Despite widespread claims, garlic has not been proven to lower cholesterol. Studies on the effectiveness of garlic have shown conflicting results. A number of the studies indicate that it lowers cholesterol, while other studies show that it has no effect at all.

Dr Christopher Gardner at the Stanford Prevention Research Center, California, enlisted 192 men and women to participate in a study. The patients all had slightly elevated cholesterol (LDL) levels. The range of LDL concentrations in their blood was between 130 and 190 mg/dL.

The study participants were split in to one of four random groups. The first group was given raw garlic, the second a powdered garlic capsule, the third with a garlic extract, and the fourth group took a placebo (sugar pill).The participants who took a supplement equivalent to an average dose of a 4 gram clove of garlic for 6 days per week for 6 months. In the first group that was given raw garlic, the garlic was provided in a sandwich.

Each participant’s blood was tested once a month for the three cholesterol indicators, LDL and HDL cholesterol and triglycerides. The results of the study showed that, statistically, there was no significant effect of any of the garlic treatments on the cholesterol readings.

People who are 65 years of age or older and who have a higher than average caffeine intake are indicated to be a lower risk of coronary vascular disease and also heart mortality than those of the same age with a lower recorded intake. The reason is most likely to be due to the beneficial effect of caffeine on blood pressure. It was also found that the higher their intake, the more beneficial the results except for those who were overly hypertensive.

The same was not found to be true in people below age 65.

Elderly nursing home residents (average 89 years old) taking part in a study were given 800 IUs of vitamin D daily for five months. They were found to take less falls than those who were given lower doses, no vitamin D or a sugar pill placebo. Most participants in the study were white women who had experienced a fall within the previous year.

For the duration of the five-month study, 61 participants, or 59%, suffered falls. The group taking the daily doses of vitamin D daily was the only group to exhibit a reduced fall risk. They were found to be 72% less likely to fall than those taking the placebo. Researchers took other factors in to account including BMI (body mass index and age.

It is recognized that there are many reasons why people fall. Although vitamin D is known to strengthen bones it is not proven to strengthen muscle. The researchers therefore concluded that it's not certain if vitamin D was the only reason for the decrease in falls for residents taking a specific dose of 800 IU of vitamin D on a daily basis.

SOURCES: "Dietary Supplement Fact Sheet: Vitamin D." News release, Blackwell Publishing; Broe, K. Journal of the American Geriatrics Society, February 2007; Office of Dietary Supplements, National Institutes of Health.

At least 25 percent of women suffer from uterine fibroids and as many as 77 percent of women may actually have the condition but be unaware of it, according to the U.S. National Institutes of Health. Although the tumors are benign, there are several uncomfortable and often very painful symptoms such as heavy bleeding, frequent urination, cramping and painful periods. Traditionally, treatment options have included some rather expensive hormonal treatments or even invasive surgical procedures like hysterectomies and myomectomies.

The MRI Imaging of Georgia is a medical center that now offers a non invasive outpatient treatment option for the ablatement or the breakdown of uterine fibroids. The procedure itself is performed with a Magnetic Resonance guided Focused Ultrasound device designed specifically for treating uterine fibroids. The procedure offers significant improvement in quality of life for patients as it preserves the uterus and the cervix. Menstrual bleeding and urinary dysfunction are also greatly improved.
Using a magnetic resonance (MR) scanner, the device enables the physician to determine the level of heating and further to track the progress of treatment both during and after the treatment. In addition it allows the doctor to distinguish between treated and untreated tissue and to recognize the three-dimensional boundaries of the fibroid itself and the surrounding organs with exact precision.

During the procedure, the ultrasound waves break the tumor down while the patient lies inside the scanner, which precisely targets the affected tissue. The heat of the ultrasound waves ablates the tumor and the process can be repeated as many times as is needed until the fibroid is completely broken down. As part of a natural process the patient’s body eliminates the unwanted tissue.

