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16-12-2012 | Article

Global medical news in review: December 9-15, 2012

medwireNews: A roundup of select stories of interest to US physicians from the MerckMedicus Medical News wire.

Let the muscles just ride

Approximately 10 years ago studies began to find that the universal ritual of stretching before exercise resulted in poorer performance. Athletes who did a lengthy pre-excursion stretch could not jump as high, run as fast, or hit a golf ball as hard after stretching.

Research even found that static stretching could make the nervous system a bit tense, which would transfer to the muscles.

Other studies found that the effects of stretching all depend on degree and sport. It seems that holding a stretch for a long, uncomfortable period of time (longer than 1 minute) could have detrimental effects on subsequent performance compared to shorter stretches (less than 30 seconds), which do not notably improve performance either.

Contributing to the ongoing debate is an Italian study, which seems to support the stretch-less argument; a series of 45-second stretches before high-intensity cycling led to reduced efficiency and stamina.

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A poised treatment option

Depression has been described as a disorder of impaired emotion regulation, which makes it difficult for affected individuals to control complex psychological processes involving cognitive, physiologic, and behavioral components.

This lack of control often results in an attention bias toward negative material and rumination.

But a German study now suggests that targeting emotion regulation may be a worthwhile option for improving treatment outcomes after finding it plays a role in skill improvement and the reduction of depressive symptoms as patients undergo treatment.

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Every little particle counts

Fine particulate matter is less than 2.5 microns in diameter and is believed to pose the greatest health risk in the context of air pollution. By being approximately 1/30th of the average width of a human hair, they are able to lodge deeply into the lungs and stay there.

Combustion activities are the main source of fine particles, such as motor vehicles, power plants, and wood burning. Since the implementation of the Clean Air Act 30 years ago, the average concentrations of both fine and coarse particulate matter have fallen with a notable gain in life expectancy.

Now a Harvard study - the largest to date to explore the health benefits of air pollution reduction - finds that further decreases in fine particulate levels since 2000 are still improving life expectancy.

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Treating hypertension's nuances

Obesity and hypertension almost always co-occur. But the link between body size and hypertension is not as straightforward as a linear relationship, due to numerous other physiologic effects that obesity brings.

According to a Lancet editorial, obesity has a large impact on hemodynamics, neuroendocrine, and metabolic processes. An overabundant amount of body fat also demands higher cardiac output per metabolic demand, causing vascular resistance to actually be lower in an obese patient than a lean patient suffering from hypertension.

To further explore the disparate nature of hypertension in normal weight versus obese patients, a study in the same journal sought to see how a diuretic-based antihypertensive regimen and calcium channel blocker-based regimen compared in providing cardiovascular protection.

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Drug adherence and God

An important component to disease outcome is the degree of patient adherence to a drug prescription. Unfortunately, medication nonadherence is becoming all too common and a mounting concern to clinicians, healthcare systems, and payers since it is associated with harmful effects and pricier costs of care.

Studies that attempt to measure and understand the nature of patient adherence are relatively sparse. Yet it is understood that poor adherence is often due to reasons that can be deliberate or nonintentional: a patient can either be careless or neglectful about their treatment regimen, or consciously consider the risks and benefits of treatment versus its adverse effects.

While most cases of medication nonadherence are in the form of sporadic oversight or delays, a recent study considered another nuance to the issue that is the belief that God determines health outcomes.

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By Peter Sergo, medwireNews Reporter