Quantum Sufficit

Just Enough



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Am Fam Physician. 2001 Mar 15;63(6):1019-1020.

▪ “A cold front is moving in—look for snow, sleet, and the probability of heart attacks, strokes and broken bones.” Think that's a strange weather forecast? It's perfectly normal for people living in some regions of England. According to the British Medical Journal, some areas are testing weather forecasts designed to give hospitals and primary care physicians early warning of projected increases in illnesses and injuries related to changes in the weather. Can descriptions of “hail the size of gallstones” be far off?

▪ An article in Family Practice News describes 11 things physicians can do to build good doctor-patient relationships. One is to establish eye contact when talking or listening to a patient; another is to physically touch the patient. Even if you can make the diagnosis from several feet away, it is suggested that you approach the patient and touch the area in question or put a reassuring hand on the patient. In case the advantages of such rapport building aren't obvious to you, consider this: when something goes wrong, patients are less likely to sue a physician they feel is truly interested in them.

▪ According to an article published in JAMA, teaching hospitals provide better care than nonteaching facilities when it comes to treating Medicare patients with acute myocardial infarction (AMI). Researchers found that large teaching hospitals prescribe more aspirin, ACE inhibitors and beta blockers for elderly patients admitted with AMIs. They concluded that, in this patient population, mortality was greater at minor teaching hospitals and even greater at nonteaching hospitals.

▪ Have you “heard” the latest in prescription drug dispensing? The University of Pittsburgh Medical Center has announced a new product that helps patients who have sight, language or memory difficulties by dispensing prescriptions in containers with “talking labels.” The labels contain pharmacy-written instructions and other information about the medication that the patient can play back at home using a replay unit. The message can be replayed indefinitely and cannot be deleted or changed by the user.

▪ Is there a correlation between sweets, alcohol and twins? Researchers at the University of North Carolina at Chapel Hill think so. A recent UNC-CH study shows a strong link between men's preferences for sweet tastes and whether their twin brothers like sweets. The researchers also believe there is a genetic correlation between a preference for alcohol and a taste for sweets.

▪ “Sorry, hon, you'll have to find something else to blame for your tossing and turning at night.” Researchers set out to see if the symptoms experienced by women in menopause are caused by hormonal changes. As reported in Women's Health in Primary Care, sleep problems increased gradually between early and late perimenopause, suggesting that these problems were not directly caused by hormonal changes.

▪ “Got milk? And—is it still good?” An article in a recent issue of AAP News indicates that breast milk is still safe to drink after being refrigerated for up to 72 hours. The author of the study recommends freezing milk at −20°C (−4°F) for storage from three to 30 days, or deep-freezing at −70°C (−94°F) for milk kept more than a month.

▪ Feeling grumpy? Eat some fish. New research shows that fish oil's omega-3 fatty acids may improve mood and mental health. A Harvard Medical School psychiatry professor studied 30 patients with bipolar disorder to determine whether eating fish oil or olive oil in conjunction with their regular medications would aid in stabilizing their moods. The study, published in the Archives of General Psychiatry, shows that after four months, the patients eating fish oil had a longer period of remission from the disorder than those eating olive oil.

▪ Given the amount of information available about health insurance, this news may surprise you. According to an item published in Business & Health, more than half of Americans are unfamiliar with the term “managed care.” In fact, three out of five people who are enrolled in a managed care system say that they have never been in such a plan. Two out of three are completely confident that their employers will continue to offer health insurance, and most believe that their employers do a better job of selecting plans than they would.

▪ A recent study conducted at the University of California at Los Angeles suggests that a mild brain concussion could prevent a child's brain from developing to its fullest potential. If a child loses developmental potential for even a short period of time, he or she could miss an important window of opportunity for learning or developing certain skills. Those skills could be much more difficult to learn or develop at an older age.

▪ Who takes care of caregivers? A recent issue of Psychology Today cites a study at the State University of New York in Buffalo that included 60 hypertensive men and women who were caring for seriously ill spouses. As part of the study, half of the caregivers adopted a dog. For six months, both groups wore ambulatory blood pressure monitors while interacting with their spouses and new pets. The caregivers with dogs had significantly reduced blood pressure and heart rate levels compared with those who had no pets.

▪ Does wishful thinking interfere with making end-of-life prognoses? Physicians tend to overestimate the amount of time a dying patient has left to live. According to a study published in the British Medical Journal, physicians, on average, estimate their terminally ill patients will live about five times longer than they actually do. The study of more than 460 patients showed that their doctors overestimated length of life 63 percent of the time—and the closer the doctor-patient relationship, the more likely doctors were to overestimate.

▪ The missing piece to the female puberty puzzle might have been found. A study published in Pediatrics showed that female infants who weighed less than 5.5 lb at birth advanced more quickly through puberty and started menstruation 1.6 years earlier than those with average birth weights. This rapid progression through puberty may be the body's way of catching up after a slow start.

▪ A heart attack needs to be treated immediately and aggressively. According to a study published in JAMA, heart-attack patients who receive angioplasties from experienced physicians within a few hours of the attack are less likely to die from a heart attack than those who receive clotbuster therapy. Angioplasty is commonly used in nonemergency patients with blocked arteries.



Copyright © 2001 by the American Academy of Family Physicians.
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