This Washington Post article reviews a recent study in which depressed patients were randomized to either rest quietly for 30 minutes or to walk on a treadmill for 30 minutes at 60 to 70 percent of their maximum heart rate.  The people who exercised reported higher scores of well-being afterwards.

This post-exercise sense of accomplishment and vigor is familiar to anyone who does cardiovascular exercise regularly.  To put it simply, exercise feels good.

Cardiovascular exercise also has proven benefits in decreasing anxiety, reducing blood pressure, improving control of diabetes, and decreasing risk of stroke and heart attack.  Weight-bearing exercise, like walking, also improves bone density.  So get out there today and take a walk for 30 minutes, especially if you’re in a bad mood!

The California Department of Health Services monitors influenza (flu) activity in the state. By all measures, the peak of activity in California was two or three weeks ago. Click here for their weekly report.

There are still new cases, and the season is by no means over, but each week has seen fewer new cases than the week before. The national Centers for Disease Control (CDC) still recommends having the flu vaccine if you are 50 years-old or older or are at high risk for complications from influenza. The vaccine should be given as early as possible in the season, but for those who are still unvaccinated, the CDC recommends giving the vaccine as late as May. You can review the CDC recommendations for the flu vaccine here. You can learn general information about flu prevention and what to do if you get sick here.

This Reuters UK article cites a study published in today’s Journal of the American Medical Association which has interesting implications about the management of men with hernias that are causing only minimal symptoms. The standard of care until now has been to repair hernias as soon as they are diagnosed, fearing that delay may result in complications or the need for an emergency repair later. The study demonstrates that there is no harm in waiting until a hernia becomes more bothersome, and then operating only on the men whose symptoms are worse. Dr. David R. Flum, from the University of Washington in Seattle, predicted in a related editorial

“If the results of this study are reproduced in other populations and for other types of hernia, then the era of preventive hernia repair should go the way of prophylactic tonsillectomy, cholecystectomy [gallbladder removal], and appendectomy.”

I see this as a part of a larger trend away from surgical procedures as our knowledge increases. Surgeries for bleeding ulcers were more common before the discovery that many ulcers could be treated with antibiotics. Heart bypass surgery is becoming less frequent as cholesterol lowering medications help slow the progression of heart disease. It’s exciting to hope that as our understanding improves, other surgeries for which there is currently no adequate alternative, like joint replacement or spine surgery, will also be replaced by less invasive therapies.