FIVE YEAR OLD SEVERELY INJURES BABY WHEN IMITATING TV SHOW
It's obvious that TV and movies directly affect the behavior of people. A case presented at the Canadian Pediatric Society's annual meeting was a tragic example. A 5 year old imitated a wrestling move on his 22 month old cousin, who subsequently suffered a spinal cord injury. Comment: remember this case when you next hear the Hollywood elite avoid responsibility and justify the violence they create on TV and in the movies by saying that their "art" simply "imitates life." [ article ]  posted at 6/26/2002 03:15:11 PM by Tom Heston, MD   comment on this article

EYE PATCHES NOT RECOMMENDED FOR CORNEAL ABRASIONS
This study of 163 patients with a corneal abrasion found that eye patching did not decrease pain nor did it improve healing. Because of the risks of eye patching (e.g. a greater risk of infection), the authors recommend that eye patching not be used to treat corneal abrasions. [ Ann Emerg Med August 2001;28:129 ]  posted at 6/25/2002 02:22:48 PM by Tom Heston, MD   comment on this article

PREVENTING LYME DISEASE AFTER TICK BITE
This study gave a single 200 mg dose of doxycycline to 506 patients presenting within 72 hours after a tick bite. They found that this was 87% effective in preventing the development of Lyme disease. Comment: it is important that the medication be given within 72 hours of the tick bite. The authors warn that this is a very small study. However, it does show that antibiotic prophylaxis works, whereas other studies have not shown any benefit of giving antibiotics to people with a tick bite. This strategy is probably best employed only in areas where the prevalence of Lyme disease is very high. It is recommended that prompt removal of all ticks before they begin to feed (within 48 hours) may be the most effective means to prevent tick borne illnesses. [ article ]  posted at 6/25/2002 02:19:45 PM by Tom Heston, MD   comment on this article

Inosine May Help Grow New Brain Connections After Stroke
Good news for stroke patients- research has found a possible way to stimulate the regrowth of brain connections. This would have the effect of lessening the severity of a stroke. This study is from Harvard. [ article ]  posted at 6/25/2002 02:23:27 AM by Tom Heston, MD   comment on this article

Possible Marker for Post-Partum Depression
This study of 310 women found that the presence of thyroid peroxidase antibodies in the blood was associated with an increased risk of post-partum depression. [ article ]  posted at 6/25/2002 02:18:29 AM by Tom Heston, MD   comment on this article

Bush Leads By Example
In an attempt to get Americans more health-conscious, President Bush participated in a 3 mile fitness race with hundreds of White House workers. He completed the course in 20:29, a 6 min 46 sec per mile pace. Bush is 55 years old. [ article ]  posted at 6/23/2002 03:05:57 AM by Tom Heston, MD   comment on this article

STEPHEN HAWKING: ALIVE FOR 40 YEARS WITH DISEASE THAN NORMALLY KILLS IN 1
Stephen Hawking, Cambridge University physicist and author of A Brief History of Time has done remarkable well with motor neuron disease, a condition which is normally fatal within 14 months. Comment: the question is whether his active mind was able to keep him alive whereas other people who have this condition deteriorate rapidly. [ article ]






  posted at 6/22/2002 09:40:22 PM by Tom Heston, MD   comment on this article

"Mad Cow" Disease Found in New Mexican Deer
Chronic wasting disease has been found in a deer in New Mexico. When this disease affects cows, it's called "mad cow" disease. Since last fall, the disease appears to be spreading, with cases as far east as Wisconsin and up into Canada. Comment: regular readers of the Internet Medical Journal will remember comments made by health officials in the US that we don't need to worry about mad cow disease in the US. My response at the time was that it is very likely to spread into the US. This prediction appears to be coming true as the disease is starting to spread among our deer population. (in cows called "mad cow" disease) [ article ]  posted at 6/21/2002 08:01:31 PM by Tom Heston, MD   comment on this article

Weight Training Helps Trim Fat -- But Women Lose More From Their Waist
This 12 week study of 12 women and 14 men, aged 61 to 77 years old, found that women are more likely to lose fat from their waist as compared to men. However, both groups lost a similar amount of body fat--about 2 kilograms (4.4 lbs). Comment: weight training is beneficial for people of all ages. [ article ]  posted at 6/20/2002 09:47:41 PM by Tom Heston, MD   comment on this article

