Homozygous familial hypercholesterolaemia is a rare genetic disorder in which both LDL-receptor alleles are defective, resulting in very high concentrations of LDL cholesterol in plasma and premature coronary artery disease. This study investigated the use of an antisense inhibitor of apolipoprotein B synthesis, mipomersen, to lower LDL cholesterol.

Patients aged 12 years and older who were already receiving the maximum tolerated dose of a lipid-lowering drug, were randomly assigned to mipomersen 200 mg subcutaneously every week or placebo for 26 weeks.

34 patients were assigned to mipomersen and 17 to placebo. Mean concentrations of LDL cholesterol at baseline were 11·4 mmol/L in the mipomersen group and 10·4 mmol/L in the placebo group. The mean percentage change in LDL cholesterol concentration was significantly greater with mipomersen (?24·7%) than with placebo (?3·3%).

The most common adverse events were injection-site reactions in 76% of patients in mipomersen group vs 24% in placebo group. 12% of patients in the mipomersen group had increases in alanine aminotransferase of three times or more the upper limit of normal.

Inhibition of apolipoprotein B synthesis by mipomersen represents a novel, effective therapy to reduce LDL cholesterol concentrations in patients with homozygous familial hypercholesterolaemia who are already receiving lipid-lowering drugs, including high-dose statins.

References:
Mipomersen, an apolipoprotein B synthesis inhibitor, for lowering of LDL cholesterol concentrations in patients with homozygous familial hypercholesterolaemia: a randomised, double-blind, placebo-controlled trial. The Lancet, Volume 375, Issue 9719, Pages 998 - 1006, 20 March 2010.

CDC video: Health experts suggest that you take several key steps to be protected against injury or illness when travelling to developing nations. This includes packing a health kit, bringing medications, and getting immunizations for safe and healthy travel.

To prevent infections transmitted by acupuncture, infection control measures should be implemented, such as use of disposable needles, skin disinfection procedures and aseptic techniques.

Acupuncture may be risky as needles are inserted up to several centimeters beneath the skin. In the 1970s and 1980s most infections associated with acupuncture were sporadic cases involving pyogenic bacteria.

There is a new syndrome - acupuncture mycobacteriosis - infection caused by mycobacteria that rapidly grow around the acupuncture insertion point as a result of contaminated cotton wool swabs, towels and hot-pack covers. There is a long incubation period and the infection usually leads to large abscesses and ulcers.

References:

Americans work 50% more than the Germans, the French and the Italians. Americans may work more than Europeans because of domestic tax rates - there are lower tax rates in the US than in Europe, and hence working more pays off more in the US. In other words, working longer hours pays off more in the US than in Europe.

This study compares the working hours and life satisfaction of Americans and Europeans using the World Values Survey, Eurobarometer and General Social Survey.

The purpose is to explore the relationship between working hours and happiness in Europe and America. Is it possible that working more makes Americans happier than Europeans?

The findings suggest that Americans may be happier working more because they believe more than Europeans do that hard work is associated with success.

References:
Europeans Work to Live and Americans Live to Work (Who is Happy to Work More: Americans or Europeans?). Adam Okulicz-Kozaryn. Journal of Happiness Studies, 2010.

ProBlogger collected 29 Debates Bloggers Have about Blogging. Some of my responses are listed below, see ProBlogger's site for the complete list. Please share your thoughts in the comments.

RSS Feeds - Full vs Partial Feeds
- My opinion: Full feed.

Comment Sections – Comments vs No Comments
- Comments always open.

The weekly podcast by Johns Hopkins Medicine now has a blog hosted for free at Blogger.com by Google:

Are Doctors Ready for Virtual Visits? Many fear telemedicine will jeopardize the doctor-patient bond. NYT http://bit.ly/7c2RA8

Telemedicine has a place for second opinion when initiated by a physician but primary assessment is more problematic. One successful example of telemedicine is Cleveland Clinic's second opinion service for physicians abroad. For reference, please see our blog post from a few years ago: Cleveland Clinic Offers a Second Opinion Online for $565 http://bit.ly/4NQyer

The accuracy of teledermatology was inferior to real-life clinic dermatology for melanoma diagnosis http://bit.ly/8A4oiu.

Embedded video from CNN Video

CNN Video: Doctor will see you now -- on Webcam. Telemedicine takes a new turn. Now you can see the doctor while you shop, as CNN's Elizabeth Cohen reports.

Sharing powerful stories from his anti-obesity project in Huntington, W. Va., TED Prize winner Jamie Oliver makes the case for an all-out assault on our ignorance of food.

Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus. NEJM, 1/2009.
GIANTmicrobes in Toys & Games section of Amazon.com http://goo.gl/gMrf

In February 2010, the tennis legend was diagnosed with an aggressive form of ductal carcinoma in situ (DCIS), considered the earliest form of breast cancer. Navratilova had a lumpectomy in February, during which her doctors determined that the cancer had not spread to her lymph nodes. She says there is only a "very small chance of it coming back."

Navratilova's cancer was diagnosed during a routine mammogram, after not having one for four years, and she hopes that speaking out will inspire other women to get mammograms.

"The reason I wanted to speak about this is to encourage these woman to have mammograms," she said. "I just want to encourage women to have that yearly check-up."

References:
Martina Navratilova Fighting Breast Cancer

Ben Goldacre's Moment of Genius on BBC4 radio:

"The average American spends a good 100 minutes per day commuting to and from work. That amounts to about 433 hours per year! Now imagine using that time to learn something new — to read a great book, to take a class from a top university, to learn a new language.

