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Am Fam Physician. 2001;64(1):25

In the ongoing human effort to adorn our bodies with piercings, we have discovered yet another way to damage ourselves. This time it's with what the British Medical Journal refers to as “high” ear piercing—piercing the ear through the cartilage located in the upper third of the pinna. Soft tissue infection is an acceptable, if not expected, complication of piercing, but high ear piercing often results in auricular perichondritis. The patient is not only at risk for abscess, necrosis and endotoxic shock, but also likely to develop a deformity such as “cauliflower ear,” which is just as ugly a condition as its name implies. Authors of the BMJ article suggest that “Doctors should be vigilant to intervene early and aggressively to prevent the considerable cosmetic sequelae that usually occur in young people who have undergone high ear piercing…. for its aesthetic effect.” Good luck.

Ever wonder what laboratory rats dream about? Researchers at the Massachusetts Institute of Technology (MIT) have, and they found that rats dream about the mazes they spend the day learning to run. As reported in Psychology Today, MIT researchers say that the maze patterns learned by the rats appear again during REM sleep, to the point where researchers can determine at any given moment exactly where the rat would be in the maze if it were awake. They believe this is an indication that the rats are reactivating a learned experience while sleeping, perhaps even reevaluating to figure out how to do better the next day. Or, maybe it's the cheese ….

“I need to take what?” Nearly 70 percent of women of childbearing age do not understand the importance of folic acid in preventing neural tube defects in developing fetuses. As reported in America's Pharmacist, according to are cent study conducted by the Centers for Disease Control and Prevention and the Michigan Department of Community Health, only 42.4 percent of the women surveyed said they routinely take a multivitamin or a folic acid supplement.

“This is your brain. This is your brain on alcohol.” Many alcoholics will tell you that alcoholism is a disease that rewires the brain. Now, with the help of new imaging techniques, scientists are seeing this rewiring firsthand. Research at the Medical University of South Carolina shows that the frontal cortex in alcoholic patients lights up when they see the image of an alcoholic beverage. The frontal cortex, responsible for decisions and memories, is where the memory of the original drink is stored. Alcohol may also affect areas of the frontal cortex involved in judgment and impulse control, according to a report found atwww.usnews.com.

Sometimes a patient's explanation of “what happened” is hard to swallow. Case in point: a 27-year-old woman presented to an ER after swallowing her toothbrush. She said she slipped on a wet bathroom floor while brushing her teeth, thus lodging the toothbrush in her esophagus. Unusual? Not if you consider that the same thing happened to her one year earlier. According to a case report published in The Lancet, physicians should be suspicious when finding foreign items lodged in such places as the esophagus and the stomach. According to the report, a MEDLINE search of years 1988 to 2000 found 11 published articles on this topic describing about 40 cases of misguided toothbrushes. In most cases, the injuries resulted from bulimic patients who lost control of their toothbrush as they tried to induce vomiting.

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Copyright © 2001 by the American Academy of Family Physicians.

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