Dr. Heston's Book Review Published in JAMA
Check out my review of a couple of textbooks of primary care medicine that was recently published in JAMA. The bottom line: primary care in the big city is viewed quite differently than primary care in rural settings (I practice in rural Idaho, the authors of the books I reviewed primarily practiced in large metropolitan areas). Nonetheless, the books reviewed are of outstanding quality and highly recommended. [ article ]  posted at 6/19/2002 05:36:35 PM by Tom Heston, MD   comment on this article

Botox Wrinkle Treatments Also Help Treat Headaches
This study of 112 patients with chronic migraines found that Botox--a treatment for wrinkles--resulted in a 75% reduction in migraine-associated disability. [ article ]  posted at 6/19/2002 05:21:11 PM by Tom Heston, MD   comment on this article

Daily Multivitamin Recommended
Doctors from Harvard are now recommending that Americans take a daily multivitamin. They recommend low-cost generic brands. Comment: this demonstrates how isolated academics are from the rest of us. I remember selling Shaklee vitamins when I was a teenager (25 years ago) and at that time all the academics were saying "don't take vitamins." But now we are learning that a daily multivitamin has substantial health benefits, such as a reduced rates of colon cancer. Furthermore, in general it is absurd to opt for low-cost, generic vitamins. These are generally poorly digested, and the vitamins & mineral content poorly balanced (check out the content of calcium and biotin in the cheap vitamins). There are several good multivitamin brands; the ones I recommend are the Amway and Shaklee products. [ article ]  posted at 6/19/2002 04:24:40 AM by Tom Heston, MD   comment on this article

ABC Method for Diabetics
Many diabetics are not fully aware of the greatly increased risk they face from heart disease, according to research presented at the American Diabetic Association meeting. Diabetics should focus on their ABC's: a) control their Hemoglobin A1C, b) control their Blood pressure, and c) control their Cholesterol (especially their LDL, i.e. bad cholesterol). Comment: this ABC method of monitoring diabetics is very useful for both patients and doctors. [ article ]  posted at 6/18/2002 08:36:46 PM by Tom Heston, MD   comment on this article

Urine Test Helps Predict Alzheimer's Disease
Urine testing for isoprostane was shown in a recent research article to be linked with mild congnitive impairment, an early sign of Alzheimer's Disease. Comment: if this research is confirmed, simple urine testing would be helpful in identifying individuals that are at a high risk of Alzheimers. Several medications currently available can help slow down or delay the onset of Alzheimers. [ article ]  posted at 6/18/2002 08:30:48 PM by Tom Heston, MD   comment on this article

Medication Error Reporting
The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) has released a medication error reporting form that will assist in identifying and learning from mistakes. Comment: the NCC MERP recommends that facilities have a formal reporting system in place to help improve care and lessen medical mistakes. This form is a useful starting point. [ article ]  posted at 6/17/2002 07:10:39 PM by Tom Heston, MD   comment on this article

Death of a Child
This article is a poignant story about how medical errors can cause death. This viewpoint, from one of the doctors involved, is an excellent, touching commentary. Of note, the author makes important recommendations on how to prevent similar errors in the future. [ article ]  posted at 6/17/2002 07:02:52 PM by Tom Heston, MD   comment on this article

Screening Teens for Substance Abuse
Researchers from Boston have developed and validated a screening tool for teen substance abuse, similar to the CAGE questionairre for alcoholism. The research found that 17% of the routine primary care teenaged patients had a diagnosis of either abuse or dependence. The questions can be found online at the following link ->> [ article ]  posted at 6/16/2002 08:57:20 PM by Tom Heston, MD   comment on this article

Nasal Antibiotic Reduces Post-Surgical Infections
Use of a topical nasal antibiotic ointment after surgery was shown to reduce the rate of post-op infections by 50% or better. The antibiotic used was mupirocin (Bactroban). Comment: this is promising research, showing a simple way to decrease S. aureus surgical wound infections. [ article ]  posted at 6/16/2002 03:13:01 AM by Tom Heston, MD   comment on this article

Telemedicine Not Necessarily Cost-effective
This analysis of the literature found that tele-medicine does not necessarily lead to a reduction in costs. [ article ]  posted at 6/16/2002 03:04:23 AM by Tom Heston, MD   comment on this article

