Joseph M. Keenan

The effects of concentrated barley β-glucan on blood lipids in a population of hypercholesterolaemic men and women

Barley, like oats, is a rich source of the soluble fibre beta-glucan, which has been shown to significantly lower LDL-cholesterol (LDL-C). However, barley foods have been less widely studied. Therefore, we evaluated the LDL-C-lowering effect of a concentrated barley beta-glucan (BBG) extract as a vehicle to deliver this potential health benefit of barley. In a 10-week blinded controlled study, subjects were randomized to one of four treatment groups or control. Treatment groups included either high molecular weight (HMW) or low molecular weight (LMW) BBG at both 3 and 5 g doses. Treatment was delivered twice per day with meals in the form of two functional food products: a ready-to-eat cereal and a reduced-calorie fruit juice beverage. Levels of total cholesterol, LDL-C, HDL-cholesterol (HDL-C), and TAG were determined at baseline and after 6 weeks of treatment. The study group comprised 155 subjects. All treatments were well tolerated and after 6 weeks of treatment the mean LDL-C levels fell by 15 % in the 5 g HMW group, 13 % in the 5 g LMW group and 9 % in both the 3 g/d groups, versus baseline. Similar results were observed for total cholesterol. HDL-C levels were unchanged by treatment. Concentrated BBG significantly improves LDL-C and total cholesterol among moderately dyslipidaemic subjects. Food products containing concentrated BBG should be considered an effective option for improving blood lipids.

Effects of whey peptides on cardiovascular disease risk factors.

Previous studies have shown that peptides derived from milk proteins can improve blood pressure. Therefore, the authors tested the blood pressure‐lowering effects of a hydrolyzed whey protein supplement rich in bioactive peptides. In a 6‐week controlled study, 30 prehypertensive or stage 1 hypertensive subjects (blood pressure ≥120/80 mm Hg and ≤155/95 mm Hg) were randomized to receive 20 g/d of either a hydrolyzed whey protein (active treatment) or an unmodified whey protein (control treatment). Blood pressure, blood lipids, safety measures, side effects, and diet were evaluated throughout the trial. After completion of treatment, a 4‐week follow‐up was conducted. There was a mean reduction of 8.0+3.2 mm Hg in systolic blood pressure (P<.05) and of 5.5±2.1 mm Hg in diastolic blood pressure (P<.05) in the treatment group compared with the control group. Low‐density lipoprotein cholesterol and high‐sensitivity C‐reactive protein were significantly improved by treatment. Whey‐derived peptides might be a viable treatment option for prehypertensive and/or stage 1 hypertensive populations.

Rapid HIV testing : Wait time reduced from days to minutes

PREVIEW Recent breakthroughs in technology have produced tests for HIV antibody that are highly accurate and easy to use and can give a preliminary result in 20 minutes or less. These rapid HIV tests will be used increasingly in labor and delivery wards, emergency departments, urgent care centers, and the primary care office. They have unique applications for healthcare worker exposures, military operations, public health venues, and developing countries. In this article, Drs Keenan, Keenan, and Branson discuss the advantages and limitations of rapid HIV testing in various settings.

Home Care: Past and Present, Problems and Potential

he American Geriatrics Societys position statement on Home Care and Home Care Reimbursement is published elsewhere in this issue. T Our paper is intended to provide additional background and perspective on an area of health care that has become increasingly important in the care of older persons. Past and recent events (societal, technological, and medical) will be reviewed, events that led first to a decline and now are bringing about a renaissance in home care. Then we will examine the current problems and future potential of home care for frail older people.

Treatment of hypercholesterolemia: comparison of younger versus older patients using wax-matrix sustained-release niacin.

Compare lipid response, side effect profile and toxicity of younger (<50 years) versus older (50 to 70 years) hypercholesterolemic subjects taking wax‐matrix sustained‐release niacin (Endur‐acin®).

The Home Care Practice and Attitudes of Minnesota Family Physicians

Objective: Assess home care practice and attitudes of Minnesota family physicians (FPs).

COPD—The Primary Care Perspective: Addressing Epidemiology, Pathology, Diagnosis, Treatment of Smoking's Multiple Morbidities and the Patient's Perspective

COPD is a major public health problem worldwide and the impact is expected to increase in the next several decades (1). In the United States, more than 10 million people have been diagnosed with COPD and another 14 million show signs of the disease, although they have not yet been diagnosed (2). The COPD death rate for women has more than doubled in the past 20 years (from 20.1 to 56.7/100,000), and the financial burden of COPD is significant, costing an estimated

Reported Home Health Agency Referrals by Internists and Family Physicians

14.7 billion annually for direct medical costs, and an estimated

The effects of dietary oat products on blood cholesterol

15.7 billion annually for indirect costs (loss of productivity and premature mortality) (3). Despite increasing knowledge of disease pathogenesis, prevention and intensified efforts at patient education and early detection, the prevalence of COPD and COPD mortality is on the rise, especially in women and African Americans (4). For primary care physicians this means that the need to provide care at all stages of COPD will increase, requiring us to develop new skills, find new tools for diagnosis and management and gather new knowledge for integrating COPD into chronic care treatments. This article reviews the epidemiology, pathophysiology, recognition, diagnosis and management of COPD from a primary care perspective. Where feasible primary care focused tools and recommendations for COPD care are presented.

Soluble fiber and hypertension.

Objective: To evaluate the frequency of home health agency referrals (HHRs) by internists and family physicians.