The doctors used this therapy among diabetic patients aged 55 or older and any patients with coronary artery disease.

The blood pressure medications used were either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. The most common set of drugs patients took were lovastatin (40 mg/day), lisinopril (20 mg/day), and a low dose aspirin.  Doctor’s evaluated each patient to make certain that there was no reason they should not be taking any of the prescribed medicines.

Patients taking the “bundle” of cheap meds had a much lower rate of heart attacks and stroke that those who did not.  In their paper, the doctors who did the study argue that these relative cheap old medicines can clearly be extremely effective, and perhaps it’s more important to help patients take their medications regularly, than to try and develop new drugs with slight benefits over the old ones.

We all love the idea of having “wonder drugs” that wipe away our ills, but if we don’t take our medications regularly, how can we expect to get the benefits?

The study looked at more than 2000 patient visits from members of a Minnesota health plan that paid for patient visits to such clinics for more than five years.  They analyzed how retail clinic patients were treated for: ear infections, sore throats or urinary tract infections.  That information was then compared to data about patients treated for the same problems, but at doctors’ offices, ERs and urgent care centers.

“The costs of care in retail clinics were 30 to 40 percent lower than in physician offices and urgent care centers and 80 percent lower than in emergency departments,” the study found. Ouch.  That’s a lot of dollars.

Meanwhile, the quality scores retail clinics received: “Were equal to or higher than those of other care settings,” according to the study.

CVS, Walmart, and Walgreens are among the companies now running retail clinics.  These new “convenience” medical clinics have been attacked by medical associations around concerns that they might provide poor care.  Apparently, that worry isn’t supported by the data.

Because they are being watched so closely and judged, the staff at these clinics might even be especially cautious. That’s just a theory.

Having all your care at one spot is usually the best idea, as well as forging a good relationship with your doctor. But retail clinics seem offer a valuable option to people who can’t afford the ideal.

For more, see this Time story.

Part of the problem is that people tend to touch their faces a lot.  Disease-causing germs can infect people through the moist tissue of the mouth, nose and eyes, as well as through breaks in the skin.

Keeping your hands clean breaks the cycle.  In one study of college students the “risk of getting sick was 20 percent lower in the dorms where hand hygiene was emphasized, and those students missed 43 percent fewer days of school.”

Kids might not like hearing that, but definitely the moms, dads, teachers, and others who come into contact with them will.

The U.S. Center’s for Disease Control (CDC) has encouraged people to get their seasonal flu vaccines as soon as possible, although it is possible to get both the H1N1 and seasonal vaccines at the same time.  Possible side effects from both types of flu vaccine are similar, and include: soreness at the injection site, mild fever, body aches, and fatigue. For nasal spray versions of the vaccine, possible side effects include runny nose or nasal congestion, sore throats in adults, and — in children 2 to 6 years old — fever.

According to the FDA release: “As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal.  People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.”

The gene is called  IL28B and it codes for the immune molecule interferon--3. Patients with specific genetic alterations around IL28B are twice as likely to benefit from drug treatment compared to other patients.  And it turns out the “good response gene” is much more common in patients of European ancestry compared to those of African-American ancestry.  That helps to explain why many fewer African-American’s respond to the treatment.

According to a Nature press release: “The findings represent the strongest study of predictors of treatment response to date, and may be of immediate clinical use in the development of a test for those considering treatment for hepatitis C.”

These types of genetic tests are relatively easy to make. There are many laboratories around the world that could conceivable create this test within a few hours.  The important thing, says John Compton of GeneDx is that a finding like this needs to be confirmed in another study before most doctors will consider prescribing it.

But treatment for hepatitis C is ardous:  It usually takes 48 weeks of therapy, and the medicines have potentially serious side effects.  If this test does indeed work, it will be extremely valuable to hepatitis C patients who are considering the standard therapy.

After all, some fish are literal depots for the bad chemicals we’ve been dumping in the oceans.  It’s a serious problem because  we also know that eating fish can be good for us. Since motherhood carries so many anxieties with it already, couldn’t we just get some peace over the eating fish thing?

KaBLOOM!  Your wish is answered.  Now there is a site that addresses this dilemma: Fish for Your Health.

State by state, Fish for Health lists the seafood-related advisories you need to be aware of.  It also tells you the nutritional benefits of particular fish, provides details about the specific contaminants that you need to be worried about, and to top it all off, there is a priceless video on how to clean fish.

The site was created by a group at Purdue University that does research on this very topic:  What should you tell pregnant and nursing women about how much and what seafood they should/can eat?

There is also a wallet card with key info that you can print out, or an iPhone application you can download.

Now, if you’re looking for recipes for cooking up that fish, try : LandBigFish,  FishRecipes, or if you want something on the lighter side: CookingLight20SuperFastFishRecipes.

The study looked at three types of patients, the first group was those with no sign of spread to the nodes.  The next group showed very small traces of cancer in their nodes, including “micrometastases” or “isolated tumor cells.”  Half of these patients received more aggressive therapy, including additional drugs and chemotherapy.  The other half did not get aggressive treatment.

