Having the same GP halves chance of early death

Published by The Times on June 29, 2018

By Chris Smyth

Seeing only one family doctor cuts the risk of dying early by up to 53 per cent, an international analysis has found.

Having repeated appointments with the same GP was as effective at reducing death rates as some drugs, according to an overview of 22 studies.

Sir Denis Pereira Gray, who led the work, said NHS policy needed a “complete change” to recognise the value of a personal relationship with a family doctor, rather than diverting GPs from their regular patients to provide evening and weekend appointments.

“If you can build a worthwhile relationship with a doctor it will be to your advantage and theirs over time,” he advised patients.

Four fifths of the studies covered in the research showed that continuity of care had clear benefits over periods ranging from a weekend in hospital to 17 years. Previous work has shown that patients who see the same doctor regularly are more satisfied and less likely to go to A&E, but Sir Denis argued that health chiefs should stop seeing this continuity as a luxury “like a nicely decorated room”.

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Eamonn Vitt
Germs in Your Gut Are Talking to Your Brain. Scientists Want to Know What They’re Saying.

Published by the New York Times January 28, 2019

By Carl Zimmer

The body’s microbial community may influence the brain and behavior, perhaps even playing a role in dementia, autism and other disorders.

In 2014 John Cryan, a professor at University College Cork in Ireland, attended a meeting in California about Alzheimer’s disease. He wasn’t an expert on dementia. Instead, he studied the microbiome, the trillions of microbes inside the healthy human body.

Dr. Cryan and other scientists were beginning to find hints that these microbes could influence the brain and behavior. Perhaps, he told the scientific gathering, the microbiome has a role in the development of Alzheimer’s disease.

The idea was not well received. “I’ve never given a talk to so many people who didn’t believe what I was saying,” Dr. Cryan recalled.

A lot has changed since then: Research continues to turn up remarkable links between the microbiome and the brain. Scientists are finding evidence that microbiome may play a role not just in Alzheimer’s disease, but Parkinson’s disease, depression, schizophrenia, autism and other conditions.

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Eamonn Vitt
Can a Nice Doctor Make Treatments More Effective?

Published by the New York Times January 21, 2019

By Lauren C. Howe and Kari Leibowitz

Connecting with patients doesn’t just make them think someone cares. It can make a difference for health outcomes.

In the age of the internet, it’s easier than ever to pull together lots of information to find the best doctor. And if you’re like most patients, the metric you probably rely on most is the doctor’s credentials. Where did she go to school? How many patients has he treated with this condition?

You might also read some Yelp reviews about how nice this doctor is; how friendly and how caring. But all that probably seems secondary to the doctor’s skills; sure, it would be great to have a doctor whom you actually like, but that’s not going to influence your health the way the doctor’s competence will.

But our research in the psychology department at Stanford University suggests that this view is mistaken. We found that having a doctor who is warm and reassuring actually improves your health.

The simple things a doctor says and does to connect with patients can make a difference for health outcomes.

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Eamonn Vitt
Regular Exercise May Keep Your Body 30 Years ‘Younger’

Published by the New York Times on November 21, 2018

By Gretchen Reynolds

The muscles of older men and women who have exercised for decades are indistinguishable in many ways from those of healthy 25-year-olds.

The muscles of older men and women who have exercised for decades are indistinguishable in many ways from those of healthy 25-year-olds, according to an uplifting new study of a group of active septuagenarians.

These men and women also had much higher aerobic capacities than most people their age, the study showed, making them biologically about 30 years younger than their chronological ages, the study’s authors concluded.

All of us are aging every second, of course, which leads many of us also to be deeply interested in what we can expect from our bodies and health as those seconds — and subsequent years and decades — mount.

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Eamonn Vitt
Your Lifetime Health Checkup Roadmap

Published by the New York Times

By Anahad O'Connor

Many of the leading killers of Americans are chronic diseases that can be prevented with healthy habits like a good diet and plenty of exercise. But there’s a key part of prevention that should not be overlooked: At every stage of your adult life, you should undergo routine screening exams to catch any health problems so you can try to nip them in the bud. Read on for the lowdown on the routine but potentially lifesaving tests and preventive procedures that you need at every stage of your adult life. 

Routine Maintenance

There are some tests that come up again and again. Know when to look for them. 

GET A FLU SHOT EVERY YEAR

For most people, the flu shot is an inconvenience. You might think you don’t need it because the flu doesn’t seem that serious. But every year, more than a hundred thousand people in the United States are hospitalized with the flu, and about 57,000 people die from it. The flu is a top killer of Americans. It’s the eighth leading cause of death, right behind diabetes – even though it can be prevented in most cases with a quick and easy vaccine. 

Everyone who is older than 6 months of age should get the flu vaccine annually, except for people who have a rare, life-threatening allergy to it or people with a history of Guillain-Barré syndrome. For more about the flu vaccine and where to find it, you can read this primer from the Centers for Disease Control and Prevention

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Eamonn Vitt
Lifestyle changes reduce the need for blood pressure medications

Published by the American Heart Association on September 08, 2018 

Study Highlights:

  • Men and women with high blood pressure reduced the need for antihypertensive medications by making lifestyle changes.

