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Am Fam Physician. 2000;61(8):2313-2314

I'm a little bit country, but not a little bit pollution control? A recent study indicates that rural vehicles emit more pollutants than urban vehicles. The study looked at ppvm (pollutant per vehicle-mile), which measures the total particulate matter emission made by a vehicle per mile. The study, conducted at Washington University, implicated factors such as more diesel traffic and greater road-dust emissions related to travel on open land as the cause of the higher readings. According to the study, first published in the Journal of Air and Waste Management Association, rural vehicles emit up to 300 mg ppvm, while urban cars emit from 30 to 40 mg ppvm.

Don't know much about geography? This subject may be more important than you think. A report in the New England Journal of Medicine states that men in the United States and Northern Europe are four times as likely to die as men with similar blood pressure levels in Japan or in the Mediterranean region of Europe. Researchers at the Dutch National Institute of Public Health and the Environment said that the differences are likely linked to geographic variation in diet and lifestyle. The study findings prompt questions about the current practice used to define hypertension. Currently, hypertension is defined as a systolic blood pressure of 140 mm Hg or higher, or diastolic pressure of 90 mm Hg or higher. Researchers propose that a more encompassing “global score” would be a better way to decide which patients would benefit from aggressive treatment. Along with blood pressure, the new scoring system would measure a person's cholesterol level and smoking status, and determine whether the patient has diabetes.

You may want to tell your patients with PMS to veg out. A report in the Journal of Obstetrics & Gynecology credits a low-fat, vegetarian diet with significant reductions in menstrual pain and other symptoms of PMS. The high-fiber diet works to increase sex-hormone binding globulin that neutralizes estrogen until needed, states Health Education Reports.

Doctors may be too timid when it comes to pulling out all the stops in cases of hair loss, suggests Internal Medicine News. In a recent report, physicians are cautioned against waiting too long to begin hair loss treatment in female patients. Women with hair loss often feel more vulnerable and lose more self-esteem than their follicularly challenged male counterparts, but female hair loss can be successfully treated in up to 70 percent of cases. Researchers suggest that the cause of hair loss can be determined in almost 50 percent of women by taking a simple history.

Sports-related injuries may cause more mental agony than physical pain, reports U.S. News & World Report. Of the 236 respondents to a Web site poll on sports injuries, 58 percent claimed to suffer more from mental pain than from the actual physical injury. Fifty-nine percent of injured athletes spent more time watching television, 59 percent bickered more with their partners, and 78 percent reported a decrease in sexual activity after a sports-related injury. Suggestions for warding off injury include stretching, staying in shape and not overdoing it.

The long and short of it is that taller men are more successful at reproduction. A study of 3,201 healthy men ages 25 to 60 years found that men with children were significantly taller than childless men. The study, which was conducted at the Lower Silesian Medical Centre in Wroclaw, Poland, also found urban men to be taller than rural men. The results were attributed to the theory that shorter men are disadvantaged in the search for a mate.

We've got the pain, but where's the gain? Almost 50 percent of the general population have chronic pain, according to a report in Lancet. In a survey of 5,036 Scottish general practice patients, 46.5 percent reported pain or discomfort lasting more than three months. The random sample also revealed that more than one third of these patients linked their pain to arthritis or back pain. Arthritis pain was the most common cause of discomfort in older women and back trouble the most common problem in younger men. Other listed sources of pain included headaches and leg pain.

Heard the scoop? With increased intake of calcium, the risk of stroke in women is decreased, according to results of the ongoing Nurses' Health Study conducted by Brigham and Women's Hospital and Harvard Medical School. The decreased risk was identified in a study of 86,000 women ranging from 34 to 59 years of age, published in Stroke. The recommended optimum dosage is 400 mg per day and can be obtained from supplements, milk, hard cheeses, yogurt and even ice cream, reports Vim & Vigor.

Time keeps ticking away, especially for those who smoke. The British Medical Journal reports that smoking one cigarette reduces a smoker's life by 11 minutes. A recent study found that the average male smoker consumes 311,688 cigarettes in his lifetime, reducing life expectancy by roughly 6.5 years.

An increased sexual desire, more sexual episodes and more satisfying intercourse may be benefits on the horizon for women after hysterectomies. A report in the Wall Street Journal attributes the benefits to the reduction of pain and heavy bleeding that often exist in prehysterectomy patients. The most significant improvement occurred in pain experienced during intercourse. At the start of the trial, which followed the progress of 1,100 women undergoing hysterectomies, 41 percent of participants claimed to have pain on intercourse. Two years after the surgery, only 15 percent reported painful intercourse.

People who order contact lenses on the Internet might not be seeing clearly, or at all, reports Southwestern News. The biggest danger hides in the colored or patterned contacts popular with teens and young adults. The lenses can be ordered online without prescriptions, which is illegal and dangerous. Ophthalmologists warn that ill-fitting lenses could cause infections that could lead to blindness.

Are your patients running into side stitches? Here are some helpful suggestions from the Physician and Sportsmedicine. Patients should postpone running for at least two to three hours after a large meal or drink. Only small drinks should be taken during exercise to keep the stomach fluid mass at a low level, and exercisers should opt for sports drinks instead of pop or water because they are less likely to trigger the pain. Other suggestions include leaving more air in the lungs after each breath, keeping lips pursed to resist airflow during exhaling and bending forward and tightening the abdominal muscles during episodes of pain.

Can you giggle your way to greater accomplishments at work? According to Psychology Today, laughter just might be the best medicine. Researchers report that viewing funny films improved performance in men with jobs involving creativity and problem solving. However, humor had the opposite result in women; those shown funny clips performed worse than those who did not view the humorous selections.

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