than sugar pills, and have little if any benefit to people with mild to moderate depression, but they can increase suicidal thoughts and tendencies, and violent behavior, especially in children, teens and young adults. Antidepressants have also been linked to diabetes and impaired immune function.

Unfortunately, since most of the treatment focus of depression and other mental conditions is on drugs, many safe and natural treatment options that DO work are being completely ignored .

Asthma

Advair and Singulair, two popular asthma drugs, also made the top 10 list. While these drugs may be justified when used acutely, they should only be used temporarily until the underlying problem is solved, as they, too, carry risks.

Advair, for example, contains the long-acting beta-agonist (LABA) salmeterol, which actually increases the risk of death from asthma problems! Singulair also has serious side effects, including suicidal thoughts and actions, depression, aggressive behavior, hallucinations, sleep walking, tremor and more. Like many chronic diseases, asthma can often be managed using natural strategies, such as optimizing vitamin D levels and increasing your intake of omega-3 fats.

Rheumatoid Arthritis (RA)

Humira, used for rheumatoid arthritis, rounds out the top 10. Humira belongs to a newer class of RA drugs, the “biologic” drugs, called TNF-alpha inhibitors, sold under the brand names Humira, Enbrel, and Remicade. While these drugs are aggressively promoted, there are still concerns about their safety. Not only are drugs like Humira made from genetically engineered hamster cells, and not only do they suppress your actual immune system, but they can lead to tuberculosis, lethal infections, melanoma, lymphoma and unusual cancers in children and teenagers. This is one class of drugs that I feel are simply too dangerous too use.

My revised and updated drug-free RA protocol based on Dr. Thomas Brown’s RA treatment tends to provide a 60-90 percent improvement rate in most RA sufferers. Important aspects of the treatment protocol include dietary modifications, low-dose Naltrexone, optimizing your vitamin D levels, astaxanthin, beneficial bacteria (preferably in the form of fermented foods), and getting regular exercise

Are Drugs Really the Solution You’re Searching For?

Most chronic diseases, including cancer, heart disease, diabetes, and obesity, are largely preventable, and sometimes treatable, with simple lifestyle changes and other holistic approaches. Even infectious diseases like the flu can often be warded off by a healthy way of life.

Imagine the lowered death toll, not to mention costs to the economy, if more people decided to take control of their health…

The added bonus to this is that the healthier you are, the less you will need to rely on conventional medical care such as medications, which is a leading cause of death. Please make this transition with wisdom or you can get yourself into serious trouble. Avoid stopping any medications you are currently taking until you are working with a knowledgeable natural health care practitioner who can help guide you, but remember that minimizing your use of drugs should be a goal if you want to achieve optimal health.

The first step in treating virtually any illness, and certainly any of the ones discussed above is to optimize your health through your diet and lifestyle. It took me over 30 years to compile my free Nutrition Plan for you. It is divided into three levels, beginner, intermediate and advanced, but it would be best to start at the beginning. I recently edited the entire document to include updates that we have learned that will help you and your family take control of your health.

Watch the video on youtube, URL: http://www.youtube.com/watch?v=OOcJA4Tyw50&feature=player_embedded

Source: Dr. Mercola

 

 

Aspirin Use Linked to Less Cognitive Decline in Women at High CV Risk .


Aspirin use is associated with a lower likelihood of cognitive decline among older women at high cardiovascular risk, according to an observational study in BMJ Open.

Researchers used Swedish registries to identify some 700 women aged 70 to 92, most of whom had a 10-year CV risk of 10% or higher. Low-dose aspirin use was assessed at baseline, and psychiatric exams were conducted at baseline and 5 years later.

Women who took aspirin had less cognitive decline then nonusers. However, the risk for dementia did not differ significantly between aspirin users and nonusers — possibly because of the relatively short follow-up, according to the authors. They write: “Our finding that ASA use influenced cognitive function may reflect an effect on preclinical dementia, indicating that treatment must start early to have a sufficient neuroprotective effect.”

Source: BMJ

 

 

Aspergillus Meningitis Linked to Steroid Injections Sickens 26, Kills 4 .


Twenty-six patients have contracted fungal meningitis after receiving spinal steroid injections for back pain, CNN reports. Four of the patients have died.

The majority of cases — 18 — have occurred in Tennessee; the rest are divided among Florida, Maryland, North Carolina, and Virginia.

Clinicians suspect that the steroid, preservative-free methylprednisolone acetate, was contaminated with the fungus Aspergillus. All patients received injections between July 1 and September 20, and with the incubation period lasting as long as 4 weeks, more cases may still be identified.

The New England Compounding Center, which has been implicated in the outbreak, has recalled three lots of methylprednisolone acetate: #05212012@68, #06292012@26, and #08102012@51.

Asked to comment, Journal Watch‘s Paul Sax said: “What makes this [outbreak] notable is both the severity and the rarity of the condition, Aspergillus meningitis. Needless to say, consultation with a specialist in infectious diseases would be highly recommended for any clinician encountering such a case.”

Source: CNN

Screening for Type 2 Diabetes Does Not Reduce Mortality


Screening high-risk patients for type 2 diabetes does not reduce mortality, according to a Lancet study.

Some 30 U.K. general practices were randomized to screening plus intensive diabetes control, screening plus routine diabetes care, or no screening. Over 16,000 patients aged 40 to 69 were eligible for screening, as determined by a risk score based, in part, on BMI and antihypertensive drug use. Three percent were diagnosed with diabetes.

During roughly 10 years’ follow-up, the screening and control groups did not differ in terms of all-cause mortality, diabetes-related mortality, or cardiovascular mortality. Adjustment for intensive versus routine diabetes care did not alter these findings.

Pointing out the low prevalence of undiagnosed diabetes in this cohort, Lancet commentators suggest that screening might be more beneficial in countries where diabetes is more common. They conclude that screening recommendations are “likely to be country-specific and context-specific for the foreseeable future.”

Source: Lancet