On average the treatment is found to last approximately 3-4 hours depending on the size of the tumor. Typically patients are able to return to normal activities within one to two days and report relief from symptoms within 3 months, depending on the size of the original tumor.

A high level of vitamin D in the blood can reduce breast cancer risk by half. Edward Gorham, a professor of family and preventive medicine at the Moores UCSD Cancer Center, and colleagues analyzed data from two previous studies on the response to vitamin D among 1,760 people. The researchers divided participants into five groups based on vitamin D levels. The study found that participants with the lowest vitamin D levels had the highest incidence of breast cancer, while breast cancer incidence among participants who took 2,000 international units of vitamin D daily decreased by half.

The researchers recommend that people take 2,000 IUs of vitamin D daily.

Vitamin D and breast cancer, Journal of Steroid Biochemistry and Molecular Biology

Patients seeking treatments that might be controversial should learn about their medical options and choose physicians accordingly. Some medical professionals do not make their patients aware of all treatment options, including abortion, contraception, or even sedation for dying patients, that they oppose on moral grounds.

A bioethicist at the University of Chicago, Farr Curlin, submitted questionnaires to 2,000 physicians nationwide and received responses from 1,144. The answers provided by the participating physicians showed that 52% were opposed to abortion after failed contraception, 42% to providing contraception to minors without their parents’ consent, and 17% were opposed to "terminal sedation." Further, 8% felt under no obligation to present all the options, 86% believed they should, and 6% were undecided.

The study was prompted by the question of medical professionals who might refuse to provide care that conflicts with their moral or religious beliefs. This would include physicians and nurses who refuse provide an abortion or to prescribe contraception as well as pharmacists who decline to fill prescriptions for birth control or emergency contraception.

According to a survey published in the February issue of Consumer Reports, they polled 39,000 subscribers and 335 primary care physicians selected at random from a national list.

Patients said that their physicians failed to disclose the cost of medications or office visits, and one-third said that their physicians failed to discuss the side effects of treatments. About 19% of patients said that they could not make appointments with their physicians within one week, and 7% said that their physicians did not return test results promptly, the survey found.

Among physicians, 59% said that patients did not follow their advice "completely," and one-third said that many of their patients are not specific about their symptoms, the survey found. A number of physicians also said that patients do not make appointments as early as they should, according to the survey. About 40% of patients said that they researched information about their conditions on the Internet, and 41% of physicians said that such patients were misinformed, the survey found. According to the survey, almost 80% of physicians said that their patients asked for prescription drugs they saw advertised on television, and 40% said that they oppose direct-to-consumer advertisements for medications.

Generic-drug utilization exeeds 60 percent in Medicare Part D. The high generic dispensing rate in Medicare Part D is helping to keep Part D premiums and program costs lower than originally forecast. In recent months, numerous studies have shown the important role that increased use of generic drugs can play in lowering health care costs. In addition, competition from generic alternatives helped contribute to prescription drug-spending growth rate in 2005 slowing to its lowest growth rate in over a decade, rising just 5.8 percent.

Despite FDA's recent approval (November 2006) of silicone breast implants, there still are considerable risks that women must consider before walking into the operating room. The FDA approval stipulates that the manufacturers inform women that the implants are not lifetime devices and that most recipients will need at least one additional surgery to replace or remove their implants. In addition, women also will need to receive magnetic resonance imaging every two to three years to ensure the implants are not leaking.

The medical community does not have a clear picture of how many women have become sick due to a leaking implant. Silicone that leaks into the lymph nodes poses greater risks than leaking saline. Requiring silicone manufacturers to conduct a study on the implants long-term effects after the approval is the greatest indicator that the FDA has proceeded too quickly. Women considering the implants need to be fully aware of the lack of data showing these implants are safe.

Texas Gov. Rick Perry (R) signed an executive order mandating that girls entering the sixth grade receive a human papillomavirus vaccine beginning in September 2008. Merck's HPV vaccine Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases.

