Quantum Sufficit

Just Enough



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Am Fam Physician. 2001 Apr 1;63(7):1283-1284.

▪ Humans have a difficult time walking or even standing after prolonged bed rest. Not so the bears, who wake up from a lengthy hibernation (about 130 days) with the ability to stand, walk and climb immediately. According to an article in The Lancet, bears maintain their muscle mass during hibernation by recycling more than 90 percent of their urea—unlike humans, who recycle about 14 percent during prolonged rest. Research is being conducted to determine how bears achieve such efficient recycling. The hope is to uncover data that might help people who are confined to bed, patients in kidney failure and astronauts.

▪ Here we go again. Diet soda is now suspected of causing brain dysfunction. The safety of saccharin has been debated for the past several decades, but this time the culprit ingredient is aspartame, commonly found in sugar-free diet drinks. According to information published in Psychology Today, researchers at Texas Christian University found that people who regularly drink diet sodas containing aspartame experience long-term memory loss. However, most laboratory testing is done in search of the ingredient's effect on short-term memory. Unlike the studies conducted in the 1960s that blamed the deaths of unsuspecting laboratory rats on saccharin, aspartame researchers haven't mentioned anything about lab rat mortality. Maybe they just forgot.

▪ Research published in the Journal of Personality and Social Psychology showed that one's memory may be restricted by emotional suppression. Participants were asked to view a film of an arguing married couple. Even though all the subjects described having similar emotional experiences, those who were asked to hide their emotions during the viewing remembered less of the film. Researchers think that hiding one's emotions taps resources critical to forming memories because of continuous self-monitoring. Hmm … maybe that's why so many spouses have trouble remembering those special dates.

▪ Someday a decision may be made about the effectiveness of garlic in reducing cholesterol levels—but not today. The results of a study published in the Annals of Internal Medicine dispel the theory that taking garlic is effective in reducing hypercholesterolemia. In the meta-analysis of 13 randomized, double-blind, placebo-controlled trials, garlic did reduce the total cholesterol level from baseline more than placebo. However, the size of the effect was modest, and the study concluded that the “robustness of the effect is debatable.”

▪ Leave 'em laughing! According to an article in the Australian Family Physician, the work of such humor-in-medicine pioneers as Dr. Patch Adams and the Clown Care Unit (CCU) in New York has inspired the Humour Foundation in Australia. The foundation offers an outreach program that sends hospitals “clown doctors,” complete with red noses, big floppy shoes, white lab coats, stethoscopes and doctors' bags filled with medical items (e.g., a stuffed kitty that can be placed on a patient to perform a “cat scan”). Clowns work in cooperation with clinicians to assess the needs of each patient and adapt their funny activities accordingly. It must be working—they're leaving a lot of happy patients behind.

▪ Besides spreading messages, your pager might also be spreading diseases. According to a letter published in the American Journal of Infection Control, an assessment of 36 doctors' pagers at a large urban hospital showed that they all carried bacteria. The letter writer wasn't surprised at this finding, because of doctors' hectic pace and their “notoriously bad” reputation for not washing their hands.

▪ Controlling epileptic seizures may soon be as easy as flipping a switch. Even though this is just a hypothesis for now, scientists are testing its likeliness for treating epilepsy in the future. A study in the Journal of Neuroscience used slices of rat brain to create a loop similar to that of an electrical feedback circuit. Just as a circuit knows when it's being overloaded and shuts itself off, these brain “circuits” could stop a seizure by sensing when specially treated brain slices are firing spasmodically.

▪ Smile. Eighty-three percent of Americans say they are in a good mood despite today's hurried lifestyle. Only 7 percent told the Gallup Poll that they were in a bad mood, while 9 percent were neither sad nor glad. The remaining 1 percent were either in too bad of a mood to respond or up on cloud nine.

▪ Once again, age is only a number. A Canadian study in the Archives of Internal Medicine showed that healthy people 80 years and older can benefit and successfully recover from joint replacement. Researchers studied the outcomes of total hip or knee replacement surgery in 454 patients, 69 of whom were older than 80 years. Regardless of age, all patients showed significant improvements in pain, function and stiffness after surgery. The patients older than 80 reported less stiffness at six months than the younger patients.

▪ From the “public health versus religion” file: in County Kildare, Ireland, entrants in the Irish Young Scientist contest analyzed holy water from local church fonts. The team of three schoolgirls chose this as their project after one of the girls developed a rash soon after blessing herself with holy water at a local church. According to an article in the British Medical Journal, the young researchers found tiny green worms in one font and large quantities of dirt in others. Nor was this an isolated incident. In 1998, a group of students competing in the annual science fair in County Clare grew bacterial cultures from holy water. In the cultures were found staphylococcus, yeasts, coliforms and molds. In Dublin two years ago, some church fonts were removed when it was learned that drug users rinsed their syringes in the holy water.

▪ Unsedated colonoscopy may be a good idea for the patient as well as the physician. Studies at the Scott & White Clinic in Temple, Texas, show a high success rate with unsedated colonoscopy and indicate that most patients not only accept, but prefer, not being sedated during the procedure. Colonoscopy without sedation saves money by significantly reducing procedure and recovery time; it also spares the patient the risks associated with sedation. Nearly 90 percent of patients who underwent the procedure without sedation described their discomfort immediately after the procedure as “tolerable to somewhat uncomfortable.” That number rose to 94 percent during follow-up one to three days later.

▪ Patient noncompliance often presents a frustrating situation for the prescribing physician and a potentially dangerous situation for the patient. Case studies in Australian Family Physician highlight this point. For example, a 60-year-old man was prescribed the use of a home oxygen delivery system for treatment of COPD. He was told that he must quit smoking and was warned about the risk of having oxygen near an open flame. While cooking on his gas stove (and wearing his home oxygen delivery system), the patient was badly burned when the nasal cannula he was wearing ignited. In another case, a 73-year-old patient with COPD, who had also been given warnings, had a similar experience while trying to smoke with his home oxygen system still attached. He graphically described flames streaming from his nostrils at the time of the unfortunate incident. Ouch!



Copyright © 2001 by the American Academy of Family Physicians.
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