Diseases & Conditions Archive

In the journals

If you have problems sleeping through the night, you may be at risk for atrial fibrillation (afib), an irregular heart rate that may cause heart palpitations and is a leading cause of stroke.

A study published online June 25, 2018, by HeartRhythm reviewed four studies and found a link between afib and poor sleep. In one study, people with afib had more frequent nighttime awakenings compared with those who did not have the condition. In the other studies, poor sleep quality, including frequent nighttime awakenings and less REM (rapid eye movement) sleep, predicted which individuals would develop afib.

Ask the doctor

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Q. I've had several bouts of acute bronchitis in the past year. What causes it, and is it contagious?

A. Acute bronchitis is an inflammation of the breathing tubes in the lungs. It comes on suddenly and lasts for at least five days, often longer.

New medications add advantages to treatments that help prevent stroke, pulmonary embolism, and deep-vein thrombosis.

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The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa).

Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). A dose of vitamin K is used to reverse the action of warfarin (Coumadin), a blood thinner used routinely for more than half a century and, until recently, the only such option for most people.

Research we're watching

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About one in 10 people has eczema, a chronic inflammatory condition that leaves skin dry and itchy. People with more severe forms may experience a scaly rash or skin that cracks and oozes. These people may also be at greater risk for heart attack and stroke, according to a study in the May 23 issue of The BMJ.

For the study, researchers analyzed data from more than 385,000 adults with eczema, which was classified as mild, moderate, or severe. Each was matched with up to five people of similar age and sex who didn't have eczema.

Research we're watching

A bite from a lone star tick can trigger an unusual allergy that causes hives, swelling of the throat and lips, or an upset stomach when you eat red meat. But that's not all: people with this rare red meat allergy may be particularly prone to narrowed, stiff arteries in the heart, a new study finds.

Researchers analyzed blood samples from 118 adults living in Virginia and found that 26% had evidence of a red meat allergy (that is, they had antibodies to a molecule called alpha-gal, the main allergen in red meat). Lone star tick saliva may contain alpha-gal, so when a tick bites a person, it may trigger an immune response by the body, which then recurs when the body encounters alpha-gal in red meat. Lone star ticks are found throughout the southeastern and eastern United States.

In the journals

Many people with rheumatoid arthritis (RA) also deal with ongoing depression and anxiety related to their pain and disability. While drugs used to treat the disease help alleviate the joint pain and stiffness, a recent study suggests they may not extend to improving patients' mental health.

The findings, published online June 6, 2018, by Arthritis & Rheumatology, reviewed more than 70 clinical trials and found only a small association between various drugs used for RA, such as adalimumab (Humira), rituximab (Rituxan), abatacept (Orencia), and tocilizumab (Actemra), and mental health outcomes in patients.

Ask the doctors

Q. I recently saw something recommending that older Americans get screened for hepatitis C. I'm 68 years old. Should I be screened?

A. Yes. Since 2012, the CDC has recommended that all adults born from 1945 to 1965 be tested for hepatitis C, a bloodborne virus that affects anywhere from 2.7 million to 3.9 million Americans — many of whom don't know they have the condition. Hepatitis C can go undetected in the body for years, eventually leading to cirrhosis, liver damage, and liver cancer. You may be at risk even if you don't think you have any risk factors for the disease, which is most commonly transmitted today through intravenous drug use. People born from 1945 to 1965 are five times more likely than other Americans to have hepatitis C, although experts aren't sure why this is the case, according to the CDC. It's possible that some people were infected during health care procedures or blood transfusions that took place before the discovery of the hepatitis C virus. A study published in the April 2018 issue of Cancer Epidemiology, Biomarkers & Prevention found that less than 13% of these individuals have had the test. Since you're one of those who hasn't, it's a good idea to call your doctor and make a screening appointment.

For more on diagnosing and treating indigestion, read The Sensitive Gut, a Special Health Report from Harvard Medical School.

News briefs

Encouraging news for people who suffer with migraines: in May, the FDA approved erenumab (Aimovig), the first medication aimed at preventing these debilitating headaches. Current medications to treat migraines were actually designed to control other conditions, such as seizures or an irregular heartbeat; their side effects (like sexual dysfunction and fuzzy thinking) often cause people to skip treatment. Erenumab offers a new approach. Injected once a month, it works by blocking a molecule (calcitonin gene-related peptide) involved in migraine attacks, and compared with other drugs, it appears to have fewer side effects (primarily constipation and injection site reactions). "This drug is for people who have more than four migraines per month, but it won't take migraines away entirely," says Dr. Gad Marshall, a neurologist at Harvard-affiliated Brigham and Women's Hospital. Clinical trials suggest it can reduce frequency by one or two migraines per month, or even more in some people. "For people with frequent debilitating migraines it could be a game changer," says Dr. Lee Schwamm, a neurologist at Harvard-affiliated Massachusetts General Hospital. "But erenumab is expensive, and it will take time to find out if it's effective and safe over the long term."

Two recent drugs have opened new treatment opportunities for this common eye disease.

Glaucoma is a leading cause of blindness in people over age 60, and it's estimated that the number of new cases will more than double over the next few decades. "There is no cure for glaucoma once it appears, so treating it at its earliest stages can help save your vision," says Dr. David Solá-Del Valle, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear.

Once diagnosed, glaucoma is treated with eye drops to reduce pressure inside the eye by lowering the amount of fluid or improving fluid drainage. They can keep glaucoma from getting worse and hopefully avoid the need for surgery to correct this drainage problem.