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Am Fam Physician. 2004;69(12):2753

Leading-edge treatments for stroke can be delivered and new clot-busting drugs can be tested only if patients understand the warning signs of stroke and seek help immediately. According to a press release from the University of Texas (UT) Southwestern Medical Center at Dallas, only 19 percent of 349 patients diagnosed with stroke sought treatment at Parkland Hospital within three hours of stroke onset—the period of time in which tissue plasminogen activator (tPA) can be used. Last year, UT Southwestern started a trial of a new clot-busting drug (derived from vampire bat saliva) that can be administered as late as nine hours after stroke onset. Only 40 (16 percent) of 252 patients screened for the study arrived within that time frame. None of the 40 patients qualified for the trial because they did not meet inclusion criteria or arrive in time for tPA to be administered.

The early birds are getting a jump start on preventing coronary heart disease (CHD). Food products that are free of trans-fatty acids will be introduced over the next several months by manufacturers like Kraft (reduced-fat and trans-fat–free Oreos) and Pepperidge Farm (trans-fat–free Goldfish crackers). This move is coming about two years ahead of a federal law that will require manufacturers to list trans-fatty acids on food labels, according to an article published in USA Today. Despite the trans-fat–free labeling, consumers still need to be aware of other nutritional factors of a food, such as calories.

Many babies today aren’t sleeping like babies. Published in The New York Times, a survey of more than 1,400 parents and other caretakers, which was undertaken by the National Sleep Foundation, found that infants average almost 90 minutes less sleep a day than the 14-hour minimum that doctors recommend. Researchers say that infants and toddlers need to get adequate sleep to be alert and aware of the world around them. The survey also found that 69 percent of young children have sleep-related problems a few nights a week. Experts attribute the drop in sleep and the high number of children with sleep problems to today’s 24/7 lifestyle.

What is the quality of end-of-life care in America’s finest hospitals? It varies, finds a retrospective cohort study published in BMJ. Researchers studied Medicare claims data from 77 hospitals that were featured in a U.S. News and World Report list of the “best hospitals” for geriatric, cancer, and heart and pulmonary disease services. Wide variations were found in many aspects of care during the last six months of life, including the amount of time spent in a hospital or intensive care unit, number of physician visits, and enrollment in a hospice program. For example, the number of physician visits ranged from 17.6 to 76.2, and hospice enrollment varied from 10.8 percent to 43.8 percent.

Good news! More Americans seem to be heeding warnings about tanning. According to a survey conducted by Mintel International Group Ltd., sales of sun-care products increased to $421 million in 2003 and are expected to rise 25 percent by 2008. Furthermore, sales of sunless tanning products increased 66 percent from 1998 to 2003. The survey showed that 45 percent of Americans use a sunscreen, and that nearly one half (49 percent) do not tan at all. Women were more likely than men to avoid tanning completely, and men were less likely to use sunscreen.

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