Don't Take Antibiotics for That Sore Throat!

Approximately three-quarters of adults who visit a primary care physician because of a sore throat are given an antibiotic, according to a recent study. Antibiotics can be effective at killing certain bacteria. Almost all sore throats are caused by viruses, however, which are untreatable with antibiotics. The most common bacterial cause of sore throats is a germ present in only five to 17% of adults annually.

The authors of a study in the Journal of the American Medical Association examined data from over 2,200 sore-throat patient visits in the National Ambulatory Medical Care Survey (NAMCS) from 1989 to 1999. They calculated rates of prescriptions for patients with sore throats, as well as the different antibiotics prescribed by physicians. The results showed that when antibiotics were prescribed, they were frequently unnecessary, and often the wrong ones. The recommended antibiotics were only prescribed in one-quarter of all visits. The use of recommended (correct) antibiotics also decreased, from 32% of cases in 1989 to 11% in 1999.

There are two main concerns for the overuse of antibiotics: unnecessary monetary costs and the development of a bacterial resistance to antibiotics. The more resistant bacteria become to antibiotics, the less effective these antibiotics will be when you truly need them.

The next time you have a sore throat, consider home remedies like chicken soup, extra vitamin C, and lots of rest and fluids - instead of antibiotics. For more information on children's health, visit http://www.chiroweb.com/tyh/childhood.html.

Reference: Linder JA, Stafford RS. Antibiotic treatment of adults with sore throat by community primary care physicians: A national survey, 1989-1999. Journal of the American Medical Association, September 12, 2001:286(10), pp. 1181-1186.

Considering Elective Surgery? Weigh the Risks

If you are considering surgery, information regarding the risks involved is important for you to be able to make the right decision. Elderly people in particular need to know what risks they face going into an elective surgical procedure, because they are at a much greater risk of accidental death.

A recent study in Effective Clinical Practice assessed the death rates for 14 types (six cardiovascular, eight cancer-related) of elective, high-risk surgeries in 1.2 million patients 65 and older. Deaths were also examined related to the age of the patient and the procedure performed.

In older patients, the risk of operative death was "frequently" higher than 10%, which is much higher than typically reported in trial studies. Risk of death substantially increased with age in most cases; operative death for patients 80 years or older was more than double that of patients ages 65 to 69. Also, mortality differed significantly between procedures: heart valve replacement and partial lung or esophagus removal (because of cancer) were the most dangerous procedures (over 15% operative mortality rate in patients older than 80).

Age is probably the most important predictor of operative mortality. Think twice before going under the knife if you are past middle age, even if it initially appears to be your only option. Talk to your doctor of chiropractic about preventing senior health problems, or visit http://www.chiroweb.com/tyh/senior.html.

Reference: Finlayson EVA, Birkmeyer JD. Operative mortality with elective surgery in older adults. Effective Clinical Practice, July/August 2001:4(4), pp. 172-177.

Glue Ear: An All-Too-Common Condition

"Glue ear," a condition involving the build-up of sticky fluid behind the eardrum, is the primary cause of acquired hearing loss in children. Although hearing usually returns to sufferers, problems in language development can occur: study findings indicate that children with glue ear are more likely than their peers to have behavioral problems and reading difficulties.

Twenty percent of 2-year-olds will suffer from this condition, which is often caused by infections. Afflicted children are sometimes treated with steroids because of evidence from past studies that shows steroids may control symptoms. A recent review in the Archives of Pediatrics & Adolescent Medicine examined 10 studies involving steroids to treat glue ear. The authors wanted to weigh the pros and cons of using steroids to treat the condition. They focused on studies of children 12 and under who had suffered a significant hearing loss from glue ear.

The results showed that there was no long-term benefit from either steroids or antibiotics at preventing a hearing loss associated with glue ear. Considering that this condition often clears up without medical treatment, think twice before accepting the use of nasal steroids on your children. To avoid the onset of the condition, dont smoke around your children, and be sure to breast feed (rather than bottle feed) your infant.

