Diseases & Conditions Archive

Simple changes can help to turn down the volume.

If your wife or sleep partner often seems bleary-eyed and resentful in the morning, you may be one of the millions of adults who snore habitually—a condition that affects twice as many men as women. Snoring occurs when your upper airways narrow too much, causing turbulent airflow. This, in turn, makes the surrounding tissues vibrate, producing noise.

"Snoring is a sign that there is a really narrowed space," says Dr. Sanjay Patel, a sleep disorder specialist at Harvard-affiliated Beth Israel Deaconess Medical Center. "That happens either in your nasal passages or in the back of your throat." Some men are snorers because they have excess throat and nasal tissue. Others have floppy tissue that's more likely to vibrate. The tongue can also get in the way of smooth breathing. 

Here's another reason to get depression treated as soon as possible: a Harvard study found that people with persistent symptoms of severe depression were twice as likely to suffer a stroke compared with people who have mild symptoms. The study appeared May 13, 2015, in the Journal of the American Heart Association. Researchers looked at the health information of more than 16,000 men and women ages 50 and older. The participants were interviewed every two years during a 12-year period and asked about many health issues, including depression symptoms. Researchers found that people who reported high depression symptoms at two consecutive interviews were more than twice as likely to have a first stroke than people with low depression symptoms. The stroke risk remained high even after depression symptoms went away.

The study showed only an association, and didn't prove that depression causes strokes. So why the link? Researchers speculate that depression—which is associated with high blood pressure, increased inflammation, and physical inactivity—may have a cumulative effect that causes damage to the blood vessels over time. Bottom line: Seek treatment if a case of the blues lasts more than two weeks, because it could be a sign of depression.

It appears that cognitive behavior therapy may help people with chronic insomnia and no underlying medical problems fall asleep faster.

An international team of researchers has pored over scores of studies of bone density, osteoporosis, and hip fracture and has concluded that the number of hip fractures that have been prevented by bone-building drugs called bisphosphonates since 1995 doesn't justify the expense and potential side effects of the medication. Their findings were published online by the journal BMJ on May 26, 2015.

In their report, the researchers cited earlier studies to support their conclusion, including

Findings from a major clinical trial show that a new type of vaccine for shingles is much more effective than the existing vaccine in older people, although the new shot comes with more side effects.

Q. I heard that there is a new stool test for colon cancer screening. Can this test replace colonoscopy for me? I am 68 years old with no history of colon problems, and my last colonoscopy was normal.

A. Among screening tests for hidden colorectal cancer, colonoscopy remains the "gold standard" because it's the most effective technique for detecting colon cancers and simultaneously provides an opportunity to remove any precancerous growths (polyps). The new DNA-based stool test (Cologuard) is less invasive and inconvenient than colonoscopy and finds more cancers and polyps than older stool tests, but it does not entirely eliminate the need for colonoscopies.

Q. I have been struggling with persistent athlete's foot. I have tried several over-the-counter medications for several weeks without improvement. How can I rid myself of this rash.

A. Athlete's foot, a common rash on the soles of the feet and in between toes, is caused by a skin fungus (Tinea pedis). The rash usually improves with use of antifungal creams and sprays for two to four weeks. If not, you have several options.

Early detection and proper use of eye drops are essential to preventing vision loss.

Glaucoma is a leading cause of irreversible blindness and is more common with aging. The condition affects peripheral vision at first, but eventually becomes more widespread. Treatment with daily eye drops helps to slow the process, but it's best to start early. "Glaucoma tends to be like a snowball," says Dr. Brian Song, a glaucoma specialist at Harvard-affiliated Massachusetts Eye and Ear Infirmary. "It's easier to control it early than if you wait for it to build momentum."

Q. I've been taking dabigatran (Pradaxa) for atrial fibrillation for a few years and haven't had any problems. But I've seen ads on television suggesting that this drug and others like it aren't safe. What's your advice?

A. Known as novel oral anticoagulants, these drugs make the blood less likely to clot, which helps prevent strokes. Others in the class include rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa). They work as well as the older anti-clotting drug warfarin (Coumadin) but don't require frequent testing for clotting function and are less likely to interact with food and other drugs.

By Anne Fabiny, M.D., Editor in Chief

Every so often, medical professional organizations issue new guidelines for treating diseases, based on an accumulation of new evidence. In 2013 the American College of Cardiology and American Heart Association issued a guideline on treating blood cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk, using a new risk calculator (online at health.harvard.edu/heartrisk) to estimate a person's risk of developing ASCVD over the next 10 years. The guideline created a controversy because using the new risk calculator gives everyone over 75 a risk score of at least 7.5%—the threshold for prescribing statins to prevent heart disease in younger people. By that measure, everyone over the age of 75 should be on a statin!