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February 2002
Diet
for Prevention of Kidney Stones
To prevent the recurrence of kidney stones, doctors often recommend
changes in diet. For instance, reducing calcium intake seems to make
sense. Kidney stones frequently occur from a build up of calcium oxalate
(calcium combined with the mineral oxalate). Or doctors may prescribe
a diet that maintains a normal calcium intake but limits the amount
of salt and animal protein. Research shows both salt and animal protein
influence the amount of calcium excreted by the body, and a high level
of calcium excretion is a risk factor for the formation of stones.
But which of the diets is more effective over the long-term was unknown.
Recently, researchers conducted a study to compare the benefits of
the two diets on the recurrence of kidney stones and calcium levels
in the urine. Sixty men with histories of kidney stones and high calcium
levels in their urine were randomly assigned to each diet for five
years. Men on both diets drank plenty of water — a mainstay of
kidney stone prevention. The study participants were evaluated annually
for signs of kidney stone formation and urine calcium and oxalate levels.
Over the five years of the study, the risk of recurrence of stones
was 50% less for men on the normal calcium, low salt, and low animal
protein diet compared to men on the low-calcium diet. Both diets significantly
reduced the amount of calcium excreted. But the low calcium diet actually
increased the amount of oxalate passed through the kidney into the
urine.
If you suffer from recurrent kidney stones and a high urinary calcium
level, you should talk with your doctor about beginning a normal calcium,
low salt, and low animal protein diet. This diet appears to be the
most effective at preventing the condition.
February 2002 Update
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Birth
Control Patch
The
first skin patch approved for birth control by the U.S. Food
and Drug Administration will be available by prescription
in 2002. Ortho Evra works by slowly releasing progestin and
estrogen, the same hormones used in birth control pills,
into the bloodstream. Its efficacy lies in the prevention
of ovulation and the thickening of the cervical mucus, which
makes it harder for sperm to enter the uterus.
Ortho Evra is 99% effective in preventing pregnancy. However,
the side effects include an increased risk of blood clots,
heart attack, and stroke. This risk is even higher for
cigarette smokers. In three clinical trials involving over
3,000 women taking Ortho Evra, 5% of participants had at
least one patch that detached from their skin and 2% withdrew
from the trial due to skin irritation. Also, the patch
appeared to be less effective in women weighing more than
198 pounds.
The regimen is similar to that of birth control pills.
The patch is changed once a week for three weeks. The patch-free
fourth week allows for a menstrual period. The small (less
than two square inches) and paper-thin design makes Ortho
Evra easy to hide beneath clothing. It can be applied to
the buttocks, abdomen, upper torso (front or back), and
the upper outer arm, and be worn in a different place each
week.
February 2002 Update
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Bicycle
Helmets Save Lives
Although
bicycling is one of the most popular sports, injuries associated
with bicycling are the leading cause of emergency room visits
for children and adolescents. Unfortunately, many of these
injuries include head trauma.
Previous studies have shown helmets can sharply reduce
the serious head injuries that can occur with cycling.
But the majority of children (and their parents) still
don't use helmets regularly. Why? Reasons suggested include
discomfort, lack of style, peer pressure, and not recognizing
the importance of helmets on short rides.
The American Academy of Pediatrics recently published a
statement emphasizing the importance of correct bicycle
helmet use. In these recommendations, all bicyclists (children
and parents alike) should wear proper helmets every time
they ride. A helmet made after March 1999 should be used.
These newer helmets meet US Consumer Product Safety Commissions
standards.
Children should be properly fitted because helmets come
in several sizes. Keep in mind that:
- In its correct position,
the helmet should sit low on the forehead and be parallel to the
ground.
- Velcro pads should be
placed in, or removed from, the inside of the helmet as needed
to make the helmet fit snugly.
- The chinstrap should
be adjusted so that no more than two fingers can be placed between
the strap and the chin.
- The helmet should not
shift or come off when the child shakes his head.
- All helmets should be
replaced every five years.
February 2002 Update
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