Reference: Butler CC, van der Voort JH. Steroids for otitis media with effusion. Archives of Pediatrics & Adolescent Medicine, June 2001:155(6), pp. 641-647.

Give Yourself the Gift of Antioxidants

Dietary antioxidants like beta-carotene and vitamins C and E are known to aid in the prevention of some cancers. Do they also effectively avert the onset of cardiovascular diseases of the heart and blood vessels? Observational studies in the past have shown that these antioxidants may protect against incidences of cardiovascular disease and death, but now there may be more conclusive evidence.

To determine if dietary antioxidants are related to the presence of peripheral arterial disease (a cardiovascular disease), the authors analyzed data on approximately 4,400 people in the Rotterdam Study. This study was designed to investigate cases of long-term, disabling diseases and their risk factors in the Netherlands. The 55- to 94-year-olds diets were evaluated, and peripheral arterial disease was examined using blood pressure readings in the hands and feet.

Eating foods high in antioxidants decreased incidences of peripheral arterial disease, but with differences between genders. In women, subjects with high vitamin C intake were less likely to have the disease, compared to those with low intake of vitamin C. Men with high vitamin E intake, on the other hand, were less likely to have cardiovascular disease than those with low intake.

Women: You can get natural vitamin C in high concentrations from fruits and vegetables like oranges, green peppers, tomatoes, watermelons, and leafy greens. Try to eat these foods raw or lightly cooked for higher vitamin concentrations.

Men: Be sure to eat foods rich in vitamin E, such as soybean and vegetable oils, nuts, spinach, and sweet potatoes. Wheat germ oil, although less common, has the highest amount of natural vitamin E.

Both men and women should eat a variety of these foods to obtain the other health benefits of these vitamins.

Reference: Klipstein-Grobusch K, den Breeijen JH, Grobbee DE, et al. Dietary antioxidants and peripheral arterial disease: The Rotterdam Study. American Journal of Epidemiology 2001:154(2), pp. 145-149.

Go to http://www.chiroweb.com/tyh/nutrients.html for more nutrition information.

Work Stress: A Real Pain in the Neck

Up to 40% of people experience neck pain at least once every year. Many things can cause neck pain, including a person's social environment at work and individual psychological factors. Researchers decided to investigate how employer demands, organizational structures, relationships, and economics at work affected neck pain in employees.

The study, recently published in the journal Spine, utilized a three-year study on the effects on health of stress at work. Over 1,300 workers in the Netherlands rated aspects of their job on a questionnaire at the beginning of the study, and completed another questionnaire to determine cases of neck pain that lasted at least one day.

Approximately 15% of the workers reported neck pain over the three years. Low co-worker support increased the risk of neck pain two-and-a-half times, and high job demands increased the risk over two times. High job demands included employees having to work under deadlines or work under pressure.

These results are consistent with results of previous studies that indicate a link between job demands and neck pain. If you have a high-stress job, do your best to stay relaxed and rested. Be sure you have a safe outlet for your stress, such as exercise or meditation. Try not to take your work home with you, either - your neck may appreciate it as much as your family will.

Reference: Ariëns GAM, Bongers PM, Hoogendoorn WE, et al. High quantitative job demands and low coworker support as risk factors for neck pain. Spine, September 1, 2001:26(17), pp. 1896-1903.

For more information on neck pain, visit http://www.chiroweb.com/tyh/neckpain.html.

Future of Alternative Therapies Glowing

The 1990s witnessed more than just the rise of alternative music. Visits to providers of alternative medicine (such as chiropractic, acupuncture, and massage therapy) increased in the U.S. almost 50% between 1990 and 1997. For this reason, many studies have recently begun to explore patient perceptions of complementary and alternative medicine (CAM) and its comparison to conventional medicine.

To determine perceptions regarding the helpfulness of CAM use relative to conventional medicine, a study in a recent issue of the Annals of Internal Medicine involved over 800 adults who had seen both an alternative therapist and a medical doctor in a one-year period. The researchers conducted a national telephone survey to gather information.