Teen Pregnancy Prevention Programs Don't Work
This analysis of programs designed to prevent teenage pregnancy rates found that they are not effective at delaying sexual intercourse, increasing birth control usage, or decreasing pregnancy rates. The analysis evaluated several different types of interventions, all of which were ineffective. [ article ]  posted at 6/16/2002 02:59:17 AM by Tom Heston, MD   comment on this article

Leech Therapy Useful in Arthritis
Russian scientists presented research at the European Congress of Rheumatology showing that leech therapy helped patients with arthritis. Over a hundred patients were studied, and all patients benefited from the therapy. Both rheumatoid and osteoarthritis patients benefited. Comment: an interesting idea. Leeches were placed directly on the painful joints. No side-effects were identified. [ article ]  posted at 6/14/2002 07:37:39 PM by Tom Heston, MD   comment on this article

Too Much or Too Little Sleep Linked to Heart Problems
According to a study presented at the Associated Professional Sleep Societies' annual meeting, women getting less than 6 hours or more than 9 hours of sleep a night had an increased risk of heart disease. Comment: other studies have shown that irregular hours, such as switching from night shift to day shift, also have been associated with an increased risk of health problems. [ article ]  posted at 6/14/2002 11:39:12 AM by Tom Heston, MD   comment on this article

Acarbose Shown to Delay Development of Diabetes
This study 1429 patients randomly assigned to either acarbose or placebo found that those on acarbose were approximately 25% less likely to develop adult-onset diabetes mellitus. Comment: maintaining your proper weight is probably the best way to prevent adult-onset diabetes. [ article ]  posted at 6/14/2002 06:58:37 AM by Tom Heston, MD   comment on this article

President Bush: Start Exercising
A new campaign by President Bush will urge Americans to get off the couch and start exercising more. Citing epidemic proportions of obesity and inactivity, the President's spokesman announced a series of public activities to encourage Americans to exercise. [ article ]  posted at 6/14/2002 04:30:57 AM by Tom Heston, MD   comment on this article

Online Chats Healthy for the Mentally Ill
A program in Germany has greatly reduced hospital re-admission rates for the mentally ill. The program consists of a private, online chat area for patients once they are discharged from the hospital. Most patients end up participating in the online chats (more than 80%). [ article ]  posted at 6/13/2002 08:24:46 PM by Tom Heston, MD   comment on this article

Malpractice Reform Being Considered by Congress
Warning that the out-of-control legal system is begining to limit access to medical care, the American Medical Association lobbied the US House of Representatives to pass a tort reform bill. Comment: as expected, the Democratic party is against any form of tort reform, and party members claim that limitless lawsuit awards are beneficial. As noted in a previous article, Democrats in the Senate almost assuredly will kill any chance for a meaninful tort reform. [ article ]  posted at 6/13/2002 04:57:50 PM by Tom Heston, MD   comment on this article

Off-Road Diesel Engines Linked to Premature Deaths
Pollution from off-road diesel equipment and machinery has been estimated to cause more than 8500 premature deaths, according to a study prepared in part by the State and Territorial Air Pollution Program Administrators. [ article ]  posted at 6/12/2002 05:07:30 PM by Tom Heston, MD   comment on this article

New Guidelines for Asthma Treatment
New guidelines released by the National Asthma Education and Prevention Program recommend combining a long acting beta-2 agonist to an inhaled corticosteroid when inhaled corticosteroids alone aren't working. Previous guidelines recommended simply upping the dose of the corticosteroid. The guidelines also state that inhaled corticosteroids in children are both safe and effective. [ article ]  posted at 6/12/2002 04:55:57 PM by Tom Heston, MD   comment on this article

MMR Vaccine Not Linked to Autism
This review of five decades of research on the measles, mumps, and rubella vaccine found no association with the vaccine and autism or bowel diseases. Comment: vaccines are in general overwhelmingly safe, and have greatly decreased disease throughout the world. [ article ]  posted at 6/12/2002 04:42:59 PM by Tom Heston, MD   comment on this article

