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Am Fam Physician. 2002;66(2):205

Practice makes perfect… Hospitals that do a high volume of certain operations report fewer complications in patients, reported two studies published in New England Journal of Medicine. After reviewing 2.5 million Medicare claims from 1994 to 1999, one study found that hospitals performing a low number of six types of cardiovascular operations and eight cancer operations reported death rates that were up to 12 percent higher in each procedure than those in high-volume hospitals. Despite these results, the importance of volume remains a debatable issue because other indicators in the quality of care a patient receives are important.

Orange juice that helps strengthen bones? Margarine that lowers cholesterol? The health claims made by these products, called fortified foods, aren't convincing to many baby boomers, according to a survey conducted by Mintel International Group and published in American Demographics. Of more than 1,000 adults surveyed between 35 and 54 years of age, about 75 percent said they would consider trying fortified foods, but 39 percent of 35- to 44-year-olds and 50 percent of 45- to 54-year-olds said they were unsure of the health benefits. Baby boomers agreed on one thing, though; they would rather eat fatty food that tastes good than bland, nutritious food.

Aspirin, often called a miracle drug because of its ability to do everything from cooling a fever to reducing the risk of stroke or heart attack, may not perform miracles for the 30 percent of Americans who are resistant to it. According to a study cited in Time and published in Circulation, people who are aspirin resistant have a higher risk of dying of heart disease than those who are not resistant to aspirin. In people who are aspirin resistant, the drug does not adequately block thromboxane, which promotes the formation of life-threatening clots in the arteries.

Researchers are changing their thinking when it comes to preventing falls and fractures in the elderly. According to information presented at a meeting sponsored by the American College of Rheumatology and published in Family Practice News, two recent studies suggest that oral vitamin D may be help to reduce the number of falls and fractures in the elderly. In one study of 122 persons, participants who took vitamin D plus calcium had 51 percent fewer falls than those who took calcium alone. The findings are exciting to osteoporosis researchers, who have primarily looked at ways to increase bone density. Vitamin D has a limited effect on bone density but may help improve musculoskeletal function and increase agility.

Parents who smoke produce more female offspring than nonsmoking parents. According to a study published in The Lancet, the offspring sex ratio (male to female) was lower when either one or both of the parents smoked 20 or more cigarettes daily compared with couples in which neither of the parents smoked. Researchers recorded the sex of 11,815 infants delivered from December 2000 to July 2001 and divided the parents into three groups: nonsmokers; those who smoked one to 19 cigarettes daily; and those who smoked at least 20 cigarettes daily. Study results showed that the sex ratio declined as the number of cigarettes smoked by one or both of the parents increased, with the lowest sex ratio (255: 310) occurring in the group in which both mothers and fathers smoked 20 or more cigarettes daily.

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