We highlight our free audio resources that will maximize your drive time. Before getting started, make sure you have a big mp3 player and a way to listen to your mp3 player over your car speakers."

References:
Getting Smart During Your Daily Commute | Open Culture

Related:

Is there a doctor who wants to spend 3 hours per day on social media while running the risk of being sued?

This useful critical review by a freelance journalist at the NEJMJobs site has a focus on some of the litigation risks inherent to the use of social media in healthcare:

From WebMD:

When investigators treated mice with an experimental drug that stopped the gut from synthesizing serotonin, they were able to reverse severe bone loss and essentially cure osteoporosis in the animals.

Serotonin May Hold Key to Halting Osteoporosis. NatureVideoChannel — February 05, 2010 — A drug that reverses osteoporosis in mice looks like a promising candidate for treating the human version of the disease. Gerard Karsenty and his colleagues at Columbia University Medical Center have shown that blocking the neurotransmitter serotonin--secreted from the gut--promotes bone growth. The research appears on-line at http://www.nature.com/naturemedicine - Yadav et al. Nature Medicine, 7 February 2010. DOI: 10.1038/nm.2098.

Most bone treatments work to block bone loss and make existing bone stronger. One drug, Forteo (teriparatide), does build new bone, but it requires daily injections and is limited to two years of use.

References:
Serotonin May Be a Key to Treat Osteoporosis. WebMD.

Believe or not, but the two current heavyweight world boxing champions both have PhDs... The two researchers are the Ukrainian heavyweight boxers and brothers Wladimir and Vitali Klitschko.

Wladimir Klitschko, called "Dr. Steel Hammer"(born 25 March 1976, Semipalatinsk, Kazakhstan), currently holds the IBF, WBO, IBO and Ring Magazine world heavyweight titles. His older brother, Vitali Klitschko, is the current WBC world heavyweight champion.

In the summer of 1996, Klitschko finished Pereyaslav-Khmelnitsky Pedagogical Institute (Ukraine) and was accepted in the postgraduate study program of Kiev University. On 18 January 2001 in a conference hall of Kiev University of physical science and sports, Klitschko presented his doctoral dissertation and was awarded a Ph.D. in Sports Science. Klitschko speaks four languages: Ukrainian, Russian, German and English.

Image source: Wikipedia, GNU Free Documentation License.

Vitali Klitschko, called "Dr. Ironfist", (born 19 July 1971 in Belovodsk, Kirghiz SSR, Soviet Union (now Kyrgyzstan) is a Ukrainian professional heavyweight boxer and the current WBC world heavyweight champion. He has the highest knockout percentage (94.9%) of any heavyweight boxing champion in overall fights.

Vitali is the first professional boxing world champion to hold a Ph.D. In 1996, he graduated from the Pereyaslav-Khmelnytsky Pedagogical Institute (Ukraine) and was accepted into the postgraduate study program at Kiev University. On 29 February 2000, he presented his doctoral thesis on "talent and sponsorship in sports" at the Kiev University of Physical Science and Sports, and his Ph.D. in Sports Science was conferred.

Image source: Wikipedia, GNU Free Documentation License.

References:
Klitschko KOs Chambers to keep titles. CNN.
Klitschko-Chambers round-by-round blog. CNN.
Wladimir Klitschko. Wikipedia.

Vitali Klitschko. Wikipedia.

The BMJ has produced a short video to help you find out about getting research published there. It includes interviews with published authors and clips from some of the short films that accompany important research articles.

Only 27% of men who used Propecia (finasteride) said it was “very” effective. Finasteride is a 5-alpha reductase inhibitor used to treat prostate enlargement symptoms and baldness. Finasteride has 2 trade names: Propecia for baldness and Proscar for BPH.

Over-the-counter minoxidil (Rogaine) is applied directly to the scalp and is the only hair regrowth drug approved for use by women. Just 4% of respondents said it was very effective, with 43% of users saying it was not effective at all.

Only 2% of men surveyed underwent hair transplants; but of these, 49% were either very or completely satisfied with the results of their surgery, the poll shows.

One in five heavy smokers over age 40 have findings of COPD, but only one-third have been previously diagnosed with the common lung disease.

10% of people worldwide over the age of 40 are affected by COPD.

Researchers screened 1,003 people aged 40 and over who were current or former heavy smokers. Heavy smoking was defined as a smoking history of 20 pack-years or more.

The results showed that 20.7% of the people screened met the criteria for a diagnosis of COPD but only 32.7% had previously been diagnosed with the disease or were aware of their COPD diagnosis.

From Wachter's World:

"In 1984, one resident even wrote a letter to the New England Journal of Medicine called “Ripping and Filing Journal Articles,” taking the Journal to task for its habit of beginning an article on the back of the last page of the previous one (which meant the page needed to be photocopied if you wanted to tear both articles out of your personal copy of the journal). Fair point, but talk about a resident who needed to get a life.

Today, as in so many other parts of our lives, the computer, with its magical access to the universe of on-line resources, has democratized the learning of clinical medicine. At UCSF, by the time morning rolls around, the students and interns have often already read the on-line UpToDate synopsis of the topic at hand, and may be as capable of teaching the resident (or attending) about it as visa versa."

For hundreds of years people have practiced the Chinese martial art of Tai Chi for its many health benefits. Researchers who study Tai Chi say it can help reduce blood pressure, decrease anxiety, improve flexibility and much more. For these reasons, some doctors at Mayo Clinic have embraced Tai Chi and are teaching it to their patients.