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06 June 2000 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue will be available on the Internet at on June 6, 2000.

Hangovers Have Psychological, Physical and Job-Related Consequences

The alcohol hangover places stress on the heart, impairs learning and visual-spatial acuity, which can limit job performance and driving ability, and costs billions of dollars each year from employee absences and decreased productivity (Review, p. 897). Because of this, the authors say, screening for hangovers is reasonable and may be one of the best ways to find patients' problems with alcohol. Of treatments surveyed, only drinking fluids and taking vitamin B6 tablets seemed to reduce hangover symptoms.

Long-Term Anticoagulant Probably Not Needed After Knee or Hip Surgery

Although the anticoagulant low-molecular-weight heparin is often used after knee and hip replacement surgery to prevent development of leg blood clots, a new study found that extended out-of-hospital use does not significantly reduce venous thromboembolism or death (Article, p. 853). An editorial says that the most promising approaches to prevent leg blood clots after knee and hip replacement surgery are to minimize clot formation while patients are in the hospital and lower the cost of the drug (Editorial, p. 914).

Recombinant Hormone May Help Scleroderma

In an early drug trial, recombinant human relaxin significantly reduced skin thickening and improved mobility in patients with moderate to severe diffuse scleroderma (Article, p. 871). Scleroderma is a progressive, disabling disease in which the skin and some internal organs harden. It is difficult to treat, and no therapies to date prevent or reverse the hardening. In the phase-two trial involving 68 patients, recombinant human relaxin showed promise at a dose of 25 micrograms of body weight per day for 24 weeks but had no effect at 100 micrograms.

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