Eriene-Heidi Sidhom
A new study came to the conclusion that treating herpes in those also infected with H.I.V. does not reduce the chance of transmission. According to Dr. Connie Celum, a professor of global health at the University of Washington, this is a surprising result, since the medication reduces the levels of H.I.V. in the blood. In the study all participants were given condoms, but half were given acyclovir and half were given a placebo. Although those on the medication experienced fewer genital sores and had lower levels of H.I.V. in their blood, the virus was transmitted to their partners at the same rate. However, giving condoms and advice did lower the overall infection rate. The study concludes that “new strategies are needed” to stop AIDS transmission.
Reference: McNeil, Donald G., Jr. (2010, February 8). H.I.V. and Herpes: Treating Herpes Doesn’t Reduce Chance That AIDS Virus Will Spread, Study Finds. The New York Times. Retrieved February 21, 2010 from http://www.nytimes.com/2010/02/09/health/09glob.html?ref=health.
Image: Scanning electron micrograph of HIV-1. Available here.
Robot-Assisted Surgery Winning Over Patients and Doctors, Yet Still Unproven
David Gennert
In recent years, a trend has emerged among surgical patients to have their surgeries carried out by robots being remotely controlled by surgeons. Thus, many surgeons who are staying with the method of directly operating on patients themselves are seeing potential patients walk away in favor of surgeons who have begun using the new technology. For example, last year, 86% of those who underwent prostate surgery chose the robotic method, which is almost 15 times more patients than the same figure eight years ago.
While robotic surgery clearly has its benefits– a robot can reach places human hands cannot, patients receive smaller incisions– the costs of the new technology are still unclear. Money-wise, the typical prostate surgery will cost $1,500-2,000 more than traditional surgery. A large-scale study of Medicare patients also suggested that robotic surgery might lead to more impotence and incontinence among patients. The same study also indicated that the new method might lead to fewer in-hospital complications. It should be noted that the study was not ideal, since patients were not randomly assigned types of surgery and laparoscopic surgeries were included in the numbers of robotic surgeries because Medicare does not distinguish between the two.
The learning curve for surgeons becoming proficient at robotic surgery is also a factor that needs to be considered when discussing the cost of the technology. One leading surgeon in the robotic surgery community, Dr. Ashutosh K. Tewari, who has done 3,200 robotic surgeries, estimates that a surgeon needs between 200 and 300 operations to become proficient.
Despite the uncertainty surrounding the trade-offs for choosing robotic surgery, the trend makes clear the fact that robot-assisted surgery is skyrocketing in popularity. Health care institutions, doctors, and patients are all advocating more strongly for the use of the robot. Hospitals pay huge sums of money for the device and subsequent service contract, so it is not surprising they want to advocate for the procedure. One urologist at the University of Texas, who held out for a while before beginning to offer robotic surgery, states the issue very well, “Marketing is driving the case here.”
Reference: Kolata, Gina. (2010, February 13). Results Unproven, Robotic Surgery Wins Converts. The New York Times. Retrieved February 20, 2010 from http://www.nytimes.com/2010/02/14/health/14robot.html?ref=health.
DSM Revision Could Have Widespread Impact
Kristin Bradley
The first overhaul of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM) in more than a decade is creating controversy over proposals that are aiming to revise the definitions of psychiatric disorders. Regarded as one of the fundamental manuals of psychiatry, the DSM represents decades of psychiatric research and has far reaching influences as it guides the diagnosis of disorders affecting such disparate areas as the focus of psychiatric research, the profits of the pharmaceutical industry, the cost of health insurance plans, the formation of legislation, and the social perception of disorders. Critics are concerned that newly proposed diagnoses for individuals at risk for the development of a disorder, designed to allow that person to benefit from early treatment, will cause the individual undue distress. These preemptive measures raise questions over whether they will lead to the diagnosis of individuals perceived to be “at risk” who are actually functioning within the normal spectrum of human behavior and perception. There is also fear that over-labeling patients with disorders will lead to a higher cost of health care for those patients and an increase in revenue for pharmaceutical companies that could benefit from a corresponding increase in the prescription of drugs. These concerns will be debated over the course of the next three years, with definitive changes to the DSM fully released in early 2013.
Reference: Stein, Rob. (2010, February 10). Revision to the bible of psychiatry, DSM, could introduce new mental disorders. The Washington Post. Retrieved February 20, 2010 from http://www.washingtonpost.com/wp-dyn/content/article/2010/02/10/AR2010021000009.html.
Migraines: Sign of Bigger Problems?
Paulina Zheng
Current research seems to suggest that migraine sufferers have more serious headaches in store of them. Researchers found that individuals who get migraines have a higher prevalence of factors contributing to the manifestation of heart disease compared to healthy individuals. Such risk factors include high cholesterol, high blood pressure, and diabetes. Patients with migraines are twice as likely to have a heart attack, otherwise known as a myocardial infarction, compared to the control patients. There also appears to be some distinction between migraine sufferers. Patients who also experienced visual or bodily sensations with their migraines, otherwise known as migraines with aura, were at an increased risk of stroke, while patients with migraines, but without aura, did not demonstrate this increased risk. It is important to note that the researchers failed to find a clear relationship between the two health conditions. This remains to be determined by future research. In the meantime, however, health practitioners are recommended to be on the lookout for any cardiovascular risk factors in patients with migraines.
Reference: Fiore, Kristina. (2010, February 12). Migraine Ups CVD, Heart Attack Risk. MedPage Today. Retrieved February 20, 2010 from http://www.medpagetoday.com/Neurology/Migraines/18465.
Study Reveals that Diabetics Tend to be More Impulsive
Alex Sakers
In a recent study conducted by Yasuhiko Iwamoto, MD and colleagues of Tokyo Women’s Medical University in Japan, diabetes was tied to poor impulse control. This study could help to explain why patients with diabetes often have difficulty making the necessary lifestyle and dietary changes needed to curb the effects this disease. The researchers found that on standard psychological tests of impulsiveness, diabetic patients of all weights (both overweight and normal weight), had higher levels of impulsiveness than did a control group (with both overweight and normal weight participants). Previous studies have shown that overweight individuals are more likely to score higher on tests of impulsivity than are normal weight individuals. This study attempted to control the potentially confounding factor of overweight participants by including both overweight and normal weight participants in both the control and the test group. Controlling for this confounding factor still yielded results suggesting that individuals with diabetes are more likely to be impulsive than are individuals without diabetes, regardless of their weight, although a causal relationship could not be established. Regardless, this study could help to explain why many diabetics have difficulty making proper lifestyle choices in order to maintain their health.
Reference: Gever, John. (2010, February 12). Diabetes Tied to Poor Impulse Control. MedPage Today. Retrieved Feburary 20, 2010 from http://www.medpagetoday.com/PrimaryCare/Diabetes/18448.
Eriene-Heidi Sidhom is the 2009 - 2010 News and Analysis Editor.
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