News in brief - Oct. 3, 2005

NIH offers Katrina help - Obese women should be counseled to lose weight before pregnancy - Patients who choose their own depression therapy do better - Memory loss and brain filters - Holiday drinking and heart disease

NIH offers Katrina help

The National Institutes of Health has opened its round-the-clock telephone medical consultation service to hurricane evacuees. The toll-free number, 866-887-2842, already had been available to health care workers.

The service will make available medical expertise at the NIH, academic medical centers and medical professional societies for environmental or toxin concerns, infectious diseases, tropical medicine and a full range of other illnesses.

"Our goal is to match national experts with care providers dealing with difficult or complicated medical cases," said NIH Director Elias A. Zerhouni, MD.

"We also want to help patients in the affected area who were on clinical trials and receiving treatment."

Obese women should be counseled to lose weight before pregnancy

Because of the increased risk of complications, women who are obese should be advised to reduce their size before becoming pregnant. If they don't, special care is needed to ensure the health of mother and child, according to a committee opinion issued by the American College of Obstetricians and Gynecologists.

The College, which published the statement in the September Obstetrics and Gynecology, also recommended that nutrition and exercise counseling go to all obese women throughout pregnancy and after birth and that screening for gestational diabetes be considered. Obese pregnant women also are more likely to require emergency cesareans, and an anesthesiology consultation in preparation for this possibility should be encouraged.

"In preconception visits, we talk to patients about genetic risks and immunity to rubella, but rarely do we discuss their weight or diet and exercise," said Vivian M. Dickerson, MD, ACOG's immediate past president. "But optimizing your weight before conception is one of the most important things you can do to have a healthy baby."

Patients who choose their own depression therapy do better

People who are depressed and decide on their own treatment improve more rapidly than those whose regimen is chosen by the physician alone, according to a study in the October Annals of Behavioral Medicine.

Researchers at the Dept. of Veterans Affairs Puget Sound Health Care System assessed the preferences of 335 adults presenting to a primary care clinic. Depression was assessed at three and nine months.

Nearly three-quarters received the treatment they preferred, and this was associated with a greater improvement in their disease.

The authors suggest that patient agreement could be an important factor to consider and suspect that some of the improvement might be related to the fact that those who agree with the recommended treatment are more likely to adhere to it.

"The good news is that depression improved for patients in both groups," said Edmund F. Chaney, PhD, one of the authors and a psychologist at the VA Puget Sound Health Care System. "Although we can't say for certain, it might be that the preference-matched patients were better able to stick with the treatment plan."

Memory loss and brain filters

The short-term memory problems that accompany normal aging are associated with an inability to filter out surrounding distractions, not problems with focusing attention, according to a study in the Sept. 11 online Nature Neuroscience.

Functional magnetic resonance imaging studies of the brain showed memory failure owes more to interference from irrelevant information than to an inability to focus on relevant information, according to the study.

"These results reveal that efficiently focusing on relevant information is not enough to ensure successful memory," said Adam Gazzaley, MD, PhD, professor of neurology and physiology at the University of California, San Francisco. Dr. Gazzaley was lead author on the study, which was conducted while he was at the University of California at Berkeley.

The finding could mean that inability to ignore distracting information is at the heart of many cognitive problems that accompany aging, he said. Drugs that target that problem could be more effective at improving memory than drugs that improve focusing ability, he added.

Holiday drinking and heart disease

Heavy alcohol consumption -- 35 or more drinks per week -- can significantly increase men's risk of developing atrial fibrillation, according to a large study published in the Sept. 13 Circulation.

Risk of this rapid, irregular heartbeat was as much as 45% higher among heavy drinkers than abstainers. The findings also support what has become known as the holiday heart syndrome. "Since our research found that the risk of developing atrial fibrillation begins to increase at about four drinks per day, and clearly goes up at five drinks per day, this would seem to confirm what has long been suspected regarding periods of significant alcohol consumption, like during vacations," said Kenneth J. Mukamal, MD, MPH, an internist at Beth Israel Deaconess Medical Center in Boston.

The researchers used information from the Copenhagen City Heart Study in Denmark, obtained from 16,415 individuals with an average age of 50. They controlled for smoking, education, income, physical activity, body mass index and diabetes. Few women in the study were heavy drinkers, so conclusions could be drawn only for men.