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Am Fam Physician. 1998;58(8):1733-1734

U.S. tuberculosis rates continue to fall. In 1997, 19,855 cases of tuberculosis were reported to the Centers for Disease Control and Prevention; this represents a decline of 7 percent from 1996 and 26 percent from 1992. According to statistics published in Morbidity and Mortality Weekly Report, 57 percent of all cases of tuberculosis were reported in six states: California, Florida, Illinois, New Jersey, New York and Texas.

In the struggle to lower cholesterol, eating healthy may not be enough. A study by Merck found that in patients at risk for heart disease, low-density lipoprotein (LDL) cholesterol levels fell 13 percent in men and 9 percent in women who ate a low-fat diet and exercised. However, in patients who did not exercise and only changed their diets, LDL levels fell by only half of those percentages, reports New England Journal of Medicine.

Can you blame your cavities on antidepressants? Findings of a study in General Hospital Psychiatry suggest that you can. Antidepressant medications reduce salivary secretions, resulting in dry mouth. Dry mouth syndrome can interfere with the removal of bacteria from the teeth. The number of dry-mouth related cavities and mouth infections has increased with the rising use of antidepressants. Doctors should warn patients of these risks.

Here's a new hands-on approach to improving your child's health: massage. A study by the University of Miami School of Medicine suggests that parents can improve their child's asthma, insomnia, diabetes or dermatitis by giving daily 15- to 20-minute massages. The massage helps to reduce stress, which improves functioning of the immune system. In children with asthma, the massage therapy lessened anxiety and improved lung function. Children with insomnia were more than twice as likely to improve with massage therapy, according to Prevention.

What are the 10 most effective preventive services, ranked by importance? According to the Partnership for Prevention, cited in Family Practice News, the most important service is childhood immunizations, followed by the influenza vaccine for people over the age of 65, the pneumococcal vaccine for people over the age of 65, tobacco use screening and smoking cessation advice for people over the age of 18, blood pressure screening, hormone replacement therapy for peri-and postmenopausal women, folic acid intake for women of childbearing age, screening of newborns, screening for cervical cancer and cholesterol screening.

Is your glass half full or half empty? Researchers at Ohio State University questioned 224 middle-aged and older adults to assess the impact of optimism or pessimism on their life. High-scoring pessimists were more likely to report stress, anxiety and poor overall health, although no inverse correlation was found between these symptoms and optimism. Researchers concluded that it may be more important not to be a pessimist than to try to be an optimist, says Prevention.

Among the 600,700 new cases of cancer in women expected in 1998, the predicted top five cancers and five-year survival rates are as follows: 178,700 cases of breast cancer, 84 percent five-year survival rate; 80,100 cases of lung cancer, 14 percent survival; 67,000 cases of colon/rectal cancer, 62 percent/60 percent survival; 36,100 cases of endometrial/uterine cancer, 84 percent/69 percent survival; and 25,400 cases of ovarian cancer, 46 percent survival, according to data from the American Cancer Society, cited in USA Today.

Less oxygen equals less exercise time? According to advertisements for new hypobaric chambers that are showing up in select health clubs across the United States, cutting the percentage of oxygen in the air from 20 percent to 16 percent will force the body to work harder in the oxygen-depleted environment, reports Family Practice News. However, many experts feel that these claims are misleading and that the chambers aren't safe. The chambers might not help exercisers lose weight because they're unable to work out as intensely. Moreover, the chambers may pose a threat to people with cardiovascular disease, many of whom have unrecognized disease.

A woman in labor can scream louder than an ambulance siren, according to a study cited in Family Practice News. A researcher measured the sound levels from 30 nonmedicated women in labor. The loudest woman registered 115 decibels from 1 yard away. That's compared with an ambulance siren measuring 110 decibels at 5 feet and a passing subway train measuring 100 decibels. The researcher figured that medical staff standing near a woman who is screaming at 100 decibels at each contraction three minutes apart would be subjected to a noise level exceeding standards set down by the Occupational Safety and Health Administration.

As girls become teenagers, their rate of physical activity drops while their rate of dieting increases. A survey from the Commonwealth Fund found that 39 percent of girls in grades five through eight have dieted before, compared with 58 percent of girls in grades nine through 12. Eighty-one percent of girls in the younger group exercise three or more times a week, versus 67 percent in the older group, reports Family Practice News.

Ever wonder how many vacation days most employees receive after a year on the job? Well, wonder no more. According to data from Hewitt Associates, published in Business & Health, Austria and Brazil are the best places to work. Employees in those countries receive an average of 30 days of vacation after the first year; those in Germany get 24 days; employees in Britain receive 23 days; workers in Finland and Switzerland get 20 days; employees in Canada, Japan, and the United States all receive 10 days; and workers in Mexico get six days.

Meet Xylo the alien, the star of a new patient-oriented CD-ROM for children. Xylo was created by Steven Spielberg's Starbright Foundation to help children more fully understand diabetes. The CD-ROM is a game about an alien, Xylo, who needs the child's help in order to return to his planet. By properly managing his or her illness, the child earns points to help Xylo return home. Games, quizzes and interactive exercises teach children how to handle their illness. Parents of children with diabetes between the ages of five and 13 may obtain the free CD-ROM by calling 800-760-3818, reports USA Today.

Anti-infective agents cause the majority of adverse drug reactions in children, according to researchers at the Drug Safety Clinic at Sunnybrook Health Science Centre in Toronto. A review of the Health Canada database revealed 1,545 cases of reactions in children 16 years of age and younger between 1985 and 1995. What agents are most often to blame? Amoxicillin and ampicillin were at the top of the list, causing 24 percent of the total reactions; vaccines caused 19 percent; cefaclor, 8 percent; sulfamethoxazole-trimethoprim, 8 percent, erythromycin, 5 percent; opiate analgesics, 4 percent; penicillin, 3 percent; cloxacillin, 2 percent; anticonvulsants, 2 percent; and erythromycin/sulfisoxazole, 2 percent, according to Family Practice News.

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