In this Canadian study of 144 children with moderate to severe croup, dexamethasone significantly improved croup scores and decreased hospitalization rates. The use of oral dexamethasone, at least initially, is encouraged. Johnson D et al. AUG 20, 1998; N Engl J Med 0339:0498.

Among 1877 men and 1076 women referred for myocardial perfusion imaging, inability to achieve 85% of the predicted maximum heart rate was associated with a 84% increased risk of death over the following 2 years. Lauer MS et al. FEB 10, 1999; JAMA 0281:0524.

Alendronate reduced the risk of fractures among osteoporotic women (t < -2.5) by 36% over a 4 year period. Cummings SR et al. , 1998; JAMA 0280:2077.

In the 893 smokers studied, using a nicotine patch was associated with a 16.4% quit rate at 12 months. Adding oral bupropion to use of the nicotine patch increased quit rates to 30.3%, i.e. nearly doubled the quit rate. Jorenby DE et al. , 1999; N Engle J Med 0340:0685.

Snowboarding results in a different pattern of injuries than skiing. One unusual injury seen in snowboarders is a fracture of the lateral process of the talus. Diagnosis requires special care, and it is often misdiagnosed as an ankle sprain. Boon AJ et al. APRIL, 1999; Phys Sports Med 27(4):0094.

In this double-blind randomized study of 25 patients with moderate hypercholesterolemia, garlic oil consumption had no effect on serum lipoproteins (including cholesterol). Berthold HK et al. JUN 17, 1998; JAMA 0279:1900.

This review concluded that beta blockers should no longer be used as first line therapy for uncomplicated hypertension in the elderly. Messerli FH et al. JUN 17, 1998; JAMA 0279:1903.

In this review it was noted that DHE nasal spray is about as effective as sumatriptan nasal spray, but the headache recurrence rate is only 15% compared with 35% to 40% with sumpatriptan. Tepper SJ.. MAY, 1998; Consultant 38(5):1163.

Findings presented at the 21st San Antonio breast cancer symposium suggest that raloxifene significantly reduces the incidence of newly diagnosed breast cancer. . , ; .

In this study of 289 adults aged 18 to 65, echinacea was ineffective at preventing upper respiratory infections. Melchart D et al. , 1998; Arch Fam Med 0007:0541.

In this study of 2876 Americans aged 15 to 34 years, significant coronary atherosclerosis was seen even in the youngest, and steadily increased with age. Strong JP et al. FEB 24, 1999; JAMA 0281:0727.

In this study of 9014 patients with coronary artery disease, pravastatin significantly reduced cardiovascular events and death. About 40 patients would need treatment for 6 years to prevent 1 death, i.e. 240 patient-years of treatment to prevent 1 death. . NOV 5, 1998; N Engl J Med 0339:1349.

In this 7 year study of 6246 men and 8196 women found that those that didn't exercise at least weekly had about a 20% increased risk of death compared to exercisers. Villeneuve PJ et al. NOV, 1998; Epidemiology 9(6):626.

An office-based fingerstick test for H.Pylori was found to have a sensitivity of 90% and specificity of 97%. Harrison JR et al. , 1998; J Clin Gastroent 27(1):50.

In this Johns Hopkins study, blind insertion of a cotton swab into the vaginal pool, along with a 2nd swab along the anterolateral vaginal wall was as good as a speculum exam in diagnosing trich, bacterial vaginosis, and yeast infections in adolescents. Blake DR et al. OCT, 1998; Pediatrics 102(4):939.

In this study of 297 patients with carpal tunnel syndrome, a medical reason rather than occupational was found in about a third of the patients (most commonly diabetes or hypothyroidism). Atcheson SG et al. JUL 7, 1998; Arch Intern Med 0158:1506.

Nortriptyline was found to reduce withdrawal symptoms and increase smoking cessation rates in this study of 214 smokers. Prochazka AV et al. OCT 12, 1998; Arch Intern Med 0158:2035.