Clot risk low for most fliers

Paul Taylor

From Friday's Globe and Mail

Despite recent fears that cramped airline seats can cause potentially dangerous blood clots, the risk is not all that huge, a new study says.

Dutch researchers came up with an estimate of the actual risk by examining the flying habits and health of almost 9,000 employees of international corporations and large organizations.

From those data, they concluded that one person out of every 4,656 who boards a long-haul flight will develop deep vein thrombosis (DVT) - a blood clot usually in the legs - within eight weeks of the trip.

"Most people who go on an airplane should not need to worry," said Suzanne Cannegieter, who was part of the research team at Leiden University Medical Center in the Netherlands. It is "a low risk, in general."

However, the researchers found that some people were at a slightly elevated risk - women who used oral contraceptives or individuals who were especially short, tall or overweight.

The condition is often called economy-class syndrome because it is thought to be caused by sitting immobilized in a tight spot for long periods. Serious health problems can arise if a clot reaches the lungs. This can cause chest pain, shortness of breath or coughing up phlegm tinged with blood and, in rare cases, death.

Tall people (over 185 centimetres) are vulnerable because it can be especially hard for them to fit into the snug seats. And short people (less than 165 cm) can run into problems if their legs do not touch the floor, which puts extra pressure at the back of their legs. The birth control pill, by itself, raises the odds of blood clots.

"The risks in these subgroups are increased but still not extremely high," Dr. Cannegieter said in an e-mail interview. "So, I would advise them mainly to stay mobile - get out of their seats occasionally - not to take sleeping pills or drink too much."

People with a history of thrombosis, or multiple risk factors, should talk to a doctor about whether they need to take a blood-thinning medication before their trip.

The study was published in the online journal, Public Library of Science.

Magnets draw dollars

Almost one-third of people who suffer from rheumatoid arthritis, osteoarthritis or fibromyalgia use magnets, hoping the devices will ease their pain. Magnet therapy has become a multi-billion-dollar industry; there are now arm and leg wraps, mattress pads, necklaces, shoe inserts and bracelets that contains magnets.

But do they really work? A new study suggests the only thing the magnets are doing is pulling money out of the pockets of desperate chronic-pain patients.

The study, led by Max Pittler at Peninsula Medical School in Exeter, England, reviewed the existing medical research. A few studies did indeed show a possible beneficial effect in the treatment of some forms of osteoarthritis. But these particular trials involved very few patients and lacked the "rigour" of good scientific research.

"Across all trials with sample sizes about 100, there was no evidence of a convincing effect in favour of magnets," concluded the researchers in their study published in the Canadian Medical Association Journal.

Assisted suicide

Opponents of physician-assisted-suicide have long worried that the practice could lead to the legalized extermination of vulnerable people. In other words, pressure would be imposed on the poor, those considered a burden to their families, or other socially disadvantaged terminally ill patients to accept a premature, though painless, death.

But a new study looking at the two places where the practice is legal - the Netherlands and Oregon - found that vulnerable groups are not being disproportionately euthanized.

In fact, quite the opposite is true. It is the rich and well-educated who seek what proponents call death with dignity.

"The joint picture yielded by the available data from the two jurisdictions shows that people who died with a physician's assistance were more likely to be members of groups enjoying comparative social, economic, professional and other privileges," the researchers wrote in the Journal of Medical Ethics.

Still, not a lot of people decide to check out early, according to the study, which was led by University of Utah bioethicist Margaret Battin.

In Oregon, 292 people have taken advantage of the assisted-suicide legislation since it took effect in 1997. That amounts to only 0.15 per cent of all deaths in the U.S. state.

The Netherlands introduced strict guidelines for the practice in 2002. Physician-assisted suicide currently accounts for about 0.1 per cent of deaths in that country.

In both places, cancer patients accounted for 80 per cent of those who died with a doctor's help. Their average age was 70.

Booze and breast cancer

Doctors already know that drinking alcohol boosts a woman's chances of developing breast cancer. But there has been much uncertainty about whether some types of alcohol might be worse than others.

Now, a major study suggests it makes "no difference" whether a woman drinks wine, beer or spirits. "It is the alcohol itself and the quantity consumed that increases breast cancer risk," says a statement released with the study, which was presented this week at the European Cancer Conference in Barcelona.

The researchers, at Kaiser Permanente in California, studied the drinking habits of more that 70,000 women to reach their conclusions.

They found that the risk of cancer rose by 30 per cent in women who had more than three alcoholic drinks a day - a level considered high - and could lead to other health problems. "The message is that heavy drinking should be avoided - and not just because of the breast cancer," said Dr. Yan Li, lead author of the study.

The risk was significantly lower for lighter drinkers. Women who downed between one and two drinks per day increased their risk of breast cancer by 10 per cent compared with light drinkers who consumed less than a drink a day.

On the flip side, moderate alcohol consumption is associated with a lower risk of heart disease. Dr. Li said each woman needs to weigh the pros and con of drinking, based on her own circumstances.

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