The study hoped to answer whether those tiny traces of tumors made a big difference or not.  It seems that they do.  Many more women that were in the second group (i.e. node positive) and got aggressive treatment lived beyond five years.

The authors point out that since the study was begun, doctors are treating this kind of breast cancer more aggressively anyway, so it is likely that most women with these traces of cancers in their nodes are already getting the more aggressive treatment.

If you’ve been diagnosed with breast cancer, ask your doctor about this study and what it means to you.

REFERENCE: de Boere, et al. “Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer,” NEJM, August 13, 2009: 653-663.

The clinics, which are run out of Wallgreens, currently offer a lot of routine services at a very reasonable price, including treatment for minor injuries or illnesses, adult vaccinations, physical exams, and a range of diagnostic tests including those for pregnancy, tuberculosis, and flu.  You can even get a skin tag or a wart removed there.  All their services and some of the prices are listed here. 

The company says it has added nebulizer treatments in direct response to feedback and because respiratory diseases are so common.

Take Care’s staff already treat patients with bronchitis, asthma exacerbations or other respiratory illnesses.  “Offering nebulizer treatments at Take Care Clinics across the country provides our nationally certified clinicians another tool to ensure individuals and families can receive clinically appropriate care where and when it’s needed,” said Sandra Ryan, RN, MSN, CPNP, FAANP and chief nurse practitioner officer for Take Care Health Systems.

These clinics are a Godsend during such hard economic times.  If you’re paying your own health care bills, it’s hard to imagine where else you could get a physical exam for $60.

And, as I noted in an earlier post, Take Care clinics are also offering free health care to some jobless people.  You can find out if you qualify for the program at  www.takecarehealth.com, or by calling l 1-866-Take-Care (1-866-825-3227).

It’s a very touchy subject.

The statistics about teen sexual health released earlier this year by the CDC are depressing:

• There were approximately 745,000 pregnancies among U.S. females under age 20 in 2004.
• About 1 million adolescents and young adults aged 10-24 years  were reported to have chlamydia, gonorrhea, or syphilis in 2006.
• Nearly a quarter of females aged 15-19 years, and 45 percent of those aged 20-24 years, had a human papillomavirus (HPV) infection during 2003-2004.

Recently, The New York Times described how some teens are getting frank answers to their questions about sex through their cell phones:  “Programs in Washington, D.C.; Chicago, Toronto and San Francisco allow young people to text a number, select from a menu of frequently asked questions (“What 2 do if the condom broke”) and receive automated replies, with addresses of free clinics. Last month, California started HookUp 365247, a statewide text-messaging service. The texter can type a ZIP code and get a local clinic referral, as well as weekly health tips.”

The Birds and Bees Text Line is a similar service set up by the Pregnancy Prevention Campaign of North Carolina, in Durham.

Below are the websites recommended by Standford Medical School researcher Sophia Yen, who led the study on accuracy of information about sexual health on websites.

• Go Ask Alice
• Center for Young Women’s Health
• TeensHealth
• Teen Wire

You probably want to take a look at any website before you pass the url over to your teenager.

And remember, giving your teen access to a primary care doctor or nurse practitioner that they trust and feel comfortable talking with is a crucial part of their health care.  A friend of mine whose son had such a pediatrician loves to tell me how even today, at the age of 26, if he has a potentially embarrassing question, her son still calls his pediatrician.

The best part?  The pediatrician always takes his calls.

Besides directing several acclaimed coming-of-age films, such as “The Breakfast Club,” “Ferris Bueller’s Day Off,” and “Sixteen Candles,” Hughes wrote dozens of screenplays including the original “Home Alone,” its sequels, and “Planes, Trains, and Automobiles.”

There is no word yet about whether he had obvious symptoms of heart disease.   According to the American Heart Association (AHA), warning signs include:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness

The AHA points out that chest pain or discomfort is the most common symptom for both men and women, but women are more likely than men to experience shortness of breath, nausea/vomiting, and back or jaw pain.  The organization also cautions that “Even if you’re not sure it’s a heart attack, …tell a doctor about your symptoms.”

The group emphasizes that “Minutes matter!” with a heart attack.  “Don’t wait more than five minutes to call 9-1-1.”

People can seem perfectly healthy but suffer a heart attack because of blocked arteries. Last year renowned television journalist Tim Russert died of a heart attack at age 58.  Marathoner Jim Fixx’s death at age 52 also brought attention to this health problem. Russert had been diagnosed with heart disease before his sudden death and Jim Fixx had a family history of the condition, which can be an important factor with heart disease.

A healthy lifestyle is the key defense against heart attack, the AHA recommends “heart-healthy nutrition, daily physical activity, eliminating tobacco, controlling diabetes and a commitment to follow your healthcare professional’s recommendations.”  That includes getting any recommended tests, such as those for cholesterol and high blood pressure. Having high blood total cholesterol, a low HDL, high blood pressure, and smoking are the leading predictors of heart disease.

For more information on preventing a heart attack or other useful information about this condition visit the AHA website at www.americanheart.org.