New herbal remedies are being studied, with good results. The most exciting thing about herbal remedies is that the side effects are usually very low. An exciting finding is that Prunella vulgaris may help fight the herpes simplex virus. This is currently being studied by Dr. Spencer Lee of Dalhousie University in Halifax, Nova Scotia (story).

Recommended reading this week is Protein Power: the metabolic breakthrough by Drs. Michael R. and Mary Dan Eades. The book outlines a method of weight loss that results in improved sugar levels for diabetics, improved cholesterol levels, and more energy. Several patients in our clinic have had excellent results using this method.

Now for the Medical Pearls....

Riboflavin 400 mg once a day was effective in reducing the number of migraines per month from 3.83 to less than 2 in this study of 80 patients; the number needed to treat was 2.8 for a 50% reduction in attack frequency. Schoenen J et al Neurology, 1998, 050:0466.

Vitamin D deficiency is very common among hospitalized patients; in this study of 290 patients, 57% were vitamin D deficient. Thomas MK et al NEJM, 19-MAR 1998, 338:0777.

Estrogen replacement therapy was shown to decrease the rate of Parkinson's Disease associated dementia by almost 5 times. Marder K et al Neurology, 1998, 050:1141.

In this study of 10,519 patients over 55, taking BOTH a diuretic and a nonsteroidal anti-inflammatory drug was associated with a relative risk of 2.2 for subsequent hospitalization for congestive heart failure. Heerdink ER et al Arch Intern Med, 15-MAY 1998, 158:1108.

A free/total PSA level of 25% or less is a risk factor for prostate cancer; in this study of 773 men, this 25% threshold detected 98% of cancers in men in their 50's, 94% for men in their 60's, and 90% for men in their 70's. Roberts RO et al Urology, 1998, 051:0578.

Corticosteroids are better than nonsteroidals at treating the symptoms of carpal tunnel disease. Chang MH … Neurology, 1998, 051:0390.

Want to prevent blisters on your feet from hiking? This study of Army cadets found that applying antiperspirant to your feet prior to hiking decreased the chance of blistering. Amer Acad Derm, 1998, 039:0202.

Head injury patients do better when they are referred to a specialist soon after the injury; in this study of 314, those referred early had better social skills and fewer symptoms 6 months after the injury. Neurol Neurosurg Psych, 1998, 056:0177.

Calcium at 1200 mg per day decreased premenstrual syndrome symptoms by about 50% in this study of 720 women. Thys-Jacobs S … Am J Obstet Gynecol, 1998, 179:0444.

Green tea consumption has been shown to enhance the antibacterial properties of penicillin, and may make "drug resistant" bacteria LESS resistant to antibiotics. Hamilton-Miller JMT … J Antimicrobial Chemotherapy, 1998, 042:0211.

Amoxicillin and folate inhibitors are just as effective as the newer, broad spectrum antibiotics in the treatment of acute sinusitis; antibiotics decreased the treatment failure rate by half as compared with placebo. de Ferranti SD et al BMJ, 05-SEP 1998, 317:0632.

Whole grain foods offer protection against death from ischemic heart disease; the 35% benefit found when comparing the top 25% with the bottom 25% of whole grain intake was not explained on the basis of the fiber content alone. Jacobs DR Jr et al Am J Clin Nutr, AUG 1998, 068:0248.

Even though insurances covered most or all of the cost of the prescription medications, older patients failed to fill their prescriptions for cholesterol lowering drugs about 40% of the time. 7,287 patients over age 65 were studied. Avorn J et al JAMA, 13-MAY 1998, 279:1458.

Four factors have been identified as predictive of healthy aging: normal weight, no smoking, low blood pressure, and low serum glucose. These 4 factors are largely modifiable by individuals. The study looked at 6,500 men of Japanese ancestry. Reed DM et al Am J Public Health, 1998, 088:1463.

Exercise during pregnancy was found to promote on-time deliveries: in this study of 557 women, there were fewer preterm deliveries, and faster post-term deliveries among very active women. Am J Public Health, 1998, 088:1528.