Annals of Internal Medicine, tip sheet, August 1, 2000

July 31, 2000

Physicians should prescribe sterile needles, writers say

Sterile needles prevent spread of diseases such as AIDS and the hepatitis viruses among injection drug users and their families. Authors argue that prescribing and dispensing injection equipment is ethical and clinically appropriate and in most states is legal (Perspective, p. 218). They say that physicians should prescribe this equipment for appropriate patients and, where the practice is illegal, work to change these laws. Smoking is a risk for developing type 2 diabetes

A prospective cohort study of 1,266 men found that the number of cigarettes smoked daily and the number of years smokers smoked was associated with development of impaired fasting glucose and type 2 diabetes (Article, p. 183). Drugs that promote reflux may increase risk for an esophageal cancer

A study of the relationship between drugs that relax the lower esophageal sphincter and allow gastroesophageal reflux, or backward flow of stomach fluid, found that daily, long-term use of the drugs was a risk factor for esophageal adenocarcinoma, a cancer that is increasing among men in the Western world (Article, p. 165). The authors say that the increment in absolute risk to individual patients is small, and the risk must be weighed against the therapeutic benefits of the drugs, which may be substantial. An editorial says that "medical practice will probably not be affected by the findings," but that the increase in cases of esophageal adenocarcinoma and the link between the cancer and gastroesophageal reflux need careful watching (Editorial, p. 227).
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 previous highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue is available on the Internet at on August 1, 2000.

American College of Physicians

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