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Am Fam Physician. 2002;66(10):1817

“Do the cross-and-squeeze.” No, it's not the latest dance move, but a technique developed at the Academic Medical Center in Amsterdam for people with a condition that causes their blood pressure to drop when they stand up. Twenty patients who had previous fainting spells were taught to cross their legs with one ankle over another and tense the muscles in their legs, buttocks, and abdomen when they felt their blood pressure drop. They were then strapped upright to a tilting table for 20 minutes. Use of the cross-and-squeeze maneuver stabilized the blood pressure and heart rate of all 20 patients, according to the study reported in the New York Times. The “cocktail party stance” forces blood out of the legs and into the brain.

Results of a study published in The Lancet should offer some reassurance to most families who have a child with epilepsy. The population-based cohort study followed 692 children who developed epilepsy in Nova Scotia between 1977 and 1985. Twenty-six of the patients died. One percent of 97 patients with absence epilepsy died. Of the 510 patients with other primary generalized and partial epilepsy, 12 (2 percent) died. Thirteen (15 percent) of the 85 patients with secondary generalized epilepsy died. Although the study concluded that children with epilepsy have more than five times the risk of dying than the general population, most deaths are related to comorbid neurologic disorders and not to the epilepsy.

What diagnoses are you making the most? According to a survey conducted by Scott-Levin of 505 physicians, hypertension, diabetes mellitus, and chronic sinusitis were the most frequently made diagnoses during family physician office visits last year, reports Family Practice News. Also high on the list were acute upper respiratory tract infection, bronchitis, and hyperlipidemia.

Are you allergic to life? A poll conducted by RoperASW for the American College of Allergy, Asthma & Immunology finds that allergies are making many persons feel that way. Of 300 persons surveyed, 94 percent said allergies affected their quality of life, including their ability to sleep (68 percent), participate in outdoor activities (53 percent), and work productively (43 percent). Despite these problems, 64 percent said they had not visited a physician the last time their allergies flared up.

Smoke-free workplaces may be helping smokers as well as nonsmokers. A systematic review of 26 studies that was reported in BMJ found that the prevalence of smoking and the number of cigarettes consumed by continuing smokers were lower in work environments that were completely smoke free. When these outcomes are combined, the studies showed a total reduction of 29 percent, which is promising news for the health of all workers in the United States, where many workplaces have banned smoking.

A diet high in vitamin E and other antioxidants may reduce a person's risk of Alzheimer's disease. According to two studies reported in JAMA, antioxidant vitamins have been shown to block the effects of free radicals, which are found in lesions in the brains of Alzheimer's patients. One of the studies also suggested that vitamin C may provide benefits. The studies did not show a benefit from antioxidants in supplements, however, but from foods like whole grains, green vegetables, and nuts. More definitive studies on antioxidants and Alzheimer's disease risk are needed.

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Copyright © 2002 by the American Academy of Family Physicians.

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