1. The Internet Medical Journal
The Official Journal of the Internet Medical Association. ISSN=1093-7935
Volume 3, Number 17. 16-September-1999
Medical Pearls
WHITE COAT HYPERTENSION IMPORTANT. This study of 926 patients with
hypertension found that the blood pressure measured in the office was
identical to the blood pressure measured at home. This suggests that
blood pressures measured in the office be taken seriously, and
elevated measurements not be disregarded as due to stress from being
in the doctor's office, i.e. "white coat" hypertension. Kjeldsen SE
et al. Hypertension 1998;31:1014.
BLOOD PRESSURE HIGHER WHEN TALKING. This study of 28 men and 22 women
found that talking raised the blood pressure an average of 17 mm Hg.
Measurements taken when the doctor and the patient talked with
eachother were higher than if both of them were silent when the blood
pressure was measured. Le Pailleur C et al. Am J Hypertens
1998;11:203.
LOWERING CHOLESTEROL WITH LOVASTATIN REDUCES THE RISK OF A FIRST
HEART ATTACK. In 5608 men and 997 women with average total and LDL
cholesterol levels, and low HDL cholesterol levels, those who took
lovastatin (20 to 40 mg a day) had a 40% decreased risk of a first
heart attack compared to those who received a placebo. Downs JR et
al. JAMA 1998;279:1615.
HIGH INTENSITY STRENGTH TRAINING HELPS CARDIAC REHAB. Among the 38
cardiac rehab patients studied, high intensity strength training was
safe, and increased overall physical functioning and vitality.
Beniamini Y et al. Am J Cardiol 1997;80:841.
PAIN RELIEF DOES NOT INCREASE RISK OF A MISSED APPENDICITIS.Among
these 340 patients with suspected appendicitis, giving morphine for
pain relief did not have a deleterious effect upon management
decisions by the surgeon. Vermeulen B et al. Radiology
1999;210(3):639.
CARDIORESPIRATORY FITNESS DECREASES RISK OF DIABETES. This 6 year
study of 8633 men found that the most fit 40% of the group (3453 men)
were much less likely than the least fit 20% of the group (1727 men)
to develop diabetes, even after controlling for age, smoking, alcohol

2. use, and family history. Wei M et al. Ann Intern Med 1999;130:89.
PSYCHOACTIVE DRUG WEBSITES MOST POPULAR IN PHARMACEUTICAL INDUSTRY.
Among the 84 pharmaceutical product sites available to netizens, 7
out of the top 10 viewed sites deal with psychoactive drugs. Sussman
N. Primary Psychiatry 1999;6(8):12.
PASSIVE SMOKING INCREASES RISK OF CORONARY HEART DISEASE. In this
meta-analysis of 650,000 people, exposure to second hand smoke was
associated with a 25% increased risk of coronary heart disease. He J
et al. NEJM 1999;340(12):920.
DUKE TREADMILL SCORES HIGHLY PREDICTIVE OF MORTALITY.Duke
classification scoring of exercise treadmill tests was highly
predictive of overall mortality among a group of 939 patients with T-
wave and ST segment abnormalities on their resting ECG. Cardiac
survival was 97% at 7 years for the low risk group, as defined by the
Duke classification score. JAMA 1999;282:1047.
CHRONIC SINUSITIS FREQUENTLY DUE TO FUNGUS. 202 out of 210 patients
with chronic sinusitis were found to have fungi in their sinal mucus.
In addition, their eosinophil levels were elevated suggesting that an
immune response to fungi caused the chronic sinusitis. Ponikau J et
al. Mayo Clin Proc 1999;74:877.
FAST FACTS: SUICIDE. In the United States:
* Every minute 1 person attempts suicide
* Every 15 minutes 1 person dies from suicide
* Suicide is the 2nd leading cause of death among college students
* Men are 4 times more likely than women to commit suicide
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