STUDY: No age requirement for exercise

JOURNAL: Arthritis Care & Research 2003;19:129-135

AUTHORS: Dr. Jennifer M. Hootman

ABSTRACT: While people with arthritis may know that joint-friendly activities such as walking and gardening can help reduce their pain and disability, study findings show that many of them still remain completely inactive.

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COMMENTARY: One possible reason is that such exercise may initially increase arthritis-related pain, and, in some cases, arthritis patients had been inappropriately advised against participating in regular physical activity, according to the authors of the study. But the new findings show that people with arthritis can not only exercise regularly but can also meet national recommendations for the general population.

People with arthritis should strive to become more physically active by engaging in moderate intensity physical activity, such as walking, bicycling or swimming, for 30 minutes a day at least three times per week.

And there's no age requirement for exercise. A recent study found that even people aged 80 and older who exercise just a couple of times a week can improve their health.

STUDY: Take Your Vitamins

JOURNAL: Memorial University of Newfoundland

AUTHORS:

ABSTRACT: Recent clinical studies showed that dietary supplements can treat nutritional deficiencies in the elderly, boost their immune systems, combat short-term memory loss, reduce risks of Alzheimer's, and improve seniors' overall health.

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COMMENTARY: The first, conducted at Memorial University of Newfoundland, concluded that supplementation with moderate amounts of 18 vitamins, minerals, and trace elements improved short-term memory and overall cognitive abilities and strengthened immune system function in 86 elderly people treated over the course of one year.

A separate study published in the May 2001 issue of Neurology found that seniors with low levels of folate and vitamin B12 have an increased risk of developing Alzheimer's disease.

A third study, published in the August 2001 issue of Nutrition, showed that nutritional deficiencies greatly increase with age, and that supplement use helps eliminate these deficiencies in the elderly. However, a recent survey conducted by Harris Interactive found that the age group over 65 is least likely to discuss dietary supplements with doctors

STUDY:

JOURNAL: Diabetes Care. 2003;26:446-451

AUTHORS: Ronald A. Sherman, MD, MSC

ABSTRACT: Maggot therapy is more successful in debriding nonhealing ulcers than is continued conventional care.

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COMMENTARY: "Over the past few years, there has been a resurgence in the use of maggot therapy, even though its optimal role has not been clearly defined," write Ronald A. Sherman, MD, MSC, and colleagues from the Veterans Affairs Medical Center in Long Beach and the University of California, Irvine.

In the study, of 20 nonhealing ulcers in 18 patients, six wounds were treated with conventional therapy, six with maggot therapy, and eight with conventional therapy followed by maggot therapy.

Although conventional therapy failed to achieve any significant debridement during the first 14 days, maggot therapy allowed necrotic tissue to decrease by an average of 4.1 cm2 during the same time frame (P = .02). After five weeks of therapy, necrotic tissue still covered more than 33% of the surface of conventionally treated wounds, but maggot-treated wounds were completely debrided after four weeks of therapy (P = .001).

Growth of granulation tissue was faster and wound healing rates were also better with maggot therapy.

"Maggot therapy was more effective and efficient in debriding nonhealing foot and leg ulcers in male diabetic veterans than was continued conventional care," the authors write.

STUDY: CVD risk is at least doubled among people with undiagnosed diabetes

JOURNAL: Ann Intern Med 2003;138:212-229.

AUTHORS: Dr. Alfred Berg

ABSTRACT: Patients with high blood pressure or high cholesterol levels should be screened for diabetes mellitus type 2.

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COMMENTARY: While screening can detect diabetes in the preclinical, asymptomatic stage, the most beneficial interventions are those that reduce cardiovascular risk.

CVD risk is at least doubled among people with undiagnosed diabetes, and aggressive treatment of hypertension or dyslipidemia reduces morbidity and mortality within 5 years of diagnosis.

Glycemic levels are often only slightly elevated during the preclinical phase, the authors note. The benefit of glycemic control during the ensuing 15 years following diagnosis, or in the presence of impaired fasting glucose and impaired glucose tolerance, "is unknown but probably small" because the risk for severe visual impairment, end stage renal disease or amputation is low during this time.

The task force recommends screening for diabetes in patients with hypertension or lipid abnormalities.

STUDY:

JOURNAL: N Engl J Med 2003;348:489-490,518-526.

AUTHORS: Dr. Munoz

ABSTRACT: Results of a pooled analysis of 11 case-control studies provide robust estimates of the level of risk of cervical cancer associated with 30 different human papillomavirus (HPV) types.

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COMMENTARY: The data indicate that, in addition to HPV types 16 and 18, the following types should be considered carcinogenic or high-risk: types 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82.

Three HPV types--26, 53, and 66--should be classified "probably carcinogenic" or "probable high-risk types," according to the data, as they were detected in only one to three cervical cancer patients and in none of the controls.

Low-risk HPV types are types 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108. Three HPV types--34, 57, and 83--were not detected in any of the samples and so were classified as of "undetermined risk."

Based on the classification, Dr. Munoz said, the "composition of 'cocktails' used to diagnose high-risk HPV types could be expanded. For example, the commercially available Hybrid Capture II test (Digene), includes only 13 out of the 18 HPV types that we classified as high-risk or probably high-risk, which would result in missing 1% of women with cervical cancer."

Importantly, Dr. Munoz added, "if a woman is found positive for 1 of the 12 HPV types that we classified as low-risk, she can be told not to worry."

The investigators believe this classification system will be useful in "planning prevention by HPV vaccines and for screening programs based on HPV testing."