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02-12-2012 | Article

Global medical news in review: November 25 - December 1, 2012

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

Bitter news for a bitter fruit

Grapefruit's reputation as a healthy breakfast choice is quickly being overshadowed by a Canadian study that lists several drugs that potentially interact with the citrus fruit. The effects are often adverse, ranging from respiratory depression to gastrointestinal bleeding, say the researchers in the Canadian Medical Association Journal.

Despite grapefruit juice being the first documented juice to interact with drugs, not all the blame should fall on this bitter, subtropical fruit. Increasingly, new chemicals are being introduced into drugs that can interact with the produce, multiplying the number of adverse side effects as a result.

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Forecasting the fickle, injured brain

Traumatic brain injury (TBI) is one of the leading causes of death and disability. A reliable way to predict survival and functional outcomes after TBI would serve patients and practitioners well in guiding treatment, counseling, and rehabilitation.

But no two injuries are the same. The varied nature of TBI makes it difficult for scoring systems to consistently forecast the outcomes of an injury. Amplifying this heterogeneity are a patient's unique premorbid state and physiologic reserve as well as endpoints that are difficult to define.

Yet a multicenter study in Anesthesiology found an approach that is highly predictive for poor outcomes 1 year after TBI. By applying quantitative diffusion tensor imaging, French researchers were better able to predict outcomes compared with in the IMPACT study - another research effort to improve TBI treatment.

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The marginalized future smoker

To assess how the adolescent school phase might impact future smoking habits, Swedish researchers have compared juvenile social success to the number of cigarettes 13-year-olds smoke per day in young adulthood.

While other studies have looked at peer status in relation to health-related behavior, this one gauged status through classmates inadvertently gauging other's popularity rather than self-assessing ones own attractiveness as a friend.

The study, published in Addiction, concluded that the effect of marginalized adolescents belonging to a "lower peer status" could impact later choices and encourage controversial, non-conformist behaviors, such as smoking.

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Stoking fears of prostatectomy

According to the American Urological Association, most men over the age of 50 years fear the side effects of prostate cancer treatment enough to prevent them from getting screened. Indeed, prostate cancer usually hits during a period when men's hormonal, sexual, and erectile functions are on the decline - and after prostatectomy, erectile dysfunction is immediate and recovery is slow.

Looking into this matter in greater detail, a Journal of Urology study conducted an unprecedented 8-year follow-up of men who tried intracorporeal injections (ICI) to treat post-prostatectomy erectile dysfunction.

Less than half of those surveyed claimed to still be satisfied with the treatment years after surgery. The survey also found that pre-operative baseline erections and degree of post-operative decline in sexual dysfunction also played into the motivation to try ICI.

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Another downside to unemployment

The last few years of economic struggle have injected fear into the hearts of many. Now, a study shows that unemployment, multiple job losses, and only brief periods of work are actually taking a toll on the ticker.

Researchers found that unemployed people were at a significantly higher risk for acute myocardial infarction (AMI) than those with a steady job. The apex of that risk occurred within a year after unemployment.

Contextualizing the unemployment experience of a patient may provide added nuance to AMI risk factors in addition to other known elicitors to better cater interventions, write the study authors in the Archives of Internal Medicine.

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By Peter Sergo, medwireNews Reporter