Am Fam Physician. 1998 Sep 1;58(3):639-640.
▪ Waiting too long to read tuberculosis skin tests in children may cause up to 10 percent of positive results to be missed. According to a researcher at the Western clinical research meetings, cited in Family Practice News, 450 children up to 18 years of age were given the purified protein derivative (PPD) skin test. Of the 427 children who returned for a reading within 48 to 72 hours, 45 had a positive result. Of the 35 PPD-positive children who returned for a second reading a week after the test was administered, only 32 remained positive. If the PPD skin test can't be read within 48 to 72 hours, the researcher recommends repeating the test.
▪ Can organs be donated after a person's heart has stopped beating? While this practice is uncommon in the United States, physicians in Europe and Japan have begun to use kidneys from brain-dead persons whose hearts have stopped beating. In a study published in the New England Journal of Medicine, the outcome of 229 kidney transplants from donors whose hearts had stopped beating was compared with the outcome of 8,718 transplants from donors with beating hearts. One year later, 83 percent of the patients who had received a kidney from a person whose heart had stopped beating were still alive, compared with 89 percent of those who had received a kidney from a person with a beating heart.
▪ The bond between a mother and her child could be even stronger than was previously thought. Scientists at DuPont Merck Laboratories studied the importance of the mother/child relationship by observing orphaned children in Romania. Physical contact is necessary for children, but so are attention from and interaction with care-givers. Without the social stimulation provided by family life, a child's growth can be stunted—physically, emotionally and cognitively. The hormone produced in response to stress, cortisol, fluctuates more than normal in institutionalized children and leaves them more vulnerable to stress, says BrainWork.
▪ “Drug holidays,” the cessation of antiretroviral drugs for a period of time, are alarmingly common among HIV-infected patients, according to a survey conducted by Johnston, Zabor & Associates of 665 HIV-positive patients. Of those surveyed, 23 percent reported taking a drug holiday in the past six months, an average of two times, with each drug holiday lasting approximately 11 days. For patients on antiretroviral therapy for one year, the average drug holiday lasted 6.2 days, while patients with two years of therapy took 11.5 days off and patients with three or more years of therapy took 14.4 days off.
▪ Is there a correlation between disasters and the rate of suicide? According to a report published in the New England Journal of Medicine, researchers who studied records from 377 counties that had been struck by a disaster found that the suicide rate among victims of floods, hurricanes or earthquakes is almost 14 percent higher than the rate among those who didn't experience a disaster. Reasons for this increase could include loss of home, family, friends or jobs, and the loss of important social networks, says Medical Tribune.
▪ Today three fourths of adults over 25 years of age are heavier than the recommended weight range for their height and frame—which is up from just over half of adults in 1984. According to The Harris Poll, cited in USA Today, 76 percent of adults surveyed this year exceed the recommended weight range. That's compared with 74 percent in 1996, 69 percent in 1994, 66 percent in 1992, 64 percent in 1990 and 1988, 59 percent in 1986 and 56 percent in 1984.
▪ While the elderly are becoming more prosperous with the help of social programs, the status of children is declining. According to an article in Social Work Research, researchers at Washington University in St. Louis found that the living conditions of children have been deteriorating over the past 20 years, as the living conditions of the elderly have been rising. In 1973, only 12 percent of children in the United States were living below the poverty line; that number has since doubled. Twenty-five percent of the elderly were living in poverty in 1970; only 12 percent were living below the poverty line in 1994.
▪ How much money does the average person need? It all depends on whether you're part of the general public or the top 1 percent of the population (those with incomes over $250,000 or assets over $2.5 million). In 1997, according to a Worth/Roper Starch Worldwide survey by the Census Bureau, reported in American Demographics, in order to just “get by,” the top 1 percent would require an income of $80,000 annually; the general public would need $25,000. To live in reasonable comfort, the top 1 percent would need $150,000, while the general public would have to earn $41,000. And, in order to fulfill all their dreams, the top 1 percent would have to earn $500,000 a year; the general public would require $102,000.
▪ Want to prevent the incurable common cold? Then avoid stress, says a study presented to the American Psychosomatic Society. The cold virus was given to 276 adults who participated in the study. Researchers then waited to see how many would develop a cold. They found that work-related stress made people up to five times more vulnerable to sickness. What helped? Having more than six social roles to play, such as parent, friend, spouse, child, club member, etc. Researchers say it is possible that people with many social roles and a desired job are less vulnerable to colds because they have less interpersonal and job-related stress, reports USA Today.
▪ Thinking of getting into shape? Exercise can reduce your risk of death even if genetic disorders are present, according to a study by the University of Helsinki. Researchers studied leisure time activity and death in 7,925 healthy men and 7,977 healthy women involved in a twin study. Those co-twins who exercised at least six times a month for 30 minutes had a 56 percent lower risk of death compared with the sedentary twin. Co-twins who exercised occasionally had a 34 percent reduced risk of death compared with the co-twin who didn't exercise, says the Journal of the American Medical Association.
▪ Tonsillectomies may become unnecessary for many children undergoing extensive antibiotic treatment. A study in Pediatrics showed that a 30-day treatment with amoxicillin-clavulanate often delays the need for tonsillectomy in children and sometimes works so well that surgery is not needed. After one month of treatment, 62.5 percent of the children no longer needed surgery and the benefits lasted as long as two years. Many of the children treated “could simply outgrow the need for a tonsillectomy.”
▪ Are the calendar and the clock related in first-time labor? A retrospective study in the American Journal of Obstetrics and Gynecology found a correlation between the time of year and the time at delivery in women having their first child. For 15,910 women studied over the past 10 years, the timing of first-time labor seemed to be regulated by the calendar. Winter births were most likely to occur around 5 p.m., and by summertime, deliveries occurred at about 1 p.m., showing that labor began earlier as the days grew longer, reports the Medical Tribune.
Copyright © 1998 by the American Academy of Family Physicians.
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