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Am Fam Physician. 2002;65(12):2425

Hormone replacement therapy (HRT) ages gracefully along with its users. A study of 2,073 women older than 65 without dementia showed that the older the woman, the greater the cognitive benefits of HRT. Published in Women's Health, the study found that HRT use was associated with a slower rate of cognitive decline and better baseline scores on the Mini-Mental State Examination in women 75 or older. The benefits of HRT may be latent until older age, when cognitive reserve is depleting or Alzheimer's disease is more likely to set in.

A 21-year-old man presented to the emergency department with difficulty breathing and swallowing, and the sensation of a lump in the back of his throat, reports The Lancet. He admitted to having recently smoked crack cocaine and taking a “superman ecstasy” tablet. Examination showed an anteverted, enlarged, inflamed uvula. There have been several other reports of airway injury from crack cocaine use. If you're wondering what caused this patient's swollen uvula: the smoked vapors of crack cocaine exceed 200°C.

“How many licks does it take to kick the habit?” Smokers wanting to kick the habit can now lick it away, reports an article in Time. Available in flavors such as Very Berry and Lemon Lime and shaped like lollipops and gummi bears, candy contains either 2 or 4 mg of nicotine salicylate. The candy is intended to be used when the urge to smoke becomes overpowering. As soon as the craving has passed, the lollipop is to be replaced in its reusable bag. Unfortunately, because the candy has not been studied extensively, we don't know how many licks it takes to kick the habit.

Many people find the cost of prescription drugs hard to swallow. According to results of a telephone survey conducted in 2001 by Harris Interactive and published in Family Practice News, one in five Americans did not fill at least one prescription over the period of a year because of the cost. The survey of 1,010 adults also found that some patients have taken a medicine less often than prescribed (16 percent) and in smaller doses than prescribed (14 percent) to stretch their dollars.

What's in a name? When it comes to “disease,” more than you might think. In a recent theme issue, BMJ set out to define disease by asking editors and readers to say what it is not. They came up with a list of nearly 200 “nondiseases,” including aging, work, ugliness, childbirth, pregnancy, and loneliness. According to the editor of BMJ, the debate stirred up by this list is important because more conditions are being labeled as disease, a diagnosis that can change a patient's life and self-image. But if this question seems tough to define, BMJ points out that defining “health” isn't any easier.

We've all heard that eating fish regularly provides health benefits. Now, results of a study published in JAMA suggest that this diet may help women help their hearts. Researchers evaluated the dietary habits of 84,688 women over a 16-year period and found that women who included more fish and heart-healthy omega-3 fatty acids in their meals had a lower risk of coronary heart disease (CHD) and CHD mortality than those who did not. Because this study supports the current recommendation of two servings of fish per week to prevent CHD, more women are sure to get “hooked” on fish.

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Copyright © 2002 by the American Academy of Family Physicians.

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