Diseases & Conditions Archive

Q. Why is my doctor checking me for tuberculosis? I thought that was eradicated long ago

A. It would be wonderful if tuberculosis (TB) had been eradicated long ago, but unfortunately that's not the case. It is true that the annual number of new cases in the United States has been dropping over the past 20 years; in 2013, there were about 9,500 new cases. However, around the world, particularly in developing nations, TB remains a huge problem. In 2013, there were nine million new cases of TB, and 1.5 million deaths from TB, in the world.

Excessive sun exposure can cause damage that shows up many years later.

It may boost the effect of your current medication.

If your weather forecaster warns about a heat wave this summer, take it seriously. A study by Harvard researchers found that people with certain conditions were at an increased risk of winding up in the hospital during periods of high heat. Their work was published Dec. 23, 2014, in The Journal of the American Medical Association.

Researchers analyzed hospitalization rates for specific diseases among 23 million Medicare beneficiaries between 1999 and 2010. What sent older adults to the hospital most often during a heat wave? Heatstroke, fluid and electrolyte disorders, kidney failure, urinary tract infections, and sepsis (a dangerous blood infection). For some diseases, the risk of hospitalization was elevated for up to five days after a heat wave day, suggesting that preventing and treating heat-related illnesses is crucial both during and after a heat wave.

Colonoscopy saves lives, and adequate prep is essential for a successful colonoscopy. New laxative preps are making the process easier to tolerate.

Q. I'm 82 and a landscape painter. Lately the sight in my right eye seems to be affecting my painting, although I can still see well enough to read small print and drive. I have a cataract in that eye. Should I have cataract surgery?

A. A cataract is a thickening and cloudiness of the lens of the eye that is more common as we age. If your eye doctor has recommended that you have the cataract removed, then yes, you should have the surgery, especially if your vision is impaired. The surgery involves taking your lens out and replacing it with an artificial one. Being able to see more clearly will not only help your painting, but it will also reduce your risk of falling. There is even some evidence that people who have cataracts removed live longer than those who don't, possibly because their improved vision allows them to participate more fully in life.

Harvard scientists are getting international attention for their work with breakthrough technology that can edit genes in living cells. Five Harvard experts—Dr. George Church of Harvard Medical School, and Drs. Keith Joung, David Liu, Kiran Musunuru, and Derrick Rossi, all of Harvard University—were featured speakers in the first-ever CRISPR Congress, held in Boston in February 2015. CRISPR stands for clustered regularly interspaced short palindromic repeats. These are segments of genes that contain repeating sequences of DNA.

The Harvard experts spoke to other scientists about CRISPR, which holds the potential to repair gene mutations, fight disease, and improve food supplies. Harvard researchers have demonstrated that CRISPR may be able to lower cholesterol levels, correct gene mutations, and block HIV infection. "Suddenly anyone can edit any piece of any DNA a thousand times more easily and precisely than before, which is game-changing for gene therapies, organ transplantation, aging reversal, and malaria," says Dr. Church.

Hidden causes of shortness of breath can make the problem tricky to treat.

High blood pressure is one of the many health risks associated with not getting enough sleep, which is often caused by insomnia, or difficulty falling or staying asleep. Although often considered a nighttime problem, some people with insomnia may be in a state of "hyperarousal" that also makes it hard for them to nod off during the day. Now, new research suggests that people with chronic insomnia who also have trouble napping face a higher risk of high blood pressure.

The study, in the March 2015 issue of Hypertension, included more than 200 people with chronic insomnia (defined as insomnia that lasts more than six months) and almost 100 normal sleepers. All underwent daytime nap tests, which measures how quickly a person falls asleep in a quiet environment during the day. People with chronic insomnia who took longer than 14 minutes to fall asleep during the nap studies had three times the risk of high blood pressure compared with normal sleepers, the researchers found. Treatments such as medications and biofeedback to help dampen hyperarousal may be best for people with this type of insomnia, they suggest, although more research is needed.

Q. I'm 68, and I had the pneumonia vaccine a few years ago. Now I hear that I need to have two different ones. Do I really need to do this?

A. For many years, men who turned 65 were told that they needed a single pneumonia shot, called Pneumovax. Now the CDC suggests that older adults get an additional vaccination with a different vaccine, called Prevnar. The combination stimulates the immune system more effectively than either alone.

The two vaccines build immunity against different types of the bacterium, known as pneumococcus, that causes pneumonia. Pneumovax (PPSV23) protects against 23 common types of pneumococcus. Prevnar (PCV13) protects against 13 types.