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Am Fam Physician. 2000;62(6):1256

This will only hurt a little. A team of University of Pittsburgh Medical Center and Veterans Affairs surgeons and anesthesiologists recently performed minimally invasive direct coronary bypass (MIDCAB) surgery on a 51-year-old patient. Not exactly newsworthy, you say? It is, considering that the patient was awake during the procedure. Doctors performing the “beating-heart” surgery say that this method offers advantages over standard cardiac bypass surgery. For example, a much smaller incision is required, there is a reduced risk of neurologic complications and the patient has a much shorter hospital stay. Patients do have to be intubated and must spend at least one night in intensive care following surgery.

“But, Doctor, I do get exercise. I walk to my car every day.” Sound familiar? According to an item in HealthTips, a newsletter published by Stanford University Medical Center, even a small amount of exercise is better for patients than no exercise at all. According to the article, it's the accumulation of exercise that helps build endurance. The theory is, if a little bit of exercise makes patients feel better, they might go on to discover that more exercise increases that feeling and that could encourage them to continue. You never know. It could happen.

“Before starting any exercise program, consult your physician.” Good advice. In fact, you're probably telling your patients to avoid injury by stretching their muscles before exercising. Also good advice. Or is it? The American College of Sports Medicine recently published a study in Medicine & Science in Sports & Exercise suggesting that static stretching before exercise may not be as effective in reducing the incidence of lower limb injury as previously believed. Even if stretching may not prevent such injuries, tailored stretching at other times to achieve or maintain flexibility for daily activities is still considered to be beneficial.

Are your patients confused by new “miracle cancer cures” they hear about on the nightly news? Many patients don't realize that the FDA has a three-phase review process before a drug is approved for use. According to a recent article in Time, Phase I of the FDA review process is tried on a few human patients after extensive testing on animals. Only about one half of all cancer agents tested make it beyond Phase I. Of those that do, 70 percent make it beyond Phase II, the phase that determines the drug's efficacy. According to the article, the public should only start paying attention to news reports about drugs in Phase III. At that point, chances of FDA labeling approval are greater.

Are your patients afraid of getting shots? How about offering them potatoes instead? Researchers at the University of Maryland School of Medicine's Center for Vaccine Development have successfully tested a potato-based vaccine to fight the Norwalk virus. The rapidly spreading virus causes severe abdominal pain and diarrhea and is spread by contaminated food and water. The study, published in the Journal of Infectious Diseases, describes an exciting new edible vaccine delivery system in which people eat a raw vegetable that contains the gene for the vaccine protein.

Ever try to squeeze juice from a pomegranate? It could be a worthwhile effort. According to a study recently published in the American Journal of Clinical Nutrition, pomegranate juice can decrease LDL susceptibility to aggregation and retention. The study, based on healthy humans and atherosclerotic apoliproprotein E-deficient mice, showed that pomegranate juice has potent antiatherogenic effects that may be attributable to its antioxidative properties.

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