Misplaced Faith in the PDR
A study published in the Annals of Emergency Medicine1 concludes that the popular Physician's Desk Reference contains bad information that can cost lives. The researchers examined the advice for overdose treatment of the 20 most commonly prescribed drugs associated with deaths from overdose and found it outdated (up to 25 years old) and inadequate. Many times, the PDR does not mention treatments that could save lives and recommends harmful advice, considering current toxicology knowledge. For example, the PDR advises treatment of Elavil toxicity with physostigmine, a drug that many years ago was found to increase the risk of death in these cases.2 However, patients may be comforted (or not) by another finding of the group: They surveyed doctors and found that less than half had consulted the PDR at all in the past year.
1. AEM, February 1, 1997.
2. United Press, January 31, 1997.
Women's Top Health Worry Prevention magazine3 recently conducted a survey of American women to find out how threatened they felt by two high-profile and potentially fatal conditions. Most of the women were more worried about breast cancer than heart disease. In fact, women are five times more likely to die from a heart attack than breast cancer. Researchers say that the misconception contributes to many women's lack of motivation to maintain a healthy lifestyle.
3. Prevention, February, 1997.
Holistic Veterinarians There is a growing movement among pet owners to share the advantages of holistic health care with their animal companions.
Many vets and other animal practitioners are beginning to use acupuncture, herbs, homeopathy, massage, and even music therapy on their patients. The American Holistic Veterinary Medical Association in Bel Air, Maryland has a referral service with a membership of about 1,600 practitioners.4 Tufts University animal hospital, which uses acupuncture on animals that don't respond to conventional methods, is currently involved in a research project examining the effect of the treatment on horses with chronic obstructive pulmonary disease.5
4. American Holistic VMA, 410-569-0795.
5. Associated Press, February 2, 1997.
Body Fights Leukemia "Challenging an article of faith among doctors,"6 new research suggests that the body is not totally at the mercy of aberrant cells found in children with acute lymphoblastic leukemia.
Physicians have long considered that they must rid the body of every last bad cell to achieve a "cure," but researchers at the MD Anderson Cancer center at the University of Texas in Houston have found that patients who have been declared "cured" can still have leukemia cells in their body that never cause a relapse.7 Using polymerase chain reaction (PCR) studies, they found up to one million cancer cells in such patients. The researchers theorize that the immune system keeps the bad cells in check.
6. Associated Press, January 29, 1997.
7. New England Journal of Medicine, January 30, 1997.
Hospital Mishaps Another study of hospitals, this one published in The Lancet,8 reports that a hospital can indeed be a risky place to be, at least if you're a patient. This study is a little different. Instead of relying on hospital records for their data, specially trained researchers actually joined the rounds in a large teaching hospital, monitoring treatments and patient care decisions.
They discovered that mistakes were much more prevalent than previously acknowledged. Following over 1,000 treatment plans in a surgical care center, they watched as mistakes were made on 45 percent of the patients. At least four people died as a direct result of the errors. There were 185 who suffered serious results, increasing their hospitalization time and costs. According to the study, the chance of a given patient experiencing an "adverse event" increased six percent for every day they stayed in the hospital. Researchers were surprised that only about one percent of those patients injured ever brought forth a malpractice suit, and most of those were abandoned within four years.
8. The Lancet, February 1, 1997.
The Thrill is Gone An editorial in the British Medical Journal9 suggests that doctors should be sure to inform patients considering prostatic surgery and some anti-depression drug treatments of a possible side effect in their male patients: inability to achieve orgasm. According to one study, About half of prostatic surgery patients report "absent or altered orgasmic sensations." About one in five men taking serotonin re-uptake inhibitors can no longer experience orgasm. There is no effective treatment for the condition, which according to the editorial, can cause "disappointment" and "anger" at not having been warned.
9. BMJ, February 1, 1997.
Beware the Communal Whirlpool A recent outbreak of Legionnaires' disease in southwestern Virginia has been traced to a whirlpool spa display in a large home improvement outlet. One person died, and about 23 became quite ill according to the Centers for Disease Control and Prevention.10 Those who became the sickest spent an average of 79 minutes in the spa display area, while persons spending less than one-half hour there suffered no ill effects. The CDC recommends changing spa filters frequently and liberal doses of chlorine.
10. Morbidity and Mortality Weekly Report, January 31, 1997.
Monkey Virus in Polio Vaccine A scientific meeting was convened recently at the National Institutes of Health to discuss the impact of the monkey virus SV40 on the 98 million Americans who were inoculated with the contaminated polio vaccine from 1955 to 1962. The virus has been isolated from a number of human brain, bone, and lung cancer tumors. SV40 causes cancer when injected into laboratory animals. The virus presumably was present in the monkey tissue used for culturing the polio virus. Recent research suggests that the virus disrupts proteins that normally control cancerous growths.11
11. Associated Press, January 29, 1997, reporting on the work of Dr. Michele Carbone of Loyola University Medical Center.
Allergy Shots Don't Help Asthma In a study of 121 children published in the New England Journal of Medicine,12 researchers examined the effects of allergy shots on children with asthma. The treatment is commonly used in the belief that a decreased sensitivity to an allergen will decrease the frequency and/or severity of asthma attacks. However, this research does not support that conclusion.
Researchers were not trying to discredit shots, but had hoped to quantify the effectiveness in children sensitive to dust mites, ragweed, and rye-group grasses. They were so surprised by the outcome, that they urged caution in accepting the study's conclusions, suggesting that maybe the results were due to such things as the children being over-medicated before the start of the research. Doctors were encouraged to withdraw the children's daily medication as much as the patients could reasonably tolerate during the study. The researchers suggest that maybe the beneficial effects of environmental counseling and withdrawing the medication (about one-third of the children were able to stop medication completely in both the allergy shot and placebo groups) completely overshadowed any effect that the shots may have had!
12. NEJM, January 30, 1997.
B12 and AIDS A nine-year study of Baltimore AIDS patients concludes that nutrition plays a much more important part in progression of the disease than most doctors think. Doctors found that HIV-positive patients with low blood levels of vitamin B12 progress to AIDS 87% faster, or about four years sooner. They hope that further studies will be done to find out if supplementation during early stages will help.13
13. Journal of Nutrition, February, 1997.
Unhealthy Screenings Commentaries published in the British Medical Journal14 argue that some health screening programs may be doing more harm than good. People begin to miss more work, become more anxious, and show a lowering health confidence when told they are hypertensive, even if the elevation of blood pressure is too mild for treatment. Patients testing positive for high cholesterol, while reducing their heart disease deaths, seem to die from other causes at an overall higher rate than similar people who were never informed of their status. Britain's National Health Service announced in February that prostate screenings have led to more problems (such as incontinence, impotence, postoperative deaths, and psychological disturbances) than they prevented. Even testing negative for a problem seems to have a detrimental effect, as these people tend to consider themselves immune and feel free to pursue unhealthy lifestyles.
14. BMJ, February 22, 1997.
Non-alcoholic Wine If you're a non-drinker and feel cheated by the recent reports of the cardiovascular benefits of wine, there may yet be some good news for you. A group of British researchers has found that a non-alcoholic extract of a French wine, Cabernet sauvignon, seems to show similar (though possibly less pronounced) effects on the cardiovascular system. Volunteers who consumed the concoction, a drink called Nutrivine, showed increased antioxidant action in their blood stream within two weeks. The product will be test marketed in Singapore.15
15. Reuters, February 20, 1997.
Brian Sutton, DC
Manitou Springs, Colorado
Email: BSuttonDC@aol.com
73160.676@compuserve.com
