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Clinical Times: February 2007

Uncertainty still surrounds the treatment of diabetic patients, part one

Prof Gerald Tomkin | 23 February 2007 | Diabetes

“To sleep perchance to dream.” This Shakespearean line may seem an unusual opening to an article on the treatment of type 2 diabetes but a discussion about such treatment in 2007 has to pay some attention to the DREAM (diabetes... Read more

AIDS and sexual violence stalk a landscape of beauty and colour

Emer Mullins | 23 February 2007 | Infections & Immunology

Kenya is a vast land, a natural environment of great beauty full of colour and tradition. One of Africa’s foremost tourist destinations, its people are warm and gracious. But away from the famous coastline of Mombasa and the game parks,... Read more

Symptoms of depression linked to early stages of coronary artery disease

Archives of General Psychiatry 2007;64:225-233 | 23 February 2007 | Cardiovascular

Depressive symptoms may be associated with thickening arteries, which may reflect an early sign of coronary artery disease. Researchers looked at 324 men and women who were an average of 60.6 years old. At the beginning of the study, participants... Read more

Patients who get ICDs for prevention need fewer driving restrictions

Circulation, 7 February 2007 | 23 February 2007 | Cardiovascular

Patients who receive implantable cardioverter defibrillators (ICD) as a preventative measure don’t need the same driving restrictions as people who get an ICD after surviving a life-threatening heart rhythm disturbance, according to an updated scientific statement from the American Heart... Read more

Intensive atorvastatin treatment cuts hospital time for heart failure

Circulation 2007;115:576-583 | 23 February 2007 | Cardiovascular

Intensive treatment with atorvastatin in patients with stable coronary disease significantly reduces hospitalisations for heart failure, a new study has found. In the study, doctors randomised 10,001 patients with stable coronary disease to treatment with 80 mg per day or... Read more

Aprotinin limits loss of blood but it could increase risk of death after bypass surgery

JAMA 2007;297:471-479 | 16 February 2007 | Cardiovascular

Aprotinin, a drug used for limiting blood loss in patients undergoing cardiac surgery, is associated with an increased risk of death during five years following the surgery, according to a new study. In all, more than four million patients worldwide... Read more

Blindness terrifies teens, but few realise link with smoking

British Journal of Ophthalmology | 16 February 2007 | Eye, Ear, Nose & Throat, Respiratory

Teenagers fear blindness more than lung cancer or stroke, but nine out of 10 don’t know that smoking can rob them of their sight in later life, according to a new study of 260 UK teenagers. One in five of... Read more

Doctors’ own fear of death can be linked to hastening death of sick newborns

Archives of Disease in Childhood, Fetal Neonatal Edition | 16 February 2007 | Mental Health & CNS

Doctors who fear their own death say they are more prepared than other doctors to hasten the death of sick newborns for whom further medical treatment is considered futile, new research has found. Neonatologists in New Zealand and Australia were... Read more

An aggressive research agenda is needed to fight metabolic syndrome

Dr Mary Ryan | 16 February 2007 | Cardiovascular, Diabetes

For most of the 20th century, cardiovascular disease was identified as the major cause of morbidity and mortality in the developed world. During this period considerable efforts were made to understand the underlying biology of the disease and to identify... Read more

Statin therapy linked to regression of coronary atherosclerosis

JAMA 2007;297:499-508 | 16 February 2007 | Cardiovascular

An analysis of data from four clinical trials suggests that statin therapy is associated with regression of coronary atherosclerosis when low-density lipoprotein cholesterol (LDL-C) is substantially reduced and high-density lipoprotein cholesterol (HDL-C) is increased. Despite such findings, it remains to... Read more

Severely mentally ill more at risk of cardiovascular death

Archives of General Psychiatry 2007;64:242-249 | 16 February 2007 | Cardiovascular, Mental Health & CNS

A large British study has found that individuals with severe mental illnesses are significantly more likely to die from coronary heart disease and stroke, but not cancer, than those without mental illnesses. In the study, doctors selected 46,136 individuals with... Read more

Prior information about test results helps reassure patients

BMJ | 09 February 2007 |

Giving patients prior information about diagnostic tests can help improve patient outcomes and give reassurance, according to a new study from New Zealand. In the study, researchers set out to analyse whether giving patients information about the meaning of normal... Read more

Caffeine may not effect birth weight or length of pregnancy

BMJ | 09 February 2007 | Women's Health

There is no evidence that moderate levels of caffeine consumption during pregnancy lead to a greater risk of premature births and underweight babies, according to a new study. Some previous studies have suggested that a high caffeine intake can lead... Read more

Thrombolysis therapy with alteplase could routinely treat stroke

The Lancet 2007;369:275- | 09 February 2007 | Cardiovascular

The thrombolytic drug alteplase, despite recent concerns, is safe and effective in routine clinical use when used within three hours of stroke onset, according to a new study. Alteplase is the only approved medical therapy for patients with acute ischaemic... Read more

Improved prediction of stroke after TIA

The Lancet 2007;369:283-292 | 09 February 2007 | Cardiovascular

Existing prognostic scores for early-risk stroke prediction after transient ischaemic attack (TIA) have been validated and refined to develop a unified score that is more predictive than previous methods. Recent studies have shown that four to 20 per cent of... Read more

Alerting clinicians to the dangers of hyperhomocysteinaemia

Dr Neville Wilson | 09 February 2007 | Cardiovascular

Homocysteine is an amino acid that, if present at a high level within the blood, is associated with an increased risk of arterial thrombosis, including heart attacks and strokes. This condition is known as hyperhomocysteinaemia. Recent publications (IMT, 8 December... Read more

Folic acid supplements in early pregnancy reduces risk of cleft lip

BMJ | 09 February 2007 | Nutrition, Women's Health

Taking folic acid supplements in early pregnancy seems to substantially reduce the risk of cleft lip, a new study says. It is known that taking folic acid in early pregnancy reduces the risk of neural tube defects. The recommended daily... Read more

ARBs and ACE inhibitors are least likely to lead to diabetes

The Lancet 2007;369:201-207 | 02 February 2007 | Diabetes

Antihypertensive agents least associated with incident diabetes are angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACE) are according to a new study. In the study, doctors undertook a network meta-analysis to assess the relative odds of developing diabetes during long-term treatment... Read more

Antidepressant link to fracture

Archives of Internal Medicine 2007;167:188-194 | 02 February 2007 | Musculoskeletal

Daily use of selective serotonin reuptake inhibitors (SSRIs) by adults aged 50 years and older is associated with a doubled risk of some fractures, according to a new report from Canada. In the study, doctors evaluated 5,008 community-dwelling adults aged... Read more

Rapid flu testing linked to decreased antibiotic use

Archives of Internal Medicine, February 26 2007 | 02 February 2007 | Infections & Immunology

Rapid influenza testing is associated with reductions in the use of antibiotics in hospitalized adults, according to a new report. American doctors reviewed the medical records of 166 patients with documented influenza hospitalized at one hospital during four winters. Of... Read more

Lifestyle changes effective in protecting against type II diabetes

BMJ | 02 February 2007 | Diabetes

Changing to a healthier lifestyle appears to be at least as effective as taking prescription drugs in reducing the risk of developing Type 2 diabetes, a new UK study has found. Researchers from Leicester reviewed studies which measured the effects... Read more