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Am Fam Physician. 2000;61(5):1251-1252

Alternative remedies are gaining ground with more than two-thirds of Canadians convinced that natural herbal supplements can be as effective as over-the-counter remedies or even prescription drugs. According to a survey released by Traditional Medicinals, more than 50 percent of respondents said they would treat a cold with herbal supplements and almost 40 percent would look to nature to ease sleeplessness or stress.

A simple vaginal pH self-screen can reduce the risk of preterm labor by up to 90 percent, reports Family Practice News. In a German trial of 2,400 pregnant women, monitoring based on weekly self-administered vaginal tests reduced the rate of births before 32 weeks gestation and dropped the rate of cesarean deliveries by 27 percent. The test, which is simple to perform, has only been tested in Germany but may eventually be marketed in the United States.

Fast-food restaurants could be defeating patients in the battle of the bulge. The U. S. Department of Agriculture found that, in 1995, at least 20 percent of the American diet consisted of meals eaten in restaurants. Consumer Reports On Health offers five simple tips to trim takeout calories. By cutting down portion sizes, leaving off toppings, opting for baked or broiled foods, avoiding refined grains and choosing high nutrient, low-calorie drinks, consumers can cut their fast-food calories dramatically. If all else fails and patients do overindulge, the report suggests counteracting the mistake by eating only fruits, vegetables, lean meats and whole grains for the next few meals.

Smooches from pooches may result in purulent otorrhoea and possibly even meningitis, reports the Lancet. In a recent case, a dog lover was treated for meningitis due to Pasteurella multocida transmitted by saliva from his dog. P. multocida are commensals usually found on animals that can cause infections in humans, usually after bites. The report cautions patients with perforated tympanic membranes to ward off licks from their pets.

Here a pill, there a pill. Drug mix-ups are all in the name, reports Time magazine. A recent report blamed the strikingly similar names of the more than 15,000 drugs on the market for common medication mix-ups. Some problematic prescriptions to watch out for include such drugs as Flomax and Fosamax that are spelled similarly but are used to treat drastically different problems. To reduce problems, physicians should inform patients of the generic and brand name, expected color and shape and possible side effects of the drug they prescribe.

A recent study conducted at Howard University found that physicians sustain more needle-stick injuries than phlebotomists or nurses. Almost 40 percent of the 77 cases of needle-stick injury reported in 1998 at Howard University happened while a physician was handling a needle. Researchers suggest that the lack of in-service training with safety-lock needles for physicians may be to blame. However, the results of the study may be skewed, reports Internal Medicine News, because physicians at Howard traditionally draw blood and administer many injections.

It's a sore subject, but at least 20 to 25 percent of Americans have to deal with it, reports Prevention magazine. The subject? Cold sores, of course. According to a recent study at Semmelweis Medical University in Hungary, the painful life of these sores could be cut in half with a little help from the medicine cabinet. The study, which monitored cold sore breakouts in 42 subjects, found that 125 mg of aspirin taken at the first tingle or itch, and then once daily, could ease pain and speed healing. However, patients should be cautioned not to confuse cold sores with canker sores, which could be irritated by aspirin.

Are tardy teenagers telling us something? Recent findings cited in Health Education Reports claim that the health, behavior and academic performance of students could be improved if the school bell rang later in the morning. According to the report, the amount of sleep students get highly correlates with social behavior and academic performance. Because the natural circadian rhythms of adolescents generally operate on a different time frame than the traditional high school timings, experts suggest that schools incorporate later start times to produce better academic results.

A recent report in the Journal of the National Cancer Institute credits research on testicular cancer, a disease that traditionally strikes young men, with uncovering some of the most effective cancer treatments for cervical, ovarian, bladder, small cell lung cancers and pediatric sarcomas. Trial drugs for testicular cancer, such as Cisplatin, etoposide and cyclophosphamide, might not exist today without the success of testicular cancer research.

Indoor pollutants can spell big trouble for small patients, reports Family Practice News. Carbon monoxide, tobacco smoke, mercury and mold are the four most dangerous indoor pollutants. Carbon monoxide is the second leading cause of poisoning deaths in the United States. Males 15 to 24 years of age are most at risk from this pollutant because they are most likely to spend time working on running engines in confined spaces. Exposure to tobacco smoke in childhood can increase the risk of developing lung cancer up to 50 percent in adulthood. Everyone is wise to the mercury dangers in paints, but patients need to know that button batteries, mercurial antiseptics and broken thermometers are sources of mercury. Finally, researchers warn against the dangers of the slimy black mold known as Stachybotrys chartarum, which grows most often in homes with chronic water damage and can cause acute pulmonary hemorrhage in infants.

Chocolate: we know it and love it—but can it really be a cause of migraine pain? According to a report in the National Headache Foundation Headlines, chocolate is innocent, as far as headaches go. The report, which asserts that chocolate is often labeled guilty by chance association, points to other factors, such as skipped meals and menstrual cycles, as the real sources of pain. However, researchers don't dismiss the fact that chocolate is known to contain vasoactive amines that affect blood vessels in the brain. When triggered, these amines can cause vasodilation, which is associated with migraines. Many people who have migraines often crave sweets at the prodromal stage of the headache. Sufferers might later blame consumed sweets for setting off an attack that was already in motion at the time they gave in to temptation

Seventy-five percent of terminal care is provided by women, reports Physician's Financial News. A recent study in the New England Journal of Medicine, which followed 988 patients with a life expectancy of six months or less, found that female relatives provided the majority of day-to-day care. Moreover, caregivers often do not receive proper instructions for tasks such as changing feeding tubes, replacing intravenous medication and bathing.

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