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Am Fam Physician. 2004;69(4):797

Even so-called “good” air quality affects some children with asthma. A study published in JAMA showed that ozone levels below the current standard of the U.S. Environmental Protection Agency (120 parts per billion [ppb], one-hour average; 80 ppb, eight-hour average) are associated significantly with respiratory symptoms and the use of rescue medications in children using maintenance medication for asthma. The study of 271 children younger than 12 years evaluated the effects of exposure to ambient concentrations of ozone and particulate matter from April through September of 2001. A 50-ppb rise in one-hour ozone levels increased wheezing by 35 percent and chest tightness by 47 percent.

May the force be with you! … but not too much. As reported in a press release from Johns Hopkins University, biomedical engineering students at the school have created a device that could help physicians and midwives deliver babies safely during complicated births (e.g., when a baby's shoulder must be extracted from behind the pubic bone). The device, composed of three electrodes attached to the clinician's forearm and connected to a small box that fits into a pocket, measures electric impulses in the muscles to determine how much force a physician or midwife uses while delivering a baby.

“Wired” since birth? Even the youngest children in the United States are heavily exposed to electronic media, according to a telephone survey conducted by the Henry J. Kaiser Family Foundation and the Children's Digital Media Center in consultation with the Princeton Survey Research Associates. The survey showed that children six months to six years of age spend about the same amount of time watching TV and videos as they do playing outside (about two hours a day). In contrast, they spend only about 39 minutes a day reading or being read to. By the age of six years, 48 percent of children have used a computer, and 30 percent have played video games. Of the 1,065 parents surveyed, 43 percent believed that TV helped their children's learning, and 72 percent said that computers helped learning.

Some warning symptoms of acute myocardial infarction (MI) are less obvious than others in women. A study published in Circulation found that 95 percent of women who had an acute MI within the previous six months described symptoms other than or in addition to chest pain before the event. In the study of 515 women at five sites in three states, the most common prodromal symptoms were unusual fatigue (70.7 percent), sleep disturbance (47.8 percent), shortness of breath (42.1 percent), indigestion (39.4 percent), and anxiety (35.5 percent). Only 29.7 percent of the women reported chest discomfort, which is a hallmark symptom of acute MI in men. The researcher noted that absence of chest pain could be one reason that acute MI often is unrecognized or misdiagnosed in women.

It is never too late to start dieting—at least if you are a fruit fly. A study published in Science found that dietary restriction in Drosophila prolonged life span by reducing the short-term risk of death. When dietary restriction (i.e., 35 percent less yeast and sugar than standard medium) was initiated for the first time in fruit flies of any age who had previously been fully fed, the flies were no more likely to die than were flies of the same age that had been subjected to long-term dietary restriction. The investigators suggest that initiation of dietary restriction at any age could have the same effect in mammals, although specific experiments remain to be conducted.

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Copyright © 2004 by the American Academy of Family Physicians.

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