  • A 16-week program, focused on the DASH diet, weight management and exercise, resulted in the most dramatic declines in blood pressure.

Embargoed until 1:30 p.m. CT / 2:30 p.m. ET Saturday, Sept. 8, 2018

CHICAGO, Sept 8, 2018 —  Men and women with high blood pressure reduced the need for antihypertensive medications within 16 weeks after making lifestyle changes, according to a study presented at the American Heart Association's Joint Hypertension 2018 Scientific Sessions, an annual conference focused on recent advances in hypertension research.

Lifestyle changes are the first step in reducing blood pressure according to the 2017 American College of Cardiology/American Heart Association Hypertension Guideline.

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Eamonn Vitt
Weight Training May Help to Ease or Prevent Depression

Published by the New York Times June 6, 2018

By Gretchen Reynolds

Benefits essentially were the same whether people went to the gym twice a week or five times a week.

Lifting weights might also lift moods, according to an important new review of dozens of studies about strength training and depression. It finds that resistance exercise often substantially reduces people’s gloom, no matter how melancholy they feel at first, or how often — or seldom — they actually get to the gym and lift.

There already is considerable evidence that exercise, in general, can help to both stave off and treat depression. A large-scale 2016 review that involved more than a million people, for instance, concluded that being physically fit substantially reduces the risk that someone will develop clinical depression. Other studies and reviews have found that exercise also can reduce symptoms of depression in people who have been given diagnoses of the condition.

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Eamonn Vitt
Trying to Put a Value on the Doctor-Patient Relationship

Published by the New York Times May 16, 2018

By Kim Tingley

IN ITS PUSH FOR PROFITS, THE U.S. HEALTH CARE SYSTEM HAS MADE IT DIFFICULT FOR PATIENTS TO GET PERSONAL ATTENTION FROM DOCTORS. BUT WHAT IF HANDS-ON MEDICINE ACTUALLY SAVES MONEY — AND LIVES?

In October 2014, my father was startled to receive a letter announcing the retirement, in a month’s time, of our family physician. Both he and his doctor were in their late 60s by then, and their relationship went back about 30 years, to the early 1980s, after my father followed his father and paternal grandparents, all from the Midwest, to Southwest Florida. How they began seeing the doctor is beyond memory, but as my father’s grandparents grew increasingly frail, his father frequently drove them to their doctor for checkups. At one of them, in the mid-’80s, the doctor suggested that it might be less strenuous for my great-grandparents if he met them in the parking lot. From then until they died, he came downstairs from his seventh-floor office with his black bag and climbed into the back seat of their yellow Oldsmobile 88 to give them their physicals.

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Eamonn Vitt
The Germs That Love Diet Soda

Published by the New York Times April 6, 2018

By Moises Velasquez-Manoff

There are lots of reasons to avoid processed foods. They’re often packed with sugar, fat and salt, and they tend to lack certain nutrients critical to health, like fiber. And now, new research suggests that some of the additives that extend the shelf life and improve the texture of these foods may have unintended side effects — not on our bodies directly, but on the human microbiome, the trillions of bacteria living in our guts.

These substances may selectively feed the more dangerous members of our microbial communities, causing illness and even death.

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Eamonn Vitt
Running From the Pain

Published by Slate on March 12, 2018

By Scott Douglas

Exercise can be a very effective way to treat depression. So why don’t American doctors prescribe it?

Here’s the most important thing I learned while writing a book on running and mental health: In clinical studies, regular aerobic exercise is as effective as antidepressants in reducing symptoms of mild to moderate depression. And that’s not just because moving might help you get into shape and feel better about yourself. Exercise actually causes the same structural changes to the brain as antidepressants—neuroplasticity, or creating new neural pathways, and growth in the hippocampus, a part of the brain that’s generally shrunken in people with depression.

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Eamonn Vitt
The Challenge of Doctor-Patient Relations in the Internet Age

Published by the New York Times March 1, 2018

By Doris Iarovici, M.D.

“Let me do some research, and I’ll get back to you,” my patient said.

My patient, a 19-year-old undergraduate, had already taken time off from school because of her anxiety. I was her psychiatrist, with over two decades of experience treating university students, and had just explained my diagnostic impressions based on a lengthy evaluation. I’d recommended that she try a medicine I expected would help. I’d also laid out the risks and benefits of other treatment options.

“Do you have additional questions I can answer?” I asked. I wanted to let her know that’s why I was there, to cull the research, to help make sense of it.

“No, I like to go online and look for myself,” she said.

More and more, I see students turning away from the expertise that a live person can offer and instead turning to the vast and somehow more objective-seeming “expertise” of the digital world.

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Eamonn Vitt
Doctors, Revolt!

Published by the New York Times February 24, 2018

By Rich Joseph

Boston — The 96-year-old patient with pneumonia in Bed 11 was angry. “Do you really need to check my vital signs every four hours?” he asked.

Checking things like temperature, blood pressure and respiratory rate every four hours on hospitalized patients has been the standard of care since the 1890s, yet scant data indicates that it helps. In fact, data shows that close to half of patients are unnecessarily awakened for such checks, perhaps to the detriment of their recovery. My patient wanted to know how, with all that poking and prodding, he was supposed to rest and get better.

