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Numerous observational data sets acknowledge that religious involvement is associated with favorable health outcomes. However, the few studies that have examined religion as an intervention, (e.g., prayer) have had mixed results. The current study prospectively investigated the effect of intercessory prayer (IP), both direct-contact (in-person) and/or distant (no personal contact between subject and person(s) praying) upon 40 rheumatoid arthritis patients in a private rheumatology practice. Individual prayer sessions in which Christian ministers prayed aloud and touched affected body parts (2 h/d ´ 3) were enhanced in one group with distant prayer, in which ministers prayed at least 10 minutes daily for the patient, with whom they did not have additional contact.
IP was associated with significant increases in mean grip strength, reduction in number of tender and swollen joints, and improvements in patient pain, fatigue, and level of functional impairment. Supplemental distant IP had no additional statistically significant effect.
The study was not randomized or placebo controlled. IP was associated in this study with improvements in RA. Distant IP added no further benefit. The authors comment that the degree of improvement seen compares favorably with recipients of DMARD therapy.
Matthews DA, et al. South Med J 2000;93(12):1177-1186.
Both community acquired and nosocomial infections with Staphylococcus aureus (SA) are important causes of morbidity and mortality. Concern about progressively more difficult levels of antibiotic resistance has prompted investigation for opportunities to interrupt the cycle of infection. It has already been determined that SA colonization is the primary source of SA infections in hospitals, and as many as 40% of hospitalized persons harbor SA as nasal carriers. Though interventional trials have shown that elimination of SA from nasal carriers reduces the frequency of SA hospital infection, such studies did not use modern molecular methods to define the correlation between nasal carrier and clinical infection strains.
In the first part of this two-segment study, nasal swab cultures were immediately obtained from all patients in 32 hospitals who had blood cultures positive for SA, and genotyping was performed if SA positive. The second segment of the study consisted of prospectively obtained nasal cultures from hospital patients; in those who subsequently developed bacteremia, analysis was done to confirm if the same strain was involved.
In both segments of the study, more than 82% of isolates from blood were identical to those obtained in nasal cultures. von Eiff and associates conclude that elimination of nasal SA carriage may prevent subsequent SA infections.
von Eiff CV, et al. N Engl J Med 2001; 344:11-16.
Alpha-antagonists (e.g., doxazosin, tamsulosin, terazosin) have become the mainstay of therapy for most symptomatic men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). Unfortunately, not all men respond to alpha-antagonist (AA) treatment, and must often be treated surgically. This report details results of a retrospective chart review of three years of data on men at the Department of Urology, Ochsner Clinic, in New Orleans, La. Study subjects were divided into two groups: group 1 had undergone transurethral resection of the prostate (TURP) after failure of AA therapy; group 2 had undergone TURP for symptomatic BPH but had not undergone AA therapy.
Outcomes in Group 2 were better than Group 1: persistent irritative voiding symptoms, new stress incontinence, and chronic urinary retention appeared more often as persistent problems in Group 1. Complete resolution of symptoms occurred more frequently in group 2 (92% vs 71%). Contrary to popular wisdom, prostate size did not contribute to relative success or failure of therapy. Blanchard and associates counsel that men who fail AA treatment should be informed that surgical results for them might not be as good as for other candidates.
Blanchard K, et al. South Med J 2000; 93(12):1192-1196.