Fast-Food Restaurants Invade Hospitals
Over a third of the nation's leading hospitals have fast food restaurants on site according to a recent survey. Of the 16 hospitals surveyed, 6 had contracted with a fast-food franchise. Comment: this is sort of like the dentist giving kids some candy after their dental appointment. Clearly, the onslaught of fast-food restaurants has contributed to obesity worldwide. Hospitals should remain committed to good health-- and not promote high fat foods full of empty calories. [ article ]  posted at 6/12/2002 04:39:21 PM by Tom Heston, MD   comment on this article

Low Fat Foods Contribute to Obesity
The American Heart Association warned that low fat and fat-free foods have contributed to the epidemic of obesity worldwide. Because these foods tend to be full of simple sugars, their nutritional value is very low. Furthermore, the number of calories in low-fat and fat-free foods can be quite high. The AHA states that the promotion of foods as "low-fat" or "fat-free" has misled people into believing they can safely eat as much of the food as they want. [ article ]  posted at 6/11/2002 05:24:53 PM by Tom Heston, MD   comment on this article

Smallpox Epidemic in Swabi?
The DAWN group of newspapers reported Sunday that there is an outbreak of smallpox in Swabi, which is in Pakistan. [ article ]  posted at 6/10/2002 06:33:02 PM by Tom Heston, MD   comment on this article

More Concerns That Film Violence *CAUSES* Real Violence
There is growning concerns in France that screen and video game violence causes real violence. There have been several murders specifically linked to Wes Craven's movies. To view a catalog of the killings associated with these films, click here. [ article ]  posted at 6/10/2002 06:23:31 PM by Tom Heston, MD   comment on this article

Monkeypox & Camelpox: Agents of Bioterror
Genetic manipulations of the monkeypox and camelpox viruses could make them future agents of bioterrorism. The viruses have been studied extensively in Russia, with concern that the virus has been leaked to other nations including Iraq. Standard variations of monkeypox and camelpox can cause disease and death in humans. The smallpox vaccine is protective against these standard variations of the virus. Although the majority of Americans support nation-wide vaccination with the smallpox vaccine, the government is not releasing it to the general public. [ article ]  posted at 6/10/2002 06:17:07 PM by Tom Heston, MD   comment on this article

Hippotherapy- Riding Horses as a Medical Therapy
Hippotherapy- the use of riding horses for therapeutic benefit- is gaining attention in the US. It has been practiced in Europe for more than 50 years, now there are approximately 150 centers in the US that offer the therapy. The use is primarily for patients with developmental disorders, neuromuscular disabilities, or skeletal impairments (especially children). [ article ]  posted at 6/10/2002 06:06:56 PM by Tom Heston, MD   comment on this article

How to Treat Postmenopausal Osteoporosis
This is an excellent review article in The Lancet that discusses the treatment for postmenopausal osteoporosis. [ article ]  posted at 6/10/2002 06:00:42 PM by Tom Heston, MD   comment on this article

Junk Food Companies Invading Schools; Obesity Rates Rising
This editorial is a thoughtful commentary on the rising rates of obesity in developed nations, and offers several solutions, including the need to stop advertising by junk food companies within our schools. Comment: this is a must read. [ article ]  posted at 6/10/2002 05:56:07 PM by Tom Heston, MD   comment on this article

Cyber Medical Specialists
This study looked at the use of videoconferencing instead of face-to-face consultations. It found that patients were very satisfied, and furthermore that fewer (unnecessary?) tests and investigations were ordered as a results. [ article ]  posted at 6/10/2002 05:50:14 PM by Tom Heston, MD   comment on this article

Diet High in Fiber Healthy for Young Girls
This study found that a diet high in fiber delayed the onset of menstruation in young girls. This delay in the onset of menstruation has been shown in other research to lessen the risk of breast cancer. Comment: another good reason to consume a diet high in vegetables, a primary source of dietary fiber. [ article ]  posted at 6/10/2002 05:45:01 PM by Tom Heston, MD   comment on this article

Meth Use Skyrocketing
Statistics show that 40% of women arrested in the counties surrounding Honolulu and San Jose, California in 2000 tested positive for meth use. Many other areas as well showed a rate over 20%. Men abusing meth are more likely to be involved in an assault or drive drunk. Comment: meth causes huge problems, especially it's tendency to cause violence and assault. Why does law enforcement still focus so much of their resources on fighting medical marijuana (breaking up medical marijuana clubs in California)? It seems that the bureaucracy in law enforcement simply finds that busting medical marijuana users is much easier that fighting the real problem-- meth users. [ article ]  posted at 6/10/2002 05:42:59 PM by Tom Heston, MD   comment on this article