Perry said that parents who do not want their daughters to receive an HPV vaccine "for reasons of conscience, including religious beliefs," will be able to opt out of the requirement. Last year, 1,169 new cervical cancer cases were reported and about 400 women in Texas died from the disease.

The U.S. has a shortage of geriatric care physicians, in part because salaries for the field are lower than for other specialties. There are fewer than 7,000 geriatricians in the U.S. About 14,000 are needed to meet demand, according to experts. The shortage is expected to worsen as baby boomers age and require care. Annual salaries of geriatricians average about $150,000, while other specialists, such as radiologists or orthopedists, can earn more than $400,000 per year.

In addition, many medical schools have inadequate training in geriatrics because often they have assumed students learn about geriatrics by treating older patients on hospital rounds. As a result, some physicians do not understand the different needs of an elderly patient. With the shortage expected to worsen, geriatricians will likely be reserved for seniors with the most complicated problems, and "nternists and family practice physicians will continue to serve most old people.

Despite the claims that tv ads play an educational role, they contain limited information about causes and symptoms of their target illnesses, their prevalence and risk factors. They also show people that have lost control over their social, emotional or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting public health.

We're seeing a dramatization of health problems that many people used to manage without prescription drugs. The ads send the message that you need drugs to manage these problems and that without medication your life will be less enjoyable, more painful and maybe even out of control.

Should we consider banning direct to consumer tv advertising of prescription drugs altogether?

Under value based insurance design costs would be lowest for those for whom the benefit is strongest and vice versa, with higher costs for services where the proof of benefit isn't strong. With VBID, a person with diabetes would pay little for drugs that can delay diabetes-related health problems, and for eye and blood tests that can spot those problems early. And employees in their 50s might get free or low-cost colonoscopies, to spot pre-cancerous polyps and treat them before they become cancer. While a person making a doctor visit with flu symptoms might pay the maximum copay.

One prominent example is the University of Michigan, where 2,200 diabetic employees and dependents are receiving free or reduced-cost medications and tests as part of a pilot project, designed to test the VBID principle rigorously including its ability to encourage patients who aren't yet taking beneficial medications to start taking them and to stick with them. For instance, people with diabetes are known to receive great benefit from taking inexpensive blood pressure drugs called ACE inhibitors but most of them aren't using the medications. The U-M project is looking at whether "free" availability of select medications will help encourage their appropriate use.

Other examples cited in the new paper include the Pitney Bowes Corporation, which has reported saving money by lowering co-pays for asthma and diabetes medicines across the board, and the city of Asheville, NC, which showed increased adherence to recommended diabetes medications and tests, and decreased sick leave and health costs, after reduced co-pays and other programs were put in place for employees with diabetes. Both illustrate the potential of the VBID approach.

Among the challenges to implementing VBID -- the initial short term increase in cost that would result from increased utilization of medications and tests by appropriate patients, and the lack of research on many health issues that would steer the tailoring of insurance plans to reduce costs for those who stand to benefit most from any one test or treatment. If these issues can be surmounted, the VBID approach could lead to better health and perhaps cost savings in the long term.

Patients treated at the top 5% of U.S. hospitals are 28% less likely to die and 5% less likely to experience complications than those treated at other facilities in the nation, according to a study released on Monday by HealthGrades.

For the study, researchers analyzed mortality rates for 26 medical procedures and diagnoses -- such as bypass surgery, angioplasty and heart attacks -- among almost 39 million patients treated from 2003 through 2005 at all 5,122 U.S. hospitals not operated by the federal government. The top 5% of hospitals reduced their mortality rates by an average 11.7% over the three-year period, the study found.

According to the study, in the event that all hospitals provided the same quality of care as the top 5% of facilities, 158,264 fewer patients would have died over the three-year period, and 12,409 fewer would have experienced major complications. Samantha Collier, senior vice president of medical affairs at HealthGrades, said, "The continued gap between the nation's top and poorest-performing hospitals continues."