Far more patients perceived CAM therapies as more effective than conventional medicine for back, neck, and head pain. Conventional medicine was perceived to be better only for high blood pressure and lung and digestive conditions. Also, confidence was higher in CAM providers than in medical doctors. Regarding an integration of therapies, patients perceived a combination of CAM and conventional medicine as superior to either by itself.

Regarding sequence of use, most people sought a medical doctor prior to a CAM therapist or remedy. The study revealed that over half of the patients did not tell their medical doctor about using an alternative therapy; often they felt it wasn't important for their doctor to know.

Speak openly with any health practitioner you seek, keeping them aware of all the forms of treatment you are using. And remember that medical doctors should be viewed as only one of many health care professionals you can seek for advice or treatment.

Reference: Eisenberg DM, Kessler RC, Van Rompay MI, et al. Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey. Annals of Internal Medicine, September 4, 2001:135(5), pp. 344-351.

Only You Can Prevent Diabetes!

Type 2 diabetes occurs when your body can't properly utilize the insulin it produces to regulate blood sugar, preventing your body from getting the fuel it needs. This type of diabetes is the most common, and usually develops gradually after age 40. Symptoms include excess thirst, urination, fatigue, and weight loss.

Dietary and lifestyle factors are known to heavily influence the development of type 2 diabetes, prompting the authors of a recent study in The New England Journal of Medicine to determine the proportion of cases of type 2 diabetes that could be avoided through low-risk behavior. Nearly 85,000 women completed questionnaires and were examined over 16 years of follow-up. The authors defined five variables of low-risk women: a healthy weight-to-height ratio; a diet high in cereal fiber/"healthy" fat and low in "unhealthy" fat/simple sugars; a half-hour or more of moderate daily exercise; nonsmoking; and consumption of some alcohol.

Ninety-one percent of diabetes cases were attributable to having negative lifestyle behaviors in all five areas. When only diet, weight, and exercise were considered, 87% of cases were preventable. Being overweight was the single-greatest predictor of type 2 diabetes.

Almost all cases of type 2 diabetes can be avoided through a healthy lifestyle. Keep your body weight at a safe level by exercising several times per week and limiting the amount you eat. Also, eat lots of cereals, whole grains, and the healthy fats found in nuts, fish, and olive oil. Avoid sugary foods and meals loaded with dairy or meat fats. To learn more about health and wellness, see http://www.chiroweb.com/find/archives/general.

Reference: Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. The New England Journal of Medicine, September 13, 2001:345(11), pp. 790-797.

Run Away from Pancreatic Cancer

The pancreas is a gland in your body that produces juices that help you digest food. It also produces hormones (namely insulin) that regulate your body's use and storage of nutrients. Pancreatic cancer kills 95% of those who are diagnosed, and is the fifth-leading cause of death related to cancer in the U.S.

Other than smoking, few factors have been associated with pancreatic cancer, although some studies have linked it to diabetes. A review in the Journal of the American Medical Association sought to identify other possible causes of the condition. To investigate the relationship of physical activity, obesity, and height to pancreatic cancer risk, the authors examined two studies lasting up to 20 years: the Health Professionals Follow-up Study and the Nurses' Health Study. Nearly 50,000 men, and twice as many women, participated in the studies.

Walking or hiking one-and-a-half hours per week reduced pancreatic cancer risk by 50% in both men and women. Those who participated in the least amount of moderate activity were more than twice as likely to develop the condition as those who were most active, and exercise was more important for reducing risk in overweight persons. In the 350 documented pancreatic cancer cases, sufferers also tended to be sedentary, obese, and taller than average.

Treating pancreatic cancer is difficult, so the key is to avoid it altogether. Any exercise can greatly improve your overall health - and it can save your life. Walk, lift weights, swim, bike, or perform some other form of moderate exercise as often as possible.

Reference: Michaud DS, Giovannucci E, Willett WC, et al. Physical activity, obesity, height, and the risk of pancreatic cancer. Journal of the American Medical Association, August 22/29, 2001:286(8), pp. 921-929.