Oh Really!
This study found that an active fetus can disrupt a mom's sleep during the third trimester. Comment: who funded this study? Every mom on the planet could have told you the same thing. [ article ]  posted at 6/10/2002 05:33:53 PM by Tom Heston, MD   comment on this article

Celebrex to Claim Lower Gastrointestinal Complication Rate
Pharmacia, the pharmaceutical company that makes Celebrex, is going to change the label of the medication to state that Celebrex has a lower risk of gastrointestinal ulcers compared to standard nonsteroidal anti-inflammatory drugs. This label change is based on a recent study that compared Celebrex with ibuprofen and diclofenac. Comment: this change comes right after the British Medical Journal published an editorial stating that there is no good evidence that Celebrex is safer than other nonsteroidal anti-inflammatory drugs. [ article ]  posted at 6/10/2002 05:30:40 PM by Tom Heston, MD   comment on this article

Raloxifene Associated With 40% Reduction in Cardiac Events
Research presented at the annual meeting of the American College of Cardiology reported that among the 1035 participants in the MORE trial, those who took 60 mg/day of raloxifene had a 40% reduction in coronary events compared with those taking a placebo. The reduction in strokes was 62%. Comment: this selective estrogen receptor modulator is very promising, and likely will be the preferred post-menopausal agent, replacing estrogen. [ Family Practice News 15 May 2002;32(10):1 ]  posted at 6/9/2002 02:57:13 AM by Tom Heston, MD   comment on this article

Probiotics Effective in Preventing Antibiotic Associated Diarrhea
This meta-analysis found that probiotics such as lactobacilli, when given in conjunction with antibiotics, reduce the rate of antibiotic-associated diarrhea by approximately 60%. That is, they helped prevent antibiotic-associated diarrhea. Comment: this analysis found insufficient evidence that probiotics were effective in *treating* antibiotic-associated diarrhea, but state that this issue is worth looking into. [ article ]  posted at 6/8/2002 02:55:22 AM by Tom Heston, MD   comment on this article

Screening All Smokers For Emphysema Recommended
This study of 651 smokers concluded that performing pulmonary function tests on all smokers would be a feasible and reasonable way to screen for emphysema. Comment: 18% of the smokers (1 in 5) were found to have chronic obstructive pulmonary disease (defined as an FEV1 < 80% of predicted). [ article ]  posted at 6/8/2002 02:41:00 AM by Tom Heston, MD   comment on this article

US to Spend $900 Million USD in Global Fight Against Aids
The US will donate approximately $900 million US dollars to foreign nations this year to help them fight HIV and AIDS. Comment: this money is greatly needed by the countries most affected by AIDS, mainly located in Africa. [ article ]  posted at 6/8/2002 02:31:33 AM by Tom Heston, MD   comment on this article

Weight Gain Linked to Breast Cancer
Weight gain after age 20 has been found to be associated with an increased risk of breast cancer, according to a Canadian study of 2470 women. This study also found that obesity after menopause was also associated with an increased risk of breast cancer. Comment: another good reason to have a diet high in vegetables. [ article ]  posted at 6/8/2002 01:58:07 AM by Tom Heston, MD   comment on this article

Honey Not Effective in Treating Hayfever
This double-blind study of 36 people with hayfever found that local honey, pateurized honey, and fake honey made from corn syrup all were equally effective in controlling symptoms. Comment: despite the fokelore, locally grown, unpasteurized, unfiltered honey was no better than a corn syrup honey during the 30 week study period. Ann Allergy Asthma Immunol 2002;88(2):198.  posted at 6/8/2002 01:57:17 AM by Tom Heston, MD   comment on this article

Experts Recommend Voluntary Smallpox Vaccination
Experts speaking at a forum hosted by the Cato Institute recommended voluntary smallpox vaccination by US citizens. The "ring vaccination" method currently being endorsed by the CDC recommends vaccination based on geographical proximity to the initial person infected with smallpox, forming a ring of immunity around the infection. The experts say that in our mobile society, basing vaccination on geographical proximity probably won't work. Although this method worked in the distant past, at that time mass transportation, interstate highways, and air travel wasn't present. These factors, according to the experts, make the "ring vaccination" strategy no longer viable. [ article ]  posted at 6/5/2002 05:02:05 PM by Tom Heston, MD   comment on this article

