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Herman J. Woltring
03-14-1990, 07:05 AM
Dear Biomch-L readers,

The following items were selected from Volume 3, numbers 5 - 8 of MEDNEWS,
available from LISTSERV@ASUACAD.BITNET (Feb - March 1990).

(1) Medical News

(2) Article: Progress in Chronic Disease Prevention -- Prevalence of
Arthritic Conditions -- United States, 1987

With kind regards -- Herman J. Woltring.

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(1) Medical News

Copyright 1990: USA TODAY/Gannett National Information Network
Reproduced with Permission
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NECK CAUSES ANGINA-LIKE PAIN:

Angina-like chest pains are often caused by neck injuries and can be
treated without surgery, says a New York State Journal of Medicine report.
Findings: Of 164 patients with cervical angina (also called pseudoangina), 145
had suffered whiplash in car accidents, 10 had been injured at work. The
symptoms of neck and arm pain and headache can be relieved by traction.

ATHLETE ALCOHOL USE A PROBLEM:

High school coaches nationwide cite alcohol abuse by their athletes as a
bigger problem than drug abuse, a USA TODAY poll shows. Findings: 88 percent
of 798 coaches called liquor the greatest threat to their players, 6 percent
cited cocaine and/or crack, 1 percent identified illegal steroids. (From the
USA TODAY Sports section.)

FLUORIDATION DEBATE RESPARKED:

A National Toxicology Program study has linked fluoridated water to a rare
bone cancer in rats. Research: Four of 80 rats drinking 79 parts per million
fluoridated water developed the bone cancer, osteosarcoma; one rat drinking
water fluoridated to 45 ppm developed the disease. But no rats drinking
fluoride-free water developed cancer. (From the USA TODAY Life section.)

HYPERTENSION DRUG HELPS BONES:

The elderly over age 65 who take thiazides to treat high blood pressure can
cut their risk to hip fractures by one third, reports Thursday's New England
Journal of Medicine. Reason: Thiazides, a form of diuretics, can prevent
calcium loss. But the drug can cause side effects like high cholesterol and
potassium deficiency. (From the USA TODAY Life section.)

BONE HINTS OF FRACTURE RISK:

Measuring bone density can help predict which older women are most likely
to fracture a hip, reports researchers at University of California-San
Francisco. Findings: Of 9,703 women over age 64, those with lowest bone
density had a threefold risk to hip fractures. The study may help women decide
whether to take the hormone estrogen to aid bone strength after menopause.

SAKHAROV BRAIN TO BE STUDIED:

Russia's Academy of Sciences will study the brain of the late Andrei
Sakharov, human rights activist and father of the Soviet hydrogen bomb,
reports Tass. The Creative Medical Institute in Virginia says very brilliant
people often parallel-think, rather than think serially: An idea may go via
multiple brain pathways to yield more thought patterns. (From the USA TODAY
News section.)

NEW TREATMENT FOR OSTEOPOROSIS:

A promising new drug called calcitonin may be used against osteoporosis as
an alternative to estrogen therapy, reports UCLA scientists. Estrogen-
replacement therapy has been linked to increased breast and endometrial cancer
in older women who often suffer the crippling, bone-thinning disease.
Calcitonin prevents degeneration of skeletal tissue and replaces lost bone.

ELECTRONICS AID FALL STUDY:

Texas Tech University researcher Tom Leamon is using a $300,000 federal
health grant to study how and why people fall, equipping his basement lab with
three video cameras and a minicomputer. Findings: People jerk sideways when
they slip forward; `microslips' up to a centimeter occur every time the foot
connects with the ground. Annually, 200,000 people over age 65 suffer hip
fractures.

MS STUDY NEEDS MORE FAMILIES:

A five-year survey of 600 families nationwide who are affected by multiple
sclerosis will be launched Monday by Montana State University. The goal of the
survey is to see the type of stress families of MS patients encounter and
develop ways to help them. The study, however, needs more families to
participate.

DRUGS COULD INHIBIT BONE LOSS:

Researchers say that new drugs could play an important roles in prevention and
treatment of osteoporosis, a bone loss disease that affects mostly women in
the menopausal stage. Two drugs are being studied in greater detail: Salmon-
calcitonin and Bisphosphonates. Researchers say the best preventor of bone
loss is still calcium and exercise. (From the USA TODAY Life section.)

DRUGS BEING STUDIED:

Two drugs being studied as preventors of bone loss are: Salmon-calcitonin,
a synthetic hormone now being used on those who have the disease, known to
slow bone loss in women who have the disease and prevent it in those that
don't; Bisphosphonates, chemicals used for treatment of other bone diseases
that protect the bone from harmful cells.

SKATEBOARDS CAUSE INJURIES:

The American Academy of Pediatrics Committee on Accident and Poison
Prevention warns that the number of skateboard injuries is on the rise once
again. In 1977, there were 150,000 injuries reported. Recommendations: kids
under 5 not skateboard; no skateboarding on homemade ramps or near traffic;
helmets and protective padding for all skateboarders.

NEGLIGENCE KILLS THOUSANDS:

Negligence kills thousands of people in New York hospitals each year and
injures more, reports researchers from Harvard University. Out of 2.7 million
patients hospitalized in New York in 1984, the researchers estimate that 3.7
percent - nearly 99,000 patients -experienced injury because of their medical
treatment. One-quarter of those were considered the result of negligence.

