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Old July 30th, 2001, 12:23
sysadmin sysadmin is offline
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1998.02.01

Clinical Pearls, 1-Feb-1998. On Thursday, January 29th, Vice President Gore discussed the Clinton Administration's plan to dramatically increase spending on cancer research. The proposal calls for an increase of about 65% over a 5 year period.

Recently released documents indicate that tobacco companies have targeted children as young as 14 years old in their advertising campaigns. This is in direct contradiction to earlier statements they have made. A 1975 document in discussing the Camel Filters brand stated that "the brand must increase its share penetration among the 14-24 age market, which have a new set of more liberal values and which represent tomorrow's cigarette business."

At a recent international conference, it was suggested that the organism Chlamydia Pneumonia may be at least partially responsible for the progression of asthma in certain individuals. This raises the possibility that both coronary heart disease and asthma may benefit from antibiotic therapy.

The 25th anniversary of the landmark Roe v Wade abortion ruling finds the USA still deeply divided over abortion.

Recommended reading this week is A Child Called 'It' by Dave Pelzer. This is a New York Times Bestseller and a powerful testament to the will to survive in a severely abused child. This is a modern day version of
Man's Search for Meaning by Victor Frankl (another exceptional book and testament to the human spirit). The great part of Dave's story is that he came out of his abuse as a survivor, not a victim. This is a story about an incredible man who has been honored by both U.S. Presidents Reagan and Bush. He also carried the Olympic Torch during the 1996 run. I strongly recommend this book.


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Now for the pearls of the week---

Asthmatics should receive a yearly flu shot. It has been thought by many that the vaccine could trigger an asthma exacerbation, but in this study of 255 patients the conclusion was that the risks of catching the flu was greater than the risks of the shot. Nicholson KG Lancet 1998 31-JAN 351:0326.

Vitamin E, and to a lesser extent Vitamin C and Beta-Carotene may help prevent tobacco related fetal damage in pregnant women who smoke. In this study, less placental calcification was found among smokers with higher intakes of these antioxidants. Am J Epidemiol 1998 147:0127.

In a study of 28 healthy volunteers, the 14 who spent 6 sessions listening to Respighi, Ravel, Bach, and Brahms over a 12-wk period had significantly improved their mood, felt less fatigued, and had less depression, compared to how they felt before. McCabe PM Health Psychol 1997 016:0390.

A high dietary iron intake has been linked to a greater risk of heart disease among people older than 60 years. When all ages are considered, there does not appear to be a relationship between the two. Trichopoulos D Am J Epidemiol 1998 147:0161.

The combined intake of Vitamin E (1000 IU/d) and Vitamin C (2 grams/d) helped protect against sunburn in this study of 10 people. J Am Acad Dermatol 1998 038:0045.

Being overweight was associated with an increased rate of esophageal cancer. J Nat Cancer Inst 1998 090:0150.

In the diagnosis of tibial stress fractures, if the patient has increased pain when a tuning fork is placed on the shin, the likelihood of a stress fracture is high. The test is negative, a bone scan is recommended. Lesho EP Military Med 1997 162:0802.

A high caffeine intake during pregnancy was associated with a 100% increase in the risk of Sudden Infant Death Syndrome. It may be because caffeine is a respiratory stimulant, when the baby loses this stimulation (when born) the SIDS risk increases. Ford R Arch Diseases Children 1998 0078.

Upon the initial diagnosis of diabetes mellitus, type II (adult onset), oral agents should be tried first before beginning insulin therapy according to this study of 458 patients. Annals Intern Med 1998 01-FEB 128:0165.

The application of nonsteroidal antiinflamatory drugs (NSAIDS) is useful for pain relief in both acute and chronic conditions. Ketoprofen, felbinac, ibuprofen, and piroxicam were found useful; benzydamine and indomethacin were not helpful in acute pain. Moore RA BMJ 1998 31-JAN 316:0333.

Cat allergens were found in almost one third of homes in which no cat lived; it may be more difficult than originally thought to keep cat allergens out of the home in a neighborhood with a lot of cats. Thorax 1998 053:0033.

After controlling for several factors, including total cholesterol intake, a diet high in soy products was associated with a lower serum cholesterol. J Nutrition 1998 128:0209.

In both men and women, obesity (defined as weight above the 95th percentile) was associated with an increased rate of both coronary heart disease and diabetes. J Nutrition 1998 128:411S.
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