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sysadmin April 3rd, 1996 22:00

1996.03.01 Pearls
Enalapril reduced progression of microalbuminuria to macroalbuminuria by 42% over a 7 yr period in normotensive diabetics. (Arch Intern Med 1996 ;156:286-289)

In a study of 8877 women, estrogen replacement therapy resulted in a significantly decreased risk for tooth loss and edentia (relative risk=0.64). (Arch Intern Med 1995 11/27;155:2325-2329)

All americans should get at least 30 minutes a day of exercise, which may be done in 10 minute spurts, according to a National Institutes of Health consensus panel. (Medical Tribune 1996 01/11;)

In a study of 1623 patients, anger outbursts doubled the risk of myocardial infarction within the following 2 hours (relative risk =2.3). (Circulation 1995 10/01;92:1720-1725)

Low serum pyridoxal 5'-phosphate (from vitamin B6) was associated with a 4 fold increased risk of coronary disease (relative risk=4.3, p < 0.05). (Circulation 1995 11/15;92:2825-2830)

In a study of 258 breast cancer patients compared with 614 control patients, there was no association between stressful life event scores and breast cancer. (Cancer 1996 03/15;77:1089-1093)

Smoking at least 20 cigarettes per day was a stronger risk factor for myocardial infarction in women (who had a sixfold increace) than in men (who had a threefold increase) in this study of 11,843 patients. (Circulation 1996 ;93:450-456)

The acellular pertussis vaccine (which is safer than the standard whole-cell vaccine) is effective in protecting against pertussis. (JAMA 1996 01/03;275:37-41)

Lead exposure in childhood was associated with an increased risk of antisocial and delinquent behavior in a study of grade school boys. (JAMA 1996 02/07;275:363-369)

Progesterone protected the endometrium against hyperplastic (generally considered bad) changes in this study of 596 postmenopausal women on estrogen replacement therapy. (JAMA 1996 02/07;275:370-375)

Despite advances in antibiotics, age adjusted death rates from infections have increased 58% over the 12 year period of 1980 to 1992; HIV disease alone was only partially responsible for this increase. (JAMA 1996 01/17;275:189-193)

Pneumococcal pneumonia, a major cause of pneumonia in the US, is becoming increasingly resistant to antibiotics (14% to penicillin, 12% to ceftazidime, 24% to tri-sulfa); increased use of the pneumococcal vaccine is urged. (JAMA 1996 01/17;275:194-198)

Coffee was not associated with the development of heart disease in a study of 85,747 American women. (JAMA 1996 02/14;275:458-462)

A high dietary fiber intake was associated with a decreased risk of heart disease, independent of fat intake, in a study of 43,757 men. (JAMA 1996 02/14;275:447-451)

The National Center for Health Statistics has defined overweight as a body mass index (BMI) of over 27.7 kg/m2 in men, and over 27.2 kg/m2 women (BMI = wt in kilograms / height in meters squared) (Ann Intern Med 1993 ;119:646)

Although a high plasma beta carotene level was associated with a lower death rate, supplementation alone did not lower the death rate in a study of 1720 people (implying other factors were more important than the beta carotene?). (JAMA 1996 03/06;275:699-703)

Supplementation with vitamin E decreased the incidence of angina in a study of 29133 male smokers; those taking supplements had a 9% decreased risk of developing angina during the average 5 yr follow-up period. (JAMA 1996 03/06;275:693-698.)

Final infarct size among patients treated within 1 hour of symptom onset were only 40% as large as the infarct size among a similar group of heart attact patients who waited 4 - 6 hours before thrombolytic therapy. (Circulation 1996 01/01;93:48-53)

Drinking caffeinated beverages either before or during exercise due to the abnormal increase in blood pressure caused by the caffeine, according to a study of 30 men. (Amer J Hypertension 1995 12/01;)

One year after coronary artery bypass surgery, those who continued to smoke had more than twice the heart attack and reoperation risk compared to those who quit, in a study of 415 patients. (Circulation 1996 01/01;)

In a study of women who previously had delivered a preterm baby, 250 mg of Flagyl TID x 7d with erythro 333 mg TID x 14 d decreased a second preterm delivery in those women with active bacterial vaginosis. (NEJM 1995 12/28;333:1732-1736)

An early fever after a stroke increases the mortality rate; a temperature of 100.2 F or more raised the odds of dying 3.4 times suggesting the need to aggressively treat fevers (even low grade) in acute stroke patients. (Stroke 1995 11/01;26:2040-2043)

Dog owners were significantly more likely to be alive 1 year after a heart attack in a study of 369 patients; cat owners did not benefit, suggesting that the need to walk the dog (in contrast to cats) was a important factor in their survival. (Am J Cardiol 1995 12/15;76:1213-1217)

The use of a pacifier increased the risk of ear infections in children, causing an estimated 25% of all cases of ear infections. (Pediatrics 1995 11/01;96:884-888)

High doses of acetaminophen (>1000 mg) should be avoided in aspirin sensitive asthmatics, according to a study of 70 asthmatics; 34% of aspirin sensitive pts were also sensitive to high dose acetaminophen. (J Allergy Clin Immunol 1995 ;96:480-485)

The death rate during the 6 months after a heart attack was cut 50% by aspirin (from 17% to 8.4%); unfortunately, a full 25% of patients were NOT prescribed aspirin (even though NO contraindications existed) in this study of 5490 medicare patients. (Ann Intern Med 1996 02/01;124:292-8)

In pts with proven, symptomatic coronary artery disease, vitamin E (400 - 800 IU per day) reduced the rate of subsequent fatal and/or nonfatal myocardial infarction by 45% during a mean follow-up period of 510 days in a study of 2002 pts. (Lancet 1996 03/23;347:781-786)

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