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Clinical Times: July 2008

Index for atherosclerosis risk may predict cardiovascular risk

JAMA 2008;300:197-208 | 31 July 2008 | Cardiovascular

The ankle brachial index may be useful to improve the accuracy of cardiovascular risk prediction, according to a new meta-analysis of previous studies. The researchers noted that attention has been given to indicators of asymptomatic atherosclerosis, such as coronary artery... Read more

Statin not helpful for children with neurofibromatosis

JAMA | 30 July 2008 | Mental Health & CNS

Use of simvastatin by children with neurofibromatosis type 1 (NF1), a genetic disorder that can cause learning disabilities, does not result in improved cognitive function, according to a new study. Characteristics of NF1 include skin disorders, problems with small and... Read more

The case for retaining ECT treatment

Dr Paul O'Connell | 30 July 2008 | Mental Health & CNS

Dr Paul O'Connell writes that the campaign to ban ECT is wrong and that the tone of the debate gives the 'alarming' impression of doctors motivated to do harm. The following preamble may appear a little off the point, given... Read more

Psychiatric problems in Crohn's and colitis

Dr Muhammad Arshad and Zoya Ali | 28 July 2008 | Gastro-intestinal, Mental Health & CNS

Dr Muhammad Arshad and Zoya Ali write about the psychiatric problems that can result from receiving a diagnosis of inflammatory bowel disease "They certainly give very strange names to diseases" Plato (427 BC-347 BC). Inflammatory bowel disease (IBD) is a... Read more

Focus on children's and infants' diet

Gary Culliton | 27 July 2008 | Nutrition

Gary Culliton reports on the latest developments in paediatric nutrition — as reported to a recent meeting in Dublin — and the success that some clinicians are having treating some newly-diagnosed Crohn's patients. The aim of paediatric nutritional intervention is... Read more

Healthy ageing – a challenge for Ireland

Prof Davis Coakley | 26 July 2008 | Men's Health, Women's Health

Prof Davis Coakley writes that investing in strategies to preserve health and prevent illness in older people will benefit the economy in the longer term. The number of people surviving into old age is increasing across all European states. In... Read more

Slowing down ageing process may be the future of disease prevention

26 July 2008 | Men's Health, Women's Health

Slowing the ageing process would have a much greater benefit for people’s health than traditional medical approaches that target individual disease, according to leading experts. Most medical research focuses on preventing and curing individual diseases as if they were independent... Read more

Evidence needs to be robust

Prof Eoin O'Brien | 25 July 2008 | Cardiovascular

What exactly is the Euro Consumer Heart Index that ranks Irish heart care ranks only 16th out of 29 European countries? A rather dramatically-worded press release issued from Brussels on 3 July 2008 carrying the above headline went on to... Read more

Formula predicts admissions in older adults

25 July 2008 | Men's Health, Women's Health

Using data from clinical encounters and drug prescriptions over three years, researchers have devised a model to predict emergency hospital admissions in the following year in individuals aged 40 years and older, according to a new report from Scotland. Scottish... Read more

Excellent long term outcomes for hip and knee replacements

23 July 2008 | Musculoskeletal

Older adults who have hip or knee replacement surgery for severe osteoarthritis may take several weeks to recover but appear to have excellent long-term outcomes, according to a new report. According to the report, doctors studied medical decision-making and treatment... Read more

Keys to success in treating asthma

Dr Peter Barry and Prof Charles G Gallagher | 21 July 2008 | Respiratory

Dr Peter J Barry and Prof Charles G Gallagher discuss the diagnosis and treatment of asthma — a disease which is on the increase in Ireland. Asthma has been long recognised as a distinct clinical syndrome. Early papyrus manuscripts located... Read more

Androgen deprivation does not improve survival in elderly

JAMA | 20 July 2008 | Cancer

Androgen deprivation therapy is not associated with improved survival for elderly men with localised prostate cancer, compared to conservative management of the disease, according to a new study. Doctors assessed the association between primary androgen deprivation therapy (PADT) and disease-specific... Read more

Elderly satisfied with sex lives

19 July 2008 | Genito-urinary

An increasing number of 70-year-olds are having good sex and more often, and women in this age group are particularly satisfied with their sex lives, according to a new study. In the study, researchers in Sweden examined attitudes to sex... Read more

SSRIs linked to upper GI bleeding

Archives of General Psychiatry | 18 July 2008 | Gastro-intestinal

Selective serotonin reup-take inhibitors (SSRIs) appear to be associated with bleeding in the upper gastrointestinal (GI) tract, according to a report from a new Spanish study. The effects appear increased when antidepressants are combined with other stomach-harming medications and decreased... Read more

Pregnancy alone is not linked to mental disorders

Archives of General Psychiatry | 17 July 2008 | Mental Health & CNS

Pregnancy alone does not appear to be associated with an increased risk of the most prevalent mental disorders, according to a new report. However, post-partum women may have a higher risk of major depressive disorder, the study also found. In... Read more

Is there a place for ECT in today's psychiatry?

