Want to take a bite out of cardiovascular disease? Get your teeth cleaned. At least, that's the implication of a small but compelling Italian study showing consistent reduction in endothelial dysfunction and carotid intimal medial thickness when people with mild to moderate periodontitis got their teeth and gums scrubbed.
Many holistic physicians have claimed that gum disease correlates with CVD, with the two conditions sharing a common factor of systemic inflammation. Previous studies have shown associations between the gum bug, Porphyromonas gingivalis, and atherosclerotic plaque, as well as correlations between gum disease and inflammatory markers like C-reactive protein.
But this study, by Dr. Mario Clerici of the University of Milan, is the first to document actual physical changes in the cardiovascular system following perio-dontal intervention. Dr. Clerici and colleagues studied 35 people, mean age 46, with mild to moderate gum disease. They underwent basic periodontal care consisting of tartar removal and cleaning of the gums—and nothing else, no drug therapies or gum surgery.
Echo Doppler showed clear and consistent IMT reductions at three carotid sites, following the dental intervention and persisting for as much as 12 months. Patients also showed marked reductions in oral bacterial loads, as well as C-reactive protein and other serum inflammatory markers. The data were reported last December in the Journal of the Federation of American Societies for Experimental Biology (FASEB).
Dr. Clerici said he was pleasantly surprised by the results, and the size of the beneficial effect. The cohort was small, and there was no control group, so the investigators refrained from making definitive directives, but you might want to add "visit the dentist" to your list of advice for patients at high CVD risk.
Source: ACC Heartwire/WebMD
Let's Face It
Radiology can be a pretty cold, unfeeling specialty: you spend the day looking at x-rays, CT scans or MRIs and dispassionately doling out the good or bad news with little cognizance of the actual people behind the images.
A recent study by researchers at the Shaare Zedek Medical Center, Jerusalem, showed that inserting digital photographs of patient's faces into a CT scan not only increased radiologists' empathy, it improved their diagnostic attention.
The study involved 15 radiologists and 318 patients undergoing CT scans who agreed to be photographed. The investigators looked at the extent to which radiologists captured and reported incidental findings beyond the primary disorder for which the scan was ordered (i.e., recognition of kidney cysts in an appendicitis case). The radiologists were not aware of the intention of the study, and the patient photos showed up at the top of the CT images unannounced.
When the patient's faces were included, the radiologists detected and reported incidental findings in 81 of 318 cases (26%). Three months later, unbeknownst to the radiologists, they were asked to read the exact same scans, only without photographs and with different identifying information, This time, they failed to report 80% of the incidental findings they'd reported previously. The study was presented at the 2008 meeting of the Radiological Society of North America.
Irith Hadas-Halpern, MD, one of the co-authors, noted that seeing the patient's face engenders empathy and calls on the radiologists to really pay attention to the fine details that might be important.
Though it would certainly add a degree of human warmth to the diagnostic process, putting faces on radiographic images might also introduce potential for triggering racial/ethnic prejudices or other personal biases that might cloud a radiologist's clarity. Even if the benefits clearly outweighed this risk odds are, this idea would never fly in the US; HIPAA and other confidentiality laws would preclude it.
Source: Associated Press (thanks to Cell2Soul.com for pointing it out)
NY State Ponders Pop Tax
It would raise billions in state revenue, while lowering prevalence of diabetes and obesity? Sa-weeeet!
At least that's how a lot of health-conscious New Yorkers feel about Gov. David Paterson's proposed 18% tax on all sugar-containing sodas, juice-drinks and other gluco-charged beverages. The governor's office argues that the tax, akin to the heavy sales taxes many states have put on cigarettes, would help fill ghastly holes in the state's budget, provide increased state-level healthcare funding, and probably help a lot of citizens lose weight.
There's some fairly sound science behind the proposal, including studies that show soft-drink consumption to be a primary driver of both diabetes and obesity especially in children. Physiologically, the body treats soda pop as if it were water; since we did not evolve drinking copious amounts of corn syrup, there's no mechanism that lets us feel the caloric weight of all the soda we're drinking. And, as a nation, we drink A LOT. The average American sucks down 35 gallons of sugared soda every year.
Gov. Patterson estimates that putting an end to cheap, super-sized soft-drinks with a sizeable tax could raise up to $400 million annually, while creating a strong financial incentive for New Yorkers to kick the sugar habit. It won applause from New York Times columnist Nicholas Kristof, who called it a "landmark effort that, if other states follow, could help make us healthier."
It's a safe bet that the beverage industry sees it differently, and will flex considerable lobbying muscle to try and defeat the proposal.
Source: NY Times