Quantum Sufficit

Just Enough



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Am Fam Physician. 2000 Oct 15;62(8):1761-1762.

▪ Every product warning, no matter how unnecessary it may seem, was precipitated by the unexpected actions of at least one consumer. Case in point: the British Medical Journal recently reported that an 18-year-old Briton with a prominent right ear used super glue to press his ear back against the postaural skin to make his ears appear symmetric. It took six months for his severe skin reaction to heal before surgeons could perform a limited otoplasty on the young man.

▪ Speaking of warnings that shouldn't be necessary in an intelligent society: the American Optometric Association recently felt compelled to warn patients against tinting their contact lenses with food dye. According to Family Practice News, the warning cited the possibility of allergic reactions, infections from nonsterile dyes and impaired vision from deep-colored lenses. This practice seems to have become popular among kids who read about it in teen magazines.

▪ The National Law Journal reports that a Texas appellate court has reversed a 1999 jury verdict against a large, nationwide retail pharmacy. In the judgment, the court determined that pharmacists in Texas are not required to warn patients of possible adverse side effects of the prescription drugs they dispense. Attorneys representing the pharmacy successfully argued that the responsibility to warn of the potential dangers of a prescription drug rests with the prescribing physician, not the pharmacist. According to the report, an appeal is expected.

▪ If sleeping eight hours each night is considered healthy, could sleeping seven hours be even healthier? According to a study reported recently in Family Practice News, people who get only seven hours of sleep per night live longer than those who sleep eight hours or more. The study of more than 1.1 million participants shows that the mortality risk ratio for sleeping 5.5 to 7.5 hours per night was less than that for sleeping more than 7.5 hours per night, whether or not participants used sleeping pills or reported insomnia. That's one less thing to worry about while tossing and turning in bed at night.

▪ Coronary heart disease may be a picky customer when targeting women. According to a study by researchers at the University of Pittsburgh Graduate School of Public Health, mortality rates for black women and women living in the South were highest. Among American women 45 to 54 years of age, there were 125 deaths per 100,000 blacks in Arkansas compared with 17 deaths per 100,000 white women in Colorado.

▪ Soon we will be able to throw birthday parties for water. A professor of earth and planetary sciences at Washington University in St. Louis has developed a nonradioactive method of giving water “fingerprints.” Using this technique to discover the age of water in any system, researchers and environmentalists will be able to assess water quality and track environmental changes.

▪ Simple: if you want to know if your patients are taking their medications, call their pharmacist. The University of Florida researchers' solution may be imperfect and cumbersome, but it might also save you and the patient unnecessary, sometimes life-threatening, complications in the long run.

▪ It might not be all in your head after all. Premenstrual dysphoric disorder might be partially caused by 30 percent lower levels of beta-endorphins, according to a study conducted at the University of North Carolina at Chapel Hill. This situation leads to lower pain thresholds and shorter tolerance times.

▪ What goes up must come down. Ecstasy, a recreational drug known for its use in all-night “raves,” causes the brain to release massive amounts of the mood-altering neurotransmitter serotonin. But just as in Einstein's theory, the drug then sends the brain's serotonin levels to a depressing state, according to a study published in Neurology. The study examined the brain of a young man who died of a drug overdose after nine years of using Ecstasy.

▪ Can an Advil a day keep dementia away? Perhaps. According to a study reported in the UCLA News, researchers think they have found a connection between ibuprofen (and other anti-inflammatories) and delay in the onset of Alzheimer's disease. In the study, laboratory mice that were genetically programmed to be prone to Alzheimer's disease were treated with ibuprofen for six months. They had only half as many amyloid plaques as mice who were not treated with ibuprofen. In people, the accumulation of amyloid plaques in the brain continues for approximately 20 years before clinical symptoms of Alzheimer's disease appear. Therefore, reducing the number of amyloid plaque lesions in human patients by 50 percent could delay onset of the disease by as many as 10 years and might prevent as many as 75 percent of cases.

▪ Smokers subject their families to secondhand smoke. There's nothing new about that information—but are they also responsible for “secondhand fat”? According to a study reported in Psychology Today, smokers' spouses consume an average of 3 g more of total fat per 1,000 calories than nonsmokers' spouses. As if that weren't bad enough, husbands of female smokers have an additional problem—they consume more alcohol and cholesterol than husbands of nonsmoking women.

▪ Patients are likely not to survive more than 20 years after coronary artery bypass surgery unless they quit smoking. If that statement doesn't catch your patients' attention, maybe the fact that continued smoking is likely to necessitate repeat heart surgery or angioplasty will. These facts, according to the Journal of the American College of Cardiology, are the results of a study that followed 985 patients for an average of 20 years after bypass surgery. These results are the first to show the long-term effects of continued smoking on survival after bypass surgery.

▪ Will good oral hygiene some day include brushing with chocolate toothpaste? The BBC recently reported on a research study conducted at Osaka University in Japan in which part of the cocoa bean used to make chocolate was found to be effective against mouth bacteria and tooth decay. An extract from the cocoa bean husk (CBH) has an antibacterial effect on the mouth and is effective in the fight against plaque and other damaging agents. In the study, rats on a high-sugar diet who were given CBH in their drinking water developed fewer than half the number of cavities in rats who were not given CBH. Researchers are now planning to test their findings on human subjects.

▪ The debate between the use of colonoscopy and double-contrast barium enema continues. A recent report in the New England Journal of Medicine shows that colonoscopy enables the detection of twice as many polyps as does enema. However, enema is less invasive and less expensive. And while enema isn't able to detect half of the larger, more cancerous polyps, colonoscopies are more prone to complications. Stay tuned.


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