New research overturns common health ‘truths’
AN APPLE A DAY - AN APPLE A DAY By Tyrone M. Reyes, M.D. () - January 30, 2007 - 12:00am
Not so long ago, doctors warned parents to put their babies to sleep on their stomachs to prevent crib death, told ulcer patients their condition stemmed from stress, and advised every menopausal woman that hormone replacement therapy would help prevent heart attacks. Every one of those beliefs and practices turned out to be wrong. Other medical treatments, once equally discredited, proved useful after all. Psychiatrists are (carefully) giving electroshock treatments to some people who have severe depression. And thalidomide, a drug banned in the 1960s because it caused horrific birth defects, was found years later to be effective for certain cancers.

Here’s our top list of other medical beliefs and practices that have recently undergone major revisions.
Giving Your Baby A Pacifier Will Interfere With Breastfeeding And Damage Teeth
In November 2005, The American Academy of Pediatrics for the first time encourages the use of pacifiers in infants, saying that they appear to substantially cut the risk of sudden infant death syndrome (SIDS). The new guidelines also say that there’s little evidence that pacifiers damage teeth or cause infants to lose interest in breast-feeding.

What you can do: Consider giving your baby a pacifier at bedtime during his/her first year or so, when the risk of SIDS is greatest. Using "binkies" or thumb-sucking at other times of the day probably doesn’t harm your child, provided it stops after age two, when it may cause protruding front teeth and improper bite. Other steps that have been associated with a lower risk of SIDS include breast-feeding, placing babies on their backs to sleep, and clearing the crib of squishy items such as pillows, fluffy bumper pads, comforters, and soft toys.
Stretchiing Before Exercise Boosts Performance And Prevents Injury, And Getting A Massage Afterwards Speeds Recovery
Two large reviews, published in 2004 and 2005, failed to support the notion that stretching your muscles before exercise prevents injury or post-exercise muscle soreness; another found only two to five percent improvement, on average, in running speed, jumping height, and muscle power, a slight gain that nonprofessional exercisers probably wouldn’t even notice. At least five clinical trials now show that getting a massage after exercise doesn’t help restore muscle strength and does little to soothe aching muscles.

What you can do: While it may not pay to stretch your muscles before working out, warming them up first probably does help to prevent injury. Before each workout, spend at least five minutes slowly performing all the movements you’ll be doing more vigorously during the actual exercise. And some evidence suggests that stretching also keeps you limber, making it easier to perform everyday activities. Though it’s not useful after exercise, massage does help relieve stress, back pain, headache, fibromyalgia, insomnia, and post-surgical and pregnancy-related pain.
You Need To Drink Six To Eight Glasses Of Water A Day To Stay Properly Hydrated
In February 2004, after reviewing more than 400 studies, the US National Academy of Sciences rejected this conventional wisdom. It concluded that most men need about 15-1/2 cups of fluid a day, and women about 11-1/2. But that included fluids from all beverages, including the alcoholic and caffeinated kinds, and the water in food. Majority of Filipinos probably get that much liquid in their everyday diets. Certain people are actually at increased risk of getting too much water, which can cause sodium concentrations in the body’s cells to drop dangerously low and trigger headaches, confusion, and, in rare cases, even seizures, coma, and death. High-risk groups include people with congestive heart failure or hypothyroidism; those who regularly take certain medications, notably nonsteroidal anti-inflammatory drugs such as ibuprofen, ketoprofen, and naproxen; and amateur athletes who take literally the common advice to "drink as much as possible" during exercise.

What you can do: Most people naturally feel thirsty after strenuous exercise and drink more fluids without being prompted. However, people over age 65 or so may need to pay special attention to their fluid intake, since the sense of thirst tends to diminish with age. Scanty, strong-smelling, dark-yellow urine indicates that you need to drink more. Finally, while any beverage counts toward your daily intake, plain water does offer several advantages: It’s cheap, thirst-quenching, and calorie-free. People at increased risk of overhydration should be especially careful not to exceed the recommended amounts for their gender. And exercisers should take care to consume at least one cup of fluid an hour but no more than three.
Episiotomy Prevents Serious Tears During Delivery
It’s one of the most common surgical procedures, performed during labor on thousands of women a year: a short incision to enlarge the vaginal opening, meant to reduce the chance of a tear in the skin surrounding the vagina. But several studies published since 2000 show that the operation actually makes skin tears more likely and increases the risk of fecal incontinence. While episiotomy may sometimes slightly shorten labor, the American College of Obstetricians and Gynecologists says that speedier delivery is only necessary if the baby appears to be in distress or the mother is overly exhausted or in excessive pain. But many doctors perform the procedure routinely, when there are no such signs.

What you can do: Ask your physician not to do an episiotomy unless you or your baby are in distress. You may be able to lower your risk of a vaginal tear during childbirth by practicing Kegel exercises – relaxation and contraction of the pelvic floor muscles – before delivery and by having a doctor, nurse or midwife massage and apply warm compresses to the region around the vagina during childbirth. Any tears that do occur usually heal on their own or can be stitched up, depending on the severity.
Most Women Need A Pap Smear At Least Once A Year
This simple test has cut the mortality rate from cervical cancer nearly in half over the past 20 years – and made the Pap smear a standard part of the annual exam. But revolutionary changes in our understanding of cervical cancer have substantially altered recommendations about how often women should undergo Pap smears. These include:

• Doing them less often than previously recommended, since it typically takes four to seven years for precancerous cells to progress to cancer.

• Testing the cells from the Pap smear for infection with human papillomavirus (HPV) which researchers know causes the malignancy.

• Stopping the smears completely in women who’ve undergone hysterectomy, including removal of the cervix for reasons other than cancer, as well as in older women. The cancer risk in those groups is so low that testing isn’t worthwhile. The US Preventive Services Task Force now says that for women over age 65, the risks of routine Pap smears – mainly false positive results that trigger anxiety and follow-up procedures – often outweigh the benefits.

What you can do: All women should still have annual Pap smears starting three years after their first sexual intercourse or by age 21, whichever comes first, and continuing through age 30. After that, they have an option: annual Pap smears until they have three normal results in a row, at which point they can get tested every two or three years; or an annual Pap smear plus the HPV test until they get one normal result on both tests, after which they get the combination every three years. Most women can stop testing entirely after a hysterectomy or after age 65 or 70 if they’ve had no abnormal results in the previous decade. To improve the accuracy of your Pap smear, avoid sexual intercourse, vaginal creams, and vaginal douches for 24 hours before the exam, and reschedule your appointment if you have your period or a urinary tract or yeast infection.
Impacted Wisdom Teeth Should Come Out
Wisdom teeth, which usually emerge between 17 and 25, can get impacted, or lodged so firmly in the jawbone that they can’t break through. Many dentists believe that routinely removing impacted wisdom teeth can prevent future problems, such as damage or malalignment of other teeth. But this practice has little or any supportive evidence. In fact, the scanty available research suggests that surgically digging out impacted wisdom teeth is more likely to cause problems than prevent them. Even with the latest surgical techniques, nearly all patients must endure postoperative pain and swelling, about one percent will suffer nerve damage that permanently numbs the tongue or lips or impairs the ability to sense pain and temperature.

What you can do: Don’t get unerupted wisdom teeth removed unless they’re decaying below the surface, infected, damaging a nearly tooth, or causing other problems.

AGE AMERICAN ACADEMY OF PEDIATRICS AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS CENTER EXERCISE PAP RISK TEETH WOMEN
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