New Eng J Med Vol 353–354
2433 Clostridium is getting more difficile, probably due to increasing use of quinolone antibiotics, selecting aggressive subtypes which are quinolone-resistant. And the bug is getting commoner due to wide use of proton pump inhibitors (JAMA 295: 2989).
2462 Ulcerative colitis responds well to the anti-TNF monoclonal antibody infliximab, without any serious side-effects in two trials.
2539 At every contraceptive update you've been to, you'll have been told not to prescribe the combined pill to women with systemic lupus erythematosus: this prospective study, and another on page 2550, shows that it is safe to do so.
2559 Influenza vaccine annually for all children under 5? In the winter of 2003–2004, over 150 children died of influenza-related causes in the US, and only a third had identifiable risk factors.
2643 UKPDS may leave doubts about the value of tight control in type 2 diabetes, but in type 1, this study shows a 57% reduction in serious cardiovascular events over 17 years in those randomised to tight control.
2667 Oseltamivir (Tamiflu®) unfortunately leaves avian flu viruses with ways to get round its neuraminidase-blocking action (page 2633) and this is borne out a by case report of resistant H5N1.
2758 There's no getting away from it: immediate angioplasty and stenting produce better outcomes after myocardial infarction than thrombolysis; and this trial shows the same following failed thrombolysis.
11 The prospects for a safe rotavirus vaccine didn't look good after a previous type had to be withdrawn due to a risk of intussusception; but now a new vaccine has been trialled and shown to be free of this risk.
34 Intraperitoneal chemotherapy for stage III ovarian with paclitaxel and cisplatin is quite an ordeal, but buys an extra 16 months of life.
Lancet Vol 366–367
2005 Patients with heart failure live 35% longer if they are highly compliant with medication, according to the CHARM trial — a much bigger effect than that of the trial drug, candesartan.
2026 In fact, drugs that block the renin-angiotensin system may be generally overrated, according to this systematic review of their renoprotective properties, which turn out to be imaginary.
2107 Mothers of babies who die suddenly and unexpectedly have a greater risk of complications in later pregnancies.
52 Britain used to have much lower rates of liver cirrhosis than the rest of Europe, but we've managed to catch up and overtake, with particularly heroic efforts from the Scots.
JAMA Vol 294–295
2720 Coughs and sneezes spread diseases, but in the future, they might spread protection from influenza by transmitting the protective strains from live attenuated intranasal vaccine.
2866 The best predictor of death and events in people who have had an acute coronary syndrome is serial measurement of B-type natriuretic peptide.
3101 Eat lots of plant foods containing zinc and vitamins A, C and E if you want to reduce your risk of age-related macular degeneration.
3117 Don't just write down ‘FH of CVD’ — name the offending relative. Cardiovascular disease in a sibling worsens risk more than disease in a parent.
39 Low-fat diets do not cause rebound weight gain, according to a long-term study in postmenopausal American women.
58 Another ‘health supplement’ proves harmful to those it is supposed to help: L–arginine increases mortality after myocardial infarction.
Arch Intern Med Vol 165
2644 The ‘metabolic syndrome’ is obesity, hypertension, impaired glucose tolerance and bad lipids. This UK study unsurprisingly finds that it predicts diabetes and cardiovascular disease.
2671 One reason we can't put statins in the water supply is that they can cause myopathy. This usually resolves within 3 months and half the patients were OK on a different statin.
Ann Intern Med Vol 143–144
785 If you've had a heart attack, worry about a stroke; the risk is 44-fold in the first 30 days, and doubled for 3 years after.
849 This study found that yoga helped chronic back pain if continued for 26 weeks. Levitation was not observed.
10 It's official: patients with peripheral vascular disease who walk more show less disease progression.
Guest publication: The Journal of Happiness Studies
Feeling terminally SAD as winter grinds to an end? Turn to a journal which specialises in looking on the bright side of life. Try, for example, a paper arguing that increasing inequality of income has not led to decreasing life satisfaction (2005; 6: 457).
Plant of the Month: Chimonanthus praecox
If your limy soil won't support witch hazel, grow wintersweet for an even nicer smell in late winter.
- © British Journal of General Practice, 2006.
