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Younger doctors; fewer hysterectomies

A woman can lower her odds of having a hysterectomy by choosing a younger gynecologist _ male or female _ and then simply telling the doctor she wants to avoid surgery, a new study concludes.

The study of North Carolina gynecologists blasts the common assumption that male doctors are more likely to perform the controversial operation and suggests that women have a lot more control over their treatment than previously realized.

"If a woman has any question at all, she really ought to be right up front with her concerns," said Dr. Nina Bickell, whose study appears in the American Journal of Public Health. "That could have a major impact."

Critics say between 25 percent and 50 percent of the 650,000 hysterectomies performed every year in this country are unnecessary, putting overall healthy women at risk of serious complications and even death.

The controversy is fueled by the great disparity in hysterectomy rates. In the South, 83 hysterectomies are performed for every 10,000 women, versus a rate of 48 per 10,000 in the Northeast.

The male gynecologists performed 60 percent more hysterectomies than females. But Bickell scrutinized that data further, controlling for age. The gender gap disappeared among recently trained gynecologists, leading her to theorize that gynecology itself became more sensitive to hysterectomy when women began flooding the field in the early 1980s.

Sense and vitamin C

People who believe that large doses of vitamin C every day can keep the doctor away should think twice. More precisely, they should take two doses a day for maximum effect, according to a new study.

Released just in time for flu season, the study found that the largest sensible dosage of vitamin C is 500 milligrams taken by pill every 12 hours.

That is the most the human body can handle, according to the report published this week by the gerontology journal, Age. That dosage maintains a continuously high level in the body; any more is excreted so quickly it can yield no benefit.

Addicted to move

Most exercise addicts are women, and their addiction is more closely related to eating disorders than the desire to keep fit.

A study conducted for the Journal of Behavioral Psychotherapy in 1993 found a sample group of anorexics did four times as much exercise as a control group of sporty students. According to one medical estimate, 78 percent of anorexics are exercise addicts.

"Since the 1970s our culture has emphasized not just thinness but fitness," says Clive Long, consultant psychologist on eating disorders at St Andrew's Hospital in England. "People who become obsessed with exercise feel guilty and anxious if they do not stick to their schedule. Their exercise regimen becomes socially inappropriate. Addicts know that what they are doing is excessive and so become secretive _ jogging in the early hours for instance."

Help for arthritis?

Two studies suggest that a new drug offers temporary relief from the pain of rheumatoid arthritis, a chronic, debilitating joint disease.

Experts called the findings an exciting step forward, but far from a cure. Larger studies are necessary to demonstrate that the drug is truly effective and does not have dangerous side effects.

The drug, made by Centocor, is an antibody that blocks TNF-alpha, a chemical thought to spur swelling, pain and cartilage destruction.

A major drawback of the new drug is that it must be given intravenously. Researchers hope to design an effective pill that patients can take to ease pain.

"This is something more hopeful than we've seen for a long time," said Dr. Ravinder N. Maini of the Kennedy Institute at Charing Cross Hospital in London, who led a team that conducted the studies.

_ Compiled from Times wires.

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