Cholesterol Medications May Also Lower Fracture Risk
This study from the Archives of Internal Medicine looked at 1370 women and found that those taking a statin medication to lower their cholesterol also experienced fewer fractures. Comment: this finding shows an association, but not a causal relationship. For example, those taking the cholesterol medication may simply have been more health conscious, and taken measures at home to reduce fractures such as adequate lighting and safe floors. [ article ]  posted at 6/4/2002 10:55:34 PM by Tom Heston, MD   comment on this article

Eczema Responds to Short Course Therapy
This study of 174 children with atopic eczema found that a short course (3 days) of a potent topical steroid was as effective as a longer term treatment (7 days) with a mild topical steroid. The topical steroids used were betamethasone valerate 0.1% (potent) and hydrocortisone 1% (mild). [ article ]  posted at 6/4/2002 05:31:19 PM by Tom Heston, MD   comment on this article

Ramipril Recommended to Prevent Stroke in High Risk Patients
This editorial from the British Medical Journal recommends that all high risk patients (for a stroke) should receive the ace inhibitor ramipril, regardless of their blood pressure. The editorial primarily addresses the results of the paper by Jackie Bosch et al, Use of ramipril in preventing stroke: double blind randomised trial
. Comment: most important is blood pressure control and aspirin treatment. This research paper and editorial suggest that adding ramipril has an additive benefit in preventing stroke. [ article ]  posted at 6/4/2002 04:58:19 PM by Tom Heston, MD   comment on this article

Swiss Legalize First Trimester Abortion
Switzerland has voted to decriminalize abortion during the first 12 weeks of pregnancy. Comment: this is much different than US law, which allows abortion at any time during pregnancy, even third trimester abortions- which abort fetuses that could live outside of the womb. [ article ]  posted at 6/4/2002 04:03:43 PM by Tom Heston, MD   comment on this article

Breast Cancer Diagnosis "Within Minutes"
Computer specialists and medical doctors are developing a hand-held scanner device that will allow general practitioners and other primary care providers to quickly and easily screen for breast cancer. The technique uses Doppler imaging, and is still under development. [ article ]  posted at 6/4/2002 04:00:34 PM by Tom Heston, MD   comment on this article

Rectal Bleeding Best Evaluated With Colonoscopy
This analysis found that rectal bleeding in anyone 35 years or older is best treated with colonoscopy. A strategy of evaluating patients with a barium enema and flexible sigmoidoscopy also produced the greatest life expectancy. Rectal bleeding was defined as blood in the toilet bowl, on the tissue paper, or mixed with stool. Comment: this analysis found that colonoscopy was the most cost-effective work-up strategy in those 35 years or older. In younger patients, flexible sigmoidoscopy was recommended. This is a surprising finding in that it found that the most aggressive work-up (colonoscopy) was the most cost-effective. Ann Intern Med January 15, 2002;136:99.  posted at 6/4/2002 03:10:59 AM by Tom Heston, MD   comment on this article

Soy Isoflavones Help Relieve Menopausal Symptoms
This study of 82 women aged 45 to 55 years old found that soy isoflavones effectively relieved menopausal symptoms. Furthermore, the soy lowered th women's LDL (bad) cholesterol levels. The isoflavones were given as a 100 mg oral pill. Comment: this is good news given the recent findings that hormone replacement therapy may not be that great. Still, research into soy isoflavones is very preliminary. Obstet Gynecol March 2002;99:389-94.  posted at 6/4/2002 03:05:04 AM by Tom Heston, MD   comment on this article

Diet Worse Now Than During Post-WWII Rationing
Pediatricians in the United Kindom are warning that the current diet of junk food is worse for kids than the diet given children during the post-war rationing. The main offenders are white bread, chips, and sweets. [ article ]  posted at 6/3/2002 07:11:50 PM by Tom Heston, MD   comment on this article

Seaweed May Help Prevent Surgical Infections
A study from Australia found that chemicals in algae can hlep kill bacteria, including methacillin resistent strep A (MRSA). This is an important finding since MRSA is resistant to multiple antibiotics. [ article ]  posted at 6/3/2002 07:04:58 PM by Tom Heston, MD   comment on this article

