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Am Fam Physician. 2001;64(2):207

“Don't do what I do, do what I tell you to do.” A study published in Southern Medical Journal reviewed patient visits for acute sinusitis in a teaching practice over the course of two years to see whether residents or staff physicians prescribe broader-spectrum antibiotics more often. It was hypothesized that residents would prescribe broad-spectrum antibiotics more frequently and that they would adopt more appropriate prescribing practices as their training level advances. In fact, the opposite was found: firstand second-year residents were more likely to prescribe narrowspectrum antibiotics than thirdyear residents or staff.

Ever wonder why some people consistently form kidney stones on the same side? The answer may lie in how little they toss and turn during the night. According to study results recently published in the Journal of Urology, there may be a correlation between recurrent unilateral nephrolithiasis and sleep posture. Researchers think that sleeping for long periods of time on one side may alter renal hemodynamics during sleep and promote stone formation.

“Care for some wine? Beer? Folate?” Here's another seemingly endless debate: some researchers think that alcohol, even one glass a day, can increase a woman's risk of developing breast cancer. Of course, others disagree. But for women who are concerned, there may be a way to protect themselves from cancer without giving up an occasional drink. According to an item published recently in Time, results of a study of 35,000 postmenopausal women show that 400 μg of the B vitamin folate seems to neutralize the cancer-causing effects of alcohol. Perhaps women should ask for a handful of dried beans or some green leafy vegetables to go with each glass of Chardonnay.

This is for anyone who thinks that medical assistants have an easy job. A case study published in the Journal of the American Board of Family Practice describes a 21-year-old medical assistant who suffered an acute anaphylactic reaction and respiratory distress shortly after a patient attacked her by spraying perfume in her face. The employee's adverse reaction was severe enough to warrant a two-day hospitalization along with two weeks of tapering steroid treatment and oral bronchodilator therapy, followed by two months of persistent shortness of breath. The attacker said she had sprayed on extra perfume so the physician would not notice she had been smoking. When questioned by the assistant, she pumped three sprays of perfume directly into the medical assistant's face.

Here's good advice: don't put your face within biting distance of an iguana. Despite what pet lovers may think, the giant lizards don't like to be cuddled, patted on the head or kissed. In fact, those behaviors can make the scaly critters downright irritable—and an irritable reptile can be an aggressive reptile. When provoked, iguanas lunge toward the nearest target. If your face happens to be the cause of the lizard's irritation, your nose will probably become that target. A recent issue of the Journal of the American Board of Family Practice details case studies of iguana/nose confrontations. Being bitten by an iguana is not a good thing. First, it hurts. A lot. Second, the iguana's victim usually ends up with an ugly nose. Third (here's where a physician comes in), the patient can develop Salmonella infection from such a bite.

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