Health Updates 31 July 2012

  • Obese‘ label may not apply to heavy ex-NFL players: “Standard definitions of obesity, which are based on height and weight, may not apply to former National Football League players and other groups with greater muscle mass, according to a new study.  ‘We found [body-mass index] to overestimate the number of obesity cases in a population of retired professional football athletes,’ Dr. Mark Human and colleagues from the University of California, Los Angeles, said in a new release from the American College of Occupational and Environmental Medicine.  The study was published in the July issue of the Journal of Occupational and Environmental Medicine.  Critics of the widespread use of BMI to determine obesity have noted that highly fit athletes such as New England Patriots quarterback Tom Brady would be considered overweight using that measurement alone.  Researchers compared several measures of obesity among a group of nearly 130 former NFL players who had retired up to 32 years before the study began.  Based on the standard definition of obesity — having a BMI of 30 or higher — 67 percent of players would be considered obese.  The former plays also underwent a test called dual-energy X-ray absorptiometry, or DEXA, to provide a detailed measurement of their fat and lean body mass.  The researchers noted the DEXA cutoff point for obesity is 25 percent body fat, or 27 percent for those older than 40.  Based on this measure, only 13 percent of the retired athletes were classified as obese.  The study concluded that DEXA may provide a more accurate measure of obesity in this unique population…The longer a player’s NFL career, the more likely they were to be obese by either definition, the researchers found.  Those with a BMI of 30 or more also were more likely to have obstructive sleep apnea, a common obesity-related condition.” (HealthDay)
  • Panel advises against routine treadmill stress tests: “Every year, hundreds of thousands of older Americans get on a treadmill in a doctor’s office and walk or jog as an electrocardiogram monitors their heart function.  But a growing number of medical authorities  would like to make routine screening using the procedure, known as the treadmill or exercise stress test, largely a thing of the past.  On Monday an expert government panel, the United States Preventive Services Task Force, joined the call by recommending against routine testing with electrocardiograms, or EKGs, in people who have no known risk factors or symptoms of heart disease, like shortness of breath or chest pains.  The recommendations, published online in Annals of Internal Medicine, made the test the latest addition to an expanding list of once routine screening tools that have fallen out of favor.  Earlier this year, the task force advised against regular screening with the prostate specific antigen, or PSA, blood test, long considered the gold standard for early detection of prostate cancer.  The panel has also come out against measures like annual Pap smears for many women and regular mammograms for women in their 40s…The usefulness of the stress test has been questioned for some time, and in April, a group of nine medical specialty boards included it on its list of 45 common tests and procedures that doctors should perform less often.  Their reasoning, like that of the task force, was than problems associated with the test can outweigh its benefit in many people, perhaps even leading to unnecessary harm….An underlying point of the new recommendations is that the emphasis should no longer be on screening people without symptoms, but on keeping coronary artery disease from developing in the first place.” (NY Times)
  • Adverse drug reactions a major cause of unplanned hospitalizations of elderly veterans: “Veterans who are age 65 and older and taking multiple medications for various conditions are at risk of adverse drug reactions (ADRs) that can lead to unplanned hospitalizations.  In fact, a new study reveals that 10 percent of unplanned hospitalizations among this group were related to ADRs.  The study included a group of 678 veterans hospitalized directly from an ambulatory care setting for an unplanned admission.  There were 70 ADRs involving 113 drugs in 68 hospitalizations.  More than one-third (36.8 percent) of these hospitalizations were considered to be preventable.  The researchers estimated that if they applied these findings to the population of more than 2.4 million veterans receiving care during the study period (2003-2006), as many as 8,000 hospitalizations would have been preventable.  Multiple medication use, also known as ‘polypharmacy’,  has been shown to be the most consistent and strongest predictor of ADRs in older adults.  Overall, 44.8 percent of veterans took nine or more outpatient medications and 35.4 percent took five to eight.” (
  • Florida appeals ruling on gun gag law: “The state of Florida is appealing a federal judge’s ruling that halts implementation of a law preventing doctors from asking patients and families about guns in the home.  ‘This law was carefully crafted to respect the First Amendment while ensuring a patient’s constitutional right to own or possess a firearm without discrimination,’ Florida governor Rick Scott (R) said in a Monday press release announcing the appeal, which was filed by the state Department of Health.  ‘I signed this legislation into law because I believe it is constitutional and I will continue to defend it’.  Scott signed the measure, known as the Firearms Owners’ Privacy Act, on June 2, 2011.  The law made it illegal for physicians to ask patients about guns in their homes; violators faced $500 fines and loss of their medical licenses.  A few days after Scott signed the bill into law, medical groups filed suit to overturn it….In September 2011, US District Judge Marcia Cooke ruled the law unconstitutional.  In her 22-page opinion, she ridiculed the arguments by state officials that the law is necessary to protect gun rights.  ‘Despite the State’s insistence that the right to ‘keep arms’ is the primary constitutional right at issue in this litigation, a plain reading of the statute reveals that this in no way affects such rights,’ she wrote.  Appointed in 2004 by President George W. Bush, Cooke asserted that, instead, the legislation clearly violated both physicians’ and patients’ right to free speech….Pediatrics groups have recommended that physicians ask patients whether they keep guns at home, and discuss gun safety with those that do in order to prevent shootings involving children.  In 2009, according to the CDC, nearly 400 children younger than 15 were killed by firearms.  But gun-rights advocates contended that such questions are an invasion of patients’ privacy and an infringement of Second Amendment rights.”.  Cooke disagrees strongly.   “Although some people may be ‘offended or uncomfortable’ at the mere question about gun possession, Cooke added, there is not a compelling government interest in protecting them from such discomfort.” (Joyce Frieden, MedPage One)

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