False Positives Prevalent in Food Allergy Testing

Moral of the story: Lots of allergy testing is done either by blood tests or patch skin tests, both of which are NOT reliable.  Challenge tests are the best way to make sure you actually have to worry about your children eating peanuts.

Source: AMA Morning Rounds 7/23/2010

Study highlights prevalence of false positives in food allergy skin, blood tests.

The Chicago Tribune (7/24, Munz) reported, "Food allergies are often misdiagnosed, leaving many parents needlessly worrying about dangerous reactions and painstakingly monitoring food, said Dr. Leonard Bacharier, director of pediatric allergy and immunology at Washington University School of Medicine." One "key reason, he said, is many parents rely solely on the results of blood or skin tests, which are increasing in use because of easier access," yet, "experts agree blood and skin tests are not reliable." In fact, a recent study published in Journal of Allergy and Clinical Immunology found that 66 of "79 children who had positive skin or blood tests for peanut allergy" were actually not allergic.

Several strategies may be worth trying to prevent Alzheimer's

Moral of the story: While there are many things that do NOT work (such as ginseng and those brain games), here are a few strategies that be worth exploring to help prevent alzheimer's disease.

Source: AMA Morning Rounds 7/26/2010

Several strategies may be worth trying to prevent Alzheimer's.

In the first of a related series of articles focusing on Alzheimer's disease, the Los Angeles Times (7/26, Roan) reports that nothing has been found to prevent Alzheimer's disease, according to an "assessment was issued by a National Institutes of Health task force at an April meeting." However, "several healthy and inexpensive strategies are clearly worth trying, say neurologists and Alzheimer's researchers." Currently, "the strategies with the most support are regular physical activity, a Mediterranean diet, and high levels of cognitive engagement."

        Early-stage programs may be valuable for those recently diagnosed with Alzheimer's. The Los Angeles Times(7/26, Ogilvie) discusses the value of "early stage programs" to assist patients newly diagnosed with Alzheimer's and their families. Such programs provide "a safe place to be heard; educational seminars and day trips; and access to practical advice on matters, such as financial planning and end-of-life care," as well as alleviate the isolation such a devastating diagnosis brings. In fact, according to Steven Arnold, a professor of psychiatry and neurology at the University of Pennsylvania and the director of the Penn Memory Center, "interacting with people who are sensitive to what they're going through...can comfort people with the disease and help alleviate that isolation, as well as the depression that the Alzheimer's Assn. estimates affects 20%-40% of patients."

        Five medications have been approved to treat cognitive symptoms of Alzheimer's. The Los Angeles Times (7/26, Roan) reports, "Five medications have been approved to treat the cognitive symptoms of Alzheimer's disease." The medicines, which include Namenda (memantine), Razadyne (reminyl galantamine), Exelon (rivastigmine), Aricept (donepezil), and Cognex (tacrine) "can reduce some symptoms -- such as difficulties with memory, language, attention and reasoning -- especially in the early stages of the disease." However, "they don't work for everyone, and none of them works permanently."

        Researchers now targeting tau as well as beta-amyloid to develop new therapies . The Los Angeles Times (7/26, Adams) reports that researchers "studying treatments for Alzheimer's disease have focused on telltale plaques that appear in patients' diseased brains as a target for therapy. The plaques are clumps of a small protein called beta-amyloid that build up in the space around nerve cells and interfere with normal brain function." However, "earlier this month at an international conference, different tangled structures inside neurons took center stage alongside plaques. These so-called neurofibrillary tangles involve another protein, called tau, that normally functions to move critical supplies around neurons. Tau tangles are now being targeted with new experimental therapies."

        Researchers report progress on Alzheimer's blood test. The Houston Chronicle (7/25, Ackerman) reported, "Texas scientists are on the verge of developing a blood test to identify patients with Alzheimer's disease, a potential breakthrough on the difficult-to-diagnose ailment. The test, details of which were presented at an international conference on Alzheimer's in Hawaii this month, would give nonspecialists who often have trouble diagnosing the disease a tool to catch it earlier and make a referral when its progression can still be slowed. ... The study was the product of the Texas Alzheimer's Research Consortium, a Legislature-created collaboration that includes Baylor, Texas Tech, UT Southwestern Medical Center in Dallas, the UT Health Science Center at San Antonio and the University of North Texas Health Science Center in Fort Worth."

        Research in mice explores role sirtuin may play in Alzheimer's. The New York Times (7/24, A9, Wade) reported, "A potentially promising approach to treating Alzheimer's disease has been developed by researchers studying sirtuin, a protein thought capable of extending lifespan in laboratory animals." In fact, by "using mice prone to developing Alzheimer's, the researchers showed that activating sirtuin suppressed the disease and that destroying sirtuin made it much worse." The researchers from the "Massachusetts Institute of Technology...say it raises the hope of treating Alzheimer's, and possibly other neurodegenerative diseases like Parkinson's and Huntington's, with drugs that activate sirtuin." The Boston Globe (7/26, Weintraub) also covers the story.

