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Old August 31st, 1996, 21:00
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Vitamin E supplementation may be useful in preventing macrovascular disease in diabetics. (Am J Clin Nutr 1996 ;63:753)

In a study of 336 people with adult onset diabetes, 52% of men had impotence, nearly half had vascular injury, and more than a third had mental problems such as forgetfulness, depression, and blurred vision. (Arch Fam Med 1996 ;5:0135)

Postmenopausal women with diabetes on hormone replacement therapy should be monitored closely for elevated triglyceride levels; they are at an increased risk of acute pancreatitis. (Diabetes Care 1996 ;19:0480)

In 125 pts with suspected acute myocardial infarction, the pts given a daily regimen of antioxidant vitamins did better than the other pts in terms of cardiac death and reinfarction (vit A-50,000 IU/d, vit C-1 g/d, vit E-400 mg/d, b-carotene-25mg/d). (Am J Cardiol 1996 02/01;77:0232)

Transcendental Meditation, 20 minutes 2x/day, enabled pts with coronary artery disease to increase exercise capacity by 15% greater than the control group; TM was considered helpful in the prevention and treatment of coronary artery disease. (Am J Cardiol 1996 04/15;77:0867)

In addition to the ECG and CK-MB level, it is helpful to look at the relative lymphocyte count: pts with a differential of less than 20.3% lymphocytes were much more likely to have an acute myocardial infarction. (Ann Intern Med 1996 ;122:0335

A useful screening tool for cardiovascular risks is the waist circumference: above 37.6 inches for men and 32 inches for women indicates a need for more in depth evaluation, and most likely a need for weight loss. (BMJ 1995 ;311:1401)

Among 30-69 year old Finns, the highest quartile of flavonoid intake had a 46% lower risk for coronary mortality and a 31% reduced total mortality (foods high in flavonoids: apples, onions, tea, red wine). (BMJ 1996 ;312:478)

Simvastatin, a cholesterol lowering drug, significantly reduces healthcare costs; the net effect is a cost of $0.28 per day for simvastatin, a drug shown to decrease total mortality by 30% in a select group of pts. (Circulation 1996 ;93:1796)

Aspirin plus low-molecular-weight heparin was superior to aspirin plus regular heparin (weight based protocol) in reducing the occurence of acute myocardial infarction, the need for revascularization, and recurrent angina. (J Am Coll Cardiol 1995 08/26;26:313)

Walking more than 4 hours per week versus less than 1 per week was associated with a 31% decrease in hospitalization for cardiovascular disease in this study of 1,645 Americans over 65. (J Am Geriatr Soc 1996 ;44:113)

Treating hypertension is important in preventing congestive heart failure and other cardiovascular complications; this entire issue of JAMA covers a broad range of hypertension topics. (JAMA 1996 05/22;275(20))

In this study of 46 black men, regular moderate aerobic exercise significantly decreased blood pressure, left ventricular hypertrophy, and medication requirements. (NEJM 1995 ;333:1462)

Because of the risk of infection (mainly from cryptosporidium), the CDC now recommends all AIDS patients boil their water, install filters on faucets, or drink only bottled water; municipal water supplies are too unreliable in several large cities. (American Medical News 1996 05/20

Full implementation of the 2-dose schedule of measles vaccination is essential for community-wide protection. (Pediatr Infect Dis J 1996 ;15:0031)

The results of skin testing for tuberculosis (PPD testing) should be interpreted by health care professionals; self reporting is highly inaccurate. (Pediatr Infect Dis J 1996 ;15:0090)

Chromum supplementation has no benefitial effects on strength gain or body composition in this study of 36 men. (Am J Clin Nutr 1996 06/01;63:0897)

In elderly patients with chronic rheumatoid arthritis requiring nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen), taking misoprostol as well reduced the risk of gastrointestinal complications by 38% in this study of 8843 patients. (Ann Intern Med 1995 08/15;123:241-249)

The rate of UNRECOGNIZED pernicious anemia among Americans over 60 yrs old is estimated to be about 2%, i.e. about 800,000 Americans have unrecognized pernicious anemia. (Arch Intern Med 1996 ;156:1097-1100)

In 18 patients with chronic low back pain, 13 were found to have major depression, suggesting the need to rigorously look for depression in those with chronic (more than 6 months) low back pain. (Gen Hosp Psychiatr 1995 11/01;17:0399)

