Lehman’s Journal Review 10.4.2010

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BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review, 4 October 2010

Like about 40% of adults of my age in Western countries, I have a fatty liver, though I don’t qualify for having nonalcoholic fatty liver disease because I drink too much. If I wanted to know what is really happening to my liver I would have to have serial biopsies, as would several million people in the UK. This non-disease correlates with a number of other non-diseases such as asymptomatic reduced left systolic ejection fraction and pre-diabetes, and some real risk factors such as actual diabetes and high blood pressure. So I might die of vascular disease; or liver failure if I really overdo the wine; or else from cancer or general crumble or whatever else awaits me and everyone else. This paper on the risk of cardiovascular disease in patients with nonalcoholic fatty liver disease goes through the data and leaves me none the wiser: and by the way, these people are not patients and they don’t have a disease.

 

General crumble?

Low Carb Diets and Mortality

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Low-Carbohydrate Diets and All-Cause and Cause-Specific Mortality — Ann Intern Med

Conclusion: A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.

High Noise Levels and CHD

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Medical News: Noise on the Job Linked to CHD – in Cardiovascular, Myocardial Infarction from MedPage Today

There are several ways in which noise could contribute to cardiovascular events, according to the researchers. One is through the development of isolated diastolic hypertension, which has been shown to independently predict CHD and is more common among younger individuals.

The stress caused by loud noise also might lead to activation of the endocrine and sympathetic nervous systems, resulting in vasoconstriction, occlusion, and plaque disruption, they explained.

A limitation of the study was the possibility of selection bias. Workers who don’t tolerate noise or who have cardiovascular disease could have moved to other, less stressful jobs — or could have died while still in their noisy jobs.

Hypoglycemia in DM2 = Higher Mortality Risk

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Medical News: Hypoglycemia a Marker of Poor Diabetes Outcomes – in Endocrinology, Diabetes from MedPage Today

Type 2 diabetes patients who experienced these serious drops in blood glucose had nearly three times the risk of death and twice the risk of a major macrovascular event compared with those who didn’t experience hypoglycemia, Sophia Zoungas, MD, PhD, of the University of Sydney in Australia, and colleagues reported in the New England Journal of Medicine.

Read a Book a Week – 3Q 2010 Update

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Life has been rich, full, and busy.  Thankfully, business for me has been good.

These are my excuses for not reading a book a week.

I’ve managed to read about half a book a week this year through the end of September.  The 4Q has traditionally been a low reading period due to football, hockey, basketball, and baseball playoffs.  The number of RSS feeds I have decided to follow have increased.  This website is taking more time to maintain.

What to do…what to do?

Memantine for PDD or DLB

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Underwriting Quick Notes:

  • PDD = Parkinson’s Disease Dementia
  • DLB = Dementia with Lewy Bodies
  • Memantine = Namenda

Memantine for patients with Parkinson’s disease dementia or dementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial : The Lancet Neurology

Memantine seems to improve global clinical status and behavioural symptoms of patients with mild to moderate DLB, and might be an option for treatment of these patients.