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Am Fam Physician. 2000;62(1):35-36

Here's some news to pass on to your patients. Faster is better. It is better to head for the closest medical facility, regardless of invasive capabilities, than to take the time to travel to a more sophisticated facility farther away. A study of 30,402 heart attack victims revealed that although patients taken to less sophisticated facilities had a higher likelihood of being transferred, they received equivalent immediate care at all types of hospitals, reports the American College of Cardiology Newsletter.

According to Internal Medicine News, swearing is not uncommon in surgical settings. Who slips the most? Would you believe gynecologic, general and orthopedic surgeons? The study, first published in the British Medical Journal, used a point system to measure the severity and frequency of harsh language in the operating room during elective surgeries. Whose lips were the cleanest? Why, ear, nose and throat surgeons, of course!

The prevalence of HIV-positivity among state and federal prison inmates was 2.1 percent in 1997, reports USA Today. This incidence is down from the 2.2 percent rate of reported HIV cases in U.S. prisons in 1991. The rates, provided by the Bureau of Justice Statistics, show a gradual decline in cases since the high of 2.5 percent in 1992.

St. John's wort may ward off the benefits of cyclosporine and indinavir, according to a report in Lancet. Indinavir, used to treat AIDS, and cyclosporine, used to help prevent rejection of transplanted organs, are made less effective by the herbal antidepressant. The herb reduces the concentrations of these drugs in the blood and lowers their effectiveness, notes Time.

Controlling high blood pressure in your prenatal patients may be a “moo” point, suggests Nutrition and Health News Alert. A recent study of 82 pregnant women from 18 to 35 years of age found that women whose daily consumption of calcium was equivalent to that found in three glasses of milk had lower blood pressure than women who consumed less calcium. An estimated 7.3 percent of pregnant women have high blood pressure.

Laying off the sugar might do more for your patients than just slimming their hips. Family Practice News reports that cutting out excessive quantities of sugar will help alleviate the occurrence of frequent vaginal yeast infections in some patients. By limiting their intake of sweets, wine, fruit and dairy products, patients can curb the amount of sugar present in the urine, decreasing the risk of a yeast infection. However, total abstinence from these foods is unnecessary.

Are your patients' marriages weighing them down?. The weight of marriage might be heavier than you think, at least according to a recent report in Psychology Today. Unhappily married women gain an average of 42 lb after 13 years of marriage. Although this gain is usually restricted to female partners, men often take advantage of their spouse's weight increase by using it as an excuse to continue bad habits or put on pounds of their own.

You might say that smokes and alcohol go hand in hand. Laboratory rats injected with nicotine can ingest almost 50 percent more alcohol than rats that have never been exposed to nicotine. Without nicotine, rats drink the equivalent of five drinks per hour. When nicotine equal to that contained in 20 cigarettes per day is administered, the rats can handle seven drinks per hour, reports Time.

According to Internal Medicine News, mammograms performed on obese women have degradations of sharpness and image contrast. These problems increase the chances that health professionals will miss early breast cancers or other breast masses. In addition, because of the larger size of the breasts, obese women have a longer exposure time and receive a higher radiation dose than lean or average women. Research done at the University of Michigan has shown that breast images taken of obese women were 79 percent less geometrically sharp than those of lean women, and the mean glandular dose of mammographic radiation was 2.33 times higher for obese women than for lean women.

Are you talking to me? If you dial in to dictate your medical notes, there is a chance you could be talking to a transcriptionist in India, reports the Wall Street Journal. The recent explosion of medical dictation has opened up the door for companies across the world to work while the American medical community sleeps, insuring faster turnaround and less expensive services such as transcription. Companies save an estimated 30 to 50 percent on scribes based in countries such as India, compared with U.S. employees. There are an estimated 250,000 medical scribes in the United States.

Brushing up on your bedside manner may mean more to your patients than spending more time with them. A recent study showed that patients were more satisfied with care from interns who had been rated highly by hospital faculty with regard to humanistic qualities, according to Internal Medicine News. Surprisingly, the amount of time spent with the patients or their families was not a factor in the patients' satisfaction. Other noncontributing factors included medical knowledge, training examination scores and workload for the particular day.

Frequent Internet users spend 59 percent less time watching television than their non-Web buddies, reports Stanford University. New statistics, notes a report in Time, show that people who spend significant amounts of time on the Internet often border on social isolation. Other things Web users give up include reading newspapers, talking on the phone and attending social events. Internet gurus also spend an average of 13 percent less time with their families than those who don't log on to the information highway.

Soccer now, suffer later, suggests a report in Psychology Today. Neurologic examinations of amateur runners, swimmers and soccer players revealed that 27 percent of soccer players displayed moderate to severely impaired memory, compared with 7 percent of other athletes. Additionally, 39 percent of soccer buffs demonstrated poor planning skills. Soccer players traditionally experience more concussions than persons involved in other sports.

About 10 to 15 percent of body piercings become infected, reports Internal Medicine News. According to experts, infections are most likely to occur in piercings of moist areas such as the genitalia or the nose. Oddly enough, piercings in the lips or tongue rarely become infected. Experts advise doctors to discourage diabetic patients against piercing, as well as patients who are prone to keloid formation. Patients should also be reminded of the risk of transmitting infections such as HIV, hepatitis and syphilis. Although body piercings are common now, they may soon give way to newer fads including scarification and branding.

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