In Alzheimer's Disease, the average age of onset is 72, average age of diagnosis is 75; most patients institutionalized at age 77, with death occuring at an average age of 80 1/2 years old in this study of 100 patients with Alzheimer's. (J Am Geriatr Soc 1995 ;43:1248)

In a study of 382 Swedes, hypertension at age 70 was associated with an increased risk of dementia, including Alzheimer's type dementia. (Lancet 1996 ;347:1141)

Enteric-coated fish oil capsules (containing 2.7 grams of omega-3 fatty acids) reduced by about 50% the frequency of relapse in a study of 78 pts with Crohn's disease. (NEJM 1996 06;334:1557-1560)

Famotidine (pepcid) at a dose of 40 mg twice daily significantly decreased the rate of gastric and duodenal ulcer formation in patients with arthritis require long term nonsteroidal anti-inflammatory drug (e.g. ibuprofen) therapy. (NEJM 1996 ;334:1435)

The CDC reported that nearly 1 million illnesses and almost 1,000 deaths each year are the result of tap water that fails to meet federal standards (report issued by the Environmental Working Group & the Natural Resources Defense Council). ( 1996 )

Fish oil at a daily dose of 4 g per day was effective in lowering blood pressure and triglyceride levels in this study of 78 non-diabetics. (Ann Intern Med 1995 ;123:0911)

Simple advice and encouragement from a physician to stop smoking was as or more effective than nonspecific behavior modification therapy, group therapy, or the use of health promotion clinics; nicotine replacement therapy is also highly effective. (Arch Intern Med 1995 10/9;155:1933)

In this study of 1,957 randomly selected Oregon high school students, 31% reported being physically abused; these students were more likely to carry weapons, use cocaine, smoke, have multiple sexual partners, and have suicidal thoughts. (Arch Pediatr Adolesc Med 1995 ;149:1254)

In this study, the nicotine patch did help smokers quit; only minimal counseling was necessary as adjunctive therapy (i.e. intensive counseling was not superior to a physician's advice to quit). (JAMA 1995 ;274:1347)

Vitamin D deficiency is highly prevalent among homebound and community-dwelling elderly patients. (JAMA 1995 ;274:1683)

Requiring vision testing as part of a driver's license renewal increases road safety; given a 4 year renewal interval, adding vision testing is estimated to prevent 7% of all fatal crashes. (JAMA 1995 ;274:1026)

Sharing a bedroom with one or more adults was associated with a decrease in the rate of sudden infant death syndrome; these authors recommend infants sleep in the same room as their parents for the 1st 6 months of life. (Lancet 1996 ;347:0007)

Thrombolysis with tPA within 7 hours of the onset of a stroke was found both safe and benefitial; tPA was given with heparin to a group of 43 pts with a mean age of 65. (Stroke 1996 ;27:0882)

In this study of pregnant Indonesian women, once a week supplementation with iron was as effective as daily supplementation. (Am J Clin Nutr 1996 06/01;63:0884)

Low thyroid homone levels were found in this group of recently obese (now normal weight) women compared with a similar group of never obese women, suggesting that mild hypothyroidism plays a role in the obese and obese-prone. (Am J Clin Nutr 1996 06/01;63:0879)

After 2 years of treatment, amenorrhea (i.e. no periods or spotting) was achieved in 90% of women on continuous combined hormone replacement therapy. (Am J Obstet Gynecol 1995 ;173:1446)

Women with a prior c-section and a lower uterine segment thickness of less than 3.5 mm at 37 weeks gestation are at high risk of uterine rupture during a trial of labor after c-section. (Lancet 1996 ;347:0281)

In selected postmenoposal women with osteoporosis (women on estrogens were excluded), alendronate reduced new vertebral fractures and increased bone mineral density. (NEJM 1995 11/30;333:1437)

The use of an epidural for anesthesia during labor was associated with a 2 fold increase in the likelihood of c-section, when compared with the use of intravenous meperidine; also, labor was prolonged and evidence of infection (chorioamnionitis) increased (Obstet Gynecol 1995 ;86:0783)

In women undergoing a c-section after 4+ hours of labor or 4+ hours of ruptured membranes, 14% had bacteremia (13 of 93 pts studied) putting them at risk for endocarditis. (Obstet Gynecol 1996 ;87:779-784)
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