“I understand your frustration,” I replied, “and wish I could help to change the situation.”

I may have been a lowly intern, but it was a feeble reply. And he knew it. “Understanding is not enough,” he said. “You should be doing something to help fix this system.”

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Eamonn Vitt
Fiber Is Good for You. Now Scientists May Know Why.

Published by the New York Times January 1, 2018

By Carl Zimmer

A diet of fiber-rich foods, such as fruits and vegetables, reduces the risk of developing diabetesheart disease and arthritis. Indeed, the evidence for fiber’s benefits extends beyond any particular ailment: Eating more fiber seems to lower people’s mortality rate, whatever the cause.

That’s why experts are always saying how good dietary fiber is for us. But while the benefits are clear, it’s not so clear why fiber is so great. “It’s an easy question to ask and a hard one to really answer,” said Fredrik Bäckhed, a biologist at the University of Gothenburg in Sweden.

He and other scientists are running experiments that are yielding some important new clues about fiber’s role in human health. Their research indicates that fiber doesn’t deliver many of its benefits directly to our bodies.

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Eamonn Vitt
Gut Microbiome Affects Salt-Sensitive Hypertension in Mice and Humans

Published on January 2, 2018

by Anthony L. Komaroff, MD reviewing Wilck N et al. Nature 2017 Nov 30 Relman DA. Nature 2017 Nov 30

When dietary salt intake increases, lactobacilli are lost and blood pressure rises.

Salt-sensitive hypertension is caused, at least in part, by expansion of intravascular volume due to a high-salt diet. In a new study, researchers investigated an additional mechanism: the gut microbiome's response to a high-salt diet.

In mice, a high-salt diet led to depletion of Lactobacillus species, particularly of one Lactobacillusspecies, L. murinus. This was followed by an increase in the number of particular lymphocytes (T-helper [TH]17) that drive many autoimmune diseases and then by a rise in blood pressure. When researchers supplemented the mouse feed with the depleted species of lactobacilli, these changes were reversed.

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Eamonn Vitt
Prescription Drugs May Cost More With Insurance Than Without It

Published December 9th 2017 by the New York Times

By Charles Ornstein and Katie Thomas

Having health insurance is supposed to save you money on your prescriptions. But increasingly, consumers are finding that isn’t the case.

Patrik Swanljung found this out when he went to fill a prescription for a generic cholesterol drug. In May, Mr. Swanljung handed his Medicare prescription card to the pharmacist at his local Walgreens and was told that he owed $83.94 for a three-month supply.

Alarmed at that price, Mr. Swanljung went online and found Blink Health, a start-up, offering the same drug — generic Crestor — for $45.89.

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Eamonn Vitt
Coffee's Numerous Health Benefits Detailed in New Analysis

Published November 27, 2017 by New England Journal of Medicine JOURNAL WATCH 

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Coffee consumption — in particular, several cups daily — is associated with a wide range of health benefits, according to an umbrella review of meta-analyses in The BMJ.

The review included over 200 meta-analyses of observational or interventional research into coffee consumption and health outcomes in adults. Among the benefits:

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Eamonn Vitt
How to Start Running

Published by the New York Times

By Tara Parker-Pope

Running is a great way to get fit, feel better and even form new relationships with other runners. Starting a new running habit doesn’t have to be hard — all it takes is a comfortable pair of shoes and a willingness to move a little or a lot, all at your own pace. The Well Guide makes it easy to get started, get inspired and stay on track. Are you ready? Let’s go!

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Eamonn Vitt
Antibiotic-resistant gonorrhoea on the rise, new drugs needed

Published July 7, 2017 by the World Health Organization

Data from 77 countries show that antibiotic resistance is making gonorrhoea – a common sexually-transmitted infection – much harder, and sometimes impossible, to treat.

"The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.

WHO reports widespread resistance to older and cheaper antibiotics. Some countries – particularly high-income ones, where surveillance is best – are finding cases of the infection that are untreatable by all known antibiotics.

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Eamonn Vitt
When Evidence Says No, but Doctors Say Yes

Published by The Atlantic on February 22, 2017

By David Epstein and Propublica

Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.

First listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come.

That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. The next day, he went to a local emergency department. 

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Eamonn Vitt
The Self-Medicating Animal

Published by the New York Times May 18, 2017

By Moises Velasquez-Manoff

Chausiku was clearly sick. The chimpanzee was in her 30s, a chimp’s prime. She was usually a gentle, doting mother. But one day she built a nest in a tree, climbed in and lay down, letting her infant, a male named Chopin, roam unsupervised. Another female chimp began looking after Chopin while Chausiku rested.

Later that day, after Chausiku descended from the tree, a scientist named Michael Huffman noted that she could barely walk. Huffman wasn’t there to watch Chausiku specifically; he was studying older chimps, researching their social relationships in the troop. But Chausiku did something so out of the ordinary that it captured his attention: She sat down in front of a leafy plant, began pulling off branches, chewing their tips, spitting out the fibrous pulp and swallowing only the juice.

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Eamonn Vitt