Doctors' convictions influence patient treatment

Physicians' religious and moral convictions influence what they tell, and don't tell, patients, a new survey shows.

About 1,100 physicians answered a questionnaire about three controversial medical treatments. Their answers showed that 17 percent objected to sedating dying patients into unconsciousness; 42 percent opposed prescription birth control for teens without parental consent; and 52 percent objected to abortion for failed contraception.

The doctors also answered questions about their obligations to patients regarding these treatments. Although 86 percent felt obliged to inform patients about options they were unwilling to provide, 63 percent said it would be ethical to explain their moral objections, and 29 percent said they would not feel obliged to refer patients to other doctors for the treatment.

The survey, conducted by medical ethicists at the University of Chicago, appeared in last week's New England Journal of Medicine.

   - Marie McCullough

Loneliness may raise risk of developing Alzheimer's

Being lonely and isolated may increase your risk of developing Alzheimer's disease.

In a study led by the Rush Alzheimer's Disease Center in Chicago, 823 healthy elderly people from various backgrounds were interviewed and followed for four years. During that period, 76 of them developed dementia.

Those who said they had few or no friends and felt misunderstood were more than twice as likely to develop dementia as people who said they were not lonely.

Previous studies have suggested that a rich social and intellectual life has a protective effect against Alzheimer's. The new one, published in Archives of General Psychiatry, "suggests that both the quantity of social interaction and the quality of social attachments affect risk of late-life dementia."

   - M.M.

Stable placement benefits children in foster care

It makes sense: Children who wind up in foster care because their own homes are unstable benefit from a stable foster home.

Researchers at the Children's Hospital of Philadelphia analyzed data from the National Survey of Child and Adolescent Well-Being, a nationally representative study of children referred to child welfare agencies for maltreatment in 1999 and 2000. From a sample of 729 children in foster care, the study team compared the children's behavior problems when they entered foster care and after 18 months. The children ranged in age from infancy to 15 years old.

Those who entered foster care with many behavior problems were less likely to have problems only 18 months later if they stayed in the same foster home. Conversely, among children who began foster care with fewer apparent behavior problems, those who were moved frequently were more likely to have subsequent problems.

The study is in the February issue of Pediatrics.

   - M.M.

Infertility drug indicated for women with ovary syndrome

Women with a metabolic disorder called polycystic ovary syndrome often suffer from infertility.

The standard infertility drug, clomiphene, is more effective than a diabetes drug, metformin, in helping such women have babies, according to a federally funded study that included the University of Pennsylvania School of Medicine.

Earlier studies showed that metformin, which makes the body more sensitive to insulin, could increase ovulation among PCOS patients, who frequently are resistant to insulin. Clomiphene, in contrast, stimulates hormones that trigger ovulation.

In the study, women who took metformin with or without clomiphene ovulated more than those who took clomiphene alone, but this did not result in more pregnancies or deliveries. About a quarter of the 209 women who took only clomiphene gave birth.

The study appeared in last week's New England Journal of Medicine.

   - M.M.