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(2) Article: Progress in Chronic Disease Prevention -- Prevalence of Arthritic
Conditions -- United States, 1987

Arthritis is a widely prevalent, disabling disease that places substantial
demands on health-care resources. National estimates of the prevalence of
arthritic diseases and of associated disability have been based on data from
the 1960-1962 National Health Examination Survey, the 1971-1975 National
Health and Nutrition Examination Survey (NHANES I), and the 1983-1985 National
Health Interview Surveys (NHIS) (1,2). This report uses 1987 NHIS data to
update national estimates of arthritis prevalence and resulting physical
activity limitation and provides estimates of the prevalence of arthritic
conditions for each state. Estimates are based on a probability sample of the
civilian noninstitutionalized (CNI) population of the United States (3).
Survey respondents were asked whether they had had various arthritic
conditions in the past year and, if so, whether they had seen a physician for
them. The national and state estimates reported here are based on the 3036
persons reporting one or more of four conditions: arthritis, bursitis, gout,
and unspecified rheumatism (Table 1). Information about limitation in
activity attributable to arthritic conditions is based on responses to
questions regarding whether a person is limited in or prevented from working,
housekeeping, or performing other activities as a result of a health
condition, followed by questions about conditions causing the limitation.
Because NHIS is a probability sample of the CNI population, the
proportions of persons with arthritic conditions in each of 36 age-sex-race
strata in the sample were adjusted to generate national estimates. For each
state, 1987 population estimates for the same 36 strata were obtained (4) and
adjusted to approximate the CNI population using unpublished estimates from
the Bureau of the Census.*
In 1987, approximately 14.6% of the U.S. population (34.7 million persons)
reported having an arthritic condition, and approximately 12.1% consulted a
physician for it (Table 2). Self-reported arthritic conditions were over twice
as prevalent in the state with the highest proportion (Florida) as in that
with the lowest (Alaska) (Table 3). Arthritis was responsible for limiting
the activity of 2.6% of the CNI population; for persons greater than or equal
to 75 years of age, the proportion was 12.6% (Table 2).

Reported by: Office of Surveillance and Analysis and Div of Chronic Disease
Control and Community Intervention, Center for Chronic Disease Prevention and
Health Promotion, CDC.

Editorial Note: The validity of using self-reports of arthritic conditions as
a measure of "actual" prevalence is unknown. However, the national age-
specific prevalence proportions for physician-consulted arthritic conditions
(Table 2) are similar to estimates for clinically confirmed osteoarthritis,
rheumatoid arthritis, other arthritis and rheumatism, and bursitis reported
from NHANES I (5).
Excluding nursing home residents (in 1985, 1.5 million persons (6)) from
NHIS did not result in a substantial underestimate of the prevalence of
arthritic conditions. Based on prevalence estimates for nursing home residents
(7), the inclusion of this population in the analysis probably would have
increased by less than 2% the 28.6 million persons with self-reported,
physician-consulted arthritic conditions.
Because of the method used to produce the state-specific estimates,
differences in prevalence among the states primarily reflect variations in
demographic composition. For example, Florida's high prevalence proportion for
arthritic conditions is due primarily to its relatively large population of
elderly persons, and the low prevalence in Alaska can be attributed partly to
its high proportions of persons of "other" race (e.g., Asian/Pacific Islander
and Native American), among whom the prevalence of arthritic conditions is low
(Table 2). However, these estimates do not account for other factors that
influence the prevalence of some arthritic conditions, such as obesity and
occupation (8).
Approximately 2.5% of the U.S. population (6 million persons) believe they
have an arthritic condition but have not consulted a physician for it (Table
2). These findings indicate the need for health-care providers and public and
private health agencies to determine why these persons have not sought medical
care and to identify approaches for overcoming barriers to care.
Given the high prevalence of arthritic conditions among older persons and
trends that favor population survival to older ages, the number of persons
with these conditions and associated disabilities can be expected to continue
increasing. Efforts aimed at limiting disease progression and preventing
disability associated with arthritic conditions should include developing
education programs for patients and primary-care providers and developing
specific indications for referral of patients to specialists.

References

1. Lawrence RC, Hochberg MC, Kelsey JL, et al. Estimates of the prevalence of
selected arthritic and musculoskeletal diseases in the United States. J
Rheumatol 1989;16:427-41.

2. LaPlante MP. Data on disability from the National Health Interview Survey,
1983-85. Washington DC: National Institute on Disability and Rehabilitation
Research, 1988.

3. NCHS. National Health Interview Survey (machine-readable public-use data
tape). Hyattsville, Maryland: US Department of Health and Human Services,
Public Health Service, CDC, 1987.

4. Irwin R. 1980-1988 Intercensal population estimates by race, sex, and age
(machine-readable data file). Alexandria, Virginia: Demo-Detail, 1988.

5. Cunningham LS, Kelsey JL. Epidemiology of musculoskeletal impairments and
associated disability. Am J Public Health 1984;74:574-9.

6. NCHS. The National Nursing Home Survey: 1985 summary for the United States.
Hyattsville, Maryland: US Department of Health and Human Services, Public
Health Service, CDC, 1989; DHHS publication no. (PHS)89-1758. (Vital and
health statistics; series 13, no. 97).

7. NCHS. Profile of chronic illness in nursing homes: United States--National
Nursing Home Survey, August 1973-April 1974. Hyattsville, Maryland: US
Department of Health and Human Services, Public Health Service, CDC, 1977;
DHEW publication no. (PHS)78-1780. (Vital and health statistics; series 13,
no. 29).

8. Anderson JA, Felson DT. Factors associated with osteoarthritis of the knee
in the first National Health and Nutrition Examination Survey. Am J Epidemiol
1988;128:179-89.

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*The 36 proportions from NHIS were multiplied by each state's 36 CNI
population estimates and the products summed to obtain the estimated number of
persons with arthritic conditions for the state. Division of this figure by
the state's CNI population gave a prevalence proportion.