new england journal

Health benefits of moderate drinking may not apply to African Americans

The widely reported health benefits of drinking a moderate amount of alcohol do not extend to African-Americans, according to a new study. These findings follow a widely reported Jan. 9 New England Journal of Medicine article saying that moderate daily or near-daily alcohol consumption could decrease a man’s risk of heart disease. The researchers in the new study, published in the January issue of the journal Alcoholism: Clinical and Experimental Research, suggest that the difference in protective benefits of alcohol for black men could also be a result of not how much people drink but how they do it.

Presence of T-Cells Predicts Survival in Ovarian Cancer

The presence of tumor-infiltrating lymphocytes predicts the length of remission after chemotherapy and the overall survival of patients with ovarian cancer, according to researchers from the Abramson Cancer Center and the Center on Women’s Health at the University of Pennsylvania School of Medicine. Their findings, which are presented in the January 16th issue of the New England Journal of Medicine, constitute the first proof that a spontaneous immune response against the tumor dramatically impacts the clinical course of ovarian cancer. These novel findings generate hope that immune therapies may significantly prolong the response to chemotherapy and improve the survival of patients with advanced ovarian carcinoma.

Community-based treatment of TB can save hundreds of thousands of lives

Multidrug-resistant tuberculosis no longer must be considered a death sentence for infected individuals living in resource-poor nations, according to a study by a consortium of researchers led by Harvard Medical School’s Program in Infectious Disease and Social Change. The study, which appears in this week’s New England Journal of Medicine, provides the first hard evidence that outpatient community care in poor, urban shantytowns can work for this most difficult to treat form of tuberculosis. The multidrug-resistant tuberculosis treatment model could ultimately help save hundreds of thousands of lives worldwide.

Amputation, Reconstructive Surgery Have Same Outcomes for Severe Leg Injuries

Patients with severe leg injuries often face a difficult choice of whether to have multiple operations to repair their damaged limb or undergo amputation. With advances in medical technology, limb reconstruction has replaced amputation as the primary treatment at many trauma centers. But a new study finds that patients have similar outcomes regardless of the treatment. The study, coordinated by the Johns Hopkins Bloomberg School of Public Health, was conducted at the University of Maryland Shock Trauma Center and seven other trauma centers across the country. It found that while patients who undergo reconstructive surgery have a higher risk of complications, additional surgeries, and hospitalizations, they fared about the same as those patients who have a leg amputated. After two years, both groups had similarly high levels of disability and psychological distress, and only about half of the people in each group were able to return to work.

Researchers study screening, treatment of immigrants for tuberculosis

Study findings from the Inner City Health Research Unit at St. Michael’s Hospital/ University of Toronto and the NewYork-Presbyterian Hospital Weill Cornell Medical Center demonstrate that screening and treating new immigrants from developing nations for the latent stage of tuberculosis infection would result in substantial public health and economic benefits. Results are published in tomorrow’s issue of The New England Journal of Medicine. Tuberculosis is one of the world’s most prevalent diseases which infects nearly two billion people worldwide or roughly one-third of the world’s total population, most of which live in developing nations.

Controlling Heart’s Irregular Rhythm No Better Than Controlling Rate

The preferred and most frequently used initial therapy for the common heart rhythm disorder atrial fibrillation (AF) is a strategy to restore and maintain a normal heart rhythm. However, a study supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health found that this “heart rhythm” strategy prevents no more deaths than the alternative, often secondary, approach to treatment which merely controls the rate at which the heart beats – and may have some disadvantages, including more hospitalizations and adverse drug effects.

Outpatient Cardiology Care Improves Survival Odds After Heart Attack

Elderly heart attack patients who visit a cardiologist’s office in the months after leaving the hospital are less likely to die within two years than patients who visit only their primary care doctor, a study by Harvard Medical School researchers finds. And patients who visit both a cardiologist and a primary care doctor have even better outcomes than those who visit only a cardiologist.

Causes of Life-Expectancy Gap Between Races, Education Levels ID’d

Researchers for the first time have identified and ranked which diseases contribute most to the life-expectancy gap between races and between education levels. The top four contributors to the life-expectancy disparity between blacks and whites are hypertension, HIV, homicide and diabetes. The top six contributors of mortality differences between education levels are all smoking-related diseases.

Exercise, even without weight loss, helps cholesterol

For the first time, researchers have demonstrated that exercise — without accompanying weight loss — has a positive impact on improving cholesterol levels. Further, they report that it is the amount of activity, and not necessarily any changes in fitness or intensity of exercise, that is important for cholesterol improvement. In the process of their studies, the researchers also demonstrated that the standard lipid panels used by doctors to measure the so-called “bad” LDL and “good” HDL forms of cholesterol do not necessarily provide the most accurate information in determining one’s risk of developing heart disease.

Risk of dying after heart failure down by one-third

Survival after a heart failure diagnosis has greatly improved over the past 50 years, according to a study from the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. The study found that the risk of dying after being diagnosed with heart failure had dropped by about a third in men and women during that period. About 4.8 million Americans have heart failure, with about 550,000 new cases being diagnosed each year. Heart failure contributes to about 287,000 deaths a year.

Eczema all about infection

Researchers say they’ve found that people with atopic dermatitis, a.k.a. eczema, are susceptible to bacterial infections in their skin because their bodies don’t produce enough of two antimicrobial peptides. The findings show that while an allergic reaction can cause a rash, true eczema is all about infection. And medicines containing or inducing the peptides could be used to fight the disorder, which affects millions worldwide.