Magnesium Sulfate Effective in Treating Pre-eclampsia
This study of 10 110 women confirmed that magnesium sulfate is effective in the treatment of pre-eclampsia, effectively reducing maternal mortality by approximately 45%.[ article ]  posted at 6/3/2002 06:22:20 PM by Tom Heston, MD   comment on this article

Repeat Cesarean Section Safer Than Trial of Labor
This review of 313 238 singleton births in Scotland between 1992 and 1997 found that both perinatal death and maternal death rates were increased in women who underwent a trial of labor after having a previous cesarean section with a previous child. It was safer to perform a planned c-section. Comment: the absolute risk still remains very small, however, a repeat c-section was safer than a trial of labor. [ article ]  posted at 6/3/2002 06:17:54 PM by Tom Heston, MD   comment on this article

Obesity Continuing to Increase
This survey from the Behavioral Risk Factor Surveillance System randomly selected adults aged 18 and up in 49 US states. The survey found that obesity increased in all states during the study period from 1991 to 2000. [ article ]  posted at 6/3/2002 06:10:06 PM by Tom Heston, MD   comment on this article

Is Celebrex Really Better Than Ibuprofen?
This editorial in the British Medical Journal argues that due to a poor study design, there is insufficient proof that the selective COX-2 inhibitors celecoxib and rofecoxib are any better at decreasing gastrointestinal bleeding than traditional non-steroidal anti-inflammatory drugs. The major trial that made the claims of improved safety of the selective COX-2 inhibitors was funded by Pharmacia, the manufacturer of Celebrex. Comment: this editorial highlights the dangers of poor peer-review. The study showing superiority of the selective COX-2 inhibitors was published in JAMA, and widely publicized. This led to an explosion in prescribing the much more expensive medications (in part due to malpractice concerns). Thus, a poorly done study has led to the needless expense of a newer, but no more effective class of medications according to this editorial. [ article ]  posted at 6/3/2002 04:38:29 PM by Tom Heston, MD   comment on this article

TV Watching Increases Eating Disorders
This study from the British Journal of Psychiatry found that television watching increases eating disorders among girls. [ article ]  posted at 6/3/2002 04:21:38 PM by Tom Heston, MD   comment on this article

Knowing the Facts Most Effective at Preventing Alcohol and Drug Abuse
A study presented at the annual meeting of the Society for Prevention Research concludes that giving kids the facts on how to prevent drug abuse is the best way to decrease drug abuse. Scare tactics aren't as effective. [ article ]  posted at 6/3/2002 04:18:40 PM by Tom Heston, MD   comment on this article

Skin Cancer Risks Being Ignored
This survey of 10 079 teens found that only a third of the mostly white kids routinely used sunscreen, 10% used tanning beds, and most had suffered at least one sunburn the previous summer. Comment: regular use of sunscreen in childhood is estimated to reduce the risk of skin cancer significantly, perhaps as much as 75%. [ article ]  posted at 6/3/2002 04:12:35 PM by Tom Heston, MD   comment on this article

Restrictive Laws Fail to Decrease Teen Smoking
This study published in the journal Pediatrics found that laws limiting the sale of cigarettes to teenagers have not decreased the teen smoking rate. The authors conclude that therefore these laws should be abandoned. Comment: this research refutes the holy grail that restrictive laws lead to decreased drug abuse. It is interesting to note that nations that have decriminalized marijuana use do not have higher rates of use than the US does. This suggests that the laws in the US simply lead to more imprisonment but not less usage. This study found that the restrictive tobacco laws simply have increased law-breaking, and not had the desired effect of decreasing smoking. Probably a better way to decrease teen smoking is to increase the excise tax on cigarettes. [ article ]  posted at 6/3/2002 04:08:09 PM by Tom Heston, MD   comment on this article

Bedroom TV's Increase Childhood Obesity
A TV set in the bedroom can be hazardous to a child's health. This study of over 2700 low income parents with preschool aged children found that nearly 40% of the kids had a TV set in their bedroom, increasing their risk of obesity by nearly a third. Comment: this is an incredible finding-- 40% of low income parents chose to put television sets in their child's bedroom. [ article ]  posted at 6/3/2002 04:00:59 PM by Tom Heston, MD   comment on this article