Doctors may be treating severe ankle sprains the wrong way, according to the
results of a surprising British study.
Normally, physicians recommend the use of ice and elevation to ease pain and
reduce swelling, and wrap the ankle in a compression bandage. The main piece of
advice is to keep the foot moving - within limits of tolerable pain.
But the new research shows that short-term use of a below-the-knee cast, which
essentially immobilizes the joint, is the best approach to speed healing.
"Contrary to popular clinical opinion, a period of immobilization was the most
effective strategy for promoting rapid recovery," the researchers concluded in
the medical journal The Lancet.
The study was conducted for the British National Health Service, which wanted to
know the most cost-effective means of treating the common injury that can
sideline people for months.
The researchers followed 584 sprain patients who were randomly assigned to
receive one of four different types of ankle support: a compression bandage; a
below-the-knee cast; an Aircast brace (which includes an inflated cushion); or a
Bledsoe boot (a lightweight device that limits motion).
The lead researcher, Sarah Lamb of the University of Warwick, admits she was
surprised to see that 10 days in a standard cast beat out some of the latest
high-tech foot supports on the market.
Although such a cast is now made with light-weight materials and comes in many
vibrant colours, "it is a bit like one of the old-fashioned plaster casts in
appearance," Dr. Lamb said. Yet the key to its success is "the way it fixes the
ankle and foot in a rigid position," she said.
"I think what is happening is that the injured tissues are best protected from
further damage by the cast ... The ligaments get a real change to start healing
and it sets people up for good recovery," she said. "None of the other devices
encase the joint in the same way, and, importantly, patients can very easily
remove them."
Dr. Lamb noted that the Aircast brace came in a close second and would be a
suitable alternative. The Bledsoe boot, however, wasn't much better than a
compression bandage, which provided the least support.
The overall findings are relatively good news in terms of health care costs - at
a price of £16.46 (about $30), the cast is one of the cheaper options. The
Bledsoe boot, priced at £215, was the most expensive. The Aircast brace rang in
at £39.23, and the bandage cost £1.44.
Predicting elections
Does the physical appearance of a candidate matter more to voters than the
political platform? A study published today in the journal Science seems to
suggest so.
Researchers used photos of candidates (the winner and the runner-up) from a
previous French election and showed them to Swiss adults who knew nothing about
outcome. When the Swiss were asked to rate the two candidate's competence based
on their photos alone, a majority of them picked the politician who had won.
The researchers, from the University of Lausanne in Switzerland, conducted a
similar experiment in children (aged 5 to 13) and found an identical result. The
children were playing a computer game involving a boat trip. The researchers
showed the kids photos of the candidates and asked them which one they would
like to see as the captain of their boat. Once again, the majority of children
selected the election winner.
Although the study wasn't designed to determine what aspect of a person's face
denotes competence, it must be deeply rooted in the human psyche because it
holds true for both kids and adults.
The sunshine vitamin
Here's another reason to make sure you're getting enough vitamin D this winter -
it may help guard against colds and flu, a new study indicates.
The research is based on a survey conducted by the U.S. National Center for
Health Statistics.
About 19,000 adults and teens received a physical examination, which included
the collection of a blood sample, and were asked questions about their health.
The results, published in Archives of Internal Medicine, revealed that people
with the lowest blood levels of vitamin D had significantly more respiratory
infections such as colds and flu. The risks were even higher for those with
chronic respiratory disorders including asthma and emphysema.
The senior author, Carlos Camargo of Massachusetts General Hospital, speculates
that vitamin D helps protect the airways by activating the production of an
antimicrobial peptide called cathelicidin.
Vitamin D is produced naturally in skin that is exposed to sunlight. But during
winter when days are short and the sun is low in the sky, people tend to
experience a drop in their vitamin D stores.
"We think that low vitamin D levels in winter probably contribute to the winter
increase in respiratory infections," Dr. Camargo said in an e-mail interview.
He added researchers would have to do a large clinical trial to know for sure
that vitamin D supplements can prevent colds and flu.
Even so, the Canadian Cancer Society is already recommending supplementation
because the vitamin is also thought to guard against certain cancers. During
fall and winter, Canadian adults are urged to pop a pill containing 1,000
international units of vitamin D a day.
The society also suggests that some people - such as those with dark skin or
over the age of 50 - take supplements year-round.
