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Am Fam Physician. 2003;68(2):215

Toilet training can take longer if a child is not ready. A study published in Pediatricscompared the length of intensive toilet training (directing the child to use the toilet more than three times a day) in 378 children in a suburban private pediatric practice. Parents were interviewed every two to three months until training was completed. Training took 10 to 16 months in children who began the process before 27 months of age, and ended, on average, when the child was 35 months old. Children who began the process at the age of 27 to 33 months were toilet trained, on average, by 36 months of age. The two groups showed no differences in constipation or stool withholding, which have been described as side effects of starting toilet training too early.

Habitual snoring and chronic headaches may go together, based on the findings of a case-control study published in Neurology. Using responses to a telephone survey, researchers compared the prevalence of snoring in 206 adults with chronic daily headache and 507 adults with episodic headache (control subjects). Habitual snoring was reported by 24 percent of adults with chronic daily headache, compared with 14 percent of those with episodic headache. The researchers cited other studies showing that headaches may cause or be caused by sleep disorders, and that headache is associated with habitual snoring, even without sleep apnea. They also noted the need for studies that assess snoring and sleep in more detail.

Vaccines to treat drug addiction? According to U.S. News & World Report, clinical trials of vaccines against cocaine and nicotine have recently begun. These “vice vaccines” work through the creation of antibodies that keep the drug from reaching the brain and creating a high. The vaccines could be used to break an addiction or prevent one from forming; however, researchers are aware of the societal issues involved and are focusing on treatment rather than prevention. The antibodies last only months and they do not completely block the drugs' effects; higher doses of the drugs could overwhelm the antibody response.

A very-low-carbohydrate diet is effective for short-term weight loss in obese women who are otherwise healthy. A randomized trial published in the Journal of Clinical Endocrinology & Metabolismshowed that women who consumed a very-low-carbohydrate diet for six months lost more than double the amount of weight and more body fat than women who followed a low-fat diet. Measurements of cardiovascular health improved in both groups and did not differ between groups.

Tattooing and body piercing may increase the risk of serious infections. As reported on the Aphrodite Women's Health Web site, a survey of 874 tattoo and body-piercing establishments in New South Wales, Australia, found that only about one half of parlor operators followed government guidelines for the control of blood-borne infections. Thus, they could be putting their customers at risk for infection with human immunodeficiency virus, hepatitis B, and hepatitis C. More than one half of the respondents admitted that they needed to follow those guidelines more closely, despite problems such as lack of employee compliance and perceived customer resistance to the use of proper sterilization practices.

In 2001, children in families receiving welfare had a prevalence of asthma that was almost twice the national average, according to child trends analysis of data from a national survey conducted by the Centers for Disease Control and Prevention. The survey found that 10 percent of children in families receiving welfare had asthma, compared with 6 percent of children in families that did not receive this aid.

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