Quantum Sufficit

Just Enough

Am Fam Physician. 2002 Mar 15;65(6):1021.

▪ The ill effects of diabetes start early. Study results published in Pediatrics show that complications from type 1 diabetes mellitus cause longer hospital stays and higher medical charges for nonwhite and poor children. Children from the National Inpatient Sample data set, who were admitted for diabetes complications during 1996 and 1997, were identified by age, race, gender, and type of insurance coverage. Each hospital admittance was examined for length of stay and cost. The study shows that nonwhite children stay in the hospital longer than white children, that children covered by Medicaid insurance accrue higher charges than children with other types of insurance, and are usually younger.

▪ Buckle up, front, center, and rear! A research letter published in The Lancet show that deaths of front-seat occupants in car crashes can be attributed to lack of seat-belt use in rear-seat passengers. Information was obtained from the Japanese Institute for Traffic Accident Research and Data Analysis on the number of deaths and severe injuries sustained as a result of car wrecks between 1995 and 1999. The risk of death in front-seat occupants increase fivefold when unbelted rear-seat passengers are thrown forward. The study estimates that 79 percent of front-seat deaths could be prevented if rear-seat occupants buckle up.

▪ The best time to have a baby is during the day, and preferably at a time when hospital personnel are not changing shifts, suggest study results published in BMJ. Researchers, analyzing data from more than 2 million births in Sweden between 1973 and 1995, found that infant mortality and early neonatal mortality, especially when related to asphyxia, were more likely to occur at night than in the daytime. The highest risk period, especially for preterm infants, is from 5 p.m. to 1 a.m. and again around 9 a.m., during or right after hospital staff changes.

▪ Giving good advice just one time benefits mothers and babies. Results of a study published in Obstetrics & Gynecology show that one discussion of folic acid supplementation during preconception counseling significantly improves usage of this important supplement. In the 111 study subjects, folate levels in those who had not previously taken folic acid supplements increased from a mean of 540 nmol per L to 680 nmol per L four months after counseling. Women who had low precounseling folate levels showed an increase in red cell folate from a mean of 475 nmol per L to 689 nmol per L.

▪ Most U.S. adults take at least one medication per week, making it more important than ever to ask patients about all the medications they are taking, including prescription drugs, vitamins, and herbal supplements. According to the results of an ongoing telephone survey published in JAMA, 50 percent of 2,590 adults surveyed said they took one or more prescription drugs the previous week, and 16 percent indicated they were also taking an herbal supplement. Participants most often named headache and hypertension as the reasons for taking drugs. The most common reason given for taking vitamins and herbal supplements was “health.”

▪ Who says technology doesn't have heart? The U.S. Food and Drug Administration recently approved a cardioverter defibrillator that requires no surgery to implant and can be held to the body with a belt or vest. The device, designed and manufactured by Lifecor, Inc., monitors the heart continuously and will deliver a shock to the heart if the patient does not respond to alarms warning of abnormal heart rhythms. It comes with a modem that allows patients to send data recorded by the device to their physician's computer via the telephone.


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