November 7, 2001[Volume 2, Issue 23]

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In this issue of To Your Health:

• Don't Take Antibiotics for That Sore Throat!
• Considering Elective Surgery? Weigh the Risks
• Glue Ear: An All-Too-Common Problem
• Give Yourself the Gift of Antioxidants

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 https://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 https://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, don’t 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 https://www.chiroweb.com/tyh/nutrients.html for more nutrition information.

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