Flavonoid-rich Fruit and Vegetables Improve Microvascular Reactivity and Inflammatory Status

Results: In men, the HF F&V diet increased endothelium-dependent microvascular reactivity P = 0.017 with +2 portions/d at 6 wk and reduced C-reactive protein P = 0.001, E-selectin P = 0.0005, and vascular cell adhesion molecule P = 0.0468 with +4 portions/d at 12 wk. HF F&Vs increased plasma NO P = 0.0243 with +4 portions/d at 12 wk in the group as a whole. An increase in F&Vs, regardless of flavonoid content in the groups as a whole, mitigated increases in vascular stiffness measured by PWA P = 0.0065 and reductions in NO P = 0.0299 in the control group.

via Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease—FLAVURS: a randomized controlled trial.

Mom was right.

Killing Pain: Script by Script

Primary care doctors wrote about 53 million benzodiazepine prescriptions in 2013, roughly four times the number written by psychiatrists, a group that penned 13 million benzo scripts.

Nurse practitioners and physician assistants were close behind with 11 million prescriptions for the drugs, according to data obtained by MedPage Today and the Milwaukee Journal Sentinel.

In 2013, non-doctors wrote 30 million opioid prescriptions, compared with 92 million written by primary care doctors that year, according to data provided by IMS Health, a drug market research firm.

In 2010, the most recent year for which data were available, 30% of the 16,651 people who died of an opioid overdose also had taken a benzodiazepine, according to the U.S. Centers for Disease Control and Prevention.

via Killing Pain: Script by Script.

Killing Pain: Benzo ‘Boost’ Can Be Deadly.

Killing Pain: Xanax Tops Charts.

Pancreatitis May Confer Higher Risk for Cancer

In an effort to quantify the relationship between acute pancreatitis and pancreatic cancer, Agarwal and colleagues reviewed inpatient and outpatient records for 495,504 patients who received care through the Veterans Health Administration from 2000 through 2007. The authors identified 5,720 patients who had one or more episodes of acute pancreatitis, 710 of whom subsequently had diagnoses of pancreatic cancer.

Median follow-up was 60 months for the entire cohort, 26 months for patients who developed pancreatic cancer, and 60 months for patients who did not develop pancreatic cancer.

The patient cohort was predominately male (89%). A third of the patients smoked, a fourth had a history of heavy alcohol use, and 3% had a history of gallstones.

The 710 patients included 86 who had one or more episodes of acute pancreatitis prior to cancer diagnosis. The authors found that 76 of the 86 patients had a least one episode of acute pancreatitis within 2 years of cancer diagnosis.

In 69 of the 76 cases, the preceding pancreatitis occurred within a year of pancreatic cancer diagnosis. In fewer than half of the cases (N=34), acute pancreatitis preceded pancreatic cancer diagnosis by 2 months or less.

via Pancreatitis May Confer Higher Risk for Cancer.

Cardiac Catheterization: A New Route – Johns Hopkins Health Alerts

Cardiac Catheterization: A New Route: Johns Hopkins Health Alerts.

Cardiac Catheterization: A New Route

Doctors use cardiac catheterization to diagnose and treat heart conditions. The technique involves threading a thin tube called a catheter through an artery (usually the femoral artery in the upper thigh or groin) to the heart. Serious complications during cardiac catheterization are rare. But the procedure comes with risks of bleeding and damage to arteries.

Increasingly, cardiologists perform cardiac catheterization from an alternate site — the radial artery in the wrist — an equally effective tactic that’s linked to fewer bleeding and vascular complications, according to a review published in Circulation.

Why the wrist? After patients undergo cardiac catheterization through the femoral artery, they must remain flat on their back with their leg immobile for two to six hours to allow the artery to heal and help prevent both internal and external bleeding. Because the radial artery is smaller and closer to the skin’s surface, there’s no risk of internal bleeding, and external bleeding is easier to stop or prevent, an advantage for obese patients or those taking blood thinners.

Patients who undergo cardiac catheterization through the wrist can sit up, walk and eat immediately after the procedure — good news for people with back problems who find it difficult to lie still. A compression device is worn around the wrist for two hours. Patients must refrain from heavy lifting with the hand for a few days.

Radial cardiac catheterization most benefits patients in the highest risk groups — women, patients 75 and older and people with acute coronary syndrome. Yet doctors have been less likely to use the wrist site for these groups.

The decision to use radial versus femoral artery cardiac catheterization is largely based on the abilities and the experience of the cardiologist who’ll perform the procedure. The radial procedure is more technically challenging, and a greater number of U.S. doctors have more experience with the femoral approach — something that’s likely to change in the near future.