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24-02-2013 | Article

Global medical news in review: February 18–24, 2013

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

Quantity versus quality

Eating fruits and vegetables undoubtedly provides health benefits with their high amount of phytochemicals helping to protect against cardiovascular disease, cancer, hypertension, and Type 2 diabetes.

Recently, a technique that is increasingly being used to boost the concentration of this healthful product in fruits and vegetables is environmental stress, such as low mineral availability, which is conducive to oxidative stress and the production of secondary metabolites.

To test whether the moderate stresses that organic farming techniques inherently apply to vegetable and fruit crops enhances the production of phytochemicals, a PLoS ONE study compared quality parameters of tomatoes that were cultivated organically and conventionally at local farms in Brazil. While conventional growing systems won the brawn category, organic farms still produced fruit with higher concentrations of soluble solids and phytochemicals, such as vitamin C and total phenolic compounds.

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Controlled passage

Protein pump inhibitors are often the go-to option to reduce the production of stomach acid in people with gastroesophageal reflux disease (GERD). Yet, almost half of patients with GERD have only a partial response to this class of medication.

To check whether an alternative therapy for GERD is effective, a New England Journal of Medicine study evaluated a new magnetic device that was designed to augment the lower esophageal sphincter.

The novel implant lessened esophageal acid exposure in patients while enabling them to reduce their drug therapy. The string of beads that prevents abnormal opening of the sphincter opens the possibility of improving the lives of partial responders.

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Function over form

The Consultation and Relational Empathy (CARE) measure evaluates one-on-one doctor-patient consultations based on a quick 10 questions that patients must answer. It is designed to measure patient satisfaction with their clinician's level of empathy.

To evaluate whether advanced communication skills training (ACST) significantly increases the empathetic expressions of clinicians according to patients' perspective, a European Journal of Cancer Care used the CARE measure to see if the course had any impact.

Counter to what the researchers expected, completing a 3-day ACST course did not lead to clinicians having higher scores in relational empathy. The authors theorized that practical issues might have "overshadowed" the niceties of the instruction.

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Stationary peril

The current mantra of maintaining a healthy lifestyle is balancing one's energy intake and expenditure. Today's modern, sedentary people who work hard in a cubicle often expect to make up for it by also working hard in the gym and give it their all for an hour.

But this thermodynamic view of our corporeal temples is becoming less valid as more evidence is showing that daily physical inactivity from sitting at our desks and on our sofas is itself a risk factor that is related to adverse changes in our metabolism. Even worse, this unhealthy impact sustains no matter how much we sweat at our 45-minute spin class.

Confirming that excessive sitting time indeed increases health risk, a PLoS ONE study found that an hour of daily physical exercise cannot make up for negative effects of inactivity on insulin level and plasma lipids if the rest of the day is spent off our feet.

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Deadly preventative

When it comes to calcium, our bodies do not mess around. The mineral is one of the most abundant in our body while serum levels are closely regulated in various ways. Its importance is reflected by the fact that low intake is associated with a greater propensity for bone fractures and secondary hyperparathyroidism.

This is why more than 60% of middle aged and older women in the USA are avid users of calcium supplements. Yet taking this healthy initiative to stave off bone weakness in old age has a sobering down side as numerous studies have tied this mode of boosting calcium to ischemic heart disease and stroke.

A study in the British Medical Journal did not brighten the picture when it assessed this flip side to bolstered calcium intake; women who used calcium supplements when they already consumed sufficient amounts from their daily diets had an increased risk for death from all cause and cardiovascular disease.

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By Peter Sergo, medwireNews Reporter