Quantum Sufficit

Just Enough



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Am Fam Physician. 1999 Jul 1;60(1):25-26.

▪ Continuous irrigation makes full range of motion possible in patients with an infected finger, reports Physician's Weekly. Seven men with purulent tenosynovitis had a butterfly catheter (with the needle removed and holes cut in the sides) inserted in the tendon sheath from the palm to the distal finger crease. The end of the catheter was tied in a knot for retention, and no sutures were needed. Irrigation with 2 percent lidocaine in sterile saline began immediately after surgery. The patients began exercises in the recovery room and, in seven to nine days, full range of motion returned.

▪ Women with asthma who are pregnant with girls seem to have more severe asthma symptoms than do women pregnant with boys, reports British Medical Journal. Researchers speculate that it may have something to do with minute hormonal differences. Symptoms were reported by 34 women with moderate to severe asthma at 12 to 21 weeks' gestation. Sixteen of the mothers delivered girls and 18 had boys. Fifty percent of the mothers who had girls reported that their asthma symptoms were worse during pregnancy, compared with only 22 percent of the mothers of boys. None of the mothers of girls had improvement of asthma during pregnancy, compared with 44 percent of the mothers of boys.

▪ Is suicide predictable? A long-term study in England followed 3,500 persons who were born in the same week in 1946 until 1996; assessments of personality, intelligence, behavior, emotional stability, aggressive tendencies, anxiety and physical, cognitive and social development were conducted periodically before the age of 16. By 1996, 167 of the original participants had died, and 11 of these deaths were suicides. Suicide was linked to low anxiety levels in childhood, bed-wetting in boys at age four and behavioral problems in girls. Low social class, poor academic achievement, childhood psychiatric treatment and chronic disability in a parent were also linked to suicide, reports The Harvard Mental Health Letter.

▪ Does your patient need an immune system boost? Why not recommend a trip to the massage therapist? According to Internal Medicine News, massage therapy may help improve the immune system. Researchers at the University of Miami studied the effect of massage therapy in 10 control subjects and 10 women with stage I or II breast cancer who had undergone mastectomy or lumpectomy. After a five-week study period, women who had received massage showed a significant increase in natural killer cell count and cytotoxicity. Besides the added benefit of relieving stress and anxiety in some patients, massage therapy can be relatively inexpensive, costing as little as $45.

▪ Are people drawn to the thrill of the chase and the possibility of danger? The people of Cooper's Hill in England hope so. Danger and injury are part of this age-old game for those who take part in the annual cheese rolling festivities. A 7- to 8-lb wheel of cheese, about a foot in diameter, is released at the top of Cooper's Hill, where the incline is about 60 degrees. The cheese is then chased to the bottom of the hill by participants, reaching a speed of 30 miles per hour on its way down. What kind of injuries are most common in cheese rolling? Cuts, sprains, bruises and some dislocations, according to The Wall Street Journal.

▪ Being overweight and fit is healthier than being thin and unfit, reports the American Journal of Clinical Nutrition. About 22,000 men between 30 and 83 years of age underwent body composition evaluation and maximal treadmill exercise testing to determine their cardiorespiratory fitness. During the eight-year follow-up period, 428 of the participants died, 144 of whom died of cardiovascular disease. The fit participants had lower death rates from all causes than did their unfit counterparts, whether they were thin, of normal weight or obese. The study also showed that the rate of mortality was higher in unfit thin men than in fit obese men, showing that cardiovascular fitness influences the health effects of obesity.

▪ Men who smoke may be doing so to control their emotions, reports a University of California, Irvine research team. Twenty-five women and 35 men, 18 to 42 years of age, recorded their moods and smoking behavior every 20 minutes for 48 hours. Researchers then studied how study participants' emotions affected their urge to smoke, whether emotions caused them to smoke and how smoking affected their emotions. They found that smoking reduced anger in men who were often angry. Men were also more likely to smoke in response to fatigue and sadness. Women experienced no change in emotion after smoking.

▪ Is the midlife crisis just a myth? Researchers at the MacArthur Foundation surveyed 3,032 Americans between 25 and 74 years of age to find out. As it turns out, middle-age persons are less stressed than persons under 40 years of age, and only about 10 percent of people actually have a midlife crisis. In fact, 40- and 50-year-olds feel they have more control over their work, marriage and finances, and 72 percent of spouses 35 to 64 years of age describe their marriages as “excellent” or “very good.” And who's the happiest of them all? The married, extroverted man over 45 years of age, reports The Brain in the News.

▪ Vision problems, not mental confusion, may cause patients with Alzheimer's disease to become lost in familiar surroundings. According to investigators of a study in Neurology, “motion blindness” may result from isolated brain damage. Six healthy young persons, 12 healthy elderly persons and 11 persons with Alzheimer's disease were tested on their ability to see and interpret visual patterns. Patients with Alzheimer's disease had more than two times as much trouble interpreting the patterns than persons in the other groups. When asked questions about spatial navigation, victims of Alzheimer's disease scored significantly worse than other groups. Researchers concluded that Alzheimer's disease greatly disrupts the ability to see visual-spatial patterns that healthy persons use to orient themselves.

▪ A short pep talk during an office visit may be all it takes to get inactive patients moving again. In an Australian study, cited in Hippocrates, physicians spent two or three minutes discussing the benefits and risks of moderate exercise with 416 inactive adults, and also gave them pamphlets on the benefits of exercise. Another group of 347 inactive patients did not receive the counseling or the pamphlets. A survey given a month later showed that 40 percent of the patients who were encouraged to exercise had done so recently, compared with only 31 percent of patients in the control group. A year later, 36 percent of the patients who received the pep talk were still exercising.



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