Public Health

The Myths of Dehydration and Heat Illnesses

• The primary cause of hyponatremia in athletes is drinking too much water.
• The incidence of hyponatremia appears to be between 13% and 15% among endurance athletes.
• Gender and the duration of athletic activity appear to be predictors of the incidence of hyponatremia.
• Sodium supplementation has no effect on the occurrence of hyponatremia.
• There seems to not be a single case of death resulting from sports-related dehydration in the medical literature.

• Postoperative myocardial infarction (MI) is the 3rd leading cause of death in the U.S.
• Intraoperative hypotension, arterial occlusion and other phenomena appear to be part of the multifactorial causes.
• Intraoperative clonidine is not protective against this phenomenon.
• Perioperative aspirin use was not related to intraoperative or postoperative MI.

• Surgical meniscus repair was not superior to sham surgery in a randomized, controlled trial.
• Non-surgical care of meniscus-injury related pain, such as exercise, was equally or more effective than surgical interventions.
• Approximately 700,000 arthroscopic partial meniscectomies are performed annually in the U.S.
• Annual direct medical costs are estimated at $4 billion.
• Physicians and patients should consider all non-surgical options before undertaking surgical intervention for knee pain related to meniscus injury.

• The Preventure program has been shown to reduce substance abuse among adolescents.
• Identification of 4 personality traits along with intervention related to those traits reduces rates of substance abuse.
• Program has been studied in randomized controlled trials in schools in the U.K.

• Patients with lung and colorectal cancer and limited financial reserves are more likely to have a higher symptom burden and a decreased quality of life.
• Patients with lung and colorectal cancer and limited financial reserves are more likely to have a higher symptom burden and a decreased quality of life.
• Results Among patients with lung and colorectal cancer, 40% and 33%, respectively, reported limited financial reserves.

• State crackdown on high prescribers is associated with more than 1000 fewer deaths.
• CDC reports that prescription drug-related deaths have continued to rise.
• Johns Hopkins researchers find the Florida program to be effective.
• Physicians are being urged to prescribe opioids in fewer cases, to fewer patients, in lower dosages.
• The epidemic of prescription and non-prescription opioid deaths makes clear the need for drug treatment programs and for the widespread use of naloxone kits.

• There is increasing evidence linking alcohol consumption to cancer.
• Mechanisms by which drinking alcohol increase the risk of cancer are not yet understood.
• New meta-analysis concludes that alcohol causes cancer of the oropharynx, larynx, esophagus, liver, colon, rectum, and breast.
• “Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8% of all cancer deaths world-wide,” the authors note.

• There is increasing evidence linking alcohol consumption to cancer.
• Mechanisms by which drinking alcohol increase the risk of cancer are not yet understood.
• New meta-analysis concludes that alcohol causes cancer of the oropharynx, larynx, esophagus, liver, colon, rectum, and breast.
• “Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8% of all cancer deaths world-wide,” the authors note.

• In 2012, there were 24,190 fatal and 3.2 million medically treated non-fatal fall related injuries.
• Direct medical costs totaled $616.5 million for fatal and $30.3 billion for non-fatal injuries in 2012 and rose to $637.5 million and $31.3 billion, respectively, in 2015
• During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized
• The projected 2030 population would result in an estimated 48.8 million falls and 11.9 million fall injuries.

• Nutritional benefits of maternal fish consumption outweighed the risk of neurologic deficits associated with mercury.
• The better neurobehavioral performance observed in infants with higher mercury biomarkers should not be interpreted as a beneficial effect of mercury exposure, which is clearly neurotoxic.
• Better neurobehavioral performance in mercury-exposed infants likely reflects the benefits of polyunsaturated fatty acid intake associated with fish consumption.
• Polyunsaturated fatty acid intake has been shown to benefit attention, memory, and other areas of development in children.

• Results of largest study to date were published in The New England Journal of Medicine.
• Randomized trial involved more than 9000 patients who had stable or unstable coronary artery disease.
• The primary outcome was a composite of death from any cause and nonfatal spontaneous myocardial infarction at 5 years of follow-up.
• Secondary outcomes included repeat revascularization, stent thrombosis, and quality of life.

• New data from the Centers for Disease Control and Prevention show urgency of vaccination adherence.
• Between the period 2005–2006—before the 2-dose vaccine recommendation—and 2013–2014, the overall incidence of varicella infection declined by 84.6%.
• The largest declines were reported among children aged 5 to 9 years (89.3%) and 10 to 14 years (84.8%).

• Deaths due to traffic collisions rose in 2015 by 7.7%—the largest increase in 1966.
• Opioid-related overdose deaths are at epidemic levels.
• Cannabis use is legal in 25 states.
• The cost of these collisions and deaths is estimated at nearly $38 billion.

• Are these phenomena related?