Most women may be able to safely give birth vaginally following C-sections

Moral of the story: More evidence pointing to the safety of VBAC and that our cesarean numbers can decrease in this country.  Safer, cheaper, better.

Source: AMA Morning Rounds 7/2//2010

Most women may be able to safely give birth vaginally following C-sections.

NBC Nightly News (7/21, story 6, 0:25, Williams) reported, "New guidelines out tonight from the American College of Obstetricians and Gynecologists are out to reverse the old expression 'once a cesarean, always a cesarean.'" The group is now saying that "most women who have had a c-section, and many of them who have had more than one, should be allowed to try labor with their next birth."

        "In recent years hospitals, doctors and insurers have been refusing to let them even try, insisting on repeat Caesareans instead," the New York Times (7/22, A1, Grady) reports on its front page. The "decisions have been based largely on fears of medical risks and lawsuits, medical and legal experts say." This, in turn, has "infuriated many women, added to the nation's ever-increasing Caesarean rate and set off a bitter debate over who controls childbirth."

        The "OB-GYN group has acknowledged that one word in its 1999 and 2004 VBAC guidelines is partly to blame," USA Today(7/22, Rubin) reports. "Previously, the group had recommended that only hospitals with a 'readily available' surgical team -- interpreted as no more than a half-hour drive away -- allow VBACs." Then, the "1999 guidelines called for an 'immediately available' surgical team," which many hospitals "interpreted...as needing to have an anesthesiologist and operating room standing by whenever a patient attempts a VBAC. If they can't meet the guidelines, they argue, they're opening themselves up to lawsuits should mother or baby be injured during a VBAC attempt."

        Important to note is that "there's less than a one percent chance" that the "scar from the earlier surgery" would rupture, the AP(7/22, Neergaard) reports. What's more, "with most recently performed C-sections, that scar is located on a lower part of the uterus that's less stressed by contractions." In fact, "of those who attempt VBAC, between 60 percent and 80 percent will deliver vaginally, the guidelines note," but the "rest will need a C-section...because of stalled labor or other factors."

        "'Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals and insurers to swing the pendulum back to fewer caesareans and a more reasonable VBAC rate,' Dr. Richard N. Waldman, president of ACOG, said in a news release," according to the Los Angeles Times (7/21, Roan) "Booster Shots" blog. Notably, the "guidelines follow the release in March of a report from a National Institutes of Health advisory panel calling for an easing of restrictions surrounding VBAC." The NIH "report combined with ACOG's new guidelines have the potential to usher in a new era of childbirth in the United States, returning it to a more natural, less-invasive event." WebMD (7/21, Doheny) also covered the story.

Moral of the story: IBS may be due to the way the brain develops

Source: AMA Morning Rounds 7/23/2010

Scientists identify possible connection between IBS, brain.

The Los Angeles Times (7/22, Roan) "Booster Shots" blog reported that researchers from McGill University and UCLA have identified "a possible connection between IBS and the brain." After taking "MRI scans of 55 IBS patients and 48 healthy women for comparison," investigators noted that the "women with IBS tended to have different amounts of brain gray matter in certain areas; for example, decreases in gray matter in parts of the brain that govern attention and areas that suppress pain." That association has "been identified in other disorders, such as...fibromyalgia and hip pain," which suggests that IBS, "like these other conditions...may be due to the brain's inability to inhibit the pain response."

Brain decline reduced with activity, vitamin D and tea

Moral of the story:  This is a topic that many are trying to find information about, but answer are often conflicting.  Take this with a grain of salt, and if you are already doing everything great, otherwise it is up to you whether you want to drink more tea.  However, everyone should make sure they have normal levels of vitamin D and get enough physical activity (ideally 60 min every day).

Source: AMA Morning Rounds 7/12/2010

Physical activity, tea-drinking, sufficient vitamin D levels may help reduce risk of brain decline, studies suggest.

USA Today (7/12, Marcus) reports that, according to three studies presented at the Alzheimer's Association International Conference, "improved living and diet habits -- including lots of physical activity, regular tea-drinking and sufficient vitamin D levels -- could reduce the risk of brain decline." In a study following some 1,200 elderly individuals over two decades, investigators discovered that "participants who had moderate to heavy levels of physical activity had about a 40% lower risk of developing any type of dementia." A second study "including data on more than 4,800 men and women ages 65 and older" found that "those who drank tea one to four times a week had average annual rates of decline 37% lower than people who didn't drink tea."

        HealthDay (7/11, Preidt) reported that a third study that "analyzed data from 3,325 people aged 65 and older" found that "the risk of cognitive impairment was 42 percent higher