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Am Fam Physician. 2000;61(3):621-622

Genetic testing might allow some at-risk patients to reduce their risk of cancer. According to a recent study reported in the Journal of the National Cancer Institute, prophylactic bilateral oophorectomy significantly reduced breast cancer risk in patients who had the BRCA1 gene mutation. The study included 43 women with the gene mutation who underwent surgery and 79 patients with the mutation who did not undergo surgery. The risk of breast cancer was reduced by almost 70 percent in women who had bilateral oophorectomy. Statistics cited in U.S. News and World Report indicate that 8,000 of 180,000 women diagnosed with breast cancer each year carry the mutated gene. Although removing the ovaries eliminates estrogen production that is linked to tumor growth, it also carries risks associated with premature menopause.

No bones about it, men are also at risk for osteoporosis. In recent research by the American Society for Bone & Mineral Research, more than 2 million American men were found to have the bone-thinning disease and more than 3 million may be at risk. However, alendronate (Fosamax), a bisphosphonate used to treat the disease in women led to a 7 percent improvement in the bone density of men regardless of age, reports Time magazine.

Time magazine reports a baldness breakthrough—but for mice, not men. Scientists recently found that hair follicles were awakened from the resting state by injections of a gene nicknamed “Sonic hedgehog.” However, the gene, which forces hair follicles into an active state, has an association with basal cell carcinoma and the trial has only been successful in mice.

There's power in the blood, report researchers from Mayo Clinic. A recent study of patients with multiple sclerosis found that a new treatment called plasma exchange reversed some symptoms, such as loss of speech and paralysis. According to the study, 42 percent of 19 patients who received the therapy experienced partial improvement to full function recovery and maintained the benefits for up to three years. However, the treatment includes seven sessions at a cost of $2,500 each, and it does not carry any guarantee of protection against future attacks. Moreover, the plasma treatment is only effective for patients with sudden debilitating attacks rather than slowly worsening symptoms.

Depression in men and women 65 years of age and older may be caused by “silent strokes” or small cerebral infarcts. The microstrokes, which are not accompanied by the symptoms associated with major strokes, proved to be closely associated with symptoms of depression such as apathy, motor impairment and psychomotor retardation. According to the study cited in Psychiatric News, involving 3,660 men and women, depression in older adults might be prevented with careful monitoring of cardiovascular risk factors.

NHF Head Lines, the newsletter of the National Headache Foundation, reports that chronic daily headaches could be caused by the abuse of over-the-counter analgesics. A recent study found that 17 of 32 patients hospitalized for chronic headache were overusing headache medications daily. Three months after treatment, more than 50 percent of patients reported that the intensity and frequency of their headaches had decreased. Among patients reporting no improvement in headaches, more than half were still abusing headache medications.

Use it or lose it! Is it possible that your patients are putting themselves at risk by consuming out-of-date products? A recent report in U.S. News & World Report claims that several common products, such as canned soup, beer and film, can be used well past their expiration dates. Other products, such as sunscreen, over-the-counter medications, baby formula, condoms and eggs, don't enjoy such a lenient shelf-life. Sunscreens lose 50 percent of their effectiveness when exposed to extreme heat and should be discarded after two years. Other products, such as infant formula, lose nutrients if they sit on the shelf too long. Infant formula that is more than four months old should be discarded. Cold medication loses 10 percent of its potency after it expires. Lubricated condoms should only be considered effective if they are used within five years of the manufacture date, while condoms with spermicide are reliable for only three years.

Thirty-eight percent of patients treated for high blood pressure may stop taking their medication because of drug tolerability problems, reports the Association of Black Cardiologists, Inc. Of commonly reported side effects, fatigue and dizziness were the most prevalent. Interestingly, headaches, potassium loss and weakness were more likely in black respondents than in white respondents.

If the shoes fit, wear them. An estimated 43 million Americans have foot problems, according to the American Academy of Orthopedic Surgeons. Many of these problems could be avoided by wearing correct footwear. People who participate in an activity more than three times a week should purchase shoes that will protect their feet for the specific activity, according to advice given in Time. Sports such as basketball, aerobics and running are activities that require supportive footwear regardless of how often they are done. When shopping for shoes, buyers should try on sneakers 30 minutes to 1 hour after completion of exercise, while the feet are still fully expanded from exercise. Shoes should be tried on while wearing the same type of socks that will be worn during the exercise, and at least a thumb's width of room should be left between the toes and the tip of the sneaker. Careful attention to protective footwear could help stomp out foot problems and lower the $3.5 billion associated cost of treatment and lost workdays.

Writing may alleviate symptoms of arthritis and asthma, reports Psychology Today. Evidence released by North Dakota State University and State University of New York at Stonybrook indicates that 50 percent of patients with chronic asthma or arthritis reduced symptoms after writing about traumatic events in a journal. The trial, which required that patients write about neutral topics or stressful incidents during three 20-minute sessions on consecutive days, found that only 25 percent of participants who wrote on neutral topics showed any improvement.

Patented prescription drugs are significantly more expensive in the United States than they are in other wealthy nations, reports USA Today. In a study released by the Canadian Patented Medicine Prices Review Board in 1998, drug prices in other countries, such as Italy, France, Canada and Great Britain, proved to be as much as 47 percent lower than U.S. prices. The most comparable drug costs were found in Switzerland, but even those were 26 percent lower than costs in America.

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