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sysadmin September 24th, 2001 14:27

1999.07.19 Pearls
In this study of 72 patients over 60 years old, the cause of dizziness was cardiovascular in 28%, a peripheral vestibular disorder in 18%, and a central neurologic cause in 14%. Symptoms more common in those with a cardiovascular cause included syncope, lightheadedness, pallor, and associated cardiovascular diseases such as angina, hypertension, or coronary artery disease. Lawson J et al. J Am Geriatr Soc 1999;47:12.

In this study of 496 patients with a fungal toenail infection (onychomycosis), continuous treatment with terbinafine (250 mg/d for 12 to 16 weeks) was more effective than pulse treatment with itraconazole (400 mg/d for 1 week every 4 weeks, for 12 to 16 weeks). At 72 weeks' follow-up, cure rates for the terbinafine group was 76% to 81%, whereas cure rates for the intraconazole group was 38% to 49%. Evans EG et al. BMJ 1999;318:1031.

This review of osteoporosis in men notes that men over 50 are more likely to suffer an osteoporosis related fracture than clinical prostate cancer. Also, mortality after a hip fracture is greater in men than in women (one out of three men die within 1 year after a hip fracture). Approximately 1.5 million American men have osteoporosis, and 3.5 million men have osteopenia. Galus MA. Consultant 1999;39(6):1640.

Smoking among teenagers may be especially harmful. The growing and developing lungs of children are especially susceptible to the carcinogenic effects of cigarettes according to this study of the DNA in 143 lung cancer patients. Wiencke JK et al. J Natl Cancer Inst 1999;91(7):614.

In this study of 2876 people from 15 to 34 years old, essentially everyone had atherosclerotic damage to the aorta, and more than half of even the youngest had damage to the right coronary artery. The findings suggest that efforts to prevent coronary artery disease should begin sometime during childhood. Strong JP et al. JAMA 1999;281(8):727.

This British study of 46,000 women, followed for a median of 49 years, found that the risks of oral contraceptives (e.g. circulatory disease, cervical cancer) are more than offset by the benefit of decreased ovarian cancer. Beral V et al. Br Med J 1999;318:96.

Several studies have suggested that treating C. pneumoniae with antibiotics (usually with tetracycline or quinolones) may help prevent the development of coronary artery disease. This observational study of 3315 patients who suffered from an initial heart attack, compared with 13139 control patients, found a significant reduction in risk among those who had taken a tetracycline or quinolone antibiotic within the previous three years. Meier CR et al. JAMA 1999;281(5):427.

Beta blockers - specifically bisoprolol - was shown to reduce mortality among patients with New York Heart Association Class III or IV heart failure. Bisoprolol (or placebo) was added to the baseline regiment of an ace inhibitor and a diuretic, with or without digoxin. CIBIS-II Investigators. Lancet 1999;353:9.

Childhood obesity, defined as being in the top 3% of weight at school entry, was significantly decreased among children who had been breast fed during infancy. Von Kries R et al. BMJ 1999;319:147.

Regular consumption of fish was associated with a lower risk of digestive tract cancer, including colorectal cancer. This study of over 10,000 cancer patients, compared with 8,000 control patients, compared those who had fish 2 or more times a week with others who avoided consumption of fish. Fernandez E et al. Amer J Clin Nutr 1999;70:85.

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