Diseases & Conditions Archive

Ask the doctors

Q. I heard that there is a new medication that you can take for the flu. Is this a vaccine?

A. In October 2018, for the first time in 20 years, the FDA approved a new medication to treat the flu. Baloxavir marboxil, sold as Xofluza, is not a vaccine, but rather an antiviral drug that can help your body fight off influenza more quickly. Antivirals work by stopping viruses from reproducing, lessening both the severity of your symptoms and their duration. Xofluza joins two antiviral drugs commonly prescribed for flu, oseltamivir (Tamiflu) and zanamivir inhaler (Relenza). (A third flu drug — peramivir, trade name Rapivab — is administered as an intravenous infusion.)

Direct-to-consumer tests may help predict risks to your future health. But are they worth the cost and trouble?

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Direct-to-consumer (DTC) genetic test kits are a popular way to identify a person's ancestral history, but the technology may also reveal whether someone is at risk for specific diseases and conditions, like Alzheimer's disease, heart disease, and even cancer.

"More and more people want to explore their own medical data, and a DTC genetic test is one way to begin to understand some aspects of your future health," says Dr. Robert Green, a medical geneticist at the Harvard-affiliated Brigham and Women's Hospital and director of the Genomes2People Research Program. "Yet it is important to realize that DTC testing is not the same as genetic testing in a medical context, and is not a comprehensive examination of your DNA."

Occasionally these heart rhythm disruptions signal a more serious condition.

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Lately you've felt like a flipping fish is stuck inside your chest. You feel fine otherwise, but there it is again — flip, flop. It's gone as fast as it appears. But you're starting to worry: is it a sign of a serious heart problem?

Chances are what you're feeling is a condition called heart palpitations, which are usually harmless blips in the heart rhythm, explains Dr. Peter Zimetbaum, a professor of cardiovascular medicine at Harvard Medical School. Only occasionally are these rhythm disturbances the sign of a more serious heart problem that should be checked out.

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Research we're watching

For years, many have speculated that taking vitamin D and omega-3 fatty acid supplements might help to prevent heart attacks, strokes, and certain cancers. But a study by Harvard researchers published online November 10, 2018, by The New England Journal of Medicine has found that the benefits may be more limited than originally hoped.

The results of the Vitamin D and Omega-3 Trial (VITAL), which enrolled more than 25,000 people and ran for more than five years, showed that while omega-3 supplements did appear to reduce the risk of heart attack, particularly among African Americans, they did not appear to be effective in preventing stroke or cancer. Vitamin D supplements also saw few benefits when it came to preventing heart attack, stroke, or cancer — but they were associated with a drop in cancer deaths in people who had taken the supplements for at least a year or two.

Research we're watching

A long-used vaccine is showing promise in helping to restore near-normal blood sugar levels in people with advanced type 1 diabetes. Researchers from Harvard Medical School injected adults who had type 1 diabetes with two doses of the bacillus Calmette-Guérin (BCG) vaccine, which is traditionally used to prevent tuberculosis.

Participants in the study, all of whom had type 1 diabetes for many years, all showed significant improvements in their average blood sugar levels after the vaccination. The improvements lasted for the next five years. Researchers said that it appears the vaccine affected a metabolic mechanism that increases consumption of glucose by cells.

Research we're watching

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People whose daily diets include at least two servings per day of milk, yogurt, or cheese appear to have a lower risk of heart disease, stroke, or death than people who don't consume dairy products.

The findings, published Sept. 11, 2018, in The Lancet, were based on food questionnaires from more than 136,000 people from 21 countries. After a follow-up that lasted an average of nine years, researchers found that adults who consumed two or more servings of dairy each day had a 22% lower risk for heart disease, a 34% lower risk for stroke, and a 23% lower risk of heart-related death. Observational studies such as this one cannot prove cause and effect. But dairy-based foods contain vitamins D and K, calcium, and other nutrients thought to be good for cardiovascular health. The findings support the benefits of all types of dairy, including full-fat versions. However, current guidelines still recommend nonfat or low-fat milk, yogurt, and cheese, which contain fewer calories and less saturated fat.

In the journals

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An observational study has shown an association between eating vegetable nitrates, found in green leafy vegetables and beets, and a lower risk of developing an early stage of age-related macular degeneration (AMD), the leading cause of permanent vision loss among Americans ages 60 and older. The results were published online Oct. 17, 2018, by the Journal of the Academy of Nutrition and Dietetics.

Researchers studied the eating habits of more than 2,000 adults ages 49 and older over a 15-year period and compared them with diagnoses of AMD among the group. They found that people who ate 100 to 142 milligrams (mg) of vegetable nitrates each day had a 35% lower risk of developing early AMD than people who ate less than 69 mg of vegetable nitrates daily.

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In the journals

People with atrial fibrillation, or afib, a type of irregular heartbeat that is linked with stroke, also may have a greater risk of dementia than those without the condition, according to a study published online Oct. 10, 2018, by Neurology.

Researchers recorded medical data from 2,685 people, average age 73. None of them had dementia and 243 had afib. After nine years, another 279 people developed afib. The researchers found that people with afib showed a faster rate of decline in thinking and memory skills than those without the condition, and were 40% more likely to develop dementia.

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In the journals

It is often assumed that appendicitis means automatic surgery to relieve the pain and avoid complications. Yet, a study published online Sept. 25, 2018, by JAMA found that many people with uncomplicated acute appendicitis may be safely treated with antibiotics and avoid an appendectomy.

About 70% to 80% of acute appendicitis cases are uncomplicated, which means the appendix hasn't ruptured or formed an abscess. In the study, researchers had 530 people with uncomplicated acute appendicitis either undergo an appendectomy or receive 10 days of antibiotic therapy. After five years, 61% of the antibiotic group had no recurrences of appendicitis and no appendectomies.

Certain eye conditions offer clues to your chances of developing dementia.

It's long been said that the eyes are the windows to the soul, but can they also provide a view of your brain's future? Researchers increasingly say yes. Studies have identified links between common eye conditions and Alzheimer's disease and other forms of dementia.

One study, published in the July 2018 issue of Alzheimer's & Dementia, appeared to validate past findings that linked three eye diseases — glaucoma, age-related macular degeneration, and diabetic retinopathy — to an increased risk of Alzheimer's disease.