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3-4-10-2.mp3

Today's second installment is about the WHO definition of diabetes, and whether today's New England Journal of Medicine paper is enough to change it.

You may remember the story of the cat who almost unerringly predicts when a hospice patient is about to die.  The report was published in the New England Journal of Medicine.

If you were wondering what happened to that cat (as, I'll admit, sometimes I do), prepare to be amazed: the cat continues to be very accurate in detecting when a patient is about to die. 

A study published in last week's New England Journal of Medicine looked at Stage II cervical cancer as the outcome and found that testing for HPV DNA was about twice as accurate as Pap smears. Pap smears will "soon be of mainly historical interest" says a Professor of Gynecology at Stanford Dr. Paul D. Blumenthal. http://www.nytimes.com/2009/04/07/health/07virus.html?partner=rss&emc=rs... Don't tell that to laypeople just yet. There are plenty of stories of fortuitous finds on Pap smears.

FDA official reports possible connection between osteoporosis drug and esophageal cancer in letter to New England Journal of Medicine. Dr. Diane Wysowski calls for further research and investigation into the connection which so far is only documented in reports made by clinicians to the FDA. http://www.reuters.com/article/healthNews/idUSTRE4BU4TX20081231?feedType...

Multiple sclerosis (MS) is the most common neurological disorder which affects the brain and spinal cord of generally young persons. Majority of researchers consider it as an "autoimmune disease” in which white blood cells intend to fight infection or disease are mistaken to target and attack the body's own cells. MS affects almost 400 000 people in the United States and quite a few million worldwide. Many useful medications are available for the treatment of MS.

According to American Heart Association more than 1.2 million patients in the U.S. go through cardiac angiograms every year and out of which 1 to 2% of cases results in complications and nearly 25 people die every year with this process. A new study published in the New England Journal of Medicine (NEJM) however has revealed that noninvasive CT scans are almost as precise at imaging coronary artery blockages as against traditional angiography and are much safer for the patients.

As many as 73 million Americans have high blood pressure problem. While current guidelines recommend initial hypertension therapy with a diuretic an international blood pressure study has illustrated a non-diuretic drug combination as more successful than diuretic-based therapy in preventing heart-related events like heart attacks and strokes.

A new study has found that cholesterol medicines known as "statins" may reduce the risk of strokes heart attacks and death by almost half when studied in patients with normal levels of cholesterol. With this finding at least 32 million people would be eligible for treatment.  The drug studied is AstraZeneca Plc’s Crestor. The patients eligible for the study are those who have high amounts of a protein linked to inflammation.

A survival improvement in a randomized trial is a rare occasion in medical oncology and today there's reason to be excited: researchers from an international European consortium published a paper in today's New England Journal of Medicine demonstrating a benefit for adding cetuximab (Erbitux) to conventional chemotherapy in recurrent carcinoma of the head and neck. The magnitude of the improvement was from ten months median survival to thirteen months. Progression-free survival was improved also. There were a total of 442 patients in the study.

The patient with type 2 or adult onset diabetes and who keeps a tight rein on their blood sugar even if they only do so for the first ten years after being diagnosed will have far lower risks of heart attacks and multiple other complications. Followup studies indicate a "legacy effect" which will likely put an emphasis on increasingly "rigorous" treatment of type 2 diabetes when they are first diagnosed. "What you don't want is for people to think that they had a period of good glucose control and then they allow their blood glucose to go high _ that would be disadvantageous " said Dr.