UAB Magazine Weekly - Features on Health Care
Analyzing a New Prescription for Cardiovascular Disease
By Kathleen Yount
If you don’t already have a bottle of statins in your medicine cabinet, there could be one in your future. This class of cholesterol-lowering drugs has been so successful in treating millions of Americans with high cholesterol and heart disease that momentum is gathering to broaden its use: In March, the pharmaceutical company AstraZeneca secured the government’s permission to market its statin medication, rosuvastatin (Crestor), to some groups of people who don’t even have high cholesterol.
The move was prompted by a 2008 study called JUPITER, which showed that taking rosuvastatin reduced participants’ risk of death by 20 percent. The drug also reduced the incidence of major cardiovascular events in men 50 years and older and women 60 years and older who had “near optimal” LDL—a.k.a. “bad”—cholesterol levels (less than 130 mg/dL) and no history of cardiovascular disease or diabetes, but did have elevated levels of high sensitivity C-reactive protein (see “Do You Need a Statin?”).
The interpretation of the JUPITER study results has been hotly debated in the scientific community. Some say the effects are statistically significant but don’t have much clinical impact for people at normal risk. Others, such as UAB cardiologist Vera Bittner, M.D., argue that many people who do not fall into a high-risk category in the near term still have a significant lifetime risk of heart disease, and that early medical intervention could be the key to preventing premature death and disability in these populations.
Bittner says that there’s good reason to consider broadening the prescription of statins: Our nation is at higher risk for cardiovascular disease than we think it is.
Examining the Draw of E-Cigarettes
By Tara Hulen
E-cigarettes offer a nicotine fix without the toxic smoke of traditional cigarettes, but are they really a healthier alternative to smoking?
Cherie wants to quit smoking—again. As with a lot of former ex-smokers, this busy Birmingham businesswoman found that stress triggered a relapse. But she doesn’t yet feel ready to give quitting another try, so, in the meantime, she has chosen what she sees as a healthier option: electronic cigarettes.
E-cigarettes, as they are called, are becoming a popular intermediary step for smokers looking to gradually kick the habit—and for those, like Cherie, searching for a less toxic, less offensive substitute in the interim. The basic e-cigarette design has a tan mouthpiece designed to look like a cigarette’s filter and an LED light on the tip that can glow when active. When a smoker breathes in, a battery-powered internal atomizer creates a water vapor that draws nicotine into the mouth from a replaceable cartridge.
Answers About a Dangerous Allergy
By Kathy Seale
It’s a sign of the times: Across America, the entrances to many elementary-school classrooms are now guarded by the image of a large peanut trapped behind the red circle and slash that is the international symbol for “NO.”
Potentially deadly allergic reactions to peanuts have become a serious issue at schools, birthday parties, and anywhere else children and food mix in uncertain ways. And according to a heavily publicized study in the May 12 issue of the Journal of Allergy and Clinical Immunology, the problem is getting worse. Based on a 5,300-household survey, the study reported that the number of peanut allergies more than tripled over 10 years, from 0.4 percent of children surveyed in 1997 to 1.4 percent of children surveyed in 2008.
Extrapolating those findings nationwide is problematic, says UAB pediatric allergist and immunologist Prescott Atkinson, M.D. But the number of confirmed cases of peanut allergy in the United States is trending upward, he agrees.
New UAB Treatment Dispels Depression with Magnetism
By Bob Shepard
UAB is the first medical provider in Alabama to offer repetitive Transcranial Magnetic Stimulation treatments to patients suffering from depression. To learn more about this new form of therapy, click here.
Julia Rogers has battled depression for two decades. It has caused serious issues in her life, both personally and professionally. She tried medications—lots of them—with no real effect. Most days, she had to struggle just to function at all.
Depression is a difficult illness to treat because no single therapy works every time in every patient. Psychiatrists now have very good medications to offer, but many patients still find little relief. Psychotherapy and electroconvulsive therapy (ECT) are also successful for some patients, but they do little for others.
That’s why UAB psychiatrist Bates Redwine, M.D., is so excited about the university’s new repetitive Transcranial Magnetic Stimulation, or rTMS, device. This non-invasive treatment delivers a series of highly focused, MRI-strength magnetic pulses to a particular area of the brain linked to depression—the left dorsolateral prefrontal cortex. The Food and Drug Administration approved rTMS therapy within the past two years, and UAB’s device is the only one in Alabama.
“The left dorsolateral prefrontal cortex is known to have decreased activity in depressed patients,” says Redwine. “rTMS seems to ‘wake up’ the neurons, stimulating them to fire and become more active.”
UAB Travel Medicine Expert Joins Global Health Panel
By Troy Goodman
David Freedman is a new member of the Roster of Experts for the World Health Organization International Health Regulations.
Disease knows no boundaries, and neither does David O. Freedman, M.D. At any time, the director of UAB’s Travelers’ Health Clinic could get a phone call summoning him to Europe to help stop a global epidemic.
Freedman isn’t a superhero. He’s an expert in travel medicine—and a new member of the Roster of Experts for the World Health Organization (WHO) International Health Regulations (IHR). A comprehensive set of rules and procedures endorsed by the 193 WHO member states, the IHR is designed to limit the worldwide spread of diseases and other public-health threats while minimizing disruption to travel, trade, and economies. “The emergence of H1N1 influenza in 2009 and SARS in 2003 demonstrates how interconnected the world has become and how rapidly a new disease can spread,” Freedman says.