1999.07.05 Pearls
 

In this study of 5335 people suffering a nontraumatic cardiac arrest outside of a hospital, survival was 3.5% overall. Notably, for those who received bystander CPR (i.e. CPR given prior to the arrival of medical personnel) were three times more likely to survive than those who did not receive CPR until the emergency medical service personnel arrived. Stiell IG et al. Ann Emerg Med 1999;33(1):44.

This study of 141 patients with pyelonephritis demonstrated that oral ciprofloxin was as effective as intravenous ciprofloxin. The treatment failure rate was the same in each group. Mombelli G et al. Arch Intern Med 1999;159(1):53.

This review on the treatment of sore throats recommends against antibiotic treatment for the following reasons: a) the development of acute rheumatic fever from a sore throat is rare- they estimate that for 12 primary care doctors, only 1 would see this happen during their professional lifetime. b) acute glomerulonephritis from a strep throat is even more rare. c) the average reduction in symptom duration is only eight hours in patients treated with antibiotics compared to those treated with supportive care only. Del Mar CB et al. J Ped Child Health 1998;34:498.

Treatment with famciclovir (250 mg twice daily) greatly decreased the recurrence of genital herpes. The mean recurrence time in those taking a placebo was 7 weeks, whereas the mean recurrence time in the famciclovir group was 10 months. Patients on famciclovir were 3 times less likely to suffer a recurrence compared to those on placebo. Diaz-Mitoma F et al. JAMA 1998;280:887.

In this study of 371,692 births of infants in the breech position, delivery by Cesarean Section was associated with a lower infant mortality in all birth weight groups. At 28 days after birth, after adjusting for birth weight, babies delivered vaginally were 2.6 times more likely to have died compared to those delivered via Cesarean Section. Lee KS et al. Obset Gynecol 1998 (Nov);92:769.

In this meta-analysis, it was found that Vitamin B-6 (in doses up to 100 mg a day) was helpful in the treatment of premenstrual syndrome (PMS). The author recommends against routine use because of concerns about side-effects (mainly peripheral neuropathy). Also, most often 50 mg/day is used, in combinations with the other B vitamins and magnesium. Wyatt KM et al. British Med J 1999;318:1375.

Experts are now recommending that the daily recommended allowance of Vitamin C be raised from 60 mg a day up to 120 mg a day. Reasons cited include the beneficial effects of Vitamin C upon chronic diseases. Frei B, Carr AC. Amer J Clin Nutr 1999;69:1068.

The use of cocaine was found to increase the risk of a heart attack by nearly 24 times in the hour after consumption. Circulation 1999;99:2737.