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Sleep-Disordered
Breathing and Hypertension
Sleep-disordered breathing is characterized by repeated episodes of apnea
or hypopnea during sleep. Obstructive sleep apnea is considered to be present
when the frequency of such episodes is high. In this prospective study,
sleep-disordered breathing, as measured by polysomnography, was an independent
predictor of the subsequent development of hypertension over a four-year
period. Sleep-disordered breathing may therefore be a risk factor for hypertension.
Physiologic
Cardiac Pacing versus Ventricular Pacing
In patients with bradycardia requiring permanent cardiac pacing, two
options are available: ventricular pacing and "physiologic"
(atrial or dual-chamber) pacing. This study compared the two methods.
The rates of death, stroke, and hospitalization for heart failure were
indistinguishable, though the risk of atrial fibrillation was somewhat
lower with physiologic pacing. Physiologic pacing provided little benefit
over ventricular pacing.
A High-Fiber
Diet for Diabetes Mellitus
The effect
of a high intake of dietary fiber in patients with type 2 diabetes is
controversial. This study examined the issue in patients with diabetes
who consumed a high-fiber diet and a diet with moderate amounts of fiber
for six weeks each. The high-fiber diet improved glycemic control, as
reflected by a reduction of 13 mg per deciliter in the mean daily preprandial
glucose concentration, and lowered cholesterol and triglyceride concentrations.
Declining Mortality
from Pneumonia in Children
 In
developed countries, mortality from pneumonia in children has decreased
markedly. This analysis documents that, in the United States, deaths from
childhood pneumonia declined from 24,637 in 1939 to 800 in 1996. The steep
declines in the 1940s may be due to the use of penicillin. An increase in
mortality among older children in 1957 coincided with an influenza pandemic.
The steady decline in mortality from 1966 to 1982 coincided with an increase
in the access of poor children to medical care under Medicaid. |
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Longevity
and Spending for Acute and Long-Term Care
In the United States, the proportion of the population that is 65
years of age or older is projected to increase from 13 percent in
2000 to 20 percent by 2030.
After analyzing data from several national sources, this study found
that the total costs of acute and long-term care for the elderly rise
substantially with increased survival after the age of 65. The main
reason for the overall increase in costs, however -- from $31,181
(in 1996 dollars) for persons who die at the age of 65 to $200,000
for those who die at the age of 90 -- is the greater numbers of elderly
persons, not the increased costs per person. |
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