It turns out that N95 respiratory masks may be no better than ordinary disposable surgical masks for preventing H1N1 swine flu. In September 2009, researchers reported that only N95 masks could provide significant protection against H1N1. But now, the same group of researchers report that updated results of their research reveal that this is not the case.
These new results were presented at the Infectious Diseases Society of America 47th Annual Meeting in Philadelphia. To date, all of the research on the N95 mask and the H1N1 flu virus has been done in health care workers who have a higher risk of H1N1 exposure than the average person. The good news is – regular disposable surgical masks are a lot less expensive and easier to find than the N95 mask.
So, it seems that, if you want to protect yourself against H1N1 swine flu, the best thing to do is to get your flu shots – both the seasonal flu vaccine and the H1N1 flu vaccine (if you can find it).
Source:
Infectious Diseases Society of America 47th Annual Meeting. Presented 31 October 2009.
According to a new study presented at the American Society for Radiation Oncology 51st Annual Meeting, men with low-risk prostate cancerwho undergo radiation therapy do not need to be treated with hormone therapy. Hormone treatment does not improve survival in this group of prostate cancer patients.
This study, involving 1979 men with prostate cancer, is the largest prostate cancer study to date. Study participants were randomly assigned to receive either hormone therapy plus radiation or radiation alone. After 8 years of follow-up, the overall survival and prostate cancer-specific survival were similar between the two groups of patients. Since hormone therapy can lead to loss of sexual function and liver toxicity, being able to skip hormone treatment means fewer adverse side effects for low-risk prostate cancerpatients.
This new study definitively establishes that there is no benefit to hormone therapy in men with low-risk prostate cancer. On the other hand, short-term hormone treatment does improve survival in men with intermediate-risk prostate cancer. This study is the first to demonstrate compelling evidence of survival benefit in men with intermediate-risk patients with prostate cancer. However, the radiation doses and techniques used in this study are outdated, and it may be that the higher doses of radiation that are given now would eliminate the need for hormone therapy.
Source:
American Society for Radiation Oncology (ASTRO) 51st Annual Meeting, Presented 2 November 2009.
Depression does not become more common as you get older, but it may become more complex. Recent findings on age and depression confirm the so-called ‘U-curve’ of well being and happiness over the human life cycle. Put simply, we’re at our most dissatisfied in our mid-forties – a finding that’s so in 47 of 55 countries surveyed. Depression seems to have much less of an impact in terms of daily disability in the older age groups.
But depression in the elderly is complicated by other diseases and it’s often hard to sort out cause and effect. Do you get depressed because you’ve had a heart attack? Does depression make it more likely that you’ll get diabetes? We really don’t know! Elderly depression is not so much about the numbers of people who are depressed, but more a matter of knowing how best to treat it. Higher costs in terms of time, money and health care resources are involved in treating elderly depression and, too often, such resources simply aren’t adequate. Moreover, the growing number of people over 60 (and, proportionately, even more so those over 80), means that elderly depression is set to rise dramatically. As yet, society seems unprepared for this. Recent findings from the Zürich Study of younger persons (stretching over 20 years and with an age range of 20-41) have pointed to high levels of chronic depression existing alongside heart and lung problems, insomnia, pain (other than backache and headache) and sexual problems. Interestingly, the authors ascribe the heart and lung problems in this age group as probably ‘associated with increased anxiety’.
In the elderly, by contrast, depression tends to exist alongside age-related conditions like stroke, high blood pressure, atrial fibrillation, diabetes, cancer and dementia.
The Zürich Study also found that other mental health problems co-exist with depression in the 20-41 age group. The six leading risk factors were found to be tobacco dependence, substance abuse, generalized anxiety disorder, obsessive-compulsive syndrome, panic attacks and alcohol use disorder. Again, with the exception of anxiety, these are probably more prominent risk factors for depression in younger persons than for the elderly. The psychosocial impact of bereavement, loneliness and growing physical and cognitive problems in coping with the normal activities of daily life are more characteristic associations with depression in old age.
The next article in this series looks at current practice in the diagnosis and treatment of elderly depression.
Sources:
J. Angst, A. Gamma et al, “Long-term depression versus episodic major depression: results from the prospective Zürich study of a community sample”, J. Affective Disorders 115, 112-121, 2009
N. G. Choi & J. S. Kim, “Age group differences in depressive symptoms among older adults with functional impairments”, Health & Social Work 32[3], 177-188, August 2007
Researchers from the University of Sydney in Australia sampled 973 patients presenting to primary care with complaints of low back pain of less than 2 weeks’ duration. Of these patients, 406 participants went on to experience low back pain for three months. The researchers found that, among those participants who developed chronic low back pain, 35 percent were pain-free at nine months and 41 percent were pain-free at 12 months. Delayed recovery was linked to previous sick leave due to low back pain, high disability or pain intensity levels, lower levels of education, and greater perceived risk of persistent pain.
It is estimated that 11 to 84 percent of people will experience chronic low back pain at some point in their lives. Based on the findings of this study, many patients with recent onset, non-radicular chronic low back pain will recover fully within 12 months. A limitation of this study was that it only included Australian participants. However, this study does offer a moderately optimistic outlook for patients with chronic low back pain, as long as they do not have the characteristics associated with delayed recovery.
In order to examine the theory that mid-life weight gain was associated with poorer health status among those who survived to older ages, investigators from the Harvard School of Public Health and their colleagues studied 17,065 women enrolled in the Nurses’ Health Study who were free from major chronic disease at mid-life and who survived until at least the age of 70. Of the study participants, 1686 met the criteria for healthy survival, which was defined as having no history of 11 major chronic diseases and having no significant cognitive, mental, or physical limitations. The investigators found that increased body mass index (BMI) was significantly associated with a reduced probability of health survival. Women with a BMI of at least 30 had 79 percent lower odds of healthy survival than women with a BMI of under 23. In addition, the greater the weight gain from age 18 until mid-life, the less likely was healthy survival after the age of 70. Women who had a BMI of 25 or more at age 18 and experienced a weight gain of at least 10 kilograms had the lowest likelihood of healthy survival.
This study highlights the importance of maintaining a healthy weight from early adulthood and avoiding weight gain, especially for women, as obesity at mid-life is a strong risk factor predicting a lower probability of healthy survival. It seems that maintaining a healthy weight throughout adulthood may be associated with optimal overall health at older ages. As more and more Americans are living longer and longer, the implications of this study grow increasingly important.
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November 5th, 2009 
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