Study suggests high mound a factor in pitchers' injuries


As baseball season begins, pitchers will stand atop regulation-height, 10-inch mounds to wind up. Then they'll stride, cock their arms, accelerate, decelerate and follow through to release a ball that can reach speeds of 100 mph. Now, a motion analysis study of 20 elite pitchers from the major leagues and NCAA Division I-A college teams suggests that a 10-inch mound, also standard for high school baseball, might contribute to injuries.

The stresses on the shoulders and elbows of pitchers were greater from the standard-height mound than from flat ground, according to a presentation at a Major League Baseball Team Physicians Association meeting.


"That greater stress can result in injury to the shoulder, including tearing of the rotator cuff," says lead researcher Dr. William Raasch of the Medical College of Wisconsin, physician for the Milwaukee Brewers. "We can't say that those different stresses are ... resulting in all the injuries we see," he says, and there's not enough evidence to recommend lowering the mound.

But he suggests that pitchers with injuries practice on flat ground. "If you have young kids struggling from the mound, get them onto flat ground," he says. "Wait till they get better."

Los Angeles Times


Coronary calcium scans benefit diverse group

Coronary-artery calcium scanning -- a method that takes images of the coronaries and uses them to predict heart-attack risk -- has soared in popularity over the past decade. But controversy has dogged the test for two reasons: a lack of scientific evidence that it can predict risk in people of all ethnicities and doubts about its cost-effectiveness.

One of those issues appears to be resolved. A study in the New England Journal of Medicine shows that the test is a strong predictor of heart-attack risk in an ethnically and racially diverse group of people.

The study, funded by the National Institutes of Health, is the largest evaluation of coronary calcium testing to date, involving more than 6,700 people nationwide.


The researchers showed that participants with a moderate amount of calcium buildup in their coronary arteries had a seven times greater risk of heart disease than people with no deposits. And people with a large buildup had a 10 times greater risk.

But the issue of who should have the test remains controversial. The test costs about $500. Insurance coverage varies widely, but the test is rarely reimbursed without prior

authorization by an insurance company.

Los Angeles Times


FDA probes reports linking drug, suicide


The Food and Drug Administration is studying a possible link between Singulair, Merck & Co.'s hugely popular asthma drug, and suicide.

The agency will review reports it has received about behavior and mood changes, suicidal thoughts and suicide itself among patients on the drug.

The FDA did not say how many reports it had received. Merck said it was a "very limited number" involving both adults and children.

Merck's best-selling product has been used by millions of patients for a decade to treat asthma and runny noses associated with allergies. Annual sales reached $3.4 billion last year in the United States.

With the springtime allergy season beginning, patients should not stop taking the drug unless they have had side effects and discussed it with their physician, experts said.

The FDA said it also is reviewing reports of similar problems in patients who took related drugs, including Accolate, Zyflo and Zyflo CR.