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Am Fam Physician. 2000;61(11):3235-3236

If your cancer patients are turning to alternative therapies, they may be in trouble, according to a recent report in Hippocrates. A recent Harvard study showed that 28 percent of 480 women with stage I or II breast cancer used alternative treatments after surgery. When patients were polled three months after surgery, new users of alternative treatments were found to have a greater likelihood of being depressed, a greater fear that the cancer would recur, less sexual satisfaction and a higher volume of pain, nausea and insomnia than women who did not seek alternative treatments. This discovery is significant because symptoms of depression or anxiety are often overlooked or unreported by patients who are seeing doctors for a major illness, such as breast cancer.

Can you handle this? According to Family Practice News, most sports injuries in youths should be easily diagnosed and managed in the primary care office. The report lists the top 10 most common sports injuries seen in children and teens: fractures (most common), anterior knee pain, Osgood-Schlatter disease, calcaneal epiphysitis, ankle sprain, muscle strain, shoulder injury, back pain and stress fracture. A key to diagnosis seems to reside in which particular sport the athlete is involved with. Injuries such as accessory navicular are often seen in gymnasts and basketball players, while more common injuries, such as ankle sprains, can occur in almost any sport.

Elderly patients with diabetes, cardiovascular disease or the apolipoprotein E e4 gene, which is linked with Alzheimer's disease, can lose their memory up to eight times faster than their healthier counterparts, according to a report in JAMA. Researchers suggest that exercising regularly and eating a healthful diet may help protect against short-term memory loss, notes Psychology Today.

High school subjects just “ain't” what they used to be, claim researchers from U.S. News and World Report. In a recent survey conducted by the UCLA Higher Education Research Institute, almost 35 percent of incoming college freshmen claimed to have maintained an “A” average in high school. This achievement was reached by only 15 percent of students polled in 1966. How could this be? According to the report, teachers and schools are lowering the bar in many situations to help students get into competitive colleges and to avoid dealing them esteem-damaging low grades. The survey also indicated that many students missed classes, felt bored in class and spent less than six hours per week on homework during their last year in high school.

Could rainy days and Mondays really be causing your patients' headaches? A recent study of 75 migraine patients from 16 to 65 years of age found that 32 patients had migraines triggered by a Canadian weather pattern called Chinook winds. This pattern occurs in Alberta and consists of warm westerly winds with velocities reaching more than 24 miles per hour. Most of the affected subjects were more likely to get migraines on pre-Chinook days or on very windy days, reports Neurology.

New ammunition supporting sexual abstinence has been released by the New England Journal of Medicine. Persistent human papillomaviruses, lasting a year or more, increase the risk of developing cervical cancer by 200 times. The sexually transmitted infection causes genital warts and is somewhat prevented by condoms, but monogamy or abstention are the most effective precautions, reports Time magazine.

Fashionable or not, cigars increase the risk of heart disease and lung cancer. The sale of these tobacco products, which has increased almost 50 percent in the U.S. between 1993 and 1997, largely reflects their popularity among affluent, educated men. A recent study of 1,500 male cigar smokers, reported in the New England Journal of Medicine, found a 27 percent increased risk of heart disease and a 45 percent increased risk of chronic obstructive pulmonary disease in cigar smokers compared with nonsmokers. Smoking cigars also more than doubles a smoker's risk of lung, oropharynx or upper aerodigestive tract cancers, reports Hippocrates.

Children who experience severe burns in childhood often grow up to have the same quality of life as uninjured children. A recent study reported in the Lancet evaluated 80 children who had survived burns affecting more than 70 percent of their bodies. The children had experienced the burns before they were 18 years of age and were admitted to the Shriner's Burns Hospital between 1969 and 1992. Surprisingly, not only did these subjects score relatively close to unharmed children on a quality-of-life scale, they also score better than the control group in the mental health domain. The report points to multidisciplinary aftercare and family support as the main reason that they were able to achieve a good quality of life.

Want to get in good with your brokers? Buy them a pet, suggests study findings reported in Internal Medicine News. In a recent study, 48 male and female stockbrokers taking ACE inhibitors with an average resting blood pressure of 165/110 mm Hg were presented with a stressful situation. Those who did not own a pet experienced a 50 percent greater increase in blood pressure during the stressful interaction. Here kitty, kitty!

Are we running on empty? The United States uses up to 40,000 units of blood every day, reports Physicians Financial News. The demand has recently increased because of the rise in organ transplants and other new medical therapies, creating worries that we will soon use more blood than we collect. According to the report, the number of transfusions is up by 5 percent and the number of donations is down by 5 percent. What can you do? Experts suggest that talking to your healthy patients about the safety of donating blood and learning more about your area's blood banks is the best line of defense against shortages of donated blood. Almost 50 units of blood are required in procedures after an automobile accident, while an estimated 40 units are required to perform a single organ transplant.

How do your patients decide which political issues are important to them? It's not by listening to their mates, reports U.S. News & World Report. Only 23 percent of women polled say their partner has the greatest influence on their political views, while a mere 14 percent of men say they are swayed by their partner's concerns. In fact, 80 percent of men and women say that people of the opposite sex focus on the wrong issues.

Out with the old and in with the new: some traditional parenting rules may end up hurting your kids. According to the Journal of the American Dietetic Association, forcing your children to clean their plates may increase the chance that they will overeat when they get older. A study showed that children five years of age who were given unusually large portions of food continued eating until their plate was empty, while children three years of age who were given oversize portions ate only until they were full. The older children had learned to ignore their bodies' signals and eat until the food ran out, while the younger children were more in tune with their bodies, reports Time magazine.

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