March 15, 1998, Tip Sheet
Annals of Internal Medicine is published by the American College of Physicians (ACP), more than 100,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. The full text of selected articles will be on the Internet at www.acponline.org on March 15. * * *
Exposure to Passive Smoking -- Not Only To Active Smoking --Damages Aorta, New Study Finds
Exposure to passive smoking is associated with deterioration in the elasticity of the aorta, the body's major artery, a new study finds. (Article, p. 426.) The effect occurred promptly after exposure to the passive smoke and lasted for at least 20 minutes. The authors say these results imply great clinical significance when applied to large populations combined with the number of occurrences each day. * * *
Exercise Prevents Gallstones
A study finds that over 30 percent of cases of gallstone disease might be prevented by 30 minutes of endurance-type training five times per week. (Article, p. 417.) A study of men aged 40 to 74 found increased physical activity lowered risk and sedentary behavior increased risk for symptomatic gallstone disease. For example, older men who watched television more than 40 hours per week had a higher risk for gallstones than men who watched less than six hours per week. * * *
Is Low Cholesterol Related to High Risk for Violent Death? A Perspective
A study of English-language medical literature, including studies of nonhuman primates, found a significant association between low or lowered cholesterol levels and violent death. (Perspective, p. 478.) Further evaluation of the association of cholesterol level reduction with illness from all causes, not just from heart disease, should figure in risk-benefit analyses for cholesterol screening and treatment. * * *
Is Managed Care a "Monstrous Hybrid?"
Using the lens of author Jane Jacobs' "guardian" and "commercial" moral framework, Annals' editor concludes that managed care has begun to turn medicine into a "monstrous hybrid." (Editorial, p. 496.) A solution for joining the two moral frameworks might be "knowledgeable flexibility" in which everyone is "habitually aware of the moral implications of what he or she is asked to do." * * *
Thalidomide Effective for Treating Behcet Syndrome (Article, p. 443; Editorial, p. 494.)