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Physician, heal thy manners.

That's the message that emerges from a study showing patients expect their doctors to be courteous and respectful, but are sometimes disappointed.

"The first few moments of a medical encounter are critical to establishing rapport, making the patient feel comfortable and setting the tone of the interview," said Gregory Makoul, director of the Center for Communication and Medicine at Northwestern University in Chicago.

He surveyed 415 adult patients and studied videotapes of their encounters with physicians. The research, published in the journal Archives of Internal Medicine, showed that:

78.1 per cent of patients want doctors to shake their hand, while doctors do extend a hand in greeting 82.9 per cent of the time;

50.4 per cent of patients want to be greeted with their first name, 17.3 per cent prefer their last name be used and 23.6 per cent want the doctor to use both their first and last names; the research showed that 50.4 per cent of the time, doctors didn't mention the patient's name at all;

56.4 per cent of patients want physicians to introduce themselves using first and last names, 32.5 per cent expect physicians to use their last name and 7.2 per cent would like physicians to use their first name only; the study showed that doctors used their first and last names 58.5 per cent of the time but that in 11.4 per cent of visits, they did not introduce themselves at all.

But introductions are just the tip of the iceberg. Previous research showed that doctors interrupt patients within 18 seconds of them speaking. Only 2 per cent of patients actually finish their opening sentence.

A SOBER WARNING

People who undergo gastric bypass surgery (commonly known as stomach stapling) to lose weight should be very careful about their alcohol intake because research shows that they can get drunk on a single glass of wine. Speaking yesterday at the annual meeting of the American Society for Bariatric Surgery in San Diego, Calif., bariatric surgeon John Morton said he was intrigued by anecdotal reports of his patients being charged with drunk driving after a single drink.

He and colleagues conducted an experiment, having 19 postoperative gastric bypass patients and 17 control subjects each drink five ounces of red wine, and then testing each person's blood-alcohol level. The patients blew, on average, 0.08, the legal limit, while the controls measured 0.05 per cent. Alcohol also lingered much longer in the blood of the gastric bypass patients.

Dr. Morton said the procedure alters a number of physiological functions in the body that may explain the low tolerance for alcohol. In particular, he said, the enzyme alcohol dehydrogenase, which is most responsible for alcohol metabolism, is markedly reduced after the operation.

"Patients have to be careful with alcohol because they'll become tipsy a lot easier," Dr. Morton said, adding that the high number of calories in alcohol is another good reason to abstain.

I DON'T SNORE! I'M ALLERGIC

In adults, snoring is often a result of obesity.

But in children, snoring appears to be the result of allergies, according to a study.

The research, published in the journal Pediatric Pulmonology, found that the risk factors for snoring and allergic disorders are almost identical, namely exposure to cigarette smoke in the first year of life, asthma and eczema.

Among the study group of 213 five-year-olds, each of those risk factors increased the likelihood of snoring by about 2½ times, said lead author Nathaniel Marshall of the Woolcock Institute of Medical Research in Sydney, Australia. By contrast, the body mass index of preschool children was not related to their risk of snoring.

"Snoring in children may be regarded as part of the spectrum of allergic diseases," he said.

HOPE IN CANCER FIGHT

A rare bit of good news for women suffering from ovarian cancer, one of the deadliest forms of the disease.

A study published in the journal Clinical Cancer Research shows that hormone therapy can prolong the life of some patients up to three years and delay chemotherapy in others.

The study included only 44 women, and all of them had relapsed after surgery and chemotherapy. They were treated with letrozole, a drug that reduces estrogen levels, and which is used for some breast cancer patients. The research seems to confirm the theory that some cases of ovarian cancer are highly sensitive to the hormone estrogen, which opens new avenues for treatment and research.

"This is an important landmark in the research and treatment of ovarian cancer," said lead author John Smyth, a professor of medical oncology at the University of Edinburgh.

"Despite intense scientific research over the past 20 years, there have been few new leads in our understanding of how this disease operates. But this study suggests that the addition of hormone therapy to our treatment strategy could extend and improve the lives of women with cancer," he said.

VETERANS AND SUICIDE RISK

Some sobering health news for Canadian soldiers toiling in Afghanistan.

A new study shows that former military personnel are twice as likely to kill themselves as people who have not seen combat.

Suicide rates were highest in former soldiers who had health problems related to their military service. Veterans who killed themselves were also more likely to be older, white, better educated and less likely to have been married than others who committed suicide.

The research, published in the Journal of Epidemiology and Community Health, involved 320,000 men who were tracked for at least 12 years.

Mark Kaplan of the school of community health of Portland State University in Portland, Ore., and lead author of the study said that physicians treating veterans should be alert for signs of suicidal intent. He said military and health authorities should be planning to deal with the mental health problems of soldiers who are now serving abroad.

"With the projected rise in functional impairments and psychiatric morbidity among veterans of the conflicts in Afghanistan and Iraq, clinical and community interventions that are directed towards these patients are needed," he said.

apicard@globeandmail.com