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19 October 2004 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These 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.

Chronic Prostatitis and Pelvic Pain Not Reduced by Antibiotic or A-Blocker

A six-week study of 196 men with moderately severe symptoms of chronic prostate/chronic pelvic pain (CP/CPPS) found that neither of two commonly prescribed drugs, ciprofloxacin, an antibiotic, or tamsulosin, an a-receptor blocker, successfully relieved symptoms (Article, p. 581). CP/CPPS is a common disorder in men, characterized primarily by pain in the pelvic region and sometimes lower urinary tract symptoms and sexual dysfunction. Its cause is not known, but it is usually treated with an antibiotic and/or a-receptor blocker. An editorial writer says that the study shows that antibiotics aren't useful but notes that some studies have shown improvement if a-receptor blockers are used for extended periods of time, e.g., three to six months (Ed., p. 639).

Simple Exercises Help Many with Vertigo and Dizziness

Simple exercises markedly improved dizziness in a study of 170 adult patients assigned to either an exercise group or a usual-care group (Article, p. 598). Patients in the exercise group met with a nurse, then at home recorded and performed daily exercises, such as rotating the head from left to right while keeping eyes open. The exercise program, known as vestibular rehabilitation, is seldom offered in primary care situations, but an editorial writer says it is an easy, inexpensive and effective method to control balance, especially important in an aging population (Ed., p. 641).

Study Searches for Best Blood Pressure Drugs for Black Patients

A meta-analysis of studies that looked at the effect of different antihypertensive drugs in black adults with hypertension found that commonly used drugs differ in ability to reduce blood pressure (Article, p.614). Choice of drugs is important because black people are more likely to develop hypertension than others, and the disorder is often more severe, more resistant to treatment and more likely to be fatal at an earlier age. Authors say that until future research clarifies issues such as the effects of different drugs on mortality, morbidity and diabetes as well as on blood pressure, physicians should prescribe antihypertensive drugs that have the lowest possible risk for side effects.

Survivors of Childhood Cancer Are at Risk for Subsequent Breast Cancer

In a study of 6,068 women who had childhood cancer, 95 subsequently developed breast cancer (Article, p. 590). At most risk were those who had been previously treated with chest radiation therapy, those with a family history of breast cancer or a personal history of thyroid disease.

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