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Alertness drug modafinil (Provigil) helped patients with fatigue that wouldn't resolve on its own after stroke, according to a single-center, phase II randomized trial in Stroke.
The double-blind comparison of 200 mg daily (half the maximum-approved dose for sleep disorders) against placebo for 6 weeks each in a crossover design included 36 people with "debilitating" fatigue more than 3 months after stroke. Modafinil yielded a 7.38-point relative decrease in fatigue on the 100-point multidimensional fatigue inventory and significantly improved quality of life as well compared with placebo.
"These positive findings are encouraging, but preliminary, owing to the small size of the study," the researchers concluded, noting that a phase III trial might be warranted for modafinil in this common condition.
Diabetes Complications
Complications of diabetes, including cardiovascular disease, have dropped dramatically over the past two decades, CDC researchers reported in the New England Journal of Medicine.
The rate of MI, for example, dropped roughly 68% from 1990 to 2010; and stroke rates were halved.
"These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes," the lead author said in a statement. "While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes."
See the full MedPage Today article here.
Active Commuting
A large U.K. population-based study supported substantially lower health risks with walking or biking to work.
A commute on foot was associated with lower cardiovascular disease incidence and lower mortality during the study period. But the effect was bigger with cycling to the job and included lower cancer and all-cause mortality risks as well. These findings were independent of major measured confounding factors, the researchers reported in BMJ.
"The findings, if causal, suggest population health may be improved by policies that increase active commuting, particularly cycling, such as the creation of cycle lanes, cycle hire or purchase schemes, and better provision for cycles on public transport," they concluded.
Faint Out of Jobs
People newly diagnosed with syncope are at 40% higher risk of occupational accidents and twice as likely to lose their job compared with the general population, according to a large Danish population-based study in Circulation: Cardiovascular Quality and Outcomes.
In the 2 years after initial diagnosis, 31% of people lost employment.
"Our study suggests that working-age patients with syncope could benefit from further attention to work-related implications. In particular, the association of excess risk of termination of employment among patients with syncope of young age supports the need for intervention because it might have broader implications for individual physical and mental health, and significant public health and socioeconomic consequences.
In Other News
The high rate of marriages between close relatives in Pakistan has created "human knockouts" that can reveal genetic sources of heart trouble, researchers reported in Nature.