Quantum Sufficit

Just Enough



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Am Fam Physician. 1999 Dec 1;60(9):2485-2486.

▪ What are the top drugs prescribed by family physicians? According to Scott-Levin, Premarin was the most commonly prescribed drug between June of 1997 and June of 1998, accounting for 4.4 percent of the total family practice retail market. With almost 13 million prescriptions, Synthroid came in second, and Trimox fell in third with more than 10 million prescriptions. Other top sellers included Prozac, Prilosec, ibuprofen and cephalexin, reports Family Practice News.

▪ Anemic elderly persons 85 years of age or older are twice as likely to die as persons of the same age without anemia, reports Internal Medicine News. According to a recent report by associates at Leiden (the Netherlands) University Medical Center, a study of 755 participants 85 years of age or older revealed anemia in 17 percent of women and 28 percent of men. Of anemic patients, 13 percent had malignant neoplasms and 5 percent had underlying infection; of persons without anemia, only 5 percent were found to have malignant neoplasms and only 2 percent had infection. The report also shows that the risk of mortality increases as hemoglobin levels decrease.

▪ Where do your underage patients get their cigarettes? According to a survey in the American Journal of Public Health, the most common sources of tobacco for underage smokers are social sources, such as relatives or friends, rather than retail stores. A survey for the Independent Evaluation of the California Tobacco Control, Prevention and Education Program polled a sample of 6,985 adults 18 years of age or older to determine which adults are more frequently asked to purchase cigarettes for minors. A little more than 10 percent of all adults polled had been asked to provide tobacco to a minor within the past year. Smokers 18 to 19 years of age had the highest rate of being asked to provide cigarettes (59 percent), while those 55 years or older had the lowest rate (2.6 percent). Other factors that affected the likelihood of providing cigarettes included sex, smoking status and income. Smokers 20 to 24 years of age were the second most likely group to be asked, followed closely by nonsmokers 18 to 19 years of age.

▪ Concerned about denied patient coverage? You're not alone. According to a recent survey from the Kaiser Family Foundation, cited in USA Today, 87 percent of doctors say their patients have dealt with denied health care claims from providers in the past two years. Drugs were the most common items denied, followed by tests or procedures, hospital stays, subspecialist visits and referrals for mental health care.

▪ A survey conducted by the National Highway Traffic Safety Administration shows that seat belt use is improving in the United States. According to the survey, cited in USA Today, almost 70 percent of passenger vehicle occupants wore their seat belts in 1998, compared with less than 60 percent in 1994.

▪ Don't forget to eat your vegetables. A study released by the Pennington Biomedical Research Center shows that getting teenagers to eat vegetables isn't the problem, it's getting them to eat the right vegetables. According to the study, derived from data collected by the U.S. Department of Agriculture, 31.2 percent of vegetable servings eaten by children 13 to 18 years of age are in the form of potato chips and french fries. These foods make up almost 25 percent of vegetable servings in persons 19 to 30 years of age and almost 17 percent of vegetable servings in the population as a whole.

▪ Need a quick tip to offer to your patients struggling with weight problems? Think water—and wait. Health Tips, a health letter published by Stanford Health Care, suggests that drinking water or tea about 10 minutes before meals is a simple way to help people stay on their weight management plans. The report states that thirst is often mistaken for hunger and that dieters often eat when they should really be replenishing liquids. Another tip is to eat slower. If dieters wait until they feel full to stop eating, they may overeat, because it often takes 20 to 30 minutes from the first bite for the body to recognize that its hunger has been satisfied.

▪ Diabetics should shy away from alcohol, right? Not necessarily, suggests a recent study published in JAMA. Findings in a study of 903 patients with adult-onset diabetes revealed that consuming one alcoholic drink per day along with a meal reduces patients' risk of death from coronary heart disease by 79 percent. The study compared the health of light to moderate drinkers with the health of nondrinkers. A summary of the report published in U.S. News & World Report suggests that physicians use caution in providing these statistics and always remember to provide ample information about the dangers involved in alcohol consumption, such as impaired driving, alcoholism and the effect of alcohol on blood sugar levels. The daily recommended amount of alcohol corresponds with the amount in one glass of wine, one beer or one shot of liquor.

▪ Morning sickness? Nausea experienced in pregnancy can be just as bad—if not worse—than nausea caused by some forms of chemotherapy, reports Family Practice News. In a study of 160 obstetric patients, researchers determined that pregnant women had a mean score of 1.9 on the Overall Nausea Index (a scale ranging from zero to 5), compared with a mean score of 1.8 in patients receiving 5-fluorouracil chemotherapy. The study, presented at the annual meeting of the Society of Obstetricians and Gynaecologists of Canada, also showed that nausea in pregnancy was seldom limited to the morning hours; up to 80 percent of the patients had nausea all day.

▪ Do your patients listen to you? According to a recent survey conducted by the Centers for Disease Control and Prevention, they do. The 1997 study, which polled 20,847 adults, found that of the 42 percent who reported receiving physician advice to exercise more and adapt to a lower fat diet, 83 percent said that they were heeding the advice. Seventy-five percent of those instructed to exercise by physicians were exercising, compared with 51 percent of persons who were involved in exercise programs without being advised by their doctors to do so, reports Family Practice News.

▪ The American Journal of Psychiatry reports that a natural body substance may help alleviate symptoms of depression. A study of 22 patients with major depression revealed that the addition of dehydroepiandrosterone (DHEA) improved symptoms and, in some patients, eliminated the need for antidepressants, according to a report in the Harvard Mental Health Letter. The hormone, which helps synthesize testosterone and estrogen, worked equally well for men and women. Evidence suggests that long-term use of DHEA can cause body hair growth, acne, oily skin, a deepening voice and aggressive or psychotic behavior.



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