Originally created 11/04/99


Cheap health care?

Bedside manner doesn't matter when some men want drugs to improve sexual function.

At least 77 Web sites offer direct delivery of Viagra without a visit to a doctor, a new study has found, and only 42 of the sites require customers to answer a questionnaire about their medical histories. Of those, only 27 sites said that a physician would review the medical information.

Such wide availability of the impotence drug through a computer "highlights the need for effective regulation of Internet prescribing in the public interest," researchers from the University of Pennsylvania School of Medicine and the Philadelphia VA Medical Center wrote last week in The New England Journal of Medicine.

On 52 of the Web sites, consumers were required to release companies from liability. The average cost of a Viagra tablet was about $13, but some were as cheap as $5 apiece.

Surgery cut off

It may be time to call a halt to most of the adenoidectomies and adenotonsillectomies that more than 425,000 children under the age of 15 undergo each year.

A study of 461 children with persistent middle ear infections, the most common reason for these operations, found that those who had their adenoids removed or who had both adenoids and tonsils removed fared little better than those who did not undergo surgery, said Jack L. Paradise of Children's Hospital of Pittsburgh.

The average number of ear infections in children who had an adenotonsillectomy was 1.4 per year, compared to 2.1 per year for children who did not have surgery, he reported in the Journal of the American Medical Association. However, 14.6 percent of children having surgery had complications.

"Given that we found both operations to have limited efficacy, and in view of their not inconsiderable risks, morbidity and costs, we believe that neither operation ordinarily should be considered as an initial intervention in such children," Dr. Paradise said. Medical treatment followed by ear tubes should be tried first, he added.

Got milk substitute?

The average American black woman consumes only about half the calcium she needs, largely because many are lactose intolerant and avoid milk, a primary source of calcium.

To help remedy this imbalance, the National Medical Association, which is made up of black physicians, has called on the U.S. Department of Agriculture to promote lactose-free dairy products in the Food Guide Pyramid and Dietary Guidelines for Americans.

"We think this is an easy solution to help address the calcium problem in the African-American community," Dr. Gary C. Dennis reported at the association's recent annual meeting. "Unfortunately, many people just don't know about the lactose-free options."


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