Medical Center

People with varus (outward-facing), but not valgus (inward), knee alignment have an increased risk for the development of osteoarthritis (OA) of the knee, according to a study published online May 28 in the Annals of the Rheumatic Diseases.
Existing arthritis worsens when both varus-aligned and valgus-aligned joints bear increased stress, report Leena Sharma, MD, from the Feinberg School of Medicine, Northwestern University, Chicago, Illinois, and colleagues.

OA is associated with deterioration of joint cartilage, causing pain and often resulting in disability. According to the Centers for Disease Control and Prevention, knee OA affects 6.1% of adults older than 30 years.
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Women who use estrogen-only hormone replacement therapy don’t appear to be at increased risk of dying from lung cancer. That’s according to a new analysis of data from the Women’s Health Initiative on postmenopausal women who had hysterectomies.
The new results agree with a large study published earlier this year that found no link between estrogen-only HRT and lung cancer risk (see Reuters Health story of Feb 24, 2010).

In the current study, estrogen alone resulted in only one more lung cancer death than placebo pills over a mean follow-up of nearly eight years, Dr. Rowan T. Chlebowski, of Harbor-UCLA Medical Center in Torrance, California, and colleagues reported Friday.
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Meningococcal disease, commonly called meningitis, is a serious bacterial infection that can cause swelling of the lining around the brain and spinal cord (meningitis) or blood infection (meningococcemia). Each year, up to 2,800 people get the disease1, which strikes quickly and can lead to death and other devastating complications, such as deafness, brain damage, and amputation of arms, legs, fingers and toes within hours of first symptoms. 2

Risk Factors for Meningococcal Disease

Anyone can get meningococcal disease, but pre-teens and teens are at greater risk of contracting the disease. In fact, pre-teens and teens account for nearly 30 percent of all cases of reported meningococcal infection in the U.S.,3 and death rates are up to five times higher among 15- to 24-year olds compared with other age groups. [need ref]

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More than 42% of physicians have been sued for medical malpractice at some point in their careers, and more than 20% were sued at least twice, according to a new American Medical Association (AMA) report.

An average of 95 claims were filed for every 100 physicians — almost 1 per physician — the AMA’s Physician Practice Information survey of 5825 physicians, fielded in 2007 and 2008, found.

Despite the pervasive threat of litigation across 42 different specialties surveyed, two thirds of claims are dropped or dismissed, and physicians prevail 90% of the time in cases that go to trial, the study found. Still, the costs to physicians in terms of malpractice premiums and to the entire healthcare system resulting from the practice of defensive medicine are quite high. Average defense costs per claim range from a low of $22,000 among claims that are dropped or dismissed to a high of more than $100,000 for cases that go to trial.
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A new prospective cohort study suggests younger people will pay for high cholesterol in the present with coronary calcium in the future, according to results of a study published in the August 3, 2010 issue of the Annals of Internal Medicine [1].

In the latest study from the ongoing Coronary Artery Risk Development in Young Adults (CARDIA) trial, Dr Mark Pletcher (University of California, San Francisco) and colleagues measured LDL cholesterol, HDL cholesterol, triglycerides, and coronary calcium in 3258 subjects age 18 to 20 in 1985 and 1986. They estimated time-averaged cumulative exposures to lipids between age 20 and 35 with repeated serum lipid measurements over 20 years and then related these data to coronary calcium scores acquired with computed tomography at years 15 and 20.
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Tree Pollen Allergoid Eases Allergy Symptoms
Patients with rhinoconjunctivitis due to tree pollen allergy suffer fewer symptoms after 18 months’ treatment with a depigmented-polymerized pollen extract, according to a European study.

Conventional subcutaneous immunotherapy (SCIT) carries a risk of systemic side effects. To get around that, allergoids have been developed by polymerizing allergen extracts with glutaraldehyde to reduce specific IgE binding while retaining T cell reactivity. Pigments are removed to increase solubility and inactivate enzymes.

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Recent media reports of potential misdiagnosis and overtreatment of early-stage breast cancer may be frightening women away from recommended screening for breast cancer, according to a joint news release from Susan G. Komen for the Cure and the College of American Pathologists.
Rather than forgo screening because of fears of being misdiagnosed and receiving unnecessary therapy, women should know what questions to ask and be confident about weighing their options, the release emphasizes.
The joint statement was released primarily in response to a recent article in the New York Times, which described the disturbing case history of a women misdiagnosed with ductal carcinoma in situ (DCIS). The patient had a “golf-ball sized” section of her breast removed, underwent radiation and chemotherapy, and then was told a year later that she never had cancer.
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Recent evidence and management principles concerning the use of acupuncture for chronic low back pain are reviewed in an article published in the July 29 issue of the New England Journal of Medicine.

“Acupuncture is a therapeutic intervention characterized by the insertion of fine, solid metallic needles into or through the skin at specific sites,” write Brian M. Berman, MD, from the University of Maryland School of Medicine in Baltimore, and colleagues. “The technique is believed to have originated in China, where it has remained a fundamental component of a system of [medicine that] espouses an ancient physiological system (not based on Western scientific empiricism) in which health is seen as the result of harmony among bodily functions and between body and nature. Internal disharmony is believed to cause blockage of the body’s vital energy, known as qi, which flows along 12 primary and 8 secondary meridians.”
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Researchers here described the development of iron-containing multiwalled carbon nanotubes (MWCNTs) that can be tracked by magnetic resonance imaging (MRI) and targeted with a laser once they enter a tumor. The nanoparticles have enormous potential for the treatment of breast cancer.

The new technology was described here at the American Association of Physicists in Medicine 52nd Annual Meeting.

“This could change the field,” explained Franklin Epstein, MD, chief of the Division of Neurosurgery at Audie L. Murphy Memorial Hospital in San Antonio, Texas, in an interview with Medscape Medical News. Dr. Epstein is not affiliated with the study.
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20 Suspected Carcinogens Represent Occupational Hazards
A new international report identifies 20 suspected “high-priority” carcinogens for which the potential to cause cancer is unclear and in need of further study.
The report focuses on possible carcinogens in the workplace, such as metals and solvents, but the list also includes shift work.
The report is a collaboration of the International Agency for Research on Cancer (IARC), in Lyon, France, and the National Occupational Research Agenda, a program of the National Institute for Occupational Safety and Health (NIOSH) in the United States.
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