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Old July 30th, 2001, 11:11
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1997.09.01

INTERNET MEDICAL JOURNAL
ISSN 1093-7935
VOL 1, NO. 3
01-SEPT-1997

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)

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)

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)

Full implementation of the 2-dose schedule of measles vaccination is essential for community-wide protection. (Pediatr Infect Dis J 1996 ;015:0031)

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)

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

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 ;015:0090)

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)

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)

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 ;005:0135)

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;017:0399)

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;063:0884)

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;063:0879)

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;063:0897)

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 ;043:1248)

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)

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)

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)

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)

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 ;086:0783)

The use of selegiline in patients with new onset mild Parkinson's Disease is associated with an increased mortality and no clinical benefit. (BMJ 1995 ;311:1602)

The induction of labor in women who have premature rupture of membranes at term was associated with shorter labors and less maternal infection. (NEJM 1996 ;334:1005)

Nicotine nasal spray, soon due on the market for prescription use, has been associated with quit rates of 33% at 6 months; this compares with rates for the patch of 22% and placebo of 12-15% at 6 months. (Physicians Clin Digest 1996 07/01;007:0053)

Late whiplash syndrome--neck pain, headaches, and mental impairment after a motor vehicle accident--causes significant disability in the US, however, this international study suggests the cause of late whiplash syndrome is purely economic and/or legal. (Lancet 1996 ;347:1207)

Elevated blood homocysteine levels appear to increase the risk of heart disease, fortunately lowering the level is easy- just take a multivitamin or B-Complex vitamin pill with folate daily; recommended dose is unknown, 1 mg/d probably sufficient. (Your Patient & Fitness 1996 ;10(4):0006)

It is estimated that 650,000 to 900,000 persons in the US were infected with HIV in 1992, approximately 0.3% of the population. (JAMA 1996 07/10;276:0126)

Failure to achieve the target heart rate on exercise treadmill testing was shown to be an independent predictor of coronary heart disease, with the risk of a cardiac event increased by 75% over the average 7.7 years of follow-up. (Circulation 1996 ;093:1520)

In this study of 333 patients with an ischemic stroke, those given thrombolytic therapy with t-PA were at least 30% more likely to have a favorable outcome at 3 months after the stroke; treatment was given within 3 hours of the onset of symptoms. (NEJM 1995 12/14;333:1581)

Nearly 50% of participants in a 4 community wide sample of patients with a history of myocardial infarction did not take aspirin regularly indicating a servere underutilization of aspirin in the prevention of subsequent myocardial infarctions. (Am Heart J 1996 ;131:0915)

In this study of 11178 people aged 67 - 105 years, the use of vitamin E supplementation reduced the risk of all cause mortality by 34%; simultaneous use of vitamin C reduced the risk by 42%. (Am J Clin Nutr 1996 ;064:0190)

According to the HALT trial of 851 patients studied for 16 weeks, doxazosin effectively lowered blood pressure while also lowering total cholesterol by 2.7%, LDL cholesterol by 2.4%, and significantly reducing the ratio of total to HDL cholesterol. (Am Heart J 1996 ;131:0966)

In a study of 411 patients, compliance with advice to exercise was increased if their doctor was of an appropriate weight, exercised regularly, and didn't smoke. (Clin J Sport Med 1996 ;6(2):0112)

The treatment of asymptomatic bactiuria in older women is not helpful; in this study of 50 women, antibiotic treatment did not lower the rate of symptoms during the following 6 months; it is recommended that antibiotic treatment not be given. (J Am Geriatr Soc 1996 ;044:0293)

Eradication of H. Pylori is useful not only in patients with ulcers, but also in those with dyspepsia. Treatment with pepto-bismol, Flagyl, and amoxicillin lead to a 75% eradication, and overall improvement in symptoms. (Am J Gastroenterol 1996 ;091:0441)

The use of calcium channel blockers is associated with an increased risk of gastrointestinal bleeding compared with beta-blockers and ace-inhibitors. (Lancet 1996 ;347:1061)

Transdermal estrogen is helpful in the treatment of postpartum depression. (Lancet 1996 ;347:0930)

In a study of 307 pts presenting with symptoms and complaints of a common cold, approximately 20% had bacterial colonization and benefitted from antibiotics; the other 80% did not benefit from antibiotics and were more likely to experience side-effects. (Lancet 1996 ;347:1507)

The initiation of early feeding after a cesarean section (sips of water immediately after surgery and pudding within 6 hours) was associated with a more rapid return of gastrointestinal function. (Obstet Gynecol 1996 ;087:1006)

In this study of 500, treatment of deep venous thrombosis can be safely treated with outpatient enoxaparin, 1 mg per kg body weight twice daily. (NEJM 1996 ;334:0677)

In this study of 400, treatment of deep venous thrombosis can be safely treated with outpatient enoxaparin. (NEJM 1996 ;334:0682)

In this meta-analysis of 2459 women, calcium supplementation of 1.5 g to 2.0 g per day during pregnancy decreased blood pressure and the rate of preeclampsia; the mean number needed to treat to prevent 1 case of preeclampsia was estimated to be 23. (JAMA 1996 ;275:1113)

Membrane stripping of the woman at term promoted the onset of labor in this study of 120; the mean time to onset of labor was 12.7 d for controls and 8.2 d for those receiving stripping. (Obstet Gynecol 1996 ;087:0767)

Results from a 6 year study indicates that that both aspirin and nonsteroidal anti-inflammatory drugs can lead to a significant reduction in risk for colorectal neoplasia, possibly as much as a 50% reduction in risk. (Dig Dis Sci 1996 ;041:1319)

Postmenopausal estrogen use was associated with a decreased risk and delayed onset of Alzheimer's disease in this study of 1124 elderly women. (Lancet 1996 ;348:0429)

Results of a 7-year study of over 475,000 people indicate that passive smoking is associated with an approximately 20% increased risk of heart disease death. (Circulation 1996 ;094:0622)

Adding progesterone to postmenopausal estrogen therapy does not appear to reduce the cardiovascular benefits of estrogen therapy. (NEJM 1996 ;335:0453)

A continuous infusion of furosemide was found to be more efficacious and safer than intravenous bolus administration. (JACC 1996 ;028:0376)


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