Dr Michael Corry | 16 July 2008 | Mental Health & CNS

Dr Michael Corry believes that electro-convulsive therapy should now be abolished from modern psychiatric practice. Electro-convulsive therapy (ECT) is the deliberate administration of electric shocks to the brain. As described by the UK Department of Health in 2007: “Electro-convulsive therapy... Read more

Relationship violence common for students

Archives of Pediatrics and Adolescent Medicine | 16 July 2008 | Mental Health & CNS

Violence between partners, friends and acquaintances appears prevalent both during and before college, according to results of a new American survey. Researchers interviewed 910 students aged 17 to 22 years in 67 randomly chosen college classes.... Read more

Heavy birthweight babies twice as likely to develop rheumatoid arthritis

Online First Annals of Rheumatic Diseases | 12 July 2008 | Musculoskeletal

Heavy birthweight female babies are twice as likely to develop rheumatoid arthritis in adulthood as their average birthweight peers, a new study has found. The results support the foetal origin of disease theory, which argues that certain conditions and diseases... Read more

Looking forward to the future of retinitis pigmentosa research

Derbhile Dromey | 12 July 2008 | Eye, Ear, Nose & Throat

Derbhile Dromey writes that research being carried out in Trinity College may lead to a better understanding of retinitis pigmentosa. Some 65,000 people in Ireland are affected by conditions which result in deterioration of the retina. One of the most... Read more

Angiotensin-receptor blockers as cardioprotective drug therapy

Dr John Cox | 11 July 2008 | Cardiovascular

Dr John Cox reports on a number of clinical trials which have investigated the pros and cons of treatment with ARBs compared to or combined with ACE inhibitors. General practitioners are by now very familiar with the drugs used in... Read more

Low vitamin D levels linked with death from all causes in the elderly

Archive of Internal Medicine | 11 July 2008 | Nutrition

Older individuals with lower blood levels of vitamin D appear to have an increased risk of death overall and from cardiovascular causes, according to a new study. A recent consensus panel estimated that about 50 per cent to 60 per... Read more

Olfactory bulb size linked to sense of smell

Archives of Otolaryngology and Head and Neck Surgery | 10 July 2008 | Eye, Ear, Nose & Throat

The olfactory bulb in the brain appears to change in size in a way that corresponds to individual alterations in sense of smell, according to a new report. In the study, doctors investigated 20 patients with loss of sense of... Read more

Highly active retrovirals decrease HIV death-rates

JAMA | 09 July 2008 | Infections & Immunology

Because of the introduction of highly active antiretroviral therapy, persons infected with HIV now appear to experience mortality rates similar to those of the general population in the first five years following infection, according to a new study. In the... Read more

Anatomy of a physician

Mike Power | 09 July 2008 | Mental Health & CNS

Mike Power, Research Psychologist, begins his series focussing on the stresses and challenges that doctors face to their own health in the medical profession. There’s something about medicine and its devotees that exerts an immediate fascination for lay people. Hollywood... Read more

Common diagnostic errors in child, adolescent and adult psychiatry

Prof Michael Fitzgerald | 07 July 2008 | Mental Health & CNS

Prof Michael Fitzgerald writes on how to avoid the most common major errors in clinical practice, with special regard to ADHD. In attention deficit hyperactivity disorder (ADHD), missing comorbidities is extremely common. ADHD is diagnosed and the autism features are... Read more

Prozac may help to curb disease activity in MS patients

05 July 2008 | Mental Health & CNS

The antidepressant Prozac may help to curb disease activity in the relapsing remitting form of multiple sclerosis (MS), according to a new study. The study’s research team randomly allocated 40 patients with the relapsing remitting form of MS to treatment... Read more

Omega-3 fatty acids lessen risk of age-related macular degeneration

Archives of Ophthalmology 2008;126:826-833 | 03 July 2008 | Eye, Ear, Nose & Throat, Nutrition

Eating fish and other foods high in omega-3 fatty acids is associated with reduced risk of the eye disease age-related macular degeneration (AMD), according to a new meta-analysis. The researchers conducted a systematic review of studies published before May 2007... Read more

Diabetes drug link to slower progression of retinopathy

Archives of Ophthalmology | 02 July 2008 | Diabetes

Patients with diabetes who take the medication rosiglitazone may be less likely to develop the eye disease proliferative diabetic retinopathy or to experience reductions in visual acuity, according to a new report. In the study, doctors reviewed the medical records... Read more

Neurological disease: subtle nervous system abnormalities may predict risk of death in elderly

Archives of Internal Medicine 2008;168:1270-1276 | 01 July 2008 | Mental Health & CNS

Subtle but clinically detectable neurological abnormalities, such as reduced reflexes and an unstable posture, may be associated with the risk of death and stroke in otherwise healthy older adults, according to a new report. In the study, doctors in Italy... Read more

Drug-releasing stents can decrease revascularisation

JAMA | 01 July 2008 | Cardiovascular

The widespread adoption of the use of drug-releasing coronary artery stents into routine practice is associated with a decrease in the need for revascularisation procedures, a new study has found. In the study, doctors compared the rates of revascularisation, heart... Read more

Thrombosis: 'silent killer' strikes without warning

Natalya Anderson | 01 July 2008 | Cardiovascular

Natalya Anderson reports from a conference in London, at which delegates heard that venous blood clots kill an average of 544,000 people in Europe every year. Preventative treatment is essential in reducing the potentially fatal effects of thrombosis, but challenges... Read more